A5049747325- Viral gastroenteritis research and epidemiology
- Hepatitis Viruses Studies and Epidemiology
- Animal Virus Infections Studies
- Viral Infections and Immunology Research
- SARS-CoV-2 and COVID-19 Research
- Escherichia coli research studies
- Congenital Anomalies and Fetal Surgery
- COVID-19 Clinical Research Studies
- Respiratory viral infections research
- Vaccine Coverage and Hesitancy
- COVID-19 epidemiological studies
- Clostridium difficile and Clostridium perfringens research
- Salmonella and Campylobacter epidemiology
- SARS-CoV-2 detection and testing
- Infant Nutrition and Health
- Advanced Thermodynamic Systems and Engines
- Vibrio bacteria research studies
- Antibiotic Resistance in Bacteria
- Viral Infections and Outbreaks Research
- Child Nutrition and Water Access
- Parasitic Infections and Diagnostics
- Amoebic Infections and Treatments
- Pneumocystis jirovecii pneumonia detection and treatment
- Long-Term Effects of COVID-19
- Bacteriophages and microbial interactions
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
2016-2025
University of Liverpool
2016-2025
Health Protection Research Unit in Emerging and Zoonotic Infections at University of Liverpool
2020-2025
Kamuzu Central Hospital
2021-2025
Kamuzu University of Health Sciences
2021-2024
University of the Free State
2023
University of Health Science
2023
Blantyre Institute for Community Ophthalmology
2023
University of Malawi
2015-2022
National Institute for Health Research
2020
Rotavirus is the main cause of severe acute gastroenteritis in children Africa. Monovalent human rotavirus vaccine (RV1) was added into Malawi's infant immunisation schedule on Oct 29, 2012. We aimed to assess impact and effectiveness RV1 2 years after introduction.From Jan 1, 2012, June 30, 2014, we recruited younger than 5 who were admitted Queen Elizabeth Central Hospital, Blantyre, Malawi, with gastroenteritis. assessed stool samples from these for presence use ELISA genotyped...
Background. Rotavirus vaccines have been introduced in many low-income African countries including Malawi 2012. Despite early evidence of vaccine impact, determining persistence protection beyond infancy, the utility against specific rotavirus genotypes, and effectiveness vulnerable subgroups is important. Methods. We compared prevalence diarrheal stool hospitalization incidence before following introduction Malawi. Using case-control analysis, we derived (VE) second year life for human...
In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing socioeconomic constraints, leading predictions that the COVID-19 pandemic would progress rapidly. However, due limited capacity test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of true burden infection and death. We, therefore, conducted SARS-CoV-2 serosurvey amongst care...
The COVID-19 pandemic has profoundly impacted health systems globally and robust surveillance been critical for control, however not all countries can currently sustain community pathogen programs. Wastewater proven valuable in high-income settings, but less is known about the utility of water pathogens low-income countries. Here we show how wastewater SAR-CoV-2 be used to identify temporal changes help determine circulating variants quickly. In Malawi, a country with limited community-based...
Abstract Background Shigella is a leading cause of acute watery diarrhea, dysentery, and diarrhea-attributed linear growth faltering, precursor to stunting lifelong morbidity. Several promising vaccines are in development field efficacy trials will require consortium potential vaccine trial sites with up-to-date diarrhea incidence data. Methods The Enterics for Global Health (EFGH) surveillance study employ facility-based enrollment cases aged 6–35 months 3 follow-up establish rates document...
Malawi experienced its deadliest Vibrio cholerae (Vc) outbreak following devastating cyclones, with >58,000 cases and >1700 deaths reported between March 2022 May 2023. Here, we use population genomics to investigate the attributes origin of 2022-2023 Vc isolates. Our results demonstrate predominance ST69 clone, also known as seventh cholera pandemic El Tor (7PET) lineage, expressing O1 Ogawa (~ 80%) serotype followed by Inaba 16%) sporadic non-O1/non-7PET serogroups 4%). Phylogenetic...
Shigella is a major cause of diarrhea in young children worldwide. Multiple vaccines targeting are development, and phase 3 clinical trials imminent to determine efficacy against shigellosis. The Enterics for Global Health (EFGH) surveillance study designed the incidence medically attended shigellosis 6- 35-month-old 7 resource-limited settings. Here, we describe microbiological methods used isolate identify Shigella. We developed standardized laboratory protocol isolation identification by...
To combat the high burden of rotavirus gastroenteritis, multiple African countries have introduced vaccines into their childhood immunization programs. Malawi incorporated a G1P[8] vaccine (Rotarix) its schedule in 2012. Utilizing surveillance platform hospitalized gastroenteritis cases, we examined phylodynamics strains that circulated before (1998 to 2012) and after (2013 2014) introduction. Analysis whole genomes obtained through next-generation sequencing revealed all randomly selected...
<ns4:p><ns4:bold>Background</ns4:bold>: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing socioeconomic constraints, leading predictions that the COVID-19 pandemic would progress rapidly. However, due limited capacity test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of true burden infection and death. We, therefore, conducted...
Abstract Identifying risk factors for impaired oral rotavirus vaccine (ORV) efficacy in low-income countries may lead to improvements design and delivery. In this prospective cohort study, we measure maternal antibodies, environmental enteric dysfunction (EED), bacterial gut microbiota development among infants receiving two doses of Rotarix India ( n = 307), Malawi 119), the UK 60), using standardised methods across cohorts. We observe ORV shedding seroconversion rates be significantly...
