Hepatitis (Viral Hepatitis A, B, C, D, E, G)

Hepatitis, or inflammation of the liver, most often is caused by hepatitis A, B, and C viruses.

The CDC divides travel vaccinations into three categories: 1) routine, 2) recommended, and 3) required. The only vaccine classified as “required” by International Health Regulations is the yellow fever vaccination for travel to certain countries in sub-Saharan Africa and tropical South America.

“Routine” vaccinations are those that are normally administered, usually during childhood, in the United States. These include immunizations against:

  • tetanus
  • pertussis (whooping cough)
  • hepatitis B
  • hepatitis A

Viral hepatitis definition and overview

Hepatitis means inflammation of the liver. Many illnesses and conditions can cause inflammation of the liver, for example, drugs, alcohol, chemicals, and autoimmune diseases. Many viruses, for example, the virus causing mononucleosis and the cytomegalovirus, can inflame the liver. Most viruses, however, do not attack primarily the liver; the liver is just one of several organs that the viruses affect. When most doctors speak of viral hepatitis, they are using the definition that means hepatitis caused by a few specific viruses that primarily attack the liver and are responsible for about half of all human hepatitis.

There are several hepatitis viruses; they have been named types A, B, C, D, E, F (not confirmed), and G. As our knowledge of hepatitis viruses grows, this alphabetical list will likely become longer. The most common hepatitis viruses are types A, B, and C. Reference to the hepatitis viruses often occurs in an abbreviated form (for example, HAV, HBV, and HCV represent hepatitis viruses A, B, and C, respectively.) The focus of this article is on these viruses that cause the majority of human viral hepatitis.

Hepatitis viruses replicate (multiply) primarily in the liver cells. This can cause the liver to be unable to perform its functions.

The following is a list of major functions of the liver:

  • The liver helps purify the blood by changing harmful chemicals into harmless ones. The source of these chemicals can be external, such as medications or alcohol, or internal, such as ammonia or bilirubin. Typically, these harmful chemicals are broken down into smaller chemicals or attached to other chemicals that then are eliminated from the body in the urine or stool.
  • The liver produces many important substances, especially proteins that are necessary for good health. For example, it produces albumin, the protein building block of the body, as well as the proteins that cause blood to clot properly.
  • The liver stores many sugars, fats, and vitamins until they are needed elsewhere in the body.
  • The liver builds smaller chemicals into larger, more complicated chemicals that are needed elsewhere in the body. Examples of this type of function are the manufacture of fat, cholesterol, and protein bilirubin.

When the liver is inflamed, it does not perform these functions well, which brings about many of the symptoms, signs, and problems associated with any type of hepatitis. Each hepatitis viral type (A-F) has both articles and books describing the details of infection with that specific virus. This article is designed to give the reader an overview of the predominant viruses that cause viral hepatitis, their symptoms, diagnosis, and treatments, and should help the reader choose the subject(s) for more in-depth information.

SLIDESHOW

What are the common types of viral hepatitis?

Hepatitis

Although the most common types of viral hepatitis are HAV, HBV, and HCV, some clinicians had previously considered the acute and chronic phases of hepatic infections as “types” of viral hepatitis. HAV was considered to be acute viral hepatitis because the HAV infections seldom caused permanent liver damage that led to hepatic (liver) failure. HBV and HCV produced chronic viral hepatitis. However, these terms are outdated and not currently used as frequently because all of the viruses that cause hepatitis may have acute phase symptoms (see symptoms below). Prevention techniques and vaccinations have markedly reduced the current incidence of common viral hepatitis infections; however, there remains a population of about 1 to 2 million people in the U.S. with chronic HBV, and about 3.5 million with chronic HCV according to the CDC. Statistics are incomplete for determining how many new infections occur each year; the CDC documented infections but then goes on to estimate the actual numbers by further estimating the number of unreported infections (see the following sections and reference 1).

Hepatitis A (HAV)

In 2016, there were 2,007 new HAV cases reported to the CDC. Hepatitis caused by HAV is an acute illness (acute viral hepatitis) that never becomes chronic. At one time, hepatitis A was referred to as “infectious hepatitis” because it could be spread easily from person to person like other viral infections. Infection with hepatitis A virus can be spread through the ingestion of food or water, especially where unsanitary conditions allow water or food to become contaminated by human waste containing hepatitis A (the fecal-oral mode of transmission). Hepatitis A typically is spread among household members and close contacts through the passage of oral secretions (intimate kissing) or stool (poor hand washing). It also is common to have infections spread to customers in restaurants and among children and workers in daycare centers if hand washing and sanitary precautions are not observed.

Hepatitis B (HBV)

There were 3,218 new cases of HBV infection estimated by the CDC in 2016 and more than 1,698 people died due to the consequences of chronic hepatitis B infection in the United States according to the CDC. HBV hepatitis was at one time referred to as “serum hepatitis,” because it was thought that the only way HBV could spread was through blood or serum (the liquid portion of blood) containing the virus. It is now known that HBV can spread by sexual contact, the transfer of blood or serum through shared needles in drug abusers, accidental needle sticks with needles contaminated with infected blood, blood transfusions, hemodialysis, and by infected mothers to their newborns. The infection also can be spread by tattooing, body piercing, and sharing razors and toothbrushes (if there is contamination with infected blood). About 5% to 10% of patients with HBV hepatitis develop chronic HBV infection (infection lasting at least six months and often years to decades) and can infect others as long as they remain infected. Patients with chronic HBV infection also are at risk of developing cirrhosis, liver failure, and liver cancer. It is estimated that there are 2.2 million people in the U.S. and 2 billion people worldwide who suffer from chronic HBV infections.

Hepatitis C (HCV)

The CDC reported that there were 2,967 reported new cases of hepatitis C in 2016. The CDC reports that the actual number of acute cases is estimated to be 13.9 times the number of reported cases in any year, thus, it is estimated that 41,200 acute hepatitis C cases were occurring in 2016. HCV hepatitis was previously referred to as “non-A, non-B hepatitis,” because the causative virus had not been identified, but it was known to be neither HAV nor HBV. HCV usually is spread by shared needles among drug abusers, blood transfusion, hemodialysis, and needle sticks. Approximately 75%-90% of transfusion-associated hepatitis is caused by HCV. Transmission of the virus by sexual contact has been reported but is considered rare. An estimated 75% to 85% of patients with acute HCV infection develop chronic infection. Patients with chronic HCV infection can continue to infect others. Patients with chronic HCV infection are at risk of developing cirrhosis, liver failure, and liver cancer. It is estimated that there are about 3.5 million people with chronic HCV infection in the U.S.

Types D, E, and G Hepatitis

There also are viral hepatitis types D, E, and G. The most important of these at present is the hepatitis D virus (HDV), also known as the delta virus or agent. It is a small virus that requires concomitant infection with HBV to survive. HDV cannot survive on its own because it requires a protein that the HBV makes (the envelope protein, also called surface antigen) to enable it to infect liver cells. How HDV is spread is by shared needles among drug abusers, contaminated blood, and sexual contact; essentially the same ways as HBV.

Individuals who already have chronic HBV infection can acquire HDV infection at the same time as they acquire the HBV infection, or at a later time. Those with chronic hepatitis due to HBV and HDV develop cirrhosis (severe liver scarring) rapidly. Moreover, the combination of HDV and HBV virus infection is very difficult to treat.

Hepatitis E virus (HEV) is similar to HAV in terms of disease and mainly occurs in Asia where it is transmitted by contaminated water.

Hepatitis G virus (HGV, also termed GBV-C) was recently discovered and resembles HCV, but more closely, the flaviviruses. The virus and its effects are under investigation, and its role in causing disease in humans is unclear.

Health News

Who is at risk for viral hepatitis?

People who are most at risk for developing viral hepatitis are:

Risk for Hepatitis A

Travelers to countries with high infection rates and the inhabitants of those countries are at higher risk for developing hepatitis A.

  • Workers in the health care professions
  • Asians and Pacific Islanders
  • Sewage and water treatment workers
  • People with multiple sexual partners
  • Intravenous drug users patients
  • People with hemophilia who receive blood clotting factors

Blood transfusion, once a common means of spreading viral hepatitis, now is a rare cause of hepatitis. Viral hepatitis is generally thought to be as much as 10 times more common among lower socioeconomic and poorly educated individuals. About one-third of all cases of hepatitis come from an unknown or unidentifiable source. This means that a person does not have to be in a high-risk group to be infected with a hepatitis virus. In countries with poor sanitation, food, and water contamination with HAV increases the risk. Some daycare centers may become contaminated with HAV, so children at such centers are at a higher risk for HAV infections.

What are the symptoms and signs of viral hepatitis?

Symptoms of Hepatitis

If the infection becomes chronic as is the case with hepatitis B and C, that is, infection lasting longer than months, the symptoms and signs of chronic liver disease may begin.

