Current Research and Training Programs

Strokes in sickle cell anemia (SCA), particularly in children living in Africa, are associated with significant morbidity and an increased risk of premature death. In the US, primary stroke prevention in children with SCA involves screening for elevated transcranial Doppler ultrasound (TCD) velocity coupled with regular blood transfusion therapy for those with elevated velocities. However, regular blood transfusion therapy is not feasible in Africa due to inadequate supply of safe blood and the reluctance of parents to accept regular blood transfusion therapy for their children.

Sickle cell disease (SCD) is the most common genetic disease, affecting about 25 million people worldwide. Approximately 150,000 Nigerian children are born each year with sickle cell disease (SCD), making it the country with the largest burden of SCD in the world. Recent advancements in care for children with SCA have translated into improved survival of children in both high and low-resource settings. However, more complications of SCD are seen in those who survive to adulthood.

The University of Liberia College of Health Sciences is the leading educational institution for developing Liberia’s clinicians, researchers, health policymakers and innovators.

Principal Investigator(s):  Carolyn Audet, Ph.D.

In South Africa, HIV testing has been undermined by HIV stigma, distrust in the allopathic health system, a preference for traditional medicine, and distance to the health facility. South Africa has made progress towards their 90-90-90 goals, yet a substantial proportion of the population do not test regularly; only 33.9% of adults in rural Mpumalanga (our study site) underwent HIV testing in the past year.

Human Immunodeficiency Virus (HIV) infection remains a significant public health problem in the United States (US). It is estimated that almost 15% of the 1.17 million people living with HIV (PLWH) in the US are unaware of their HIV status. And despite the existence of highly effective HIV treatment (antiretroviral therapy, ART), only 65% of people living with diagnosed HIV have achieved viral suppression. Similarly, among HIV-negative people eligible for PrEP, only 18% have used PrEP.

The Republic of Mozambique, a Portuguese-speaking country of 28 million people on the southeast coast of Africa, has experienced significant economic growth and distinct progress in improving health indicators over the past two decades. Since the end of a devastating civil war in 1992, health has been a government priority, particularly in response to the crushing burden of HIV/AIDS.

Excerpt from the article Fogarty awards $3.3M in COVID-19 supplements to support research, training published in Global Health Matters by the Fogarty International Center: 

Principal Investigator(s):  Muktar Aliyu, M.D., M.P.H., Dr.P.H. Edwin Trevathan, M.D., M.P.H.

Status epilepticus (SE) is the most common serious neurological emergency among children worldwide. In the low- and middle-income countries (LMICs) of sub-Saharan Africa, the burden of childhood SE-associated mortality and morbidity appears to be especially high. However, the phenotypes of childhood SE, clinical predictors of SE-associated mortality and of SE-associated neurodevelopmental morbidity, and genomic predictors of SE, SE-associated mortality and neurodevelopmental morbidity have not been well-characterized in this region.

Principal Investigator(s):  Muktar Aliyu, M.D., M.P.H., Dr.P.H. William Wester, M.D., M.P.H.

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Principal Investigator(s):  Kate Clouse, Ph.D., M.P.H.

The UNZA-Vanderbilt Training Partnership for HIV-Nutrition-Metabolic Research (UVP-1) and the UNZA-Vanderbilt Partnership for HIV-NCD Research (UVP-2) continue a longstanding training collaboration between the University of Zambia School of Medicine/University Teaching Hospital (UNZA/UTH), Vanderbilt University (VU) and the Vanderbilt Institute for Global Health (VIGH).

PI: Martin C. Were, M.D., M.S. 

Principal Investigators: Timothy Sterling, MD Bruno Andrade Thomas Hawn

The Improving Perioperative Anesthesia Care and Training in Africa (ImPACT Africa) program addresses the critical need for safe surgery by training local anesthesia providers and building educational capacity of local institutions. Vanderbilt Institute for Global Health (VIGH) faculty members, Marie Martin and Elizabeth Rose, along with other VIGH staff and student collaborators, have partnered with ImPACT Africa leaders to provide education consulting and develop new courses.

The West African Ebola outbreak of 2014-2015 exposed the fragility of Sierra Leone’s health system and highlighted the need for further investments to ensure its future capability of responding to a disease outbreak of this magnitude.

The growth in research activity projected for the next decade by the Mozambican government and international agencies highlights the continued need for capacity building in research ethics well into the future. With the groundwork laid for systems of basic, translational, clinical and public health research, capacity development in research ethics has been essential to address critical research questions in an ethically consistent way. The four most evident areas in which attention is still needed are:

Research addressing the causes, diagnosis, and treatment of epilepsy and childhood neurological disorders, as well as implementation of diagnostic and treatment services, is urgently needed in Africa.

