The purpose of these grants are to provide research support to Northwestern faculty who are a) collecting preliminary data to support a future grant submission and/or b) supplemental support for ongoing sponsored-research for work outside the aims and/or scope of work of the funded project. The fund is not meant to support the same aims of an existing study or projects that lack a specific plan to obtain sponsor-support.
The Global Health Research Catalyzer Fund is supported by the Feinberg School of Medicine’s Global Health Initiative, which is generously supported by Northwestern Medicine Primary & Specialty Care, its patients, and Feinberg’s donors.
Winter 2017 Awards
This will be one of the first studies to conduct a comprehensive epidemiologic study of assessing liver related clinical outcomes including HCC in HIV and HIV/HBV co-infected patients in Nigeria. A unique aspect of this study is the setting and population. Nigeria has some of the highest prevalence rates of HIV and HBV in the world, making it an ideal location to perform these types of longitudinal studies. Our study will provide important and new information the risk of HCC in both HIV and HIV/HBV co-infected individuals, identifying new areas for research in the prevention and treatment of this important non-AIDS defining malignancy. It will also be the first to implement and assess the utility of HCC screening in high-risk (cirrhotic) populations. The recruitment of an additional 300 patients to an already existing cohort who have been followed for over five years will make it one of the larger longitudinal cohorts of HIV and HIV/HBV in SSA. The cohort will provide an excellent platform for future observational and interventional studies, including longer-term natural history studies and potential therapeutic studies for HBV. It will also provide a rich source of specimens and data for retrospective analyses such as genetic and molecular studies of HIV and HBV. Results from this study will fill some of the key research gaps identified in the recently published 2015 WHO HBV prevention, care and treatment guidelines.
Partner Institution: Jos University Teaching Hospital
Principal Investigator: Claudia Hawkins, MD
Site-Prinicpal Investigator: Patricia Agaba, BmBcH
Persistent infection with oncogenic human papillomavirus (HPV) is necessary for cervical carcinogenesis. Although evidence suggests that the vaginal microbiome may relate to the HPV infections in women with cervical intraepithelial neoplasia (CIN), the complex relationship between vaginal microbial flora, HPV infection, and CIN is not completely understood. We hypothesized that the change of microbiome diversity could be associated with persistent infection of HPV and subsequent CIN. The study population will come from Chinese women with normal cervix and CIN I, CIN II/III diagnosed by pathology of our CIN study cohort. PCR and Gene chip hybrid technology will be used to identify the HPV genotypes (15 high-risk and 6 low-risk types), and llumina MiSeq sequencing of 16S rRNA gene amplicons will be applied to detect the characterise of the vaginal microbiota in all study participants. The vaginal microbiota composition and microenvironment, and the relationship between HPV infecton and characteristics of vaginal microbiome in the evolution of CIN will be analyzed.
Partner Institution: Shanxi Medical University
Principal Investigator: Lifang Hou, MD
Site-Prinicpal Investigator: Jintao Wang, PhD
Tuberculosis (TB) remains a public health problem in developing countries and recent reports also indicate a constant increase in the prevalence of nontuberculous mycobacteria (NTM) in those areas that are traditionally endemic for TB. Infections by NTMs are clinically undistinguishable from tuberculosis. This complicates the management of patients as sputum smear microscopy, the most widely used diagnostic tool for TB cannot differentiate mycobacterial species. We found in Mali that 18% of patients considered being TB chronic cases that were empirically treated as multidrug-resistant TB (MDR-TB) cases were in fact infected by NTM, most of which were M. avium (73%). In addition, we found that only 36% of the "chronic cases" treated as MDR-TB were true MDR-TB cases. Without an appropriate diagnostic, these patients receive more than 3 years of incorrect, expensive and potentially toxic medications. An effective treatment is available for M. avium, therefore it's not acceptable to leave this continuously growing population undiagnosed and untreated. The ongoing broad implementation of Xpert MTB/RIF assay and other molecular tools recommended by World Health Organization to replace sputum smear microscopy contribute to more accurate and sensitive TB diagnosis, but does not address the problem of NTM infection. In addition to limited resource settings, NTM infections are also prevalent in most developed countries including United States, especially in HIV infected individuals. New diagnostic tools to differentiate M. avium infection from M. tuberculosis are thus desperately needed and will significantly improve patients' management worldwide. In this application, we propose to build upon existing scientific infrastructures at Northwestern Center for Global Health (CGH) and Center for Innovation in Global Health Technologies (CIGHT), as well as leverage our ongoing studies through CGH at the Mali University of Sciences, Techniques and Technologies of Bamako (USTTB)'s SEREFO Laboratory (R01 study, Mali02 study, and D43 training program, PIs: S. Diallo and R. Murphy) to develop a new diagnostic test that will differentiate M. tuberculous complex (MTBC) from the treatable and the most common NTM, M. avium complex (MAC).
