International Clinical Trials Unit

Summary

Principal Investigator: John A Bartlett
Abstract: [unreadable] DESCRIPTION (provided by applicant): The four partners in this ISAAC Unit application, Kilimanjaro Christian Medical Centre (KCMC), Kibongoto National Tuberculosis Hospital (KNTH), KIWAKKUKI and Duke University Medical Center wish to expand their studies of AIDS-associated co-infections. Tanzania is an area with extraordinary need for HIV/AIDS-related care, and is listed among the 14 countries in the President's Emergency Plan for AIDS Relief. These partners have existing research collaborations investigating AIDS-associated co-infections that have generated the preliminary data in this application. A broad spectrum of co-infections will be studied, including MTB, malaria, bacterial and non-malarial protozoa, fungi, and human papillomavirus involving the female genital tract, reflecting the diverse research expertise of the ISAAC Unit partners. Expertise in HIV viral and immune pathogenesis will offer outstanding insights into HIV/Co-Pathogen interactions. A Pediatric Scientific Program will ensure the opportunity to study age-specific co-infections, and community participation will be solicited through the Community Relations/Education Administrative Program. During year 1 of the ISAAC Unit, our goal will focus on expanding research infrastructure through training and the purchase of key laboratory equipment. Research training will be provided through didactic presentations and site monitoring by Pharmaceutical Product Development, and twinning between U.S. and Tanzanian personnel will provide ongoing support. During years 2-4 the ISAAC Unit Scientific Programs will generate concept proposals for specific research projects, and 24 concept proposals are included with this application as examples of the research creativity and capabilities of ISAAC Unit investigators. These concept proposals will be reviewed by the Principal Investigators, and with the guidance of the ISAAC Unit Scientific Advisory Committee, select proposals will be funded. Logistic assistance to ensure the efficient conduct of ISAAC Unit research will be provided by the Administrative Programs, and the Principal Investigators will hold research projects to a timeline, leading to the publication of research results. In summary, substantial research infrastructure, experience and collaboration among the four partners is currently available. Award of an ISAAC Unit will allow these partners to dramatically expand research by providing a scientific and administrative support organization, well-trained personnel for the conduct of research, laboratory equipment and research funding. [unreadable] [unreadable]
Funding Period: 2004-09-01 - 2009-08-31
more information: NIH RePORT

Top Publications

  1. pmc A randomized controlled trial of standard versus intensified tuberculosis diagnostics on treatment decisions by physicians in Northern Tanzania
    Elizabeth A Reddy
    Duke University Medical Center, Durham, NC, USA
    BMC Infect Dis 14:89. 2014
  2. pmc Changes in HIV risk behavior and seroincidence among clients presenting for repeat HIV counseling and testing in Moshi, Tanzania
    Suzanne P Fiorillo
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC, United States
    AIDS Care 24:1264-71. 2012
  3. pmc Histoplasmosis among hospitalized febrile patients in northern Tanzania
    Sarah M Lofgren
    Division of Infectious Diseases and International Health, Department of Medicine, Box 102359, Duke University Medical Center, Durham, NC 27710, USA
    Trans R Soc Trop Med Hyg 106:504-7. 2012
  4. pmc Predicting mortality for paediatric inpatients where malaria is uncommon
    Dana C Clifton
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
    Arch Dis Child 97:889-94. 2012
