Meet the CIPHER grantees

Birkneh Tadesse

Year awarded: 2015
Institution: Hawassa University, Ethiopia
Research site: Hawassa University
Primary mentor: Andrea Ruff, Johns Hopkins School of Hygiene and Public Health

Birkneh Tadesse is a paediatrician and Associate Professor of paediatrics at Hawassa University, Ethiopia. Dr Tadesse’s area of research focuses on paediatric infectious diseases and specifically on paediatric HIV treatment optimization in Ethiopia.

More information on Birkneh | Email

“The CIPHER grant has been a tremendous opportunity and an eye opener for my research career.”

Research project: Improving treatment of Ethiopian children living with HIV through better detection of treatment failure

The issue

Refining detection of treatment failure among children on first-line ART is crucial for improving ART success among children living with HIV. The WHO guidelines for detection of first-line ART failure (ARTF) are proven to have low sensitivity and lead to a significant number of misclassifications in the absence of viral load testing. Developing a prediction rule, which has a high sensitivity and is not overly dependent on viral load determination, is demanding, especially in resource-limited settings where such assays are not readily available.

The CIPHER project

This is a prospective cohort study involving children living with HIV on or initiating first-line ART, conducted to identify the performance of WHO criteria in detecting ARTF as defined by viral load. Specifically, Dr Tadesse’s research project was aimed at determining the performance of WHO clinical criteria for detection of ARTF in Ethiopian children living with HIV. The intention was to identify clinical and immunological predictors of ARTF and develop a practical, acceptable and accurate clinical prediction rule to improve detection of ARTF among these children. This is the first study that tried to evaluate the application of local scoring systems for the diagnosis of ARTF in children in resource-poor settings.

The impact

Dr Tadesse is in the second year of his PhD programme at Karolinska Institute. Related to the CIPHER project, Dr Tadesse collaborated with Dr Zabrina Brumme at Simon Fraser University to assess the prevalence, predictors and genotyping of HIV drug resistance among children and adolescents living with HIV who fail treatment. Moreover, ART nurses were trained in paediatric HIV treatment and follow up and data collection methods. His team supported students with access to its dataset, and two MSc students conducted their research on this dataset.