Global Health Research Projects.

Global Health research spans a wide range of interrelated and complex public health topics. Please explore our current projects by their primary theme listed below. Be sure to investigate more detailed descriptions of projects that have hyperlinked project titles.  Many project areas overlap, so please explore them all.

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Childhood Pneumonia

Mobile Bedside Ultrasound for the Diagnosis of PediatricPneumonia

This project has two goals: 1) to assess the accuracy of bed-side ultrasound vs. digital xray for identifying lobar pneumonia in African children; and 2) to use artificial intelligence to automate the interpretation of ultrasound image sets as a way of diagnosing pneumonia without needing a radiologist.

Faculty/PI

Christopher Gill

Location

Zambia

 

The Zambia Pertussis/RSV Infant Mortality estimation study

This project has three goals:1) to determine the burden of fatal RSV and pertussis disease in infants; 2) to determine the burden of fatal CV19 disease across all ages; and 3) in a subset to obtain pathologic evidence, via minimally invasive tissue sampling, of CV19 disease.

Faculty/PI

Christopher Gill

Location

Zambia

 

Southern African Mother Infant Pertussis Study – Nasopharyngeal Carriage

This project has the following goals:1) to determine the proportion of pertussis infections that are asymptomatic vs. symptomatic; 2) to use those data to revise models of pertussis burden at a population level; and 3) to assess and model the impact of RSV transmission at the community level; and 4) to explore microbiomic patterns from the nasopharynx of mother infant pairs to understand patterns that correlate with clinical disease such as sepsis and pneumonia.

 

Faculty/PI

Christopher Gill

Location

Zambia

 

Point of Care Diagnostics

Technology to Improve Decision Making and Neonatal Outcomes in Special Neonatal Care Units (SNCUs) in India

There have been major improvements in childhood mortality around the world over the last 20 years, but it has been more difficult to reduce mortality of babies in the first month of life. The study is evaluating how to optimize design and use of medical equipment and point of care diagnostics to improve care of newborns in India.

Faculty/PI

Patricia Hibberd

Location

India

SARS-COV-2/HIV/TB Testing Optimization

This study supports and evaluates the implementation of optimized diagnostic networking in low- and middle-income countries through the integration of diagnostic networks across disease priorities using the open-source OptiDx software. The cost and expected outcomes of siloed diagnostic networks optimized independently for HIV and TB will be explored, and compared to the cost and impact of an integrated network to assess potential efficiencies and cost savings that can be gained through a unified approach. Finally, using a mathematical modeling approach, this study will also aim to determine optimal SARS-CoV-2 testing and screening policies to improve the use of scare testing resources in low- and middle-income countries.

Faculty/PI

Brooke Nichols

Location

Zambia, South Africa, Burkina Faso, the Gambia, Vietnam, Bangladesh; worldwide

 

Diagnostic and Prognostic Biomarkers for Bacterial Infection in Pediatric Clinical Pneumonia

Bacterial pneumonia is one of the leading causes of childhood mortality, particularly in resource-limited countries. The disease burden can be partially attributed to the lack of an accurate and reliable diagnostic test to allow promptly starting antibiotic therapy. Lack of a diagnostic test also results in accelerated resistance to available antibiotics. Previously, we identified a combination of blood inflammatory proteins that could accurately diagnose bacterial infection in Mozambican children with clinical pneumonia. We are currently validating and improving upon this combinations in Gambian children with clinical pneumonia to further start development of a point-of-care diagnostic test with partners.

Faculty/PI

Clarissa Valim

Location

The Gambia

Project SEARCH (Scanning EARs for Child Health)

We have developed a cell-phone based biometric identification system based on analysis of children’s ear morphology. We see this as a potential solution to the general challenge of identifying children over time and space.  The current in ability to do so constitutes a major barrier to the longitudinal delivery of medical care.  As part of this work, we are also assessing the accuracy of the system as children age, and exploring the relationship between ear growth, age, and weight gain over time.