  5. pmc Brucellosis among hospitalized febrile patients in northern Tanzania
    Andrew J Bouley
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
    Am J Trop Med Hyg 87:1105-11. 2012
  6. pmc Prevalence of mycobacteremia among HIV-infected infants and children in northern Tanzania
    Katherine D Gray
    Duke University Medical Center, Durham, NC, USA
    Pediatr Infect Dis J 32:754-6. 2013
  7. pmc Leptospirosis and human immunodeficiency virus co-infection among febrile inpatients in northern Tanzania
    Holly M Biggs
    Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
    Vector Borne Zoonotic Dis 13:572-80. 2013
  8. pmc Chest radiography for predicting the cause of febrile illness among inpatients in Moshi, Tanzania
    S P Fiorillo
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC, USA
    Clin Radiol 68:1039-46. 2013
  9. pmc Etiology of severe non-malaria febrile illness in Northern Tanzania: a prospective cohort study
    John A Crump
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
    PLoS Negl Trop Dis 7:e2324. 2013
  10. pmc Brucellosis in low-income and middle-income countries
    Matthew P Rubach
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina, USA
    Curr Opin Infect Dis 26:404-12. 2013

Scientific Experts

  • John A Crump
  • John A Bartlett
  • L A Szczech
  • Karen H Keddy
  • Lesley E Scott
  • Elizabeth A Reddy
  • Allan R Tenorio
  • A C Tribble
  • David Haas
  • Holly M Biggs
  • Habib O Ramadhani
  • Venance P Maro
  • Grace D Kinabo
  • Anne B Morrissey
  • Julian T Hertz
  • Nathan M Thielman
  • Wilbrod Saganda
  • Susan C Morpeth
  • John F Shao
  • Humphrey J Shao
  • Malavika Prabhu
  • Sarah M Lofgren
  • Jan Ostermann
  • Dafrosa K Itemba
  • Keren Z Landman
  • O Michael Munishi
  • Levina J Msuya
  • Dana C Clifton
  • Antipas Mtalo
  • Anna Mgonja
  • Matthew P Rubach
  • Katherine D Gray
  • Renee L Galloway
  • S P Fiorillo
  • Sarah Cleaveland
  • Isaac A Afwamba
  • Ann M Buchanan
  • Andrew J Bouley
  • Suzanne P Fiorillo
  • Jecinta J Onyango
  • Ben Amos
  • Werner Schimana
  • Meghan M Shorter
  • L G Tillekeratne
  • Feng Gao
  • Fangping Cai
  • Rune Philemon
  • George Mtove
  • Rebecca Lester
  • Hugh Reyburn
  • Behzad Nadjm
  • Jim E Todd
  • V P Maro
  • W Saganda
  • H O Ramadhani
  • Godfrey S Mushi
  • B N Njau
  • Coleen K Cunningham
  • Joanne P Sharp
  • Annie B Morrissey
  • Duy M Bui
  • G D Kinabo
  • P C Goodman
  • M S Mwako
  • A B Morrissey
  • Florian Marks
  • Jo E B Halliday
  • H C Diefenthal
  • Shiqin Howe
  • Helmut C Diefenthal
  • L Joseph Wheat
  • Emily J Kirsch
  • Boniface N Njau
  • Eng Eong Ooi
  • Angelia Chow
  • Robyn A Stoddard
  • Wen Yan Lim
  • Duane J Gubler
  • Nathan Thielman
  • Robert F Massung
  • Jeffrey Wilkinson
  • Bernard Njau
  • Aubree J Roche
  • Dafrosa Itemba
  • Lindsay D Oliver
  • Bariki McHome
  • Sabina Mtweve
  • Keren Landmann
  • William L Nicholson
  • Gilbert J Kersh

Detail Information

Publications46

  1. pmc A randomized controlled trial of standard versus intensified tuberculosis diagnostics on treatment decisions by physicians in Northern Tanzania
    Elizabeth A Reddy
    Duke University Medical Center, Durham, NC, USA
    BMC Infect Dis 14:89. 2014
    ..This study sought to determine the impact of providing mycobacterial culture results over standard of care [unconcentrated acid-fast (AFB) smears] on management of persons with suspected tuberculosis...
  2. pmc Changes in HIV risk behavior and seroincidence among clients presenting for repeat HIV counseling and testing in Moshi, Tanzania
    Suzanne P Fiorillo
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC, United States
    AIDS Care 24:1264-71. 2012
    ..Promoting behavior change through HCT should continue to be a focus of HIV prevention efforts in sub-Saharan Africa...
