The CDC-Hubert
Global Health Fellowship
2016–2017 Assignment Opportunities
Third- and Fourth-Year Medical and Veterinary Student Projects
 Clinical Studies of Tropical Acute Febrile Illnesses — Puerto Rico

Curriculum Development, Field Epidemiology Training Program — Vietnam

Enhancing Cambodia’s Laboratory Surveillance System with Antimicrobial
Resistance (AMR) Data
— Cambodia

Evaluation of a National HIV Drug Resistance Surveillance System — Swaziland

Launching a Rabies Control Strategy — Cambodia

Quantifying Morbidity and Mortality Incidence — Kenya
Fourth-Year Medical and Veterinary Student Projects
 Evaluation of Rabies Control Programs — Guatemala
Third- and Fourth-Year Medical Student Projects
 Cervical Cancer Surveillance — Yap, Federated States of Micronesia
 Hepatitis C Elimination — Georgia

Pediatric Respiratory Etiology Surveillance Study (PRESS) — Kenya
Fourth-Year Medical Student Projects
 Improving Infection Prevention and Control — Georgia
Third- and Fourth-Year Veterinary Student Projects

Characterization of Extended-Spectrum beta-Lactamase Producing Escherichia coli
in Pigs and Pig Products — Thailand

Preventing Zoonotic Diseases — Kenya
The CDC-Hubert Global Health Fellowship is made possible by the joint efforts of the CDC Foundation and CDC with an
endowment established by the O.C. Hubert Charitable Trust.
Project title:
Clinical Studies of Tropical Acute Febrile Illnesses
Fellow requested:
Year:
Third year
Fourth year
Location:
Puerto Rico
Project availability:
September 2016 – June 2017
Type:
Medical student
Veterinary student
Project duration:
8–10 weeks
Project supervisor:
Tyler Sharp, PhD, Acting Epidemiology Team Lead, CDC Dengue Branch
Languages:
English, Spanish
Skills:
Competency with Microsoft Excel and Access, RedCap, and either SAS or STATA. Experience with medical chart
review and Spanish language fluency are useful assets, but are not required.
Project description:
Dengue, chikungunya, and Zika viruses are tropical arboviruses that present as acute febrile illnesses (AFIs). To
study the epidemiology and clinical outcomes of AFI in the tropics, CDC supports the Sentinel Enhanced Dengue
Surveillance System (SEDSS) through a cooperative agreement with a medical school in Puerto Rico. SEDSS
enrolls individuals presenting to the emergency department of a referral hospital (and will soon extend to an outpatient clinic) with fever, collects comprehensive clinical data on outpatient and inpatient encounters, and
conducts diagnostic testing for >20 pathogens that cause AFI in the tropics (e.g., dengue, chikungunya, Zika,
influenza, leptospirosis). SEDSS has completed 4 years of data collection, and is expected to continue enrollment
through at least 2020. SEDSS-based projects available for the Fellow include using existing data and potentially
collecting additional clinical data through hospital-based studies and/or chart abstraction to: 1) define the clinical
spectrum and severity of one or more AFIs among hospitalized case-patients (e.g., an epidemiologic and clinical
description of clinically apparent Zika patients); 2) compare the clinical and/or epidemiologic characteristics of
patients infected with diverse etiologic agents of AFI (e.g., clinical indicators that differentiate between patients
hospitalized with dengue and influenza); or 3) conduct a project proposed by the Fellow.
Objectives:
Analyze data collected via SEDSS to better understand the epidemiologic and clinical profile of patients with
acute febrile illness in the tropics.
Project design:
SEDSS is currently operating at a hospital located in the municipality of Ponce, and will soon be extending to an
outpatient clinic. By the time the Fellow starts the project, there will be 4 years of existing data available. One
component of cleaning the SEDSS dataset is reviewing medical records to collect any data that clinicians did not
gather while the patient was hospitalized, and the Fellow will contribute to SEDSS by collecting such information
through chart review. The Fellow will have the opportunity to analyze SEDSS data for either a descriptive or
analytic project, which would be dictated in part by immediate project needs (including urgent public health needs
or outbreak responses) but also by the Fellow's clinical and research interests.
Student responsibilities:
The Fellow will assist in collecting and analyzing data from the first 4 years of SEDSS, and is likely to spend
considerable time working with hospital partners at the SEDSS sites. The Fellow will also have a project related
to analysis of existing SEDSS data that will be conducted primarily at CDC Dengue Branch, but will likely involve
consultation with hospital partners. Depending on the project, patient follow-up for collection of additional data
may be required. The Fellow may also assist with establishing the outpatient SEDSS site, which would involve
close interaction with and training of hospital staff in the relevant protocols for patient enrollment, data and
specimen collection, data cleaning and analysis, etc.
