Pilot Award

Standard diagnostic strategies for tuberculosis (TB) are inadequate, and result in misuse of resources in public health programs; overutilization of hospital isolation facilities; and anxiety for patients. The reason for this waste is that standard diagnostic tests for TB are either inaccurate (smear microscopy) or slow (mycobacterial culture).

Antimalarial chemoprevention is an emerging modality to prevent deaths and morbidity from malaria in children living in highly endemic areas, but there are concerns that it will delay the natural acquisition of antimalarial immunity. Recent studies in mice and humans have challenged this paradigm, and suggest that selective blockade of blood stage infection with antimalarial drugs may paradoxically enhance the development of sterilizing antimalarial immunity, but this has not been tested in field settings.

Standard diagnostic strategies for tuberculosis (TB) are inadequate, and result in misuse of resources in public health programs; overutilization of hospital isolation facilities; and anxiety for patients. The reason for this waste is that standard diagnostic tests for TB are either inaccurate (smear microscopy) or slow (mycobacterial culture).

The overall objective of this study is to determine if active tuberculosis (TB) case finding among persons residing in the same household as a person with active pulmonary TB (household contact investigation) is an effective TB control intervention in a low-income setting with a high incidence of TB and a high prevalence of HIV infection.

In sub-Saharan Africa, HIV is predominantly transmitted via discordant sexual relationships. With the availability of antiretroviral (ARV) medications, individuals infected with HIV can live relatively normal productive lives. Societal and cultural expectations as well as personal reproductive intentions drive HIV positive women in discordant relationships to conceive. Approximately 50% of HIV infected couples desire children.

The overall objective of this study is to determine if active tuberculosis (TB) case finding among persons residing in the same household as a person with active pulmonary TB (household contact investigation) is an effective TB control intervention in a low-income setting with a high incidence of TB and a high prevalence of HIV infection.

In sub-Saharan Africa, HIV is predominantly transmitted via discordant sexual relationships. With the availability of antiretroviral (ARV) medications, individuals infected with HIV can live relatively normal productive lives. Societal and cultural expectations as well as personal reproductive intentions drive HIV positive women in discordant relationships to conceive. Approximately 50% of HIV infected couples desire children.

Retention in care is important for the health and well-being of HIV-infected persons. However, we do not know which measures of retention best predict key clinical outcomes such as mortality. In addition, existing studies of retention have only established an association between retention and mortality, rather than a causal effect.

Objectives: 1) accurately measure alcohol and drug use, especially amphetamine-type stimulants (ATS) and HIV prevalence, among female sex workers (FSW) and male clients of FSW in Preah Sihanouk Province, Cambodia, and; 2) assess the synergy between alcohol and/or drug exposures and HIV risks according to the type of sex work venues.

Retention in care is important for the health and well-being of HIV-infected persons. However, we do not know which measures of retention best predict key clinical outcomes such as mortality. In addition, existing studies of retention have only established an association between retention and mortality, rather than a causal effect.