Current Community Outreach & Education and Medical Care and Research Grants
ORGANISATION: IKAHENG Community Association
LOCATION: South Africa; Eastern Cape Khahlamba District
AIM OF PROGRAM: To reduce the impact of HIV/AIDS on individuals, families and communities.
OBJECTIVES: Facilitate training of traditional medical practitioners and traditional circumcision surgeons in the management, prevention and control of HIV/AIDS and communicable diseases in their practices
Facilitate effective support and care of people living with HIV/AIDS and orphans
Network and collaborate with governmental departments associated with sexual health
Strengthen partnerships with interested NGO’s and educational institutions
STATUS: Ongoing. Over exceeded in supporting most target areas. Working on sustainable efforts to keep the project active.
INVESTIGATOR: Dr. Douglas Wilson, Prof. Gary Maartens
LOCATION: KwaZulu-Natal
INSTITUTION(S):: University of KwaZulu-Natal
AIM : Primary objective: To evaluate an algorithm for the diagnosis of smear-negative tuberculosis in adult tuberculosis suspects living in high HIV prevalence settings.
Secondary objective: To evaluate the morbidity and mortality associated with the use of the diagnostic algorithm.
STATUS: Ongoing. The no cost extension will evaluate HIV-infected SNPTB suspects using the WHO’s SNPTB algorithm with additional clinical criteria and response to therapy in order to derive data that may inform future versions of the WHO guidelines.
INVESTIGATOR: Prof M Essex, Dr Richard Marlink
LOCATION: Gaborone, Botswana
INSTITUTION(S):: Prof. M Essex, The Botswana-Harvard Partnership for HIV Research and Education
AIM: Prospectively measure the kinetics of emergence of drug resistant genotypes within the HIV-1 reverse transcriptase gene, pol, among two treatment groups of mothers.
Prospectively measure the kinetics of emergence of drug resistant genotypes among HIV-1C positive adult AIDS patients.
Prospectively measure transmission events, viral load and CD4 count of mothers at baseline, 34 weeks of gestation and in mothers and infants at birth and then at 1,3,6,9,12 and 18.
Prospectively measure pol genotype among those infected infants and their mothers adult AIDS patients
Determine the common genetic “signature” of pol resistance in HIV-1C
STATUS: Patients now transferred to national program. Data cleaning and analysing underway.
INVESTIGATOR: Prof. Kiepiella and Prof Ndunga
LOCATION: Durban, South Africa
INSTITUTION(S): University of Natal, Harvard Medical School
AIM: To seek ways to protect the neonatal immune system from HIV-mediated damage, and to boost immunity against the virus in order to achieve successful long-term control
OBJECTIVE: To determine the natural history of paediatric HIV infection following peripartum single-dose nevirapine (sd-NVP) prophylaxis in a resource-limited country, and to assess implications for antiretroviral roll-out programs.
STATUS: Ongoing. Results to date have shown of the 740 infants born to 719 HIV-infected women. The mother-to-child transmission (MTCT) rate was 10.3%; 31% were IP and 69% IU transmissions. VL was higher in mothers of IP than IU infants (median 279,000 vs 86,600, P=0.039) and lower in mothers of uninfected infants (median 26,750, P<0.001).
INVESTIGATOR: Prof. Greg Hussey
LOCATION: Western Cape, South Africa
INSTITUTION(S): University of Stellenbosch, University of Cape Town, Medical University of South Africa, Windhoek Central Hospital (Namibia), Brewelskloof Hospital (Worcester)
AIM: To determine the optimum treatment duration for tuberculosis in HIV-infected children and to assess the effect of TB on the natural history of HIV infection.
OBJECTIVES: To determine the effect of tuberculosis on the natural history of HIV infection in particular the occurrence of other opportunistic infections and nutritional status
To delineate the immediate and long-term consequences of HIV-TB co-infection on adaptive immunity in childhood
To determine whether children with dual infections are able to develop effective anti-mycobacterial immunity
To identify how to improve the microbiological diagnosis of TB in HIV-infected children
STATUS: Ongoing. Enrolment completed and pharmacokinetics analysis and evaluation is underway.
INVESTIGATOR: Prof. David Beatty
LOCATION: Western Cape, South Africa
INSTITUTION(S): University of Cape Town, Department of Paediatrics Imperial College, London
AIM : To develop and evaluate a range of novel diagnostic tests for childhood and adult tuberculosis
OBJECTIVE: The first part of the study aims to detect TB organisms by smear culture and molecular methods (PCR) or antigen detection. The second part aims to detect a specific host immune response (cellular or humoral) following exposure to MTB.
STATUS: Ongoing. The evaluation of the role of the ELISPOT in the diagnosis of childhood tuberculosis is underway.
INVESTIGATOR: Dr Shabir Madhi
LOCATION: Gauteng, South Africa
INSTITUTION(S):: University of Witwatersrand
AIM : To define the efficacy of primary INH prophylaxis in reducing clinical and culture confirmed TB in HIV infected children
OBJECTIVE: To evaluate the efficacy of primary isoniazed prophylaxis in reducing the burden of clinically diagnosed as well as culture-confirmed tuberculosis amongst HIV-1 infected children under two years of age. Potential subjects would be recruited at the time of counselling of mothers who are identified, as being HIV-1 infected at the time contrimoxazole prophylaxis would be started in all children. At the time of their third visit to the we111-baby immunisation clinics, subjects would be screened for HIV-1 infection using a HIV-1 PCR assay.
