Learn more about the projects for each research theme at MRC Unit The Gambia.
Collaborative network for adolescent nutrition and health in sub-Saharan Africa and India -5QX0R0
Contacts: Landing Jarjou, Ramatoulie Janha , Sophie Moore
Funding: MRC GCRF
The project seeks, in the pump-priming phase, to understand the diet and activity behaviour of human adolescents across diverse geographic and cultural settings. The work is designed to prepare for a larger-scale study, which will additionally include assessments of habitual diet (food frequency questionnaires and 24 hour recalls), physical activity (objective methods using accelerometers), body composition (bio-impedance and/or DXA), nutritional status (blood micronutrient and inflammatory biomarkers) and fitness (using simple 'beep' tests - timed running across a fixed distance). These studies are intended to address major knowledge gaps about the nutritional status of adolescents and will necessitate free-living human participants. The findings will be used to develop culture- and setting-specific interventions, and to influence regional and national policies for adolescent health and nutrition.
EMPHASIS (Epigenetic mechanisms linking maternal pre-conceptional micronutrient supplementation with offspring health in India and The Gambia) – 5QX0J0
Contacts: Ayden Saffari or Matt Silver
Funding: Newton Fund (MRC, Indian DBT & UK DFiD)
EMPHASIS is a joint initiative between researchers in The Gambia, India and the UK, established to investigate epigenetic mechanisms by which maternal nutrition before and during pregnancy could influence offspring health. This study brings together two previous randomised controlled trials investigating the effectiveness of maternal dietary intervention on fetal development: the Mumbai Maternal Nutrition Project in India and the Peri-conceptional Multiple Micronutrient Supplementation Trial in The Gambia. In this study we are measuring DNA methylation in the children of these mothers, and assessing links to health outcomes in later life. Full results are expected in 2018.
Impact of maternal diet on the epigenome and potentially modifiable effects on offspring health – MDEG 2 5QX0F0
Contacts: Matt Silver, Phil James or Andrew Prentice
Evidence indicates that the nutritional environment experienced by a developing embryo around conception may leave a lasting mark on the offspring’s epigenome. This suggests epigenetic mechanisms may in part underpin observed long-term adverse health effects arising from suboptimal nutrition in early life. In this study we assess the impact of deficiencies in methyl donor nutrients on areas of the methylome programmed in the developing embryo, including imprinted genes and metastable epialleles. Insights gained will inform the design of supplements to be tested first in non-pregnant women to assess their ability to influence the methyl donor metabolome. Full results expected in 2018. Later large-scale trials in women hoping to have a baby are anticipated.
ENID (Early Nutrition and Immune Development) 5QX00 – ING Core Science
Contacts: Sophie Moore, Momodou Darboe or Andrew Prentice
Funding: MRC ING core, with supplementary funds from the Bill & Melinda Gates Foundation
Observational research indicates that human immune development can be programmed by nutritional exposures early in life. The ENID Trial (ISRCTN49285450) was designed to test whether nutritional repletion can enhance infant immune development in a marginally malnourished population. During pregnancy, women were randomised to a combination of protein-energy and micronutrient supplements and, from six-months of age, their infants randomised to a micronutrient fortified weaning food or placebo. The primary outcome was thymic development, with antibody response to vaccination also measured. Full results from ENID will be published in 2017.
MILQ (The Mothers, Infants, and Lactation Quality Project) 5QX0Q0
Contact: Sophie Moore
Funding: United State Department of Agriculture – Research, Education, and Economics (USDA)
Exclusive breastfeeding is recommended by WHO for the first 6 months of life, and it is important to support this recommendation by all possible means. This includes paying more attention to the nutrient content (“quality”) of breast milk and the nutritional status of the mother and infant during the first 6 months postpartum, especially in resource-poor settings. The MILQ study is a four-centre (Gambia, Brazil, Bangladesh, Denmark) study to develop Reference Values for nutrients and other constituents of human milk, to improve estimates of nutrient requirements and intake gaps for infants and lactating women. Field work will start in late 2017.
BRIGHT (BRain Imaging in Global HealTh) - Developing brain function-for-age curves using novel biomarkers of neurocognitive development from birth in Gambian and UK infants'. 5QX0K0
Contacts: Clare Elwell, Sophie Moore, Sarah Lloyd-Fox or Sam McCann
Funding: Bill & Melinda Gates Foundation
There is a large body of research highlighting the detrimental effects of malnutrition on cognitive development. However, very little is known about the neural basis of this association. The BRIGHT study will use novel objective neuroimaging techniques; Functional Near Infrared Spectroscopy (fNIRS) and Electroencephalography (EEG), alongside behavioural assessment, anthropometric measurements, biological samples and questionnaires (http://www.globalfnirs.org/the-bright-project). Neuroimaging data is collected at 6 time points between birth and 24 months of age in babies in rural Gambia and Cambridge, UK. The data will be used to construct brain function-for-age curves and investigate roles of malnutrition, social and environmental factors in infant development.
Genes-in-Action: Hepcidin, iron and anaemia (5QX00)ING Core Science
Contacts: Carla Cerami, Momodou Wuri Jallow, Andrew Prentice
Funding: Nutrition Theme
Anaemia continues to be one of the most common health problems facing children and pregnant women in low income countries. Genome-wide association studies have identified several single nucleotide polymorphisms (SNPs) within hepcidin regulatory genes that are associated with anaemia in African populations. Our study aims to investigate the impact of these genetic alterations on host iron status and on the pharmacokinetics of oral iron absorption. We will conduct a recall-by-genotype using an existing database of individuals in rural Gambia (West Kiang) who have been pre-genotyped and are known to have the SNPs of interest.
Seroepidemiology study of Zika virus and other arboviral fevers in selected West African countries
Contact: Olubukola Temitope Idoko
Funded by: University of Siena
Continuous disease surveillance at a global level is required as arboviruses cause large outbreaks and epidemics with high disease burden in the affected population. This study is a seroepidemiological survey should conducted to define the dynamics of the infection and disease, implement preventive programs and stimulate the interest for the development of specific drugs and vaccines.
Exploring the relationship between nutrition and vaccine responses
Contact: Olubukola Temitope Idoko
Funded by: Welcome Trust ISSF (Institutional Strategy Support Fund)
This study seeks to relate anthropometric, metabolic and proteomic data to vaccine response with a view to better understanding the role of nutritional parameters on vaccine responses. The responses will be linked to a wide range of antigens given around the vulnerable ages and around the age of growth faltering.
Contact: Thushan de Silva
Funded by: Vaccines and Immunity Theme (MRC Unit The Gambia at LSHTM)
Acute respiratory infections are a major cause of morbidity and mortality worldwide. No formal surveillance system exists in The Gambia to assess the proportion of influenza-like illness (ILI) in children <5 years of age caused by influenza, RSV and other respiratory viruses. CSDILI is a 1-year prospective, observational study of the prevalence and seasonality of respiratory viral infections in children <5 years old presenting to the MRC Clinical Services Department. This information will help inform future vaccine strategies for influenza and RSV. Other secondary outcomes will include assessment of inappropriate antibiotic use for ILI and how this can be improved.