Doris Duke Charitable Foundation - International Clinical Research Fellowships

The Office of Student Research at Yale University School of Medicine has been awarded a Doris Duke Charitable Foundation International Clinical Research Fellowship for medical students conducting research at selected international sites in low or middle income countries. Up to 3 one-year fellowships will be awarded to medical students each year to study topics that significantly impact morbidity and mortality and are relevant to the international site including communicable diseases, non-communicable diseases, trauma, and maternal and child health. Students will be paired with two mentors, one at Yale and the second at the international institution.

The fellowship year will begin in July, with formal courses at Yale, followed by at least 8 months of research conducted at the international site.

Students must complete an application via the Doris Duke Charitable Foundation website and also submit additional materials that are requested below.

Application Information

Interested students should complete the Doris Duke online common application. The Doris Duke online common application formal deadline is January 10, 2017.

Items 1-6 are to be submitted on line when you submit the Doris Duke online common application. Item number 7 should be sent to our office via email to donna.carranzo@yale.edu.

1. Online Application Form 
Complete all sections of the online application form, which requests the following information:

  • Your contact information
  • Education history
  • Areas of clinical research you are interested in during fellowship year
  • School(s) to which you are applying
  • Description of prior medical and/or research experience in an international setting, if applicable

2. Letter from the Dean

Request the letter of support from your Dean on the online application form well in advance of the deadline.  Your Dean will receive an e-mail from ddcfcrf@aibs.org and will be asked to submit their recommendations through the online DDCF Application system by January 10, 2017.

3. Letter of Support
Request the letter of support from your references on the online application form well in advance of the deadline.  Your references will receive an e-mail from ddcfcr@aibs.org and will be asked to submit their recommendations through the online DDCF Application system by January 10, 2017.

4. Personal Statement
A personal statement containing a description of a) your reasons for undertaking global clinical research; b) your plans for future professional or graduate education as well as your long-term career plans; and c) a brief description of your research interests. (Limit to 1 page, 10 pt. font) (PDF)

5. Curriculum Vitae
You will need to upload a copy of your CV (PDF) to submit your application. (Limit to 2 pages, 12pt. font)

6. Medical School Transcript
Request your medical school transcript well in advance of the deadline. You will need to upload a copy (PDF) to submit your online application. This can be an unofficial copy.

7. Names of 2-3 potential faculty research mentors and sites from the options below.
Please send this information to Donna Carranzo at donna.carranzo@yale.edu (See Mentor Selection section below for further information)

Detailed instructions are provided for each of the six items listed above required by the Doris Duke Charitable Foundation in the online application. Read the FAQs on the Doris Duke Charitable Foundation website before starting to prepare your application for helpful guidance on questions about the program, application process and eligibility, well as for students who are considering applying to schools at which they are not matriculated.

DDCF 2016-2017 Fellowship Opportunities (International site mentor and Yale mentor)

Doris Duke Medical Student Fellows will participate in clinical research with our collaborator, Dr. Christie-Samuels, at University of West Indies, Jamaica. Dr. Christie-Samuels is the PI of several projects with support from Jamaican Ministry of Health, the Global Fund to fight AIDS, TB, and Malaria, and other international funding agencies. These include:

  • Jamaica’s Pediatric, Perinatal and Adolescent HIV/AIDS Programme - University of the West Indies (JaPPAAIDS).
    This project aims to consolidate existing gains while scaling up to provide universal access to treatment, care and prevention services with special emphasis on vulnerable populations in Jamaica. Doris Duke research fellow will conduct research projects to assess the impact of this program.
  • A prospective observational study of HIV-infected pregnant women and their infants at Clinical sites in the Caribbean.
    This project accesses
    1. the determinants and the rate of mother-to-child transmission and
    2. the effect of treatment of HIV disease progression in this cohort.

Contact:
Dr. Elijah Paintsil, elijah.paintsil@yale.edu

Affiliation: Oswaldo Cruz Foudantion, Mato Grosso do Sul/ Faculty of Health Sciences, Federal University of Grande Dourados (UFGD), Yale  Schools of Public Health and Medicine

Focus: Tuberculosis in Neglected Populations

Projects: Oswaldo Cruz Foundation, Federal University of Grande Dourados and Yale University have a long-standing research and training program in the city of Dourados and Campo Grande, which focuses on tuberculosis in neglected populations such as indigenous, drug users and prisoners. The program focuses on epidemiology and social determinants of tuberculosis. The site also provides research-training opportunities in non- communicable diseases, which affect neglected populations such as sexually transmitted diseases, HIV/AIDS, suicide and violence. Furthermore, FIORUZ, UFGD has participated with Yale in a NIH-sponsored Global Infectious Disease Training Program  (D43 TW00919) since 2008. Please contact the site PIs for more specific details. On-going projects include:

  1. Strategies for tuberculosis control in Prison (Co-PI, NIH, R01 AI130058-01): We propose to leverage unique research and tuberculosis surveillance infrastructure in prisons and community settings in Central-Western Brazil to address three hypotheses:
    1. a major burden of tuberculosis in communities is attributable to transmission in prisons;
    2. testing pooled sputum samples using a new, sensitive molecular diagnostic assay (Xpert Ultra) on a mobile diagnostic unit can accurately and efficient detect tuberculosis cases; and
    3. prison-based mass screening can cost- effectively reduce the community burden of tuberculosis.

