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2017

YEAR IN REVIEW


ccghe mission Johns Hopkins Center for Clinical Global Health Education (CCGHE) works to improve patient outcomes and ease the burden of infectious disease in places where it is most severe. For more than a decade, we have partnered with clinical and educational professionals in low and middle income countries to: • Conduct cutting edge infectious disease research • Train in-country professionals to conduct groundbreaking studies • Develop and test novel technologies that improve healthcare access and treatment adherence.


DIRECTORS’ MESSAGE

What a year! 2017 was the most ambitious 365 days we’ve had to date. Our collaborative India-JHU research enterprise led by Dr. Amita Gupta is certainly our largest area of focus. It currently employs 180 people who in 2017 designed and implemented 90 studies on HIV, tuberculosis, and antimicrobial resistance across four clinical sites in India. We are particularly excited to be researching a new tuberculosis vaccine candidate. Findings were published on our longstanding work on HIV in Uganda in which a prevention strategy was developed that reduces new infections by 42%. Emocha, the mobile health platform developed by CCGHE researchers, received national recognition as a remote patient engagement and management platform—particularly for its role in the aftermath of Hurricanes Harvey and Maria. Researchers on the miLAB handheld diagnostic team led by Dr. Bob Bollinger presented a processing technique for lens-free imaging that shows great promise for being able to count and detect blood cells using mobile technology. This has potential for enormous impact on the world’s most common test, the complete blood count (CBC).

2017

And what a year. In the midst of progress, we watched as health—at the global, national, and patient levels—was downgraded on the list of national priorities. The NIH’s Fogarty International Center came under fire, but through advocacy and evidence of impact, our group along with many others successfully made the case to preserve a program that’s integral to domestic and global health. We are anxious about what measures like this portend. Clinical research and training is federally supported because it is a core component of the public welfare; research yields changes in patient care, and improved patient outcomes elevate the health of society. In an era of stagnant and diminishing federal resources, we are profoundly grateful for philanthropy and support from donors who put their trust in us to continue to make a difference. We were able to balance the highs and lows of 2017 by keeping keenly focused on our mission and the people it serves. 2018 will be no different. We are working on a number of really exciting areas we expect will yield more effective options for infectious disease prevention, treatment, and management. We wish all our friends and colleagues a happy and hopeful new year.

L-R: Amita Gupta, Jane McKenzie-White, Bob Bollinger

Robert C. Bollinger, MD, MPH Director Professor of Medicine, Public Health, and Nursing Johns Hopkins University

Amita Gupta, MD, MHS Deputy Director Associate Professor of Medicine and Public Health Johns Hopkins University

Jane McKenzie-White, MAS, MSEd Managing Director Director of Education Technology and Design Johns Hopkins Center for Clinical Global Health Education


2017

by the numbers PEOPLE

180

ACTIVE CLINICAL RESEARCH STUDIES

PUBLICATIONS

42

VACCINE TRIALS

WEBSITES

76

1

4

PRESENTATIONS & INVITED TALKS

SHORT FILMS

48

1

PRESS RELEASES & NEWS ARTICLES

30


highlights

JAN: As part of a $31 million Johns Hopkins effort, Indo-JHU research partnership is tapped by CDC to conduct research for its Developing Healthcare Safety Research (SHEPheRD) program, and launches the study: Healthcare-Associated Sepsis in the Neonatal Intensive Care Unit in Pune, India. More than 3000 newborns are being followed. FEB: 6 research studies are presented at the Conference on Retroviruses and Opportunistic Infections in Seattle.

MAR: The Mobile Health and Wellness Clinic is deployed in Pune for a Health Camp at a large construction site. Of 76 workers screened for TB, 7 suspected cases are referred into care. APR: BJGMC Clinical Research Site marks World TB Day with a full-day women’s empowerment workshop for study participants. MAY: Drs. Amita Gupta and Jyoti Mathad address an engaged crowd on female leadership in academic global health at the Consortium of Universities of Global Health. Two scholars present abstracts at the American Thoracic Society International Conference. Dr. Bob Bollinger featured in JAMA article about the Fogarty International Center. JUN: The New York Times interviews Dr. Kathleen Page about how deportation orders for undocumented immigrants are affecting healthcare access. JULY: Peer reviewed papers are published in Lancet, Anthropology and Medicine, Heart Asia, and Tobacco Regulatory Science. AUG: Dr. Amita Gupta publishes commentary in India Abroad: Reduced level of disease possible by India’s 100th year. SEPT: Indo-JHU research partnership joins a $59 million UNITAID effort to improve TB prevention and treatment. OCT: 12 abstracts and invited lectures are presented at the 48th Annual Union Conference on Lung Health; Continuing Medical education Credit is offered for ID Clinical Minute; JHU Provost Sunil Kumar addresses donors at the India Impact luncheon, convened to honor the Ujala and Wyncote Foundations and present research findings. NOV: Dr. Larry Chang publishes HIV prevention efforts and incidence in HIV in Uganda in New England Journal of Medicine; Gail Jessop, Ana Cervantes, Rose Warlick are recognized by the Hopkins Department of Medicine for reflecting Hopkins core values in their work everyday. BJGMC-JHU Fogarty Scholars work is featured in The Indian Express. DEC: Dr. Bob Bollinger publishes commentary in The Hill: 4 ways that telemedicine can address the opioid crisis; BJGMC Team offers community counseling and preventive care on World AIDS Day.


Usha Balasubramanian No photo available

people

ROW 1: Rupak Shivakoti, Jonathan Golub, Kathleen Page, Amita Gupta, Bob Bollinger, Jane McKenzie-White, Maunank Shah, Larry Chang, Yuka Manabe, Natasha Chida | ROW 2: Matt Robinson, Andrea DeLuca, Akshay Gupte, Jeff Tornheim, Jessica Elf, Kelley Dooley, Jyoti Mathad, Anita Shankar | ROW 3: Bharat Randive, Sachin Atre, Sandesh Patill, Nishi Suryavanshi, Vidya Mave, Nikhil Gupte, Mallika Alexander, Neetal Nevrekar, Mandar Paradkar, Ivan Marbaniang, | ROW 4: Shri Vijay Bala Yogendra Shivakumar, Rewa Kohli, Neeta Pradhan, Vandana Kulkarni, Sona Deshmukh, Smita Nimkar, Sadaf Inamdar, Sameer Khan, Savita Kanade, Gauri Dhumal | ROW 5: Gail Jessop, Kate Bergstrom, Gabriela Smit, Samyra Cox, Rose Warlick, Ana Cervantes, Sagar Bhagwat, Matt Williams, Molly Bowen, Amita Nagaraj. Along with 150 contract research staff in India.


clinical research Infectious diseases exact a cruel toll on people who live in low and middle income countries. Tuberculosis, HIV, and bacterial infections are the worst offenders. A convergence of factors linked to poverty form an environment in which infectious diseases thrive, such as: Large burden of chronic disease Densely populated living environment Poor air and water quality and poor sanitation Food scarcity Shortages of adequately trained health workers Lack of sustained resources for supplies, equipment, research, and training • Social stigma that keeps people from seeking care. • • • • • •

CCGHE faculty conduct research here in Baltimore and in regions of the world where disease prevalence is shocking.


