Liverpool School of Tropical Medicine (LSTM)
Evaluation of MDA restart in the context of COVID-19 in Kwara and Kano, Nigeria
1. Can MDA resume and achieve high performance while minimizing risk of COVID-19 transmission through adherence to SOPs?
2. Can local teams easily implement the recommended modifications to MDAs; what is the added cost; and how do the above vary by context?
3. What aspects of local context influence implementation of SOPs?
Enhanced self-care protocol for case management of severe lymphoedema
This study aims to determine if the addition of lymphatic stimulating activities to community-based home-care for lymphoedema can improve outcomes for people affecetd by moderate to late stage disease.
Novel immuno-proteomic strategies to develop a polyspecific, non-cold chain liquid snake antivenom with unparalleled sub-Saharan African efficacy
To develop a polyspecific, non-cold chain liquid snake antivenom with unparalleled sub-Saharan African efficacy
Late lead optimisation
Optimizing and implementing A·WOL macrofilaricidal drugs and regimes
Establish the best registered drug for deployment as a macrofilaricide alone and/or in combination with standard anti-filarial drugs.
Deliver at least one novel pre-clinical candidate capable of delivering a macrofilaricide treatment for onchocerciasis (and lymphatic filariasis) within a seven-day treatment period or less.
The development of Trypanosoma brucei within the tsetse vector is accompanied by the expression of several stage-specific families of GPI-anchored surface glycoproteins. We recently discovered that saliva from T.brucei-infected tsetse flies is enriched with Brucei Alanine-Rich Proteins (BARP), VSG and a novel family of GPI-anchored surface glycoproteins. The latter are phylogenetically grouped within the Clade IV of family 50 of trypanosome surface proteins and are encoded by five paralogs, whose products are over 90% identical in sequence. Immunofluorescence and transcript analysis showed that Clade IV proteins are expressed on the surface of metacyclic trypanosomes and also on epimastigotes and pre-metacyclic forms although in lower abundance. This expression pattern opposes that of BARP, which is highly expressed in the epimastigote stage and diminishes during differentiation to metacyclics. Because Clade IV proteins are almost identical in sequence and are heavily expressed in the metacyclic stage, we named them Metacyclic Invariant.
Global Health Innovative Technology Fund (GHIT): 2014-2016 Anti-Wolbachia lead optimisation
Establish the most promising template for final lead optimization from a screen of >10000 compounds from the BioFocus library which revealed compounds with very good anti-Wolbachia activity.
Defining the insecticide resistance status of dengue vectors in Jeddah and Makkah; essential prerequisite to developing an effective response in the event of an outbreak in these important sites.
Improving the impact of IRS for Visceral Leishmaniasis with enabling integrated decision support systems
Improving effectiveness of vector control against Visceral Leishmaniasis
Impact of Malaria Vector Control & Status of Lymphatic Filariasis Transmission in the Lake Zone of Tanzania
Sample Size: 6,024 DBS and 2,854 anopheline mosquitoes
Lead on social science
Determine the best health systems approaches for:
1. Improved planning and delivery of integrated programmes;
2. Increased and sustained access to NTD drugs;
3. Harmonised inter-sectoral approach; and
4. Strong and generalisable evidence base for integrated elimination and control of NTDs.
Strengthen the capacity of the 5 African university departments hosting the MCDC programme
To strengthen the capacity of the 5 African university departments hosting the Malaria Capacity Development Consortium (MCDC) programme
COUNTDOWN Calling
Helping increase and sustain the scale-up of preventive chemotherapy campaigns in West and Central Africa
Gender, equity, ethics & health systems
What are the most strategic approaches to building capacity for gender equity analysis in health systems?
Improving health workforce performance
Which strategies best strengthen strategic decision making for resilient and responsive health systems at the district level in Ghana, Malawi, Uganda and Tanzania?
Effectiveness of tiny target technology in controlling tsetse vectors for HAT
To determine the effectiveness of tiny target technology in controlling tsetse vectors for Human African Trypanomiasis
Research for stronger health systems post conflict
What are the best approaches to develop sustainable and equitable approaches to human resources for health, health financing and governance in post conflict health systems?
