BHP investigators lead a group of studies to evaluate and address untreated hypertension in Botswana, as this is a major risk factor for cardiovascular disease (including stroke) in the region. Investigators are also evaluating the prevalence and manifestations of frailty, particularly in older persons with and without HIV.
There is growing recognition that HIV-exposed children might have poorer developmental outcomes compared with HIV-unexposed children, particularly in low-income and middle-income countries. Several studies have reported impairments in cognitive, language, or motor function. Other studies did not find substantial differences between HIV-exposed and HIV-unexposed children. Given that data are inconsistent, the exact nature of developmental delay and the clinical relevance in HIV exposed infants remain unclear.
Expertise and infrastructure related to HIV surveillance, clinical trials and molecular diagnostics allowed BHP to be in a unique position to rapidly respond to the COVID-19 pandemic. BHP partnered with the government to stand up robust SARS CoV2 PCR testing within days of the first diagnosed cases (performing more than 1/3 of testing for the country). Additionally, the BHP lab created a world-class program for SARS CoV2 genomic surveillance using molecular sequencing which led to the discovery of the omicron variant [ht
The BHP research laboratory has over the years played a critical role in carrying out molecular virology work on HIV and this has built capacity that has enabled work on other pathogens including Hepatitis B virus(HBV), Mycobactrerium tuberculosis (M.Tb), Human Papillomavirus (HPV) and more recently SARS-CoV-2. The overarching aim of the lab is to use genomic data to understand phenotypic and clinical impact of genomic variation.
HIV prevention research, primarily through biomedical means, has been a significant area of focus for BHP.
Botswana is vulnerable to climate change and its impact. BHP investigators are starting to evaluate the impact of climate change on human health--for example, demonstrating that adverse birth outcomes vary by season in Botswana (https://bmjopen.bmj.com/content/11/9/e045882).
From ground-breaking clinical trials to observational cohorts and epidemiologic surveillance, BHP has remained a global leader in maternal and pediatric HIV research since early in the HIV epidedmic, with BHP findings leading to global guidelines changes. The focus of the research has always been to find ways to improve the health outcomes of pregnant women living with HIV and their children.
Breastfeeding for child survival is one of the cornerstone interventions to alleviate under five child mortality, especially in low resource settings. The benefit of breastfeeding on child survival has been documented worldwide as a key intervention to avoid mortality in children in low- and middle-income countriesMaintaining breastfeeding and HIV-free survival is critical, and requires a great level of dexterity.
Sexual and Reproductive Health (SRH) and HIV risk behaviors for young people are intertwined. This rationalizes the need for integration of HIV and SRH services within the health care system, especially in countries with high HIV burden. The widespread success of highly active antiretroviral therapy (HAART) has improved the outlook and life expectancy people living with HIV worldwide. Ironically, the number of people with behaviorally acquired HIV infection is on the rise (majority during the perinatal period and aged 15–24 years).
The BHP Clinical Trials Unit (CTU) has conducted multiple international clinical trials, under the AID Clinical Trials Group (ACTG) and and other related networks, which are high impact and aimed to improve the treatment of HIV and its co-infections, including TB, viral hepatitis and other co-morbidities and seeking to advance approaches to cure HIV.