CLINICAL RESEARCH

tuberculosis

REGIONAL PROSPECTIVE OBSERVATIONAL RESEARCH FOR TUBERCULOSIS (RePORT) CONSORTIUM

The RePORT Consortium is an international effort to identify reliable biomarkers that (1) predict that TB infection will progress from latent to active disease and (2) offer signals predicting treatment failure, treatment success, or disease relapse. Research is being conducted in high TB burden countries of India, Brazil, South Africa, Indonesia, and China, in partnership with US research institutions. Each region collects and maintains its own country-specific TB data, and the research of the consortia is governed by a common protocol that specifically calls for biomarker identification. Leadership. Dr. Amita Gupta is Co-chair of RePORT India, a countrywide effort jointly funded by the US and Indian governments through the Indo-US Vaccine Action Program. Dr.Vidya Mave is Co-chair of the common protocol, and Dr. Nikhil Gupte is Co-chair of data management. In addition to leadership postitions, CCGHE conducts clinical research as a member of 2 consortia in India: • Host and Microbial Factors Associated with Poor Treatment Response and Progression to Active TB (C-TRIUMPH): Research partnership among BJGMC in Pune, India, the National Institute of Research in Tuberculosis (NIRT) in Chennai, India, and Johns Hopkins University in Baltimore. • MDR-TB Treatment Outcomes, Adverse Effects, Mtb Genotyping, and Pharmacokinetic Testing: Research partnership between PD Hinduja Hospital in Hinduja, India, and Johns Hopkins University in Baltimore.

2017 Studies

C-TRIUMPH: Cohort for TB Research by the Indo-US Medical Partnership  MDR-TB MUKT: Monitoring Adverse Effects, Utilizing Resources Optimally, Knowing Resistance Patterns, and Treatment Strategy (Hinduja Hospital)  Whole Genome Sequencing and Trek Sensititre Testing of Stored Isolates of Drug Resistant Tuberculosis from a Clinical Cohort at Hinduja Hospital, Mumbai  Residual Respiratory Impairment Following Pulmonary Tuberculosis: Lung Health Substudy  Measuring TB Drugs in Hair as a Tool to Monitor Adherence, Exposure and Response in Patients with HIV  Transcriptomic and Metabolomic Analysis of Microbiologically Confirmed Pediatric Tuberculosis Patients and Uninfected Household Contacts  A Multicenter Phase II/III Double-Blind, Randomized, Placebo Controlled Study to Evaluate the Efficacy and Safety of VPM1002 in the Prevention of TB (Tuberculosis) Recurrence in Pulmonary TB Patients after Successful TB Treatment in India  Understanding of Tuberculosis Infection and Preventive Therapy among Skin-Test Positive Household Contacts of Tuberculosis Cases  Comparison of Available Purified-Protein Derivative (PPD) Tuberculin Skin Test (TST) Antigen Solutions in Detecting Latent Tuberculosis Infection In India  Impact of HIV and Diabetes Mellitus on TB Drug Resistance and Recurrence  Biomarkers for Tuberculosis Diagnosis and Treatment Response  MDR-TB and HIV at RePORT Sites in India  Validation of Transcriptional Signature to Predict Active TB Disease among Advanced HIV Patients  Whole Genome Sequencing of Clinical Isolates from Patients with Multidrug Resistant Tuberculosis in Pune, India  Targeting Mycobacterium Tuberculosis Persisters by Enhancing Stringent Response-Specific Cellular Immunity  The Human Virome in Health and Disease  The Role of Innate Immunity in the Acquisition of Sterile Protection against TB Infection


tb

AMONG PREGNANT WOMEN

TB is the leading cause of death among pregnant women, particularly those who are HIV+. Pregnant women who have TB are more likely to deliver infants that are stillborn, or born premature and underweight. And, there is increased risk for acquiring TB after giving birth, but we do not fully understand what that looks like in the immune system. Thus there are no guidelines for how to identify and treat pregnant women who are at risk for developing TB after they deliver. Because there is very little data about drug toxicity in pregnant women, India does not provide preventive therapy to all HIV-infected pregnant women, as recommended by the WHO. We are investigating the immunological and physiological changes that occur during different stages of pregnancy and how they contribute to greater risk for acquiring TB. We also are researching what impact those changes have on the effectiveness of TB treatment.

2017 Studies

Impact of Immune Changes of HIV and Stages of Pregnancy on Tuberculosis  Vaginal Microbiota in HIV Infected Pregnant Women  Studying the Molecular Mechanisms Leading to Suppressed Immunity in Pregnancy and Studying the Relationship between Diet, Gut Microbiome and Inflammation during Pregnancy  Temporal Dynamics of Gut Microbiota in HIV-infected Pregnant Women  Predictive Value of TB Symptom Screen in HIV-infected and HIV-uninfected Pregnant Women in Pune, India: Substudy on Inflammation in HIV-Infected Pregnant Women: Relationship with Diet, Gut Microbiome and Preterm Birth  Diagnosis of Latent Tuberculosis Infection and Th1 Immune Response in Pregnant Women in India  Zika Surveillance among ANC Outpatients in BJ Govt Medical College and Sassoon General Hospitals, Pune, India  Investigating Maternal Antibodies to Modify Infant Tuberculosis Acquisition (MAMA Study)

CLINICAL RESEARCH


CLINICAL RESEARCH

tb

AMONG CHILDREN

TB disease is more severe among children than it is among adults in India, particularly among younger children who spend most of their time in the home. There is a surprising lack of data about how to safely and effectively treat children who have TB. Their physiology and immunology are different from adults. And while they respond differently to disease treatment, it is administered as if they were small adults. We are committed to advancing the science that offers safe and effective TB treatment options for children.

2017 Studies

A Phase I/II Randomized, Open-label Trial to Evaluate the Pharmacokinetics, Safety, and Treatment Outcomes of Multidrug Treatment Including High Dose Rifampicin with or without Levofloxacin versus Standard Treatment for Pediatric Tuberculous Meningitis  A Randomized Therapeutic Interventional Comparative Study between Three Different Modalities of Paediatric Antitubercular Treatment  Adherence to Indian National Guidelines for Isoniazid Chemoprophylaxis among Pediatric Contacts of Pulmonary Tuberculosis Cases  Shorter Treatment for Minimal TB in Children (SHINE)


tb

AND DIABETES

Having TB and diabetes together causes more severe disease than either of the two diseases does alone. People with diabetes are 3 times more likely to develop tuberculosis infection, and tuberculosis treatment can heighten the risk for diabetes by diminishing glucose tolerance. It’s enough of a problem that the World Health Organization calls out for reducing the impact of diabetes in its End TB Strategy. The Indo-JHU research partnership has several collaborative TB diabetes studies underway.

2017 Studies

Impact of Diabetes on TB Treatment Outcomes  Screening of Patients with Diabetes Mellitus for TB at a Tertiary Care Hospital in Pune, India  Impact of Diabetes on TB Treatment Outcomes: Nested Study on Lipid Mediators of Inflammation in TB and TB-Diabetes  Tuberculosis/Diabetes Mellitus mHealth Survey

tb

OTHER INVESTIGATIONS

The Indo-JHU clinical research partnership is exploring many lines of inquiry to help ease the burden of TB in India, including a vaccine trial.

