Dr Carla Cerami
MRC - Senior Investigator Scientist*
MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Atlantic Boulevard
Gambia
Dr. Carla Cerami is an Associate Professor at MRCG Unit the Gambia at the London School of Hygiene and Tropical Medicine who leads the Iron, Infection and Anemia group within the Nutrition and Planetary Health theme. She has been based in The Gambia since 2016. She is an MD with a PhD in Immunology.
With more than a decade of expertise in clinical research and development, Dr. Cerami has effectively orchestrated and analysed observational and clinical trials, spanning the entire spectrum from observational trials to late-phase trials. This multifaceted experience has extended across a diverse array of global regions, encompassing both low-income countries, and the United States.
She has led the clinical research teams in human genetics, infectious diseases, nutrition and neurology. She has authored many scientific and clinical publications, clinical trial study and regulatory documents. Driven by a commitment to transparency and knowledge dissemination, she has effectively communicated study findings to diverse audiences.
She is a team player, experienced in collaborating with colleagues from different cultural backgrounds to achieve objectives in a timely manner.
https://www.ncbi.nlm.nih.gov/myncbi/1HaRjmYb9nr5c/bibliography/public/
With more than a decade of expertise in clinical research and development, Dr. Cerami has effectively orchestrated and analysed observational and clinical trials, spanning the entire spectrum from observational trials to late-phase trials. This multifaceted experience has extended across a diverse array of global regions, encompassing both low-income countries, and the United States.
She has led the clinical research teams in human genetics, infectious diseases, nutrition and neurology. She has authored many scientific and clinical publications, clinical trial study and regulatory documents. Driven by a commitment to transparency and knowledge dissemination, she has effectively communicated study findings to diverse audiences.
She is a team player, experienced in collaborating with colleagues from different cultural backgrounds to achieve objectives in a timely manner.
https://www.ncbi.nlm.nih.gov/myncbi/1HaRjmYb9nr5c/bibliography/public/
Affiliations
MRC Unit The Gambia at LSHTM
Teaching
I currently supervise or co-supervise 2 PhD students. I am open to supervising MSc and PhD projects.
Research
Key words: Anaemia, Iron Deficiency, Early infant iron supplementation, malaria parasite and human host interactions, human genetic biobanking and recall by genotype studies.
Current trials and projects:
1) Enhancing brain development by early iron supplementation of African infants: An enabling pilot study (The “Iron Babies Trial”)
Our previous work has shown that most breast-fed Gambian infants are iron deficient by five months of age. This two-arm, double-blind, placebo-controlled, randomised superiority trial introduced iron supplements alongside breastfeeding much earlier in infancy than has previously been attempted in a low-income setting with an aim to improve serum iron concentration. Infants were randomised to receive iron drops (7.5mg/day of elemental iron) or placebo daily for 98 days, to test the impact of daily for 98 days on serum iron concentrations in infants (n = 100) aged 6-10 weeks at enrolment. Participants were visited daily for supplementation, daily health and weekly breastfeeding questionnaires will be administered. Anthropometry, and venous blood and faecal samples were collected at enrolment and after 98 days of supplementation. At enrollment, participants were 6-10 weeks old, healthy and exclusively breastfed. Low birthweight (less than 2.5kg at birth) and infants born prematurely (< 37 weeks) were not excluded. Formula-fed and infants with any illness were excluded. The primary outcome is serum iron after 98 days.
We have just completed the in-life phase of the trial. Data analysis is underway.
2) Haem iron versus ferrous iron salts to treat iron deficiency anaemia in Gambian children: a randomised controlled trial
The World Health Organization recommends universal iron supplementation for children aged 6-23 months in countries where anaemia is seen in over 40% of the population. Conventional ferrous salts have low efficacy due to low oral absorption in children with inflammation. Haem iron is more bioavailable and its absorption may not be decreased by inflammation. This study aims to compare daily supplementation with haem iron versus ferrous sulphate on haemoglobin concentration and serum ferritin concentration after 12 weeks of supplementation.
This is a two-arm, randomised controlled trial. Gambian children aged 6-12 months with anaemia will be recruited within a predefined geographical area and recruited by trained field workers. Eligible participants will be individually randomised using a 1:1 ratio within permuted blocks to daily supplementation for 12 weeks with either 10.0mg of elemental iron as haem or ferrous sulphate. Safety outcomes such as diarrhoea and infection-related adverse events will be assessed daily by the clinical team. Linear regression will be used to analyse continuous outcomes, with log-transformation to normalise residuals as needed. Binary outcomes will be analysed by binomial regression or logistic regression, Primary analysis will be by modified intention-to-treat (i.e., those randomised and who ingested at least one supplement dose of iron), with multiple imputations to replace missing data. Effect estimates will be adjusted for baseline covariates (C-reactive protein, alpha-1-acid glycoprotein, haemoglobin, ferritin, soluble transferrin receptor)
The study will determine if therapeutic supplementation with haem iron is more efficacious than with conventional ferrous sulphate in enhancing haemoglobin and ferritin concentrations in anaemic children aged 6-12 months. Trial is currently on-going.
3) Keneba Biobank
The Keneba Biobank was initiated in 2009 with the aim to create a platform for future genetic studies.
The aim of the project was to collect biological samples and health information from all the residents of the West Kiang District above 1 year of age. This ambitious project resulted in the collection of blood (DNA extracted and stored) and urine samples from over 12,000 individuals. These biological samples have been stored in freezers at the MRCG at LSHTM. In addition, blood sugar, full blood counts and blood pressure were measured on all adults (18 years and above).