The period between exposure to hepatitis and the onset of the illness is called the incubation period. The incubation period varies depending on the specific hepatitis virus. Hepatitis A virus has an incubation period of about 15 to 45 days; Hepatitis B virus from 45 to 160 days, and Hepatitis C virus from about 2 weeks to 6 months.

Many patients infected with HAV, HBV, and HCV have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu-like symptoms including:

Less common symptoms include:

  • Dark urine
  • Light-colored stools
  • Fever (a yellow appearance to the skin and white portion of the eyes)

IMAGES

What is acute fulminant hepatitis?

Rarely, do individuals with acute infections with HAV and HBV develop severe inflammation, and the liver fails (acute fulminant hepatitis). These patients are extremely ill with the symptoms of acute hepatitis already described and the additional problems of confusion or coma (due to the liver’s failure to detoxify chemicals), as well as bruising or bleeding (due to a lack of blood clotting factors). Up to 80% of people with acute fulminant hepatitis can die within days to weeks; therefore, it is fortunate that acute fulminant hepatitis is rare. For example, less than 0.5% of adults with acute infection with HBV will develop acute fulminant hepatitis. This is even less common with HCV alone, although it becomes more frequent when both HBV and HCV are present together.

What is chronic viral hepatitis?

Chronic Hepatitis B and C

Patients infected with HBV and HCV can develop chronic hepatitis. Doctors define chronic hepatitis as hepatitis that lasts longer than 6 months. In chronic hepatitis, the viruses live and multiply in the liver for years or decades. For unknown reasons, these patients’ immune systems are unable to eradicate the viruses, and the viruses cause chronic inflammation of the liver.

Chronic hepatitis can lead to the development over time of extensive liver scarring (cirrhosis), liver failure, and liver cancer. Liver failure from chronic hepatitis C infection is the most common reason for liver transplantation in the U.S. Patients with chronic viral hepatitis can transmit the infection to others with blood or body fluids (for example, by sharing needles, sexually, and infrequently by organ donation) as well as infrequently by transmission from mother to newborn.

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How is viral hepatitis diagnosed?

Hepatitis Diagnosis

Diagnosis of viral hepatitis is based on symptoms and physical findings as well as blood tests for liver enzymes, viral antibodies, and viral genetic materials.

Symptoms and physical findings

Diagnosis of acute viral hepatitis often is easy, but the diagnosis of chronic hepatitis can be difficult. When a patient reports symptoms of fatigue, nausea, abdominal pain, darkening of urine, and then develops jaundice, the diagnosis of acute viral hepatitis is likely and can be confirmed by blood tests. On the other hand, patients with chronic hepatitis due to HBV and HCV often have no symptoms or only mild nonspecific symptoms such as chronic fatigue. Typically, these patients do not have jaundice until the liver damage is far advanced. Therefore, these patients can remain undiagnosed for years to decades.

Blood tests

There are three types of blood tests for evaluating patients with hepatitis: liver enzymes, antibodies to the hepatitis viruses, and viral proteins or genetic material (viral DNA or RNA).

Liver enzymes: Among the most sensitive and widely used blood tests for evaluating patients with hepatitis are liver enzymes, called aminotransferases. They include aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). These enzymes normally are contained within liver cells. If the liver is injured (as in viral hepatitis), the liver cells spill the enzymes into the blood, raising the enzyme levels in the blood and signaling that the liver is damaged.

The normal range of values for AST is from 5 to 40 units per liter of serum (the liquid part of the blood) while the normal range of values for ALT is from 7 to 56 units per liter of serum. (These normal levels may vary slightly depending on the laboratory.) Patients with acute viral hepatitis (for example, due to HAV or HBV) can develop very high AST and ALT levels, sometimes in the thousands of units per liter. These high AST and ALT levels will become normal in several weeks or months as the patients recover completely from their acute hepatitis. In contrast, patients with chronic HBV and HCV infection typically have only mildly elevated AST and ALT levels, but these abnormalities can last years or decades. Since most patients with chronic hepatitis are asymptomatic (no jaundice or nausea), their mildly abnormal liver enzymes are often unexpectedly encountered on routine blood screening tests during yearly physical examinations or insurance physicals.

Elevated blood levels of AST and ALT only mean that the liver is inflamed, and elevations can be caused by many agents other than hepatitis viruses, such as medications, alcohol, bacteria, fungi, etc. To prove that a hepatitis virus is responsible for the elevations, blood must be tested for antibodies to each of the hepatitis viruses as well as for their genetic material.

Viral antibodies: Antibodies are proteins produced by white blood cells that attack invaders such as bacteria and viruses. Antibodies against the hepatitis A, B, and C viruses usually can be detected in the blood within weeks of infection, and the antibodies remain detectable in the blood for decades thereafter. Blood tests for the antibodies can help diagnose both acute and chronic viral hepatitis.

In acute viral hepatitis, antibodies not only help to eradicate the virus, but they also protect the patient from future infections by the same virus, that is, the patient develops immunity. In chronic hepatitis, however, antibodies and the rest of the immune system are unable to eradicate the virus. The viruses continue to multiply and are released from the liver cells into the blood where their presence can be determined by measuring the viral proteins and genetic material. Therefore, in chronic hepatitis, both antibodies to the viruses and viral proteins and genetic material can be detected in the blood.

Examples of tests for viral antibodies are:

  • anti-HAV (hepatitis A antibody)
  • antibody to hepatitis B core, an antibody directed against the inner core material of the virus (core antigen)
  • antibody to hepatitis B surface, an antibody directed against the outer surface envelope of the virus (surface antigen)
  • antibody to hepatitis B e, an antibody directed against the genetic material of the virus (e antigen)
  • hepatitis C antibody, the antibody against the C virus

Viral proteins and genetic material: Examples of tests for viral proteins and genetic material are:

  • hepatitis B surface antigen
  • hepatitis B DNA
  • hepatitis B e antigen
  • hepatitis C RNA

Other tests: Obstruction of the bile ducts, from either gallstones or cancer, occasionally can mimic acute viral hepatitis. Ultrasound testing can be used to exclude the possibility of gallstones or cancer.

Internships in Global Health

World

Princeton’s Center for Health and Wellbeing sponsors the Internships in Global Health, fully-funded internships spanning global health topics overseas and in the U.S. Hands-on experience brings new dimensions to classroom work and can inspire future research, lead to new interests, and influence career directions.

The internships below are open to all Princeton first-years, sophomores, juniors, and graduate students, both in and outside the GHP certificate program, which makes this a great place to begin your global health internship search. Students are welcome to apply for as many of these internships as interest them.

GHP Students: Internships on this list are pre-approved to fulfill the GHP certificate research requirement when completed in the summer after junior year. Students may not pre-fulfill the GHP research requirement during their first or sophomore years, but students can get great experience through these internships at any time, even if they aren’t pursued for GHP certificate credit.

The Internships in Global Health are part of Learning and Education in Service (LENS), a University commitment to ensure that every undergraduate student is able to participate in a summer internship in service and social impact funded by Princeton.

Service Focus: Internships on this list are all pre-approved for the Service Focus program.

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NOTE: It is not yet confirmed whether each internship will be on-site or virtual. If health conditions permit, most internships will be on-site, in which case CHW will cover all expenses for airfare, housing, food, local transportation, and incidentals. If travel is not permitted, most internships can convert to virtual formats, with a lower stipend. CHW will make final determinations on the travel status of each internship in consultation with Princeton University officials, host organizations, and selected interns by the spring semester.

Round 1 internship opportunities for summer 2023 are posted below. The application deadline is Monday, December 5, 2022.

List of Open Round 1 Summer 2023 Internships (Click for Details):

Fiocruz (Oswaldo Cruz Foundation)

Health Research Internships

Location: Various cities in Brazil

Duration: 8-10 weeks

Number of Positions: 10

Stipend: $6,000

To Apply via GPS: Click Here

About: The Oswaldo Cruz Foundation (Fiocruz) is a research and development institution in science and technology in health, linked to the Ministry of Health of Brazil, and aims to promote health and social development, generate and disseminate scientific and technological knowledge. Our mission is to produce, disseminate and share knowledge and technologies aimed at the strengthening and consolidation of the Unified Health System (SUS) and contribute to the promotion of health and quality of life of the population and to the reduction of social inequalities and the national dynamics of innovation, with the defense of the right to health and full citizenship as central values.

Fiocruz is involved in 10 states of Brazil. Besides the institutes based in Rio de Janeiro, Fiocruz has units in the Northeast, North, Southeast and South of Brazil. Altogether, there are 16 scientific and technical units, focused on teaching, research, innovation, assistance, technological development and extension in the health sector. There is also an office in Mozambique, and in the beginning of 2020 we inaugurated a laboratory in the new Brazilian Antarctic Station.

