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December 7, 2000

GSPH researchers collaborating with counterparts on Tobago

Researchers at Pitt's Graduate School of Public Health (GSPH) are working with their counterparts in the Caribbean island of Tobago to study and treat prostate cancer there.

They also are searching for the genetic variable that protects West African descendants from osteoporosis, teaching public health workers about AIDS education programs, and studying domestic violence, alcohol abuse and Alzheimer's disease.

"Tobagonian men and most African American men share a common West African ancestry, so chronic disease patterns are similar," said project director Clarann H. Bunker, Pitt assistant professor of epidemiology. "This collaboration allows us to study the same ancestral genes in a different setting."

Tobagonian men, like black men in the United States, have a higher rate of prostate cancer than white men do. "On the other hand, people of West African descent tend to have stronger bones than Caucasians, which is why they have a lower incidence of osteoporosis," said Bunker, who has been collaborating with Tobagonian researchers since 1997.

In the United States, doctors commonly treat prostate cancer with radiation or by removing the prostate. But Tobago, which is part of the island nation of Trinidad and Tobago, currently lacks effective treatment for the disease, according to Judy Bob, secretary of health and social services for the Tobago House of Assembly.

"In Trinidad, they have an outdated [oncology] facility, which the central government is considering replacing," Bob said. "But in Tobago, we have no treatment apart from prescribing drugs" to reduce production of testosterone, which is linked with the disease.

On Nov. 30, Secretary Bob and Pitt representatives signed an agreement formalizing the GSPH-Tobago collaboration.

Bunker of GSPH said, "Beyond the research opportunities, this provides a tremendous opportunity for our students to gain experience in international epidemiological studies. We're discussing creating a course through which students could do research practica in Tobago.

"The more types of research we can do like this, the more it will enhance our ability to attract and retain good faculty and students of minority background," Bunker added. "Minority students in our school have been very interested in African and Caribbean studies."

Pacific Lutheran University, a small, private institution in Washington state, is the only other American school with a research presence in Tobago, according to Bob. "This is really a big project for us," she said of the GSPH collaboration. "It will enable our health professionals to come to the University of Pittsburgh to explore new areas of technology. We'll have the opportunity to also send persons for short training stints. And, researchers from Pittsburgh will come to Tobago, to transfer skills to our health care professionals.

"So far, five or six of our doctors have come to GSPH to take epidemiology courses, and it was an eye-opening experience for them. About the same number of nurses have come here, too. Given our population [about 1 million for Trinidad and Tobago combined] that's a significant number of people."

According to Bob, one reason that Tobago needs foreign help is because it has been shortchanged for years by the larger island of Trinidad, which receives a disproportionate share of the county's oil and natural gas revenues.

Pitt is not committing hard money to the Tobago projects, but grants won by GSPH researchers will fund much of the activity, Bunker said.

UPMC surgeons have gone twice to Tobago to perform free prostate cancer surgery for men enrolled in a GSPH screening study. Joel Nelson, chairperson of Pitt's urology department, headed a team that traveled to Tobago last month and performed a new type of radical prostatectomy on five Tobagonian men. "This surgery removes the prostate while sparing the nerves, so patients can continue to have sex and urinate normally," Bunker explained. "It was the most sophisticated surgery ever performed in Tobago and, to our knowledge, in the southern Caribbean."

Pitt officials said the Tobago collaboration dovetails with GSPH's ongoing efforts to eliminate health disparities between blacks and whites. In January, GSPH's Center for Minority Health and the National Institutes of Health will co-host a minority health summit in Pittsburgh.

— Bruce Steele

Filed under: Feature,Volume 33 Issue 8

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