So far, 1400 individuals have been exome sequenced from these 12,000 participants. It is hoped that the Keneba Biobank will contribute to the discovery of novel genetic variants that are relevant to Africans and will provide insight into the genetic determinants of health and disease in African populations. Since the inception of genomics research, the majority of studies are done on non-African populations, mainly Europeans. To address this inequity in human genetics research, efforts and now being directed to increase the participation of African populations. This is necessary as genetic findings from non-African populations are not readily transferable to Africans due to the differences in the genetic architecture between African and non-African populations.
Current trials and projects:
1) Enhancing brain development by early iron supplementation of African infants: An enabling pilot study (The “Iron Babies Trial”)
Our previous work has shown that most breast-fed Gambian infants are iron deficient by five months of age. This two-arm, double-blind, placebo-controlled, randomised superiority trial introduced iron supplements alongside breastfeeding much earlier in infancy than has previously been attempted in a low-income setting with an aim to improve serum iron concentration. Infants were randomised to receive iron drops (7.5mg/day of elemental iron) or placebo daily for 98 days, to test the impact of daily for 98 days on serum iron concentrations in infants (n = 100) aged 6-10 weeks at enrolment. Participants were visited daily for supplementation, daily health and weekly breastfeeding questionnaires will be administered. Anthropometry, and venous blood and faecal samples were collected at enrolment and after 98 days of supplementation. At enrollment, participants were 6-10 weeks old, healthy and exclusively breastfed. Low birthweight (less than 2.5kg at birth) and infants born prematurely (< 37 weeks) were not excluded. Formula-fed and infants with any illness were excluded. The primary outcome is serum iron after 98 days.
We have just completed the in-life phase of the trial. Data analysis is underway.
2) Haem iron versus ferrous iron salts to treat iron deficiency anaemia in Gambian children: a randomised controlled trial
The World Health Organization recommends universal iron supplementation for children aged 6-23 months in countries where anaemia is seen in over 40% of the population. Conventional ferrous salts have low efficacy due to low oral absorption in children with inflammation. Haem iron is more bioavailable and its absorption may not be decreased by inflammation. This study aims to compare daily supplementation with haem iron versus ferrous sulphate on haemoglobin concentration and serum ferritin concentration after 12 weeks of supplementation.
This is a two-arm, randomised controlled trial. Gambian children aged 6-12 months with anaemia will be recruited within a predefined geographical area and recruited by trained field workers. Eligible participants will be individually randomised using a 1:1 ratio within permuted blocks to daily supplementation for 12 weeks with either 10.0mg of elemental iron as haem or ferrous sulphate. Safety outcomes such as diarrhoea and infection-related adverse events will be assessed daily by the clinical team. Linear regression will be used to analyse continuous outcomes, with log-transformation to normalise residuals as needed. Binary outcomes will be analysed by binomial regression or logistic regression, Primary analysis will be by modified intention-to-treat (i.e., those randomised and who ingested at least one supplement dose of iron), with multiple imputations to replace missing data. Effect estimates will be adjusted for baseline covariates (C-reactive protein, alpha-1-acid glycoprotein, haemoglobin, ferritin, soluble transferrin receptor)
The study will determine if therapeutic supplementation with haem iron is more efficacious than with conventional ferrous sulphate in enhancing haemoglobin and ferritin concentrations in anaemic children aged 6-12 months. Trial is currently on-going.
3) Keneba Biobank
The Keneba Biobank was initiated in 2009 with the aim to create a platform for future genetic studies.
The aim of the project was to collect biological samples and health information from all the residents of the West Kiang District above 1 year of age. This ambitious project resulted in the collection of blood (DNA extracted and stored) and urine samples from over 12,000 individuals. These biological samples have been stored in freezers at the MRCG at LSHTM. In addition, blood sugar, full blood counts and blood pressure were measured on all adults (18 years and above).
So far, 1400 individuals have been exome sequenced from these 12,000 participants. It is hoped that the Keneba Biobank will contribute to the discovery of novel genetic variants that are relevant to Africans and will provide insight into the genetic determinants of health and disease in African populations. Since the inception of genomics research, the majority of studies are done on non-African populations, mainly Europeans. To address this inequity in human genetics research, efforts and now being directed to increase the participation of African populations. This is necessary as genetic findings from non-African populations are not readily transferable to Africans due to the differences in the genetic architecture between African and non-African populations.
Disease and Health Conditions
Anaemia
Malaria
Country
Gambia
United States of America
Region
Sub-Saharan Africa (all income levels)
Selected Publications
African women working in global health: closing the gender gap in Africa?
2018
The Lancet Global health
Religious Involvement Is Associated With Higher Fertility and Lower Maternal Investment, but More Alloparental Support Among Gambian Mothers.
2024
American journal of human biology : the official journal of the Human Biology Council
A practical guide to cross-cultural and multi-sited data collection in the biological and behavioural sciences.
2024
Proceedings of the Royal Society B: Biological Sciences
Early iron supplementation in exclusively breastfed Gambian infants: a randomized controlled trial.
2024
Bulletin of the World Health Organization
Practical Guidelines for Standardised Resolution of Important Protocol Deviations in Clinical Trials Conducted in Sub-Saharan Africa.
2024
Therapeutic innovation & regulatory science