Faculty/PI

Christopher Gill

Location

Zambia

Emerging Infectious Disease Surveillance and Research

GeoSentinel – The Global Surveillance Network of the ISTMH in Parternship with the CDC

This is an emerging infections global surveillance network consisting of 68 sites in 28 countries worldwide and that uses returning travelers, immigrants, and refugees as sentinel indicators of disease patterns and outbreaks. worldwide.

Faculty/PI

Davidson Hamer

Location

Global

 

BU-UL Partnership to Enhance Emerging Epidemic Virus Research in Liberia (BULEEVR)

This grant supports a training program is for Liberian Researchers to combat emerging infectious disease outbreaks, such as Ebola. Faculty at BUMC/BUSPH and the University of Liberia co-mentor trainees.

Faculty/PI

Patricia Hibberd

Andrew Henderson

Location

Liberia

 

Global Health Research Training

Fogarty Global Health Training Fellowship

This program provides mentored research opportunities to train and prepare a new cadre of health professionals in the US and LMICs in global health research by enhancing the trainees’ ability to independently plan, implement, and assess innovative clinical or operations research focused on reducing mortality and morbidity associated with HIV/AIDS and associated co-infections, NCDs including cardiovascular disease and diabetes, mental health, and MCHN. Academic partners include Harvard University (Harvard T. H. Chan School of Public Health, Harvard Global Health Institute), Boston University (Schools of Public Health and Medicine), Northwestern University (Center for Global Health, Feinberg School of Medicine) and the University of New Mexico (School of Medicine, Center for Global Health).

Faculty/PI

Davidson Hamer

Location

Bangladesh, Botswana, Ghana, India, Kenya, Nigeria, Mali, Peru, South Africa, Thailand, Uganda, Zambia

 

Health Services Research

Indlela: A nudge unit to build capacity in behavioral economics and increase HIV program effectiveness in South Africa

Indlela is the first-of-its-kind unit focused specifically on improving the effectiveness of the public sector in delivering health care and achieving better health outcomes in South Africa. In the unit’s first 3 years it will focus specifically on building capacity to expand the use of behavioral economics within HIV prevention and treatment programs in South Africa and strengthen the ability of health service delivery providers and key research institutions to develop and test contextually appropriate interventions that are informed by behavioral insights. In future years, the scope will expand beyond HIV to include other public health issues in South Africa.

Faculty/PI

Lawrence Long

Location

South Africa

 

HIV

Providence/Boston Center for AIDS Research (CFAR)

The major goals of this project are to foster HIV Research and collaborations between Brown and Boston University Developing young investigators.

Faculty/PI

Robert Horsburgh

Location

US, Ukraine, Kenya, South Africa, the Philippines

 

Dartmouth-Boston University HIV-TB Research Training for the Infectious Disease Institute at Muhimbili University of Health and Allied Sciences (MUHAS)

The major goals of this project are to train Tanzanian citizens in clinical HIV/AIDS research and to estaqblish san Infectious Dsieases Institute at MUHAS.

Faculty/PI

Robert Horsburgh

Location

Tanzania

 

Boston University’s Contributions to the Enhanced Mentor Mother Program (EMMA) Study for USG FY2021-22.

During 2014-2019, BU collaborated with the Walter Reed Project and the Kenya Medical Research Institute to complete a study titled: “Evaluating the effectiveness of implementing Option B+ under routine conditions with and without the PMTCT Patient Coordinator Program: A site-randomized impact evaluation among maternal and child health centers supported by the South Rift Valley PEPFAR program in Kenya.” The focus of this additional grant is to complete final data extraction and analysis for infant HIV testing outcomes (testing and HIV status at 18 months of age).

Faculty/PI

Bruce Larson

Location

Kenya

Location

AMBIT: Alternative Models of ART Delivery: Optimizing the Benefits 

Many high HIV-prevalence countries are scaling up differentiated service delivery (DSD) models for providing antiretroviral treatment for HIV. DSD models adjust the location, frequency, provider cadre, and other aspects of service delivery to make HIV treatment more patient-centric and more efficient. Little is known about the true impact of DSD models on the health system or patients, however. AMBIT is a research project in sub-Saharan Africa comprising synthesis of existing data, new data collection, data analysis, and modeling activities aimed at generating information for near- and long-term decision making for scaling up DSD models in Malawi, Zambia, and South Africa.