  3. pmc Histoplasmosis among hospitalized febrile patients in northern Tanzania
    Sarah M Lofgren
    Division of Infectious Diseases and International Health, Department of Medicine, Box 102359, Duke University Medical Center, Durham, NC 27710, USA
    Trans R Soc Trop Med Hyg 106:504-7. 2012
    ..Histoplasmosis is an important cause of febrile illness in Tanzania but is rarely considered in the differential diagnosis. Increased clinician awareness and availability of reliable diagnostic tests may improve patient outcomes...
  4. pmc Predicting mortality for paediatric inpatients where malaria is uncommon
    Dana C Clifton
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
    Arch Dis Child 97:889-94. 2012
    ..As the proportion of children living low malaria transmission areas in sub-Saharan Africa increases, approaches for identifying non-malarial severe illness need to be evaluated to improve child outcomes...
  5. pmc Brucellosis among hospitalized febrile patients in northern Tanzania
    Andrew J Bouley
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
    Am J Trop Med Hyg 87:1105-11. 2012
    ..Brucellosis is an underdiagnosed and untreated cause of febrile disease among hospitalized adult and pediatric patients in northern Tanzania...
  6. pmc Prevalence of mycobacteremia among HIV-infected infants and children in northern Tanzania
    Katherine D Gray
    Duke University Medical Center, Durham, NC, USA
    Pediatr Infect Dis J 32:754-6. 2013
    ..We found no cases of mycobacteremia among 93 ill, HIV-infected children in northern Tanzania, despite optimization of laboratory methods and selection of patients thought to be at highest risk for disseminated infection. ..
  7. pmc Leptospirosis and human immunodeficiency virus co-infection among febrile inpatients in northern Tanzania
    Holly M Biggs
    Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
    Vector Borne Zoonotic Dis 13:572-80. 2013
    ..Leptospirosis and human immunodeficiency virus (HIV) infection are prevalent in many areas, including northern Tanzania, yet little is known about their interaction...
  8. pmc Chest radiography for predicting the cause of febrile illness among inpatients in Moshi, Tanzania
    S P Fiorillo
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC, USA
    Clin Radiol 68:1039-46. 2013
    ..To describe chest radiographic abnormalities and assess their usefulness for predicting causes of fever in a resource-limited setting...
  9. pmc Etiology of severe non-malaria febrile illness in Northern Tanzania: a prospective cohort study
    John A Crump
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
    PLoS Negl Trop Dis 7:e2324. 2013
    ..In many areas, malaria is over-diagnosed, and patients without malaria have poor outcomes...
  10. pmc Brucellosis in low-income and middle-income countries
    Matthew P Rubach
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina, USA
    Curr Opin Infect Dis 26:404-12. 2013
    ..This review describes new information regarding the epidemiology of brucellosis in the developing world and advances in diagnosis and treatment...
  11. pmc Comparing actual and perceived causes of fever among community members in a low malaria transmission setting in northern Tanzania
    Julian T Hertz
    Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
    Trop Med Int Health 18:1406-15. 2013
    ..To compare actual and perceived causes of fever in northern Tanzania...
  12. pmc Invasive Salmonella infections in areas of high and low malaria transmission intensity in Tanzania
    Holly M Biggs
    Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina
    Clin Infect Dis 58:638-47. 2014
    ..The epidemiology of Salmonella Typhi and invasive nontyphoidal Salmonella (NTS) differs, and prevalence of these pathogens among children in sub-Saharan Africa may vary in relation to malaria transmission intensity...
  13. pmc Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania
    Holly M Biggs
    Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
    PLoS Negl Trop Dis 7:e2589. 2013
    ..In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania...
  14. pmc Controlled comparison of BacT/Alert MB system, manual Myco/F lytic procedure, and isolator 10 system for diagnosis of Mycobacterium tuberculosis Bacteremia
    John A Crump
    Box 102359, Duke University Medical Center, Durham, NC 27710, USA
    J Clin Microbiol 49:3054-7. 2011
    ..4920). M. tuberculosis bacteremia was detected more rapidly in a continuously monitored liquid blood culture system, but the mean time to positivity exceeded 3 weeks...
