Two Stellenbosch University (SU) researchers have been awarded funding through the US National Institutes of Health's Fogarty International Centre – an honour that is bestowed on only eight health leaders from across the globe every year.

Thanks to the Emerging Global Leader (K43) Award, Drs Angela Dramowski and Amy Slogrove – both from the Department of Paediatrics and Child Health of the Faculty of Medicine and Health Sciences – are now able to expand their research activities and make a lasting impact on pressing health challenges in South Africa.

The Fogarty International Centre supports and facilitates global health research, while building partnerships between health research institutions in the United States and abroad. In this way, the Centre assists in training the next generation of scientists to address global health needs. The K43 award will provide Dramowski and Slogrove with financial support, as well as funding towards a research project and career-development activities, over the next five years.

Dramowski's research centres on developing a care bundle for neonatal sepsis prevention in low-resource settings. Slogrove is investigating the effect of hypertensive disorders in pregnancy and HIV infection on maternal, birth and infant outcomes in South Africa.

Care bundle to prevent neonatal sepsis

Dramowski explains that 750 000 babies die from bacterial infections in low- and middle-income countries every year. New approaches are urgently needed to prevent infection in hospitalised newborns, especially among preterm and low birthweight babies.

“To date, most of our research on infections in newborn babies has focused on understanding the extent of the problem and on which bacteria are responsible for these infections and infection-related deaths," says Dramowski. “This award will allow us to expand our research to look for innovative ways of preventing infections and infection-related deaths in hospitalised newborns."

She explains that their research will develop a neonatal sepsis prevention care bundle for use in low-resource settings, while testing the feasibility and acceptability of this strategy in hospitalised South African newborns. “If the care bundle is successful, we hope to obtain funding to test it on a larger scale in hospitalised newborns from other low-resource countries."

Hypertensive disorders and HIV in pregnancy

The award has afforded Slogrove the opportunity to take her important HIV-related research to the next level. She explains that HIV-uninfected babies born to HIV-positive women have elevated mortality and morbidity rates compared to infants born to HIV-negative women. These trends tend to be persistent, despite improved maternal health through anti-retroviral treatment (ART) and an increased uptake of safer breastfeeding techniques.

“Even when HIV-infected pregnant women receive ART and are not severely immune compromised, they still have a 50% higher risk of having a stillborn or a preterm baby, and a 30% higher risk of having a low birthweight baby," Slogrove says.

“Why HIV-infected women still have adverse birth outcomes, even when receiving ART, is poorly understood. Hypertensive disorders of pregnancy, including gestational hypertension, pre-eclampsia and eclampsia, also increase the risk for adverse birth outcomes," she continues. “Some small studies have suggested that HIV-infected women on ART might be at increased risk for hypertensive disorders of pregnancy."

Slogrove's research, which will be done epidemiologically at a population level in the Western Cape, aims to understand whether HIV and ART are associated with hypertensive disorders in pregnancy, and whether this represents a pathway to adverse maternal and birth outcomes.

The Emerging Global Leader (K43) Award will allow Slogrove to work closely with leading international researchers in paediatric and maternal HIV. It will also afford her the opportunity to continue working as a paediatrician in a rural primary healthcare clinic outside Worcester. “This informs the research and keeps me grounded in what's needed, feasible and relevant to improve maternal and child health," she says.

Visit www.fic.nih.gov for more information about the National Institutes of Health's Emerging Global Leader (K43) Awards.