• Start Date: November 2022
• Duration: 2 years
• Funder: Medical Research Foundation 
• Principal Investigator: Dr Toyin Togun 
• Co-Principal Investigator: Dr Esin Nkereuwem
• Co-Investigators: Dr Schadrac Agbla (University of Liverpool), Dr Muyiwa Owolabi (MRCG at LSHTM), Mrs. Monica Davis (MRCG at LSHTM), Dr Sheila A. Owusu (MRCG at LSHTM), Dr Victory F. Edem (MRCG at LSHTM/University of Ibadan, Nigeria)

Spirometry is the standard method most widely used to assess pulmonary function. However, its interpretation relies on comparison with reference ranges derived from extensive studies from different parts of the world. The currently-used Global Lung Initiative (GLI) race-based and race-neutral reference ranges are deficient as they do not capture data of diverse African populations, with none from West Africa in particular. 

The RANGE study aims to generate locally-appropriate spirometry data, which can serve as a reference point for assessment of chronic lung disease among Gambian children. Healthy children from randomly selected primary and secondary schools within the Greater Banjul Area (GBA) will be recruited, and they will have lung functions tests performed by portable spirometry. We will use the Lambda-Mu-Sigma (LMS) model to generate z-scores for the age- and height-standardized reference curves for each lung function parameter stratified by sex.

The findings from this study are intended to be generalizable to other TB-endemic settings in West Africa.

• Start Date: December 2022
• Duration: 3 years
• Funder: EDCTP via the West Africa Networks of Excellence for TB, AIDS and Malaria
• Principal Investigator: Dr Toyin Togun 
• Co-Investigators: Dr Victory F Edem (MRCG at LSHTM/University of Ibadan, Nigeria), Dr Kwabena A Osman (KBTH, Ghana), Dr. Audrey G Forson (KBTH, Accra, Ghana), Dr Arnauld Fiogbe (CNHU-PPc, Cotonou, Benin), Prof Dissou Affolabi (CNHU-PPC, Cotonou, Benin)
• Collaborators:  West Africa Paediatric TB Network (WApTBNet); WANETAM TB Network

Diagnosis of pulmonary tuberculosis (TB) in children is challenging for several reasons including difficulties in obtaining good quality sputum samples and the paucibacillary nature of the disease in children. As such, sensitivity of the conventional TB diagnostic tests is considerably lower in children relative to adults.

The aim of this multi-country project is to pragmatically investigate the utility and added-value of non-sputum based approaches, including computer-aided diagnosis of TB (CAD4TB) and stool testing by Xpert Ultra, for diagnosis of pulmonary TB in children. Children with clinical suspicion of TB disease will be consecutively recruited for detailed evaluation at study sites in The Gambia (MRCG at LSHTM), Ghana (Korle-Bu Teaching Hospital [KBTH]), and Benin Republic (National Teaching Hospital for TB and Respiratory Diseases [CNHU-PPC]).

This study will provide valuable information on how many additional childhood TB cases could be detected when these non-sputum based approaches are used in combination with conventional diagnostic tests within national health systems in West Africa.

• Start Date: January 21, 2024
• Duration: 24 months
• Funder: Science for Africa (SFA) Foundation
• Principal Investigator: Dr Zakari Ali
• Co-Investigators: Prof Kris Murray (MRCG), Dr Tony Carr (LSHTM), Prof Andrew Prentice (MRCG), Prof Rosemary Green (LSHTM) 
• Collaborators: Dr Amat Bah (National Nutrition Agency - NaNA), Mr Abdou Aziz Ceesay (NaNA), Dr Alcade Segnon (Alliance of Bioversity and CIAT - Senegal)

The DiGES project aims to identify and promote the consumption and production of underutilized crops that are more resilient to climate change, reduce environmental impacts, and have positive health attributes. Studies have investigated different ways to produce enough food under climate change – with diverse evidence of success. This project examines how populations can demand and consume foods that are more climate resilient.

The project uses population diet as the entry point to agricultural adaption to climate change by identifying the barriers and opportunities for populations to demand and consume locally available and climate resilient foods. The study team will also model different food system scenarios under climate change – engage food system stakeholders, policymakers and local farmers, and use social behaviour change communication (SBCC) strategies to promote the demand, consumption, and production of climate resilient crops.

Contacts: Carla Cerami, Andrew Prentice
Funding: MRC

This project seeks to identify the sources of persistent low-grade inflammation in well and sick Gambian children. It will additionally try to understand the complex interacting mechanisms linking iron absorption, distribution and erythropoiesis to the effects of inflammation mediated through hepcidin, erythropoietin (EPO) and the newly discovered hormone erythroferrone (ERFE) which signals to the liver that the bone marrow requires iron. Finally we will conduct a randomised controlled trial to test whether it is possible to circumvent the hepcidin-induced blockade of iron absorption by administering iron in the form of haem. Another arm of this trial will be a proof-of-principle trial to assess the impact of reducing inflammation by co-administering azithromycin and galacto-oligosaccharides with iron. These studies, if successful, would suggest the need for a radical revision of current policies to combat IDA.

Contact: Alfred Ngwa
Funded by: Alliance for Accelerating Excellence in Science in Africa