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Models for Training/Maintaining the Global Health Workforce: Patrick Duffy
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Models for Training/Maintaining the Global Health Workforce: Patrick Duffy

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This session will focus on different model programs incorporating novel techniques to optimize training of health workers. Discussion will include the realities of “brain drain,” health worker ...

This session will focus on different model programs incorporating novel techniques to optimize training of health workers. Discussion will include the realities of “brain drain,” health worker migration, and maintaining a vibrant health workforce.

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  • Thanks to the organizers of this interesting meeting for the invitation to participate. I am going to talk about strategies and progress towards a vaccine that would protect pregnant mothers and their babies from the sequelae of malaria. I will start this talk with this image of an infected placenta, because it illustrates many features of pregnancy malaria. To orient those of you who are not familiar with placental sections, the projections of tissue that you see here are chorionic or fetal villi. In the spaces between the villi are the maternal blood cells. The black spots that you see here represent parasites infecting red cells, and as you can see the parasitemia in the placenta can achieve high density. Placental malaria is often accompanied by an inflammatory infiltrate, and you may be able to appreciate the large macrophages in the intervillous spaces here. Many of the macrophages contain pigment, which is the product that remains after the parasite digests hemoglobin. Recent studies have suggested that the inflammatory response to placental malaria may play a key role in the development of sequelae. You should also appreciate that despite the high density of parasites in the maternal blood spaces, there are no parasites detected in the fetal blood. Congenital malaria does occur, but it has generally been thought to be uncommon. However, recent studies using PCR on cord blood have suggested that congenital infection may be fairly common, and so the issue remains unsettled until we have more data. This image of placental malaria, by the way, is the oldest I could find in the world literature. It was drawn by Samuele Sereni in 1902. Sereni was working with some of the great Italian malariologists of that era, who were asking whether congenital malaria occurred or not.

Models for Training/Maintaining the Global Health Workforce: Patrick Duffy Models for Training/Maintaining the Global Health Workforce: Patrick Duffy Presentation Transcript

  • Malaria in Pregnant Women and Children: Research and Training in East Africa
  • Facilities Malaria in Pregnant Women and Children
  • Mother-Offspring Malaria Studies (MOMS): The MOMS Project
    • Ongoing longitudinal birth cohorts in Tanzania
    • Enrollment at delivery: >=16 years, no chronic disease
    • Malaria diagnosis made at delivery
      • placental blood  % parasitized RBC
      • 12% prevalence of infection
    • Children followed for 4 years
      • Biweekly for year 1
      • Monthly for years 2-4
      • Treated for all illnesses
  • Field Research in Tanzania
    • We perform field research involving human subjects in Muheza and Morogoro, Tanzania.
    • Our staff and salary policies are aligned with those of other research projects that are working at the site.
    • Hiring and staff administration is performed under subcontracts to the Muheza Designated District Hospital and Morogoro Regional Hospital.
  • MOMS Research Laboratory – Muheza $21,000
  • Establish Clinical Research Lab Pediatric hospitalization series Birth cohort Under-fives cohort Oct 05 Jan 06 Jun 06 Sep 06 Oct 10 MOMS in Morogoro Timeline Establish Genome Science Center Delivery hospitalization series
  • A New Site: Morogoro, October 2005 Microscopy suite Computer network Laboratory
  • MOMS Clinical Research Laboratory Research lab Sterile culture Genome Sciences Center
  • Training Malaria in Pregnant Women and Children
  • Capacity Building IMRTP (FIC/NIH) GCGH Graduate students Annual workshops
  • Academic network Graduate students Egerton U. Tumaini U. U. DSM Sokoine U.
  • MOMS PROJECT TRAINEES 2003-2008 Mwangoka MSc, SUA awarded SCIENTIST, IHI kabyemela Phd, KCMC Lecturer, MUHAS awarded chilongola, phd, sua SCIENTIST, KCMC awarded Marandu, MSc, UDSM Lecturer, UDSM awarded 6 graduate students currently in program gwamaka, phd, sua SCIENTIST, SUA awarded siwo, msc, egerton PHD NOTRE DAME awarded
  • Themed workshops Annual workshops
    • 2002: Protozoa
    • 2003: Drug resistance
    • 2004: Pregnant host
    • 2005: Vaccines
    • 2006: Drugs
    • 2007: Functional genomics
    • 2008: Cell biology
  • Workshop features Annual workshops
    • Competitive selection
      • Advertised
    • International faculty
      • East African
      • International
    • Intensive mentoring
      • 1:2 faculty-student ratio
    • Hands on lab skills
      • Wet lab
      • Dry lab
    • Proposal development
  • Benefits of Research Training
    • Conduit for technology transfer
    • Strengthens academic institutions
    • Magnet for innovators and professionals
    • Enhances clinical practice in host centers
    • Indigenous solutions to endemic problems
    • Mentors future leaders
  • Funding Gates Foundation NIAID/NIH Grand Challenges in Global Health/ Foundation for NIH Fogarty Int’l Center