Centre for Infectious Disease Research in Zambia (CIDRZ), Zambia

Centre for Infectious Disease Research in Zambia (CIDRZ) was established in 2001, as a field office for a U.S.-based university. CIDRZ has since evolved into a successful and independent local non-profit organization in Zambia, supporting the Ministry of Health in the provision of quality health services. CIDRZ offers a wealth of expertise and infrastructure gained from over two decades of experience in identifying locally relevant, culturally-acceptable research from work grounded in implementation science.

CIDRZ has been the recipient of over 100 grants that support both program implementation and research in areas such as: HIV/AIDS prevention, care and treatment; tuberculosis diagnosis, treatment and control; women’s health, family planning and reproductive cancer screening; newborn and child health; and health systems strengthening. Programs span across all ten Zambian provinces, with the bulk of the work focused in Lusaka province. This thematic diversity provides trainees a rare opportunity to partake in research across a wide range of topics and access distinct populations with different healthcare needs and opportunities.

Examples of implementation research studies include: 1) Better Information for Health in Zambia, which was a cross-sectional study of HIV care outcomes across four provinces (Bill & Melinda Gates Foundation); 2) advocacy and capacity-building for menstrual hygiene management through water sanitation and hygiene in school programs (UNICEF); and 3) TASKPEN, the application of Implementation Science approaches to assess the effectiveness of Task-shifted WHO-PEN to address cardio metabolic complications in people living with HIV in Zambia. (NIH). CIDRZ was also part of a large, multicenter, international clinical trials network that included the Alabama Clinical Trials Unit and the Global Alliance for TB Drug Development. Trials included a study of the safety, tolerability and antiviral activity of Dolutegravir (a novel integrase inhibitor) in combination regimens in HIV-1 infected children and early intensive ART for newborns.

Funding from PEPFAR/CDC has supported various HIV implementation programs and studies including: a performance validation of the simple amplification assay (SAMBA 2) for early infant diagnosis of HIV-1 infection; point-of-care CD4 testing to increase antenatal ART use; and implementation of HIV care and treatment services in support of the HPTN 071 PopART study.

Other support infrastructure for research and routine HIV program implementation includes a state-of- the-art high-capacity medical and research diagnostic laboratory and on-site specimen repository unique in Zambia for its external accreditation programs and U.S. NIH DAIDS certification for research trials. CIDRZ is one of two Zambian labs assessed for the Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) by international auditors of the Africa Society for Laboratory Medicine and are awaiting evaluation of ISO15189 lab accreditation through the Southern Africa Development Community Accreditation Service (SADCAS). In-house CIDRZ laboratory services include flow cytometry, chemistry, haematology, serology, micro-biology, polymerase chain reaction and TB culture.

CIDRZ has a longstanding and well-developed research infrastructure with dedicated Research and Regulatory Affairs, and Quality Control and Assurance units, with specially trained staff. Every study receives Zambian National Health Research Authority approval as well as other local and international ethical and regulatory approvals prior to initiation. CIDRZ also houses a robust data management and data analysis unit. This unit provides support across programs and works closely with program managers from study inception through data analysis. The team, consisting of an experienced head of data analysis, a senior data manager, a junior data manager and data coordinators, has skills in SAS, STATA, Nvivo. In 2015, CIDRZ reconstituted a larger and much broader skilled and experienced Community Advisory Board that performs a CIDRZ-wide research consultation function by advising research teams on potential research topics of need, and acceptable recruitment and retention strategies. Many of the senior level staff and principal investigators are affiliated with the oldest university (University of Zambia) and the University Teaching Hospital, which provides opportunities to engage in clinical work, teaching and research with both institutions. Over the last ten years, CIDRZ has worked hard to build strategic partnerships and relationships with both international and national stakeholders. This facilitates access to a wide range of highly skilled and specialized individuals and allows us to retain a wide range of senior research mentors on site from institutions around the world.