Awards

Sheetal Silal of the University of Cape Town in South Africa will establish a research consortium to analyze how climate change affects the transmission and control of mosquito-borne diseases, focusing on how to optimize interventions for malaria, chikungunya and dengue in Southern Africa. The consortium will integrate research projects led by local data scientists working closely with local decision-makers. Through mathematical and statistical modeling together with climate science, these projects will determine climate scenarios across time scales relevant for management of mosquito-borne diseases. These time scales will encompass short-term windows (6-12 months) as well as longer windows (5-10 years) relevant for policy planning and that incorporate the predicted impact and costs of new interventions. The consortium will also explore even longer windows (over 30 years) to provide predictions useful to initiate policy discussions and bring attention to the long-term implications of climate change on disease control strategies.

This grant is funded by The Wellcome Trust.

Roman Thibeaux of the Institut Pasteur de Nouvelle Calédonie in New Caledonia will examine how climate-driven soil changes and societal and behavioral factors can affect the incidence of leptospirosis to develop community-centered prevention strategies. The causal agent of the disease is the bacterium Leptospira, which can be found in water or soil contaminated with the urine of infected animals and thus can spread following heavy rainfall. Leptospirosis is endemic in the New Caledonia archipelago in the South Pacific, with potential climate-driven increases in incidence. Using soil microcosms in the laboratory, they will explore the effects of temperature, rainfall, and soil structure on Leptospira survival and dispersion. Through interviews and focus groups with New Caledonia community members together with ethnographic fieldwork, they will record local perceptions and knowledge relevant to leptospirosis and its transmission. In partnership with local community members and health authorities, they will then identify sustainable strategies to reduce leptospirosis incidence.

This grant is funded by the Pasteur Network.

Bryan Ranger of Boston College in the U.S. will develop a cost-effective, portable, and automated ultrasound tool to monitor nutritional health of young pregnant women in Ethiopia. The tool will incorporate AI models that guide users in collecting high quality data, so the tool can be used by frontline and community healthcare workers without extensive ultrasound training, and the models will use this data to predict metrics of nutritional status. In a pilot study conducted at the Jimma Medical center, they will create a database of ultrasound scans, anthropometry, body composition measured by gold standard techniques, and the associated clinical data from a group of young pregnant women. Ultrasound measurements will incorporate data on user position to identify the most informative positions via machine learning. They will survey clinical users to guide the ultimate design of the ultrasound system.

Susan Rumisha of Ifakara Health Institute in Tanzania will support the establishment of data modeling hubs in the Democratic Republic of Congo, Nigeria, and Tanzania, linking them into a collaborative network to guide the control of mosquito-borne diseases in the face of climate change. The focus will be on the direct and indirect effects of environmental change on malaria, modeling the interplay of these effects with public health systems and mosquito vector and disease patterns. This will encompass modeling mosquito vector distribution, abundance, and seasonality using historical climate data together with new microclimate information. The models will be designed to support national programs in prioritizing vector surveillance activities, targeting interventions, and developing early warning systems for emerging health threats. The network will strengthen model-building expertise and could be adapted to address mosquito-borne arboviral diseases.

This grant is funded by The Wellcome Trust.

Bernard Bett of the International Livestock Research Institute in Kenya will develop disease transmission models for two Aedes mosquito-borne arboviral diseases, dengue and chikungunya, and use the models to design decision support tools to guide surveillance and control of these diseases in Kenya, Somalia and Ethiopia. The models will be validated with longitudinal field data, including mosquito population density, infection patterns, blood meal sources, and the incidence of Aedes-borne diseases in humans. The models will be used to estimate important metrics for disease management, such as time-to-disease outbreak, cost effectiveness of control, and spatial distribution of risk. They will also help identify how the ecological tipping points for outbreaks of dengue and chikungunya compare to each other and how existing control measures for the two diseases could be integrated for better health outcomes. The project will link institutions including the Ethiopia Public Health Institute, Kenya’s Department of Disease Surveillance and Epidemic Response, Somalia’s Federal Ministry of Health, Jomo Kenyatta University of Agriculture and Technology, Abrar University, the Kenya Medical Research Institute, Ohio State University, Global One Health Initiative, and the International Livestock Research Institute.

This grant is funded by The Wellcome Trust.

James Beeson of Burnet Institute in Australia, Melissa Kapulu of Health Research Operations Kenya Limited in Kenya, Isaac Ssewanyana of Infectious Diseases Research Collaboration in Uganda, Faith Osier of Imperial College London in the U.K. and Pras Jagannathan of Stanford University in the U.S., will analyze clinical samples using an antibody functional assay platform with malaria antigen arrays to identify antigens targeted by protective antibodies for next-generation malaria vaccines. They will identify antigen-specific functional antibodies that strongly correlate with protective immunity to malaria observed in clinical studies with two populations: Kenyan adults after controlled experimental challenge infection with Plasmodium falciparum and children followed longitudinally who were naturally exposed in Uganda and in Papua New Guinea. They will then use biostatistical modeling approaches to identify antigen and functional antibody types that most frequently occur in protective combinations, identifying additive and synergistic combinations of responses and responses most predictive of protective immunity across age groups and populations. This will enable prioritization of antigens and their combinations for malaria vaccine candidates.

