ICAP News - April/May 2007

Featured in this issue are stories about a number of new capacity-building initiatives to support HIV/AIDS prevention, care, and treatment programs throughout Africa, including a clinical mentorship network, an advanced nursing certificate program in HIV/AIDS clinical management, and trainings for healthcare providers and laboratory technicians in the Dried Blood Spot method for early-infant diagnosis of HIV.

Ethiopia First Lady Headlines Pediatric AIDS Conference
On April 12-13, Ethiopia’s First Lady–Her Excellency, Mrs. Azeb Mesfin–joined more than 100 government officials, pediatricians, and other experts at the second national conference on pediatric HIV/AIDS in Addis Ababa, co-hosted by ICAP, U.S. Centers for Disease Control and Prevention Ethiopia, and Ethiopia’s Federal Ministry of Health (FMOH). The conference examined achievements over the past year in expanding pediatric HIV/AIDS care and treatment in Ethiopia and considered strategies for bringing HIV/AIDS services to more children. Although the number of Ethiopian children receiving antiretroviral treatment has increased substantially since last year, more than 60,000 children still urgently need antiretroviral therapy. ICAP is partnering with FMOH to accelerate access to pediatric HIV/AIDS care and treatment throughout the country. ICAP has also played a key role in the initiation of early infant diagnosis services in Ethiopia, and provides intensive site-level implementation support for pediatric care and treatment at 35 hospitals and two health centers.

Photo: Ethiopia’s First Lady–Her Excellency, Mrs. Azeb Mesfin (right)–meets with ICAP-Ethiopia Country Director Zenebe Melaku (center) and Dr. Tsehaynesh Messele, Director, Ethiopian Health and Nutrition Research Institute.
More information about ICAP Ethiopia can be found here.

Stephen Lewis Foundation Supports New Initiative to Build Clinical Mentorship Programs at ICAP-Supported Sites
A new two-year grant from The Stephen Lewis Foundation is supporting the development of clinical mentorship programs at ICAP-supported sites in Africa. Under the capacity-building initiative, staff from the ICAP Clinical Unit and two MTCT-Plus Initiative sites in Uganda will lead introductory workshops in August and November in Kampala, Uganda, on how to use clinical mentorship to facilitate delivery of the multidisciplinary, family-focused model of HIV/AIDS prevention, care, and treatment. In 2008, participants will return to Kampala to discuss successes, challenges, and lessons learned in implementing the model at their sites. The program will also enable ICAP country teams to begin a cross-continent HIV/AIDS clinical mentorship network in Africa. Stephen Lewis is the former United Nations Special Envoy for HIV/AIDS in Africa. For more information, email kd2008@columbia.edu.

South Africa Inaugurates Advanced Nursing Certificate Program in HIV/AIDS Clinical Management
On April 23, ICAP joined with the University of Fort Hare and Stellenbosch University in inaugurating South Africa’s first post-basic certification program in HIV/AIDS clinical management for professional nurses. The one-year program, which includes training in antiretroviral therapy (ART) management, consists of classroom instruction, clinical practicum, and distance learning components. The program’s first class includes 23 professional nurses with HIV/AIDS clinical experience, including work in primary health care, in-patient pediatric wards, and hospital-based ART clinics. In 2008, ICAP and its university partners plan to offer a research master’s degree in HIV/AIDS clinical management for nurses. In addition to the nursing certification program, ICAP supports a nurse mentoring initiative, among other capacity-building activties.

Photo: During a classroom exercise, Dr. Jantjie Taljaard (left) of Stellenbosch University teaches students how to conduct a comprehensive neurological examination
More information about ICAP South Africa can be found here.

ICAP Supports Decentralization of HIV/AIDS Oncology Services in Tanzania
In April, ICAP began providing technical support to the Tanzania Ministry of Health and Social Welfare (MOH) and The National Cancer Referral Hospital at Dar es Salaam's Ocean Road Cancer Institute on planning the decentralization of HIV/AIDS oncology services from Ocean Road to four additional hospitals throughout the country. As part of the initiative, ICAP consultant Donald Abrams, MD, Professor of Clinical Medicine at the University of California at San Francisco and Chief of the Division of Hematology and Oncology at San Francisco General Hospital, visited Bugado Medical Centre, where HIV/AIDS oncology services will be instituted during the first phase of service expansion. Abrams, a recognized expert in HIV-associated malignancies, will help ICAP develop guidance for the MOH on the design of national treatment guidelines for HIV/AIDS-related malignancies, including Kaposi’s sarcoma and cervical cancer, as well as the development of training curricula and service delivery tools for healthcare providers. Abrams has served as a consultant to ICAP programs in Tanzania and Mozambique since 2006. He provides ongoing clinical mentoring to physicians in both countries on the management of HIV/AIDS-related malignancies.

