A5081200156- Malaria Research and Control
- Mosquito-borne diseases and control
- Child Nutrition and Water Access
- Global Maternal and Child Health
- Iron Metabolism and Disorders
- Hemoglobinopathies and Related Disorders
- Food Security and Health in Diverse Populations
- HIV Research and Treatment
- Child Nutrition and Feeding Issues
- Complement system in diseases
- HIV/AIDS Impact and Responses
- HIV/AIDS Research and Interventions
- Blood donation and transfusion practices
- Community Health and Development
- Folate and B Vitamins Research
- Vaccine Coverage and Hesitancy
- Pneumocystis jirovecii pneumonia detection and treatment
London School of Hygiene & Tropical Medicine
2024-2025
Malawi Epidemiology and Intervention Research Unit
2024-2025
Blantyre Institute for Community Ophthalmology
2022-2025
University of London
2024
Biomedical Research and Training Institute
2022-2024
Kamuzu University of Health Sciences
2022-2023
Kamuzu Central Hospital
2022-2023
University of Health Science
2022
University of Malawi
2015-2022
University of Bergen
2018-2021
Severe malaria poses a significant challenge to under-five children in Malawi, leading high rates of hospitalization and mortality. The World Health Organization has recently recommended post-discharge chemoprevention (PDMC) as preventive strategy for with severe anaemia malaria-endemic regions. In response this recommendation, Malawi's Ministry (MoH) plans implement PDMC nationwide. To facilitate effective implementation, the MoH partnered Training Research Unit Excellence (TRUE) conduct...
Children recovering from severe malarial anaemia (SMA) remain at high risk of readmission and death after discharge hospital. However, a recent trial found that post-discharge malaria chemoprevention (PDMC) with dihydroartemisinin-piperaquine reduces this risk. We developed mathematical model describing the daily incidence uncomplicated requiring among 0-5-year old children hospitalised SMA. fitted to multicentre clinical PDMC using Bayesian methods modelled potential impact across...
In malaria endemic countries of sub-Saharan Africa, many children develop severe anaemia due to previous and current infections. After blood transfusions antimalarial treatment at the hospital they are usually discharged without any follow-up. post-discharge period, these may contract new infections rebound anaemia. A randomised placebo-controlled trial in Malawi showed 31% reduction malaria- anaemia-related deaths or readmissions among under 5 years age given drugs for 3 months...
Background The provision of post-discharge malaria chemoprevention (PMC) in children recently admitted with severe anemia reduces the risk death and re-admissions endemic countries. main objective this trial was to identify most effective method delivering dihydroartemesinin-piperaquine recovering from anemia. Methods This a 5-arm, cluster-randomized among under-5 hospitalized at Zomba Central Hospital Southern Malawi. Children were randomized receive three day treatment doses monthly...
Abstract Background An estimated 300,000 babies are born with sickle cell anaemia (SCA) annually. Affected children have chronic ill health and suffer premature death. Febrile illnesses such as malaria commonly precipitate acute crises in SCA. Thus, chemoprophylaxis for is an important preventive strategy, but current regimes either sub-optimally effective (e.g. monthly sulphadoxine-pyrimethamine, SP) or difficult to adhere daily proguanil). We propose dihydroartemisinin-piperaquine (DP) the...
In many sub-Saharan African countries, it is recommended that children with sickle cell anaemia receive malaria chemoprevention monthly sulfadoxine-pyrimethamine or daily proguanil as the standard of care. However, efficacy these interventions compromised by high-grade antifolate resistance Plasmodium falciparum and poor adherence. We aimed to compare weekly dihydroartemisinin-piperaquine for prevention clinical in areas P Uganda Malawi. did an individually randomised, parallel group,...
Severe malarial anaemia is one of the leading causes paediatric hospital admissions in Malawi. Post-discharge malaria chemoprevention (PMC) intermittent administration full treatment courses antimalarial to children recovering from severe and findings suggest that this intervention significantly reduces readmissions deaths these children. Community delivery health interventions utilizing community workers (CHWs) has been successful some programmes not very positive others. In Malawi, there...
