Training Years: 2015-2016
Training Site: UNC Project- Malawi
Mentor: Mina Hosseinipour, MD, MPH; Saeed Ahmed, MD
Title: Evaluating the feasibility and impact of community health worker-driven intensified case finding on tuberculosis case finding and treatment among HIV-infected pregnant women enrolled in Option B+ in central Malawi
Project Objectives: We propose expanding the TB incomplete intensified case finding (ICF) pilot to target HIV-infected pregnant women enrolling in the Option B+: ART safety and durability during first and subsequent pregnancies study at the three PMTCT services sites supporting the study (Area 25 Health Center, Area 18 Health Center, Kawale Health Center). In addition to providing key operational data on the performance of the TB ICF pilot among HIV-infected pregnant women in Malawi, this study will complement the study aim to assess the long-term durability of Option B+ by more rigorously identifying incident TB in the study population.
Aim 1: To evaluate the impact of Community Health Worker (CHW)-driven ICF and Xpert analysis of sputum specimens on TB case finding, time to anti-TB therapy (ATT) initiation, and TB treatment outcomes (cure, treatment completion, death, default, and treatment failure) among HIV-infected pregnant women enrolled in the S4 study.
Aim 2: To describe the feasibility and acceptability of CHW-driven ICF for TB delivered at antenatal care (ANC) service delivery.
Aim 3: To generate hypotheses regarding the impact of the ICF intervention on neonatal TB incidence, vital status at delivery, HIV acquisition risk, along with infant growth and neurodevelopment.
Aim 4: To generate hypotheses on possible clinical, demographic, and socioeconomic factors associated with prevalent TB in an Option B+ program in Malawi.
NIH Support: Fogarty fellowship doctoral training award