    Overall, this project addresses persistent scientific barriers to tuberculosis control: how to clearly identify the contribution of reservoir populations, and how to screen them efficiently in cost-conscious settings.

  2. Primary prophylaxis for prevention of TB in prison populations (Brazilian National Research Council, CNPq 401824/2016) The randomized double-blind Phase V clinical trial will involve 728 individuals and will evaluate the efficacy of Rifapentine + Isoniazid in preventing latent and active infection in the prison population.
  3. Risk factors associated with latent tuberculosis, HIV, hepatitis B, C and syphilis in the prison population in the state of Mato Grosso do Sul (Mato Grosso do Sul State Research Foundation, FUNDECT 23/200.547/2013): The Project is a prospective cohort study that began in 2013 and involves 3,500 inmates from 12 prisons in the state of Mato Grosso do Sul.
  4. Magnitude and severity of sequelae in tuberculosis (TB ) residual (Brazilian National Research Council, CNPq 40/2012): is a longitudinal study of in indigenous and non- indigenous populations aimed at assessing the disease burden, risk factors and long-term impacts related to tuberculosis.
  5. Transmission dynamics and determinants associated with the acquisition and development of tuberculosis in ethnically distinct populations (Brazilian National Research Council, CNPq 471429/2011): The study aims: a) to identify the risk factors associated with recent transmission , determined by standard genotyping by IS6110 RFLP and MIRU – VNTR, b) Identify outbreaks or clusters of spatiotemporal isolated cases with the same genotypic pattern, c) Compare the traditional identification of contacts and social network analysis to identify genetically related outbreaks, d) Identify socioeconomic factors and immunological  associated with the acquisition and development of tuberculosis in ethnically distinct populations residing in the city of Dourados, Brazil
  6. Dynamics of recent transmission of tuberculosis and multidrug resistance on the borders of Brazil  (Brazilian National Research Council, CNPq 404237/2012-6) .We will perform a multicenter study in four  border regions of Brazil to establish an active surveillance of the disease with the implementation of universal  culture in these locations and through a cross-sectional study to determine the variables associated with recent  transmission in context of borders . We will also determine the prevalence of MDR and XDR strains in these regions as well as comparing the traditional identification of contacts and social network analysis to identify genetically related outbreaks
  7. HIV / AIDS Depression and Cognitive Decline : Behavioral Model , Pilot Drug Discovery and Clinical Analysis (Brazilian National Research Council, CNPq 472044/2012-5): We will implement coordinated basic and clinical studies of depression and cognitive decline that arise in patients with HIV/AIDS. These pathologies  seriously affect patient quality of life and result from the many effects of the virus on the central nervous  system (CNS), including the pronounced CNS inflammatory response induced by HIV and the resulting elevation of inflammatory cytokines. The pathologies also arise from the neurotoxic effects of HIV proteins, including the ENV protein, which is expressed at high levels in the HIV/AIDS patient CNS.

Contacts:
Dr Julio Croda, MD, PhD, julio.croda@fiocruz.br, juliocroda@ufgd.edu.br (Site Mentor);
Dr. Albert Icksang Ko, MD, albert.ko@yale.edu (US Mentor)

Webpages for sites and research programs:
Fiocruz: http://www.matogrossodosul.fiocruz.br/site/;
UFGD: https://www.ufgd.edu.br/faculdade/fcs
Yale:Global Health Equity Scholars Program

Focus: HIV, HCV & TB Prevention and Treatment, Substance Abuse, and Prisoners Affiliation: The Ukrainian Institute on Public Health Policy (UIPHP); Yale Schools of Public Health and Medicine 

