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Research into new prevention technologies, including vaccines, effective treatment regimens, and improved deployment of existing approaches, remains of central importance to eventual control of AIDS. However, the scientific and public health questions which require the most urgent answers are increasingly difficult to investigate in developed world settings. International collaborative HIV/AIDS research, and the training needed for developing country scientists to lead that research, remains an urgent global priority and a public health necessity.
From its inception the Hopkins AITRP has endeavored to provide training and research support to developing country partners in training relevant to the growing global HIV/AIDS research agenda. Our model has been to provide training in support of collaborative research between faculty of the Johns Hopkins Schools of Public Health and Medicine and their developing country partners, to foster lasting research partnerships, and to assist developing country scientists in establishing their own, and their countries’, capacity in independent HIV/AIDS research. We have measured our success through scientific contributions, competitive funding awards, the impact on country responses of returning fellows, and leadership in international HIV/AIDS research on the part of our trainees.
The Hopkins AITRP is located in the Department of Epidemiology in the Bloomberg School of Public Health; the Principal Investigator is Dr. Chris Beyrer. However, it is a campus-wide program involving faculty and trainees in departments in both the Bloomberg School of Public Health and the School of Medicine. Our international partners include institutions and investigators in Uganda, Malawi, Ethiopia, South Africa, Cameroon, Thailand, India, China, Laos, Russia, The Dominican Republic and Brazil. Primary departments participating in the program are: Biostatistics, Epidemiology, Health Policy & Management, International Health, Molecular Microbiology & Immunology and Population & Family Health Sciences in the Bloomberg School of Public Health and the Departments of Clinical Investigation, Medicine, Pathology, Pediatrics and OB/GYN in the School of Medicine. Campus-wide centers such as the Center for Immunization Research (CIR), the Center for Clinical Trials (CCT), the Center for Clinical Global Health Education (CCGHE), the Center for Public Health and Human Rights, the Center for TB Research, The Bioethics Institute, and the Center for Communications Programs (CCP) serve as resources for faculty and training programs. The Johns Hopkins University Fogarty AITRP is now in its fourth five-year funding cycle, Years 16-20. Year 19 began June 1, 2006.
For more information, visit the program''''''''s web site.
Researchers
Chris Beyrer
Robert Bollinger Jr.
Donald Burke
David Celentano
Karen Charron
Jacqueline Coberly
Vivian Go
Ronald Gray
Laura Guay
Clayton Harro
Deanna L. Kerrigan
Andrea Ruff
Hua Shan
Susan Sherman
Nicole Simmons
Michael Sweat
Taha E. Taha
Nathan Wolfe
Xiao-Fang Yu
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Conduct activities as described in the Proposal entitled "Abstinence and Risk Avoidance for Youth (ARK) Initiative for Haiti, Kenya and Tanzania. The Subagreement’s official title is "Support to HIV/AIDS Prevention through Abstinence and Behavior Change for Youth."
Researchers
Susan Krenn
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The Voluntary HIV Counseling and Testing Integrated with Contraceptive Services Study (VICS) will evaluate the addition of family planning services to voluntary counseling and testing (VCT) programs in terms of fulfilling existing demand for contraception among VCT attendees. Through pre- and post-intervention surveys with 7700 VCT clients, the study will evaluate Pathfinder International-Ethiopia’s initiative to integrate VCT and family planning services in eight Ethiopian public sector facilities, with particular emphasis on VCT clients’ contraceptive use, fertility intentions, unmet need for contraception and barriers to contraceptive use. Such information is not known in Ethiopia and is fundamental for designing effective VCT and family planning service integration interventions, a hallmark of the Ethiopian Government’s HIV/AIDS policy.
VICS will take place over a 15-month period, with mid-term reporting expected in November, 2006, and final reporting scheduled for September, 2007. The study is a collaborative partnership between Pathfinder International-Ethiopia, Miz-Hasab Research Center and Johns Hopkins Bloomberg School of Public Health, Bill and Melinda Gates Institute for Population and Reproductive Health. The study is funded by The David and Lucile Packard Foundation, The William and Flora Hewlett Foundation, and the Bill and Melinda Gates Institute for Population and Reproductive Health.
Researchers
Duff Gillespie
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Improve HIV/AIDS/STI/TB prevention and control IEC and Behavior Change Communication (BCC) efforts in Ethiopia through effective programs.
Researchers
Susan Krenn
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In support of LIFE (Leadership & Investment in Fighting and Epidemic), CCP will establish an AIDS Information and Communications Resource Center in Addis Ababa, Ethiopia. Additional SOWs followed to include PMTCT (Prevention of Mother to Child Transmission) work in Tanzania and setting up regional ARC centers and materials development.
