International URBAN ARCH Center Core and Project Updates

Administrative Core

The Admin Core continues to facilitate training and mentoring events for trainees involved in our program. Highlights from the past quarter include a quarterly Visiting Scholar Research-in-Progress webinar in May featuring Dr. Chris Kahler from Brown University, who spoke about his work with Brown ARCH. Recordings of past webinars are now available to view here. The team also successfully hosted a trainee workshop in May entitled, “Perfecting Your Pitch: A Workshop to Practice Your Conference Presentation.” Early stage investigators were invited to submit and present their accepted posters ahead of upcoming summer conferences. Senior URBAN ARCH investigators and mentors provided helpful feedback to improve each presentation. On May 23, the Admin Core hosted two events: a spring check-in with our Program Advisory Committee and a trainee event to showcase presentations from three early stage investigators who are utilizing URBAN ARCH repository data for analyses.

The Admin Core team is also organizing one-on-one mentoring meetings on June 24, 2023 for early stage investigators attending RSA. These meetings will be held during a satellite meeting titled “Alcohol Research Involving People with HIV.” You can read more about URBAN ARCH activities at RSA in the main story!

Biostatistics and Data Management Core

BDM Core members have been collaborating with the TALC study team to prepare for study launch, including building the REDCap system. The Core continues working with the TRAC team on monitoring study progress and conduct. The BDM has been supporting the projects of each of the four trainees who presented their work recently to the Program Advisory Committee and others at the virtual Annual Meeting in May. The Core also collaborated with Kaku So-Armah and team on the submission of the “TB HIV Aging in Uganda 50-over-50 (THAU 50/50) study” supplement.

TB Risk by Alcohol Consumption (TRAC) Study

The aims of the TB Risk by Alcohol Consumption (TRAC) study are to estimate the incidence rate of new TB infection among people with HIV (PWH) with prior negative tuberculin skin test (TST) results by level of alcohol use (Aim 1) and to determine the incidence of active TB disease among PWH with prior latent TB infection (LTBI), who received TB preventative therapy (TPT), by level of alcohol use (Aim 2).

As of June, 2023, we have attempted phone contact of 586 prior study participants for Aim 1 screening. We reached 446 participants and invited all of them for screening. Of the 446 screened, we found 404 to be eligible and 12 people declined. Therefore, we have enrolled 404 participants into the study and based on alcohol use data at screening, 103 are in the no alcohol consumption group, 96 are in the low/moderate alcohol use group, and 205 are in the high-risk alcohol use. All enrolled participants have completed baseline procedures including questionnaire, biological specimen collection for dried blood spot (DBS) preparation and storage for PEth testing, urine collection for real time cotinine testing, and PPD placement. Of the 404 (203 females and 201 males) enrolled, 351 have negative TST results following placement and reading of TST within 72 hours and 52 have received a positive TST result; a 13% positivity rate. We have successfully completed 237 6-month follow up visits (98% completion rate) all done via phone calls, and 65 12-month in-person visits (100% completion rate).

Aim 2 procedures are in progress, with a goal of reviewing records from 18 HIV clinics from which we have previously recruited study participants. To date we have reviewed 987 patient records from two clinics in Mbarara, and only 1 record has not been found in this process. These are records of prior study participants who were TST positive and received INH as TB preventive therapy. Of the records reviewed, 20 participants were diagnosed with active TB after receiving INH and 23 participants had died. We are investigating the cause of death in these participants.

Enjoying the sunset in Mbarara! (L-R: Judy H, Sarah R, Nneka E, Jeffrey S, Ve T)
L-R: Sarah R, Nneka E

Tuberculosis, Alcohol, and Lung Comorbidities (TALC) Study

The TALC team has continued to make progress and is in the final phase of study start-up preparation. The team has been finalizing study launch items including submitting IRB amendments, building and testing data management systems, purchasing supplies, and finalizing standard operating procedures. The team is very excited to begin recruitment for the study once data collection systems are up and running!

Please note the spotlight interview featuring Naomi Sanyu, field coordinator for the TALC study. Naomi has been doing a phenomenal job of leading the coordination of supplies purchasing, procedure review, and logistics management. Catherine Kyampire, the qualitative research assessor, has diligently conducted multiple mock qualitative interviews with other research assessors as a method to finalizing the qualitative guides. Dr. Winnie Muyindike, the site PI, has worked tirelessly with local key stakeholders in helping us understand the epidemiology and standard of treatment of tuberculosis in Mbarara.

The team submitted an application to a notice of special interest on HIV and aging in May. The aims of the application are to determine the association between lifetime alcohol exposure and frailty, and explore whether this association differs by age or TB status. If funded, the study will utilize the infrastructure of the TALC study to recruit participants.

(L-R) Naomi, TALC field coordinator, and Dr. Winnie, site PI.
TALC RAs and field coordinator hard at work. (L-R: Catherine, Naomi, Francis, Adrine)
Catherine, TALC qualitative RA.