  15. pmc Prevalence and correlates of intimate partner violence among women attending HIV voluntary counseling and testing in northern Tanzania, 2005-2008
    Malavika Prabhu
    Duke University Medical Center, Durham, NC 27710, USA
    Int J Gynaecol Obstet 113:63-7. 2011
    ..To investigate the prevalence and correlates of intimate partner violence (IPV) among women at an HIV voluntary counseling and testing (VCT) center in northern Tanzania...
  16. pmc Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania
    John A Crump
    Division of Infectious Diseases and International Health, Department ofMedicine, Duke University Medical Center, Box 102359, Durham, NC 27710, USA
    Clin Infect Dis 52:341-8. 2011
    ..few studies describe patterns of human immunodeficiency virus (HIV) co-infections in African hospitals in the antiretroviral therapy (ART) era...
  17. pmc Q fever, spotted fever group, and typhus group rickettsioses among hospitalized febrile patients in northern Tanzania
    Malavika Prabhu
    Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Duke University, Durham, North Carolina 27710, USA
    Clin Infect Dis 53:e8-15. 2011
    ....
  18. pmc Sensitivity and specificity of typhoid fever rapid antibody tests for laboratory diagnosis at two sub-Saharan African sites
    Karen H Keddy
    Enteric Diseases Reference Unit, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, South Africa
    Bull World Health Organ 89:640-7. 2011
    ..To evaluate three commercial typhoid rapid antibody tests for Salmonella Typhi antibodies in patients suspected of having typhoid fever in Mpumalanga, South Africa, and Moshi, United Republic of Tanzania...
  19. pmc Performance of nucleic acid amplification following extraction of 5 milliliters of whole blood for diagnosis of Mycobacterium tuberculosis bacteremia
    John A Crump
    Division of Infectious Diseases and International Health, Department of Medicinea and Department of Pathology, Duke University, Durham, North Carolina, USA
    J Clin Microbiol 50:138-41. 2012
    ..Of 25 samples from patients with M. tuberculosis bacteremia, 9 (36.0%) were positive and 1 (1.5%) of 66 control samples was positive by NAAT. The NAAT shows promise, but modifications should focus on improving sensitivity...
  20. pmc Chikungunya and dengue fever among hospitalized febrile patients in northern Tanzania
    Julian T Hertz
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
    Am J Trop Med Hyg 86:171-7. 2012
    ..5, P = 0.007). CHIKV infection is an important but unrecognized cause of febrile illness in northern Tanzania. DENV or other closely related flaviviruses are likely also circulating...
  21. pmc Bacteremic disseminated tuberculosis in sub-saharan Africa: a prospective cohort study
    John A Crump
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
    Clin Infect Dis 55:242-50. 2012
    ....
  22. pmc Abbott RealTime HIV-1 m2000rt viral load testing: manual extraction versus the automated m2000sp extraction
    Lesley E Scott
    University of the Witwatersrand, Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Science, 7 York Rd Parktown, Johannesburg 2000, South Africa
    J Virol Methods 172:78-80. 2011
    ..Overall, this study found no clinically relevant differences in viral load, if samples were extracted manually...
  23. pmc Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis
    Elizabeth A Reddy
    Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
    Lancet Infect Dis 10:417-32. 2010
    ..Improved clinical microbiology services and reassessment of empirical treatment guidelines that account for the epidemiology of bloodstream infections might contribute to better outcomes...
  24. pmc Microalbuminuria predicts overt proteinuria among patients with HIV infection
    L A Szczech
    Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
    HIV Med 11:419-26. 2010
    ..This study examines the association between microalbuminuria and the development of proteinuria among HIV-infected persons...
  25. pmc Evaluation of the Abbott m2000rt RealTime HIV-1 assay with manual sample preparation compared with the ROCHE COBAS AmpliPrep/AMPLICOR HIV-1 MONITOR v1.5 using specimens from East Africa
    John A Crump
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Box 102359, Durham, NC 27710, USA
    J Virol Methods 162:218-22. 2009
    ..5 assay and that the RealTime HIV-1 assay performs well on samples from East Africa...
