Tanzania
Site Established: Research, 1999; PEPFAR, October 2004
HIV prevalence: 12.6-69%
HIV incidence: 1.6-6.2%
Activities in Tanzania, where HIV-1 subtype C is predominant, focus on strain surveillance, cohort development and social behavior. Activities are centralized in the Mbeya Region and are a collaborative effort with the Mbeya Regional Medical Office, the European Commission and the University of Munich.
Studies in Tanzania, conducted with the University of Munich, are looking at high-risk adults along trade centers of the Trans-African Highway and the role of multiple serial infections in generating recombinant viruses.
Research Efforts:
In June, 2006, the Program initiated a Phase I/II Clinical Trial to Evaluate the Safety and Immunogenicity of a Multiclade HIV-1 DNA Plasmid Vaccine Boosted by a Multiclade HIV-1 Recombinant Adenovirus-5 Vector Vaccine in HIV Uninfected Adult Volunteers in East Africa.
HIV-1 Diversity in Tanzania
Mostly C and AC recombinant
HIV Vaccine Cohort Research
- Completed high-risk cohort investigation titled: Behavioural, Immunological and Virological Correlates of HIV-1 Superinfection (HIV-1+ vs HIV-1++) in Rural Tanzania
- The study investigated the prevalence and incidence of HIV super-infection and response of the immune system, as well as risk factors for infections ad the population dynamics of the study participants.
- Ongoing is a study called Infectious Disease Surveillance (HIV, TB and Malaria) and Cohort Development Among Urban and Rural Adults in Mbeya Municipality, Tanzania.
- This is a general population cohort, providing follow-up to the high-risk cohort project. The primary objective is to analyze the feasibility, recruitment efficiency, follow-up rates, costs and knowledge base for vaccine trials.
Facilities:
The Walter Reed Project-Tanzania conducts scientific activities at the Mbeya Medical Research Program (MMRP) in Mbeya, in its laboratory, outpatient and administrative facilities. The centre is located within the Mbeya Referral Hospital, one of the four consultant hospitals in Tanzania. Facility services at MMRP include clinics, laboratory, pharmacy, data management and administration.
The MMRP facilities at the Mbeya Referral Hospital include a tuberculosis (TB) research clinic, a cohort study centre and a vaccine clinic. The TB research clinic houses counseling, treatment and examination rooms and three laboratories. The cohort study centre is in the outpatient section of the hospital and includes counseling, treatment and examination rooms, as well as defined laboratory space. The vaccine clinic has counseling and vaccination rooms, in addition to a large clinical laboratory that includes cellular immunology labs.
Laboratory capabilities at the site include testing for HIV, Hepatitis B and C; syphilis testing, pregnancy testing, clinical hematology and chemistry, clinical CD4 flow cytometry, PBMC cryopreservation, malaria microscopy and other cellular-based assays to assess immunogenicity.
Prevention, Care and Treatment:
This program was developed with local partners in the Southern Highlands, including the regions of Mbeya, Rukwa and Ruvuma, and with the Tanzanian Peoples Defense Forces (TPDF). The civilian program is conducted in collaboration with the Mbeya Referral Hospital (MRH) and the Mbeya, Rukwa and Ruvuma Regional Medical Offices in close coordination with the Ministry of Health and the National AIDS Control Programme (NACP).
USMHRP provides technical assistance for clinician training in HIV patient care, using the national NACP curriculum. This has been integral to expanding facility-based care at MRH and treatment throughout the zone. Education in HIV care and treatment also includes village health care workers, home-based care volunteers and orphans and vulnerable children caregivers in the community. This is conducted through the Regional AIDS Control Programs out of the Regional Medical Offices and broader local community-based organizations (CBOs), such as KIHUMBE. Partners also include the Anglican Church, Caritas, Iringa RTF, Oak Tree, SETA, SHDEPHA, Mango Tree and the Evangelical Lutheran Church of Tanzania.
A new zonal training center in the region will offer antiretroviral therapy, voluntary counseling and testing (VCT), prevention of mother-to-child transmission (PMTCT) and laboratory services to our partners in a consolidated fashion. Currently, the program supports eight hospitals in the zone, which are linked to more than 10 CBOs and faith-based organizations (FBO) that follow the USMHRP community continuum of care model.
The program recently initiated new prevention, care and treatment programs with the TPDF and is slated to start treatment at two facilities, as well as expand VCT and PMTCT to all seven military health facilities throughout Tanzania. This will include diagnostic counseling and testing in all TB clinics. Activities also will focus on assisting the TPDF with building a new recruit-focused prevention program. Efforts to develop a military referral level laboratory at the TPDF’s national hospital, Lugalo, in Dar es Salaam will commence in 2006 to improve referral services by providing a clinical lab quality assurance/quality control (QA/QC) program, as well as surveillance and monitoring capacity to the military in Tanzania.
Staff: 108. Personnel includes host country collaborators, as well U.S. government and HJF staff.
USMHRP International Network:
Nigeria |
Kenya |
Tanzania |
Uganda |
Thailand