Central Africa IeDEA

描述（由申请人提供）： 抗逆转录病毒疗法为数百万非洲人提供新的健康的承诺现在正在实现。随着艾滋病毒护理和治疗方案在整个非洲的实施，认真监测其有效性至关重要，以便护理和治疗资源能够得到最佳效益。对ART的免疫学和临床反应、护理保留和行为成分（例如，治疗依从性）需要被阐明并且生存的预测因子被定义。艾滋病毒和抗逆转录病毒疗法对非洲癌症的影响基本上没有描述，对与疟疾等主要环境共病的相互作用也知之甚少。我们提出了一个新的中非leDEA（CA-leDEA），旨在优化和提高科学生产力和快速，高影响力的出版物;我们将1。通过a编译和管理大量患者的二级源患者级数据。）从现有电子数据中提取，或B.）用于在低资源临床环境中有效捕获临床数据的新的实地系统; 2.）制定一个创造性和灵活的科学过程，促进高通量的许多数据分析，以回答流行病学，业务和其他艾滋病毒相关的研究问题，最终在高影响力的出版物;和3）在五至十年内，在每个中部非洲国家发展独立研究、数据管理、分析和出版的能力，确保CA-leDEA的可持续性。我们的团队在研究生产力和运营成功以及创新的IT开发领域拥有悠久的历史，以支持研究，并具有互补的技能和经验，以优化CA-leDEA的活动。我们的四个合作伙伴是艾滋病毒护理服务的实施者（即，第五个合作伙伴WE-ACTx Rwanda带来了患者数量、研究经验和调查艾滋病恶性肿瘤的特殊资源。我们将开发一个行政和数据管理基础设施，支持流行病学和实施科学的实施，以回答在资源较少的环境中艾滋病毒护理和治疗的关键问题，与美国，喀麦隆和卢旺达的综合研究团队合作。 公共卫生相关性： 撒哈拉以南非洲是全球艾滋病毒疾病负担最重的地区。需要开展研究，确定治疗成功的临床和流行病学预测因素，以指导临床医生护理艾滋病毒感染者。此外，实施科学可以指导政策制定者和方案实施者提供服务机制，以提供最有效的利用治疗资源和最佳收益的公众健康。

DESCRIPTION (provided by applicant): The promise of antiretroviral therapy (ART) to provide renewed health is now being realized for millions of Africans. As HIV care and treatment programs are implemented throughout Africa, careful monitoring of their effectiveness is of crucial importance, so that care and treatment resources can be deployed to optimal benefit. Immunologic and clinical responses to ART, retention in care, and behavioral components (e.g., treatment adherence) need to be elucidated and predictors of survival defined. The impact of HIV and ART on cancers in Africa is essentially undescribed, and interactions with major ambient co-morbidities such as malaria are poorly understood. We propose a new Central Africa leDEA (CA-leDEA), designed to optimize and augment scientific productivity and rapid, high-impact publications; we will 1.) Compile and manage secondary source patient-level data on a large volume of patients through a.) extraction from existing electronic data, or b.) new on-the-ground systems for efficient capture of clinical data in low-resource clinical settings; 2.) Develop a creative and flexible scientific process that fosters high throughput of many analyses of data to answer epidemiologic, operational and other HIV-related research questions, culminating in high- impact publications; and 3.) Develop capacity for independent research, data management, analysis and publication in each of the Central African countries over five to ten years, ensuring the sustainability of CA-leDEA. Our team brings a long history in the region of research productivity and operational success, as well as innovative IT development to support research, with complementary skills and experience to optimize the activities of CA-leDEA. Four of our partners are the implementers of HIV care services (i.e., the governments) and the fifth partner, WE-ACTx Rwanda, brings patient volume, research experience and special resources to investigate AIDS malignancies. We will develop an administrative and data management infrastructure that supports the implementation of epidemiologic and implementation science to answer key questions in HIV care and treatment in lower-resource settings, with integrated research teams in the US, Cameroon and Rwanda. PUBLIC HEALTH RELEVANCE: Sub-Saharan Africa bears the greatest burden of HIV disease globally. Research to define clinical and epidemiologic predictors of treatment success is needed to guide clinicians caring for persons with HIV. In addition, implementation science can guide policy makers and program implementers on service delivery mechanisms to provide most efficient use of treatment resources and the optimal gain to the public's health.