  26. pmc Evaluation of a dried blood spot HIV-1 RNA program for early infant diagnosis and viral load monitoring at rural and remote healthcare facilities
    Sarah M Lofgren
    Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, USA
    AIDS 23:2459-66. 2009
    ..To assess technical and operational performance of a dried blood spot (DBS)-based HIV-1 RNA service for remote healthcare facilities in a low-income country...
  27. ncbi An updated systematic overview of triple combination therapy in antiretroviral-naive HIV-infected adults
    John A Bartlett
    Duke University Medical Center, Durham, North Carolina 27710, USA
    AIDS 20:2051-64. 2006
    ..To compare the effectiveness of three drug combination antiretroviral therapy (ART) in treatment-naive HIV-infected persons, and identify the predictors of responses...
  28. ncbi Detection of minor drug-resistant populations by parallel allele-specific sequencing
    Fangping Cai
    Duke Human Vaccine Institute, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
    Nat Methods 4:123-5. 2007
    ..This assay may serve as a useful tool to study drug resistance in HIV and other infectious agents...
  29. ncbi Long-term results of initial therapy with abacavir and Lamivudine combined with Efavirenz, Amprenavir/Ritonavir, or Stavudine
    John A Bartlett
    Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
    J Acquir Immune Defic Syndr 43:284-92. 2006
    ..To compare alternative class-sparing antiretroviral regimens in treatment-naive subjects...
  30. ncbi Pharmacogenetics of nevirapine-associated hepatotoxicity: an Adult AIDS Clinical Trials Group collaboration
    David W Haas
    Microbiology and Immunology, Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee 37203, USA
    Clin Infect Dis 43:783-6. 2006
    ..Among participants in a randomized study in South Africa (FTC-302), MDR1 3435C-->T was significantly associated with decreased risk of hepatotoxicity (risk ratio, 0.30; P=.016)...
  31. ncbi Generic and branded drugs for the treatment of people living with HIV/AIDS
    John A Bartlett
    Division of Infectious Disease and International Health, Duke University Medical Center, Durham, North Carolina 27710, USA
    J Int Assoc Physicians AIDS Care (Chic) 6:15-23. 2007
    ..Generic drugs have the potential to cause harm if rigorous standards for their use are not followed, but those that are qualified offer great promise in the treatment of HIV/AIDS...
  32. ncbi Antiretroviral treatment literacy among HIV voluntary counseling and testing clients in Moshi, Tanzania, 2003 to 2005
    Keren Z Landman
    Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina 27710, USA
    J Int Assoc Physicians AIDS Care (Chic) 6:24-6. 2007
    ..Previous HIV testing was protective against low antiretroviral treatment literacy. These results support refocusing HIV education efforts and increasing synergy between HIV prevention and treatment programs...
  33. ncbi Comparative efficacy of nucleoside/nucleotide reverse transcriptase inhibitors in combination with efavirenz: results of a systematic overview
    John A Bartlett
    Duke University Medical Center, Durham, North Carolina 27710, USA
    HIV Clin Trials 8:221-6. 2007
    ..However, the nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) components may also affect efficacy...
  34. ncbi Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania
    Habib O Ramadhani
    Kilimanjaro Christian Medical Centre, Tumaini University, Moshi, Tanzania
    Clin Infect Dis 45:1492-8. 2007
    ..Access to antiretroviral therapy is rapidly expanding in sub-Saharan Africa. Identifying the predictors of incomplete adherence, virologic failure, and antiviral drug resistance is essential to achieving long-term success...
  35. pmc Effect of trimethoprim-sulfamethoxazole prophylaxis on antimicrobial resistance of fecal Escherichia coli in HIV-infected patients in Tanzania
    Susan C Morpeth
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
    J Acquir Immune Defic Syndr 47:585-91. 2008
    ..Trimethoprim-sulfamethoxazole (SXT) reduces morbidity and mortality among HIV-infected persons in Africa, but its impact on antimicrobial resistance is of concern...