2
Project title:
Curriculum Development, Field Epidemiology Training Program
Fellow requested:
Year:
Third year
Fourth year
Type:
Medical student
Veterinary student
Project duration:
6–12 weeks
Location:
Hanoi, Vietnam
Project availability:
September 2016 – June 2017
Ideally to overlap with a workshop that is run every other month – dates are not yet set.
Project supervisor(s):
Leisha Nolen, MD, PhD, Acting Resident Advisor, Field Epidemiology Training Program
Languages:
English (Vietnamese would be great, but not at all necessary)
Skills:
Knowledge of Epidemiology, PowerPoint, Creativity, Ability to work with people with limited English
Project description:
Help design an interactive curriculum for Vietnamese public health officials to boost field epidemiology skills and
knowledge. Assist with teaching of a course to understand current system. Perform interviews with alumni to
understand weakness of past curriculum. Use recent local examples of outbreaks and investigations to create
case studies, problem sets and exercises. Interact with the Vietnamese Ministry of Health, WHO and CDC
experts to create modern curriculum. Help create epi-bulletin for Vietnam.
Objectives:
Fellow is expected to redesign at least 2 one-week modules and create teaching material that will be used in the
next year. Courses should reflect feedback from previous participants and involve significant amounts of practical
sessions. Help teach one course during time in country to understand setting. Topics include: Outbreak
Response, Risk Assessment, Surveillance, Biostatistics.
Project design:
Fellow will be based at the CDC country office in Hanoi, Vietnam. Initial work will involve interviewing prior
participants around the country regarding the curriculum’s strengths and weaknesses, and integrating this
information with those from the FETP Curriculum Review Technical Working Group. Using this information
redesign curriculum to address the previous issues and to make a high quality adult learning program. Evaluate
historical research projects that have been conducted in Vietnam, identify those that would be good teaching
models, and then create material from these projects.
Student responsibilities:
The Fellow will be expected to meet one-on-one with multiple alumni of the program and conduct directed
questionnaires. In addition, the fellow will meet with the ministry of health to discuss overall goals and issues. Aim
to have fellow assist in teaching one course to understand the setting and the students. Fellow is expected to
redesign at least 2 one-week modules and create teaching material that will be used in the next year. Assist with
publication of Epi-Bulletin.
3
Project title:
Enhancing Cambodia’s Laboratory Surveillance System with Antimicrobial Resistance
(AMR) Data
Fellow requested:
Year:
Third year
Fourth year
Location:
Cambodia
Project availability:
September 2016 – June 2017
Type:
Medical student
Veterinary student
Project duration:
12 weeks
Project supervisor(s):
Mei Lin Castor, MD, MPH, FETP Resident Advisor and GHSA Program Director
Languages:
English (Khmer a bonus)
Skills:
Computer skills with Microsoft Office and Epi Info (experience with data collection/analysis a bonus)
Clinical background/knowledge of AMR issues
Any laboratory background is helpful but not essential
Project description:
Currently, Cambodia has a laboratory reporting system which is evolving into a surveillance system.
There is great need for efficient and effective collection/analysis/use of laboratory data, including AMR
data. This activity fits under the AMR Action Package of the Global Security Agenda initiative.
Objectives:
1. Familiarize oneself with the current laboratory reporting system, the envisioned surveillance system, and the
related issues around AMR data in Cambodia.
2. Retrieve/analyze existing/new data with findings contributing towards the inclusion of AMR data in the
envisioned surveillance system.
3. Participate and contribute towards various programmatic aspects of this effort.
4. Gain exposure to approaches/activities which shape public health policy.
Project design:
As the Project has multiple objectives (see above), the student will have opportunities to engage in various types
of public health-related activities, as efforts to develop a laboratory surveillance system moves forward. These
include the following:
 The student will engage with the community of partners focused on the inclusion of AMR in the
developing surveillance system by attending meetings, contributing to discussions, and participating in
related activities/field visits.
 The student will collaborate with partners to implement an activity (identified/designed prior to arrival),
which involves the collection/analysis of data with summary/sharing of the findings.
 The student will participate with partners in various programmatic and policy shaping aspects including
AMR data in the envisioned laboratory surveillance system.