2017 Studies

A Multicenter Phase II/III Double-Blind, Randomized, Placebo Controlled Study to Evaluate the Efficacy and Safety of VPM1002 in the Prevention of Tuberculosis Recurrence in Pulmonary TB Patients after Successful TB Treatment in India  Multicenter Study of the Accuracy of the BD MAX™ MDR-TB Assay for Detection of M. tuberculosis Complex and Mutations Associated with Resistance to Rifampin or Isoniazid  Establishing an Observational Cohort Database of Patients with Tuberculosis for Patient Care and Research at the Hinduja Hospital Chest Clinic Assessing the Association of Indoor Air Pollution with Tuberculosis in Adult Women  miDOT mHealth Pilot Study  Understanding Quality of Life during and Loss to Follow-up from Drug-Resistant Tuberculosis Treatment in Pune, India

CLINICAL RESEARCH


CLINICAL RESEARCH

2017 tb publications

1. Suboptimal anti-tuberculosis drug concentrations and outcomes in small and HIV coinfected children in India: recommendations for dose modifications. Guiastrennec B, Ramachandran G, Karlsson MO, Kumar AKH, Bhavani PK, Gangadevi NP, Swaminathan S, Gupta A, Dooley KE, Savic RM. Clinical Pharmacology and Therapeutics. 2017 Dec 16. 2. Isoniazid concentrations in hair and plasma area-under-the-curve exposure among children with tuberculosis. Mave V, Kinikar A, Kagal A, Nimkar S, Koli H, Khwaja S, Bharadwaj R, Gerona R, Wen A, Ramachandran G, Kumar H, Bacchetti P, Dooley KE, Gupte N, Gupta A, Gandhi M. PLOS One. 2017 Dec 7. 3. Prevalence of dysglycemia and clinical presentation of pulmonary tuberculosis in Western India. Mave V, Meshram S, Lokhande R, Kadam D, Dharmshale S, Bharadwaj R, Kagal A, Pradhan N, Deshmukh S, Atre S, Sahasrabudhe T, Barthwal M, Meshram S, Kakrani A, Kulkarni V, Raskar S, Suryavanshi N, Shivakoti R, Chon S, Selvin E, Gupte A, Gupta A, Gupte N, Golub JE. International Journal of Tuberculosis and Lung Disease. 2017 Dec 1. 4. Vitamin A and D deficiencies associated with incident tuberculosis in HIV-infected patients initiating antiretroviral therapy in multinational case-cohort study. Tenforde M, Yadav A, Dowdy DW, Gupta N, Shivakoti R, Yang WT, Mwelase N, Kanyama C. Pillay S, Samaneka W, Santos B, Poongulali S, Tripathy S, Riviere C, Berendes S, Lama J, Cardoso SW, Sugandhavesa P, Christian P, Semba RD, Campbell TB, Gupta A; NWCS319 and ACTG 5175 study team. Journal of Acquired Immune Deficiency Syndromes. 2017 Jul 1. 5. Household food insecurity associated with low IFN-y in pregnant Indian women. Vaidya A, Bhosale R, Sambarey P, Suryavanshi N, Young S, Mave V, Kanade S, Kulkarni V, Deshpande P, Balasubramanian U, Elf J, Gupte N, Gupta A, Mathad J. International Journal of Tuberculosis and Lung Disease. 2017 Jul 1. 6. Tuberculosis screening among persons with diabetes mellitus in Pune, India. Mave V, Nimkar S, Prasad H, Kadam D, Meshram S, Lokhande R, Gupte N, Jain D, Gupta A, Golub JE. BMC Infectious Diseases. 2017 Jun 2. 7. Pulmonary infections in pregnancy. Mathad JS, Gupta A. Seminars in Respiratory Critical Care Medicine. 2017 Apr. 8. Extrapulmonary tuberculosis. Shah M, Chida N. In: Grosset JH, Chaisson RE, eds. Handbook of Tuberculosis. Cham, Switzerland: Springer International Publishing Switzerland. 2017:91-118. 9. Treatment of pulmonary tuberculosis. Dorman S, Gupta A. In: Grosset JH, Chaisson RE, eds. Handbook of Tuberculosis. Cham, Switzerland: Springer International Publishing Switzerland. 2017:35-90. 10. Clinical features and diagnosis of tuberculosis: primary infection and progressive pulmonary tuberculosis. Karakousis PC, Noton KD, Manabe YC. In: Grosset JH, Chaisson RE, eds. Handbook of Tuberculosis. Cham, Switzerland: Springer International Publishing Switzerland. 2017:17-34. 11. Resident doctors' attitudes toward tuberculosis patients. Pardeshi GS, Kadam D, Chandanwale A, Bollinger R, Deluca A. Indian Journal of Tuberculosis. 2017 Apr. 12. Novel interferon-gamma assays for diagnosing tuberculosis in young children in India. Shaikh N, Gupte A, Dharmshale S, Pokkali S, Thakar M, Upadhye VJ, Ordonez AA, Kinikar A, Gupte N, Mave V, Kagal A, Gupta A, Lalvani A, Paranjpe R, Bharadwaj R, Jain SK. International Journal of Tuberculosis and Lung Disease. 2017 Apr 1. 13. The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis. Dheda K, Gumbo T, Maartens G, Dooley KE, McNerney R, Murray M, Furin J, Nardell EA, London L, Lessem E, Theron G, van Helden P, Niemann S, Merker M, rer nat, Dowdy D, Van Rie A, Siu GKH, Pasipanodya JG, Rodrigues C, Clark TG, Sirgel FA, Esmail A, Lin HH, Atre SR, Schaaf HS, Chang KC, Lange C, Nahid P, Udwadia ZF, Horsburgh CR, Churchyard GJ, Menzies D, Hesseling AC, Nuermberger E, McIlleron H, Fennelly KP, Goemaere E, Jaramillo E, Low M, Jara CM, Padayatchi N, Warren RM. Lancet Respiratory Medicine. 2017 Apr. 14. Modelling approaches for tuberculosis: are they realistic? Atre S. The Lancet Global Health. 2017 Mar.


CLINICAL RESEARCH

human immunodeficiency virus NETWORK TRIALS: NATIONAL INSITUTUES OF HEALTH

Adult Clinical Trials Group (ACTG) | International Maternal, Pediatric, Adolescent Aids Clinical Trials (IMPAACT)

Comprising clinical trial sites at Johns Hopkins Medicine in Baltimore, Whitman Walker Health in Washington, DC, and the BJGMC-JHU partnership in Pune, India, the BaltimoreWashington-India Clinical Trials Unit (BWI-CTU) is one of only 25 HIV/TB clinical trial sites globally funded by the US NIH, and the only NIH-funded site to conduct HIV/TB network studies in children and pregnant women in India. The BWI-CTU research group conducts trials within two research priorities: 1) Prevention of mother-to-child HIV transmission, and 2) Optimization of clinical management of HIV/AIDS, including treatment regimens for adults and children with HIV as well as prevention and treatment of TB, cryptococcal meningitis, HPV co-infections and other HIV-related conditions. In collaboration with the two NIAID HIV/AIDS Clinical Trials networks named above, the BJGMC-JHU research partnership has conducted more than a dozen clinical trials.

2017 Studies

A5332 (REPRIEVE), Randomized Trial to Prevent Vascular Events in HIV using Pitavastatin  A5349, Rifapentine-containing Treatment Shortening Regimens for Pulmonary Tuberculosis  NWCS 445, Novel Biomarkers to Shorten TB Treatment: A Substudy of S31/A5349  A5274: REMEMBER, Reducing Early Mortality and Early Morbidity by Empiric Tuberculosis Treatment Regimens  NWCS 408, Examining Longitudinal Cytokine Profiles in HIV-TB Co-infected Participants to Study the Exit from Latent TB Infection and Death: A Supplemental Proposal for A5274  A5279: Phase III Clinical Trial of Ultra-Short-Course Rifapentine/Isoniazid for the Prevention of Active Tuberculosis in HIV-infected Individuals with Latent Tuberculosis Infection  A5282: A Randomized, Phase II Trial to Compare an HPV Test-and-Treat Strategy to a Cytology-Based Strategy for Prevention of CIN 2+ in HIVInfected Women  A5288: Management Using the Latest Technologies in Resource-limited Settings to Optimize Combination Therapy after Viral Failure (MULTI-OCTAVE)  Role of Specialized Pro-Resolving Mediators (SPMs) on Markers of Inflammation in HIV-Infected Adults  P1077BF: Breastfeeding Version of the PROMISE Study (Promoting Maternal and Infant Survival Everywhere)  P1077FF: Formula Feeding Version of the PROMISE Study (Promoting Maternal and Infant Survival Everywhere)  P1078: A Phase IV Randomized Double-Blind Placebo-Controlled Trial to Evaluate the Safety of Immediate (Antepartum-Initiated) Versus Deferred (Postpartum-Initiated) Isoniazid Preventive Therapy among HIV-Infected Women in High TB Incidence Settings  P1108: A Phase I/II, Open-label, Single Arm Study to Evaluate the Pharmacokinetics, Safety and Tolerability of Bedaquiline (BDQ) in Combination with Optimized Individualized Multidrug-resistant Tuberculosis (MDR-TB) Therapy in HIV-infected and uninfected Infants, Children and Adolescents with MDR-TB Disease  SHINE (Shorter Treatment for Minimal TB in Children) A Randomized Trial of Therapy Shortening for Minimal Tuberculosis with New WHO-Recommended Doses/ Fixed-Dose-Combination Drugs in African and Indian HIV+ and HIV- Children  NWCS319, Impact of Nutritional Status on Early HIV Treatment Failure in Resource-limited Settings (Nutrition Study)  NWCS 414, Evaluation of a Serum Biosignature for Identifying HIV-infected Individuals at Greatest Risk for Developing Active TB


