To test the hypothesis that HIV-negative individuals living in a community of high HIV-AIDS prevalence have a greater risk of contracting the disease if their high-sensitivty C-Reactive Protein is elevated > 3.0mg/L; and to evaluate the overall health of some 1000 persons living in Balaka region in Northern Malawi.
The goals of this proposed pilot are both substantive and methodological. Substantively, we wish to: One, test the hypothesis that HIV-negative individuals living in a community of high HIV-AIDS prevalence have a greater risk of contracting the disease if their high-sensitivity C-Reactive Protein (hsCRP) is elevated > 3.0mg/L. CRP is a very strong acute-phase protein. During the acute phase of a disease or infection, CRP concentrations rise dramatically. High levels of CRP are also associated with chronic diseases. Inflammation is thought to be a common risk factor for a number of chronic diseases associated with human aging. CRP increases with age, often to levels implicated in arterial degeneration and immunosenescence. In settings with high infectious disease burdens and high mortality, such as Malawi, environmental and life circumstances provide considerable exposure to endemic parasites and associated infections, but few studies have examined the extent to which individuals with high levels of CRP or long exposures to elevated levels of inflammation are at higher risk for contracting HIV than those with low levels of inflammation. Two, evaluate the overall health of some 1000 persons living in the Balaka region in northern Malawi. While members of this community have been previously evaluated for both HIV and STDs, no other health assessments have been undertaken. We seek to evaluate their overall health and well-being using a brief face-to-face interview and conventional biomarkers, such as cholesterol, LDL, HDL, triglycerides (a lipids panel); circulating glucose; urea, albumin, creatinine, total protein, uric acid (collectively a measure of renal function and infection); and HbA1c, a three-month average of blood glucose, a measure of glucose control; and hemoglobin. Methodologically, we wish to test the logistics and feasibility of collecting blood in a developing country with poor health and transportation infrastructures. We request support to administer 1000 Demecal™ biomarker test kits in Balaka, one of three sites of The Malawi Diffusion and Ideational Change Project (MDICP). These test kits require but a single drop of blood and yield values for 15 distinct biomarker assays, including hsCRP. This will be the first test of their use for collecting measures of population health and their adaptability to extreme conditons in tropical zones.