Projects: The training site will include the Ukrainian Institute on Public Health Policy (UIPHP), which has ongoing relationships with the country’s two largest NGOs that provide HIV, HCV, and TB prevention and treatment in Ukraine – ICP Alliance for Public Health - Ukraine and the All Ukrainian Network of People Living with HIV - the Ministry of Health, Ministry of Prisons, WHO, USAID and CDC. Drs. Altice and Dvoryak have collaborated together since 2005 in these sites, which have served as training sites for numerous pre- and post-doctoral fellows. In 2005 alone, Drs. Altice and Dvoryak were among the first to train 32Ukrainian physicians and administrators on the treatment of HIV and opioid dependence when they first introduced buprenorphine into the country as primary and secondary HIV prevention. Since 2011 we have trained at least three Global Health Equity Scholars funded by Fogarty International to conduct research on issues related to urban health, HIV, HCV, tuberculosis, health services, implementation science research and addiction medicine. Many of these trainees have moved to important positions in the Ministry of Health, Clinton Foundation and professional societies within Ukraine. Drs. Altice and Dvoryak collaborate on three active R01 grants from the National Institutes on Drug Abuse. The first NIH NIDA grant is to conduct implementation research to expand methadone and buprenorphine treatment entry and retention for HIV prevention in Ukraine and to use health services research methods to introduce the integration of extended-release naltrexone into HIV clinical care settings. The second NIDA grant is to conduct research with people in the criminal justice system in prison or on probation to expand MAT in the community. This grant collaborates with multiple NGOs in former Soviet Union countries to conduct intervention research. The third NIDA R01 uses evidence-based practices to examine the effects of integrating addiction treatment into primary care clinics on health care quality of life and stigma. All of this work has mathematical modeling approaches to support the findings. In addition, Drs. Altice and Dvoryak have been funded by numerous other international agencies, including USAID, CDC, UNAIDS, Open Society Institute and the Global Fund to conduct research on healthcare delivery systems for people who use drugs, including the development of the first integrated healthcare systems. On-going projects for fellows include: 

1) A NIDA-funded (R01-DA-033679) project aimed at expanding access to and retention on medication-assisted therapies (opioid agonist therapies including methadone and buprenorphine and extended-release naltrexone, an opioid antagonist) for the treatment of opioid dependence through the use of an evidence- based intervention program, NIATx (Network for the Improvement of Addiction Treatment). Specifically, this research will: 

    (a) evaluate the individual- and organization-level facilitators and barriers to entry into and retention in MAT in Ukraine; 

    (b) train experts in the use of the NIATx model; and 

    (c) To develop a new healthcare delivery model, using XR-NTX, to increase access to MAT by integrating XR-NTX directly into HIV clinical care settings, including health services research and implementation science methods. 

2) A NIDA-funded (R01-DA-029910) research program designed to address the linked epidemics of HIV, injection drug use, and the criminal justice system among the Commonwealth of Independent States (CIS) of Eastern Europe and Central Asia (states of the former Soviet Union). This implementation science framework aims to build upon our previous five years of funding: 

    (a) evaluating the prevalence of chronic infectious diseases, mental illness, and substance use disorders among soon-to-be-released prisoners with HIV or at risk for HIV; 

    (b) disseminating research findings with criminal justice officials and stakeholders to establish research priorities and plan interventions; and 

    (c) conducting pilot studies to develop and evaluate effective strategies for reducing HIV transmission among injecting drug users. In this current project we aim to maintain and expand our CIS partners in Moldova, Kyrgyzstan, Armenia, and Ukraine to conduct MATLINK, a program to introduce or expand MAT offered to prisoners or probationers with opioid use disorders (OUDs) and post release using the MATLINK strategy that allows for culturally congruent protocols within each location. MATLINK uses 3 EBIs: 1) (screening, brief intervention to promote MAT acceptance, and referral and linkage to treatment – SBIRT) that identifies and links participants to OST post-release. We also plan to 2) assess organizational barriers and offer interventions at the organizational-level with prison administrators and personnel to promote and sustain the MATLINK intervention; and 3) assess client-level outcomes related to prisoners’ utilization of OST, linkage to community treatment, and retention post-release as well as addiction treatment outcomes like time to opioid relapse, opioid-free days, addiction severity, criminal activity and HIV risk (i.e. injection and sexual) behaviors. 

3) A NIDA-funded (R01-DA-043125) project integrating addiction treatment and HIV services into primary care clinics in Ukraine. This grant builds on our pilot work in Ukraine that has established addiction treatment in two primary care sites in two regions in Ukraine. This grant aims to integrate services in 45 clinics in 15 regions in the country and to examine health-care quality of life and stigma outcomes among clients who receive MAT by comparing integrated care sites those that provide addiction treatment alone (opioid agonist therapy sites). Three specific evidence-based programs will be implemented: 1) Project ECHO uses a collaborative learning environment to continuously train, coach, and reinforce specialty care practices (e.g., managing comorbidities) for non-specialist physicians using tele-education technology. 2) Quality Improvement (QI) techniques change clinical and organizational processes to achieve desired outcomes, provide analytical tools, and ensure stakeholder engagement. 3) Pay-for-performance (P4P) incentives encourage physicians to achieve a core set of outcomes based on quality health indicators (QHIs), which are based on pre-specified process measures that yield the best P4P results. We plan to conduct modeling and cost-effectiveness analyses (CEA) of integrating MMT for people living with HIV into primary care, with or without P4P, compared to a control group of PWIDs receiving MMT in addiction specialty settings. 

