Research Activities

​​The purpose of this application is to identify immunologic, inflammatory and metabolic factors implicated in vulnerability to Chagas disease and associated heart failure (HF) among people infected with the Trypanosoma cruzi (T. cruzi) parasite. We aim to use a validated platform of 358 protein biomarkers representing relevant pathways to identify markers most strongly associated with HF among people with T. cruzi. The analyses offer potential diagnostic importance in that they may identify people with endemic infections who have the highest vulnerability to HF; this may highlight targets for early HF prevention and intervention in these infectious states as well as in other infectious and inflammatory conditions.

Principal Investigator: Matthew Feinstein, MD
Site Principal Investigators: Edecio Cunha-Neto, MD, PhD

Status of Support: Active
Funding: Feinberg School of Medicine Global Health Research Catalyzer Fund

In the absence of an effective treatment and a vaccine for COVID-19, prevention, thorough hand washing with soap and running water, remains the most pragmatic means of curtailing it. The typical hand washing device in private and public places in Nigeria is mostly the ubiquitous Veronica bucket, a water receptacle whose water-dispensing tap one still needs to manually open with the same dirty hands to be washed: a counter intuitive thing indeed for preventing the spread of an infection. The aim of this project is to 1) develop a low-cost, automated, energy-efficient, adaptable and user-friendly hand washing device and 2) develop a user-friendly and adaptable receptacle for the handwashing effluent. The vision of this project is the development of such a utility hand washing device that can be deployed anywhere in Nigeria, in urban or rural areas.

Principal Investigator: Mamoudou Maiga, MD, PhD
Site Principal Investigator: Akinwale Coker, PhD

Status of Support: Active
Funding: Feinberg School of Medicine Global Health Research Catalyzer Fund

In February 2020, the World Health Organization declared a Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection as a global pandemic. The objectives of this study are to create a longitudinal cohort of 400 Tanzanian HCWs and to: 1) describe the baseline prevalence and anti SARS2 IgG serology among controlled factors, 2) assess the rate of seroconversion (IgG- to IgG+) and change in IgG titer at three and six months of follow-up and 3) quantify the characteristics and outcomes associated with higher titers of anti-SARS-CoV-2 IgG among those who seroconvert using a dried blood spot based assay. This study will help us better understand seroprevalence and the kinetics of seroconversion among HCW, potential immunity, quantify the characteristics and outcomes associated with high titers of SARS-CoV-2 IgG, and will have important implications for healthcare facilities, which are prone to become hot spots for COVID-19 transmissions.

Principal Investigator: Claudia Hawkins, MD, MPH
Site Principal Investigator: Tumaini Nagu, MD, MPH, MMED, PhD

Status of Support: Active
Funding: Feinberg School of Medicine Global Health Research Catalyzer Fund

The coronavirus disease of 2019 (COVID-19), caused by the SARS-CoV-2 virus, has spread rapidly across the world, threatening millions of lives. Mutations could be a major threat to the vaccine and medications being developed. Currently it is estimated that only 1 percent of SARS-CoV-2 isolates sequenced are from Africa, which could leave out the circulating strains in the continent in the ongoing vaccine designs. Our aims are to: 1) characterize the clinical presentation of COVID-19 cases in Guinea and Mali and 2) determine the clusters and examine the virological evolution of circulating SARS-CoV-2 strains in Guinea and Mali, using whole genome sequencing. The project will provide significant data about the transmission and circulating strains in West Africa.

Principal Investigator: Mamoudou Maiga, MD, PhD
Site Principal Investigator: Almoustapha Maiga, PhD

Status of Support: Active
Funding: Feinberg School of Medicine Global Health Research Catalyzer Fund

The objectives of this study are to create a longitudinal cohort of Nigerian health care workers (HCWs) and to: 1) describe the baseline prevalence and anti SARS2 IgG serology among HCW by age, sex, location, and HCW type subgroup and other characteristics associated with serologic status, 2) assess the rate of seroconversion (IgG- to IgG+) and change in IgG titer at 3 and 6 months of follow-up, and 3) quantify the characteristics and outcomes associated with higher tiers of anti-SARS2 IgG among those who seroconvert using a dried blood spot based assay.