Researchers
Susan Krenn
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The purpose of this five year Institutional National Research Service Award (NRSA) Training Grant (T32) is to train qualified United States citizens to undertake research in the area of maternal and child health in developing country settings. The program proposes to provide long-term training of pre-doctoral students leading to the awarding of the Ph.D. degree in International Health from the Johns Hopkins Bloomberg School of Public Health. The training will be multi-disciplinary, but student will be able to focus on one of three disciplinary areas; human nutrition, behavioral sciences, and epidemiology. Within these three primary areas, students will be able to include other areas of focus such as bioethics, demography, infectious diseases, and vaccinology. The focus of the training will be to use these discipline bases to better understand the etiology, epidemiology, and interventions appropriate to improve maternal, neonatal, infant and child health in developing countries. Pre-doctoral course work will be undertaken at Johns Hopkins University, and the dissertation research will be conducted at faculty-established field sites in developing countries, in conjunction with local research institutions and collaborators. The Department of International Health has established field sites with laboratory, clinic and population-based activities in countries such as Bangladesh, India, Nepal, Zanzibar, Uganda, Ethiopia, Peru, and Guatemala. Students enrolled in the program will participate in (1) structured course work (2) a seminar series offered on appropriate topics (3) research practicum at the end of the first year of course work (4) teaching assistance in appropriate courses (5) a thesis research project. Students will be able to complete the degree within 3 and 5 years, depending on their backgrounds. Students who successfully complete the training program will be able to conduct research to improve the health and survival of women of reproductive age and their offspring in resource poor environments. They will have developed the appropriate cultural sensitivities, language skills and approach to collaboration with local partners in undertaking such research, and will be able to write independent grant applications to NIH and other competitive funding sources to conduct future research.
Researchers
Joanne Katz
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Co-Chair of WHO Multicountry Study of Violence Against Women & Health: Bengaladesh, Brazil, Peru, Namibia, Tanzania, Ethiopia, Thailand, Serbia, Japan, New Zealand
Researchers
Jacquelyn C. Campbell
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With funding from the Centers for Disease Control and Prevention, Jhpiego has an extensive program in Ethiopia directed at improving the quality and access of HIV services. In this program, which began in 2003, Jhpiego’s partners are the Ministry of Health, International Training and Education Center on HIV (I-TECH), The Johns Hopkins University, Columbia University and University of California at San Diego. Currently, Jhpiego implements training activities in the prevention of mother-to-child transmission of HIV, infection prevention, counseling and testing for HIV, and provider-initiated counseling and testing, at approximately 90 training sites. The program also supports the Ministry of Health in pilot-testing the use of non-health professionals as HIV counselors. In addition, Jhpiego is applying its Standards-Based Management and Recognition approach for improving the quality of health services to the prevention of mother-to-child transmission of HIV and other HIV services, and working to integrate HIV/AIDS content with medical, nursing and midwifery education at three Ethiopian universities.
About Jhpiego:
For nearly 40 years, Jhpiego, (pronounced "ja-pie-go"), has empowered front-line health workers by designing and implementing simple, low-cost, hands-on solutions that strengthen the delivery of health care services, following the household-to-hospital continuum of care. We partner with community- to national-level organizations to build sustainable, local capacity through advocacy, policy and guidelines development, and quality and performance improvement approaches.
Researchers
Alain Damiba
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The project focuses capacity building and systems improvement in all hospitals providing Anti-Retroviral Treatment (ART) to persons with HIV/AIDS in four regions of Ethiopia (Addis Ababa, Benishangul Gumuz, Gambella, SNNPR).
Researchers
Aida Abashawl
Andrea Ruff
Nicole Simmons
William Weiss, DrPH
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This USAID project engages US-based NGOs and local counterparts to support community-based activities in support of the global polio eradication initiative. The project supports social mobilization, training and monitoring of mass immunization campaigns and routine immunization programs. The project also provides support---at the local level---to national surveillance systems and other health systems components. The project is located in Angola, Ethiopia, India and Nepal.
Researchers
William Weiss, DrPH
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Funded through the President’s Emergency Plan for AIDS Relief (PEPFAR), Samaritan’s Purse (SP) International Relief’s MET approach for primary behavior change in youth is an Abstinence and Behavior Change for Youth (ABY) program and the goal of the program is to assist youth in making healthy choices that prevent HIV through abstinence and faithfulness. Three SP MET teams per country will comprise of a supervisor, two MET trainers, and four mobilizers in target areas of Mozambique, Ethiopia, Kenya, and Uganda. The teams will mobilize, equip, and train approximately 6,000 community youth leaders to outreach to 150,000 youth ages 10-24 years through integrated education, mentorship, and care approaches focusing on abstinence before marriage, faithfulness in marriage, stigma associated with HIV, as well as mentoring in community-based service and those at risk for sexual exploitation and abuse. Community youth leaders will promote HIV/AIDS prevention using various communication methods that include character, life skills, and positive interpersonal relationships based on “There is Hope” and “It Takes Courage!” curriculum developed by Kerus Global.