Webpages for sites and research programs: Yale: http://medicine.yale.edu/intmed/people/frederick_altice-3.profile http://cira.yale.edu/people/frederick-l-altice-md http://aph.org.ua/en/home/ 

Qualifications of potential trainees: Post-third year medical school students; Post graduation from medical school; Ph.D. candidates who completed the first one to two years of their pre-doctoral program; post-PhD and Master’s of Science/MPH level fellows in the disciplines of public health, sociology, anthropology, economics, mathematical modeling, health services research and international health and business. 

Contacts: Dr. Frederick Altice, MD, MA frederick.altice@yale.edu; Sergii Dvoriak, M.D., Ph.D. dvoryak@uiphp.org.ua

Focus: HIV, Tuberculosis and Viral Hepatitis Prevention and Treatment in Criminal Justice and Community Health Settings Affiliation: University of Malaya; Yale Schools of Public Health and Medicine

Projects: The training site will be the University of Malaya and the Centre of Excellence on Research in AIDS (CERiA), which has ongoing relationships with a number of different departments and schools within the university, relationships with Malaysian government, including the Prisons Department, Ministry of Health and the Anti-Drug Agency. The site also has an ongoing relationship with the Malaysian AIDS Council, the country’s largest AIDS Service NGO that oversee the provision of HIV prevention and treatment for the country. Drs. Altice and Kamarulzaman, now the University of Malaysia’s Dean of the Medical School, have collaborated together continuously since 2005 and these have served as training sites for numerous pre- and post-doctoral fellows. Drs. Altice and Kamarulzaman have trained a number of pre- and post-doctoral fellows in both medicine and public health and collectively they have been involved in rolling out the first methadone maintenance treatment in the country as HIV prevention. They were also the first to become involved in criminal justice research and have been involved in both prison research, but also in examining alternatives to health and rehabilitation by comparing community models of care to compulsory drug detention centers. There are opportunities to work with drug use, HIV risk, tuberculosis, primary and secondary HIV prevention and intervention research within the criminal justice system and in collaboration with NGOs that provide health care services to transgender women and female sex workers. The team has continued to train individuals from Malaysia, the United States and elsewhere on issues related to urban health, HIV, tuberculosis, health services research and addiction medicine. Drs. Altice and Kamarulzaman collaborate on one large R01 grant from the National Institutes on Drug Abuse. We are currently conducting trials of both behavioral interventions and medication-assisted therapies for criminal justice populations transitioning from prison to the community as well as studies of TB in community and criminal justice settings. New studies underway are examining risk among female sex workers and transgender women. Additional studies include mathematical modeling and cost-effectiveness analysis. On-going projects for fellows include: 

A NIDA-funded (R01 DA041271) research program to include improved TB diagnostics that builds upon currently recommended TB screening practices combined with randomized controlled trials of TB prevention studies of HIV+ and HIV- prisoners with LTBI using either standard 40-week daily isoniazid (40H) or 12 weeks of weekly isoniazid plus rifapentine (12HR). 

    1. To conduct several empiric studies of TB screening and treatment strategies in prisoners, including: 

        a) Comprehensive TB diagnostic studies, including TB symptoms, chest radiographs, tuberculin skin testing (TST), AFB smear, Gene Xpert, and sputum culture to examine best practice and alternative strategies for TB screening practices in prisons for HIV+ and HIV- prisoners; 

        b) A RCT of LTBI prevention strategies among HIV+ and HIV- prisoners with high prevalence of HCV using standard 40-week daily isoniazid (40H) vs short-course weekly isoniazid + rifapentine (12HR); 

        c) A 3-arm preference trial comparing post-release treatment completion in patients on OAT (further randomized to MMT vs BMT) vs no OAT in patients being treated for active or latent TB who are transitioning to the community. 

2. To use data from specific aim 1 and publicly available data to conduct agent-based modeling for comparative and cost-effectiveness analyses of TB screening and treatment strategies among prisoners with and without HIV, incorporating the contribution of LTBI and prevalent TB on community transmission post-release. . 

Webpages for sites and research programs: Yale: http://medicine.yale.edu/intmed/people/frederick_altice-3.profile http://cira.yale.edu/people/frederick-l-altice-md http://www.ceria.um.edu.my/ 

Qualifications of potential trainees: Post-third year medical school students; Post graduation from medical school; Ph.D. candidates who completed the first one to two years of their pre-doctoral program; post-PhD and Master’s of Science/MPH level fellows in the disciplines of public health, sociology, anthropology, economics, mathematical modeling, health services research and international health and business.