CLINICAL RESEARCH

hiv

THERAPEUTICS RESEARCH, EDUCATION, & AIDS TRAINING IN ASIA (TREAT ASIA) STUDIES

The Asian Pacific is home to the greatest proportion of people living with HIV. In fact, the region accounts for 60% of the global HIV burden. In 2003, amfAR, the Foundation for AIDS Research, established TREAT Asia, a network of hospitals, clinics, research organizations, and other stakeholders to improve HIV patient treatment outcomes through clinical research, education, and community advocacy and policy. The BJGMC-JHU clinical research partnership is a proud member of these efforts.

2017 Studies

The TREAT Asia Pediatric HIV Observational Database (TApHOD)  Epidemiology of HIV/AIDS and Comorbidities in a Public Antiretroviral Treatment (ART) Clinic in Pune, India  Prevalence and Risk Factors for Oral Cancer among HIV-Infected Adults  Prevalence Survey of Risk Factors for Tuberculosis and Non-Communicable Diseases in an HIV-positive Population in Pune, India  Assessment of Cardiovascular Health Knowledge, Preventive Practices and Cardio-protective Behavior among HIV-infected Individuals in Pune, India

hiv 2017 Studies

OTHER

COMmunity Home Based INDIA Prevention of Mother-to-Child Transmission (COMBIND PMTCT) Study  Evaluating Demand Generation (Stylish Man) for HIV/Family Planning Services, Rakai, Uganda  Community Health Workers, mHealth, and Combination HIV Prevention in a Hotspot: A Randomized Trial (mLAKE)  LaMocha: A Mobile Technology to Promote HIV Testing among Immigrant Latino Men  mHealth-enhanced Peer Navigation Intervention for PrEP Delivery among MSM at STD Clinics


2017 hiv publications

CLINICAL RESEARCH

1. HIV prevention efforts and incidence of HIV in Uganda. Grabowski MK, Serwadda DM, Gray RH, Nakigozi G, Kigozi G, Kagaayi J, Ssekubugu R, Nalugoda F, Lessler J, Lutalo T, Galiwango RM, Makumbi F, Kong X, Kabatesi D, Alamo ST, Wiersma S, Sewankambo NK, Tobian AAR, Laeyendecker O, Quinn TC, Reynolds SJ, Wawer MJ, Chang LW, for the Rakai Health Sciences Program. New England Journal of Medicine. 2017 Nov 30. 2. Impact of a community health worker HIV treatment and prevention intervention in an HIV hotspot fishing community in Rakai, Uganda (mLAKE): study protocol for a randomized controlled trial. Chang LW, Mbabali I, Kong X, Hutton H, Amico KR, Kennedy CE, Nalugoda F, Serwadda D, Bollinger RC, Quinn TC, Reynolds SJ, Gray R, Wawer M, Nakigozi G. Trials. 2017 Oct 23. 3. Risk factors for early mortality on antiretroviral therapy in advanced HIV-infected adults. Bisson GP, Ramchandani R, Miyahara S, Mngqibisa R, Matoga M, Ngongondo M, Samaneka W, Koech L, Naidoo K, Rassool M, Kirui F, Banda P, Mave V, Kadam D, Leger P, Henestroza G, Manabe YC, Bao J, Kumwenda J, Gupta A, Hosseinipour MC; Adult AIDS Clinical Trials Group A5274 (REMEMBER) Study Team. AIDS. 2017 Oct 23. 4. Challenges in the evaluation of interventions to improve engagement along the HIV care continuum in the United States: a systematic review. Risher K, Kapoor S, Daramola A, Paz-Bailey G, Skarbinski J, Doyle K, Shearer K, Dowdy D, Rosenberg E, Sullivan E, Shah M. AIDS and Behavior. 2017 Jul. 5. Cardiovascular risk in an HIV-infected population in India. Marbaniang IP, Kadam D, Suman R, Gupte N, Salvi S, Patil S, Shere D, Deshpande P, Kulkarni V, Deluca A, Gupta A, Mave V. Heart Asia. 2017 Jul. 6. Maternal syphilis: an independent risk factor for mother to infant human immunodeficiency virus transmission. Kinikar A, Gupte N, Bhat J, Bharadwaj R, Kulkarni V, Bhosale R, McIntire KN, Mave V, Suryavanshi N, Patil S, Bollinger R, Gupta A. Sexually Transmitted Diseases. 2017 Jun. 7. The impact of preexposure prophylaxis among men who have sex with men: An individual-based model. Kasaie P, Pennington J, Shah MS, Berry SA, German D, Flynn CP, Beyrer C, Dowdy DW. Journal of Acquired Immune Deficiency Syndromes. 2017 Jun 1. 8. Prevalence of HIV testing provision at community organizations serving young people in a mid-Atlantic city, 2013-2014. Marcell AV, Okano L, Pilgrim NA, Jennings JM, Page KR, Sanders R, Loosier PS, Dittus PJ. Public Health Reports. 2017 Mar/Apr. 9. Cost-effectiveness of CRAG-LFA screening for cryptococcal meningitis among people living with HIV in Uganda. Ramachandran A, Manabe Y, Rajasingham R, Shah M. BMC Infectious Diseases. 2017 Mar 23. 10. High prevalence of cryptococcal antigenaemia amongst asymptomatic advanced HIV patients in Pune, India. Kadam D, Chandanwale A, Bharadwaj R, Nevrekar N, Joshi S, Patil S, Gupte N, Sangle S, Chopade K, Kulkarni V, Balasubramanian U, Suryavanshi N, Jain D, Kanade S, Dharmashale S, Kagal A, Gupta A, Mave V. Indian Journal of Medical Microbiology. 2017 Jan-Mar. 11. ยกSรณlo se vive una vez! (you only live once): a pilot evaluation of individually tailored video modules aiming to increase HIV testing among foreign-born Latino men. Dolwick Grieb SM1, Flores-Miller A, Page KR. Journal of Acquired Immune Deficiency Syndromes. 2017 Feb 1. 12. Qualitative insights into implementation, processes, and outcomes of a randomized trial on peer support and HIV care engagement in Rakai, Uganda. Monroe A, Nakigozi G, Ddaaki W, Bazaale JM, Gray RH, Wawer MJ, Reynolds SJ, Kennedy CE, Chang LW. BMC Infectious Diseases. 2017 Jan.