Student responsibilities:
We expect the student to work collaboratively with the community of partners with opportunities to take the lead,
in a specific data-related activity. We would encourage the student to be proactive, flexible, courteous, and
inquisitive in these opportunities.
4
Project title:
Evaluation of a National HIV Drug Resistance Surveillance System
Fellow requested:
Year:
Third year
Fourth year
Location:
Swaziland
Project availability:
September 2016 – June 2017
Type:
Medical student
Veterinary student
Project duration:
+/- 12 weeks
Project supervisor(s):
Trong (Tony) Ao, ScD, MSc, Epidemiologist
Languages:
English
Skills:
Basic computer and presentation skills, knowledge of public health surveillance evaluation
Project description:
Swaziland is implementing a national HIV drug resistance (HIVDR) surveillance system that will include acquired
HIV drug resistance (ADR) and pre-treatment drug resistance (PDR).
For ADR, the main objective is to estimate nationally representative prevalence of HIVDR in populations receiving
ART for 12 (±3) months and for ≥48 months. The primary outcomes of the surveillance system are:
1.1.
Prevalence of HIVDR among individuals on ART for 12 (±3) months and for ≥48 months with VL ≥1000
copies/mL
1.2.
Prevalence of HIVDR among individuals receiving first-line ART for 12 (±3) months and for ≥48 months
with VL≥ 1000 copies/mL
1.3.
Prevalence of HIVDR among individuals on ART
The PDR survey has two important outcomes:
2.1
Prevalence of HIVDR among all ART initiators, regardless of prior exposure to ARVs
2.2
Prevalence of HIVDR among ART initiators without prior exposure to ARVs
Objectives:
1. Evaluate the HIVDR surveillance system using a systematic approach of public health surveillance
evaluation techniques.
2. Based on findings of the evaluation, formulate programmatic and technical recommendations
collaboratively with Ministry of Health and other stakeholders to improve and strengthen the HIVDR
surveillance system.
Project design:
The surveillance evaluation will employ standard methodologies as outlined in the CDC Guidelines for
Surveillance Evaluation. The Fellow will design the surveillance evaluation tools before arrival and during the first
few weeks in-country (~2 weeks). The data collection and interviewing stage will comprise the second portion of
the project (~6 weeks). Data analysis, write up, collaborative recommendation formulation, and dissemination will
be the last portion of the project (~4 weeks).
Student responsibilities:
The fellow will lead in the evaluation of the HIVDR surveillance system with support from the CDC supervisor.
The fellow will have an opportunity to work closely with Ministry of Health colleagues to design and implement
the evaluation. The evaluation will follow the CDC Guidelines for Surveillance Evaluation, and might include
the following components:
 Quantitative approaches such as staff surveys, analyses of collated data on key performance
indicators, examining disease trends and burden
 Qualitative approaches such as key informant interviews, focused group meetings, and SWOT
analysis
 Travel throughout the country to conduct site assessments
 Data synthesis, report writing, and dissemination of results to all stakeholders
5
Project title:
Launching a Rabies Control Strategy
Fellow requested:
Year:
Third year
Fourth year
Location:
Cambodia
Project availability:
September 2016 – June 2017
Type:
Medical student
Veterinary student
Project duration:
12 weeks
Project supervisor(s):
Mei Lin Castor, MD, MPH, FETP Resident Advisor and GHSA Program Director
Languages:
English (Khmer a bonus)
Skills:
Computer skills with Microsoft Office and Epi Info (experience with data collection/analysis a bonus)
Clinical background/knowledge of rabies
Project description:
US CDC is involved with partners in launching a rabies control strategy in Cambodia. The initiative includes
efforts around prevention, reduction of human/animal cases, control efforts, and promoting political/financial
support. This activity fits under the Zoonoses Action Package of the Global Security Agenda initiative.
Objectives:
1. Familiarize oneself with the issues around rabies in Cambodia and the proposed Control Strategy.
2. Retrieve/analyze existing/new data with findings contributing towards implementation of a successful strategy
in Cambodia.
3. Participate in and contribute towards various programmatic aspects of the Strategy (training, public
messaging etc.).
4. Gain exposure to approaches/activities which shape public health policy.
Project design:
As the project has multiple objectives (see above), the student will have opportunities to engage in various types
of public health-related activities, as the Strategy is launched and rolled-out in Cambodia. These include the
following:
 The student will engage with the community of partners participating in the launching of the Strategy by
attending meetings, contributing to discussions, and participating in related activities/field visits.
