# Task-Shifting Pediatric TB/HIV Prevention to Community Health Workers in South Africa

> **NIH NIH K23** · JOHNS HOPKINS UNIVERSITY · 2022 · $171,720

## Abstract

Project Summary
TB and HIV are Top 10 causes of child mortality in sub-Saharan Africa. Short-course combination TB
preventive therapy (TPT) and PMTCT are highly effective and hold promise to reduce the 120,000 new HIV
diagnoses and the 102,000 child TB deaths, of which most occurred in HIV-infected or HIV exposed and
uninfected (HEU) children. TPT and PMTCT effectiveness require improved access to pediatric preventive
care. In South Africa, nearly two thirds of TB-exposed children are also HIV-exposed. Integrating these
prevention services into one community-based intervention could improve access to care, shorten time to
diagnosis and treatment of TB and HIV, and ultimately reduce TB and HIV associated child mortality. Prior
studies have shown community health workers can successfully screen and treat young children for
pneumonia, malaria and neonatal sepsis. Their effectiveness in conducting community-based pediatric TB/HIV
prevention services is unknown. During this K23 Award, we propose the following research aims: 1) use
stakeholder input to adapt a community-based, pediatric TB/HIV prevention intervention and design an
associated implementation strategy, 2) determine the accuracy of TB/HIV preventive care provided by a
community health worker, and 3) determine whether community-based versus clinic-based contact tracing
increases the identification of at-risk children under 5 years old. This research will be nested in a UNITAID
project that aims to catalyze uptake of “3HP,” a new TPT regimen consisting of weekly rifapentine/isoniazid for
people living with HIV and TB-exposed children. To date, I have acquired skills in the design, conduct and
analysis of clinical trials. I will compliment this training with advanced coursework and practical experience in 1)
qualitative study design, data collection and analysis, 2) the application of implementation science frameworks
to analyze context, optimize interventions and evaluate implementation processes, and 3) the design and
analysis of health services research. Together, this skill set will allow me to conduct hybrid effectiveness-
implementation clinical trials in TB and HIV prevention that will allow for improved understanding of an
intervention's effectiveness to inform sustainability and transferability to other settings. These research and
career development plans will be accomplished under the guidance of an international team of mentors with
expertise in TB and HIV, implementation science, qualitative research, pediatrics and health services research.
The data collected and skills earned through this K23 Award will lead to an R01 application that will rigorously
test the community-based intervention and implementation strategy's effectiveness in improving clinical TB and
HIV prevention outcomes. Over the next four years, through the proposed mentorship, coursework and
research, I will develop the expertise necessary to become an independent clinician scientist and expert in the
field of pe...

## Key facts

- **NIH application ID:** 10372987
- **Project number:** 5K23HD096973-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Nicole Salazar-Austin
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $171,720
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10372987

## Citation

> US National Institutes of Health, RePORTER application 10372987, Task-Shifting Pediatric TB/HIV Prevention to Community Health Workers in South Africa (5K23HD096973-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10372987. Licensed CC0.

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