MLW made outstanding progress in translational research supported by Fellowships, Project and Programme grants, Senior Investigator and Strategic Awards from the Wellcome trust and other major funders. We have demonstrated scientific leadership and excellence in the following areas:
- Malaria pathogenesis: standardised severe malaria diagnosis and clinical management, in-depth post-mortem studies and identification of malaria retinopathy, have enabled studies that have revolutionised the view of pathogenesis and led to new approaches to patient selection of severe cases for treatment studies
- HIV-related disease management: careful characterisation of HIV-related disease has led to landmark meningitis and bloodstream infection interventional trials (e.g. corticosteroids and pneumococcal vaccination) that have changed clinical practice internationally
- TB-HIV control: new approaches to testing and treatment evaluated in urban communities in Malawi are, together with evidence from Ethiopia and South Africa, driving an integrated TB-HIV control agenda globally
- Pathogen discovery: Identification of epidemic, human-adapted, multidrug-resistant nontyphoidal Salmonella has led to paradigm-shifting discoveries in pathogenesis (e.g. loss of genes linked to gut persistence; immune control by antibodies as well as T cells), informed antibiotic treatment guidelines and resulted in renewed interest in vaccine design, including engagement by a not-for-profit industrial vaccine partner.
- Vaccine policy: disease burden studies of Hib, pneumococcus, Group B streptococcus, influenza and rotavirus have led to critically important phase II and phase III vaccine licensure trials, supporting national and international vaccine implementation, vaccine effectiveness studies and African molecular epidemiology consortia. ”
Active engagement with policy makers throughout the life of MLW research projects is a critical component of our vision. It is increasingly recognised by MLW/ CoM researchers that informing health policy is critical to yield widespread, sustainable improvements in the public health. Historically MLW research has significantly impacted on clinical and public health practice/ health policy in Malawi with contributions to national guidelines for diagnosis and management of a range of diseases including malaria, HIV, pneumonia and tuberculosis. MLW researchers have participated in MoH advisory and working groups, and have contributed to the development of the National Health Research Capacity Strengthening Initiative and the development of the Nation Health Research Agenda. Notable examples include:
- The Blantyre Coma Score and the identification of Malaria Retinopathy. Systems used worldwide to assess comatose children and now included in the WHO handbook
- Recommendations for community-wide screening for active TB disease.
- Informing national Hib, Pneumococcal and Rotavirus vaccine implementation though surveillance
- Informing national anti-malarial policy. MLW researchers heavily involved in providing advice for the switch to artemisinin-based compounds
- Antimicrobial resistance surveillance leading to the identification of drug-resistance among invasive NTS isolates in adults and children, leading a changes in antibiotic policy for treatment of fever”
Clinical and research facilities at QECH are enhanced by a MLW Paediatric Research Ward; a Clinical Investigation Unit; and an Adult Emergency & Trauma Centre. Inpatient surveillance and linkage to laboratory data are improved by an electronic Surveillance Programme of In-patients & Epidemiology system (SPINE) and a laboratory information management system (LIMS).