Strategies to Improve Kaposi's Sarcoma Outcomes in Zimbabwe

改善津巴布韦卡波西肉瘤疗效的策略

• 批准号: 8298439
• 负责人: Thomas B. Campbell
• 金额: $ 96.5万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-09 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8298439
• 关键词: Acquired Immunodeficiency Syndrome; Address; Africa; Africa South of the Sahara; African; Anti-Retroviral Agents; Area; Award; Cancer Burden; Car Phone; Caring; Cause of Death; Cessation of life; Clinical Management; Clinics and Hospitals; Collaborations; Colorado; Communication; Country; Decentralization; Detection; Diagnosis; Disease; Early Diagnosis; Early treatment; Education; Electronics; Environment; Evaluation; Faculty; Frequencies; Goals; Guidelines; HIV; HIV-1; Health Personnel; Health Priorities; Health Sciences; Health Services Accessibility; Improve Access; Incidence; Individual; Infection; International; Intervention; Kaposi Sarcoma; Knowledge; Lead; Link; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measures; Medical; Modeling; Morbidity - disease rate; Outcome; Palliative Care; Persons; Prevalence; Prevention; Primary Health Care; Provider; Quality of life; Recording of previous events; Refractory; Registries; Research; Resources; Rural; Rural Community; Services; Southern Africa; Specialist; Staging; Symptoms; Technology; Text; Translational Research; Treatment outcome; United States National Institutes of Health; Universities; Zimbabwe; antiretroviral therapy; base; chemotherapy; clinical care; clinical practice; college; cost; design; evidence base; implementation science; improved; medical specialties; mortality; novel strategies; primary care setting; programs; tool; treatment strategy

DESCRIPTION (provided by applicant): The SIKO Project will provide important practical information about how to improve treatment of AIDS-KS and thereby improve outcomes of antiretroviral treatment in Zimbabwe and other African countries that have a high burden of this cancer. This project will lead to improved medical practice, research and knowledge related to Zimbabwe and PEPFAR health priorities. PUBLIC HEALTH RELEVANCE: AIDS-associated Kaposi' sarcoma (AIDS-KS) is a cancer that is a major cause of morbidity and mortality in Africa. To realize the greatest possible benefits from antiretroviral therapy in Africa, it is important that AIDS-KS treatment strategies be developed that are feasible and sustainable in resource constrained areas. This application for a NIH/PEPFAR Collaboration for Implementation Science and Impact Award will establish the Strategies to Improve Kaposi' Sarcoma Outcomes (SIKO) Project. SIKO will be based on the long history of strong and productive collaborations in education and research between faculty at University of Zimbabwe College of Health Sciences (UZCHS) and the University of Colorado Denver (UCD). The SIKO Project is designed to improve outcomes in KS treatment through better early detection and treatment of KS disease and common related symptoms, in people with AIDS-KS. The overarching goal of the proposed studies is to develop evidence-based, cost-efficient approaches to improve detection and management of AIDS-KS and its related symptoms in low resource environments, and to evaluate the implementation of these approaches in primary care settings in urban and rural communities in Zimbabwe. To accomplish this goal SIKO will evaluate a novel strategy for improving treatment of AIDS-KS in Africa that is based on two principles: 1) Early detection of AIDS-KS with early initiation of antiretroviral therapy will improve treatment outcome and obviate the need for expensive and potentially toxic chemotherapy. 2) Advanced or refractory KS can be more effectively managed in Zimbabwe through decentralization of consultative specialty care to primary care settings. The SIKO strategies, if successful, will facilitate the decentralization of AIDS-KS care in Zimbabwe and will serve as a model for decentralizing medical management of other common malignancies (i.e., cervical cancer) in resource-limited settings. Although our evaluations will be conducted exclusively in Zimbabwe, given the high incidence of AIDS-KS in sub-Saharan Africa, it is likely that the knowledge gained from SIKO will be applicable to other African countries and will inform international treatment guidelines.

描述（由申请人提供）：Siko项目将提供有关如何改善AIDS-K的治疗的重要实用信息，从而改善津巴布韦和其他非洲国家对这种癌症负担很高的抗逆转录病毒治疗的预后。该项目将改善与津巴布韦和Pepfar健康优先事项有关的医学实践，研究和知识。 公共卫生相关性：与AIDS相关的Kaposi肉瘤（AIDS-K）是一种癌症，是非洲发病率和死亡率的主要原因。为了实现非洲抗逆转录病毒疗法的最大收益，重要的是要开发出在资源约束领域可行且可持续的IADS-KS治疗策略。 NIH/PEPFAR合作的实施科学和影响力奖的申请将建立改善Kaposi肉瘤成果（Siko）项目的策略。 Siko将基于津巴布韦大学卫生科学学院（UZCHS）和科罗拉多大学丹佛大学（UCD）之间的悠久历史和富有成效的教育和研究合作。 Siko项目旨在通过更好的早期发现和治疗AIDS-KS患者的KS疾病和常见相关症状来改善KS治疗的预后。拟议的研究的总体目标是开发基于证据的，具有成本效益的方法，以改善对低资源环境中艾滋病K及其相关症状的检测和管理，并评估津巴布韦城市和农村社区的初级保健环境中这些方法的实施。为了实现这一目标，Siko将评估改善非洲AIDS-K治疗的新策略，该策略基于两个原则：1）早期对抗逆转录病毒疗法的早期发现的早期发现将改善治疗结果，并消除对昂贵且潜在有毒化疗的需求。 2）通过将咨询专业护理分散到初级保健环境中，可以在津巴布韦更有效地管理高级或难治性KS。 Siko策略，如果成功的话，将有助于津巴布韦的艾滋病ks护理的权力下放，并将作为在资源有限的环境中对其他常见恶性肿瘤（即宫颈癌）进行医学管理的模型。虽然我们的评估将是 鉴于撒哈拉以南非洲的艾滋病（AIDS-K）的高发病率，从津巴布韦进行的，从西科获得的知识很可能适用于其他非洲国家，并将为国际治疗指南提供信息。