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