Faculty/PI

Sydney Rosen

Location

Malawi, Zambia, South Africa

Location

Retain6: Models of care for the first 6 months of HIV treatment

For HIV-positive patients in sub-Saharan Africa and globally, the first six months after initiating lifelong antiretroviral therapy (ART) pose the greatest risk of loss to follow up. Patients who make it through the first six months have a good chance of being retained on ART for the long term, but many drop out before reaching the six-month point. The Retain6 project aims to develop new models of differentiated service delivery for patients in their first six months on ART, in an effort to improve retention in care during this period.

Faculty/PI

Sydney Rosen

Location

Zambia, South Africa

 

CAB-RPV LA Implementation Strategies for High-Risk Populations.

This will be an evaluation of a new injectable antiretroviral treatment for HIV-positive individuals receiving care at the Boston University Medical Center and its associated community-based outreach clinics. It includes qualitative research on preferences of patients and providers and a randomized controlled trial to assess feasibility and impact.

Faculty/PI

Lora Sabin

Mari-Lynn Drainoni (BMC)

Location

Boston

 

Zambia Infant Cohort Study

The ZICS study will determine if antiretroviral regimens used to successfully prevent mother to child transmission of HIV have also decreased morbidity and mortality among the children born to these mothers but who, themselves, have escaped infection with HIV. If not, then further investigation of the cause of poor outcomes in these children will be necessary. We will also determine if the mother’s immune status is a determinant of poor health outcome in their uninfected children, and in their infants early immune status.

Faculty/PI

Donald Thea

Location

Zambia

 

EVIDENCE: Evaluation to Inform Decisions using Economics and Epidemiology

EVIDENCE is a 5-year HIV/AIDS project funded by PEPFAR through USAID. With the project lead in South Africa, the Health Economics and Epidemiology Research Office (HE2RO), we conduct health economics and epidemiology evaluations and provide technical assistance in support of the goals of the South African National Strategic Plan for HIV, TB and STIs (NSP) and the PEPFAR Country Operational Plan. BU faculty and staff work closely with HE2RO on project evaluations, cost modeling, outcomes research, and financial management to improve guidelines, policies, programs, and resource allocation.

Faculty/PI

Sydney Rosen

Location

South Africa

Economic Impact of HIV Policy Briefs

This project synthesises the evidence on the economic impact of HIV into a series of 17 policy briefs that can help decision-makers in ministries of finance and health in low- and middle-income countries (LMIC) decide on the future financing of their country’s HIV programme. The project incorporates a series of seminars with an academic and LMIC government staff audience aimed at refining the content and presentation of the briefs, the presentation of the evidence base to LMIC decision makers during a comprehensive workshop, and the publication of the briefs on a website and in peer-reviewed journals.

Faculty/PI

Gesine Meyer-Rath

Location

South Africa

 

infectious disease

Cryptococcal Meningitis Screening in South Africa

Cryptococcal meningitis (CM) is a fungal infection that causes infection in the brain and spinal cord. CM is a leading cause of AIDS-related deaths globally, mainly among patients with low CD4 cell counts. Through screening HIV patients with low CD4 cells counts for cryptococcal antigen (CrAg), it is possible to identify CrAg-positive patients before they develop meningitis. Treating these patients with antifungal medications can then substantially reduce risks of progression to CM and death. Through support from the CDC Foundation (May 2015 – June 2021), the purpose of this program of research has been to evaluate costs and effectiveness of alternative CrAg screening strategies and CM treatment regimens.