Partner Institution: Universite des Sciences, des Techniques et des Technologies de Bamako
Principal Investigator: Mamoudou Maiga, PhD, MD, MSc
Site-Prinicpal Investigator: Souleymane Diallo, MD
Prostate cancer (PCa) is the most commonly diagnosed cancer in men worldwide and the most common cancer in Nigerian men despite the lack of PSA screening. The age-adjusted death rate for PCa has decreased from 2005-2015 worldwide but the incidence and death rates actually increased for sub-Saharan Africa.[1-3] The epidemiology of latent PCa and the benefits of screening are unknown in Nigeria as prior studies did not examine the entire prostate.[11-12] Men of Nigerian ancestry, including African American (AA) men, are 1.6 times more likely to be diagnosed with PCa in the US compared to European Americans (EA). AAs are also 2.5 times more likely to die from PCa, and harbor more aggressive disease at radical prostatectomy when they have similar biopsy findings as White men. Given the genetic ancestral ties, this has implications for Nigerians.[4,5] Chromosome 8q24 is the mostly associated risk locus for PCa in the US and Europe. We showed that chromosome 8q24 risk SNPs were more common in West African (WA) men relative to studies in AA and EA men; AA men SNP frequencies were similar but less than the 8q24 polymorphism frequencies seen in WA men. We also identified new PCa risk variants in chromosome 8q24 in Nigerians which were replicated in Ghanaian and Ugandan men. Shorter CAG repeats in the androgen receptor gene (AR) have been associated with PCa risk and are more common in WAs and AAs relative to EAs. This is consistent with the fact that AAs are genetically about 80% WA and 20% European.[8,9] Taken together, Nigerian men may have a higher incidence of PCa than AA men but aren’t screened thereby limiting detection. Limitations in health infrastructure, urologists and radiation oncologists impede the feasibility of PCa screening programs in Nigeria. Because public support in Nigerian for cancer registries has increased, elucidating the epidemiology of PCa and aggressive PCa might make targeted screening for aggressive PCa a public health priority. Our overarching hypothesis is that Nigerian men have a higher age-adjusted prevalence of PCa and aggressive PCa relative to autopsy studies from the US.