 The student will collaborate with partners to implement an activity (identified/designed prior to arrival)
which involves the collection/analysis of data with summary/sharing of the findings.
 The student will participate with partners in various programmatic and policy-shaping aspects of the
Strategy.
Student responsibilities:
We expect the student to work collaboratively with the community of partners with opportunities to take the lead,
in a specific data-related activity. We would encourage the student to be proactive, flexible, courteous, and
inquisitive in these opportunities.
6
Project title:
Quantifying Morbidity and Mortality Incidence
Fellow requested:
Year:
Third year
Fourth year
Location:
Kenya
Project availability:
September 2016 – June 2017
Type:
Medical student
Veterinary student
Project duration:
TBD
Project supervisor(s):
Marc-Alain Widdowson, DVM, MSc, Director, Division of Global Health Protection, CDC-Kenya
Languages:
English
Skills:
Experience with basic computer programs helpful, especially those programs similar to Epi Info™ and Microsoft
Access® (familiarity with statistical software like SAS or STATA would be a desirable asset)
Project description:
To participate in CDC-Kenya’s Population-based infectious disease surveillance project quantifying the burden of
acute febrile, respiratory, and diarrheal illness in two locations in Kenya. There will be one urban and one rural
population cohort. This surveillance platform provide the necessary denominator for conducting infectious
disease intervention effectiveness, including measuring the impact of vaccine introduction, WASH intervention
and other medical and non-medical interventions. Fellow will participate in the conduct and evaluation of
intervention studies to reduce the burden of acute infectious diseases in these two comparative populations.
Objectives:
Fellow will participate in the conduct and evaluation of intervention studies to reduce the burden of acute
infectious diseases in these two comparative populations.
Project design:
Use of established population-based surveillance platform to measure the impact of disease intervention activities
among two high risk populations in Kenya.
Student responsibilities:
Work with supervisor to develop an intervention evaluation tool; This may involve participating in actively
monitoring intervention implementation, create of study protocol, monitoring and ensuring the collection of data
and specimens according to protocol and data analysis. This highly motivated student should be willing to be part
of a research team and be able to provide scientific insight to multiple arm public health research, be sociable,
independent, flexible, and self-inspired.
7
Project title:
Evaluation of Rabies Control Programs
Fellow requested:
Year:
Third year
Fourth year
Location:
Guatemala
Project availability:
September 2016 – April 2017
Type:
Medical student
Veterinary student
Project duration:
8 weeks
Project supervisor(s):
Brett Petersen, MD, MPH, Clinical Epidemiology Unit Lead
Joe Bryan, MD, IEIP Lead
Languages:
Spanish speaking skills required
Skills:
Advanced Spanish language skills are required. Experience reviewing and analyzing data would be helpful.
Experience conducting medical chart abstractions is desired but not required.
Project description:
Guatemala is one of only four countries in the Western Hemisphere that still reports human rabies deaths due to
the canine rabies virus variant. Centers for Disease Control and Prevention (CDC) and the Pan American Health
Organization (PAHO) have been working with Latin American countries to help eliminate canine rabies. Rabies
surveillance systems (human and animal) are the backbone of rabies control programs, and routine systematic
review of the data collected through these systems is vital to monitoring a rabies control program’s success.
Guatemala has not conducted a systematic review of their rabies surveillance and control program since 2009.
The fellow will be expected to work with CDC, PAHO, Guatemalan ministry officials, the Center for Health Studies
at the Universidad del Valle de Guatemala (UVG), and local non-governmental organizations (NGOs) to describe
the current rabies program and report the most recent data.
Objectives:
1. Develop methodology for a systematic program review of Guatemala’s rabies control program with
assistance from CDC Poxvirus and Rabies leadership as well as the Global Disease Detection (GDD)
Regional Center within the CDC Central American Regional Office in Guatemala.
2. Conduct chart reviews to describe human rabies clinical cases for inclusion in a summary report.
3. Conduct a case series review of human cases with intention of publication.
4. Review Ministerio de Agricultura, Ganadería y Alimentación (MAGA) and Ministerio de Salud Publico y
Asistencia Social (MSPAS) animal and human rabies data and develop methodology for analyzing heavily
skewed data.
5. Review MAGA and MSPAS animal bite data, as described in 3.
6. Collect country-specific information for development of a Guatemala-specific analytic model for predicting the
true human and animal rabies rates, with assistance from the model creators at Glasgow University and the
CDC Poxvirus and Rabies Branch (http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003709).
