A New Paradigm for TB/HIVControl in St. Petersburg

圣彼得堡结核病/艾滋病毒控制的新范式

• 批准号: 6576829
• 负责人: ANDREI P KOZLOV
• 金额: $ 8.1万
• 依托单位: BIOMEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-22 至 2004-04-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6576829
• 关键词: AIDS; AIDS education /prevention; Commonwealth of Independent States; HIV infections; cooperative study; disease /disorder prevention /control; education evaluation /planning; educational resource design /development; health science research; tuberculosis

DESCRIPTION (provided by applicant): The re-emergence of TB, complicated by the emergence of MDR- TB, is one of the greatest public health disasters for modern Russia if not for the entire world. Unlike the TB epidemics in most countries in the catchment ICOHRTA-AIDS/TB Program (=ICATB) areas, the Russian TB epidemic is unique because of: (1) a high prevalence of MDR- TB; (2) a TB epidemic that has not yet been escalated by HIV; (3) a historically effective Soviet-era TB control program that is now highly cost-ineffective and unsustainable in the current fiscal crisis in controlling the new Russian epidemic. This TB control program constitutes both a major part of the present TB problem and a potential part of the solution. The St. Petersburg ICATB Program builds on a strong pre-existing, largely NIH-supported research infrastructure. Following a Planning Grant-enabled period of ensuring political commitment, identification of priorities and suitable partners and creation of a training and research agenda, we will establish a multidisciplinary TB Research Unit at St. Petersburg State University (SPSU) modeled after, juxtaposed to and synergistic with our successful Fogarty AITRP-funded HIV Prevention Unit. Under this model, a multidisciplinary core of scholars from the SPSU Schools of Medicine, Biology, Psychology, Geography and Management and the St. Petersburg civil and prison TB Control Programs will receive long and intermediate term training in the USA and in Russian DOTS and DOTS-Plus pilot projects. Each US trained junior faculty will receive a Re-Entry Grant for TB/HIV-related research upon return to St. Petersburg. Once TB Research Unit staffing complete, we will pursue a research agenda to generate valid, timely evidence-based data to inform. Russian national TE3 decision makers and move towards a new paradigm for Russian TB control. The TB Research Unit in which a multidisciplinary team of well-trained Russian scientists conducts applied research in Russia is likely to influence national decision making in a way that the current "harping" by international agencies has not. The initial research agenda will focus on: (1) a RCT of DOTS vs. standard Russian TB treatment; (2) a DOTS-Plus pilot project following Green Light Committee guidelines; (3) a social network analysis of high TB transmission areas combining methods of molecular biology, epidemiology, medical geography; (4) molecular epidemiology of transmission of TB in prisons.

描述（由申请人提供）：结核病的重新出现，加上耐多药结核病的出现，是现代俄罗斯最大的公共卫生灾难之一，即使不是整个世界。与大多数国家在 ICOHRTA-AIDS/TB 计划 (=ICATB) 地区的结核病流行不同，俄罗斯结核病流行具有独特性，因为： (1) 耐多药结核病患病率高； (2) 结核病疫情尚未因艾滋病毒而升级； （3）历史上有效的苏联时代结核病控制计划，在当前的财政危机中控制俄罗斯新疫情时，成本效益极低，且不可持续。该结核病控制计划既是当前结核病问题的主要部分，也是解决方案的潜在部分。圣彼得堡 ICATB 计划建立在现有的、主要由 NIH 支持的强大研究基础设施之上。在确保政治承诺、确定优先事项和合适的合作伙伴以及制定培训和研究议程的规划拨款支持期之后，我们将在圣彼得堡国立大学（SPSU）建立一个多学科结核病研究单位，效仿并并列与我们成功的 Fogarty AITRP 资助的艾滋病毒预防部门产生协同作用。在这一模式下，来自 SPSU 医学院、生物学、心理学、地理和管理学院以及圣彼得堡民事和监狱结核病控制项目的多学科核心学者将在美国和俄罗斯 DOTS 和 DOTS 接受长期和中期培训-加上试点项目。每位在美国接受过培训的初级教师在返回圣彼得堡后都将获得用于结核病/艾滋病毒相关研究的再入境补助金。一旦结核病研究小组人员配备完毕，我们将制定一项研究议程，以生成有效、及时的循证数据来提供信息。俄罗斯国家 TE3 决策者并朝着俄罗斯结核病控制的新范式迈进。结核病研究小组由训练有素的俄罗斯科学家组成的多学科团队在俄罗斯进行应用研究，该小组可能会以目前国际机构“喋喋不休”的方式影响国家决策。最初的研究议程将集中于：(1) DOTS 与标准俄罗斯结核病治疗的随机对照试验； (2) 遵循绿灯委员会指导方针的 DOTS-Plus 试点项目； （3）结合分子生物学、流行病学、医学地理学等方法对结核病高发地区进行社会网络分析； (4)监狱结核病传播的分子流行病学。