2024/25 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 2024/2025 intake.
Rebecca Searle, University of Liverpool
Project: Predictors of neurodevelopmental disability in preschool children using low-cost innovative mobile technology for assessment and as a potential platform for early intervention
Neurodevelopmental disabilities (NDD), include cerebral palsy, autism, epilepsy, and intellectual disability. NDD affect 1 in 13 children under 5 years globally, the majority living in low- and middle-income countries (LMIC). Early brain development is influenced by biological and environmental factors, including infection, birth trauma, prematurity, and malnutrition. However, the causes and number of children with NDD in LMIC are unknown and detection is low.
Current tools to identify NDD are expensive, time-intensive, and often require extensive training, making it challenging to diagnose NDD in LMIC, offering limited opportunities to intervene. A new tablet-based neurodevelopmental assessment tool has been developed for use by non-specialists in LMIC but not tested for its ability to predict future NDD and functioning.
I will conduct novel simple assessments to identify NDD and assess functioning in 430 preschool children previously assessed in a study which measured their development alongside biological and environmental factors. I will estimate the proportion of preschool children in Malawi with NDD and its predictors, including scores on a new tablet-based tool.
I will review existing simple resources, barriers, and facilitators to supporting children with NDD in sub-Saharan Africa and produce evidence of best practices linked to identification of these children.
ORCID 0009-0009-9449-6273
Sanjana Kattera, University of Liverpool
Project: Understanding the micronutrient influence on neurodevelopmental outcomes of low birthweight infants (LBW) born at Queen Elizabeth Central Hospital (QECH)
Nutrition is a critical factor in achieving adequate growth and brain development in infants. This is particularly pertinent to those born at low-birthweight (LBW) in low- and middle-income resource countries (LMIC).
Adequate nutrition provision in LMIC is challenging, exacerbated by food insecurity, environmental stress and cost of living. Early life nutritional deficits affect neurodevelopmental function. Subsequent increasing medical needs furthers the burden on already overstretched and underdeveloped health systems. LBW infants have feeding difficulties putting them at greater risk of malnutrition. This correlates with immature suck and swallow, micronutrient deficiencies and the challenge with providing long-term expressed breast milk.
Nutritional therapies hold promise for promoting brain development. Evidence, however, is lacking on individualised nutritional approaches that can address evolving nutritional needs amongst infants in LMIC. Comprehensive nutritional strategies can provide better outcomes in neurodevelopment in infants, particularly those born LBW.
This study will address the intersection between micronutrient status and early development in partnership with a local community in Malawi. Identifying developmental patterns in relation to micronutrient biomarkers will inform therapeutic interventions. Early nutrition provision and assessments of nutritional status are key to optimising long-term development.
ORCID 0009-0001-1459-022X
Akanksha Mimi Malhotra, Liverpool School of Tropical Medicine
Project: The impact of tuberculosis on lung health of silica-exposed artisanal and small-scale miners in Zimbabwe
Tuberculosis (TB) is an infectious disease, typically affecting the lungs. It is one of the deadliest pandemics, resulting in the death of over one million people each year. People working in artisanal and small-scale mines are at increased risk of getting TB due to the silica dust they breathe in at work. They often get TB multiple times. Despite this, we do not know much about how TB and silica dust affect the lung health of miners, including long-term health, after completing TB treatment.
My study aims to look at the impact of TB on the lung health of miners in Zimbabwe. Here, mining minerals such as gold, chrome and lithium are a large and growing industry, employing over half a million people. I will follow a group of miners with and without TB and check their lung-health over a 12-month period, using health questionnaires, performing specialised breathing tests, and taking chest x-rays. Separately, I will see whether a computer programme can detect TB in miners accurately from chest x-rays.
My findings will help us develop targeted interventions to improve the lung health of miners exposed to silica dust in Zimbabwe and other resource limited countries.
ORCID 0000-0002-5312-7086
Lucy O’Connor, Liverpool School of Tropical Medicine
Project: Nasopharyngeal resistome evolution under selective pressure and association with adverse health outcomes
Pneumonia is a leading cause of death in children worldwide, a problem made worse by antibiotic resistance (AMR). Bacteria that cause pneumonia live in the nose of healthy children, causing infection when they invade the lung; AMR in these bacteria can cause death, particularly in Sub-Saharan Africa where healthcare resources are limited. Preventing death due to AMR in Sub-Saharan Africa requires knowledge of how AMR develops and its impact on health outcomes, particularly where data is scarce.
Metagenomic sequencing is a technique that decodes all genetic material in a sample, enabling identification of the bacterial resistome: antibiotic resistance genes (ARGs) that cause AMR and mobile genetic elements, genetic material that moves ARGs between bacteria.
We will examine how hospital admission and antibiotic treatment for pneumonia in Malawian children changes the resistome in their nose, and investigate whether a hospital-acquired resistome in the nose leads to worse health outcomes for children after discharge, including re-hospitalisation.
Disentangling the impact of antibiotics and hospital admission on the resistome could inform public health interventions, including prescribing practices and hospital admission policies. Demonstrating an association between a hospital-acquired resistome and poor health outcomes could allow prediction of health outcomes due to AMR through resistome analysis.
ORCID 0009-0002-6592-6106