HIV and Tuberculosis Transmission and Future Trends in the African Population in

艾滋病毒和结核病的传播以及非洲人口的未来趋势

• 批准号: 8262658
• 负责人: Roxanne Pieper Kerani
• 金额: $ 12.85万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-24 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8262658
• 关键词: AIDS/HIV problem; Accounting; Address; Africa; Africa South of the Sahara; African; American; Area; Caring; Censuses; Chest; Communicable Diseases; Communities; Country; County; Cross-Sectional Studies; Data; Data Analyses; Demography; Detection; Development; Diagnosis; Emigrant; Ensure; Environment; Epidemic; Epidemiologic Studies; Epidemiology; Future; Genotype; Goals; Grant; Growth; HIV; HIV diagnosis; HIV-1; HIV/STD; Health; Home environment; Human immunodeficiency virus test; Immigrant; Immigration; Incidence; Infection; Interview; K-Series Research Career Programs; Life; Medical; Medical History; Mentors; Modeling; Mycobacterium tuberculosis; New York City; Outcome; Participant; Patients; Persons; Philadelphia; Population; Prevalence; Prevention; Provider; Public Health; Public Health Practice; Pulmonary Tuberculosis; Recording of previous events; Reporting; Research; Research Design; Research Methodology; Research Personnel; Research Training; Risk; Screening procedure; Sexual Partners; Sputum; Study Subject; Training; Training Programs; Tuberculosis; Universities; Unsafe Sex; Washington; career; career development; design; high risk; improved; infectious disease treatment; mathematical model; mortality; population health; programs; sex risk; skills; surveillance data; transmission process; trend

DESCRIPTION (provided by applicant): Sub-Saharan Africa accounts for approximately 10% of the world's population, but is home to approximately 70% of the 2.7 million people estimated to be newly infected with HIV worldwide annually, and 35% of the estimated 8.8 million new tuberculosis (TB) cases. The burden of HIV and TB in Africa is reflected in higher rates of both infections in African emigrants to other countries when compared to their local counterparts. The goal of this career development award is to gain expertise in TB epidemiology and control, and research methodologies that will broaden my abilities to address HIV, TB, and other health issues in the African population in the US. My longer-term career objective is to improve the overall health of this population through both research and public health practice. The proposed research addresses questions crucial to the development of effective HIV and TB prevention and control programs for the African-born population. The specific aims of the proposal are to: 1) Estimate the extent to which transmission of HIV and TB occurs prior to arrival in the US among African-born persons, identify barriers to HIV testing and missed opportunities for HIV diagnoses among African-born US residents, and define the potential risk of ongoing HIV and TB transmission both within and outside of the African-born community; 2) Evaluate missed opportunities for TB screening and diagnosis, describe delays in diagnosis of active TB in the African population compared to non-Africans, and estimate the prevalence of TB genotypes typically seen in African- born patients in non-African populations; and 3) Develop projections for the size and composition of the African-born HIV and TB epidemics in the US over the next 20 years, using a combination of demographic and dynamic epidemic modeling. The career development component of the application is designed to augment my existing skills in the areas of HIV and STD epidemiologic research. The proposed educational aims will allow me to build skills in four specific areas necessary to carry out my research aims, and include training in: 1) TB epidemiology and control, 2) Demography and mathematical modeling, 3) Immigration and health. The unparalleled training environment at the University of Washington (UW), the close and collaborative relationships between the UW and the HIV/STD and TB Programs of Public Health - Seattle and King County, and the exceptional team of mentors and advisors that will supervise my training and research will further contribute to my career development and transition into a successful independent investigator. PUBLIC HEALTH RELEVANCE STATEMENT (provided by applicant): The proposed research will examine HIV and tuberculosis (TB) among African people living in the US, a population at high risk for both infections. Data on how much HIV transmission occurs before arrival in the US, missed opportunities for HIV and TB screening, and how many new HIV and TB infections we can expect among this population will be essential to guide control programs and reduce transmission of these infections both within the African community, and from this community to other populations.

描述（由申请人提供）：撒哈拉以南非洲约占世界人口的10％，但在全球范围内新近感染HIV的270万人中，约有70％的家园，估计880万新的结核病（TB）案件中有35％的遗嘱。与当地同行相比，非洲在非洲移民的两种感染率较高的艾滋病毒和结核病负担都反映在非洲移民的两种感染率上。该职业发展奖的目标是获得结核病流行病学和控制方面的专业知识，以及将扩大我解决美国非洲人口中艾滋病毒，结核病和其他健康问题的能力的研究方法。我的长期职业目标是通过研究和公共卫生实践来改善该人群的整体健康。拟议的研究解决了对非洲出生人群的有效艾滋病毒和预防和控制计划至关重要的问题。该提案的具体目的是：1）估计在非洲出生的人到达美国之前，艾滋病毒和结核病的传播发生在多大程度上，确定了艾滋病毒测试的障碍，并在非洲出生的美国居民中识别艾滋病毒诊断的机会，并定义了持续的HIV和TB传播的潜在风险，以及在非洲人内外的非洲人内外传播的风险； 2）评估错失结核病筛查和诊断的机会，描述与非非洲人相比，非洲人口诊断活性结核病的延迟，并估计非洲人人口中通常在非洲患者中通常看到的结核病基因型的患病率； 3）在未来20年中，使用人口统计学和动态流行性建模的结合，在美国，在美国出生的艾滋病毒和结核病流行病的大小和组成的预测。该应用程序的职业发展部分旨在增强我在艾滋病毒和性病流行病学研究领域的现有技能。拟议的教育目标将使我能够在执行我的研究目标所需的四个特定领域建立技能，并包括：1）结核病流行病学和控制，2）人口统计学和数学建模，3）移民和健康。华盛顿大学（UW）的无与伦比的培训环境，UW与公共卫生的HIV/STD和结核病计划之间的紧密和协作关系 - 西雅图和金县，以及杰出的导师和顾问团队，将监督我的培训和研究进一步为我的职业发展和转变为成功的独立研究员。 公共卫生相关性声明（由申请人提供）：拟议的研究将研究居住在美国的非洲人群中的艾滋病毒和结核病（TB），这两种感染都有高风险。有关在到达美国之前发生多少艾滋病毒传播的数据，错过的艾滋病毒和结核病筛查机会，以及我们可以期望在该人群中可以期望有多少新的艾滋病毒和结核病感染对于指导控制计划和减少非洲社区中这些感染的传播至关重要，从这个社区中，以及从这个社区到其他人群。