As a result of successful PMTCT programs, children born from HIV-infected mothers are now effectively protected contracting the infection. However, it is not well known whether in utero exposure to virus and subsequent Cotrimoxazole (CTX) prophylaxis affect cell mediated immune system children. This observational prospective study was aimed at determining how CD4(+) T, CD8(+) T B subsets varied HIV-exposed but uninfected (HEU) different ages.We recruited HEU HIV-unexposed (HUU) 6 months age...
Co-trimoxazole prophylaxis, currently recommended in HIV-exposed, uninfected (HEU) children as protection against opportunistic infections, also has some anti-malarial efficacy. We determined whether daily co-trimoxazole prophylaxis affects the natural development of antibody-mediated immunity to blood-stage Plasmodium falciparum malaria infection.Using an enzyme-linked immunosorbent assay, we measured antibodies 8 antigens (AMA-1, MSP-119, MSP-3, PfSE, EBA-175RII, GLURP R0, R2 and CSP)...
Children initially hospitalized with severe anaemia in Africa are at high risk of readmission or death within 6 months after discharge. No intervention strategy specifically protects children during the post-discharge period. Recent evidence from Malawi shows that 3 malaria chemoprevention (PMC) monthly treatment artemether-lumefantrine malarial prevented 31% deaths and readmissions. While a confirmatory multi-centre trial for PMC dihydroartemisinin-piperaquine is on going Kenya Uganda,...
Introduction Moderate to severe acute malnutrition (SAM/MAM) and anaemia are important associated co-morbidities in children aged less than five years. Independently, these two morbidities responsible for high risk of in-hospital post-discharge deaths hospital readmissions. The primary objective this study is investigate the death among severely anaemic with moderate compared alone. Methods This was a retrospective analysis data collected from large prospective that investigating 5 years...
In countries of sub-Saharan Africa, many children are admitted to hospital with severe forms anaemia. The late admissions anaemic contribute significantly child morbidity and mortality in these countries. This qualitative study explores local health beliefs traditional treatment practices that may hinder timely seeking care for children. January 2019, nine focus group discussions were conducted 90 participants rural communities Malawi. represented four groups caregivers; mothers, fathers,...
Background: Children with sickle cell anaemia (SCA) are recommended to receive malaria chemoprevention monthly sulphadoxine-pyrimethamine or daily proguanil as the standard of care. However, efficacy these interventions is threatened by high-grade antifolate resistance and poor adherence. We determined whether weekly dihydroartemisinin-piperaquine more effective at preventing clinical in SCA than sulphadoxine-pyrimethamine.Methods: conducted an individually randomised, two-arm,...
Cotrimoxazole (CTX) prophylaxis, recommended in HIV-exposed uninfected (HEU) children primarily against HIV-related opportunistic infections, has been shown to have some efficacy Plasmodium falciparum malaria. The effects of CTX prophylaxis on the acquisition P. antigen specific CD4+ T cells-mediated immunity HEU is still not fully understood. Peripheral blood was collected from and HIV-unexposed (HUU) at 6, 12 18 months age. Proportion cells subsets were determined by immunophenotyping....
Chemoprevention with antimalarials is a key strategy for malaria control in sub-Saharan Africa. Three months of postdischarge chemoprevention (PDMC) reduces malaria-related mortality and morbidity pre-school children recently discharged from hospital following recovery severe anemia. Research on adherence to preventive scarce. We aimed investigate the predictors caregivers' three courses monthly PDMC Malawi. used data cluster randomized implementation trial Malawi (n = 357). Modified Poisson...
Background Children hospitalised with severe anaemia in Africa are at high risk of readmission or death within 6 months after discharge. No strategy addresses this post-discharge period. In Malawi, 3 malaria chemoprevention (PMC) monthly day courses artemether-lumefantrine (AL) children malarial prevented 31% deaths and readmissions. There is now a need to design evaluate an effective delivery for PMC. Methods This cluster-randomised trial whose primary objective determine the optimum PMC by...