Research to Combat AIDS

Researchers at Duke Medical Center have received a $4-million, four-year grant from the National Institutes of Health to study infectious diseases that plague AIDS patients in Tanzania.

The grant is the first and only award bestowed this year through the International Studies of AIDS-Associated Co-Infections program, initiated in 2003 by a division of NIH, and is among the largest awards ever given for study of AIDS co-infections in tropical countries with limited resources, says principal investigator John Bartlett, professor of medicine in the division of infectious diseases at Duke Medical Center. "This grant moves Duke to the forefront of working in international health," he says.

The region of northeast Tanzania where the study will take place has a population of some 10 million people; about 10 percent are living with HIV/AIDS. At least 60 percent of the grant must be spent in Tanzania, and researchers plan to use the majority of those funds to support the creation of a medical-research infrastructure.

"This is a really crucial part of our mission," Bartlett says. The investment in equipment, laboratory space, and training will enable scientists in Tanzania to develop an independent research program that will continue after the grant ends.

Duke researchers will also use the grant to develop low-cost, low-tech methods to detect and diagnose diseases such as tuberculosis, meningitis, and cervical cancer, which is caused by a virus. The majority of laboratory tests doctors in the U.S. rely on to diagnose infectious disease are unavailable in Tanzania because of cost and lack of equipment.

An important focus of the four-year study will be answering such basic questions as what are the most common infectious diseases in people with HIV/AIDS, how often do infectious diseases occur in the HIV/AIDS population, and how do infectious diseases affect the severity and morbidity of AIDS. Many of the common co-infections in Tanzania--tuberculosis, malaria, and meningitis--take the lives of HIV/AIDS patients before AIDS runs its course

The women's health study team will educate women in Tanzania about cervical cancer and train health-care providers to screen and test for the disease in a single visit. Cervical cancer is the leading cause of cancer death among women in developing countries and is preventable, says David Walmer, professor of obstetrics and gynecology and chief of reproductive endocrinology. Walmer and his Duke colleagues successfully developed a similar program in Haiti and invented a quick screening test that could be performed with available technology, including a halogen bicycle lamp.

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