Principal Investigator: Edwin Trevathan, MD, MPH

The Vanderbilt Institute for Global Health (VIGH) and Aminu Kano Teaching Hospital (AKTH) in Kano, Nigeria have received a federal grant to study the factors associated with microalbuminuria among participants in an ongoing clinical trial of genetically at-risk HIV-positive adult Nigerians. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant will provide $2.2 million over the next four years.

Principal Investigator(s):  Martin Were, M.D., M.S. David Wright, Ph.D. 

Principal Investigator(s): Timothy R. Sterling, M.D. Valeria Cavalcanti Rolla, M.D., Ph.D.

Traditional healers, community-based partners with the national health system of South Africa, are exposed to patient blood an average of 1,500 times during their careers due to the practice of delivering herbal remedies via herbs rubbed into dozens of sub-cutaneous cuts. The purpose of this proposal is to compare two implementation strategies to increase consistent use of PPE: (1) a health care worker provided training program followed by 3 educational outreach and coaching visits at the healer's place of practice vs.

The project connects Vanderbilt researchers across disciplines in order to understand how often people living with HIV move within or outside of the state, and if this mobility is associated with HIV outcomes.

Young people living with HIV (Y-PLWH) have poor adherence to antiretroviral therapy and engagement in HIV care, making HIV the leading cause of death for African adolescents. Depression and psychological distress are much more common among Y-PLWH than in the general population, and are associated with significantly worse adherence to care and treatment when compared to Y-PLWH without these co-morbid conditions. Thus, untreated depression and severe psychological distress are important contributors to poor HIV outcomes in this population.

Principal Investigator(s):  Bonnie Miller, M.D. Troy Moon, M.D. M.P.H. Marie Martin, M.Ed., Ph.D.

South Africa has more HIV/AIDS patients than any other country and is home to the world’s largest antiretroviral program. According to the World Bank, as of 2018 the prevalence of HIV among South Africans ages 15 to 49 was 20.4%. Nearly one in three pregnant women attending antenatal care in South Africa is living with HIV. As South Africans with HIV move around the country, there is a risk they will disengage from the health care system or otherwise become lost to follow-up care.

Principal Investigator(s):  Elizabeth Heitman, Ph.D. Troy Moon, M.D., M.P.H.

Building on over a decade of partnership, the Faculty of Medicine at University Eduardo Mondlane (UEM) and the Vanderbilt Institute for Global Health (VIGH) are seeking to expand upon the groundwork laid by the longstanding PRISM (Partnership for Research in Implementation Science – Mozambique 

Project Details: NIH Reporter

Vanderbilt-Emory-Cornell-Duke (VECD) is one of six consortia that comprise the Fogarty Global Health Program for Fellows and Scholars, which replaced the Fogarty International Clinical Research Scholars & Fellows (FICRS-F) Program in 2012. The purpose of this program is to provide mentored global health research training opportunities in low- and middle-income countries (LMICs) for pre- and post-doctoral candidates from the U.S. and LMICs.

Building on the partnership with University of Liberia, College of Health Sciences (ULCHS), the Vanderbilt Institute for Global Health (VIGH) will develop a develop a one-year research ethics education program for members of four institutional review boards (IRBs) in Monrovia, Liberia. Research education and training activities will adapt to the Liberian context from the well-established Collaborative Research Ethics Education (Formação Colaborativa em Etica na Pesquisa, FoCEP) Program for Mozambique.

Project Details: NIH Reporter

Project Details: NIH Reporter Abstract Text

The scale-up of global antiretroviral therapy (ART) represents an unparalleled global health success story, leading to impressive overall reductions in HIV-related morbidity and mortality. However, adolescents and young adults (AYA), especially those in Sub-Saharan Africa, have largely been left out of this story. While AIDS-related deaths declined by 30% for adults from 2005-2012, they increased by 50% among AYA over the same period, making AIDS the leading cause of death among African youth. AYA living with HIV perform poorly across the entire care continuum.

The Vanderbilt-Nigeria Building Research Capacity in HIV/Non-communicable Diseases (V-BRCH) Program builds capacity of Nigerian investigators to successfully initiate and implement high-quality clinical trials in HIV-associated non-communicable diseases.

Principal Investigator(s): William Wester, M.D., M.P.H.