CLINICAL RESEARCH

drug resistance 2017 Studies

Bacterial Antimicrobial Resistance Patterns in Pune, India in Patients with Febrile Illness: Zika and Dengue study ď ľ Antimicrobial Use and Diagnosis among Hospitalized Febrile Patients in Pune

healthcare safety

CDCSHEPHERD

2017 Studies

Healthcare Associated Sepsis in Neonatal Intensive Care Unit in Pune, India ď ľ Services for Evaluating the Source of Early Onset Neonatal Sepsis Due to Classically Hospital Acquired Pathogens (Maternal Colonization)


CLINICAL RESEARCH

tb & hiv research leadership EXECUTIVE MEMBERSHIPS Regional Prospective Observational Research for Tuberculosis (RePORT) India Executive Committee. Position: US Co-chair. CLINICAL TRIAL SCIENTIFIC COMMITTEE POSITIONS • ACTG End-Organ Disease and Inflammation Transformative Science Group. Position: Member.

CLINICIAL TRIAL PROTOCOL LEADERSHIP • IMPAACT 1077. Clinical Management Committee. Position: Member. •

IMPAACT P1078. Positions: Chair | Protocol Technologist.

IMPAACT P2001. Positions: Vice-chair | Protocol Technologist.

IMPAACT P2005. Positions: Chair | Protocol Technologist.

ACTG 5274. Position: Co-chair.

ACTG Site Operations Subcommittee. Position: Member.

ACTG 5279. Position: Vice-chair.

ACTG Site Management and Clinical Care Committee. Position: Co-vice-chair.

ACTG 5312. Position: Chair.

ACTG Tuberculosis Transformative Science Group. Positions: Member | Pharmacologist | Vice-chair | Steering Committee.

ACTG 5343. Position: Chair.

ACTG TB Meningitis Working Group. Positions: Chair | Member.

ACTG 5300/IMPAACT 2003 MDR TB Feasiblity Study PHOENIX. Positions: Co-chair | Field Representative.

IMPAACT Clinical Trial Network Tuberculosis Scientific Committee. Positions: Member | Vice-chair.

ACTG 5300B/IMPAACT 2003B MDR TB Household Study PHOENIX. Positions: Co-chair | Field Representative.

ACTG/IMPAACT Cross-Network Site Coordinators Working Group. Position: Member.

IMPAACT Multidisciplinary Protocol Review Group. Position: Member.

ACTG/IMPAACT TB Laboratory Diagnostic Working Group. Position: Member.

ACTG/IMPAACT TB Laboratory Core Team. Position: Member.


education & training Clinical education and training is critical to sustained progress in health outcomes. Expanding the infectious disease clinical research and healthcare workforce is a key component of our mission. We do this by: • Fostering interest in clinical research in LMICs among students at Johns Hopkins University Schools of Medical, Bloomberg School of Public Health, and Nursing, and mentoring them through practical studies • Designing and implementing online education opportunities that serve non-ID clinicians, and clinicians serving patients in remote areas • Partnering with academic medical institutions in LMICs to build capacity among medical students for developing and presenting Grand Rounds patient cases for discussion among peers • Developing and administering a Fogarty International Center-funded program to build capacity for clinical research design, data analysis, presentation, and publishing in peer review literature.


EDUCATION

id clinical minute ID Clinical Minute is a bi-monthly online resource addressing the latest in infectious diseases. Issues cover emerging outbreaks and epidemics, groundbreaking scientific articles, diagnostic and treatment/management reviews, and updates in the field as presented at relevant professional conferences. ID Clinical Minute is designed for clinicians and clinicians-in-training in the US and in global health settings, and issues are available for continuing medical education credit (CME). A post test for each issue evaluates ability to: 1. Discuss current treatment options for infectious diseases 2. Translate gained knowledge to clinical practice 3. Recognize new developments in the field 4. Recognize current national and international epidemics.

Editorial & Production Team • • • • •

Editor in Chief: Natasha Chida, MD, MSPH (left) Co-Editor in Chief: Chris Lippincott, MD, MPH (middle) Instructional Design: Jane McKenzie-White, MAS, MSEd (right) Managing Editor: Molly Bowen Production: Matt Williams


TRAINING

global grand rounds Dr. Natasha Chida moderates Global Grand Rounds in Infectious Diseases (GGRID), which is a live, video conference-based grand rounds among 4 institutions that is designed to help health providers care for persons with infectious diseases. Students and faculty at BJGMC, DY Patil Medical College, Krishna Medical College, and Johns Hopkins University alternate presenting challenging patient cases. Based on the presentation of patient symptoms and test results, participants collaborate to offer possible clinical diagnoses, rationale for how they came to a diagnosis, and other possible diagnoses that were considered. Issues related to clinical practice and science are also covered. All case presentations in this program have been standardized and quality assured in selection, presentation and discussion. The discussions are archived on CCGHE’s website. Our goal is to publish and build a library of cases within this program to maximize the professional development of our presenters and the infectious disease knowledge of our learners.


NATIONAL INSTITUTES OF HEALTH

fogarty scholars India

TRAINING

The Fogarty International Center's vision is a world in which the frontiers of health research extend across the globe and advances in science are implemented to reduce the burden of disease, promote health, and extend longevity for all people. YEAR 1: 2015

Dr. Sunita Girish; Dr. Anita Basavaraj; Dr. Geeta Pardeshi; Dr. Sangita Shelke; Dr. Aarti Kinikar

ABOUT

Housed within the US National Institutes of Health, the Fogarty International Center supports research conducted by partnerships of US and international scientists. Fogarty's focus is to build research capacity in low and middle income countries, and to ensure sustainability by training next generation scientists.

YEAR 2: 2016

Dr. Amit Kale; Dr. Chhaya Valvi; Dr. Rahul Lokhande; Dr. Vasudha Belgaumkar; Dr. Smita Deshpande; Dr. Shilpa Naik

The BGJMC-JHU training partnership is a decades-long Fogarty effort that offers intensive research training to clinicians in India in HIV-TB epidemiology and laboratory research as well as mentorship for preparing and presenting scientific findings. Distanceeducation supplements professional development activities at BJGMC, and training held at Johns Hopkins rounds out the program. Program activities are overseen by a Training Advisory Committee (TAC) that includes senior faculty from JHU and BJGMC.


TRAINING

NATIONAL INSTITUTES OF HEALTH

fogarty scholars India Research Studies 1. 2. 3. 4. 5. 6. 7. 8. 9.

YEAR 3: 2017

Dr. Murlidhar Tambe, Dr. Usha Nikumbh, Dr. Ibrahim Ansari, Dr. Bharti Daswani, Dr. Samir Joshi Dr. Kiran Jadhav, Dr. Rajesh Kulkarni, Dr. Sunil Bhambre, Dr. Ambarish Mathesul , Dr. Yogesh Gavali

News 1. 2. 3. 4. 5.

Journal of the American Medical Association: Fogarty International Center, a linchpin of global health research. 2017-05-17. Global Health Matters, National Institutes of Health: Four new members join Fogarty advisory board. 2017-10-12. The Indian Express: Mexico conference: Experts from BJ Medical College make presentations on TB, treatment. 2017-11-09. Global Health Matters, National Institutes of Health: Tech designed for Africa helps US fight disease, save money. 2017-10-12. Global Health Matters, National Institutes of Health: How can we encourage female leaders in global health? 2017-08-09.

10. 11. 12. 13. 14.

Identifying Strategies to Optimize Prevention, Diagnosis, and Care of Tuberculosis in Health Care Workers of Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospital, Pune, India. Barriers to Implementation of Isoniazid Preventive Treatment (IPT) in Pediatric Contacts of Sputum Positive Adults with Tuberculosis. Barriers to Early Treatment Initiation in Childhood Tuberculosis in High Incidence Setting. ART Study 1: Database: Epidemiology of HIV/AIDS and Associated Comorbidities in a Public Antiretroviral Treatment (ART) Clinic at BJGMC in Pune. The Role of GeneXpert in Bacterial Diagnosis of Spinal Tuberculosis. Antimicrobial Use and Diagnosis among Hospitalized Febrile Patients in Pune, India. A Randomized Therapeutic Interventional Comparative Study between Three Different Modalities of Paediatric Antitubercular Treatment. Optimal Algorithmic Diagnosis of Genital TB among HIV-infected and Uninfected Infertile Women. RePORT: C-TRIUMPH Substudy on Assessing the Association of Indoor Air Pollution with Tuberculosis in Adult Women and Children under 5 Years of Age. Characterization of Findings on Upper Endoscopy. Cost-effectiveness of Xpert MTB/RIF for Diagnosing Pulmonary Tuberculosis in HIV-positive Patients. Acute Febrile Illness and Antimicrobial Resistance Patterns in Pune, India: Substudy on the Characterization of the Human Virome. Barriers for Intervention to Prevent Occupationally Acquired Tuberculosis in Healthcare Workers. Risk of Tuberculosis among Health Care Workers and Trainees in a Tertiary-care Hospital in Pune, India.

