Cancer and tobacco control training and research across the lifespan in Kenya

描述（由申请人提供）：在肯尼亚，癌症和烟草消费的负担是发病率和死亡率的主要原因，这个国家的研究基础设施有限，而且严重缺乏解决这些日益增加的慢性非传染性疾病（NCD）对公共卫生威胁的能力。在内罗毕开展了近15年的研究合作；在埃尔多雷特提供医疗保健服务的长达20年的学术伙伴关系学术模式；利用目前NCI D43专门用于艾滋病恶性肿瘤的培训补助金，正在建立关键病理学、肿瘤病毒学和临床试验能力；其他NCI和cdc资助的研究项目；一个高度互动和经验丰富的国际研究团队，由博士领导。西弗吉尼亚大学（WVU）的斯科特·雷米克（scott Remick）及其肯尼亚资深合作者内罗毕大学（unon）的沃尔特·姆旺达（Walter Mwanda）；肯尼亚医学研究所Geoffrey Mutuma博士；内罗毕临终关怀医院的布里吉德·西伦戈医生；印第安纳大学（IU）的Patrick Loehrer博士和他的肯尼亚资深合作者莫伊大学（MU）的Naftali Busakhala博士正在合作，在肯尼亚发展癌症和烟草控制的可持续研究能力。我们的培训计划将首次将肯尼亚5个重要的学术医学和研究中心联系起来：联合国大学健康科学学院及其附属的内罗毕肯雅塔国家医院；亚特兰大疾病;以及MU健康科学学院和位于埃尔多雷特的Moi教学和转诊医院（MTRH）。我们的D43培训计划的总体目标是弥合肯尼亚现有的研究能力，使具有战略性和包容性的多学科团队能够为制定和实施与癌症和烟草控制相关的循证干预措施提供坚实的基础，这些干预措施将转化为肯尼亚的公共卫生政策。基本目标是加强肯尼亚癌症和烟草控制的基础设施，以便在5年福格蒂奖结束时，高度互动的调查人员和研究人员团队将：(1)在以人口为基础的登记册中登记癌症和其他非传染性疾病实体（例如脑血管疾病），以通知国家卫生官员和研究方案；(2)为社区干预制定有效的戒烟和控制战略，并进一步制定烟草政策；(3)支持病理学研究项目，以成功完成MMed（病理学）学位课程，培养下一代训练有素的癌症诊断病理学家，并领导多学科肿瘤委员会；(4)建立癌症临终关怀的研究能力，并产生有效的循证干预措施，特别是针对癌症儿童。常见的培训主题包括：(1)大部分培训将在肯尼亚现场进行，这使我们能够为更多的卫生团队成员提供直接培训；(2)兼顾智力——“人”和技术——“实验室”能力；(3)利用联合国大学病理学系新装修的电子会议室，提供各种短期、中期和长期的“南对南”和电子/网络培训课程；(4)为负责任的研究行为提供培训，保护人类受试者，以及为试点研究奖励机制提供科学/拨款写作。

DESCRIPTION (provided by applicant): The burden of cancer and tobacco consumption are major causes of morbidity and mortality in Kenya, a country with limited research infrastructure and significant scarcity to address these ever increasing chronic, non- communicable disease (NCD) threats to public health. Building on a near 15-year long research collaboration in Nairobi; a 20-year long academic partnership Academic Model Providing Access to Healthcare in Eldoret; capitalizing on a current NCI D43 training grant devoted to AIDS malignancy that is building critical pathology, tumor virology and clinical trials capacity; other NCI and CDC-funded research projects; an international team of highly interactive and experienced investigators led by Drs. Scot Remick, West Virginia University (WVU) and his senior Kenyan collaborator Walter Mwanda, University of Nairobi (UoN); Dr. Geoffrey Mutuma at Kenya Medical Research Institute (KEMRI); Dr. Brigid Sirengo at Nairobi Hospice; Dr. Patrick Loehrer at Indiana University (IU) and his senior Kenyan collaborator Dr. Naftali Busakhala, Moi University (MU) are partnering to develop sustainable research capacity for cancer and tobacco control in Kenya across the lifespan. Our training program will link for the first time the 5 essential academic medical and research centers in Kenya: UoN College of Health Sciences and affiliated Kenyatta National Hospital (KNH) in Nairobi; KEMRI; and the MU College of Health Sciences and affiliated Moi Teaching and Referral Hospital (MTRH) in Eldoret. The overall goal of our D43 training program is to bridge existing research capacity in Kenya, enabling strategic and inclusive multidisciplinary teams that will provide a solid foundation for development and implementation of evidence-based interventions relevant to cancer and tobacco control that will translate into Kenyan public health policy. The essential objectives are to strengthen the infrastructure for cancer and tobacco control in Kenya such that by the end of the 5-year Fogarty award highly interactive teams of investigators and research personnel will: (1) register cancer and other NCD entities (e.g., cerebrovascular disease) in population-based registries to inform national health officials and research programs; (2) develop effective tobacco cessation and control strategies for community intervention(s) and further frame tobacco policy; (3) support pathology research projects for successful completion of the MMed(Pathology) degree program to develop the next generation of trained pathologists for cancer diagnosis and lead multidisciplinary tumor boards; and (4) build research capacity for end-of-life cancer care and generate effective evidence-based interventions especially for children with cancer. Common training themes include: (1) the bulk of the training will be on-site in Kenya, which allows us to provide direct training for more members of our health teams; (2) address both intellectual - "people" and technical - "laboratory" capacities; (3) provide a variety of short, medium and long-term, "south-to-south", and electronic/web-based training coursework taking advantage of a newly fit-up electronic conference room in the Department of Pathology at UoN; and (4) provide training for the responsible conduct of research, protections of human subjects, and scientific/grants writing that feeds into a pilot research awards mechanism. PUBLIC HEALTH RELEVANCE: This proposal strengthens capacity in Kenya to address the growing burden of cancer and tobacco by developing vital training and research infrastructure, evidence-based approaches for intervention, and impacting public health policy across the lifespan. The training plan builds on 15-year research collaboration in Nairobi, 20-year academic partnership in Eldoret, and "trans-DHHS" assets including several NCI-supported grants and CDC-funded Prevention Research Center. Importantly, this proposal links for the first time the 5 essential medical research centers in Kenya: Univ. of Nairobi and Moi Univ. medical schools, and their affiliated national referral hospitals and KEMRI.