From Kaposi’s Sarcoma Research in Sub-Saharan Africa to Cancer Training in East Africa

The intersection between endemic infection with Kaposi’s sarcoma-associated herpesvirus (KSHV, the viral etiologic agent of KS) and the HIV epidemic in sub-Saharan Africa has resulted in KS becoming one of the most common malignancies in the region. Dr. Martin collaborates with African investigators and colleagues (dermatologists, basic scientists, and engineers from both within and outside UCSF) to study various aspects of KSHV and KS. Initially, Dr. Martin investigated the distribution, determinants, and clinical virology of KSHV in Zimbabwe, South Africa, and Uganda but more recently, has focused on the main disease manifestation of KSHV, which is KS. His team has several active projects in Uganda and Kenya concerning improving KS diagnosis, monitoring KS incidence, evaluating survival after KS diagnosis, and treating KS. The research is best characterized as human subjects research (i.e., clinical and epidemiologic research) with a strong translational emphasis, attempting to relate findings from basic research laboratories to clinical parameters.

In addition to this research, Dr. Martin’s international work emphasizes training in the methods of clinical and epidemiologic research. He has led training programs, sponsored by the NIH, which brings emerging scientists from East Africa to UCSF. Here, they access training typically inaccessible in their own regions. Students study in the same formal degree programs as local U.S.-based scholars: the UCSF Training in Clinical Research Programs. Recent graduates now collaboratively lead projects with Dr. Martin and extend their own training to colleagues in East Africa. These scientists serve as small-group leaders for UCSF-based clinical research courses taken on-line by local students. The ultimate goal is to facilitate the establishment of independent, high-quality research training programs by these East African scholars in their home countries.

Publications:

Semeere AS, Wenger M, Busakhala N, Buziba N, Bwana M, Muyindike W, Amerson E, Maurer T, McCalmont T, LeBoit P, Musick B, Yiannoutsos C, Lukande R, Castelnuovo B, Laker-Oketta M, Kambugu A, Glidden D, Wools-Kaloustian K, Martin J. A prospective ascertainment of cancer incidence in sub-Saharan Africa: The case of Kaposi sarcoma. Cancer Medicine. 2016 May; 5(5): 914–928. PMCID: PMC4864821. DOI:  10.1002/cam4.618.

Freeman EE, Semeere AS, Wenger MA, Bwana M, Asirwa FC, Busakhala N, Oga E, Odutola M, Kwaghe V, Jaquet A, Azinyui Yumo H, Dusingize JC, Anastos K, Hoover D, Dabis F, Yiannoutsos C, Wools-Kaloustian K, Martin JN. Pitfalls of practicing cancer epidemiology in resource-limited settings: the case of survival after a diagnosis of Kaposi's sarcoma in sub-Saharan Africa. BMC Cancer. 16:65, 2016. PMCID: PMC4744447. DOI:  10.1186/s12885-016-2080-0.

Geng EH, Odeny TA, Lyamuya R, Nakiwagga-Muwanga A, Diero L, Bwana M, Braitstein P, Somi G, Kambugu A, Bukusi E, Wenger M, Neilands TB, Glidden DV, Wools-Kaloustian K, Yiannoutsos C, Martin JN. Retention in care and patient-reported reasons for undocumented transfer or stopping care among HIV-infected patients on antiretroviral therapy in eastern Africa: application of a sampling-based approach. Clin Infect Dis. 62:935-44, 2016. PMID: 26679625. DOI: 10.1093/cid/civ1004.

Laker-Oketta M, Wenger M, Semeere A, Castelnuovo B, Kambugu A, Lukande R, Asirwa FC, Busakhala N, Buziba N, Diero L, Wools-Kaloustian K, Strother RM, Bwana M, Muyindike W, Amerson E, Mbidde E, Maurer T, Martin JN. Task shifting and skin punch for the histologic diagnosis of Kaposi’s sarcoma in sub-Saharan Africa: A public health solution to a public health problem. Oncology 89:60–65, 2015. PMCID: PMC4485601. DOI: 10.1159/000375165.

Byakwaga H, Hunt PW, Laker-Oketta M, Glidden DV, Huang Y, Bwana M, Mocello AR, Bennett J, Walusansa V, Bangsberg DR, Mbidde EK, Martin JN. The kynurenine pathway of tryptophan catabolism and AIDS-associated Kaposi’s sarcoma in Africa. Journal of Acquired Immune Deficiency Syndromes. 70:296-303, 2015. PMCID: PMC4607630. DOI:  10.1097/QAI.0000000000000747.

Amerson E, Woodruff CM, Forrestel A, Wenger M, McCalmont T, LeBoit P, Maurer T, Laker-Oketta M, Muyindike W, Bwana M, Buziba N, Busakhala N, Wools-Kaloustian K, Martin J. Accuracy of clinical suspicion and pathologic diagnosis of Kaposi sarcoma in East Africa. Journal of Acquired Immune Deficiency Syndromes. 71:295-301, 2016. PMCID: PMC4770348. DOI:  10.1097/QAI.0000000000000862.

Geng EH, Odeny TA, Lyamuya RE, Nakiwogga-Muwanga A, Diero L, Bwana M, Muyindike W, Braitstein P, Somi GR, Kambugu A, Bukusi E, Wenger M, Glidden DV, Yiannoutsos CT, Martin JN. Estimation of mortality among HIV-infected people on antiretroviral treatment in East Africa: a sampling based approach in an observational, multisite, cohort study. Lancet HIV 2:e107–e116, 2015. PMCID: PMC4480204. DOI: 10.1016/S2352-3018(15)00002-8.