7. Participate in dog census activities within Guatemala to aid in determining rabies vaccine coverage.
8. Review national guidelines for treatment of dog-bite victims with focus on rabies vaccination
recommendations. Revise guidelines as informed by the review.
Project design:
1–4. A report was developed in 2009, and this should be used as the template for an updated version.
5. A model was developed for calculating global burden of rabies. this model will be used as the basis for
developing a country-specific rabies burden estimation:
http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003709
8
Project title:
Evaluation of Rabies Control Programs
Student responsibilities:
It is recognized that not all of these responsibilities / objectives can be met in an 8 week period, but a substantive
subset of these responsibilities is requested:
All meetings and data collection forms will be in Spanish, therefore fluent Spanish language skills will be required
for this position.
The student will be expected to integrate into the GDD Regional Center in the CDC-Central America Regional
Office and work with locally employed staff and university officials to accomplish the described objectives.
The student will be expected to work within the confines of government-to-government collaborations and
represent the CDC in the best possible manner.
The student will be expected to produce a report on the current status of rabies control in Guatemala. The report
should be developed with close collaboration from Guatemalan stakeholders.
The student will be expected to travel to local health bureaus and two laboratories to collect and review animal
rabies, human rabies, bite exposure, and vaccination data.
The student will be expected to conduct data cleaning and univariate analysis on the collected data for the report.
The student will be expected to finish a preliminary analysis of estimated human and animal rabies burden based
on the Hampson model utilizing country-specific data collected during the fellowship
(http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003709).
The student will be expected to finalize a draft manuscript for a case-series on human rabies.
The student will be expected to draft a report summarizing the treatment of bite victims and provide
recommendations for improving post-bite rabies vaccination.
9
Project title:
Cervical Cancer Surveillance
Fellow requested:
Year:
Third year
Fourth year
Type:
Location:
Yap, Federated States of Micronesia
Project availability:
September 2016 – June 2017
Medical student
Veterinary student
Project duration:
6–12 weeks
Project supervisor(s):
Virginia Senkomago, PhD, ORISE Research Fellow
Aileen C. Tareg, DrPH, MPH, CHES; NCD Program Coordinator, Public Health, Local Project Assistant, REACHYAP
Languages:
English
Skills:
Knowledge of medical terminology, HPV, and cervical cancer; data entry; data analysis
Project description:
Invasive cervical cancer is presently the eighth most prevalent adult cancer in Yap State, FSM (Yap Cancer
Registry Data). A recent chart review evaluated death records (n = 410) at Yap State Hospital for ICD-10 causes of
death (all types), and found that 19.4% of all cancers among the deceased females were cancers specific to
females (cervical, etc.). Most of those diagnosed with cancer were first diagnosed at a late stage. The average age
at death among this female population was 58.1 years, which is twenty years lower than the current female life
expectancy in the United States.
Yap State Hospital is currently developing a more systematic way of screening for and monitoring cervical cancer
because the present system lacks several important pieces: a centralized database, a standard, comprehensive
intake form for all forms of cervical cancer screening (we have VIA and Pap smear), an efficient and effective
patient follow-up system, and consensus of opinion and methods in outreach efforts and promotion of screening
services. More importantly, people are dying early and from easily preventable deaths.
The new and improved Yap State Hospital cervical cancer screening database is expected to be completed and
operational by April 2016. We intend to collect information from the medical records of women who were
diagnosed with cervical cancer to inform surveillance and intervention efforts. The information collected will include
alcohol, tobacco, and betel nut use history; sexual history; cervical cancer screening history; medical
comorbidities; select vital signs; HPV vaccination status; and marital status.
Yap State Hospital currently relies on a single individual to perform the functions of Cancer Registrar and
Supervisor for all Medical Records. This permanent staff position is assisted by a Peace Corps Response
Volunteer. Both of these professionals have considerable experience in chart reviewing and data mining and will
provide good direction for a potential Hubert Fellow.
This work will make a meaningful contribution to the health of women in Yap. Once the data is available it will be
used to evaluate and improve cervical cancer screening and intervention.
Objectives:
By the end of his/her assignment in Yap, the Hubert Fellow will have compiled available data from charts of
women who have abnormal cervical cancer screening results. The Fellow will be able to show trends in
behavioral, medical, and demographic risk factors for cervical cancer in Yap State over the last 5 years. The
Hubert Fellow will use the data, with on-site support, to make recommendations on how to improve cervical cancer
screening and outcomes for women in Yap State.