Contacts: Dr. Frederick Altice, MD, MA frederick.altice@yale.edu; Adeeba Kamarulzaman, M.D. adeeba@um.edu.my 

Makerere University is a public university based in Kampala, Uganda with 8 Colleges, one of which is the Makerere University College of Health Sciences (MakCHS). MakCHS has 4 schools including the School of Medicine, School of Public health, School of Biomedical sciences and School of Health Sciences. The College is based at the Mulago referral and training hospital, the largest in the country.

Priority areas of research are communicable diseases – HIV, tuberculosis, and malaria – as well as non-communicable diseases, specifically diabetes and anemia, both common in Uganda.

Research has  been at the forefront of the MakCHS, with the University ranked 10th in Africa. The MakCHS has contributed significantly, with a wide repertoire of publications in national and international peer  reviewed journals. The Makerere University-Yale University (MUYU) Collaboration was created in 2006. It has a coordinator and a secretariat which coordinates activities in the MakCHS international office. This collaboration has an exchange of students, residents and faculty members mainly for research and clinical training purposes. To date, over 40 staff and students from Makerere have visited Yale University and over 100 from Yale to Makerere. Makerere has student based research collaborations with various universities in the USA, including the Fogarty research training program.

Contacts: Dr. Asghar Rastegar, asghar.rastegar@yale.edu; Dr. Tracy Rabin, tracy.rabin@yale.edu

Sub-Saharan Africa carries the highest global burden of HIV/AIDS and TB. Tugela Ferry, an impoverished area in rural KwaZulu-Natal Province, the site of our research programs, is the global epicenter of the convergence of the epidemics of HIV/AIDS and TB and the epidemic of multiple and extensively drug resistant (MDR and XDR) TB. To combat these triple epidemics, our research projects involve testing innovative health facility and community-based strategies to improve case detection, linkage to care, and health system strengthening to improve clinical outcomes and reduce community wide morbidity and mortality.

These studies are carried out in collaboration with Yale and other US investigators and colleagues from the South African Department of Health, Philanjalo (a South African NGO) and the University of KwaZulu Natal School of Medicine. NIH, CDC, PEPFAR, USAID and others provide support for these projects. Our work has increased identification and enrollment of individuals into HIV and TB care, has been associated with reduced incidence of both MDR and XDR TB, and has resulted in change in South African national health policy.

Since 2007, 8 Doris Duke International Clinical Research Fellows have played important roles in the development of the research studies, their implementation and analysis, and presentation and publication. The success of the fellows is documented by their active participation in more than 30 presentations/abstracts at local, national and international meetings and authorship on 18 publications in peer reviewed journals. In the coming years, Doris Duke student fellows will work on projects evaluating community-based interventions to improve HIV and TB outcomes, investigating TB and MDR TB mortality, integrating communicable and noncommunicable disease services, evaluating implementation of isoniazid preventive therapy, developing TB clinical disease severity models, implementing HIV pre-exposure prophylaxis, and evaluating TB host immunity in this rural, resource limited setting.

Contact Dr. Sheela Shenoi sheela.shenoi@yale.edu or gerald.friedland@yale.edu

Affiliation: Makerere University

Projects:
Makerere University in Kampala, Uganda has had long-standing research and clinical programs focusing on infectious diseases such as malaria, TB, and HIV. The Yale PI is a former recipient of a Doris Duke Clinical Scientist Development Award, and has been conducting studies in collaboration with Makerere University researchers since 2002. The research program is based currently both in Kampala and in the town of Tororo, in Eastern Uganda. Studies focus on aspects relating to the treatment of malaria in vulnerable populations, primarily young children and pregnant women. Yale Medical School also has extensive collaborations for the training of US physicians and students at the Makerere Hospital through an exchange program. Ugandan researchers also collaborate with Yale faculty through a NIH- sponsored Global Infectious Disease Training Program (Fogarty D43 TW007391) and sponsored 13 Fogarty International Research scholars and fellows in the past 4 years.

The principal project in Uganda is an NICHD-supported project, now in its 6th year, entitled Optimizing ACT use for African children in the setting of HIV and malnutrition, R01 HD068174 (Multiple PI, Parikh and Aweeka). A major goal of this project is to investigate the pharmacokinetics and pharmacodynamics of artemether-lumefantrine, the most widely adopted antimalarial therapy, in the context of development, malnutrition, and antiretroviral-related changes, with the goal of optimizing treatment for malaria and HIV. In addition, we are investigating the impact of antimalarial PK/PD on the evolution and spread of drug resistance. In Kampala, a newborn screening study is beginning to assess the prevalence of sickle cell disease, sickle variant syndromes, and linkage to care with the University Sickle Cell Clinic.