Mary Mwanyika-Sando of Africa Academy for Public Health in Tanzania will develop a mathematical model that accounts for multiple co-occurring diseases and their interactions as well as resource constraints to design integrated healthcare services for people living with HIV in Burkina Faso, Tanzania, and South Africa. The team will use high-quality longitudinal data from four health and demographic surveillance sites. They will characterize co-morbidities and the syndemic clustering of HIV with other diseases (synergistic epidemics), including hypertension, diabetes, and depression, that is due to interrelated biological, environmental, and behavioral factors. They will use the model to predict current and future chronic disease burdens of HIV and other diseases, and then determine optimal health service delivery. The results will be used to co-design intervention implementation strategies with local implementers and policy makers.

Rajshekhar Karpoormath of the University of KwaZulu-Natal in South Africa will test a set of potential anti-TB hit compounds against clinically relevant TB strains, using the results to generate optimized hit compounds for development of new anti-TB drugs. They will screen the potential hits against susceptible, monodrug-resistant, multidrug-resistant, and extensively drug-resistant TB strains as well as other Mycobacterium strains. The screening results will inform structure-based drug design to generate optimized hit compounds. Potential lead hits will be screened again, with the most promising evaluated against intracellular bacteria in macrophages, tested for in vitro cytotoxicity, and evaluated for mechanism of action in bioassays including carbon-isotope tracing metabolomics and an in vitro granuloma assay.

Solomon Hailemeskel of Debre Berhan University in Ethiopia will pilot test midwife-led birthing centers for pregnant women and newborns at low risk of complications to increase access to safe, high-quality childbirth experiences for Ethiopian women. They will implement a multicenter randomized controlled trial, recruiting a cohort of pregnant women from antenatal care clinics across diverse healthcare facilities to ensure a representative sample. After training midwives to provide continuity of care before, during, and after pregnancy, they will establish midwife-led birthing centers in dedicated spaces, either within or separate from a higher-level health facility. A subset of trial participants will be randomly assigned to the birthing centers. They will compare outcomes for the two groups, including data on maternal and neonatal health outcomes, as well as qualitative data from interviews of mothers, midwives, and healthcare providers.

Rapidemic in the Netherlands will collaborate with Mohammed Majam of Ezintsha in South Africa to develop a prototype for a molecular test for rapid multiplex diagnosis of chlamydia and gonorrhea, while determining the requirements for its deployment in South African primary care settings to serve hard-to-reach populations. The test system will be designed to diagnose symptomatic and asymptomatic patients accurately and inexpensively using a rapid and disposable test. To guide prototyping, they will research user preferences and assess the usability of the developed device. They will also conduct research to ensure that the development meets regulatory requirements for the South African market and addresses the needs of pharmacies and primary healthcare settings in South Africa.

Sona Shah of Neopenda, PBC in Kenya will integrate ChatGPT-4 as a virtual assistant for the wearable, vital sign monitor neoGuard, supporting healthcare providers in effectively monitoring and managing neonatal health. They will train ChatGPT-4 to help providers identify and address challenges with the neoGuard monitor, such as poor sensor placement on the patient, and to give providers appropriate recommendations based on vital sign data together with the clinical information they gathered. This real-time clinical decision support would be particularly beneficial in remote and understaffed healthcare facilities. For model training, they will use a dataset of newborns admitted to a hospital in Kenya, including vital signs, clinical histories, and treatment outcomes, as well as insights from unstructured clinical notes extracted using natural language processing. They will evaluate use of neoGuard with ChatGPT-4 for reliability, accuracy, and user-friendliness, and compare neonatal patient outcomes before and after ChatGPT-4 integration with the monitor.

Moses Obimbo Madadi of the University of Nairobi in Kenya and Aida Sivro of the University of Manitoba in Canada will determine the molecular epidemiology of human papillomavirus (HPV) in cervical cancer cases in Kenya to enable monitoring of changes in the prevalence of HPV types targeted by current vaccines and detect possible replacement with other types. They will perform a cross-sectional study on Kenyan women being followed-up for cervical cell abnormalities at hospitals in Nairobi and in rural Kenya. Outcome measures will include prevalence of HPV genotypes by age, geographic location, and HIV status. HPV genotypes will be stratified by cervical diagnosis to determine the top genotypes associated with cervical cancer. This research will provide robust and standardized statistics on the burden and genetics of oncogenic HPV infection in Kenyan women.

Mary Mbithi of the University of Nairobi in Kenya will test a childcare model in Kenya's Machakos County to increase women's economic participation, reduce and redistribute the burden of unpaid care, and shift gender norms related to childcare. This test will build on results from one tested by the University of Nairobi Women's Economic Empowerment Hub in a different Kenyan county and will inform the model's deployment more broadly across the country. In collaboration with the county government and the local community, they will establish childcare facilities in three sub-counties, including recruiting staff and participating children aged 0-4 years. They will measure impact on child growth, development, and school readiness, as well as measuring impact on women's economic empowerment, including video interviews as qualitative assessment of women's experiences. The county government will take over the running of the childcare centers at the end of the project.