10
Project title:
Cervical Cancer Surveillance
Project design:
This project will be guided by three on-site staff including a full time Cancer Registrar/Medical Records Supervisor,
a Peace Corps Response Volunteer currently working on an HPV epidemiologic study in Yap State, and a Doctor
of Public Health responsible for the oversight of the Quality Assurance and NonCommunicable Disease Programs
in Yap State. In addition, there will be regular support available from researchers at CDC in Atlanta. The data entry
will be conducted in the English language, utilizing an Access-based database. The student will provide much
needed technical assistance to this important project, which will result in the data needed to guide improvements in
local cervical cancer screening programming.
Student responsibilities:
The student will work onsite as an integral part of a small research team at Yap State Hospital. He/she will extract
data from medical records of female patients with abnormal cervical cancer screening results, and enter these data
into an Access-based database. He/she will then analyze the aggregate data to generate statistics and write a
report on the trends observed during entry and analysis. The student will use this analysis to generate
recommendations for preventive action to improve the morbidity and mortality from cervical cancer in Yap State.
This work will be collaborative in nature, and the student will have daily access to local expertise as needed.
11
Project title:
Hepatitis C Elimination
Fellow requested:
Year:
Third year
Fourth year
Location:
Georgia
Project availability:
September 2016 – June 2017
Type:
Medical student
Veterinary student
Project duration:
12 weeks
Project supervisor(s):
In Atlanta:
Francisco Averhoff, MD, MPH, Associate Director for Global Health, Division of Viral Hepatitis, National Center
for HIV, Hepatitis, STD and TB Prevention
In Georgia:
Juliette Morgan, MD, Medical Epidemiologist, CDC Country Director, South Caucasus GDD Office
Languages:
English
Skills:
Basic computer skills including use of Microsoft Office (Word, PowerPoint, Excel); data management and
analysis skills; strong written and oral communication skills
Project description:
Georgia, a country with a population of 4.3 million people, has a chronic hepatitis C prevalence of approximately
5%, one of the highest worldwide. Georgia’s government has identified hepatitis C as a leading public health
concern and has committed to a Hepatitis C Elimination Program that began in 2015 and aims to reduce
prevalence to 0.5% by 2020. CDC Division of Viral Hepatitis (DVH) and Center for Global Health (CGH) have
assisted the Georgian Ministry of Labor, Health and Social Affairs in planning and implementing a subsidized
public treatment program for Georgians infected with the hepatitis C virus (HCV). CDC’s role going forward will be
to provide technical assistance to improve Georgia’s HCV surveillance system, and to plan and implement a
monitoring and evaluation framework to track progress toward Georgia’s HCV elimination goals. The CDC-Hubert
Global Health Fellow will work with DVH and Ministry staff to identify gaps in Georgia’s HCV surveillance system
and draft a plan to improve it using existing and novel data sources.
Objectives:
1. Evaluate Georgia’s current HCV surveillance capabilities and practices.
2. Develop recommendations for Georgia’s Ministry of Labor, Health and Social Affairs on strategies to improve
HCV surveillance that will facilitate Georgia’s HCV elimination goals. The Fellow will work with DVH
supervisor to choose a specific area of focus (e.g., surveillance in a high-risk population such as persons who
inject drugs, or surveillance in clinical health care settings).
3. Identify data sources to implement surveillance improvement recommendations.
Project design:
The Fellow will be assigned to the CDC Global Disease Detection South Caucasus office, located in Tbilisi,
Georgia. He or she will be supervised by CGH staff based in Tbilisi, DVH staff on temporary duty in Tbilisi, and
DVH staff based in Atlanta. The Fellow’s primary project will be to assist in developing recommendations to
improve Georgia’s HCV surveillance system, with a specific area of focus determined by the Fellow in
consultation with a DVH supervisor. If time allows, the Fellow will also have the opportunity to participate in other
HCV elimination projects, including monitoring and evaluation.
12
Project title:
Hepatitis C Elimination
Student responsibilities:
 Consult with DVH supervisor to choose an area of focus within the overall HCV surveillance agenda.
 Work with DVH and Ministry staff to evaluate existing HCV surveillance practices within that area of focus.
Identify gaps in existing surveillance and potential data sources to fill those gaps.
 Assist in drafting recommendations to the Georgian Ministry of Labor, Health and Social Affairs on
strategies to improve HCV surveillance in support of the country’s HCV elimination goals
 Support DVH in management of ongoing HCV elimination activities in Georgia.
 Provide progress updates to relevant staff.