There are seventeen (17) potential focus areas for a student intern. When applying, please indicate the one or ones you would like to be considered for.

FOCUS AREA #1 – The Viral Hepatitis Ambulatory

About: The Viral Hepatitis Ambulatory focuses on acute viral hepatitis, principally hepatitis A, B and C and pregnant women infected with hepatitis B or C. The team at the Instituto Oswaldo Cruz (IOC) also follows and treats patients chronically infected with hepatitis B or C. Rapid diagnostic tests for hepatitis A, B and C are performed on site for prompt diagnosis and early tracking.

Intern Responsibilities: The intern will be responsible for:

  • Assisting the IOC team in organizing spreadsheets for:
    • Patients on dialysis with hepatitis B or C (co-morbidities, medications, laboratory results, viral sequencing data, and liver staging exams. Pre- and post-treatment results).
    • Pregnant women infected with hepatitis B or C (laboratory results, gestational and neonatal complications).
    • Patients with acute hepatitis B or C infections (laboratory results) and defining recruitment dates for serial blood draws.

    Most activities will be carried out at the Viral Hepatitis Ambulatory. However, occasional trips can be made to hemodialysis units, refugee centers, or other inner state locations during hepatitis campaigns or investigations of hepatitis outbreaks.

    Qualifications: Students in the medical or public health field might be desired as most of the work will be focused on patients and surveillance. However, as the IOC team is engaged in lymphocyte extractions and rapid diagnostic tests other backgrounds are welcome if the interns are interested in the activities proposed. The IOC team is basically composed of biologists, nurses, and physicians. Languages: English and/or Portuguese or Spanish.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #2 – Antimicrobial Resistance

    About: Multiple antibiotic-resistant bacterial infections concern public health systems, as therapeutic options are limited. The indiscriminate use of antibiotics accelerates the selection of resistant bacteria. The resistance mechanisms are diverse and generally encoded in mobile genetic elements – which are quickly disseminated among bacteria that inhabit the same niche, by horizontal gene transfer. Considering such a critical situation, the World Health Organization (WHO) and the Brazilian National Agency for Sanitary Surveillance (ANVISA) ranked as urgent priority research and development of new therapeutic approaches. The current proposal is in line with such goals. On the one hand, our group studies the structure, function, and regulation of the expression of bacterial virulence factors. With this approach, we hope to characterize targets for the rational development of virulence inhibitors. In parallel, we evaluate how metabolites produced by the intestinal microbiota modulate pathogen-host interactions – looking for antivirulence molecules. On the other hand, we characterize host signaling pathways modulated during bacterial infection and evaluate if the repurposing of pharmacological agonists and antagonists can favor bacterial elimination and infection resolution. Moreover, we perform phenotypic characterization of virulence and resistance of environmental isolates. Therefore, this project presents complementary approaches to generate knowledge that might provide a ground basis for the proposition of new therapeutic therapies to combat multidrug-resistant bacteria.

    Intern Responsibilities: The intern will perform the following tasks:

    • Learn and perform microbiological and molecular biology experiments
    • Discuss the antimicrobial resistance problem (based on literature, national data, discussion with other researchers, etc.)
    • Propose science communication activities related to antimicrobial resistance

    Qualifications: The intern should be highly motivated with a knowledge of basic biosafety rules for research labs.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #3 – Pre-Clinical Drug Development for Infectious Diseases

    About: The research group is interested in pre-clinical drug development, especially the target discovery and validation, hit identification and lead development steps. Main targeted areas are infectious diseases (multi-drug resistant bacteria, parasites, and SARS-CoV-2), diabetes and cancer. The team’s focus is on integrating computational and experimental approaches for drug discovery. Current research projects involve development of image-based phenotypic assays for drug screening (high-content screening-HCS), structure-based drug discovery of enzyme inhibitors, Artificial Intelligence (AI)-driven drug discovery and On-chip synthesis of AI-generated compounds for acceleration of the DMTA (design-make-test-analyze) cycle.

    Intern Responsibilities: Intern activities may include: manipulation of cells and parasites in culture, performing a variety of protein purification and biophysical/biochemical analysis methods, operation of HCS microscope, development of image processing and data analysis pipelines for HCS, performing several computer-aided drug design methods (docking, molecular dynamics simulations, etc.), development of machine learning models for classification and other tasks related to drug discovery, development and application of deep learning models for generative chemical modeling, synthesis of chemical compounds using a microfluid on-chip synthesis system.

    Activities will be performed on site at the Laboratory of Experimental and Computational Biochemistry of Drugs (LaBECFar) in Rio de Janeiro.

    Qualifications: A solid theoretical background on biochemistry is required. Additionally, practical skills with biochemistry, cell biology or computer science are welcome.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #4 – Leishmaniasis

    About: Leishmaniasis, caused by the parasite Leishmania and transmitted by sandfly vectors, is a very serious disease that affects mostly poor populations from tropical and sub-tropical regions over the world. Our laboratory works on many molecular aspects of the interaction of the parasite Leishmania with its sandfly vector. We have discovered many important aspects of this interaction, that go from immune responses of infected insect to genes expressed inside the vector by the parasite, that might be important for infection success. More recently we are using this knowledge to identify and test candidates for the development of transmission blocking vaccines, that are altruistic vaccines the interfere with the transmission of diseases by vectors.

    Intern Responsibilities: The intern will participate in hands-on experiments that will be carried out in the laboratory and will focus on the development of a sub-project to be defined.

    Qualifications: The intern must have genuine interest in the project topic.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #5 – Host-Pathogen Interaction of Toxoplasma Gondii and SARS-CoV-2

    About: The Instituto Oswaldo Cruz (IOC) team studies cellular and molecular aspects of host-pathogen interaction, with a special focus on protozoan parasite Toxoplasma gondii, and most recently SARS-CoV-2. Both pathogens are capable of infecting the central nervous system and our laboratory is primarily interested in investigating cerebral microvascular dysfunctions in infected organisms. Additionally, our group has interest in investigating the effects of Toxoplasma infection on the skeletal muscle system, including studies of myogenesis and repair and metabolism and muscle physiology during infection.

    The IOC team uses both in vitro and in vivo models to investigate major changes in the blood-brain barrier during infection with pathogens aforementioned. Cells and tissues are isolated and analyzed by different modalities of microscopy (confocal, electron, etc.). Protein and gene expression are evaluated by RT-qPCR and western blotting and inflammatory markers are assesses by ELISA.

    Intern Responsibilities: The laboratory that the intern will work in is located at the Oswaldo Cruz Foundation, in the traditional Carlos Chagas Pavillion, at the Manguinhos Campus. The laboratory is well equipped to perform most of the proposed studies and, when necessary, has full access to technological facilities at both the Oswaldo Cruz Institute, but at the Federal University of Rio de Janeiro as well.

    Qualifications: Ideal candidates will have some degree of training in cell biology methodologies. All activities will be held in English for the interns, but some basic online Portuguese study prior to arrival is recommended.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #6 – Leprosy Laboratory

    About: The main focus of Leprosy Laboratory is the translational research in mycobacterial diseases. The intern will be involved in research projects associated with the evaluation of mechanisms associated with the immunopathogenesis of mycobacterial diseases as well as the clinical studies performed at our laboratory.

    Intern Responsibilities: The intern will have training in biosafety and after that they will work at Souza Araujo Outpatient Clinic (ASA), a reference center in Leprosy from the Ministry of Health in Brazil that is part of Leprosy Laboratory. They will monitor the routine and care for patients affected by Hansen’s disease. They will monitor the procedures performed at ASA as skin punch and nerve biopsies and slit skin smear microscopy. Students will also be trained in histopathological routines (preparing and reading of microscopic slides), as well as in the routine serology and PCR for complementary diagnosis of Hansen’s disease. They will have the opportunity to accompany the different clinical research protocols performed at ASA, focusing on the identification of new drugs for the treatment of leprosy and its complications like leprosy neuropathy. In addition, they will accompany the studies carried out in the laboratory that aim to identify the pathways of the immunopathogenesis of the disease, having the opportunity to learn about translational research in Hansen’s disease. After 6-8-week training, students will prepare a project based on the knowledge learned during the internship and will discuss it with their supervisor.

    Qualifications: The intern must have genuine interest in the project topic. Basic online Portuguese study prior to arrival is recommended.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #7 – Drug Utilization Research and Medicines Policy

    About: The Escola Nacional de Saúde Pública (ENSP) team’s work is mainly directed to Drug Utilization Research and Medicines Policy, and it focuses on publicly available information from secondary databases. There are three ‘umbrella’ projects which are ongoing: Policies, prioritization, provision and utilization of medicines in Brazil (Project P3-MU); Research, pharmaceutical services and inequities related to cancer care; Ethics, health emergencies and disasters, and medicines for endemic and rare diseases.