Researchers
Alexander Vu
William Weiss, DrPH
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In Ethiopia, ACCESS is improving the quality of essential maternal and newborn health care (EMNC) services by building the capacity of training institutions for health workers. With ACCESS assistance, Health Officers (HOs) and Health Extension Workers (HEWs) are being trained in EMNC, including infection prevention practices in service delivery and linkages with HIV prevention, care and support services at the community level.
In partnership with the Carter Center and other key stakeholders, ACCESS is strengthening selected hospitals to serve as training sites for providers from the other HO training hospitals. In these training institutions—as well as in the HO hospitals selected for intervention—ACCESS is updating faculty and service providers in EMNC clinical and teaching skills, ensuring the availability of EMNC equipment and supplies, strengthening the clinical training sites in infection prevention and EMNC service provision, and supporting updated faculty and service providers to train additional staff at these sites.
In collaboration with local and international partners and stakeholders, ACCESS is establishing a health center-based apprenticeship program for HEWs to improve their skills in safe and clean delivery, postpartum care, and referral of complications. Through the Ethiopian Nurse-Midwives Association (ENMA), ACCESS is strengthening selected health centers in the Oromia Region to become training centers for HEW refresher training in maternal and newborn health services. These training centers will support the training of HEWs in their catchment areas as well as neighboring woredas.
ACCESS and the ENMA will strengthen the skills of health center-based midwives and maternal and child health nurses to train HEWs in EMNC, prevention and treatment of mother-to-child transmission of HIV and other HIV-related counseling skills, as well as in appropriate infection prevention (IP) practices. In addition, ACCESS works to strengthen referral linkages for HIV/AIDS prevention, care and treatment, and referrals for maternal and newborn emergency care.
About ACCESS:
The ACCESS Program is the U.S. Agency for International Development''s global program to improve maternal and newborn health. The ACCESS Program works to expand coverage, access and use of key maternal and newborn health services across a continuum of care from the household to the hospital—with the aim of making quality health services accessible for women and newborns. Jhpiego implements the program in partnership with Save the Children, Constella Futures, the Academy for Educational Development, the American College of Nurse-Midwives and Interchurch Medical Assistance.
Researchers
Koki Agarwal
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Diagnosis of pediatric tuberculosis (TB) in resource-limited settings with high rates of HIV and TB is severely limited by methods that are slow, inefficient, and costly, which leads to increased morbidity and mortality. Our research team has made significant progress in the development of new TB diagnostic tools that demonstrate significant advantages over the gold standard diagnostics in adults. We propose to evaluate the potential of these new tools as well as others for the detection and direct susceptibility testing of Mycobacterium tuberculosis (Mtb) in children from 0-5 years of age. This project will be set in Ethiopia, where pediatric TB and HIV co- infection are major problems. We hypothesize that, compared to current standard techniques, the diagnosis of active TB in children and the recovery of Mtb isolates from these children can be done more quickly, efficiently, and cost-effectively using alternative clinical specimens in combination with more rapid diagnostic methods for both confirmation of TB and detection of drug resistance. If our hypothesis is correct, use of these methods will allow clinicians to institute rapid treatment directed specifically against the bacterial isolate from the infected child, improving the speed and outcome of anti-tuberculous therapy. To evaluate the potential utility of these techniques, we propose two studies. In the first study, we will evaluate the testing of various clinical specimens using innovative, inexpensive tests that may greatly facilitate the diagnosis of pediatric TB in developing countries with high rates of TB and HIV co-infection. The second study will include children with confirmed TB (identified in the first study) and healthy age-matched children. We will evaluate three immunologically-based techniques for their sensitivity and specificity in the diagnosis of TB disease. We believe the results in known TB cases can be extrapolated to assess the potential utility of these tests in the diagnosis of the large population of children with TB who are not able to have disease microbiologically confirmed. NARRATIVE Diagnosis of pediatric tuberculosis (TB), particularly among young children and those who are infected with HIV is severely limited by methods that are slow, inefficient, and costly. Our research team has developed new TB diagnostic tools and ways of collecting specimens and we are proposing to evaluate them in young children in Ethiopia where pediatric TB and HIV co infection are major problems. If these methods work well, they could allow clinicians to institute rapid treatment directed specifically against the child''s particular infection, improving the speed and outcome of TB therapy.