The Fellow will work with counterparts in the Georgian Ministry of Labor, Health and Social Affairs, including the
National Center for Disease Control. He or she will also interact with healthcare providers involved in HCV
elimination efforts and community-based groups serving populations at high risk for transmitting HCV. The Fellow
will have translation support through the CDC Tbilisi office.
13
Project title:
Pediatric Respiratory Etiology Surveillance Study (PRESS)
Fellow requested:
Year:
Third year
Fourth year
Location:
Kenya
Project availability:
September 2016 – June 2017
Type:
Medical student
Veterinary student
Project duration:
TBD
Project supervisor(s):
Sandra S Chaves, MD, MSc; Influenza Program Director in Kenya
Languages:
English
Skills:
Experience with basic computer programs helpful, especially those programs similar to Epi Info™ and Microsoft
Access® (familiarity with statistical software like SAS would be a desirable asset)
Project description:
We enroll children <5 years hospitalized with acute respiratory illness who are hospitalized at the Kenyatta
National Hospital. We follow the enrolled child throughout hospitalization and in case of death we investigate
causes based on medical autopsy
Objectives:
Identify etiology of respiratory deaths in young children and understand pathophysiology of death to inform medical
management of future cases
Project design:
All children hospitalized at the KNH with acute respiratory illness have medical chart reviewed by surveillance
officers and clinical data, including interventions and outcomes, collected. Data also include use of antibiotics and
tests performance for diagnosis investigation.
Student responsibilities:
Work with supervisor in developing a strategy to abstract data on clinical management of the patients to be
reviewed and summarize clinical data on the management of patients during hospitalization and identify issues
that could be used to design appropriate recommendations for better patient care in the future. This will also
involve coding of open text data and the student may also be involved in data management and data analysis. This
highly motivated student should be willing to be independent, flexible, and self-inspired.
14
Project title:
Improving Infection Prevention and Control
Fellow requested:
Year:
Third year
Fourth year
Type:
Medical student
Location:
Tbilisi, Georgia (with travel throughout Georgia)
Project availability:
September 2016 – June 2017
Veterinary student
Project duration:
8–12 weeks
Project supervisor(s):
Amy Kolwaite, MS, MPH, Nurse Epidemiologist, Team Lead, DHQP
Juliette Morgan, MD, Medical Epidemiologist, Country Director-Georgia
Marika Geleishvili
Languages:
English
Skills:
Basic computer skills including use of Microsoft Office
Ability to use statistical software (Epi Info, SAS, or SPSS)
Experience in microbiology strongly desired
Project description:
Healthcare-Associated Infections (HAI) and antimicrobial resistance (AMR) are global issues. HAIs lead to
substantial morbidity and mortality in middle and lower-income countries, with at least 5–10% of patient
admissions complicated by a HAI. In Georgia, there is no formal surveillance system in place for HAIs, therefore
the number and extent of HAIs and AMR is likely underestimated in terms of disease burden, severity of
outcomes, and economic impact. In addition, training and supervision of healthcare personnel on infection
prevention and control practices (IPC) is rare. To address these issues, the Division of Healthcare Quality
Promotion (DHQP) is providing technical assistance on a prospective multisite HAI surveillance project. The
project will provide the necessary data, such as provision of AMR testing results and HAI prevalence, to facilitate
public health authorities to guide evidence-based recommendations for the prevention of HAIs and AMR.
Objectives:
1. Strengthen surveillance to detect HAIs in healthcare facilities.
2. Implement and monitor IPC practices in order to reduce transmission of HAIs.
3. Improve laboratory capacity to detect AMR and isolate HAI pathogens.
4. Provide assistance to the Ministry of Health to implement the IPC components of the national Hepatitis C
Elimination Plan.
5. Liaise with partners (WHO, hospitals, universities, NGOs, etc.) to build capacity around IPC and AMR
activities.
Project design:
The student will be based within the CDC, Global Disease Detection (GDD) office in Tbilisi, Georgia and will
receive oversight and guidance from the CDC Country Office and DHQP staff. The student will be involved with
all components of HAI and AMR surveillance but will have the opportunity to identify specific areas of interest
(e.g. training, laboratory, data management, evaluation) in which they would like to focus their assignment.
Student responsibilities:
 Conduct observational studies for hand hygiene and central line insertion.
 Assist hospitals/CDC-Georgia with developing a data analysis and dissemination plan.
 Provide on-site mentoring for IPC nurses on how to identify cases and complete case report forms; review
completed reports for accuracy.
 Mentor/Train ICU and IPC nurses and physicians on proper specimen collection techniques.