    Intern Responsibilities: The intern would have the opportunities to explore and analyze data, review literature, and discuss results. The intern would be invited to attend department talks and graduate courses of universities where several research partners work. There may be the opportunity for data collection of primary data to complement secondary data, in other Brazilian states. The intern would have the chance to work with other graduate students, doctorate students, and post-docs,

    Qualifications: Academic interest and/or background in a health field; experience/interest in public health; skills in data analysis/secondary data; interest in medicines policies and/or drug utilization research; and language skills in English, Spanish or Portuguese.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #8 – Mortality Patterns based on Social Inequality and Poverty

    About: The Escola Nacional de Saúde Pública (ENSP) team’s research is related to studies of health transition and mortality patterns by cause groups in the context of social inequality and poverty. The ongoing project is related to deaths from despair and the relationship between the behavior of this mortality group according to some social determinants of health, such as race, age, and context of deprivation.

    Intern Responsibilities: The intern will carry out data analysis and will discuss articles to elaborate a conceptual model on social inequities and health.

    Qualifications: Some familiarity with using Excel, SPSS, or R databases is desirable.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #9 – Chagas National Institute of Infectious Diseases

    About: Evandro Chagas National Institute of Infectious Diseases (INI) is a unit of Fiocruz focused on clinical research, training, referral services and assistance in infectious diseases, and its objective is to produce knowledge and technologies to improve the health of the population, by means of integrated research actions, health care, teaching, and surveillance. There are eight research lines: Health technology assessment; Parasitic diseases in humans and animals; Viral hepatitis, STD, HIV/AIDS; Comprehensive care for infectious diseases; Fungal infections in humans and animals; Pathogenesis, clinical and epidemiological of viral diseases; Infections in critically ill patients; and Tuberculosis and HIV.

    Intern Responsibilities: The intern will be assigned activities of assistance, laboratorial diagnosis and clinical research related to the patients with infectious diseases in the outpatient clinics (Tuberculosis, HIV, Chagas disease, Acute febrile diseases, Leishmaniasis/otolaryngology, Infectious dermatology), hospital (Intensive Care Unit-Hospital Center) and laboratories (Parasitology, Mycology, Zoonosis and Anatomic Pathology Service).

    The project activities will be performed at Evandro Chagas National Institute of Infectious Diseases, in the main campus of Fiocruz in the city of Rio de Janeiro. Occasionally, there may be travels to field research in the state of Rio de Janeiro.

    When applying, please indicate your preferences between: outpatient clinics, research and diagnostic laboratory in infectious diseases.

    Qualifications: The intern should have knowledge in anatomy or physiology. The intern should ideally have basic knowledge of Spanish and/or Portuguese.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #10 – Pharmaceutical Development and Analysis

    About: The Laboratory of Development and Analytical Validation (LDVA) of analytical methods is part of the Coordination of the Technological Development (CDT) of the Brazilian Institute of Drug Technology (also known as “Farmanguinhos”). LDVA works in the development of analytical methods for the analysis of drug products developed in Farmanguinhos. The intern will be involved in the research project L-Praziquantel 150 mg orodispersible tablets (ODT). This research aims to conduct the forced degradation study of L-Praziquantel 150 mg orodispersible tablets to develop an indicative stability method to support pharmaceutical development. The research team is investigating the following:

    • Forced degradation study of L-Praziquantel 150 mg orodispersible tablets.
    • Validation of the indicative stability method.
    • Evaluation of accelerated, long-term stability and determination of degradation kinetics of L- Praziquantel.
    • Isolation and identification of degradation products.
    • Determination of the safety profile of the degradation products.

    The results of this research will present a new perspective on the strategic areas of ODT development.

    Intern Responsibilities: The intern will be involved in the development of the indicative stability method. In this regard, the intern will work on the following activities:

    • Preparation of analytical solutions,
    • Sample weight,
    • Operate a high-efficiency liquid chromatograph equipment,
    • Analyze chromatographic results and discuss/organize data.

    The internship will take place at both the main Fiocruz campus in Manguinhos and at the Farmanguinhos Factory.

    Qualifications: The intern must have knowledge related to pharmaceutical sciences and, in particular, experience in a general and organic chemistry lab.

    Note: This internship takes place in Rio de Janeiro, Brazil.

    FOCUS AREA #11 – Public Health and Epidemiology in Relation to Health Inequalities

    About: This internship focuses on public health, with an emphasis on epidemiology, working mainly on the following subjects: public health, elderly health, gerontology, public oral health, epidemiology, biostatistics and spatial analysis in health (geoprocessing), and health inequalities.

    Intern Responsibilities: The intern will work with national or local secondary data about health indicators and epidemiology.

    Qualifications: The intern must be eager to help and learn epidemiological methodologies and discussion on health inequalities.

    Note: This internship takes place in the city of Recife, Brazil.

    FOCUS AREA #12 – Association of Genetic Human Variants and Chronic Diseases and Infections

    About: This project focuses on host genetics as the Fiocruz Pernambuco Instituto Aggeu Magalhães (IAM) team studies how the genetic variants of humans can be associated with infections and chronic diseases, including Covid-19, hepatitis C, schistosomiasis, hepatocarcinoma, and clinical phenotypes of sickle cell anemia.

    Intern Responsibilities: The intern will work on activities in the laboratory, including:

    • DNA/RNA extraction
    • qPCR experiments
    • Preparation of solutions
    • Database organization
    • Bioinformatics analysis

    The activities will be carried out in the Department of Parasitology.

    Qualifications: The intern must have good social communication, computer and bioinformatics skills, in addition to being able to write scientific papers.

    Note: This internship takes place in the city of Recife, Brazil.

    FOCUS AREA #13 – Virology and Experimental Therapy

    About: This internship works with a team of ten people working on protein engineering towards the development of diagnostic markers, biopharmaceuticals and vaccines against viral diseases. The group has a strong focus on arboviruses (e.g., Zika, Dengue, Chikungunya), but also works with HIV-1 and SARS-CoV-2 pseudotyped lentiviruses. Half of the group perform massive parallel computing to design the different synthetic proteins, while the other half conducts wet lab experiments. The computationally designed proteins are synthesized, and their biophysical and immunological properties characterized. Experiments include protein purification chromatography, circular dichroism, microscale thermophoresis, virus and lentivirus microneutralization, PRNT, ELISA, and general molecular biology techniques.

    Intern Responsibilities: The intern will have the opportunity to apply computational protein engineering techniques to the design of biopharmaceuticals, and/or perform wet lab biophysical and immunological assays to characterize the therapeutic potential of the biopharmaceuticals developed in the group.

    All activities would be performed at the Department of Virology and Experimental Therapy of the Aggeu Magalhães Institute, Fiocruz in Recife, Brazil.

    Qualifications: It is preferred that the intern have reasonable knowledge of Unix, basic programming skills and some background on statistical thermodynamics. Basic knowledge of biophysics, immunology or cell biology is desired to perform experiments.

    Note: This internship takes place in the city of Recife, Brazil.

    FOCUS AREA #14 – Diagnostic and Prognostic Markers of Infectious and Chronic Diseases

    About: The Fiocruz Pernambuco Instituto Aggeu Magalhães (IAM) research team studies the immunogenetic aspects of infectious diseases (Zika and COVID-19), chronic-degenerative diseases and cancer (cervix and children), in search of new diagnostic and prognostic markers and knowledge on the pathophysiology of these diseases.

    Intern Responsibilities: The intern will work with immunohistochemistry activities to assess the expression of a specific marker in pediatric solid tumors and will participate in molecular qPCR analysis to determine gene expression. The intern can also join in gene amplification, sequencing, and analysis activities to associate genetic markers with disease development. This work will take place in the Immunogenetic laboratory at the Institute Aggeu Magalhães.

    Qualifications: The intern must have academic experience in molecular biology/genetics and immunology. The intern must know the procedures for working in a laboratory environment and with human biological samples and be able to pipette small volumes.

    Note: This internship takes place in the city of Recife, Brazil.

    FOCUS AREA #15 – Amazonian Indigenous Health

    About: The research group works in the areas of public health policies for riverside and rural populations in the Amazon, indigenous medicine, and traditional practices of indigenous health, monitoring of traditional midwives in the municipalities of the State of Amazonas.

    Intern Responsibilities: The intern will participate in field activities with researchers and graduate students. There will be opportunities to participate in workshops with traditional populations in the Amazon and to visit partner institutions to explore the research group’s areas of activity. Field activities are carried out in inland municipalities, and some trips are carried out by boat and/or plane.

    Qualifications: The intern should be eager to learn and willing to participate in local activities and culture, including sleeping in a hammock, traveling on a boat, etc.

    Note: This internship takes place in the city of Manaus in the Brazilian Amazon.

