Kyle Wilson, University of Liverpool
Project: Blantyre Retinal Analysis to Investigate NeuroVascular Immunity and Endothelial Weakening in Cerebral Malaria: The BRAINVIEW-CM Study
Cerebral malaria (CM), a severe manifestation of Plasmodium infection, remains a major health challenge, with most deaths in African children. Despite advances in anti-malarial therapies some children do not respond, resulting in a fatal outcome. Deleterious effects on the brain appear to continue even after effective killing of parasites.
Due to shared embryological origins, the retina provides an excellent model for the brain in CM. Retinal studies have highlighted pathophysiological processes in CM during life that are mirrored in post-mortem brain samples. Optical coherence tomography (OCT) is non-invasive and provides high-resolution cross-sectional imaging through the retina. Research has shown characteristic findings on OCT in CM.
I aim to identify subgroups in CM by combining OCT with clinical data including transcranial Doppler and MRI of the brain. I will then establish whether these groups have distinct immunological profiles and seek to identify differences in outcomes of death, brain injury or full recovery.
I will also characterize tissue-level host immune responses in diseased vs. unaffected retina using advanced imaging of labelled protein and RNA targets in post-mortem eye tissue.
By identifying clinically-recognisable patient subgroups and cellular processes central to CM pathogenesis I plan to pave the way to targeted adjunctive treatments.
ORCID 0000-0003-0151-7530
Jordana Burdon-Bailey, University of Liverpool
Project: Evaluating the importance of Campylobacter as a zoonotic gastrointestinal pathogen in Malawi: A One Health approach
In Low- and Middle-Income Countries (LMICs), gastrointestinal infections represent a major cause of child morbidity, negatively impacting physical and intellectual development. Campylobacter is a zoonotic foodborne bacterium and is a common cause of gastroenteritis worldwide. Contact with animals and consumption of animal products, including poultry and milk, are known risk factors for Campylobacter infection. However, there is a paucity of data describing the importance and epidemiology of Campylobacter in many LMICs.
I will use a One Health approach combining classical and genomic epidemiology, to explore the prevalence, sources and transmission routes of Campylobacter in Blantyre, Malawi. I will do this through a case-control study of Campylobacter in young children with acute diarrhoea. I will explore potential sources of infection from animal products, family members and the environment within households of children with and without diarrhoea. I will investigate the presence of Campylobacter at points of sale using a cross-sectional survey, to gain a further understanding of sources beyond the household. Genotypes of Campylobacter will be determined to examine source attribution.
Through identification of sources of infection and transmission routes of Campylobacter, my study will advise public health policy by informing intervention strategies aimed at reducing Campylobacter disease burden.
ORCID: 0009-0005-2211-2905
Sheilla Achieng, University of Liverpool
Project: Infection Risk in patients with Immune-mediated Inflammatory Diseases & Systemic Lupus Erythematosus: A Global Health Challenge.
Patients with Immune-mediated Inflammatory Diseases (IMIDs) are more susceptible to infections compared with the general population. This is in part due to the immune dysregulation caused by the disease itself, immunosuppressive medications used to treat these conditions and factors related to the patient, such as co-morbid illnesses like diabetes and kidney disease.
Systemic Lupus Erythematosus (SLE) is a rare multisystem autoimmune rheumatic disease predominantly affecting females of child-bearing age. Infections are currently the leading cause of death in SLE. SLE is more prevalent and more severe in people of African and South Asian ancestry. There remains little data on SLE from low-middle income countries (LMIC) which have a higher incidence and prevalence of infectious diseases compared to the United Kingdom (UK).
Our study will assess the incidence, risk factors and patterns of infection in SLE patients from different regions of the world through a coordinated analysis with 3 countries: Kenya, Sri-Lanka and the UK. This study will help us understand the burden of infection in SLE. With this knowledge, we can develop interventions that can be used rationally to improve the balance between disease control and infection risk in SLE. The same methods will inform research in other IMIDs globally.
ORCID: 0000-0003-0738-9664
Sarah Farrell, Liverpool School of Tropical Medicine
Project: Improving parents’ recognition of neonatal danger signs in neonates to enable prompt health care utilisation: A qualitative study in Nairobi, Kenya.
In Kenya, there is no routine follow up for babies following discharge from health facilities, with parents expected to return with the baby if they become unwell. Studies in sub-Saharan Africa found that parents are often not well informed about signs of illness in babies, often do not understand when to take the baby to a health facility and use traditional medicine or do nothing.
I will examine the literature about health care professional and parents’ understanding of signs of illness or ‘neonatal danger signs’ in sub-Sahara Africa. This will inform in-depth interviews with health professionals and parents in Kenya. Concurrent analysis will allow directional sampling and enquiry, with detailed observations in health facilities used to confirm practice.
This study will identify the current context, specifically what parents understand about illness in babies, sources of knowledge and influences on health seeking behaviour in Kenya. This evaluation will allow me to collaborate with key health professionals and parents’ representatives to co-develop context-specific interventions as a strategy to reduce poor outcomes. A theory or conceptual model developed from the interviews and observations will be used alongside the identified interventions to create a study protocol to test the feasibility of the interventions.
ORCID: 0000-0003-1781-947X
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