 Monitor progress of ongoing activities and provide recommendations for improvement.
 Provide logistical and technical support for trainings.
 Assist in the preparation of PowerPoint presentations for meetings and conferences.
 Analyze datasets and synthesize findings.
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Project title:
Characterization of Extended-Spectrum beta-Lactamase Producing Escherichia coli in Pigs and
Pig Products
Fellow requested:
Year:
Third year
Fourth year
Location:
Thailand
Project availability:
September 2016 – June 2017
Type:
Medical student
Veterinary student
Project duration:
10–12 weeks
Project supervisor(s):
Toni Whistler, PhD, Director of Strengthening Laboratory Capacity Program
Languages:
English
Skills:
Basic bacteriology skill is required. Molecular biology and phylogenetic analysis are an advantage
Project description:
This project involves sample collection, bacterial isolation, antimicrobial susceptibility testing and molecular
characterization of 300 E. coli isolates from pigs, pig carcasses and pig products in Thailand.
Objectives:
Assess the recent state of ESBL-producing E. coli and to characterize genotypes of ESBL-producing E. coli pig
and pig products in Thailand.
Project design:
Pig farms, slaughterhouses and fresh markets around Thailand will be selected based on the availability of pigs,
carcasses and products at the time of sampling. Up to 100 individual samples will be randomly selected from
each site. Laboratory work will be conducted at the Faculty of Veterinary Science, Chulalongkorn University in
Bangkok. Methodologies will include bacterial isolation, antimicrobial susceptibility testing, identification and
molecular characterization of extended spectrum beta lactamase (ESBL) conferring genes.
Student responsibilities:
The student will work as part of a research team which includes academic researchers, regulatory veterinarians
and laboratory technicians. They will collect samples from live pigs, slaughtered animals, and pig products. They
will be expected to perform various laboratory procedures to identify and characterize the bacteria and conduct
statistical analysis of the data. On a regular basis they will prepare progress reports and make presentations of
their results.
The student will have the opportunity to see first hand how pigs are produced from weaning until products are
placed on shelf for consumers. This is an excellent opportunity for the student to gain insight into pig production
industry, food safety and antimicrobial resistance in a southeast Asian middle-income country.
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Project title:
Preventing Zoonotic Diseases
Fellow requested:
Year:
Third year
Fourth year
Location:
Kenya
Project availability:
September 2016 – June 2017
Type:
Medical student
Veterinary student
Project duration:
TBD
Project supervisor(s):
Marc-Alain Widdowson DVM, MSc; Director, Division of Global Health Protection, CDC-Kenya
Languages:
English
Skills:
Experience with basic computer programs helpful, especially those programs similar to Epi Info™ and Microsoft
Access® (familiarity with statistical software like SAS or STATA would be a desirable asset)
Project description:
To enhance near real-time reporting of disease syndromes in animals that could be zoonotic, an Enhanced
Passive Surveillance (EPS) electronic platform and data system developed at the Institute of Infectious Animal
Diseases (formerly Foreign and Zoonotic Disease), Department of Homeland Security Center of Excellence and
deployed in the United States has been identified and is being adapted for deployment by the Kenya Ministry of
Livestock and Fisheries development. The EPS is being adapted to integrated analysis of animal and public
health data using algorithms defined locally. This will enable rapid analysis and generation of potentially
actionable data for recognition of and response to zoonotic disease events. The plan is to deploy the EPS system
in pilot counties to capture data, transmit and analyze data at a central location and sharing data on zoonotic
disease events with the Ministry of Health for public health action.
Objectives:
Establish real-time surveillance of zoonotic diseases in animals and humans in order to detect disease before
spillover to humans.
Project design:
This is a zoonotic disease surveillance project being implemented by a GHSA partner. While adapting of the EPS
system is expected to be complete in the current year, the applications in smartphones would be deployed in
selected counties in FY 17 with systematic monitoring and evaluation of data of the surveillance system to
highlight areas of improvement.
Student responsibilities:
Work with supervisor to develop a surveillance evaluation tool; work with Ministry of Agriculture and Ministry of
Health partners in the deployment of the surveillance tool. This may involve participating in delivering
presentations on aspects of the surveillance systems, training surveillance officers on use of the application on
smart phones, monitoring data flow, evaluating/validating data that is received, site visits in pilot counties and
interaction with senior and middle level GoK surveillance officers and managers; preparing data summaries and
feedback to the field. The student may also be involved in data management and data analysis. This highly
motivated student should be willing to be sociable, independent, flexible, and self-inspired
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