  36. pmc Invasive disease caused by nontuberculous mycobacteria, Tanzania
    John A Crump
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
    Emerg Infect Dis 15:53-5. 2009
    ..avium complex sequevar MAC-D. Invasive NTM disease is present in HIV-infected patients in sub-Saharan Africa...
  37. pmc Global trends in typhoid and paratyphoid Fever
    John A Crump
    Enteric Diseases Epidemiology Branch, National Center for Zoonotic, Vectorborne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
    Clin Infect Dis 50:241-6. 2010
    ..enterica serotype Typhi and S. enterica serotype Paratyphi A confirms their place as monomorphic, human-adapted pathogens vulnerable to control measures if international efforts can be redoubled...
  38. pmc Early versus delayed fixed dose combination abacavir/lamivudine/zidovudine in patients with HIV and tuberculosis in Tanzania
    Humphrey J Shao
    Kilimanjaro Christian Medical Centre, Moshi, Tanzania
    AIDS Res Hum Retroviruses 25:1277-85. 2009
    ..ABC/3TC/ZDV was well tolerated and resulted in steady immunologic improvement. Rates of virologic suppression were similar between early and delayed treatment strategies with triple nucleoside regimens when substitutions were allowed...
  39. ncbi Successes, challenges, and limitations of current antiretroviral therapy in low-income and middle-income countries
    John A Bartlett
    Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
    Lancet Infect Dis 9:637-49. 2009
    ..There is also a need for more randomised controlled studies to identify the long-term outcomes, cost-effectiveness of ART, and use of virological monitoring in LMICs...
  40. pmc Missed opportunities for diagnosis of tuberculosis and human immunodeficiency virus co-infection in Moshi, Tanzania
    A C Tribble
    Duke University Medical Center, Durham, North Carolina, USA
    Int J Tuberc Lung Dis 13:1260-6. 2009
    ..A community-based voluntary counseling and testing (VCT) center in Moshi, Tanzania...
  41. pmc Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up in Moshi, Tanzania
    Meghan M Shorter
    Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
    J Acquir Immune Defic Syndr 52:648-54. 2009
    ..We evaluated changes in characteristics of clients presenting for voluntary counseling and testing (VCT) before and during care and treatment center (CTC) scale-up activities in Moshi, Tanzania, between November 2003 and December 2007...
  42. pmc Invasive non-Typhi Salmonella disease in Africa
    Susan C Morpeth
    Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
    Clin Infect Dis 49:606-11. 2009
    ..Much work remains to be done to understand and control invasive non-Typhi Salmonella disease in sub-Saharan Africa...
  43. pmc Morbidity and mortality among a cohort of HIV-infected adults in a programme for community home-based care, in the Kilimanjaro Region of Tanzania (2003-2005)
    L G Tillekeratne
    Duke University Medical Center, Box 3867, Durham, NC 27710, USA
    Ann Trop Med Parasitol 103:263-73. 2009
    ....
  44. pmc Delaying a treatment switch in antiretroviral-treated HIV type 1-infected patients with detectable drug-resistant viremia does not have a profound effect on immune parameters: AIDS Clinical Trials Group Study A5115
    Allan R Tenorio
    Department of Medicine, Rush Medical College, Rush University Medical Center, 600 S Paulina Street, Chicago, IL 60612, USA
    AIDS Res Hum Retroviruses 25:135-9. 2009
    ..Delaying a treatment switch in patients with partial virologic suppression and stable CD4+ T cells does not have profound effects on immune parameters...
  45. ncbi Minimizing resistance consequences after virologic failure on initial combination therapy: a systematic overview
    John A Bartlett
    AIDS Research and Treatment Center, Duke University Medical Center, Durham, NC, USA
    J Acquir Immune Defic Syndr 41:323-31. 2006
    ..To identify optimal first-line therapies based on the rate of virologic success (VS) and the preservation of future treatment options in antiretroviral therapy (ART)-naive subjects...