Friday, February 15, 2008

Fighting HIV/AIDS in Tanzania

The challenge in great; the need greater.

Working in a hospital clinic in the town of Moshi, situated right at the base of Mt. Kilimanjaro in northeastern Tanzania, researchers from Duke Medical Center are combining science and service to help fight the HIV/AIDS plague that threatens -- and too often cuts short -- the lives of so many people in Africa.

In a Feb. 14 lecture, part of a series of university seminars on global health, John Bartlett (photo) provided a you-are-there look at what his team faced when first arriving in Tanzania -- where roughly half of all hospitals lack even running water -- and how far research efforts have come. Working at Kilimanjaro Christian Medical Center (photo below), the team has built up laboratory capabilities and trained local lab personnel and health care workers to achieve world-class standards.

But of most importance, the researchers are using the power of clinical trials to bring voluntary counseling, testing and advanced treatment to people in Moshi and other areas of the country.

Dr. Bartlett, a Duke professor of medicine and co-director of the AIDS research program in Tanzania, says that in many cases they have been able to provide patients with their first-ever access to the kind of care that people in Western nations take for granted. He also stresses that they work hard to cooperate and coordinate with local health professionals and community members, and that they view their work as a long-term commitment.

"We'd like to go out of business sometime, by training enough local people to meet the area's and the country's needs," Dr. Bartlett said. "But that likely will take awhile, considering where the country started from, and we plan to be here for the long haul."

To this end, he said part of the reason for his lecture was to make an "unabashed pitch" to recruit students and faculty to come to Moshi to study and work. "We offer lots of opportunities to work with good equipment, and with good scientists from a number of nations, to address some vitally important questions," he said.

As an example of their work, Dr. Bartlett described recent promising efforts to develop an accurate, easy-to-use and inexpensive testing method that uses dried blood drops to determine whether a newborn infant is infected with HIV -- an important challenge in locations where many women carry the virus. The idea is for a health worker anywhere to obtain a few drops of dried blood from a newborn and then send the sample, with no need for costly treatment or packaging, to Moshi or some other large medical center to be interpreted.

Dr. Bartlett's lecture will soon be available for viewing on the Duke Global Health Institute's website. He also participated in a shorter discussion of research in Tanzania that can be heard here, and the AIDS center's work in Moshi has been reported in Duke Magazine.

Monday, February 11, 2008

Little Particles, Big Problems

Last Thursday night, Feb. 7, a sugar refinery in Savannah, Ga., exploded and burned, killing six people. The blast has been linked to sugar dust in the air.

Not to make light of this tragedy, but exploding sugar?

Duke physicist Robert Behringer says this actually is a well-known phenomenon. If particles of combustible material -- including food grains, coal, wood and chemical products -- become airborne and collect in an enclosed space, a wayward spark can cause them to explode just as gasoline vapors would. A deadly 2003 blast at a pharmaceutical plant in Kinston, N.C., is analyzed here.

Behringer studies the behavior of various types of granular materials that can cause their own set of problems. (In the photo, a storage container collapses as grain particles convert from a "liquid" flow to a "solid" state.) For example, his laboratory studies how coal particles flow. When such flow goes awry -- say, by clogging hoppers in a processing plant -- significant damage may result. Some of their findings have been reported in Duke news releases here and here.

"What we study is part and parcel of the larger spectrum of how granular materials behave and how they can best be handled," Behringer says. "We don't focus on the specific type of event that triggered the sugar refinery explosion. And the problem, as I see it, is that nobody seems to be looking closely at this. In practice, the primary idea simply seems to be, 'if you work with these kinds of materials, you'd better make sure they don't accumulate in the air.' "

For its part, the federal Occupational Safety and Health Administration in October 2007 announced a new National Emphasis Program for inspecting workplaces that create or handle combustible dusts. But while states are encouraged to take part, participation is not (OSHA's emphasis) required.