Quantitative polymerase chain reaction (qPCR) targeting ipaH has been proven to be highly efficient in detecting Shigella clinical samples compared culture-based methods, which underestimate burden by 2- 3-fold. qPCR assays have also developed for speciation and serotyping, is critical both vaccine development evaluation. The Enterics Global Health (EFGH) surveillance study will utilize a customized real-time PCR-based TaqMan Array Card (TAC) interrogating 82 targets, the detection...
Abstract High mortality rates caused by rotaviruses are associated with several strains such as G2, G8, G9, and G12 rotaviruses. Rotaviruses G9 genotypes emerged worldwide in the past two decades. G2 G8 however also characterized frequently across Africa. To understand genetic constellation of African rotavirus their possible origin, sequence‐independent cDNA synthesis, amplification, 454 ® pyrosequencing whole genomes five human were performed. RotaC phylogenetic analysis used to assign...
Rotaviruses of species A (RVA) are a common cause diarrhoea in children and the young various other mammals birds worldwide. To investigate possible interspecies transmission RVAs, whole genomes 18 human 6 domestic animal RVA strains identified Uganda between 2012 2014 were sequenced using Illumina HiSeq platform. The backbone had either Wa- or DS-1-like genetic constellation. One strain was Wa-like mono-reassortant containing VP2 gene origin. All eleven genes one bovine closely related to...
Despite rotavirus vaccination, diarrhea remains a leading cause of child mortality. We collected stool specimens from 684 children <5 years age hospitalized with (cases) and 527 asymptomatic community controls for 4 after vaccine introduction in Malawi. Specimens were tested 29 pathogens, using polymerase chain reaction analysis. Three or more pathogens detected 71% cases 48% controls. Pathogens significantly associated included (in 34.7% 1.5% controls), enteric adenovirus 29.1% 2.7%,...
We evaluated the efficacy, pharmacokinetics (PK), and safety of clofazimine (CFZ) in patients living with human immunodeficiency virus (HIV) cryptosporidiosis.
Abstract Background Binding and neutralising anti-Spike antibodies play a key role in immune defence against SARS-CoV-2 infection. Since it is known that wane with time new immune-evasive variants are emerging, we aimed to assess the dynamics of an African adult population prior infection determine effect subsequent COVID-19 vaccination. Methods Using prospective cohort design, recruited adults laboratory-confirmed mild/moderate Blantyre, Malawi, followed them up for 270 days ( n = 52). A...
Histo-blood group antigen (HBGA) Lewis/secretor phenotypes predict genotype-specific susceptibility to rotavirus gastroenteritis (RVGE). We tested the hypothesis that nonsecretor/Lewis-negative phenotype leads reduced vaccine take and lower clinical protection following vaccination with G1P[8] (RV1) in Malawian infants.
ABSTRACT We evaluated quantitative real-time PCR to establish the diagnosis of rotavirus gastroenteritis in a high-disease-burden population Malawi using enzyme immunoassay as gold standard diagnostic test. In 146 children with acute and 65 asymptomatic children, we defined cutoff point threshold cycle value (26.7) that predicts rotavirus-attributable this population. These data will inform evaluation direct indirect vaccine effects Africa.
<ns3:p><ns3:bold>Background</ns3:bold>: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing socioeconomic constraints, leading predictions that the COVID-19 pandemic would progress rapidly. However, due limited capacity test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of true burden infection and death. We, therefore, conducted...
Rotavirus vaccines reduce rotavirus-related deaths and hospitalisations but are less effective in high child mortality countries. The human RV3-BB neonatal G3P[6] rotavirus vaccine administered a schedule was efficacious reducing severe gastroenteritis Indonesia had not yet been evaluated African infants.We did phase 2, randomised, double-blind, parallel group dose-ranging study of three doses oral infants primary health centres Blantyre, Malawi. Healthy than 6 days age with birthweight 2·5...
Abstract Background Malawi is among 7 countries participating in the Enterics for Global Health (EFGH) Shigella surveillance study, which aims to determine incidence of medically attended diarrhea attributed Shigella, a leading bacterial cause children low-resource settings. Methods We describe EFGH study site densely populated informal settlement Ndirande Township, Blantyre, Malawi. explore site’s geographical location, demographic characteristics, and healthcare-seeking behavior its...
Molecular diagnostics on human fecal samples have identified a larger burden of shigellosis than previously appreciated by culture. Evidence fold changes in immunoglobulin G (IgG) to conserved and type-specific Shigella antigens could be used validate the molecular assignment as etiology acute diarrhea support polymerase chain reaction (PCR)-based microbiologic end points for vaccine trials. We will test dried blood spots collected at enrollment 4 weeks later using bead-based immunoassays...
Infant rotavirus vaccination was introduced in the UK July 2013, and followed by a rapid reduction disease. We compare immunity to sera of age-stratified cohorts assess effect on natural exposure rotavirus. Residual serum samples were selected from reference laboratory biobank based age, year collection. Anti-rotavirus Immunoglobulin G (IgG) IgA antibodies measured using ELISA. used censored linear spline regression models anti-rotavirus correlate protection (CoP) thresholds estimate age...