    FOCUS AREA #16 – Viral Infections in the Brazilian Amazon

    About: This internship involves two principal research themes: understanding mechanisms of immunopathogenesis and diagnosis and distribution dynamics of viral infections in the Brazilian Amazon. The laboratory studies tropical diseases such as Malaria, Chikungunya, Mayaro, Zika and Dengue, with an emphasis on translational research on immunopathological aspects, as well as the discovery of new drugs and diagnosis. Currently, there are two ongoing longitudinal cohorts in Manaus to understand durability of immune response to COVID-19 booster vaccines among adult population of both sexes (DETECTCoV-19) and immune response in Breastmilk (PROTECTCoV-19).

    Intern Responsibilities: The intern will have an overview of how field and laboratory activities integrate and how translational research is performed. Laboratory activities include understanding and performing immunodiagnostic assays (different types of ELISA, ELISpot etc), culture of mammalian cells, and virus cultivation and quantification. Field activities include interview and data collection and collection, sorting, recording, preservation, and storage of biological samples (human and/or animal).

    Qualifications: The intern should have an academic background in biological or health science. The intern should have an understanding of participant records according to IRB guidelines to ensure confidentiality, as well as prior use of REDCap software.

    Please note that the lab conducts meetings in English, but the lab is transdisciplinary and international with people speaking Spanish, Hindi, Marathi, Portuguese, and English.

    Note: This internship takes place in the city of Manaus in the Brazilian Amazon.

    FOCUS AREA #17 – Development of Point-of-Care Laboratory Diagnostic Tests

    About: The Fiocruz Paraná Instituto Carlos Chagas (ICC) research team is devoted to creating solutions that allow laboratory diagnostic tests to be used at the point-of-care or in areas with little-to-none infrastructure. They apply techniques from different fields, namely biochemistry, molecular biology, paper microfluidics and 3D printing, to develop simplified protocols for molecular diagnostic tests, without losing their specificity and sensitivity.

    Intern Responsibilities: The intern will follow the graduate students of the lab closely in performing one of the many routine experiments of developing new protocols: preparation of solutions and standard dilutions, set up/running/analysis of PCR/qPCR/LAMP protocols, 3D design and printing, oligonucleotide design, paper crafting for microfludics devices. Specific experiments will be tailored towards the intern’s knowledge, abilities, and interests.

    Qualifications: The intern should have academic backgrounds in health-, biology-, or biotechnology- related fields. Minimal qualifications include basic knowledge of laboratory practices, such as pipet handling/use and bio/chemistry safety. Ideally, the intern would have basic knowledge of molecular biology, or 3D/paper design & printing.

    Note: This internship takes place in the city of Curitiba, Brazil.

    View Internship Summary Posters and Videos from Past Fiocruz Princeton Student Interns:

    Summer 2022

    ICM logo

    International Care Ministries

    Community-Based Health Impact Assessment

    Location: Manila, Philippines

    Duration: 8-10 weeks

    Number of Positions: 1

    Stipend: $6,000

    To Apply via GPS: Click Here

    About: International Care Ministries (ICM) is a non-governmental organization that has been serving the ultrapoor in the Philippines since 1992. In partnership with community leaders from thousands of slum communities, ICM delivers programs that transform the lives of more than 100,000 destitute people each year. These multidisciplinary interventions address values, health and livelihood. ICM is a Christian faith-based non-governmental organization; however, interns may be from any background, and the analytical work is secular.

    Intern Responsibilities: Interns will partner with the ICM Health Services and Research Teams to develop a research strategy that either analyzes survey and operational data collected from community-based health interventions or collects novel data from patients to better understand intervention design and acceptance. They can use statistical and epidemiological methods to understand the outcomes of these interventions or qualitative methods to collect patient experiences and insight. Interns may also have the opportunity to participate in health program design efforts. If the internship is in-person and it is safe to travel domestically, it may be recommended for interns to travel to project sites on islands in central Philippines to interview stakeholders and collect data.

    The student will be given an opportunity to work with a real dataset collected through an intervention that is currently running in the Philippines. The households receiving the interventions live in extreme poverty; therefore, the student will also get an understanding of the challenges associated with working in these contexts. As the interventions will continue to run, the outcomes of analyses could be utilized to benefit future protocols and delivery strategies.

    Past projects also include preparing frameworks for the revision of ICM’s primary health education curriculum (including qualitative assessment of feasibility and effectiveness in the field); regional epidemic mapping of health needs to assess the applicability of ICM’s health training; assisting in development and revision of current health intervention protocols; and analysis and evaluation of ICM’s overall data collection systems. Additional responsibilities may include writing or assistance with other program activities. The intern will be expected to complete work independently, but will have weekly meetings with a supervisor.

    Qualifications: Strong quantitative and qualitative analytical skills, and experience with R, Stata, or Python (strongly preferred). Familiarity with public health issues.

    View Internship Summary Posters and Videos from Past ICM Princeton Student Interns:

    Summer 2022

    Summer 2021

    Summer 2020

    Summer 2019

    Summer 2018

    Malaya logo

    University of Malaya

    Health Research Internship

    Location: Kuala Lumpur, Malaysia

    Duration: 8-10 weeks

    Number of Positions: 1-2

    Stipend: $6,000

    To Apply via GPS: Click Here

    About: University of Malaya (UM), Malaysia’s oldest university, is situated on a 922 acre campus in the southwest of Kuala Lumpur, the capital of Malaysia. UM is committed to advancing knowledge and learning through quality research and education for the nation and for humanity.

    The intern will work in the Division of Endocrinology, Department of Medicine, University of Malaya under the direction of Dr. Lee-Ling LIM, focusing on the epidemiology of diabetes and complications among adults in Malaysia. The study aims to examine the control of cardiometabolic risk factors and to describe clinical characteristics and patterns of medication use among people with type 2 diabetes in Malaysia. Cross-sectional data collection will be conducted at 13 endocrinologist-led diabetes centers nationwide between January 2023 and June 2023.

    Intern Responsibilities: The intern will contribute to the TARGET-T2D study through data cleaning, analysis and reporting (such as abstract submission/presentation and potentially manuscript writing).

    Qualifications: Applicants should have skills in Microsoft Excel, statistical analysis software (at least a basic level of SPSS or similar app) and academic writing.

    View Internship Summary Posters and Videos from Past University of Malaya Princeton Student Interns:

    Summer 2022

    Summer 2021

    Summer 2020

    One Health Trust

    Vaccine & Antimicrobial Resistance Research

    Location: Bangalore, India

    Duration: 8-10 weeks

    Number of Positions: 2

    Stipend: $6,000

    To Apply via GPS: Click Here

    About: At One Health Trust (OHT), we believe that answers to the world’s most critical questions lie between disciplines. Accordingly, our researchers employ a range of expertise—from economics, epidemiology, disease modeling, and risk analysis to clinical and veterinary medicine, geographic information systems, and statistics—to conduct actionable, policy-oriented research. Our projects address major global health challenges, including Covid-19, antimicrobial resistance, hospital infections, tuberculosis, malaria, pandemic preparedness and response, vaccines, medical oxygen shortages, and noncommunicable diseases.

    OHT has offices in Washington, D.C., and Bangalore, India, with researchers based in North America, Africa, and Asia. Our projects lead to policy recommendations and scientific studies published in leading journals. We are experienced in addressing country-specific and regional issues as well as global challenges. Our research is renowned for innovative approaches to design and analysis, and we communicate our work to diverse stakeholders.

    Please note that there are two (2) potential focus areas for a student intern. When applying, please indicate the one or ones you would like to be considered for.

    FOCUS AREA #1 – The Value of Vaccines in Mitigating AMR in India

    About: Antimicrobial resistance (AMR) is a rapidly emerging global public health threat. The rising prevalence of drug-resistant infections challenges modern medicine by limiting life-saving therapeutic options and exacerbating the morbidity and mortality associated with infectious diseases, especially for those who cannot afford more expensive antimicrobials. Vaccines are a critical yet underutilized tool for mitigating AMR. They prevent infections, lower the demand for treatment, reduce overall antimicrobial use, and thereby mitigate one of several factors that accelerate the emergence and spread of drug resistance. Recent studies by OHT researchers and collaborators in the ARVac consortium provide compelling evidence of the significant health and economic impact of several vaccines (potential, new and current) and their contribution to reducing AMR. However, despite accumulating evidence linking vaccination to AMR mitigation, there is little awareness, recognition, and interdisciplinary funding for such efforts at the clinical and policy levels. This project will involve generating evidence on the added value of vaccines to reduce AMR and engaging with stakeholders and policymakers to translate this evidence into policy action.

    Intern Responsibilities: The position involves researching and synthesizing data on infectious disease burden, antimicrobial resistance, and vaccine coverage from databases, reports, and scientific literature. In addition, it may involve the writing of reports and the development of slide decks as communication material.

    Qualifications: Familiarity with basic epidemiology and statistics, and experience reading the scientific and social science literature are an asset, as are good writing skills, and ability to work independently.

