Alex Schade, Liverpool School of Tropical Medicine
Project: How can the outcomes of open tibia fractures in a low-income country be improved?
Open tibia fractures – broken “shin bones” that go through the skin – often occur from road traffic injuries. These are serious injuries which lead to one in ten patients requiring amputations, a third with life-threatening illness and, later, disability. However, these are often poorly managed in resource-limited settings and could be amenable to low-cost orthopaedic surgery. Research is urgently needed to decide the best approaches to improve outcomes through trauma networks.
Our study will follow people with an open tibia fracture in Malawi for six months after injury to assess their disability and the economic burden of this injury on households and society. Key goals:
- Collect data on the quality of life and function of patients with open tibia fractures across three hospitals in Malawi and explore whether delays in their operation and severity affect outcomes at six months
- Explore the economic burden of open tibia fractures on patients, their households and the healthcare system
- Assess the implementation of open fracture guidelines.
ORCID 0000-0001-7640-9812
Klara Doherty, Liverpool School of Tropical Medicine
Project: Characterising pneumococcal mucosal immunity in at-risk populations in Malawi.
The bacterium Streptococcus Pneumoniae causes significant illness and death worldwide and people living with HIV (PLHIV) are particularly at risk. The bacterium does not cause disease in everyone who is exposed and this study aims to understand how the immune systems of PLHIV control (or fail to control) the bacterium after exposure. This will be achieved by exposing volunteers to the bacterium in a safe and controlled experimental setting and measuring their immune response.
A better understanding of the most crucial parts of the immune system required for the control of Streptococcus Pneumoniae will prove vital information for developing new pneumococcal vaccines and evaluating existing vaccines. The study will also increase capacity for testing pneumococcal vaccines in PLHIV in a time-efficient and cost-efficient way by establishing the experimental exposure model in Malawi.
PLHIV are a key population of interest in many sub-Saharan Africa as they are at high-risk of disease as well as being a source of continued transmission even in vaccinated populations. This study will therefore inform national and international pneumococcal vaccination policy and will enable effective tackling of the disease burden caused by Streptococcus Pneumoniae.
Thomas Hampton, Liverpool School of Tropical Medicine
Project: Assessing the suitability, acceptability and benefit of a novel bond condutcitng hearing device for children with hearing loss in Malawi and South Africa.
We want to determine if a special type of headphones rather than a hearing aid might improve hearing. The device is designed for children age 5 to 15 years old who suffer from hearing loss but live in places where they can’t easily get treatment and/or cannot use hearing aids. We want to know who it works for best, and if the device would be useful in a real-life setting.
We will look at groups of children age 5-15 years in Blantyre, in Malawi and Limpopo, in South Africa.
We will compare the performance of the device and people’s experiences and see if there are differences in
how the device works between the two countries and also between people living in cities and the countryside.
We hope to show that the device could:
- Improve certain children’s hearing and speech whilst at school
- Cause no new problems for parents, children and teachers when used at school
- Be a good value way of treating and improving the quality of life of children with hearing loss in environments where lots of children have hearing loss but difficulties getting hearing aids or treatment for their ears.
ORCID 0000-0002-6515-8058
Kathryn Haigh, University of Liverpool
Project: Image analysis techniques to better define pathogenesis in disseminated HIV-associated Mycobacterium tuberculosis.
TB coinfection carries a high risk of death in people living with HIV. In those with advanced immunosuppression, TB spreads around the body via the bloodstream to organs like the kidneys and the spleen. This dissemination increases that person’s risk of death; the science is poorly understood. Despite widespread availability of anti-TB and antiretroviral treatment, the outcome of disseminated TB in HIV remains poor.
We aim to describe the appearance of TB bacteria in the bloodstream and any changes with treatment. We may therefore be able to describe a population of bacteria that are more resistant to anti-TB medication. We will investigate whether TB infection in the blood causes neutrophil white blood cells to release their DNA in a net-like structure to attempt to trap TB. For those who die, we will compare the number of bacteria in their bloodstream during life to the number in organs after death, assisting our understanding of the high mortality.
We aim to develop a novel method for investigating where TB bugs reside in the bloodstream.
I expect this research to fill specific knowledge gaps regarding HIV-associated TB infection and lead directly to further work to improve management of this devastating disease.
ORCID 0000-0003-1901-7315
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