RESEARCH Ohio, Uganda partners fight TB in AIDS victims

Case Western Reserve has long been involved in the Uganda project.
CLEVELAND (AP) -- A long-running collaboration involving an Ohio medical school and the AIDS epidemic in Africa has focused on tuberculosis, a common and potentially deadly complication for victims.
Cleveland's Case Western Reserve University and Makerere University in Uganda launched the Tuberculosis Research clinic in 1994 after TB, a bacterial infection that attacks the lungs, emerged as the biggest threat to the weakened immune systems of AIDS victims in Africa.
Case said its studies have led to more effective ways of tracking and treating the disease and a better understanding of how TB can accelerate the progression of AIDS.
In September, world public health leaders said the lives of up to 500,000 HIV-positive Africans could be saved if African countries started simultaneously testing for and treating TB and HIV.
Case's intervention focuses on the work of people like Joseph Nakibali, whose job is to keep track of AIDS victims and whether they are taking their TB medication.
Because even minor interruptions in treatment can cause a TB patient to relapse or skew the outcome of a medical study, the 56-year-old supervisor and his crew of four slog through Kampala, Uganda's slums making sure hundreds of patients faithfully take medicine.
Curable disease
Close to half of Uganda's TB population is HIV-positive, and TB is among the most common causes of death for Africans who have AIDS. With no AIDS vaccine in sight, Case's researchers in Uganda are focusing on TB, a disease they know they can cure.
About 9,000 men, women and children from Kampala, the East African country's capital of 1.2 million, are enrolled in studies seeking to control and prevent TB.
In 1994, shortly before Case became involved in Africa's first AIDS vaccine study, the university landed a $19 million U.S. federal grant to establish the tuberculosis research unit. A $28 million grant followed five years later.
Among Case's many research projects is one of the world's longest-running and most complex community health studies tracking the TB bacteria. The school has joined in the hunt for a more effective TB vaccine and new treatments.
Global partners
The TB research unit, based in Cleveland, has academic partners around the United States. But it does virtually all of its clinical and laboratory work in Brazil, the Philippines and Uganda, with Uganda the oldest and, by far, the busiest of the three.
Dr. Ralph Horowitz, the dean of the Case medical school, said the university may invest in a building in Kampala either independently or with another collaborator for its Uganda projects.
"We have had a long, distinguished presence overseas in TB and HIV research," said Horowitz.
"We were the first to establish a collaboration in Uganda, and we want to guarantee that we remain a leader in that area."