Faculty/PI

Bruce Larson

Location

Kenya

 

Using Behavioral Economics to Improve the Uptake of and Persistence on Pre-exposure Prophylaxis in Men Who Have Sex With Men to Prevent HIV Infection

South Africa’s HIV incidence remains high, in particular amongst populations such as men who have sex with men (MSM) who may be at increased risk. HIV pre-exposure prophylaxis (PrEP) is considered key to reducing incidence in these populations, yet pilot studies show sub optimal uptake and poor persistence amongst those most at risk. This research will focus on understanding why PrEP uptake and persistence amongst MSM in South Africa is low and how the delivery of PrEP to this population could be altered to encourage those most at risk to start treatment using behavioral insights.

Faculty/PI

Lawrence Long

Location

South Africa

 

Impact of Undernutrition on Immunity Elicited by Vaccines in the Gambia

Moderate and severe undernutrition are highly prevalent in several resource-limited countries. There is conflicting evidence on the impact of undernutrition on the immunity elicited by childhood vaccines, as well as the specific supplements that could be used to overcome vaccine hypo-responses associated with undernutrition. In a pilot project in The Gambia, we are comparing antibody vaccine responses against a panel of EPI vaccines of children with severe wasting and stunting with well-nourished children. Furthermore, through a metabolomics assay, we will assess whether specific amino acid deficiencies are associated with decreased responses in undernourished children.

Faculty/PI

Clarissa Valim

Location

The Gambia

 

Factors influencing the uptake of the tenefovir voluntary licensing in LMIC

Since 2005, millions of HIV-positive patients in low- and middle-income countries have received lifesaving antiretroviral therapy through Gilead’s voluntary licensing program for tenofovir. More recently this approach has been expanded to sofosbuvir for the treatment of Hepatitis C. To date, a rigorous evaluation has not been done to understand this process of making medicines available. To date, a rigorous evaluation has not been done to understand this process of making medicines avaailable. Boston University will be evaluating Gilead’s Global Access program over the course of 2019-2021.

Faculty/PI

Veronika Wirtz

 

IPV (intimate partner violence)

Testing the Effectiveness of an Evidence-based Transdiagnostic Cognitive Behavioral Therapy Approach for Improving HIV Treatment Outcomes among Violence-affected and Virally Unsuppressed Women in South Africa

This study will evaluate the impact of the Common Elements Treatment Approach (CETA), an evidence-based intervention comprised of cognitive-behavioral therapy elements, at improving HIV treatment outcomes among women with HIV who have experienced intimate partner violence (IPV) and have an unsuppressed viral load on HIV treatment. To evaluate CETA, we will conduct a randomized controlled trial of HIV-infected women, with or without their partners, who have experienced IPV and have an unsuppressed viral load to test the effect of CETA in increasing viral suppression and reducing violence.

Faculty/PI

Matthew Fox

Location

South Africa

 

Malaria

The Intransigence of Malaria in Malawi: Understanding Hidden Reservoirs, Successful Vectors and Prevention Failures

Under the aegis of the Malawi International Center of Excellence of Malaria Research (ICEMR) program, several cohort studies have been conducted focused on studying malaria control measures and understanding why measures such as bed nets have failed to control malaria in Malawi. Examples of these studies are the one led by Dr. Valim aiming to identify the transmission reservoir group(s) for malaria in Malawi and to assess the impact of current interventions on these human reservoirs. Another study conducted under the aegis of ICEMR aims to assess the effectiveness of the RTS,S malaria vaccine in conjunction with other malaria prophylactic measures.

Faculty/PI

Clarissa Valim

Location

Malawi

 

Maternal and Child Health

Global Network for Women’s and Children’s Health Research

The Global Network conducts observational studies and clinical trials in 8 locations in low and middle income countries in Asia, Africa and Central America. The goals of the research are (1) to evaluate whether low-cost, sustainable interventions improve maternal and child health; and (2) build local research capacity and infrastructure. Whenever possible common protocols are implemented in all 8 locations. The Boston University site works with the Lata Medical Research Foundation in Nagpur, India. The grant funds several studies.

Faculty/PI

Patricia Hibberd

Location

Global

 

Technology to Improve Decision Making and Neonatal Outcomes in Special Neonatal Care Units (SNCUs) in India

There have been major improvements in childhood mortality around the world over the last 20 years, but it has been more difficult to reduce mortality of babies in the first month of life. The study is evaluating how to optimize design and use of medical equipment and point of care diagnostics to improve care of newborns in India.