2017 Publications 1. 2. 3.

Pardeshi GS, Kadam D, Chandanwale A, Bollinger R, Deluca A. Resident doctors' attitudes toward tuberculosis patients. Indian J Tuberc. 2017;64(2):89-92. PMID: 28410704. Robinson ML, Manabe YC. Reducing uncertainty for acute febrile illness in resource-limited settings: the current diagnostic landscape. AJTMH. 2017 Jun;96(6):1285-1295. doi: 10.4269/ajtmh.16-0667. PMID 28719277. Mave V, Chandanwale A, Kagal A, Khadse S, Kadam D, Bharadwaj R, Dohe V, Robinson M, Kinikar A, Joshi S, Raichur P, McIntire K, Kanade S, Sachs J, Valvi C, Balasubramanian U, Kulkarni V, Marbaniang I Zenilman J, Gupta A. High burden of antimicrobial resistance and mortality among adults and children with community-onset bacterial infections in India. JID. 2017 Apr 15;215.


NATIONAL INSTITUTES OF HEALTH

fogarty scholars US

TRAINING

Jeffrey Tornheim, MD, MPH | Assistant Professor • MDR-TB Free: Monitoring Adverse Effects, Utilizing Resources Optimally, Knowing Resistance Patterns, and Treatment Strategy. • Multicenter Study of the Accuracy of the BD MAX MDR-TB Assay for Detection of M. tuberculosis Complex and Mutations Associated with Resistance to Rifampin or Isoniazid. • RePORT: C-TRIUMPH Substudy on Transcriptomic and Metabolomic Analysis of Microbiologically Confirmed Pediatric Tuberculosis Patients and Uninfected Household Contacts. • Whole Genome Sequencing and Trek Sensititre Testing of Stored Isolates of Drug-resistant Tuberculosis from a Clinical Cohort at Hinduja Hospital, Mumbai. • Whole Genome Sequencing of Clinical Isolates from Patients with Multidrug Resistant Tuberculosis in India. Matthew Robinson, MD | Infectious Disease Fellow • Acute Febrile Illness and Antimicrobial Resistance Patterns in Pune, India. • Acute Febrile Illness and Antimicrobial Resistance Patterns in Pune, India: Substudy on the Characterization of the Human Virome. • Acute Febrile Illness and Antimicrobial Resistance Patterns in Pune, India: Substudy on Community Health-Seeking Behavior Among Patients Admitted with Acute Febrile Illness. • Antimicrobial Use and Diagnosis among Hospitalized Febrile Patients in Pune, India. • Healthcare-Associated Sepsis in the Neonatal Intensive Care Unit in Pune, India. • Zika Surveillance among Antenatal Clinic Outpatients in BJ Government Medical College and Sassoon General Hospitals, Pune, India. Akshay Gupte, PhD | Junior Researcher • Impact of Diabetes on TB Treatment Outcomes: Nested Study on Lipid Mediators of Inflammation in TB and TB-Diabetes. • RePORT: C-TRIUMPH: Cohort for Tuberculosis Research by the Indo-US Medical Partnership. • RePORT: C-TRIUMPH Nested Study on Association of Lipid Mediators of Inflammation with TB Treatment Outcomes. • RePORT: C-TRIUMPH Substudy on Residual Respiratory Impairment Following Pulmonary Tuberculosis. • TB and Pregnancy Impact of Immune Changes of HIV and Stages of Pregnancy on Tuberculosis: Nested Study on Investigating Maternal Antibodies to Modify Infant Tuberculosis Acquisition. Matthew Murrill | MD–PhD Candidate • ACTG 5300/IMPAACT 2003 MDR TB Feasiblity Study PHOENIX. • Understanding Quality of Life during and Loss to Follow-up from Drug-Resistant Tuberculosis Treatment in Pune, India.


TRAINING

ujala scholars

The work of the following junior researchers is made possible through generous support from the Ujala Foundation of Newtown Square, Pennsylvania. Jessica Elf, MPH, PhD | Post Doctoral Fellow • Predictive Value of TB-symptom Screen in HIV-infected and HIV-uninfected Pregnant Women in Pune, India. • RePORT: C-TRIUMPH Substudy on Assessing the Association of Indoor Air Pollution with Tuberculosis in Adult Women and Children under 5 Years of Age. • Impact of Diabetes on TB Treatment Outcomes.

Jyoti Mathad, MD, MSc | Instructor of Medicine • Zika Surveillance among Antenatal Clinic Outpatients in BJ Government Medical College and Sassoon General Hospitals, Pune, India. • TB and Pregnancy Impact of Immune Changes of HIV and Stages of Pregnancy on Tuberculosis: Nested Study on Investigating Maternal Antibodies to Modify Infant Tuberculosis Acquisition. • Vaginal Microbiota in HIV Infected Pregnant Women. • Predictive Value of TB-symptom Screen in HIV-infected and HIV-uninfected Pregnant Women in Pune, India.

Rupak Shivakoti, PhD | Instructor of Medicine • Impact of Diabetes on TB Treatment Outcomes: Nested Study: Lipid Mediators of Inflammation in TB and TB-Diabetes. • Validation of Transcriptional Signature to Predict Active TB Disease among Advanced HIV Patients. • RePORT: C-TRIUMPH Nested Study on Association of Lipid Mediators of Inflammation with TB Treatment Outcomes. • Vaginal Microbiota in HIV Infected Pregnant Women. • ART Study 1: Database: Epidemiology of HIV/AIDS and Associated Comorbidities in a Public Antiretroviral Treatment (ART) Clinic at BJGMC in Pune. • TB and Pregnancy Impact of Immune Changes of HIV and Stages of Pregnancy on Tuberculosis: Nested Study on Temporal Dynamics of Gut Microbiota in HIV Infected Pregnant Women. • Maternal Inflammation, Diet and Gut Microbiome in HIV: Impact on Infant Outcomes.


wyncote program

TRAINING & COMMUNICATIONS

The work below is made possible through generous support from the Wyncote Foundation of Philadelphia, Pennsylvania. Molly Bowen | Communications Associate • Communications Strategy and Implementation • Media Relations • Message Development • Editorial and Production Management, Print and Digital Platforms Natasha Chida, MD, MSPH | Assistant Professor, CCGHE Director of Medical Education Content • Associate Director, Johns Hopkins Infectious Diseases Fellowship Program • Editor-in-Chief and Course Director, ID Clinical Minute • Moderator, Global Grand Rounds in Infectious Diseases

Maunank Shah, MD, PhD | Associate Professor of Medicine • Inventor, miDOT Directly Observed Therapy Mobile Health Application • Host, Live Monthly TB Case Conference • MDR-TB Free: Monitoring Adverse Effects, Utilizing Resources Optimally, Knowing Resistance Patterns, and Treatment Strategy • Multicenter Study of the Accuracy of the BD MAX MDR-TB Assay for Detection of M. tuberculosis Complex and Mutations Associated with Resistance to Rifampin or Isoniazid Matt Williams | Multimedia Technician • Live Video Broadcasting • Case Conference and Video Grand Rounds Recording • Multimedia Content Editing • Website and IT Support


