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Vital Signs

A research pipeline from Tanzania to DMS

By Roger P. Smith, Ph.D.

DMS faculty member Tim Lahey, far right, helped a number of Tanzanian colleagues celebrate the opening of labs there.

Tanzania may be a resource-poor country. Yet the East African nation boasts spectacular scenery, mighty Mt. Kilimanjaro, vast game-animal migrations, and—since 2000, thanks largely to Ford von Reyn, M.D., DHMC's chief of infectious disease and international health—an extensive program of research in HIV-AIDS.

Trial: It all began with a clinical trial of a tuberculosis vaccine in HIV-infected patients, the positive results of which were recently published. The contacts von Reyn made while working on that trial encouraged him to pursue funding from the National Institutes of Health's Fogarty International Center to support doctoral training at DMS for Tanzanians.

Two Fogarty Fellows have since completed their Ph.D.'s at Dartmouth and returned to Tanzania and opened labs there. They occupy the only life sciences research labs at Tanzania's Muhimbili University of Health and Allied Sciences (MU-HAS).

One of the DMS Fogarty graduates, Magdalena Lyimo, Ph.D., did her thesis research with DMS's Ruth Connor, Ph.D., and Alexandra Howell, Ph.D., studying factors that influence HIV transmission via breast milk. The virus can be transmitted by that means, but the infection rate is not 100%. Connor and Lyimo suspect that there may be factors in breast milk that both facilitate and inhibit transmission.

The other Dartmouth Fogarty graduate, Ted Mselle, Ph.D., did his doctoral work in the lab of DMS's Charles Sentman, Ph.D. He studied the function of human uterine natural killer cells, showing that they could inhibit HIV uterine infection through the production of natural cytokines.

Cells: A third Tanzanian Ph.D. student, Emmanuel Balandya, is still at DMS, working with Timothy Lahey, M.D. While acclimating to New Hampshire winters, he's studying how semen impacts HIV infection of target cells during the initial transmission of the virus.

DMS doesn't "just say good-bye and send them back to Tanzania."

All three students had already earned M.D.'s in Tanzania.

And the Fogarty-supported training is not limited to those pursuing doctoral degrees. Seven Tanzanians have earned M.P.H.'s at Dartmouth, and a number have visited DMS for a month or two of specialized training.

The list of possible future research collaborations is both long and varied. Von Reyn already has a study in progress on a protein-calorie dietary supplement for pregnant women who are HIV-positive. Charles Wira, Ph.D., who has been active in the program from the start, is poised to further his investigations into mucosal immunity in HIV-positive patients. And Jay Buckey, M.D., is conducting an NIH-funded study of possible hearing loss in HIV-positive patients—an effect that may be due to HIV, its complications, or the drugs used to treat the virus or related conditions.

Enduring: The Dartmouth-Tanzania connection has every indication of being an enduring one. As Kisali Pallangyo, M.D., vice chancellor of MUHAS, puts it: "When [DMS trains] our colleagues, they don't just say good-bye and send them back to Tanzania, they come here with them, they stay involved, and keep the collaboration growing, and the infrastructure development stays here."

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