Faculty/PI

Patricia Hibberd

Location

India

 

Antimicrobial Resistance

A-PLUS Trial: Multi-site Efficacy and Safety Trial of Intrapartum Azithromycin in LMICs – AMR Sub-study and Effect of Azithromycin on the developing microbiome.

The Global Network is conducting a trial to evaluate whether Azithromycin given during labor reduces maternal and neonatal infections and mortality. This grant supports studying the effect of azithromycin on development of antimicrobial resistance and the gut and airway microbiome.

Faculty/PI

Patricia Hibberd

Location

Global

Sequencing of Klebsiella pneumoniae isolates from Zambia

Bloodstream isolates (K. pneumoniae and E. coli) from the Sepsis Prevention in Neonates in Zambia study are being sequenced to determine serotypes and antibiotic resistance characteristics.

Faculty/PI

Davidson Hamer

Location

Zambia

Non-communicable Diseases

Evidence of the burden of diabetes, gaps in the diabetes cascade-of-care and the impact of care and treatment on diabetes outcomes in HIV-positive and HIV-negative patients in South Africa

The goal of this research project is to first build a national longitudinal diabetes cohort using novel big data probabilistic linking methods to link serial hemoglobin A1c (HbA1c) and blood glucose laboratory measurements in South Africa’s National Laboratory Services (NHLS) database. This cohort will provide significant opportunities to assess patterns of diabetes laboratory screening, the burden of laboratory diagnosed diabetes, and gaps in the diabetes ‘cascade-of-care’. Furthermore, linkage with our existing national HIV and tubercolosis (TB) cohorts, created with the same record linking methods, will enable assessment of the impact of these co-epidemics on heath outcomes.

Faculty/PI

Alana Brennan

Location

South Africa

 

Assessing the effects of HIV disease on dysglycemia in a cohort of tuberculosis patients in South Africa’s Western Cape

Our planned research will focus on compare rates of dysglycemia (both hyperglycemia and hypoglycemia) in people living with HIV (PLWH) and HIV-uninfected persons receiving tuberculosis (TB) treatment using pilot data from the The Impact of Alcohol Consumption on TB Treatment Outcomes (TRUST) Study. HbA1c’s were only collected at enrollment the TRUST. As such, we will collect blood samples to measure HbA1c and blood glucose levels at patients 18-month study visit. This will allow us to assess changes in blood glucose levels from study enrollment by HIV status. Second, we will assess the role stress and inflammation play in relation to blood sugar levels in PLWH and HIV-uninfected individuals. Research suggests that the hosts immune response to active TB and/or HIV disease results in a prolonged state of systemic inflammation which can have negative metabolic effects. We will collect samples to measure markers of stress and inflammation at the 18-month study visit when all patients will be one year post TB treatment completion and when transient hyperglycemia due to TB infection should be resolved. This will be preliminary data to assess if there are differences in these specific stress and inflammatory markers post TB treatment amongst PLWH and HIV-uninfected individuals and potentially identify underlying mechanism(s) causing abnormal blood sugar levels.

Faculty/PI

Alana Brennan

Location

South Africa

 

Programme Evaluation of Timor-Leste PEN-HEARTS Intervention

This project will evaluate early implementation in Timor-Leste of PEN-HEARTS, a community-based intervention supported by the WHO designed to improve health outcomes among individuals with non-communicable diseases such as diabetes. Building on a similar evaluation in Bhutan, a BU team of faculty and students will design and implement the evaluation with WHO and Ministry of Health officials in Timor-Leste. The evaluation will use mixed methods and involve data collection in both intervention and comparison sites in four districts of Timor-Leste.

Faculty/PI

Lora Sabin

Location

Timor-Leste

 

Evaluation of Novartis Access in Kenya

Sandoz International GmbH No No – a website already exist: Boston University was evaluating Novartis Access, a social business program to increase access to medicines for non-communicable diseases (NCDs) through the direct sale of NCD medicines to governments and other public-sector customers in low and lower middle income countries.What makes this evaluation unique? Use of multiple complementary methods such as: Cluster-randomized controlled trial, Serial qualitative interviews, Telephonic monitoring as an input into the evaluation.