Photo: Dr. Donald Abrams
More information about ICAP Tanzania can be found here.

Doris Duke Grant Supports Study of Food Supplementation for Patients Initiating Antiretroviral Therapy in Kenya
The Doris Duke Charitable Foundation has awarded ICAP Director Wafaa El-Sadr, MD, MPH, a two-year Operations Research Grant to study the effect of food supplementation on patients initiating antiretroviral therapy (ART) in Kenya. While ART has drastically improved health and well-being, HIV-infected people in resource-limited settings, particularly sub-Saharan Africa, suffer from high rates of malnutrition. Insufficient food intake can hasten disease progression and lead to death. In the proposed study, which will be conducted of patients initiating ART at two health facilities in Kenya’s Central Province, El-Sadr with colleagues and in-country partners will compare nutritional, clinical, and immunological outcomes between those who take food and micronutrient supplements to those who receive standard of care with only micronutrient supplements. The Doris Duke Operations Research on AIDS Care and Treatment in Africa Program seeks to help improve the care and treatment of HIV-infected people in resource-limited settings, inform ART policy and practice, and improve outcomes of the roll-out and scale-up of ART in Africa.

Lesotho Training Program Focuses on Improving Quality of HIV/AIDS Care
As part of its ongoing support for improved quality of HIV/AIDS care and treatment at Lesotho hospitals, ICAP co-sponsored an April 18-20 follow-up training for 50 healthcare providers from Butha Buthe Hospital focusing on prevention of mother-to-child transmission (PMTCT) of HIV, MTCT plus care and treatment, and pediatric HIV/AIDS care and treatment. Specific topics examined included HIV counseling and testing, follow-up of HIV-exposed infants, early-infant diagnosis, and engaging children in care and treatment. The Elizabeth Glaser Pediatric AIDS Foundation and the Baylor International Pediatric AIDS Initiative collaborated with ICAP on the follow-up training, which will be repeated at other ICAP-supported sites over the coming months.

More information about ICAP Lesotho can be found here.


Infant Diagnosis Trainings Conducted at Nigeria Healthcare Facilities
In April, ICAP and the Nigeria Ministry of Health led a week-long training program on infant diagnosis of HIV using Dried Blood Spot (DBS) DNA PCR testing for 31 laboratory technicians and healthcare providers from four hospitals in Kaduna State, Nigeria. In the training, participants learned about collecting, transporting, and processing DBS specimens. Additional trainings are planned at six more ICAP-supported sites. In addition to supporting DBS trainings and supervising collection of DBS samples, ICAP has developed a training module for healthcare personnel who collect DBS samples on pre- and post-test counseling of families of HIV-exposed infants.

More information about ICAP Nigeria can be found here.

Justman Surveys HIV/AIDS Clinical Research in Resource-Limited Settings at Rwanda Conference
Jessica Justman, MD, Director of ICAP’s University Technical Assistance Program, delivered a March 29 presentation titled “HIV Prevention, Care, and Treatment in Resource-Limited Settings: Selected Updates from Recent Clinical Trials” to the Third National Conference on HIV and AIDS in Kigali, Rwanda. In her presentation, Justman surveyed new data on prevention of mother-to-child transmission of HIV, management of HIV/tuberculosis co-infection, and treatment approaches to HIV/AIDS. Attending the conference were officials from the Government of Rwanda Ministry of Health and Commission Nationale de Lutte contre le Sida (CNLS), U.S. Centers for Disease Control and Prevention, the Joint United Nations Programme on HIV/AIDS, World Bank, academic and non-governmental organizations.

Satellite Radio Program Features ICAP
In April, Reach MD, a new XM satellite radio station for medical professionals, interviewed Miriam Rabkin, MD, Director of ICAP Programs in Ethiopia and Nigeria, for a clinicians’ roundtable segment on HIV/AIDS care and treatment.