    FOCUS AREA #2 – The National Oxygen Grid in India

    About: India faces a significant burden of morbidity and mortality due to the lack of access to medical oxygen. The OxygenForIndia initiative was founded by CDDEP/OHT and partnering institutions to address critical oxygen shortages — a problem revealed and exacerbated by the COVID-19 pandemic. During the devastating humanitarian crisis of April 2021, OxygenForIndia deployed 20,000 reusable oxygen cylinders and 3,000 oxygen concentrators in 57 urban and rural centers across India. Currently, the OHT team and partners are working to build a stable and reliable oxygen supply system, a national oxygen grid (NOG), to avoid preventable deaths and improve pandemic preparedness.

    Intern Responsibilities: The position involves working with a broader team that is designing a national oxygen grid. The intern is expected to support this team and to provide backup analytics for the grid design.

    Qualifications: Analytic and writing skills and ability to work independently.

    View Internship Summary Posters and Videos from Past One Health Trust (formerly CDDEP) Princeton Student Interns:

    Summer 2022

    Summer 2021

    Summer 2020

    Summer 2019

    Summer 2018

    Oxford University Clinical Research Unit (OUCRU)

    Antibiotic Resistance Internships

    Location: Hanoi, Vietnam

    Duration: 8-10 weeks

    Number of Positions: Up to 4

    Stipend: $6,000

    To Apply via GPS: Click Here

    About: The Oxford University Clinical Research Unit (OUCRU) aims to have a positive and significant impact on global health and, in particular, the prevention, diagnosis and treatment of infectious diseases. OUCRU’s key areas of research are: Dengue fever; malaria; tuberculosis; influenza; enterics; HIV and HIV coinfection; central nervous system infections; animal health and zoonoses; pharmacology; and statistics, bioinformatics, modeling, and mapping.

    Please note that there are two (2) potential focus areas for a student intern. When applying, please indicate the one or ones you would like to be considered for.

    FOCUS AREA #1 – Antibiotic Treatment, Outcomes and Hospitalization Costs of Bloodstream Infections in Hospitals

    About: The antimicrobial stewardship (AMS) research team in OUCRU Hanoi group is evaluating the health and economic impact of AMS interventions to improve antibiotic use and patient outcomes and control antimicrobial resistance (AMR) in hospitals. We use various research designs and analysis approaches including implementation research, case-control, cross-sectional surveys and assessments, interrupted time-series analysis, qualitative study, burden of disease analysis, and economic evaluation.

    OUCRU has collaborated with different hospitals in the network and generated clinical, microbiological and administrative datasets from the hospital routine information systems with various timeframes. In this proposal, we aim to analyze these datasets to characterize patients with confirmed and suspected bloodstream infections (BSI) in terms of antibiotic therapies, treatment outcomes, and costs of hospitalization to inform the design of stewardship interventions for this clinical syndrome.

    Intern Responsibilities:

    • Identify patients with confirmed or suspected diagnosis of BSI in the datasets using a combination of ICD codes and text-based diagnosis
    • Linking these patients with microbiological data to identify those with confirmed BSI
    • Summarize antibiotic treatment therapies in these confirmed and suspected BSI patients
    • Summarize the pathogens found in the confirmed BSI patients and their resistance levels
    • Summarize the discharge outcomes and hospitalization costs in confirmed and suspected BSI patients
    • Further analysis and writing activities are possible

    Qualifications:

    • Skills and experience in data processing and data analysis using R program (mandatory).
    • Studying or having knowledge of biomedical or related fields (preferred).

    This internship will take place at the National Hospital for Tropical Diseases in Hanoi, Vietnam.

    FOCUS AREA #2 – Epidemiological Studies and Interventions to Tackle Antimicrobial Resistance (AMR)

    About: OUCRU is currently conducting population-based studies in northern Vietnam to understand antibiotic use and AMR in healthcare settings, communities, farms and the environment. The OUCRU team is implementing a full system intervention across hospital, primary healthcare, community and farm settings, to optimize the use of antibiotics and reduce environmental transmission. They are also exploring the association between climate and AMR, through systematic reviews and big data analysis.

    Intern Responsibilities: Interns may be involved with literature review, writing, and/or data analysis, depending on their skills and interests. There may be opportunities to work with microbiology data and observe lab work.

    Qualifications: Required skills include the ability to review and critically appraise literature. Data analysis skills are desirable but not essential.

    Interns will be based at one of the two offices in Hanoi, but there may be opportunities to visit project sites in Nam Dinh Province.

    View Internship Summary Posters and Videos from Past OUCRU Princeton Student Interns:

    Summer 2022

    Summer 2021

    Summer 2020

    Summer 2019

    Summer 2018

    Summer 2017

    University of Sunderland

    Reducing Social Isolation through the Arts and Community-Based Approaches

    Location: Sunderland, England

    Duration: 8-10 weeks

    Number of Positions: 3

    Stipend: $6,000

    To Apply via GPS: Click Here

    About: Internships at the Helen McArdle Nursing and Care Institute, based in the School of Nursing and Health Sciences, Faculty of Healthcare Sciences at the University of Sunderland, focus on social prescribing, described as a range of non-clinical interventions designed to support health and wellbeing and reduce health inequalities. There is established evidence on the positive impact of social prescribing for both service users and the health care system. Our internships are in collaboration with the Institute’s external partners who deliver a range of social prescribing interventions across Sunderland. The Institute is home to the Sunderland Social Prescribing Research and Knowledge Exchange Centre, which aims to collect evidence of the effectiveness and impact of social prescribing in Sunderland and contribute to delivery of our Healthy City Plan 2020-2030.

    The internships are within the external organizations, with protected time in the Institute and mentoring by our team of academics to enhance the Sunderland experience. Upon arrival at Sunderland, the intern will take part in a comprehensive induction program to learn more about the history of Sunderland, health inequalities, our University and Institute and our partnership model of working across the City. Following this, interns will commence their internships in their respective organizations, but there will be synergy across the internships and opportunities for the interns to work collaboratively.

    Please note that there are three (3) potential focus areas for a student intern. When applying, please indicate the one or ones you would like to be considered for.

    FOCUS AREA #1 – Supporting the Health and Wellbeing of Veterans in Sunderland

    About: In collaboration with Veterans in Crisis Sunderland (VICS), this internship will explore the role of the voluntary sector in engaging and supporting the health and wellbeing of the veteran community in Sunderland. The intern will work closely with VICS and University staff on supporting delivery of programs offered by VICS, take part in social prescribing activities and work closely with service users.

    Intern Responsibilities: Veterans in Crisis Sunderland is a social enterprise dedicated to supporting the welfare of veterans and their families based in the City of Sunderland. VICS offers a range of services and programs to veterans which promote social inclusion and are driven by the health and wellbeing needs of the veterans themselves. VICS carry out their work supported by a range of partners across Sunderland. Current projects include running regular drop-in sessions, a series of arts workshops at the National Glass Centre in Sunderland, walking groups and establishing a network of support services for veterans and their families to access. VICS is a young, dynamic organization, and other projects are in various stages of development, allowing a wide range of experiential learning to be gained.

    The internship will be based in Sunderland, but there may be travel involved to activities and events, but the intern will travel with VICS. The intern will work collaboratively with VICS and have close contact with both VICS and the Helen McArdle Nursing and Care Research Institute.

    Qualifications: It is important that the intern has in interest in biopsychosocial approaches to health and care, and veteran wellbeing. The intern should possess strong communication skills, be able to demonstrate high levels of empathy and be prepared to be flexible in working across a range of projects with different people and liaising with other organizations. Applicants will be expected to work within a team and work independently. Subject-related mentoring support will be provided by the Faculty of Health Sciences and Wellbeing, University of Sunderland.

    FOCUS AREA #2 – Supporting the Voluntary, Charitable and Social Enterprise Sector to Deliver Social Prescribing Initiatives

    About: Voluntary, Community and Social Enterprise (VCSE) organizations are at the heart of communities and have a unique understanding of the needs of the communities they serve. They have an important role to play in building resilience, cohesion and increasing local assets to build health and wellbeing, thereby making a significant, but often under-recognized contribution to the healthcare system. In collaboration with the University of Sunderland, the candidates will work across a range of community-based projects, supporting the delivery of social prescribing interventions led by the VCSE sector in Sunderland.

    Intern Responsibilities: There is a broad scope of activities available depending on the interests of the interns, including: Face-to-face work with service users of social prescribing interventions, supporting the organization, delivery and administration of social prescribing in the VCSE sector, undertaking research activities in the Helen McArdle Nursing and Care Research Institute e.g. literature searches, data analysis, report writing, opportunities to spend time in partner organizations to learn about organizing, commissioning and delivery of health care services in NHS and government settings, and spending time in arts and cultural organizations supporting social prescribing projects. VCSE carry out their work, supported by a range of partners across Sunderland. Current projects include health and wellbeing roadshow interventions across Sunderland, activities for families to improve health inequalities and workplace wellbeing activities that support wellbeing at work.