Faculty/PI

Veronika Wirtz

 

Pharmaceutical Policy

Access Observatory

The Access Observatory (accessobservatory.org) is a public reporting platform for programs that aim to improve access to disease prevention and treatment services in low- and middle-income countries (LMICs). Programs in the Access Observatory focus on more than just medicines and include strategies to strengthen health systems and influence patient behaviors. The Access Observatory was created within the scope of Access Accelerated, a collaboration of more than 20 biopharmaceutical companies, working in partnership with the World Bank, the City Cancer Challenge (C/Can 2025) and others, that is committed to tackling the growing burden of non-communicable diseases in LMICs.

Faculty/PI

Peter Rockers

Location

global

 

Medicines, Technologies, and Pharmaceutical Services

The Medicines, Technologies and Pharmaceutical Services (MTaPS) project aims to strengthen pharmaceutical systems in low and middle income countries. Boston University is a core partner of the USAID funded MTaPS project led by Management Sciences for Health. The objectives are (1) to generate evidence on the development, implementation and strengthening of data management that can support decision-making in pharmaceutical systems; (2) to develop, implement and evaluation accountability mechanisms in pharmaceutical systems.

Faculty/PI

Veronika Wirtz

 

Amgen Access Metrics

The Sustainable Development Goals (SDGs), specifically SGD 17, recognize the specific responsibility of the private sector in contributing to global social aims. The pharmaceutical industry has a special role to play in contributing to the SDGs because their products have a direct impact on the health and well-being of populations. Part of this responsibility involves documenting their contributions in a methodologically sound and transparent manner. Boston University is supporting Amgen in developing and implementing a tailored social analytics toolkit to facilitate measurement and reporting for the company’s access programs. Social Analytics are a set of tools and methods for understanding and measuring social aspects of private industry-led programs.

Faculty/PI

Veronika Wirtz

 

Tuberculosis

Methods to estimate the impact of interventions on the transmission and incidence of tuberculosis

The major goals of this project are to develop models that can be used to monitor the success of TB interventions.

Faculty/PI

Robert Horsburgh

Location

US, Brazil

 

Predictors of Resistance Emergence Evaluation in MDR-TB Patients on Treatment.

The major goals of this project are to identify microbiologic and pharmacokinetic factors that lead to the emergence ot resistance to TB drugs during treatment.

Faculty/PI

Robert Horsburgh

Location

US, India, Brazil

 

RePORT India Consortium

The major goal of this project is to collaborate with partners in India in clinical studies of tuberculosis infection and disease.

Faculty/PI

Robert Horsburgh

Location

US, India

 

Transmission of Tuberculosis among illicit drug use linkages

The goal of this project is to assess the risk for TB transmission between persons who smoke drugs.

Faculty/PI

Robert Horsburgh

Location

Us, South Africa

 

Prevention Policy Modeling Lab

The Goal of this Project is to develop cost-effectiveness models for TB prevention.

Faculty/PI

Robert Horsburgh

Location

US

 

DRAMATIC Phase 2 Duration Randomized MDR-TB Treatment Trial

The major goal of this project is to identify a shorter, less toxic treatment for MDR-TB.

Faculty/PI

Robert Horsburgh

Location

US, Vietnam, the Philippines

 

Veterans health

Bridging the Care Continuum for Vulnerable Veterans across VA and Community Care (BridgeCC) QUERI Program

Led by investigators at the Bedford VA, this project is implementing three evidence-based practices (EBPs) that aim to improve coordinated care between VA and non-VA providers to improve the health of veterans. The EBPs focus on 1) homeless overdose prevention expansion; 2) maintaining independence and sobriety through systems integration and outreach; and 3) post-incarceration engagement to increase social support. Dr. Sabin is guiding the costing components for each EBP.

Faculty/PI

Lora Sabin

Location

Boston