2025/26 Fellows

At any one time, LCGHR may support up to 20 fellows at various stages in their 3-year fellowships. Project titles and lay summaries can be found below for fellows in our 2025/2026 intake.

Danielle Jacob, Liverpool School of Tropical Medicine

Project: Exploring postnatal care experiences of adolescent mothers: A sequential mixed-methods study in Ghana

A photo of Danielle Jacob Adolescent childbearing carries significant health risks, including maternal and neonatal complications. Ten percent of global births are to women aged under 20 with 90%occurring in LMICs. The risk of maternal mortality and neonatal deaths during the postnatal period is higher in LMICs including Ghana and many deaths could be prevented with enhanced care. Approximately 70,000 adolescent mothers die annually from complications which often occur in the postnatal period. Addressing poor outcomes requires strategies for providing quality maternity care for young mothers and babies, including the often-overlooked postnatal period.

Whilst previous research has focused on reducing adolescent pregnancies, this study aims to develop a theoretically-informed intervention in Ghanaian Ghana to improve postnatal care for adolescent mothers. This study will be conducted in three phases. Firstly, existing literature on adolescent postnatal care in LMICs and interventions will be reviewed. In the second phase, a grounded theory methodology will be used to conduct interviews and observations with adolescent mothers, health workers, and other individuals identified as being involved in the care process to explore the related social processes and influences. Finally, findings will be used to inform a consensus process to coproduce a protocol tailored to the needs of adolescent mothers in Ghana.

ORCHID 0009-0001-0521-8805

Peter Scott, Liverpool School of Tropical Medicine

Project: The spectrum of early Tuberculosis treatment responses: evaluating associations with post-treatment outcomes

A photo of Peter Scott Tuberculosis (TB) is the leading cause of death from an infectious agent worldwide. Whilst treatment success rates are improving with ongoing global health efforts, survival is often associated with poor lung function, reduction in weight and poor physical and mental quality of life. Risk factors at diagnosis have been investigated widely, however early disease trajectory on treatment has not.

My study aims to improve the understanding of the spectrum of pulmonary TB severity at presentation and how this associates with response to treatment. In particular I am interested in the immune response markers in the early stages of treatment. I will set up a cohort of people starting on TB treatment in Harare, Zimbabwe and follow them up for 9 months to review how early response to treatment predicts treatment success, and more importantly, post-treatment lung damage, nutritional deficiency and quality of life.

These findings will help identify those at risk of deterioration, and whether there are particular immune responses that are more likely to cause this, and open the door to potential future intervention. They will also allow future targeted treatment of post-TB disease in resource constrained health systems.

ORCHID 0000-0001-5292-6604

Greta Wood, University of Liverpool

Project: Developing a biosensor-enabled digital tool for real-time infection monitoring and prediction of neurological complications

A photo of Greta Wood Pneumonia, influenza and tuberculosis are consistently in the top five causes of death in South Africa, with an estimated in-hospital mortality of 7-12%. Recognising the deteriorating patient is challenging in South Africa where nurse:patient ratios can be 1:18 and laboratory testing is limited due to cost. During severe acute respiratory infection, mortality can be predicted by infection markers, and I have shown that brain injury biomarkers predict functional outcomes.

I aim to build on our low-cost continuous biosensor monitoring system optimised for the low-resource setting. Through three work packages, I will:

Conduct a mixed-methods biosensor evaluation, validating a biosensing patch and point-of-care device for infection and brain injury biomarkers (lactate, CRP, IL-6, Tau, and Glial Fibrillary Acidic Protein) in the clinical setting, and evaluating the sociotechnical system using patient journey modelling and focus groups.
Describe the profile of infection and brain injury biomarkers during severe acute respiratory infection.
Develop and validate algorithms to predict clinical deterioration by NEW2 score, and neurological deterioration by Glasgow Coma Scale, and engineer software to display results.

Short term, this will provide an early warning system for deterioration, and in the longer term, may create a platform for personalised care.

ORCHID 0000-0001-6098-2331

Benedict Porter, Liverpool School of Tropical Medicine

Project: NTM-CHIM: Assessing how Non-Tuberculous Mycobacteria Sensitisation Alters BCG Clearance and Immune Response using a Skin Challenge Model in Malawi

A photo of Benedict Porter Tuberculosis (TB) is the leading infectious killer worldwide. BCG (Bacillus Calmette–Guérin) is the only effective TB vaccine. BCG gives variable protection against tuberculous lung disease with ~80% protection in the UK but none to adults in equatorial countries, such as Malawi. Cost inhibits the development of novel effective vaccines which are urgently needed. A TB controlled human infection model (CHIM) would be an invaluable cost-effective tool for down-selecting novel vaccines, however, infecting humans with Mycobacterium tuberculosis (M. tb) is unethical. A safe intradermal CHIM has been developed using BCG as a surrogate for M. tb infection which is being established in Blantyre, Malawi.

BCG CHIM offers the opportunity to study why BCG is less effective in Malawi than in the UK. One theory is that repeated exposure to environmental non-tuberculous mycobacteria (NTM) living in the tropical climate attenuates the protective efficacy of BCG. This study will recruit BCG-vaccinated Malawians with a range of NTM sensitisation to undergo intradermal BCG CHIM and compare against UK cohorts using stored samples. We hypothesise that high levels of NTM sensitisation will be associated with lower antimycobacterial immunity. Further Malawian BCG CHIM data will develop the platform for vaccine down-selection in a setting with urgent need.

ORCHID 0009-0005-5891-5443