Principal Investigators: Mark Huffman, MD, MPH
Site Principal Investigator: Dike Ojji, MD, PhD

Status of Support: Active
Funding: Feinberg School of Medicine Global Health Research Catalyzer Fund

In Mali, a country in West Africa, cumulative confirmed COVID-19 cases and deaths among healthcare workers (HCWs) remain enigmatically low, despite a series of waves, circulation of SARS-CoV-2 variants, the country’s weak healthcare system and a general lack of adherence to public health mitigation measures. The goal of the study was to determine whether exposure is important by assessing the seroprevalence of anti-SARS-CoV-2 IgG antibodies in HCWs. HCWs had high SARS-CoV-2 seroprevalence, likely reflecting a “herd” immunity level, which could be protective to some degree. These data suggest that the low number of cases and deaths among HCWs in Mali is not due to a lack of occupational exposure to the virus but rather related to other factors that need to be investigated.

Principal Investigator: Mamoudou Maiga, MD, PhD

Status of Support: Published

Secondary Study

The Coronavirus-2019 disease (COVID-19), caused by the SAR-CoV-2 virus, is spreading rapidly across the world, threatening millions of lives. However, the healthcare systems in low and middle-income countries (LMICs) of sub-Saharan Africa could ultimately be hit far harder than developed countries and may face major challenges due to their already fragile, under-funded and under-resourced systems. A considerable proportion of cases will be among frontline Health Care Workers (HCWs). We propose here to determine, among HCWs in Mali, the rate of PCR-confirmed SARS-CoV-2 infections and conduct longitudinal assessment of serological prevalence study in this important and exposed group, with the goal of optimizing the frontline HCW resource. This collaborative project will provide significant data about the transmission and infection rates among HCWs in Mali, which could have an enormous public health impact.

Status of Support: Active

Disparities in SARS-CoV-2 genomic surveillance have limited our understanding of the viral population dynamics and may delay identification of globally important variants. Despite being the most populated country in Africa, Nigeria has remained critically under-sampled. Here, we report sequences from 378 SARS-CoV-2 isolates collected in Oyo State, Nigeria between July 2020 and August 2021. In early 2021, most isolates belonged to the Alpha “variant of concern” (VOC) or the Eta lineage. Eta outcompeted Alpha in Nigeria and across West Africa, persisting in the region even after expansion of an otherwise rare Delta sub-lineage. Spike protein from the Eta variant conferred increased infectivity and decreased neutralization by convalescent sera in vitro. Phylodynamic reconstructions suggest that Eta originated in West Africa before spreading globally and represented a VOC in early 2021. These results demonstrate a distinct distribution of SARS-CoV-2 lineages in Nigeria and emphasize the need for improved genomic surveillance worldwide.

Principal Investigator: Ramon Lorenzo Redondo, PhD
Site Principal Investigator: Olubusuyi Adewumi, PhD

Status of Support: Published

Hepatitis C virus (HCV) infection remains an important cause of chronic liver disease for populations across the globe. The goal of this study is to determine whether oral daclatasvir, when administered to pregnant women at the approved dose for non-pregnant adults, will yield drug exposures that correlate with HCV viral cure. The aims for this study are to: 1) evaluate the seroprevalence and genotype distribution of HCV among pregnant women that present for prenatal care at partner sites in Nigeria and 2) determine the prevalence of HCV core antigen (Ag) positivity from DBS samples among pregnant women who are anti-HCV positive and examine genotype distribution among those with active infection. This study will yield novel data on HCV core Ag testing and genotype distribution in pregnant women, an under-studied and under-represented population in HCV research worldwide.

Principal Investigator: Ravi Jhaveri, MD
Site Principal Investigators: Oche Agbaji, MBBS; Kolawole Oluseyi Akande, MBchB, MSc

Status of Support: Active
Funding: Feinberg School of Medicine Global Health Research Catalyzer Fund

This study proposes to assess changes in HIV/HBV co-infection prevalence in a large Nigerian HIV cohort over the past decade, to better understand how co-infection prevalence has changed in the era of HBV-active tART and also examine the utility of qHBsAg measurement in HIV/HBV co-infected patients on HBV-active therapies in this setting.

Principal Investigator: Claudia Hawkins, MD, MPH
Site Principal Investigator: Agbaji Oche, MD (Jos University Teaching Hospital)

Status of Support: Active
Funding: Feinberg School of Medicine Global Health Research Catalyzer Fund

Nigeria has the second highest number of people living with HIV (PLWH) and the most pediatric HIV infections globally; however, it has been neglected as a focus of public health efforts. The proposed study will develop and test two combination intervention approaches to improve HIV testing and linkage as well as HIV care outcomes among youth ages 15-24 in Nigeria using theoretically grounded peer navigation and mHealth components.

