Uganda-UCSF Research Training in HIV-Associated Malignancies

乌干达-加州大学旧金山分校艾滋病毒相关恶性肿瘤研究培训

• 批准号: 8009644
• 负责人: JEFFREY N MARTIN
• 金额: $ 53.84万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-09 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8009644
• 关键词: Adult; Africa; Africa South of the Sahara; Child; Clinical; Clinical Research; Communities; Community Health; Conduct Clinical Trials; Dermatopathology; Detection; Diagnosis; Early Diagnosis; Epidemic; Goals; Grant; HIV; Health Personnel; Health Professional; Herpesviridae Infections; Human Herpesvirus 8; Interdisciplinary Study; Kaposi Sarcoma; Malignant Neoplasms; Methods; Modeling; Morbidity - disease rate; Nature; Pathologic; Pathologist; Patients; Play; Prevention; Principal Investigator; Public Health; Punch Biopsy; Reagent; Research; Research Personnel; Research Training; Role; Route; Scientist; Skin; Staging; Time; Training; Training Programs; Uganda; Work; antiretroviral therapy; arm; cancer type; clinical epidemiology; mortality; multidisciplinary

DESCRIPTION (provided by applicant): In sub-Saharan Africa, the catastrophic intersection between the HIV epidemic and the endemic nature of Kaposi's sarcoma-associated herpesvirus (KSHV) infection has resulted in Kaposi's sarcoma (KS) becoming the most common malignancy amongst adults ~ and an important threat in children - in many parts of the region. Our work in Uganda in the context of R01 CA119903, as well as the findings of others, has shown us that the single largest obstacle to prevention of KS morbidity and mortality in Africa is late diagnosis. We therefore hypothesize that the fastest route to the greatest public health impact on cancer in Africa is by detection of KS in its earliest stages, at a time when antiretroviral therapy (ART) alone is most effective. While early KS diagnosis in Africa is attractive, there are challenges at many levels - all of which can be remedied with training. Therefore, the overarching aim of this training grant is to build a multidisciplinary research team poised to promote and investigate early KS diagnosis in Uganda and to perform research on the epidemiology, clinical course, and treatment of KS in the ART era. Our specific aims are to: 1) Train several hundred community health workers and traditional healers in Uganda in the promotion of early recognition of KS in the community and of early presentation to health care providers; 2) Instruct several hundred health care providers in Uganda in the clinical recognition of early KS and in the conduct of simple bedside skin punch biopsies for the pathologic confirmation of KS; 3) Educate four Ugandan pathologists in the field of dermatopathology and arm them with suitable reagents for the specific and sensitive histopathologic diagnosis of KS; 4) Comprehensively train five emerging Ugandan scientists in the methods of clinical research to transform them into independent principal investigators to study a variety of aspects of KS; and 5) Develop a cadre of three Ugandan ciinicai research coordinators in order to play a vital support role on multidisciplinary research teams that investigate KS in the ART era. At the conclusion of this three year training program, we will have assembled a multidisciplinary team of health care professionals and researchers which is able to a) study the optimal approach to encourage early diagnosis of KS; b) understand which patients still develop KS in the ART era; c) document the impact of early KS diagnosis on survival; and d) conduct clinical trials to optimize the treatment of early diagnosed KS. Once established, our approach to early KS detection can be used as a model for other cancers as well. RELEVANCE: Kaposi's sarcoma (KS) is the most common type of cancer in Africa, and now that antiretroviral therapy for HIV is available in Africa, there is hope that the suffering caused by KS can be alleviated. Yet, this can only be achieved if KS is diagnosed at early stages. Therefore, this project's goal is to train an array of Ugandan health care professionals and researchers in order to promote early diagnosis of KS and to study its impact. Once established, our approach to early KS detection can be used as a model for other cancers as well.

描述（由申请人提供）：在撒哈拉以南非洲，艾滋病毒流行与卡波西肉瘤相关的疱疹病毒（KSHV）感染之间的灾难性相交导致卡波西肉瘤（KS）的肉瘤（ks）在成人中成为最常见的恶性，并成为许多重要的儿童中的恶意。在R01 CA119903的背景下，我们在乌干达的工作以及其他的发现向我们表明，预防非洲KS发病率和死亡率的最大障碍是较晚的诊断。因此，我们假设在非洲对癌症影响最大的最快途径是在其最早的阶段发现KS，那时仅抗逆转录病毒疗法（ART）是最有效的。尽管非洲早期的KS诊断很有吸引力，但在许多层面上都面临挑战 - 所有这些都可以通过培训来补救。因此，这项培训补助金的总体目的是建立一个旨在促进和调查乌干达早期KS诊断的多学科研究团队，并在艺术时代对KS的流行病学，临床课程和治疗进行研究。我们的具体目的是：1）在乌干达培训数百名社区卫生工作者和传统治疗师，以促进社区中KS的早期认可，并提交给医疗保健提供者的早期介绍； 2）指导乌干达的数百名医疗保健提供者，以临床认可早期KS，并进行简单的床边皮肤打孔活检以进行KS的病理证实； 3）在皮肤病理学领域教育四位乌干达病理学家，并用合适的试剂将其武装起来，以进行KS的特定和敏感的组织病理学诊断； 4）全面培训五名新兴乌干达科学家，以临床研究方法将其转变为独立的主要研究人员，以研究KS的各个方面； 5）建立了三个乌干达西尼卡伊研究协调员的干部，以便在研究艺术时代的KS的多学科研究团队中发挥至关重要的支持作用。在本三年培训计划的结束时，我们将组建一个由医疗保健专业人员和研究人员组成的多学科团队，能够a）研究鼓励早期诊断KS的最佳方法； b）了解哪些患者在艺术时代仍在发展KS； c）记录早期KS诊断对生存的影响； d）进行临床试验以优化早期诊断的KS治疗。建立后，我们对早期KS检测的方法也可以用作其他癌症的模型。相关性：Kaposi的肉瘤（KS）是非洲最常见的癌症类型，现在在非洲可以使用抗逆转录病毒疗法的抗逆转录病毒疗法，希望可以缓解KS造成的痛苦。但是，只有在早期诊断为KS时才能实现这一点。因此，该项目的目标是培训一系列乌干达医疗保健专业人员和研究人员，以促进KS的早期诊断并研究其影响。建立后，我们对早期KS检测的方法也可以用作其他癌症的模型。