Contacts:
Sunil Parikh, MD, MPH: sunil.parikh@yale.edu

Webpages for sites and research programs:
Yale:

Projects: The Oswaldo Cruz Foundation (Fiocruz), the research branch of the Brazilian Ministry of Health, and Yale University have a long-standing research and training program in the city of Salvador which focuses on health problems that have emerged due to the rapid urbanization and growth of urban slum settlements. Research opportunities center on infectious diseases such as leptospirosis, a rat-borne disease which is the cause of epidemics of pulmonary hemorrhage syndrome, vaccine preventable diseases, dengue, and more recently, the emerging threats of Zika virus and Zika congenital syndrome among infants. Fiocruz and Yale coordinate a NIH-sponsored Global Health Equity Scholars (GHES) Training Program (NIH 1 R25 TW009338) that has sponsored twelve Fulbright and eleven GHES fellows in the past ten years. Please contact the site PIs for more specific details.

  1. Naturally-acquired and vaccine-mediated immunity to Leptospirosis (NIAID; R01AI121207): Our community-based investigations found that naturally-acquired infection confers immunity against reinfection with leptospirosis in high-transmission slum settings. We aim to build on these findings by identifying vaccine candidates and evaluating the feasibility of a universal vaccine approach for leptospirosis. On-going investigations are following a cohort of 2,300 slum residents, evaluating resistance and susceptibility to re-infection, and applying proteomics and immunological methods to identify correlates for immunity to leptospirosis, which in turn will inform efforts to develop a vaccine for this neglected disease problem.
  2. Ecoepidemiology of leptospirosis in the urban slums of Brazil (Fogarty International; R01TW009504): This NSF-NIH Ecology and Evolution of Infectious Disease project is conducting a systematic multi-disciplinary evaluation of the reservoir host, pathogen, environmental and social factors for the purpose of delineating the timing, location and intensity of leptospirosis epidemics within urban slum settings. We incorporate eco-epidemiological studies of rat and environmental reservoirs with long-term prospective studies of slum residents and mathematical and statistical modeling to elucidate the links between leptospirosis in its reservoirs and spillover infection in humans.
  3. RNA detection as an improved diagnostic assay for human leptospirosis (NIAID; R41AI114064): The lack of an adequate diagnostic test for leptospirosis has been a key barrier in mounting effective clinical treatment and decrease case fatality. We have developed several assays based on the PCR detection of Leptospira RNA, which appears to be more robust than standard DNA detection approaches. In this project, we are applying our RNA detection approach in two platforms, qRT-PCR and isothermal amplification, and will evaluate their performance at our clinical sites in Brazil.
  4. Characterizing the transmission dynamics and disease burden of Zika virus: This project aims to address key knowledge gaps in the natural history, transmission, and pathogenesis of this emerging pathogen. We have been following a large cohort of urban slum residents in Brazil since 2003, prior to the introduction of Zika virus as well as chikungunya virus. Our on-going investigations are conducting surveillance and biannual serosurveys among the cohort to validate new methods to diagnose Zika, determine the rates of clinical disease and infection, and identify risk factors for these outcomes.
  5. International Zika in Infants and Pregnancy (ZIP) Consortium Study: Our site in Salvador, Brazil is one of nine sites that are participating in an international consortium that aims to recruit 10,000 pregnant women in the 1st trimester of their pregnancy. The study will prospectively follow these women and their infants to identify exposures to Zika virus and adverse maternal, fetal and infant outcomes that are associated with these exposures. We plan to recruit 600 women at our specific site for the overall goal of providing key information to develop effective clinical guidelines, diagnostic tests and interventions, including vaccines, for this emerging health problem in pregnant women and their infants.

Contact: Dr. Albert Ko (Yale Mentor): albert.ko@yale.edu

Webpages for sites and research programs:

The Yale-University of Ghana Partnership in Global Infectious Diseases Research was established in 2006 with the mission of accelerating progress in Infectious Diseases and Public Health research in Africa through collaborative partnerships that build intrinsic research capacity, reverse “brain-drain” by strengthening academic infrastructures, and create viable career opportunities for African and American scientists. Research activities occur at the Medical School campus, Korle-Bu Teaching Hospital, and the Noguchi Memorial Institute for Medical Research (NMIMR) at the main campus of University of Ghana. On-going projects for medical student research fellows include:

  • Medical School site:
    • Natural history study of a cohort of HIV-infected children in Ghana. The study is supported by the Ministry of Health of Ghana and the Global Fund. The objectives of the study are to: (1) determine the effectiveness of antiretroviral therapy on HIV disease progression; (2) characterize the evolution and kinetics of HIV drug resistance mutations leading to treatment failure; (3) assess the effect of other tropical infections such as malaria, helminthiasis, schistosomiasis, viral hepatitis, and tuberculosis on HIV disease progression in children; and (3) assess whether targeted laboratory monitoring of antiretroviral therapy is clinically beneficial and cost effective in a resource- limited setting.
    • A bioecological pediatric HIV disclosure intervention in Ghana. This project is pending NICHD funding. The objectives are: (1) to evaluate through a randomized trial the effect of a structured and culturally-relevant disclosure intervention that is delivered by a specialist as an integral component of routine HIV healthcare on the rate of caregiver disclosure of pediatric HIV; and (2) to assess the effect of HIV pediatric disclosure on medication adherence and health outcomes of children (virologic, immunologic, psychosocial, and behavioral) and the caregiver (psychosocial).
  • Noguchi Memorial Institute for Medical Research (NMIMR) site:
    • The Noguchi Memorial Institute for Medical Research (NMIMR) spearheads biomedical research in Ghana, conducting research on diseases of public health importance in the country. The Institute obtains funding for its activities from both the Government of Ghana and international funding agencies. Medical student fellows will participate in the institutes several project such as:
      • Influenza disease surveillance supported and funded by the Global Influenza Surveillance Network (GISN) of the World Health Organization’s (WHO) Global Influenza Program.
      • Surveillance of the epidemiology and molecular mechanisms of antihelminthic treatment failure in Ghana.

Contact: Dr. Elijah Paintsil, elijah.paintsil@yale.edu

Focus: HIV prevention and treatment among men who have sex with men (MSM) 

Affiliation: Associación Civil Impacta Salud y Educación; Yale Schools of Public Health and Medicine 

Projects: The training site will include Impacta Peru, the country’s largest HIV/AIDS Service Organization and research institute that is a member of the AIDS Clinical Trials Group (ACTG), HIV Prevention Trials Network (HPTN) and the HIV Vaccine Trials Network (HVTN). They have ongoing relationships with many of the country’s largest NGOs that provide HIV prevention and treatment in Peru, the Ministry of Health and Cayetano Herredia School of Medicine. Drs. Altice and Sanchez have collaborated together since 2010 in these sites, which have served as training sites for numerous pre- and post-doctoral fellows. The team has conducted bio-behavioral surveillance studies, health services research, interventions that promote HIV testing, linkage and retention in care and other health outcomes. Specifically, this team has been exploring the impact of alcohol use disorders and drug abuse among men who have sex with men (MSM) because Peru is experiencing a concentrated epidemic among this group. New studies are examining the risk of TB treatment adherence and completion among those with and without alcohol and drug use disorders. Primary and secondary prevention studies are underway, including treatment as prevention and adherence studies using medication-assisted therapy (e.g., naltrexone) and behavioral interventions. In addition, Impacta has relationships with many other universities including University of Washington and UCLA, where there are many active research projects. Drs. Altice and Sanchez collaborate on two active R01 grants from the NIDA and NIAAA and are writing new grants to expand some of this work to TB. The primary R01 is to expand HIV testing and to examine the impact of acute HIV infection (AHI) on ongoing HIV transmission among MSM. We will conduct network analyses and study linkage and retention in care after acute diagnosis as well as to examine the impact of “immediate” antiretroviral therapy on reducing onward HIV transmission. A second aim of this study is to conduct a RCT using extended-release naltrexone (XR-NTX) among MSM with alcohol use disorders who are newly diagnosed and to examine the impact of XR-NTX on retention in care, adherence, viral suppression and HIV transmission. We are also examining the impact of alcohol, drugs and neurocognitive impairment on HIV treatment outcomes as well as exploring mobile health technologies on improving HIV treatment outcomes. The second R01 is a comparative effectiveness trial comparing a pharmacotherapy versus a behavioral intervention for alcohol use disorders among HIV-infected MSM. 

Webpages for sites and research programs: 

    Yale: http://medicine.yale.edu/intmed/people/frederick_altice-3.profile http://cira.yale.edu/people/frederick-l-altice-md 

Qualifications of potential trainees: Post-third year medical school students; Post graduation from medical school; Ph.D. candidates who completed the first one to two years of their pre-doctoral program; post-PhD and Master’s of Science/MPH level fellows in the disciplines of public health, sociology, anthropology, economics, mathematical modeling, health services research and international health and business.

Contacts: Dr. Frederick Altice, MD, MA frederick.altice@yale.edu; Jorge Sanchez, M.D., M.P.H. jsanchez@impactaperu.org 

Non-communicable diseases (NCDs) account for a quarter of deaths in sub-Saharan Africa. In Uganda, a country of more than 30 million people with a rapidly growing population, the burden of NCDs is rising dramatically as it continues to face highly prevalent infectious diseases. This double burden, part of an epidemiological shift catalyzed by major demographic and nutritional transitions, places major stresses on Uganda’s health system which is largely ill-prepared to address the complexities of chronic care delivery.  The Uganda Initiative for Integrated Management of Non-Communicable Diseases (UINCD) is a research consortium that links researchers at Yale School of Medicine with Ugandan researchers and senior leaders in the Ministry of Health and Mulago National Referral Hospital. UINCD developed out of a long-standing collaboration between Yale School of Medicine and Makerere University College of Health Sciences that focuses on bidirectional capacity building and medical education.

