# Global Research Endeavors to Advance Treatment of Neurological Disorders in Africa (GREAT Neurology)

> **NIH NIH R35** · UNIVERSITY OF ROCHESTER · 2024 · $530,560

## Abstract

The burden of neurological disorders disproportionately impacts resource-limited tropical settings resulting in
grossly insufficient capacity for care provision or research. This global research program aims to advance our
understanding of common neurological disorders in the African context to inform the local prevention and
treatment of these conditions while also elucidating pathophysiological processes more broadly relevant. This
will be accomplished through the continuation of Dr. Birbeck's neuro-HIV and cerebral malaria investigations
plus support and mentorship for young clinician scientists engaged in a broad range of research endeavors.
Research activities include--
 • Cerebral malaria: In a prospective cohort study of children with CNS malaria, we will examine the role
 of neuroinflammation in structural injury and neurologic morbidity with laboratory assessments of acute
 inflammation, serial neuroimaging, and long term neurological outcomes. The novel study population
 will include children in a randomized controlled trial (RCT) of aggressive antipyretics as well as a more
 representative non-RCT population. The effects of co-infection with SARS-CoV-2 on parasite
 clearance, inflammatory factors associated with malarial death and neurologic sequelae and structural
 injuries including ischemia, bleeding, and thromboses will be ascertained.
• Neuro-HIV: Given the widespread availability of HIV therapies, the next challenge in neuro-HIV care in
Africa includes noncommunicable disorders associated with chronic low grade inflammation. Utilizing
our network of rural and urban HIV clinics, we will study HIV-associated accelerated aging of the
nervous system. Given its highly inflammatory state, SARS-CoV-2 could potentially contribute to this
burden. Among children, we have recently reported high rates of subclinical cerebrovascular disease
(CVD) despite long-standing, effectively treated HIV. We will pursue further imaging studies including in
HIV uninfected but exposed children and community controls to identify risk factors for CVD, examine
the metabolic impact of antiretroviral therapies and assess the relationship between premature CVD
and infection with SARS-Co-V2. Among adults with HIV, SARS-Co-V2 infection will be evaluated for its
possible role in accelerated aging in a 5-year prospective cohort study monitoring for cognitive
impairment, psychiatric symptoms, strokes, neuropathies and seizures.
This research will be undertaken in Zambia and Malawi where Dr. Birbeck has worked for over 25 years. This
research program award will also provide infrastructure, mentorship and a vibrant environment for scholarship
and trainee engagement with both US and African academics.

## Key facts

- **NIH application ID:** 10833013
- **Project number:** 5R35NS122265-04
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** GRETCHEN L. BIRBECK
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $530,560
- **Award type:** 5
- **Project period:** 2021-05-01 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10833013

## Citation

> US National Institutes of Health, RePORTER application 10833013, Global Research Endeavors to Advance Treatment of Neurological Disorders in Africa (GREAT Neurology) (5R35NS122265-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10833013. Licensed CC0.

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