    The internship will be based in Sunderland, but there may be travel involved to activities and projects and the intern will travel with VCSE. The intern will work collaboratively with VCSE and will have close contact with the Helen McArdle Nursing and Care Research Institute.

    Qualifications: It is important that the intern has in interest in the voluntary, community and social enterprise sector in relation to health and wellbeing of communities. The intern should possess strong communication skills, be able to demonstrate high levels of empathy and be prepared to be flexible in working across a range of projects with different people and liaising with other organizations. Applicants will be expected to work within a team and work independently. Subject-related mentoring support will be provided by the Faculty of Health Sciences and Wellbeing, University of Sunderland.

    FOCUS AREA #3 – Partnership Working to Build Community Resilience

    About: Southwick Altogether Raising Aspirations (SARA) is a partnership that offers help to the community to access support and gives people in the Southwick ward a say about what the priorities should be for the area. The partnership is a joint approach to build community confidence with a range of services coming together in one community hub.

    Intern Responsibilities: In collaboration with SARA this internship will explore the role of engaging and supporting residents in the community and understanding their needs. Candidates will work closely with SARA and University staff in supporting delivery of programs and projects along with a broad scope of activities depending on the interests of the interns, including: Face-to-face work with residents, supporting the organization, delivery and administration and undertaking research activities in the Helen McArdle Nursing and Care Research Institute e.g. literature searches, data analysis, report writing, opportunities to spend time in partner organizations to learn about organizing, commissioning and delivery of community services in NHS and government settings.

    SARA carry out their work, supported by a range of partners across Sunderland including Sunderland City Council, Northumbria Police and Tyne and Wear Fire and Rescue. Current projects include developing the Southwick area using vacant land, with initiatives such as outdoor seating areas, football skills areas, and community outdoor gardens.

    The internship will be based in Sunderland, but there may be travel involved to activities and projects, but the intern will travel with SARA. The intern will work collaboratively with both SARA and the Helen McArdle Nursing and Care Research Institute and would suit a variety of academic disciplines, but it is important that the intern has in interest working directly with residents in a community setting and supporting with local topics and the delivery of projects.

    Qualifications: The intern should possess strong communication skills, be able to demonstrate high levels of empathy and be prepared to be flexible in working across a range of projects with different people and liaising with other organizations. Applicants will be expected to work within a team and work independently. Subject-related mentoring support will be provided by the Faculty of Health Sciences and Wellbeing, University of Sunderland.

    View Internship Summary Posters and Videos from Past Sunderland Princeton Student Interns:

    Summer 2022

    Telethon Kids Institute

    Various Research Internships

    Location: Perth, Australia

    Duration: 8-10 weeks

    Number of Positions: 9

    Stipend: $7,000

    To Apply via GPS: Click Here

    About: The Telethon Kids Institute (TKI) is a research organization that brings together communities, researchers, practitioners, policy makers and funders, who share a vision to improve the health and wellbeing of children through excellence in research. TKI’s research focus areas include aboriginal health; brain and behavior; chronic and severe diseases; and early environment.

    Please note that there are nine (9) potential focus areas for a student intern. When applying, please indicate the one or ones you would like to be considered for.

    FOCUS AREA #1 – Early Neurodevelopment and Mental Health

    About: The Early Neurodevelopment and Mental Health team is focused on preventing childhood mental illness and optimizing children’s development and wellbeing in the first years of their life. TKI is interested in understanding and identifying the factors that contribute to difficulties in mental health and development, as well as developing cost-effective prevention and early intervention approaches for addressing developmental needs and promoting resilience.

    This project involves working with parents and early child and parenting support services to co-design and trial a novel, strengths-based digital intervention to support self-regulation in toddlers (24-36 months). Healthy self-regulation is a cornerstone of childhood social and emotional development.

    Across developmental stages, self-regulation is consistently associated with positive mental health and adaptive functioning, while self-regulatory difficulties in the first years of life are linked to risk of mental health problems across the lifecourse. TKI aims to develop a strength-based and personalized approach in which parents feel empowered to engage with the intervention in a way that works for them. The team will work with parents and community partners to co-create the user experience elements and determine the need for implementation support resources (e.g., a manual for community partners).

    Intern Responsibilities: The intern will be responsible for assisting with co-design workshops, qualitative interviews, and supporting our data analysis and reporting activities. There may also be digital design activities, depending on the technical skills of the intern.

    Qualifications: An interest in early child development and co-design is preferred.

    FOCUS AREA #2 – Ending Rheumatic Heart Disease Research Program

    About: The END RHD Program comprises of 5 multidisciplinary teams whose projects span a wide research portfolio of basic science to translational projects. The END RHD Program sits under the Early Environment theme and the Wesfarmers Centre for Vaccines and Infectious Diseases at the Telethon Kids Institute.

    For all staff and students in the END RHD program at Telethon Kids Institute, our vision is simple: to conduct the research needed to eliminate rheumatic heart disease as a public health problem in Australia by 2031. This vision aspires that Aboriginal children have no greater risk of developing RHD than non‐Aboriginal children. It is an ambitious goal and requires cutting edge evidence translated into policy and practice. The team has aligned all research endeavors with the blueprint for ending RHD, and in collaboration with Aboriginal partners, the team will provide the evidence, research translation and policy guidance to have immediate impact. This must be done. Without this strong, clarifying vision and ambitious plan, hundreds more lives will be shortened or lost from an entirely preventable condition.

    Intern Responsibilities: With 5 teams working from bush to bench to bedside and beyond, the scope of work available to the intern is flexible to their skill sets and interests.

    Qualifications:

    • Academic study in a health care field e.g. nursing, medicine or allied health.
    • Excellent communication skills.
    • Interest in Aboriginal health and wellbeing.
    • Become part of a highly innovative team with extensive support and mentorship.
    • Be willing to work in partnership with communities.
    • Have strong data analysis skills and writing skills.

    FOCUS AREA #3 – Western Diagnostic Clinical Pathology Data for ORIGINS Mums and Children

    About: The ORIGINS team is a diverse and highly passionate team with backgrounds and experience in psychology, public health, health promotion, biological sciences, data linkage & management, project management, pediatrics and nursing. In addition to the supervisors listed above the student will have the opportunity to spend time and work alongside several members of the ORIGINS team and assist with the day-to-day running of the project, including observing face-to- face clinic appointments with ORIGINS families.

    The ORIGINS Project is a decade-long collaborative initiative between the Joondalup Health Campus (JHC) and the Telethon Kids Institute (TKI) to establish a Western Australian (WA) birth cohort of 10,000 families, enrolled during pregnancy. It is currently funded to follow up participating children and their families to five years of age. Comprehensive data and biological samples are collected from participants at up to 15 different timepoints, from the first antenatal clinic visit. This information is collected to study the origins of non-communicable disease and the health and wellbeing development of children and family in the first years of life.

    Biological samples including, saliva, buccal, blood, urine and faeces from ORIGINS Mums and Children are processed and stored at the Western Diagnostics Pathology facility in Jandakot. Clinical pathology results are significant in diagnosing a patient and are an important puzzle piece in understanding a whole picture of an individual’s health. Whilst some clinical results have been generated for the ORIGINS cohort, they have not yet been transferred to the ORGINS data system and are required for ORIGINS sub-projects and in-house data analysis.

    Intern Responsibilities: Working with the ORIGINS Western Diagnostics team, the ORIGINS Biobank and ORIGINS Data team, assist with collation of the ORIGINS clinical results in order to integrate the information into the ORIGINS Data Ecosystem.

    • Participate in daily tasks at the Western Diagnostics laboratory
    • Observe the processing and storage of samples at Western Diagnostics
    • Demonstrate an understanding of the Western Diagnostics laboratory data system
    • Extract ORIGINS clinical results
    • Link the clinical results to the ORIGINS Data Ecosystem, using ORIGINS identifiers.
    • Undertake a small analysis project of the Western Diagnostics clinical results

    The intern would spend time at multiple ORIGINS sites, including: JHC and TKI Joondalup (a northern suburb in the Perth Metropolitan area), TKI (Nedlands near Perth city) and Western Diagnostics Pathology Laboratory (Jandakot, a southern suburb in the Perth Metropolitan area).

    Qualifications:

    • Experience with and understanding of basic lab techniques including pipetting, labelling and cryo-preservation.
    • Experience with and understanding of sterile technique.
    • Ability to work in a high-throughput environment which requires strict attention to detail.
    • Vaccination status in accordance with Western Diagnostics requirements including Hep B and multiple COVID vaccinations.
    • An understanding of population health data, REDCap survey collection and health data identifiers.
    • The student is expected to have an understanding of good clinical practice and knowledge of chronic disease from the life course perspective.

