Dr. Neel Gandhi
Assistant Professor, Department of Medicine (General Internal Medicine)
Assistant Professor, Department of Epidemiology & Population Health
Dr. Sarita Shah
Assistant Professor, Department of Medicine (General Internal Medicine)
Assistant Professor, Department of Epidemiology & Population Health
Research
The focus of Drs. Gandhi's and Shah's research is on the interaction of the TB and HIV epidemics, particularly in sub-Saharan Africa. They have been working in South Africa since 2001. TB and HIV in South Africa are closely related with more than 60% of all TB patients co-infected with HIV. Before the availability of antiretroviral (ARV) therapy, annual mortality rates among TB/HIV co-infected patients were 30-40%. With the availability of ARV therapy, they have demonstrated that an integrated strategy that treats TB and HIV concurrently can reduce mortality to nearly 10%. During the course of their work in TB/HIV integration, they uncovered the largest cluster of extensively drug-resistant (XDR) TB and a burgeoning multidrug-resistant (MDR) TB among HIV-infected patients.
Both diseases have been shown to be highly fatal, with mortality rates in excess of 80% and 60%, respectively. Barriers to effective control of these diseases include a lack of: effective diagnostic tests which can provide a timely diagnosis; safe and effective medications to treat them; infection control facilities to prevent the nosocomial transmission; knowledge about the epidemiology and molecular epidemiology; and knowledge of the pathogenicity and transmission capabilities of TB strains. Additionally, without the creation of an effective TB vaccine, the prospects of effectively controlling the larger TB epidemic in this high HIV-prevalence setting are worrisome.
Planned and Ongoing Investigations: Integrated treatment of MDR TB and HIV; Community-based management of MDR TB; Transmission dynamics of XDR TB; Improving diagnosis of pediatric TB
Countries
South Africa
Students Welcome?
Yes