Principal Investigators: Babafemi Taiwo, MBBS; Robert Garofalo, MD, MPH

Status of Support: Active
Project Number: UH3HD096920

Learn more about this project on ClinicalTrials.gov.

This project will establish a cohort of infants, children and adolescents in Botswana, including both those who were exposed in utero to HIV and remained uninfected and those born to women without HIV, in order to evaluate for differences in neurobehavioral, metabolic and infectious morbidity outcomes between children who are HIV-exposed uninfected and those HIV-unexposed uninfected.

Principal Investigators: Kathleen Powis, MD, MPH, MBA; Jennifer Jao, MD, MPH; Joseph Makhema, MD

Status of Support: Active from August 17, 2020 - June 30, 2022
Project Number: R61HD103099
Funding: National Institutes of Health

Learn more about this project on the NIH website.

This project evaluates the metabolic signatures of myocardial and vascular dysfunction in South African youths living with perinatal HIV (YPHIV). These results will expand understanding of the pathogenesis and interplay between metabolic dysregulation and subclinical myocardial dysfunction as well as elucidate key pathways of cardiac dysfunction, which may identify those YPHIV at highest risk for CVD, informing future potentially targetable interventions.

Principal Investigators: Lauren Balmert Bonner, PhD; Jennifer Jao, MD, MPH; Heather Zar, MD, PhD

Status of Support: Active from May 1, 2020 - April 30, 2025
Project Number: R01HL151287
Funding: Ann & Robert H. Lurie Children’s Hospital of Chicago and NIH National Heart, Lung, and Blood Institute

Visit the project's Northwestern Scholars entry.

The overall purpose of this grant is to understand how dolutegravir (DTG) use during pregnancy affects the metabolic health of women and their children. We will leverage existing NICHD-supported research infrastructure in Cape Town, South Africa, to recruit a cohort of 1,500 pregnant women in the first trimester and follow these pregnant women and then mother-child pairs through two years postpartum. The aims of this study include examining: 1) how HIV infection/DTG use impacts patterns of weight and body composition during pregnancy, 2) the association of HIV infection/DTG use with postpartum metabolic health and 3) the association of in utero exposure to HIV/DTG with neonatal and child metabolic health.

Principal Investigators: Elaine Abrams, MD; Jennifer Jao, MD, MPH; Landon Myer, PhD

Status of Support: Active from September 25, 2020 - June 30, 2025
Project Number: R01HD104599
Funding: National Institutes of Health

Learn more about this project on its ClinicalTrials.gov page.

The overall goal of this program is to support the development of point of care technologies to promote high priority topics of NIH HIV/AIDS research, including: Reducing HIV incidence by improving screening, detection and treatment monitoring related to HIV, HIV drug resistance, and antiretroviral drug levels; Diagnosing HIV-associated comorbidities which include tuberculosis (TB), non-tuberculosis mycobacteria (NTM), hepatitis B (HBV), and hepatitis C (HCV); Reducing health disparities by developing testing technology that can function in underserved community settings; and Training of the workforce able to translate POC technologies from Research & Development to implementation.

Principal Investigators: Sally McFall, PhD; Robert Murphy, MD

Status of Support: Active 
Project Number: U54EB027049
Funding: National Institutes of Health

Visit the PubMed website for more information on this project.

Supplemental Projects

• Rapid Acceleration of Diagnostics for COVID-19 (RADx)
  The goal of this supplement funding to C-THAN is to clinically evaluate innovative new technologies that have been evaluated and assisted in their development by NIH in the Rapid Acceleration of Diagnostics for Coronavirus-19 (RADx) program. Northwestern will recruit and test patients with these novel technologies and evaluate their effectiveness in order for them to be approved for use under the Emergency Use Authorization (EUA) authority by the FDA. Successful candidate products will be used to get businesses and schools open safely during this pandemic.
  