    FOCUS AREA #4 – Calibrating Cluster Detection for Causal Discovery

    About: The Geospatial Health and Development team brings together researchers with expertise in a range of disciplines from public health to mathematics, geography and epidemiology. The team focuses on addressing global and local health challenges using innovative analysis methods. Our flagship project is the Malaria Atlas Project which tracks the global distribution of malaria, its risks and the intervention coverage.

    Intern Responsibilities: The intern will run statistical (Monte Carlo) simulations to create fake datasets of rare diseases in a population and use them to calibrate the satscan software to be used for understanding the role of environmental risk factors. The intern will also perform the following activities:

    • Simulate statistical distribution in R to write a script that writes out and reads in inputs from satscan
    • Produce visualizations and summaries of results
    • Write a report

    Qualifications: Preferred experience with writing code or using statistical analysis packages.

    FOCUS AREA #5 – Communicating Malaria Risk through Maps

    About: The Geospatial Health and Development team brings together researchers with expertise in a range of disciplines from public health to mathematics, geography and epidemiology. The team will focus on addressing global and local health challenges using innovative analysis methods. Our flagship project is the Malaria Atlas Project which tracks the global distribution of malaria, its risks and the intervention coverage.

    Intern Responsibilities: The intern will create innovative visualizations for communications of malaria risk maps. The intern will also work with ArcGIS/R/other software packages for map making and/or working with Indesign/Photoshop/other creative suite for visualizations.

    Qualifications: Preferred prior experience writing code or using ArcGIS/R. Background or interest in geography and/or graphic design useful.

    FOCUS AREA #6 – Investigating Bias in African Mosquito Records to Improve Malaria Risk Mapping

    About: The Malaria Ecology team focuses on developing model-based, data-informed research methods to guide public health decision-making on infectious diseases.

    As part of the work on the Vector Atlas, TKI is interested in understanding sources of bias in the collection of mosquito occurrence data in Africa, as a means to improve modelling and therefore understanding of malaria risk. This internship will involve the collection and exploration of bias in mosquito occurrence data by systematic reviews of literature and public data sources.

    Intern Responsibilities: The interns work will consist of project design and self-management, searching and reading scientific literature and public data sources, recording data, and may involve basic data programming and graphing in R if the intern is interested in learning these skills. The intern will work from the TKI Perth Children’s Hospital campus.

    Qualifications: The intern must have basic familiarity with scientific literature. Interns with knowledge of scientific data management and/or literature searching experience are preferred. Knowledge of the statistical programming environment R or similar is preferred.

    FOCUS AREA #7 – Mapping Tuberculosis Mortality Rate in Ethiopia Using Geospatial Analysis

    About: The Geospatial and Tuberculosis (GeoTB) Research Group is based at Telethon Kids Institute within the Geospatial Health and Development (GHD) Team. The GeoTB Research Group focuses on designing innovative approaches to improve the efficacy of public health interventions that aim to control and ultimately eliminate TB in low- and middle-income countries. The GooTB Research group focuses on geospatial modelling and other quantitative methods to improve the understanding of the TB burden at global, national, and local levels and to generate new evidence that can be applied to achieve the global end TB targets. In addition to work on TB, the GeoTB Research Group has also undertaken research on other infectious diseases including malaria, human immunodeficiency virus (HIV) and soil-transmitted helminth (STH) infections. Recently, the GeoTB Research Group has also been actively involved in Coronavirus-2019 (COVID- 19) related research to provide evidence supporting the national and global response efforts against the pandemic.

    Tuberculosis (TB) is a preventable and treatable disease, yet it remains the second leading cause of death from an infectious disease worldwide, killing more than one million people every year. The geographical distribution of TB varies across the globe, and across districts within countries. Africa is the second most affected region, accounting for a quarter (25%) of the global TB deaths. Despite the availability of various interventions such as vaccination and preventive treatment, TB continues to be an endemic disease in several countries including in Ethiopia. The emergence of multidrug resistant tuberculosis (MDR-TB) with resistance to rifampicin and isoniazid (the two most important first line therapeutic agents) has also posed an additional challenge for global and national TB control efforts. The Global Burden of Disease (GBD) study and the World Health Organization (WHO) have produced national-level estimates of mortality from TB on an annual basis. However, mortality rate for administrative units of countries such as districts may differ significantly from the national average. Sub-national level analyses are important for planning purposes and to determine where services can further be enhanced. Thus, the overall aim of this project is to estimate the morality rate of TB at national, sub-national and local levels in Ethiopia using advanced geospatial modelling techniques. The outputs of this study will provide evidence for policymakers to help reduce the mortality rate of TB in highly affected areas.

    Intern Responsibilities: The inter will be working on data management, geospatial analysis, and manuscript writing with the support of the supervisor.

    Qualifications: Qualifications in public health, epidemiology, statistics, biostatistics, economics or a health-related field are preferred. Prior knowledge and application of statistical methods and prior professional or research experience in infectious diseases both desirable.

    FOCUS AREA #8 – Dads and Development: Exploring the Role of Fathers in Promoting the Health and Development of their Children

    About: This project contributes to Dr. Vincent Mancini’s broader vision for healthy fathers, healthy families, healthy children. This newly formulated research group housed within the School and Community Wellbeing Team at Telethon Kids Institute seeks to understand the various mechanisms through which fathers can transform the lives of their children, for the better. The work of the team is expansive, though is mostly situated within a psychological or health promotion context. The work that is undertaken by Dr. Mancini is also supported by The Fathering Project (www.TheFatheringProject.org), Australia’s largest non-for- profit organisation dedicated to support children by supporting fathers. Particular research interests are given to those populations or contexts with established risk for poorer child outcomes (e.g., incarcerated populations, rural and remote locations, Indigenous Australian populations, mental health difficulties, child disability, etc.).

    One in five people living in Australia are biological fathers, and many more are “father figures”. With nearly all Australian children exposed to a father figure, empowering fathers to be able to support the positive development of their children, throughout their lives, is a critical component of population health. However, fathers have been largely underrepresented in the field of child health research, despite the increasing presence than many fathers have in child caring responsibilities. The research undertaken as part of this internship will seek to help address this gap in knowledge. At the discretion of the supervisor and the internship student, the project has several branches that students can be involved in. These are:

    • An evidence-review of fathering programs designed for incarcerated men
    • An evidence-review of fathering programs designed for fathers of children with Autism Spectrum Disorder
    • Assisting in the collection, analysis, and reporting of data pertaining to the experiences of fathers who have children born very preterm and admitted to a Neonatal Intensive Care Unit.
    • Research studies examining the association between father’s mental health, family functioning, and children’s health and developmental outcomes.

    Intern Responsibilities: Interns may undertake the following activities:

    • Developing search terms suitable for a PRISMA-Style systematic review of the literature (including potential meta-analysis).
    • Evidence Synthesis
    • Data Collection and Analysis
    • Academic Writing (i.e., journal article style – note that students contributing to formal writing will have this work recognized through a co-authorship arrangement)
    • Stakeholder engagement (e.g., helping to facilitate community reference groups, etc.).
    • Regular activities held by the School and Community Wellbeing Team (Team Meetings, workshops, etc.).

    The intern will work from the TKI Perth Children’s Hospital campus.

    Qualifications: Relevant background in health, policy, or social sciences (e.g., psychology) preferred. Experience with research methods (either quantitative or qualitative analyses) is also preferred.

    FOCUS AREA #9 – Sleep Pattern Impact on Early Child Development and Mental Health

    About: The Early Neurodevelopment and Mental Health team is focused on preventing childhood mental illness and optimizing children’s development and wellbeing in the first years of their life. The team is interested in understanding and identifying the factors that contribute to difficulties in mental health and development, as well as developing cost-effective prevention and early intervention approaches for addressing developmental needs and promoting resilience.

    This project aims to engage service providers, pediatric sleep specialists, and parents of infants and young children, to co-design the content, user experience and engagement strategies for an online health promotion resource and manual for service providers that models a series of evidence-based sleep strategies for children of different ages (0-3 years). Difficulty sleeping in infancy has been associated with an increased risk of physical and mental health difficulties in later life, and problematic infant and child sleep patterns are challenging for many parents. TKI aims to develop the suite of sleep resources and test the feasibility and acceptability of the program with families and service providers.

    Intern Responsibilities: The intern will be responsible for assisting with co-design workshops, provide support for data analysis, and assist with report writing. The intern may assist with the development of a communication plan to disseminate findings to enable the use of the intervention on a broader scale. There may also be digital design activities, depending on the technical skills of the intern.

    Qualifications: An interest in early child development and co-design is preferred.

    View Internship Summary Posters and Videos from Past Telethon Kids Institute Princeton Student Interns:

    Source https://www.medicinenet.com/viral_hepatitis/article.htm

    Source https://globalhealth.princeton.edu/internships

    Source

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