Wambui Nyabero of Medevice Kenya in Kenya and Vibhav Joshi of InnAccel Technologies Pvt Ltd in India will pilot test Fetal Lite, a fetal monitor for early detection of fetal distress to reduce intrapartum mortality. The monitor is designed for ease of use and patient comfort. It measures fetal and maternal heart rate and uterine activity, has automated data analysis with audio and visual alerts, and has a built-in electronic partogram and AI-based pregnancy risk scoring. It is cloud-enabled with a central web dashboard for report sharing and trend monitoring. They will deploy devices in medical facilities associated with the University of Nairobi, measuring the quality of the auto-generated analysis compared to blinded expert annotation and the ease of use by nursing staff. They will also capture the associated birth outcomes, the guidance provided through remote monitoring, and the number of detected fetal distress cases and referrals.

Mike Baiocchi of Stanford University in the U.S. will use LLMs to analyze conversational interviews with adolescent girls and young women in Kenya to identify causal mechanisms impairing their health within the potential interplay between living with HIV, mental health conditions, and gender-based violence. Working with the Kenyan Medical Research Institute, they will re-identify and enroll a previously studied cohort living with HIV. The new longitudinal dimension of the study will contribute to untangling causes and effects in parallel to the new LLM-based analysis. They will use LLMs to create statistical measures of participants' descriptions of their experiences to help identify the underlying causes, for instance detecting differences between the responses of those experiencing violence or depression compared to those who have not. Such improved understanding will help to design and target appropriate health interventions.

Elizabeth Nyothach of Kenya Medical Research Institute in Kenya will explore introduction of SunPad, a prototype reusable menstrual pad, determining its acceptability, marketability, and regulatory requirements in Kenya. The SunPad product is made of fabric with a built-in cleaning and disinfecting process that is activated by sunlight. They will conduct focus group discussions with women in Kenya to understand their needs in terms of washing, drying, and reusing the pad, and to gauge their willingness to pay for the product. They will also research the potential for local manufacturing of the pad and determine the regulatory requirements and associated documentation.

Halfan Ngowo of Ifakara Health Institute with Sarah Osima of the Tanzania Meteorological Authority, both in Tanzania, and Mercy Opiyo of the Centro de Investigação em Saúde de Manhiça in Mozambique will perform data-driven modeling to better understand the impact of climate change and extreme weather events on mosquito-borne malaria transmission in African countries. They will compare data from countries more prone to such events (Mozambique) to those less prone (Tanzania and South Africa). They will use retrospective and newly generated data to model the increased risk of malaria transmission, encompassing human and mosquito behavior and disease dynamics. The models along with enhanced malaria risk assessment tools will be developed in user-friendly formats for use by local, regional, and continental health authorities. Through the project platform, they will train African data scientists and modelers and expand partnerships contributing to resilient malaria control strategies in the face of changing climate patterns.

Monika Shukla of Buzzworthy Ventures Private Limited in India will establish a women-led beekeeping network in India to enhance crop yields through bee pollination and improve women's livelihoods. The network will be established initially in one climate zone with a known array of crops. They will educate women about bee pollination for agriculture and provide hands-on training in scientific methods of beekeeping. They will provide multiple types of support for the network, including guidance on integrating weather information to determine optimal times for harvesting honey and deploying bees for pollination, advice on running a beekeeping business, and access to an AI-based app for advice on beehive management. They will also create a community center serving the network with educational programs and as a central site for warehousing honey and processing hive products.

Isaac Sseswanyana of the Infectious Diseases Research Collaboration in Uganda will investigate natural anti-parasite immunity to malaria to guide the development of improved malaria vaccines and therapeutics. Natural anti-parasite immunity is observed in malaria endemic regions in adults and infants who control parasitemia at low levels without developing symptoms, in the latter group likely due at least in part to the transfer of effective maternal antibodies. They will use existing samples from two longitudinal studies in Uganda to test the hypothesis that the repertoires, biophysical properties, and functional features of Plasmodium falciparum-specific antibodies are determinants of this natural immunity. They will also identify and characterize malaria-specific T cells that correlate with anti-parasite immunity and focus on evaluating cellular or proteomic predictors of durable anti-parasite antibodies.

Provat Saha of the Bangladesh University of Engineering and Technology in Bangladesh will support women-led, rural agricultural microenterprises in Bangladesh in deploying a set of climate-smart technologies to enhance their productivity and resilience to climate change. They will engage microenterprises distributed across three sectors: vegetable cultivation, fish farming, and poultry production. They will provide each with a system for user-friendly access to weather forecasts based on international weather models. Each will also receive a cost-effective system for real-time weather monitoring, consisting of a micro-weather station along with relevant sensors, such as soil moisture meters for crops, dissolved oxygen sensors for fisheries, and ammonia and light-intensity sensors for poultry farms. They will provide technical training and guidelines on using the technologies to improve farming decisions, and they will monitor outcomes, including reductions in time, labor, and costs.