Paul K. Drain, MD, MPH, an infectious diseases fellow at Massachusetts General Hospital and Harvard Medical School, is the 2013 recipient of the Merle A. Sande/Pfizer Fellowship Award in International Infectious Diseases. This award is intended to encourage young physicians who are interested in international medicine and is given for important clinical research in infectious diseases or HIV conducted in a resource-limited setting.
Dr. Drain received his public health degree in 2001 and medical degree in 2007, both from the University of Washington. He completed residency in internal medicine at Stanford University in 2010, and fellowship in infectious diseases at Massachusetts General Hospital and Brigham and Women’s Hospital. Described by his colleagues as smart, dedicated, and energetic, with a commitment to research and clinical excellence, Dr. Drain was promoted to junior faculty at Harvard and Massachusetts General Hospital in the summer of 2013.
During his ID fellowship, Dr. Drain spent part of 2011 and 2012 in Durban, South Africa, evaluating a point-of-care urinary diagnostic test for active tuberculosis among HIV-infected adults. While caring for patients at King Edward VIII Hospital, the teaching hospital of the University of KwaZulu-Natal, many HIV-infected patients were dying from cryptococcal meningitis, despite administration of IV amphotericin. During that time, the World Health Organization endorsed a new, rapid test for cryptococcal antigens, which might allow for prompt diagnosis, early initiation of anti-fungal therapy, and prevention of cryptococcal meningitis and death.
Dr. Drain’s proposed research will evaluate the rapid, point-of-care cryptococcal antigen test and screening strategies among HIV-infected adults in an urban township of KwaZulu-Natal, South Africa. His longitudinal study will focus on quantifying the undiagnosed burden of cryptococcal infections, assessing the feasibility of implementing a nurse-driven screening strategy, measuring the impact on clinic-based testing on patient outcomes, and quantifying the cost-effectiveness of various strategies to prevent cryptococcal meningitis.
His study will evaluate whether rapid, point-of-care, clinic-based screening for cryptococcal disease will prevent cryptococcal-related mortality and be cost-effective among HIV-infected adults in a resource-limited setting. This project will produce strategies for clinicians in HIV-endemic areas to promptly diagnose life-threatening cryptococcal infections to prevent cryptococcal meningitis, and for policy makers to implement a cost-effective screening program among people living with HIV/AIDS. Collectively, his study will help provide the necessary tools to prevent cryptococcal meningitis, a leading cause of AIDS-related mortality worldwide.
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