TRAINING

education & training leadership • National Institutes of Health: Fogarty International Center Advisory Board • Consortium of Universities of Global Health Scientific Program Advisory Committee • Johns Hopkins University Faculty Advisory Committee on International Activities (FACIA) • Johns Hopkins University Task Force on Women's Academic Careers in Medicine (and founder of Fellow Subcommittee)

October 2017: Bob Bollinger Appointed to Fogarty International Center Advisory Board

CCGHE Director Dr. Bob Bollinger was appointed to the Advisory Board for the Fogarty International Center at the National Institutes of Health. Bollinger has led Johns Hopkins’ Fogarty-funded research training efforts in India since the 1990s, which have trained more than 2000 Indian clinician scientists.


mobile health technology


MOBILE HEALTH TECHNOLOGY

emocha

®

CONNECTING PATIENTS TO HEALTHCARE USING MOBILE TECHNOLOGY

First developed in 2008 by Bob Bollinger, Larry Chang, Jane-McKenzie-White, and programmer Miguel Sitjar, the emocha® Mobile Health platform is designed to keep patients connected to health care using mobile technology. miDOT, a Video Directly Observed Therapy (DOT) platform developed by Dr. Maunank Shah, garnered attention and awards in 2017.

The emocha platform was initially developed for a longitudinal study in Uganda to evaluate whether technology could help prevent HIV through targeted outreach. Dr. Chang and colleagues found that HIV prevention that includes emocha technology has population level implications, reducing new HIV infections by 42%. Findings were published in December 2017 in the New England Journal of Medicine: HIV Prevention Efforts and Incidence in HIV in Uganda. The miDOT application has streamlined the burdensome process for monitoring medication adherence among tuberculosis patients. Using a video interface, patients record themselves taking medication and report any side effects. They upload the video to a HIPPA-compliant secure server maintained by the health department, and officials then approve videos, and can use the interface to send patient reminders and important health messaging. miDOT is now connecting patients with health monitoring and services for a wide variety of issues, including TB, HIV, Hepatitis C, and, most recently, Opioid Use Disorder. In 2017 the US Centers for Disease Control and Prevention highlighted the platform’s utility in maintaining continuity of care for TB patients during recent hurricanes Harvey (Texas) and Maria (Puerto Rico). 2017 News • Notes from the Field: Use of Asynchronous Video Directly Observed Therapy for Treatment of Tuberculosis and Latent Tuberculosis Infection in a Long-Term–Care Facility ― Puerto Rico, 2016–2017. Morbidity and Mortality Weekly Report. 2017-12-22. • Video remote monitoring for directly observed therapy stems TB outbreak in Puerto Rico. MedCityNews. 2017-12-22. • Telehealth service returns 100% TB treatment adherence during Hurricane Harvey. MD Magazine. 2017-12-19. • Notes from the Field--Tuberculosis Control Activities After Hurricane Harvey--Texas, 2017. Morbidity and Mortality Weekly Report. 2017-12-15. • 4 ways that telemedicine can address the opioid crisis. The Hill. 2017-12-01. • Technology could help opioid addicts in rural America, but a federal rule needs changing. McClatchy News. 2017-11-08. • Fighting the opioid epidemic with video. Cheddar. 2017-10-17. • Tech designed for Africa helps US fight disease, save money. Global Health Matters. 2017-10-12. • mHealth closes the gaps in medication adherence during a crisis. mHealth Intelligence. 2017-10-09. • Emocha Mobile Health expands to opioid addiction treatment. Baltimore Sun. 2017-06-23. • emocha is looking to help treat opioid addiction. Technical.ly Baltimore. 2017-06-16. • Emocha launches pilot to help recovering opioid addicts. Baltimore Business Journal. 2017-06-15. • Company tests mobile health for tuberculosis treatment. NIH News and Events. 2017-05-23.


MOBILE HEALTH TECHNOLOGY

milab CLINICAL LAB ON A CHIP

CCGHE Director Bob Bollinger is leading a multidisciplinary team of JHU experts in an international collaboration with Belgium silicon chip engineering company imec, and miDIAGNOSTICS to develop a clinical lab on a chip designed to provide diagnostic testing at the point of need. The effort is through international public-private collaboration, and the technology has the potential to radically transform healthcare. • Designed for mobile platforms: highly portable, no temperature control required, able to reach people in remote areas and people who are not ambulatory • Requires only a few drops of blood, rather than vials, to process cell, protein, nucleic acid, and small molecule samples • Provides results within minutes, without the need for a laboratory. Has potential to get patients into care quicker, and provide enormous costs savings • Potential to contribute greatly to medical resources conservation in regions where they are scarce • Potential for reporting real-time data about disease clusters and outbreaks, which can inform better and more efficient decision making about international aid and resource allocation. • During 2017, the team presented a processing technique that shows promise for counting and detecting blood cells using mobile technology.


engagement support additional publications news short film websites connect


support

ENGAGEMENT

CCGHE’s work is made possible through grants from the US and Indian governments and generous and sustained support from the Ujala Foundation, Wyncote Foundation, Persistent Systems, and the Gilead Foundation.

2.10%

5.30%

23.20%

6.10%

63.30%

Ujala Foundation and Wyncote Foundations Honored for Supporting CCGHE Work in India. L-R Bob Bollinger (CCGHE), Rajiv Gupta (Ujala Foundation) Kamla Gupta (Ujala Foundation), Amita Gupta (CCGHE), David Haas (Wyncote Foundation), Sunil Kumar (JHU University Provost), Mark Anderson (JHU Dept. of Medicine), Jane McKenzie-White (CCGHE)

Grants and Contracts Foundations and Other Sources Net Endowment Other CCGHE Funds Clinical Support and Other


ENGAGEMENT

additional publications 1. The use of clinical decision support in reducing diagnosis of and treatment of asymptomatic bacteriuria. Keller SC, Feldman L, Smith J, Pahwa A, Cosgrove SE, Chida N. Published online first December 6, 2017. 2. Antibiotic utilization and the role of suspected and diagnosed mosquito borne illness among adults and children with acute febrile illness in Pune, India. Robinson M, Kadam D, Kagal A, Khadse S, Kinikar A, Valvi C, Basavaraj A, Bharadwaj R, Marbaniang I, Kanade S, Raichur P, Sachs J, Klein E, Cosgrove S, Gupta A, Mave V. Clinical Infectious Diseases. 2017 Dec 4. 3. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016. GBD 2016 Mortality Collaborators. The Lancet. 2017 Sep 16. 4. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. The Lancet 2017 Sep 16. 5. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. GBD 2016 SDG Collaborators. The Lancet. 2017 Sep 16. 6. Healthcare access and quality index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015. GBD 2015 Healthcare Access and Quality Collaborators. The Lancet. 2017 Jul 15. 7. A qualitative study exploring factors influencing clinical decision-making for influenza-like illness in Solapur city, Maharashtra, India. Ahankari AS, Myles PR, Tsang S, Khan F, Atre S, Langley T, Kudale A, Bains M. Anthropology and Medicine. 2017 Jul 3. 8. Constituent variation in smokeless tobacco purchased in Mumbai, India. Tobacco Regulatory Science. Stepanov I, Gupta P.C, Parascandola M, Yershova K, Jain V, Dhumal G.G, Hatsukami DK. 2017 Jul.