Researchers
Robert Gilman
William Kuang-Yao Pan
Andrea Ruff
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The overall goal is to reduce maternal, newborn and child mortality in high-mortality countries in Africa and lay the foundation for concerted, coordinated actions to reduce maternal, newborn and child mortality in Asia.
Researchers
Robert Black
Jennifer Bryce
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The Real-Time Monitoring of Child Mortality Project is being developed to address growing demand for estimates of short-term changes in under-five mortality. The initiative builds on the experience of the Accelerated Child Survival and Development project implemented in 11 African countries between 2002 and 2004.
Researchers
Robert Black
Jennifer Bryce
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This abstract is not available
Researchers
Andrea Ruff
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There are few data describing the prevalence of pain and distressing symptoms in children hospitalized with life-threatening illness in resource-limited settings. The existing literature from the industrialized world suggests that symptom prevalence and distress are high, and in many areas, pain management in children has been largely ignored or inadequately addressed. Pain and symptoms are subjective in nature and measurement can be particularly challenging in children. In this study, we will evaluate pain and symptom prevalence, patient health-related quality of life, and caregiver burden of illness for patients admitted to the pediatric wards of Tikur Anbessa Hospital, a large urban tertiary care teaching hospital in Addis Ababa, Ethiopia. The specific goals are to determine the prevalence of pain and distressing symptoms, and the health-related quality of life in children with life-threatening illness (HIV/AIDS, cancer, etc.) admitted for the treatment of their disease or complications associated with treatment. We will be using previously validated, standardized self-report measures for children (or proxy measures in children unable to provide self-report). We will also examine the caregiver burden of distress in families with children who have life-threatening conditions, and obtain baseline data to target areas for intervention and to guide in the provision of services as we begin to institute a comprehensive pediatric palliative care program in collaboration with physicians and health care providers in-country.
Researchers
Benjamin Lee
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The Family Health and Wealth Study is carried out in collaboration with eight partner programs of the Gates Institute. Over a three year period, it will study the relationship between family building/reproductive patterns and health and wealth consequences for a sample of households in peri-urban areas of Addis Ababa (Ethiopia), Kampala (Uganda), Blantyre (Malawi), Assiut (Egypt), Kumasi (Ghana), Ife and Ibadan (Nigeria).
Researchers
Saifuddin Ahmed
Stan Becker
David Bishai
Vladimir Canudas-Romo
Michelle Hindin
Amy Tsui
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Advance Family Planning (AFP) is an evidence-based, three-year effort designed to help developing countries achieve universal access to reproductive health (MDG 5b). It aims to revitalize family planning programs through increased and more effective funding, and improved policy commitments at the local, national, and global levels. AFP is supported by the Bill & Melinda Gates Foundation and the David and Lucile Packard Foundation. The AFP Consortium includes Johns Hopkins University Bloomberg School of Public Health, African Women’s Development Fund, Partners in Population and Development, and Futures Group International.
AFP’s goal is to increase funding and improve policy commitments at all levels of national governments, among bilateral and multilateral donors, and the private sector. It builds on past investments and ongoing activities in reproductive health advocacy, leadership development, knowledge generation, and innovative service delivery projects. The success of AFP will very much depend on effectively working with established reproductive health organizations.
AFP builds on momentum generated by the re-emergence of U.S. leadership and the continuing and growing interest of European donors. Additionally, there is increased recognition at the country level for the need to invest in family planning in order to improve health and achieve the MDGs.
The project focuses on providing policy makers with evidence on why family planning is a sound investment with dividends in terms of health, socio-economic development, the environment, and other areas. The message and the messengers will reflect each country’s situation and the interests of those policy makers.
To achieve its goals, strengthen Southern advocates and create sustainable advocacy platforms, AFP has developed three distinct, but interrelated objectives:
• Objective 1: Mobilize and strengthen sustainable family planning/reproductive health advocacy with catalytic investments in Tanzania, Uganda, and Indonesia, countries with potential for wider replication of the AFP approach in other developing countries
• Objective 2: Strengthen existing family planning/reproductive health advocacy investments in India, Pakistan, Ethiopia, Kenya, Nigeria, and Senegal by providing cutting edge and highly specialized technical assistance
• Objective 3: Voices from the South—leverage voices of Global South champions regionally and globally to demand revitalization of family planning/reproductive health agenda to achieve MDG 5b and to create a platform for greater South-to-South cooperation
Researchers
Duff Gillespie
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