Author: Dr. Baljinder Singh - 2012-10-01

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Graduating from the University of Southampton, I completed my medical internship in the UK and spent a year practicing rural medicine in New Zealand, before joining the MSc program in tropical medicine and international health at the London School of Hygiene and Tropical Medicine. Following my interest in multi-drug resistant tuberculosis, I was put in touch with Dr Richard Lessells at the Africa Centre but on arriving in Mtubatuba, was instantly inspired by the SATuRN group's groundbreaking work on HIV drug resistance, prompting me to focus my MSc thesis on this area.

My thesis focused on patients presenting with virological treatment failure to first line ART; an increasing problem seen in the shadow of the huge scale-up of treatment for HIV. I was interested to see an increasing minority of patients who were failing treatment but who did not harbor any drug resistance (the wild type group).

Using the detailed information collected within the failure clinics, I investigated whether any particular factors were associated with this group of patients. Baseline CD4 count, being female, having poor adherence to the HIV programme and remaining on the baseline ART regimen were shown to be predictors of this wild type group. These predictors could be utilised by the local ART programme to identify patients who may benefit from targeted resistance testing to direct their subsequent treatment.

Coming to the Africa Centre was a great experience. Nestled in the hills off the main highway, its structure and ideals stand out boldly but yet sit comfortably with its local environs. Dr Tulio de Oliveira and his team were fantastically helpful. Joining Dr Lessells in the clinic gave real context to the data being collected.

As a 'junior scientist', I lived with some of the other MSc/PhD students at the Ilala guesthouse, where I was inspired by the exciting work and experiences of my fellow students. When things were going badly, there was always a helping hand with the STATA programming! Outside of work, I was able to visit the Imfolozi/Hluhluwe and St Lucia national parks, where I was able to see a lion, a giraffe and a zebra crossing the road! I learnt the art of 'Braai' and developed my cheerleading skills at a local rugby game!

I have now returned to clinical training in emergency medicine but look forward to keeping in touch with the SATuRN group and hearing more about the fantastic work being produced. I would certainly recommend any budding clinical MSc/ PhD student with an interest in this area to get in touch.

A final thanks to Dr Richard Lessells, Dr Tulio De Oliveira, and all the staff and researchers at the Africa Centre for Health & Population Studies.

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