Partner Institution: Jos University Teaching Hospital
Principal Investigator: Adam Murphy, MD
Site-Prinicpal Investigator: Ayuba Madachi Dauda, BmBcH
Summer 2017 Awards
This proposal has two aims designed to explore the process and interim success of adaptation, implementaion outcomes, explore the association with early intervention outcomes and provide the pilot data needed for larger grant proposals. These aims are
Aim 1: Describe the adaptation of components of the Improvement Collaborative (IC) in the African HIV treatment context and identify key contextual factors that drive their adaptation in two countries
Aim 2: Evaluate the interim success and challenges of the implementation process and outcomes of the IC including adoption, acceptability, fidelity, feasibility, and potential for sustainment and their relationship to the identified adaptations
This work will build upon the extensive existing program data collected to monitor implementation and measure the change in quality of care at sites particating in the IC. These program documents will be supplement by targeted key informant interviews of Ministry of Health IC leaders in country and US-based HEALTHQUAL leaders and coaches who are implementing the work in one country, supplemented by ethnographic observation of one three-day Learning Session, the convening event where facilities present and discuss successes and challenges. Evaluation design will follow the EPIS (Exploration, Preparation, Implementation, Sustainment) framework capturing implementation process and outcomes and the contextual factors driving adaptation and success or failure.The evaluation results will be disseminated within the program and the two countries and serve as pilot data for grant submissions to fund more in depth and summative research of adaption and implementaion of ICs inreosurce-limited settings.
Partner Institution: Ministry of Health, Zambawe
Principal Investigator: Lisa Hirschhorn, MD, MPH
Site-Prinicpal Investigator: Tsitsi Apollo
This proposal requests supplemental support for work outside of the aims of the three-year cluster randomized controlled trial: Menstrual Cups and Cash Transfer to Reduce Sexual and Reproductive Harm and School Dropout in Adolescent Schoolgirls in Western Kenya. The trial is funded through the UK Joint Global Health Trials (Medical Research Council-Department for International Development-Welcome Trust) Grant #MR/N006046/1. This proposal will also provide data to support a future grant submission to support country-wide scale up through the Kenyan Ministry of Education.
This 24-month proposal will pilot and evaluate a Menstrual Hygiene Management (MHM) intervention for secondary school settings in Kenya. These supplemental funds significantly impact outcomes as they provide a dissemination and implementation aim to the RCT. All proposal processes and outputs will be shared with the Ministry of Education and the Ministry of Health National Environmental Sanitation and Hygiene Interagency Coordinating Committee (ICC). It is envisioned that the data collected and outcomes from this project will support a future grant submission for further intervention effectiveness testing (outcomes research) and contribute to the rapidly evolving body of knowledge surrounding Menstrual Hygiene Management (MHM) in low and middle-income settings.
Partner Institution: Kenya Medical Training College
Principal Investigator: Leah Neubauer, EdD
Site-Prinicpal Investigator: Kelvin Oruko
Winter 2018 Awards
There are an estimated 19.5 million people worldwide infected with HIV that are receiving antiretroviral therapy (ART), with Sub-Saharan Africa having the highest burden. One of the greatest problems for the HIV control programs in Africa is the development of resistance to existing ART. Monitoring people living with HIV becomes more than more difficult because of the high rate of mutations and replication of quasi-species. The current approach by Sanger Sequencing for determination of HIV drug resistance is by testing some genes identified to be responsible for drug resistance (the drugs' targets). However, the drawback with this method is its complexity, its cost, time to perform and the fragility of the equipment, all of which makes it less suitable for low-and middle-income African countries. Nanopore MinION is a new miniaturized portable and robust next generation sequencer that can characterize the full genome of viruses. We propose to use MinION to develop an assay for HIV drug resistance including a software that can automatically determine drug resistance of a wide array of HIV strains including the Circulating Recombinant Forms (CRFs). The HIV genome map is now well known but CRFs continue to evolve and hamper molecular efforts to provide assay kits based on mutations at the gene level. Our full genome strategy will eliminate this issue, as any discovery of new relevant mutations (from existing or new drugs) will only need an adaptation of the analyzing software (and not the whole kit package as it is now). This new assay will ease the protocol and enhance the turnaround time for HIV drug resistance, and facilitate precision medicine in the interest of the patient. This new assay will significantly contribute to the long-term elimination goal of this pandemic.
Partner Institution: University of Sciences Techniques and Technologies (USTTB), University of Bamako
Principal Investigator: Mamoudou Maiga, MD, PhD
Site-Prinicpal Investigator: Almoustapha Maiga, PharmD, PhD