Mapping schistosomiasis and soil-transmitted helminthiasis in Namibia
Assessing treatment needs for school-aged children and assisting Ministry of Health to develop an effective control programme
Molecular tools for insecticide resistance diagnosis in phlebotomine sandflies for sustainable leishmaniasis control and elimination programme
Developing new diagnostic tools to monitor insecticide resistance in sandflies in India
Drug formulation for pre-school children
Understanding the basic pharmacology of praziquantel tailored to paediatric setting and developing a treatment access plan for this age class
Cutaneous Leishmaniasis (CL) is exclusively transmitted by the bite of a female sand fly. In collaboration with the Saudi Arabian Ministry of Health, we have developed a programme aiming to prevent and control CL in this country. The programme focuses, among other aspects, in developing a rapid diagnostic test based on the patient’s anti-alpha-Gal response, and in identifying markers for disease exposure. We recently found evidence that treatment efficacy against Old World CL varies with parasite species, geographical locations and the development of secondary infections. This has implications on the treatment of this debilitating disease. The severity of a leishmaniasis ulcer partly depends on the patient’s previous exposure to sand fly bites. This explains the increased protection against CL in individuals living in CL-endemic areas and supports development of potential vaccine models based on sand fly salivary proteins. Furthermore, Old World CL patients produce high levels of anti-Gal antibodies (i.e. recognise terminal alpha-galactosyl epitopes). This discovery is currently being exploited for the making of rapid diagnostic tools and a potential protective glycovaccine model against CL. We hope that these tools can soon be applied in other CL-endemic countries, including refugee settings.
Life on the edge: tackling Africa HAT on the edge of wilderness areas
Our proposal will study the interaction between humans, livestock and wildlife and the role of this transition zone in the transmission of trypanosomes at the edge of the Serengeti National Park in Tanzania. To assess whether focussed control of tsetse is effective, we will develop mathematical models of the transmission of trypanosomes in the transition zone from wildlife-dominated areas on the park boundaries through to livestock-dominated areas outside the parks. The models will enable us to predict the likely extent, duration and cost of interventions required to interrupt the transmission of trypanosomes at boundary areas.
Molecular Characterisation of Anopheles gambiae Heme Oxygenase
Understanding how mosquitoes survive a blood meal
Refining, reducing and replacing in vivo WHO-standard preclinical assays of snake venom pathology and antivenom efficacy
Refining, reducing and replacing in vivo WHO-standard preclinical assays of snake venom pathology and antivenom efficacy
To understand the mechanism to reverse the neglect of snakebite victim
Use of tiny targets to control HAT in Chad
Explore the use of tiny targets to control Human African Trypanosomiasis (HAT) in Chad
Integrated HAT control - a model district in DRC
Determine the effectiveness of integrated control of Human African Trypanosomiasis (HAT) in a model district in DRC
Linking communities and health systems
How to best support close-to-community providers in their critical interface role between health systems and communities
Assessment of male genital schistosomiasis (MGS) and co-infection with HIV among fishermen on the shores of Lake Malawi in Mangochi district
To determine the current prevalence and morbidity of Male Genital Schistosomiasis (MGS) due to S. haematobium and the potential risk of HIV transmission through viral load shedding in semen, particularly of fishermen in schistosomiasis-endemic areas along shores of Lake Malawi in Mangochi district.
Evaluation of MDA restart in the context of COVID-19 in Kwara and Kano, Nigeria
1. Can MDA resume and achieve high performance while minimizing risk of COVID-19 transmission through adherence to SOPs?
2. Can local teams easily implement the recommended modifications to MDAs; what is the added cost; and how do the above vary by context?
3. What aspects of local context influence implementation of SOPs?
Evaluation of MDA restart in the context of COVID-19 in Kwara and Kano, Nigeria
1. Can MDA resume and achieve high performance while minimizing risk of COVID-19 transmission through adherence to SOPs?
2. Can local teams easily implement the recommended modifications to MDAs; what is the added cost; and how do the above vary by context?
3. What aspects of local context influence implementation of SOPs?
Utility of screening easy to access population sub groups as a surveillance tool in monitoring interruption of LF transmission
The question of how to conduct post-elimination surveillance is a high priority for the NTD community, given that most NTD programs scale back or shut down completely once elimination as a public health problem is achieved. Few solutions exist and this proposal provides an interesting and useful case study for surveillance moving forward. The study team plans to target 1708 pregnant women as a proxy for measuring LF resurgence in a post-elimination context. As a comparison group, they plan to conduct a prevalence survey of 427 households (1708 participants) in the same community to compare LF prevalence found in each methodology. Each participant at the health facility’s residence will be geo-referenced to understand the coverage area. They also plan to conduct interviews with patients and health workers, a time-motion study, and a cost analysis to assess the additional burden on health care workers and the health system. The study will occur in 14 facilities in one district of Malawi where LF was highly endemic prior to the launch of the program.
