Moshi, Tanzania
Nathan Thielman, MD, collaborates with his colleagues at Kilimanjaro Christian Medical Centre in Moshi, Tanzania.
Under the shadow of Mt. Kilimanjaro, Duke has been conducting research and offering training for Duke medical students and residents for over 10 years in partnership with Kilimanjaro Christian Medical Centre, in Moshi, Tanzania.
Overview
Duke’s Division of Infectious Diseases & International Health in the Department of Medicine established a research program at the Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania more than a decade ago. Faculty, fellows, residents and students at Moshi work alongside Tanzanian health care workers in hospitals, outpatient clinics, in other regional health care centers and within local community to provide services and conduct research. The site also serves as a center for international clinical trials and for CHAVI (the Center for HIV/AIDS Vaccine Institute).
Although historically most of the research undertaken here to date has focused on treatment of HIV/AIDS, recently the research has expanded. Now, faculty from the Center for Health Policy, from the Departments of Pediatrics, Obstetrics/Gynecology, Pathology, Community and Family Medicine, and from the Sanford Institute of Public Policy have become involved in studies at KCMC.
DGHI provides administrative and financial services to help coordinate the variety of activities – research, medical training, undergraduate service – that take place at Moshi.
Education
Over the past two decades, more than 100 people have come to learn at Moshi. Some come as faculty, residents or fellows to receive advanced training in infectious diseases, pediatrics or other areas. Medical students have participated as their third-year research project, or on short rotations.
Research
Duke faculty have conducted research studies to answer questions such as:
- What effect is use of TMP-SXT prophylaxis in persons with symptomatic HIV disease in Africa having on emergence of antimicrobial resistance?
- How common is virologic failure in patients receiving ART in Tanzania and who fails and why?
- Is it better to start ART immediately or to defer ART in patients co-infected with tuberculosis?
- What is the importance of nitric oxide (NO) and inducible NO synthase (NOS2) in resistance to malaria in humans?
Service
Beginning in 2008, Duke expects to be able to send 2-3 undergraduates to Moshi for summer global health experiences as part of the global health certificate.
Policy
Duke faculty members understand the importance of evidence-based research on policy. Thus, for example, their research study on whether provision of free HIV voluntary counseling and testing (VCT) is cost effective in Tanzania allowed the ministry of health to decide whether VCT should be free or be offered with a co-pay.
Who's Involved
Duke Faculty & Staff
John Crump, MD., Duke professor, Department of Medicine, Division of Infectious Diseases (Site Director)
- John D. Hamilton, MD
- John A. Bartlett, MD
- Nathan M. Thielman, MD, MPH
- Charles Muiruri
- L. Barth Reller, MD, DTM&H
- G. Ralph Corey, MD
- Barton F. Haynes, MD
- Michael Merson, MD
- Anne B. Morrissey, MS
- Jean Gratz, MS
- Julia Giner, RN
- Jan Ostermann, PhD
- Gary M. Cox, MD
- Carol Dukes Hamilton, MD
- Coleen K. Cunningham, MD
