GHES U.S. Fellow 2015-2016 | 2016-2017
Fellowship Site: Fluminense Federal University, Rio de Janeiro, Brazil
U.S. Institution: UC Berkeley
Project 1 Title: Biomarkers to track tuberculosis treatment response in pediatric, adolescent, and young adult patients with and without HIV.
In 2014, the WHO estimated that almost 9 million people developed tuberculosis (TB), and an additional 1.5 million succumbed to the infection, making it one of the world’s deadliest communicable diseases. The main steps to tuberculosis control are early diagnosis and proper treatment. However, standard techniques, including sputum microscopy and culture, are inadequate in children because pediatric patients often don’t produce sputum and have paucibacillary TB, resulting in false-negative results. Recent work has shown that antibodies against certain Mycobaterium tuberculosis lipids decrease in adults undergoing treatment for TB. In our study, we will evaluate the use of these antibodies as biomarkers for monitoring treatment of children with TB. In collaboration with 6 clinics in Rio de Janeiro and Recife, we will collect blood from clinically-diagnosed pediatric TB patients at the start of treatment and after one, two and six months (end of treatment). Using enzyme-linked immunosorbent assays (ELISAs), we will quantify anti-TB lipid antibodies in the blood at each of these time points to determine if they serve as reliable markers of treatment success in children. This assay has the potential to provide a rapid, inexpensive method for monitoring TB treatment in children, decreasing disease burden, reducing transmission rates, and slowing the development of drug resistant TB strains.
Project 2 Title: Development outcomes associated with congenital Zika infection
Since early 2015, when the first case of Zika virus (ZIKV) infection was identified in Brazil, between 500,000 and 1,500,000 cases were diagnosed in the country. By October 2015, Brazilian doctors had begun reporting a significant increase in the number of cases of microcephaly in newborns. In the following months, the number of microcephaly cases continued to rise, reaching almost 3000 cases by the end of the year. Various reports have served to strengthen the correlation between congenital ZIKV infection, however several questions remain unanswered. In addition to microcephaly, there is evidence that congenital ZIKV infection is associated with other diseases of the nervous system, but the spectrum and magnitude of these diseases remain uncertain. Additionally, it is unclear why only some babies born to ZIKV infected women show developmental abnormalities. In response to this epidemic of unknown proportions, clinicians and public health officials in Niteroi, Brazil have joined forces to create a citywide cohort of all pregnant women suspected of ZIKV infection, along with any baby born with microcephaly, to evaluate the range of developmental outcomes associated congenital infection. To better track the impact of congenital ZIKV infection, Kate is coordinating data collection from the congenital Zika clinic. This data will be used to quantify the various developmental outcomes associated with ZIKV infection, determine susceptible populations, and identify any correlation between infection time and outcome. The results of this study aim to not only improve treatment of babies impacted by congenital ZIKV infection, but also inform future planning of Zika infection prevention measures.