Director:
John Bartlett, MD
Co-Director:
Nathan Thielman, MD
John Crump, MD
John Hamilton, MD
The DHVI program in International Research promotes clinical research and training in diseases that threaten our global community. Current programs in Tanzania and Zambia have successfully established collaborations between Duke and investigators in these countries to focus on such diseases as HIV/AIDS, tuberculoses, and malaria.
HIV/AIDS represents a critical health obstacle for the future of Tanzania. The Kilimanjaro Christian Medical Research Center (KCMC), in Moshi, Tanzania, is the major inpatient provider of HIV/AIDS care in Northern Tanzania. This region is populated predominately by members of the Chagga and Maasai tribes, and KCMC serves a catchment area of 10,000,000 persons. DHVI investigators have established a well-funded clinical research site at KCMC with grants from the Pediatric AIDS Foundation, the National Institutes of Health, and the Fogerty International Training Center.
Also in collaboration with KCMC against the scourge of HIV/AIDS is the Kibongoto National Tuberculosis Hospital (KNTH), a 256-bed tuberculosis referral facility where 35% of inpatients are co-infected with HIV, and with KIWAKKUKI, the Kiswahili acronym for Kilimanjaro Women Fighting Vigorously Against AIDS, a key provider of home-based care for persons living with HIV/AIDS throughout the Kilimanjaro Region. DHVI has worked to insure the efforts of KCMC, KNTH and KIWAKKUKI to serve HIV-infected patients in this region in their complementary roles. KCMC offers inpatient care for complications of HIV disease and may refer suspected tuberculosis cases to KNTH for care. KCMC provides laboratory support for KNTH with daily transport of specimens to KCMC for testing. KIWAKKUKI assists with discharge planning and home-based care follow-up for KCMC and KNTH. With DHVI assistance, KCMC will soon complete construction of new clinic space dedicated to HIV/AIDS care. Clinical trials of antiretroviral treatment (ART) are being undertaken at KCMC with the assistance of DHVI.
DHVI collaborations in Zambia are focused on the Tropical Diseases Research Center (TDRC) in Ndola. TDRC’s research agenda has included malaria, tuberculosis, sexually transmitted infections, and most recently, HIV/AIDS. TDRC received a CIPRA R-03 Planning Award in 2002, and hopes to submit a CIPRA U-01 application in November 2004. Faculty from TDRC have received training at Duke, including Dr. Victor Chalwe who completed a six week intensive course in research methodology offered by the Duke Department of Medicine. With support from the DHVI’s laboratories, TDRC research protocols have addressed HIV antigenic diversity and assessed behavioral aspects of vaccine preparedness. Dr. Chalwe has initiated a comprehensive study of subjects receiving antiretroviral therapy at TDRC, including adherence, drug-related toxicities and low cost monitoring of treatment.