additional publications 9. Presence of human hepegivirus-1 in a cohort of people who inject drugs. Kandathil AJ, Breitwieser FP, Sachithanandham J, Robinson M, Mehta SH, Timp W, Salzberg SL, Thomas DL, Balagopal A. Annals of Internal Medicine. 2017 Jul 4. 10. High burden of antimicrobial resistance and mortality among adults and children with community-onset bacterial infections in India. Mave V, Chandanwale A, Kagal A, Khadse S, Kadam D, Bharadwaj R, Dohe V, Robinson M, Kinikar A, Joshi S, Raichur P, McIntire K, Kanade S, Sachs J, Valvi C, Balasubramanian U, Kulkarni V, Marbianiang I, Zenilman J, Gupta A. The Journal of Infectious Diseases. 2017 Apr 15. 11. Reducing uncertainty for acute febrile illness in resource-limited settings: the current diagnostic landscape. Robinson ML, Manabe YC. American Journal of Tropical Medicine and Hygiene. 2017 Jun. 12. Patients fifty years and older attending two sexually transmitted disease clinics in Baltimore, Maryland. Tuddenham SA, Page KR, Chaulk P, Lobe EB, Ghanem KG. International Journal of Sexually Transmitted Diseases and AIDS. 2017 Mar. 13. Chilling effect? Post-election health care use by undocumented and mixed-status families. Page KR, Polk S. New England Journal of Medicine. 2017 Mar 8. 14. Vitamin A and D deficiencies associated with incident tuberculosis in HIV-infected patients initiating antiretroviral therapy in multinational case-cohort study. Tenforde MW, Yadav A, Dowdy DW, Gupte N, Shivakoti R, Yang WT, Mwelase N, Kanyama C, Pillay S, Samaneka W, Santos B, Poongulali S, Tripathy S, Riviere C, Berendes S, Lama JR, Cardoso SW, Sugandhavesa P, Christian P, Semba RD, Campbell TB, Gupta A; NWCS319 and ACTG 5175 study team. Journal of Acquired Immune Deficiency Syndromes. 2017 Feb 6. 15. Tuberculosis associated with HIV infection. Tornheim JA, Dooley KE. Microbiology Spectrum. 2017 Jan. 16. The socioecology of sexual and reproductive health care use among young urban minority males. Marcell AV, Morgan AR, Sanders R, Lunardi N, Pilgrim NA, Jennings JM, Page KR, Loosier PS, Dittus PJ. Journal of Adolescent Health. 2017 Jan 5.

ENGAGEMENT (CONTINUED)


ENGAGEMENT

news 1.

Morbidity and Mortality Weekly Report. Notes from the Field: Use of Asynchronous Video Directly Observed Therapy for Treatment of Tuberculosis and Latent Tuberculosis Infection in a Long-Term–Care Facility ― Puerto Rico, 2016–2017. 2017-12-22.

2.

MedCityNews. Video remote monitoring for directly observed therapy stems TB outbreak in Puerto Rico. 2017-12-22.

3.

MD Magazine. Telehealth service returns 100% TB treatment adherence during Hurricane Harvey. 2017-12-19.

4.

Morbidity and Mortality Weekly Report. Notes from the Field--Tuberculosis Control Activities After Hurricane Harvey--Texas, 2017. 2017-12-15.

5.

Upstarts: A Better Blood Test? JHU Engineering Impact. December 2017.

6.

The Campaign for Johns Hopkins Medicine. Celebrating Johns Hopkins Medicine's impact in India. 2017-12-13.

7.

Indiaspora Blog. Transforming India from TB Hot Zone to TB Hot Shot. 2017-12-09.

8.

MD Magazine. Combination HIV prevention reduces infections. 2017-12-01.

9.

The Hill. 4 ways that telemedicine can address the opioid crisis. 2017-12-01.

10. Medical Xpress. Male circumcision and antiviral drugs appear to sharply reduce HIV infection rate. 2017-11-29. Interagency TB Newsletter. Toward a TB-Free India. 2017-11-09. 11. The Indian Express. Mexico conference: Experts from BJ Medical College make presentations on TB, treatment. 2017-11-09. 12. McClatchy News. Technology could help opioid addicts in rural America, but a federal rule needs changing. 2017-11-08. 13. Cheddar. Fighting the opioid epidemic with video. 2017-10-17.

14. NIH: Global Health Matters. Tech designed for Africa helps US fight disease, save money. 2017-1012. 15. NIH: Global Health Matters. Four new members join Fogarty advisory board. 2017-10-12. 16. MedPage Today. Efficacy maintained in HIV regimen switch. 2017-10-10. 17. mHealth Intelligence. mHealth closes the gaps in medication adherence during a crisis. 2017-10-09.


news

ENGAGEMENT

(CONTINUED)

18. MedPage Today. Investigational flu drug a near match for oseltamivir. 2017-10-09. 19. India Abroad. Reduced Level of Disease Possible in India by the Centennial. 2017-08-22. 20. NIH: Global Health Matters. How can we encourage female leaders in global health? 2017-08-09. 21. SELF Magazine. First lesson of herpes transmission: There is pretty much no way to know who gave you herpes. 2017-08-03. 22. The New York Times. Sick and afraid, some immigrants forgo medical care. 2017-06-26. 23. The Baltimore Sun. Emocha Mobile Health expands to opioid addiction treatment. 2017-06-23. 24. Technical.ly Baltimore. emocha is looking to help treat opioid addiction. 2017-06-16. 25. Baltimore Business Journal. Emocha launches pilot to help recovering opioid addicts. 2017-06-15. 26. NIH: News and Events. Company tests mobile health for tuberculosis treatment. 2017-05-23. 27. JAMA. Fogarty International Center, a linchpin of global health research. 2017-05-17. 28. Healio. Study highlights burden of community-onset antimicrobial resistance in India. 2017-03-21. 29. ACTG Newsletter. CROI 2017 Highlighted ACTG Network Presentations. 2017-02-28. 30. The Baltimore Sun. An undercurrent of fear in Baltimore's immigrant communities. 2017-02-23.


ENGAGEMENT

short film

UNITING FOR A HEALTHIER INDIA Baltimore and India staff teamed up with Johns Hopkins Marketing and Communications to develop and produce a short film about the Indo-JHU clinical research partnership. Titled Uniting for a Healthier India, the film outlines the history of this successful collaboration and the lasting impact that the research has had on global health. The film debuted in October 2017 at CCGHE’s India Impact luncheon, at which current and prospective supporters were briefed about ongoing efforts and the vision for the future. Uniting for a Healthier India is viewable online:

https://goo.gl/oyssrx


websites Launched in July 2017, CCGHE’s new website provides a dynamic, interactive platform for information about our work and activities. Content includes all research studies, educational offerings, and technological innovations as well as staff profiles, publications, presentations, news, and events. Planned for 2018 is a robust scholars section that offers resources for students wishing to conduct field studies in low and middle income countries.

http://ccghe.net CCGHE administers content for 3 additional websites: Baltimore-Washington-India Clinical Trials Unit: http://bwictu.jhu.edu/ RePORT India: https://www.reportinternational.org/locations/india Long-Acting/Extended Release Antiviral Resource Program: https://leapresources.org/

ENGAGEMENT


ENGAGEMENT

connect by mail

Johns Hopkins Center for Clinical Global Health Education 600 North Wolfe Street | Phipps 540 Baltimore, MD 21287

by phone

t: 410-502-2032 f: 410-287-6440

by thumb

online

facebook.com/CCGHE/ @HopkinsCCGHE

http://ccghe.net


credits content & production Molly Bowen, Communications Associate

photography Kaveh Sardari, Sardari Group: www.sardari.com: • • • • • • • • •

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Miind Sonkambale • • •

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Fred Dubs, Johns Hopkins Medicine • • •

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Will Kirk, Johns Hopkins University •

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Rakai Health Sciences Program, Uganda •

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emocha Mobile Health •

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2017 Year in Review  

Johns Hopkins Center for Clinical Global Health Education's 2017 Annual Report

2017 Year in Review  

Johns Hopkins Center for Clinical Global Health Education's 2017 Annual Report