  Principal Investigators: Sally McFall, PhD; Robert Murphy, MD
  
  
• A novel screening strategy using DBS to enhance diagnosis and treatment of viral hepatitis B and C in Nigerian PLHIV
  This study is evaluating a novel screening strategy that uses combination of rapid diagnostic tests (RDTs) for Hepatitis B and C screening at the point of care with confirmatory molecular and serologic testing to establish HBV and HCV viremia, both of which will be run dried-blood spot (DBS) collected by finger stick in the clinic. This study will be conducted on 600 ART naive adult (>18) PLWH enrolled at three HIV clinics in the Jos region of Nigeria.
  
  Principal Investigators: Claudia Hawkins, MD, MPH and The Center for Innovation in Point-of-Care Technologies for HIV/AIDS at Northwestern University (C-THAN) supplement
  
  Status of Support: Active from June 1, 2021 - May 31, 2022
  Project Number: 5U54EB027049

Cancer epigenetics and infections are inextricably linked, especially in low- and middle-income countries such as Nigeria, where there is a combined high burden of HIV, hepatocellular carcinoma and cervical cancer. The study of epigenomic biomarkers in HIV-associated cancers will improve our understanding of the role of HIV infection in cancers and help lead to effective strategies for prevention, diagnosis and treatment of cancers in this setting.

Principal Investigators: Lifang Hou, MD, PhD; Robert Murphy, MD; Folasade Tolulope Ogunsola, MD, PhD; Atiene Solomon Sagay, MD
P1 Leads (Liver Cancer): Claudia Hawkins, MD, MPH; Edith Okeke, MD; Lewis Roberts, MD, PhD
P2 Leads (Cervical Cancer): Melissa Simon, MD, MPH; Jonah Musa, MD, PhD; Rose Anorlu, MD

Status of Support: Active from September 1, 2017 - August 31, 2022
Project Number: 1U54CA221205-01
Funding: National Institutes of Health (NIH); National Cancer Institute

To learn more, visit the project's page on the NIH website.

The International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Network will be led by Sharon Nachman, MD, of Johns Hopkins University, as PI of the Leadership and Operations Center, with Family Health International as the Operations Center. IMPAACT’s mission is to decrease HIV incident infection, including mother-to-child transmission (MTCT) of HIV, and to decrease mortality/morbidity associated with HIV infection, co-infections and co-morbidities in pregnant/postpartum women, children (including infants) and adolescents worldwide. Serving as Scientific Leader, Protocol P115 Co-Chair are Ellen Chadwick, MD, and Jennifer Jao, MD, MPH.

Principal Investigator: Sharon Nachman, MD

Status of Support: Active from January 23, 2015 - December 31, 2031
Project Number: UM1AI068632
Funding: National Institute of Allergy and Infectious Diseases

Visit the project website to learn more.

Malaria epidemiology is changing in response to successfully targeting the most vulnerable populations with effective interventions. Since 2012, seasonal malaria chemoprevention (SMC), a highly effective measure against malaria morbidity and mortality in children under 5, has been scaled up to consider expanding SMC to include children as old as 10, or even 15. In this pilot study, we propose to examine the infectiousness of a cohort of individuals living in a highly seasonal community in Northern Ghana. This study will quantify the contribution to transmission of various age groups of communities in which SMC is implemented as well as the impact of expanding such intervention to include higher age groups.

Principal Investigator: Jaline Gerardin, PhD
Site Principal Investigators: Yaw Afrane, PhD; Linda Amoah, PhD

Status of Support: Active
Funding: Feinberg School of Medicine Global Health Research Catalyzer Fund

Tuberculosis (TB) affects more men than women around the world. The study proposes to address two specific aims: (1) compare the frequency and absolute count of MTB-specific CD4+ T lymphocytes in men and women before and after anti-TB treatment relative to the control groups and (2) correlate changes in sex hormone levels during anti-TB treatment with the frequency and absolute count of MTB-specific CD4+ T lymphocytes. The study will be conducted at the University Clinical Research Center (UCRC), in Bamako, Mali, and will yield new insights into immune responses to TB and provide essential preliminary data for further translational research to be investigated in an R-type application to the NIH.

Principal Investigator: Djeneba Dabitao, PhD
Site Principal Investigators: Djeneba Dabitao, PhD; Barbara Sina, PhD

Status of Support: Active from August 1, 2019 - April 30, 2024
Project Number: 1K43TW011426-01
Funding: National Institutes of Health (NIH); Feinberg School of Medicine Global Health Research Catalyzer Fund

Visit the grant's page on the NIH website.