International epidemiology Databases to Evaluate AIDS (IeDEA) Southern Africa.

南部非洲是艾滋病毒和结核病(TB)疫情的震中，南非是 新冠肺炎在非洲的大流行。迫切需要强有力的流行病学和实施科学 应对艾滋病毒、结核病和其他(新出现的)混合感染和非传染性疾病的相互作用的负担 疾病(非传染性疾病)。评估南部非洲艾滋病的国际流行病学数据库(IeDEA-SA) 为第四个资助期(IeDEA-SA IV)确定了六个具体目标：(1)研究 成人艾滋病毒护理的连续性；(2)研究孕妇、婴儿、儿童和青少年的结局； (3)研究非传染性疾病、乙肝和性传播感染(STI)；(4)研究临床和公共卫生 结核病流行病学；(5)研究癌症预防、负担和护理；(6)研究心理健康和 物质使用障碍。此外，我们定义了六个贯穿各领域的主题：(一)新冠肺炎的影响 卫生服务大流行病；(2)性别平等；(3)能力建设；(4)数字化转型；(5)开放科学； 和(6)联合国可持续发展目标，我们将在每个目标中制定这些目标并将其列为优先事项 瞄准。创新包括增加了西开普省卫生数据中心(WC PhDc)、 南非艾滋病毒癌症匹配研究，建立暴露前预防队列，以及 对新技术的评估(例如，护理点基因组测序设备、手持设备 用于宫颈癌筛查的镜设备，或在医疗保健中研究结核病传播的工具 环境)和新颖的统计和数学建模方法。多区域哨兵研究 网络(NCD-哨兵研究网络[SRN]、TB-SRN、青少年和青壮年网络 关于非传染性疾病、结核病以及青少年和青年的IeDEA)将在#年协调IeDEA六个区域的数据收集 低收入和中等收入国家。Fogarty-IeDEA导师计划将加强能力建设 在早期调查人员中。IeDEA-SA现在跟踪了近130万艾滋病毒携带者，包括 来自私营部门的285,000人(艾滋病援助计划AFA)，以及37万人获得艺术期限和GT； 十年了。IeDEA IV将通过AFA添加来自60万艾滋病毒阴性者的数据和来自最多4个 在具体分析中，来自WC PhDc的100万艾滋病毒阴性个人。在IeDEA内部，南部非洲人 该地区的成年人和儿童人数是迄今为止最多的。新冠肺炎大流行现在突显了 流行病学研究和实施科学在整个卫生系统的重要性。IeDEA-SA很好- 解决本申请中概述的具体目标和交叉主题，通过其成功 伯尔尼大学科学和业务领导层与 开普敦，与几所非洲大学合作(包括夸祖鲁-纳塔尔创新研究中心 和测序平台)、美国和欧洲大学以及世界卫生组织 和联合国艾滋病毒/艾滋病联合规划署。

Southern Africa is the epicenter of the HIV and tuberculosis (TB) epidemic, and South Africa is at the center of the COVID-19 pandemic in Africa. There is an urgent need for robust epidemiology and implementation science to address the interacting burdens of HIV, TB, and other (emerging) coinfections and non-communicable diseases (NCDs). The International epidemiology Databases to Evaluate AIDS in Southern Africa (IeDEA-SA) has defined six specific aims for the fourth funding period (IeDEA-SA IV): (1) to study outcomes along the continuum of HIV care in adults; (2) to study outcomes in pregnant women, infants, children, and adolescents; (3) to study NCDs, hepatitis B and sexually transmitted infections (STIs); (4) to study the clinical and public health epidemiology of TB; (5) to study cancer prevention, burden, and care; and (6) to study mental health and substance use disorders. Further, we defined six cross-cutting themes: (i) the impact of the COVID-19 pandemic on health services; (ii) gender equity; (iii) capacity building; (iv) digital transformation; (v) open science; and (vi) the United Nations Sustainable Development Goals, which we will develop and prioritize within each aim. Innovations include the addition of the Western Cape Provincial Health Data Centre (WC PHDC), the South African HIV Cancer Match study, the establishment of pre-Exposure prophylaxis cohorts, and the evaluation of novel technologies (for example, a point-of-care genome-sequencing device, a hand-held colposcopic device for cervical cancer screening, or tools to study the transmission of TB in the health care setting) and novel statistical and mathematical modeling approaches. Multiregional Sentinel Research Networks (NCD-Sentinel Research Network [SRN], TB-SRN, Adolescent and Young Adult Network of IeDEA) on NCDs, TB, and adolescents and youth will harmonize data collection across the six IeDEA regions in low- and middle-income countries. The Fogarty-IeDEA Mentorship Program will strengthen capacity building among early-stage investigators. IeDEA-SA now follows nearly 1.3 million people living with HIV, including 285,000 individuals from the private sector (the Aid for AIDS program AfA), and 370,000 with ART duration > ten years. IeDEA IV will add data from 600,000 HIV-negative people through AfA and information from up to 4 million HIV-negative individuals from the WC PHDC in specific analyses. Within IeDEA, the Southern African region includes by far the largest number of adults and children. The COVID-19 pandemic now highlights the importance of epidemiologic research and implementation science across the health system. IeDEA-SA is well- placed to address the specific aims and cross-cutting themes outlined in this application, through its successful track-record of collaboration between the scientific and operational leadership at the Universities of Bern and Cape Town, partnership with several African universities (including the Kwazulu-Natal Research Innovation and Sequencing Platform), United States and European universities, and with the World Health Organization and the Joint United Nations Programme on HIV/AIDS.