Under the co-Directorship of Dr. Isaac Ssinabulya (Makerere Universtiy) and Dr. Jeremy Schwartz (Yale School of Medicine), UINCD is home to a growing portfolio of research projects that aim to understand the current epidemiological landscape and gaps in health professions training and health system delivery pertaining to NCDs in Uganda. UINCD has hosted and successfully mentored two DDCF-funded trainees, three Yale MPH students and two Global Health Corps fellows. We are actively pursuing NIH and other funding opportunities to support our work. Ongoing projects include:

  • Development and implementation of a novel digital tool for measuring, mapping, and monitoring disparities in access to essential medicines
  • A nationwide needs assessment of healthcare worker education on NCDs
  • Impact of a MOH NCD training program on healthcare worker understanding and practice related to integrated NCD management
  • Development and implementation of integrated NCD training curricula for healthcare workers
  • Addressing the role of community health workers related to NCDs
  • Measuring provider performance and quality of chronic care delivery

Contact:
Jeremy Schwartz, jeremy.schwartz@yale.edu

Website:
The Uganda Initiative for Integrated Management of Non-Communicable Diseases

The Mental Health Institute, Second Xiangya Hospital, Central South University was founded in 1934, it is one of four national centers for mental health service, teaching and research. The faculty has 15 full professors, 10 associate professors. There are five major research domains, psychological stress and mental health, clinical psychological assessment, addictive medicine, child mental health and biological psychiatry. More than 50 awards have been received and more than 1,000 academic papers have been published in the last ten years. Based on an evaluation carried out by the Ministry of Education, the Institute was ranked number one in postgraduate training of psychiatry. Opportunities for medical student research projects include:

  1. The effectiveness of pharmacological or behavioral interventions to reduce opioid or amphetamine-type stimulant dependence and to reduce HIV transmission among drug users;
  2. Epidemiological and clinical investigations of substance use disorders and co-occurring HIV or HCV infection; and
  3. Experimental evaluations of behavioral, emotional, psychiatric, or cognitive correlates of patterns or severity of substance abuse disorders and/or treatment response among rural compared to urban drug users.

Contacts:
Dr. Richard Schottenfeld, richard.schottenfeld@yale.edu;
Dr. Marek Chawarski, marek.chawarski@yale.edu

The Ghana-Yale Partnership for Global Health was launched in 2006 in order to build sustainable biomedical research capacity through an ongoing collaboration between Yale University, the Noguchi Memorial Institute for Medical Research (NMIMR) at the University of Ghana, and the University of Ghana Medical School (UGMS). The Ghana-Yale Partnership has established a unique model for improving health in sub-Saharan Africa by fostering collaborative research, sponsoring bi-directional faculty and student exchanges, and training young scientists for productive careers focused on infectious diseases of great public health importance.

This innovative program effectively leverages the expertise of faculty at the University of Ghana and Yale, creating a partnership that catalyzes discovery while building research capacity. Collaborative research projects focus on the epidemiology and pathogenesis of infectious diseases, including malaria, helminth infections, and HIV. Current studies to map response to deworming medicines have identified the presence of benzimidazole resistance markers in central Ghana, work that will inform future public health strategies and policies. Student projects typically include both laboratory and field based training opportunities that provide exposure to state of the art methods in global infectious diseases research. The Partnership also provides trainees with thoughtful mentoring from collaborating faculty researchers, who carefully develop projects that are suited to the interests and long term goals of the student.

Contact: Michael Cappello MD, Professor of Pediatrics, Microbial Pathogenesis, and Public Health; Chair, Council on African Studies; Co-Director, Yale Africa Initiative michael.cappello@yale.edu.

Eligibility & Selection Criteria

Students in good standing, enrolled at any accredited U.S. medical school or accredited U.S. osteopathic school are eligible to apply. A completed application, medical school transcript, Dean's letter, personal statement, two recommendation letters and names of 2-3 potential faculty research mentors and sites from the link below will be required for consideration.

Interviews will be conducted in February after all applications are received.

Financial Information

A stipend of $30,000 annually will be provided to all Fellows. Applicants from other medical schools will not be charged tuition and should consult with their home school for information regarding tuition and fees. Funds are available to offset health insurance, travel and research expenses.

Ms. Donna Carranzo
Associate Director
Office of Student Research


Email: donna.carranzo@yale.edu
Phone: (203) 785-6633
Fax: (203) 785-6936