STATUS: Ongoing.
INVESTIGATOR: Ms B S Motswagole
LOCATION: Botswana
INSTITUTION(S):: National Food Technology research Centre
AIM : To improve the micronutrient status of the Botswana by increasing accessibility and availability of nutritious foods
OBJECTIVE: Fortified sorghum flour does not exist in Botswana, even though it is the staple cereal. Much nutritional value is lost through the milling process.
STATUS: Ongoing. The results of this study hopes to highlight the significance of Vitamin A rich consumption as part of dietary intake for PLWA’s.
INVESTIGATOR: Dr D Moodley
LOCATION: Durban, South Africa
INSTITUTION(S): University of KwaZulu-Natal, Child, Youth and Family Development Human Sciences Research Council Durban
AIM : To measure the impact of an enhanced counselling intervention strategy in I) reducing high risk bahaviour among sero-negative and sero-positive mothers, ii) in preventing new HIV infections among pregnant women and iii) reducing the risk of mother-to-child transmission of HIV during the index pregnancy and breastfeeding.
OBJECTIVES: To determine the incidence of HIV during the index pregnancy as defined by a negative HIV rapid test at an initial visit and a positive result at a subsequent visit.
To evaluate the quality and socio-behavioral impact of an enhanced/multi-level PMTCT intervention on: 1.antenatal clinic attenders with particular emphasis on medium to long-term socio-behavioral and lifestyle impact in the post-partum period; with particular emphasis on reduction of behaviors which may lead to HIV (re)infection. 2. secondary audiences such as family, partners and on a community level explored as part of assessing the intervention’s effectiveness in encouraging a social environment conducive to socio-behavioral change among women themselves
To determine the incidence of mother-to-child transmission of HIV among a cohort of antenatal attendees as an outcome of serconversion during the index pregnancy and breastfeeding.
STATUS: Ongoing. Enrolment complete and data analysis underway. Awaiting publications on the incidence of sero-conversion and the association of risk factors.
INVESTIGATOR: Prof Gabriel Anabwani
LOCATION: Botswana Baylor Children’s Clinical Centre of Excellence, Princess Marina Hospital, Gaborone, Botswana
INSTITUTION(S): Princess Marina Hospital, Baylor College of Medicine, Texas Children’s Hospital
AIM: This Phase II/III, two-arm, randomised, open label outpatient study compares the safety, tolerance, and efficacy of two treatment strategies in HIV-infected infants and children. Comparative data on antiretroviral drug resistance and cost also is being collected.
OBJECTIVES
To compare the two treatment strategies (continuous versus intermittent) with respect to rates of drug –associated toxicity or intolerance and HIV disease progression (growth failure, changes in neurodevelopmental status, development of two or more new or recurrent AIDS-defining opportunistic infections, development of clinically significant conditions, or death) in HIV-infected infants and children.
To compare the rates of emergence of antiretroviral drug resistance in the two treatment arms.
To compare rates of emergence of viral resistance in two treatment strategies.
To compare the cost of two antiretroviral treatment strategies
STATUS: Ongoing. Enrolment complete. Awaiting results
INVESTIGATOR: Dr. Ashraf H Coovadia
LOCATION: Johannesburg, South Africa
INSTITUTION: Coronation Women and Children Hospital, University of the Witwatersrand
AIM: The primary objective of the proposed study is to investigate whether or not participation in PMTCT programs which use Nevirapine may compromise or limit treatment options for HIV-infected women and children.
The study aims to measure early virologic response to treatment started within 24 months of Nevirapine exposure among HIV-infected women given Nevirapine prophylaxis to prevent transmission to their child, and among children who acquire HIV infection despite Nevirapine prophylaxis.
STATUS: Ongoing. Comparative analysis of different ARV regimens are under investigation.
ORGANISATION: Mpilonhle Project and Bhekizulu Self Sufficient Project Prevention
LOCATION: South Africa; Kwa-Zulu Natal
GRANT AWARDED: $500,000
AIM OF PROGRAM: To contribute to the reduction of Mother to Child Transmission of HIV and to prolong and improve the quality of life for HIV+ mothers in the Uthukela District of KwaZulu-Natal.
- Improving the management in PMTCT continuum of care by:
- Early ANC attendance
- VCT for Pregnant Mothers
- CD4 counts and reporting for HIV+ Pregnant mothers
- Early HAART Initiation for HIV+ pregnant mothers with CD4<200
- Nevirapine administration for mother and baby at birth
- Exclusive feeding
- Infant follow-up
STATUS: Ongoing
ORGANISATION: Bhekuzulu Self Sufficient Project
LOCATION: South Africa; Kwa-Zulu Natal
GRANT AWARDED:
AIM OF PROGRAM: To contribute to the reduction of Mother
to Child Transmission of HIV and
to prolong and improve the quality of life for HIV+ mothers in the Uthukela District
of KwaZulu-Natal.
- Improving the management in PMTCT continuum of care by:
- Early ANC attendance
- VCT for Pregnant Mothers
- CD4 counts and reporting for HIV+ Pregnant mothers
- Early HAART Initiation for HIV+ pregnant mothers with CD4<200
- Nevirapine administration for mother and baby at birth
- Exclusive feeding
- Infant follow-up
STATUS: Ongoing. Work has begun covering five Primary Health Clinics in Escourt.