Risk Factors for Abnormal Spirometry Among HIV+ Individuals in Nairobi, Kenya

肯尼亚内罗毕艾滋病毒感染者肺活量测定异常的危险因素

• 批准号: 8788893
• 负责人: Engi Farouk Attia
• 金额: $ 5.39万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8788893
• 关键词: 10 year old; Address; Adult; Age-Years; Biostatistical Methods; Bronchodilator Agents; Burn injury; CD4 Lymphocyte Count; Caring; Chronic; Chronic Disease; Chronic lung disease; Clinical; Clinical Investigator; Clinical Research; Clinical assessments; Collaborations; Communicable Diseases; Country; Data; Data Analyses; Data Collection; Databases; Developed Countries; Disease; Enrollment; Epidemiologic Methods; Evaluation; Exposure to; Forced expiratory volume function; Future; Goals; Guidelines; HIV; HIV Infections; HIV Seropositivity; Health; Healthcare; Hospitals; Incidence; Individual; Infection; Kenya; Knowledge; Life; Lung; Lung diseases; Malnutrition; Measures; Medical; Morbidity - disease rate; Outcome; Oxygen; Patient Self-Report; Patients; Pattern; Play; Predictive Value; Prevalence; Public Health; Pulmonary Function Test/Forced Expiratory Volume 1; Pulse Oximetry; Questionnaires; Research Design; Research Infrastructure; Resources; Respiratory Signs and Symptoms; Respiratory physiology; Risk; Risk Factors; Role; Sensitivity and Specificity; Severity of illness; Smoking; Spirometry; Staging; Surface; Symptoms; Time; Tobacco; Tobacco smoke; Training; Universities; Vital capacity; Washington; World Health Organization; age related; antiretroviral therapy; cigarette smoking; cohort; disability; disorder risk; experience; improved; lung development; modifiable risk; mortality; public health relevance; respiratory; response; screening; tool; treatment program

DESCRIPTION (provided by applicant): Expanding access to antiretroviral therapy (ART) in resource-limited settings has resulted in prolonged survival for many HIV-infected (HIV+) individuals. As a consequence, chronic illness and aging-related disability are likely to increase as they have in cohorts of HIV+ individuals in developed countries. How this will impact lung health and the prevalence of chronic lung disease (CLD) among HIV+ individuals in resource-limited settings remains largely unknown. In developed countries, the incidence of infectious pulmonary complications of HIV has declined dramatically and CLD has surfaced as an increasingly important determinant of morbidity and mortality among HIV+ adults in the current ART era. In resource-limited countries where still proportionately fewer HIV+ individuals have access to ART, the extent to which a similar shift in pulmonary disease has occurred over the last 20 years has not been fully explored. Factors known to increase risk of CLD such as smoking tobacco may be less important in the developing world, and risk factors including vertically-acquired HIV, indoor biofuel burning and initiation of ART at lower CD4 cell counts may play more prominent roles. This project will evaluate risk factors for decreased lung function, measured using spirometry, to detect CLD among HIV+ individuals ¿10 years old who receive HIV-related medical care at the Coptic Hope Center for Infectious Diseases in Nairobi, Kenya. The Hope Center was created in partnership with the University of Washington in 2004. Leveraging this established infrastructure and existing clinical research database, containing details of HIV disease stage and treatment, the applicant will collect standardized questionnaires and respiratory evaluations, including spirometry and pulse oximetry to achieve this project's specific aims, which are: 1) to determine risk factors for abnormal spirometry among HIV+ individuals and 2) to determine sensitivity, specificity and predictive value of a standardized assessment of self-reported respiratory symptoms, along with respiratory rate and oxygen saturation to identify HIV+ individuals with abnormal spirometry. To complete this project, the applicant will obtain formal training in advanced epidemiologic and biostatistical methods related to study design, data collection and analysis, and the responsible conduct of clinical research in resource-limited settings. This training and completion of this project will propel the applicant toward her goal of improving lung health in local and global settings as an independent clinical investigator, with a focus on HIV-related lung disease. This study will yield significant results that will enhance current knowledge of CLD risk factors among HIV+ individuals and identify modifiable risk factors that may be targeted in future studies to decrease the burden of CLD and its associated morbidity and mortality. In addition, clinical features of individuals at risk for abnormal spirometry will be identified and can be used to target future screening and improve treatment of these individuals in resource-limited settings.

描述（由适用提供）：在资源有限的环境中扩大对抗逆转录病毒疗法（ART）的访问已导致许多HIV感染（HIV+）个体的生存时间延长。结果，慢性病和与衰老有关的疾病可能会像发达国家的艾滋病毒+个体中一样增加。这将如何影响资源有限的环境中HIV+个体中慢性肺病（CLD）的肺部健康状况（CLD）的患病率。在发达国家，艾滋病毒感染性肺部并发症的事件急剧下降，CLD浮出水面，这是当前艺术时代艾滋病毒+成年人发病率和死亡率越来越重要的决定者。在资源有限的国家中，艾滋病毒+个人仍然可以使用艺术，在过去20年中发生类似的肺部疾病转变的程度尚未得到充分探索。在发展中国公司中，已知会增加烟草等CLD风险的因素可能不太重要，以及包括垂直获得的HIV，室内生物燃料燃烧以及在较低CD4细胞计数下的ART主动性在内的风险因素可能起着更为突出的作用。 该项目将评估使用肺活量测定法测量的改善肺功能的危险因素，以检测在肯尼亚内罗毕的科普特希望传染病中心接受HIV+个体的CLD。希望中心于2004年与华盛顿大学合作创建。利用该建立的基础设施和现有的临床研究数据库，其中包含艾滋病毒疾病阶段和治疗的详细信息，该适用将收集标准化的问卷和呼吸评估，以及呼吸评估，包括精神计量和脉搏量的素质性和脉搏氧化，以实现该项目的特定风险，以确定ABN的风险：1）abn h都是：1）abn HONT HONT HONT HONT HONT HONT，HONT HONT HONT HOST HOST，HONT HONT HONT，自我报告的呼吸症状评估的敏感性，特异性和预测价值，以及呼吸率和氧气安全性，以识别患有异常精神测定法的HIV+个体。为了完成该项目，适用的将获得与研究设计，数据收集和分析有关的高级流行病学和生物统计学方法的正式培训，以及在资源有限的环境中负责任的临床研究。该项目的培训和完成将推动申请人改善肺部的目标 作为独立临床研究者的本地和全球环境中的健康状况，重点是与HIV相关的肺部疾病。 这项研究将产生重大的结果，以增强HIV+个体中CLD风险因素的当前知识，并确定可修改的风险因素，这些风险因素可能是未来研究中可能针对的，以减少CLD的燃烧及其相关的发病率和死亡率。此外，将确定有异常肺活量测定法的个体的临床特征，可以使用 针对未来的筛查并改善在资源有限的环境中对这些人的待遇。