Identifying the optimal delivery model for the identification, confirmation and referral of NTD cases requiring MMDP services within an integrated health systems approach to NTD care in Liberia
This social science study will address the following:
Formative question: What are the strengths and weaknesses of the four models for case identification, confirmation and referral currently being implemented in Liberia for NTDs?
Intervention question: What is the optimal model for implementing case identification, confirmation and referral of NTD cases requiring case management, in terms of equity, effectiveness, economy and efficiency within the health system?"
Interrogating “big data” to develop a user-friendly analysis framework for gender equity in MDA to ensure no one is left behind in Neglected Tropical Disease interventions in Nigeria
To develop and pilot a standardised analytical framework for the spatial and temporal analysis of routinely collected gender disaggregated NTD programme data. This will allow increased understanding and spatial visualisation of the influence of gendered programmatic inputs, external geographic and social factors on the equity of programmatic outputs, particularly access to mass administration of medicines (MAM).
Concerted Action on Female Genital Schistosomiasis and Gynecological Diseases in Cameroon: Integrating Precision Mapping of Urogenital Schistosomiasis with Rapid Assessment of FGS for Better Community Management of Gynecological Diseases
This proof of concept study will take place over a 10-month period. They aim to compare the feasibility and acceptability of mobile gynecological clinics versus traditional, static health posts. The primary research question, Where urogenital schistosomiasis is endemic, can a static health outpost versus a mobile clinic deliver better diagnosis and treatmnet of FGS, HIV, HPV, and cervical cancer in an acceptable and cost-effective manner to women (14-30 years), will be answered through the following activities:
- Development of a consortium on FGS bringing together high-profile researchers, policy makers, program implementers, and health professionals
- Training of health professionals (nurses, physicians, community health workers) with follow up sessions to raise awareness and diagnostic capabilities through colposcopic imagery. Health workers in remote areas will utilize telehealth to transmit images for quality checks by a specialist. The team will measure the % correlation between field results and telemedicine results to determine feasibility.
- Precision mapping in select districts to determine areas with the highest schistosomiasis prevalence through parasitological surveys
- Pilot test mobile service delivery for FGS, HIV, HPV, and other common gynecological issues in two of the four districts. This will include a cost analysis to make a business case for scalability.
Developing a surveillance framework for the post-elimination phase of the lymphatic filariasis programme in Bangladesh
- Can the micro-stratification of lymphatic filariasis (LF) transmission assessment surveys positive case and clinical case data be used to identify, map and monitor transmission hotspots as part of an enhanced endgame surveillance strategy?
- Can targeted molecular xenomonitoring detect ongoing transmission [to the same extent as human surveillance] in defined LF transmission hotspots?
Operational research to compare the confirmatory mapping tool and xenomonitoring indicator (infectivity rate of L3 of Wuchereria bancrofti) in Monrovia to assess the necessity to implement MDA
What is the most appropriate method to evaluate the presence of W. bancrofti transmission in urban conurbations to establish if MDA is necessary for LF elimination?
Evaluating and Developing MMDP services in Nigeria to be responsive to patient and provider perspectives using community based participatory research approaches in a participatory action research cycle
Primary Objective: To evaluate and develop MMDP services in Nigeria to be responsive to patient and provider perspectives using community based participatory research approaches in a participatory action research cycle
Formative research question: To what extent are the support needs of people affected by NTDs being met?
Intervention research question: How can new programme strategies be adapted to meet outstanding need?
Towards the development of efficient traps for onchocerciasis xenosurveillance in Burkina Faso
1. Will the traps collect a similar daily number of host-seeking S.damnosum females than the HLC?
2. Will the physiological stage and infectivity rates of the blackflies collected by the traps be similar to those of the vector collectors?
3. Could the development of a standard and effective trap support the decision to stop MDAs by facilitating xenomonitoring of onchocerciasis?
Schisto Score: Development of a Multivariable Prediction Model for the Diagnosis of Schistosoma haematobium infections in individuals living in hard-to-reach endemic areas around the Mapé dam, West-Cameroon
1. Which combination of clinical, demographical, and behavioral variables best predict urogenital schistosomiasis diagnosis in individuals living in communities around the Mapé dam?
2. How this combination of clinical, demographical, and behavioral variables can help to establish a diagnostic score for urogenital schistosomiasis diagnosis in individuals living in communities around the Mapé dam?