Shelui Collinson, Liverpool School of Tropical Medicine
Project: Mapping snakebite risk in Kenya and eSwatini: using primary data collection and geostatistical techniques to develop an approach to remote risk estimation for snakebite.
Snakebite is a neglected tropical disease predominantly affecting populations in low-resource settings.
It causes up to 138,000 deaths per year and many more non-fatal bites that can lead to disability and psychological impact. There are very little data on snakebite to guide treatment distribution and prevention programmes, particularly across sub-Saharan Africa: hospital data can be incomplete and doesn’t capture cases seeking traditional treatment in the community, whilst community surveys require significant time and resources to conduct. An alternative approach to identifying high-risk areas is therefore needed.
We aim to assess whether geospatial statistical analysis of data on snakebite incidence (taken from health facilities and community surveys conducted in Kenya and eSwatini) and environmental and sociodemographic variables can be used to predict and map geographical variation in snakebite risk in both countries. Interviews with key stakeholders will also be conducted to explore health service decision making and how snakebite risk data can be best delivered to support this.
The results will help identify high-risk locations for snakebite in Kenya and eSwatini and may provide an approach that could be applied elsewhere. This information will support advocating for resources and guide targeting of treatment and prevention to those most in need.
ORCID 0000-0003-3857-773X
Stephen Spencer, Liverpool School of Tropical Medicine
Project: Acute multimorbid hospital presentations and breathlessness in Malawi and Tanzania.
With increasing life expectancy, the number of patients with more than one chronic condition (multimorbidity) is increasing globally.
Under-diagnosis and under-treatment of multimorbidity leads to frequent hospital admission and premature mortality. However, to date, no studies have investigated the prevalence or outcomes of multimorbidity in hospitals in sub-Saharan Africa (sSA). My PhD objectives address this research gap:
1) Define which chronic diseases are most common in patients admitted to hospital in sSA, using a systematic search of the scientific literature.
2) Determine the prevalence of multimorbidity and whether multimorbid conditions group together in specific clusters. This will be achieved through developing statistical models and working within the NIHR-funded MultiLink cohort study team researching multimorbidity in Malawi and Tanzania. These findings will inform the design of an acute care pathway intervention to diagnose and treat multimorbidity.
Targets for further investigation for my PhD will be delineating causes of acute breathlessness, which is a common clinical presentation. In sSA, limited access to diagnostic equipment and expertise impedes clinician ability to differentiate between conditions, and therefore initiate appropriate treatment. My third objective is:
3) Describe the causes of acute breathlessness, and assess whether context appropriate clinical and biochemical tools can differentiate between causes.
ORCID 0000-0001-8451-7514
Vivien Price, Liverpool School of Tropical Medicine
Project: Hospitalisation and Extended-spectrum beta-lactamase Enterobacterales colonisation in Malawi (HELM study).
Antibiotic-resistant bacteria are a major threat to global health. The impact is estimated to be greatest in sub-Saharan Africa.
Of particular concern are bacteria resistant to cephalosporin antibiotics, drugs often used as first and last resort to treat serious infections in patients attending hospitals. While it is known that both hospital admission and antibiotic administration are associated with acquisition of cephalosporin-resistant bacteria, the reasons are poorly understood. This has implications for guiding control strategies.
I aim to investigate acquisition of a family of cephalosporin-resistant enteric bacteria (including E. coli) in a hospital environment at Queen Elizabeth Central Hospital in Blantyre, Malawi. I will enrol patients and their carers admitted to medical wards, collecting stool samples on admission and at short intervals thereafter during their hospital stay. I will use the bacterial DNA sequence data from these samples to; identify resistant bacteria that are present at very low levels and may not be apparent by other means, elucidate transmission of bacteria between patients and the hospital environment, and investigate why some patients do not acquire resistant bacteria despite exposure to known risks. These findings will help guide interventions to block acquisition of cephalosporin-resistant bacteria tailored to sub-Saharan Africa.
ORCID 0000-0003-3573-5106
Camille Glazer, University of Liverpool
In memoriam, 1995-2023
Project: Investigating the epidemiology of T. solium in Malawi.
Camille sadly passed away in Liverpool in February 2023 where she was receiving treatment for Acute Myeloid Leukaemia.
Camille qualified as a vet from the University of Edinburgh and had a special interest in the epidemiology of zoonotic infections in resource-limited settings, particularly on the African continent. She completed an MSc in Epidemiology from LSHTM and was then selected to do a PhD in which she planned to investigate the epidemiology of T. solium in Malawi.
Prior to starting her PhD, Camille carried out a series of short projects at ILRI in Kenya which not only contributed to her gaining her MRes qualification, but also a foster puppy who she found orphaned by the roadside. Simba is now happily living out his days in Nairobi and is testament to her passion for the vet profession and love of animals.
During her undergrad, Camille carried out voluntary clinical work in Uganda vaccinating over 2500 dogs against rabies, and later spaying and neutering vulnerable dogs in Thailand. She was also already known in Malawi as she had conducted research into investigating helminth prevalence and rabies transmission there.
Camille was an asset to the PhD programme as a dedicated researcher, but she was also a talented musician and maker (her specialty being beautiful quilts). She was destined for great things and will be sorely missed by all who knew her.
ORCID 0000-0001-6873-7736
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