research In this section, we have outlined key themes of research in international child health which are led by key investigators who are internal and external partners of the CICH.

Our activities currently extend from research into infectious diseases affecting children globally  like TB, HIV, Malaria, Dengue, Emerging Infectious diseases to a broader understanding of immune maturation in children, which has an impact on how they can deal with infections and also vaccines.

We are interested to think about child health in the context of environmental influences such as the microbiome and nutrition, but also in relationship to maternal factors, which might already affect child health during pregnancy and how these factors might vary within different geographical settings.

It is important to acknowledge that the partners in the CICH will contribute their individual research interests to make the centre grow into a multi-disciplinary platform, and we are keen to include novel ideas from engineering and social science.

Our research ultimately also needs to have impact on policy, and we welcome investigators who are comfortable with our vision of a cross-disciplinary research agenda.

 

Research Areas

Tuberculosis

Prof. Beate Kampmann - Her main areas of research are Paediatric Tuberculosis, including HIV-co-infection and Vaccinology

Dr Robin Basu-Roy - Clinical Research Fellow. His main work includes childhood tuberculosis research with Professors Beate Kampmann and Elaine Holmes

HIV

Dr Caroline Foster is a Consultant in Adolescent HIV and Infectious Diseases at Imperial College Healthcare NHS Trust and is the clinical lead for transitional care in HIV. Current research studies include, the long term outcomes for young adults born with HIV, co-receptor tropism evolution within perinatal infection, the characterisation of the latent reservoir and the development of in vitro therapeutic vaccines in paediatric HIV. Current research/education/guideline development includes BHIVA, CHIVA, HYPNET, CHIPS, PENTA, UNICEF and the WHO.

See the presentation by Dr Foster on during the 18th Annual Conference of the British HIV Association.

Malaria

Dr Aubrey Cunnington - His research focuses on the interactions between hosts and pathogens which result in severe infectious diseases, particularly relating to malaria

Dengue

Prof. Bridget Wills is a UK trained paediatrician with a particular interest in tropical infections.  For the last 8 years she has worked at the Oxford University Clinical Research Unit in Vietnam, where she holds a Wellcome Trust Career Development Fellowship.  Her main focus is on clinical studies designed to improve management of dengue infections in children, together with research to understand the underlying pathophysiological mechanisms of the disease.  Dr. Wills also has an appointment as an Honorary Consultant in Paediatric Infectious Diseases at St. Mary’s Hospital, Imperial College in London.

Maternal Immunisation

Vaccine preventable diseases are responsible for significant maternal and childhood morbidity and mortality. This makes pregnant women a high priority group for immunisation (World Health Organization, 2013). Women who are vaccinated during pregnancy protect themselves, the foetus and baby via transplacental antibodies transmission and the baby via herd immunity.

The Influenza vaccine is advocated during pregnancy as it can cause severe illness leading to complications such as bronchitis or pneumonia. It can also cause serious problems for the unborn baby including preterm delivery or stillbirth (NHS Choices, 2014). 

During a major Pertussis outbreak in 2012, 400 babies under three months old were infected and 14 died. Consequently, the Department of Health launched a temporary vaccination programme in October 2012 advising pregnant women to be vaccinated from 28 weeks’ gestation onwards. Newborns from unvaccinated mothers have very low immunity against Pertussis (Public Health England and Department of Health, 2014). A recently published study showed babies born tovaccinated women had 91% reduced risk of Pertussis infection in their first week of life compared with babies whose mothers had not been vaccinated (Amirthalingam, et al., 2014). Unfortunately, the uptake of the selected vaccines during pregnancy is low for both seasonal Influenza and Pertussis (Public Health England, 2014a; 2014b). 

Women should be informed of the vaccination programme through their General Practitioners and other healthcare professionals (HCP) such as midwives or obstetricians. However, around only one third of childbearing women reported being offered the vaccines (Jain, 2014; Wong, et al., 2014; Yuen & Tarrant, 2014; Moukarram, et al., 2012). 

Consistent delivery of information about Influenza and Pertussis is needed to ensure women are making an informed choice. 

Currently 85% of the UK population aged 16 to 44 years old use a smartphone (Ofcom, 2014). Also between 48% and 56% of smartphone owners utilise applications (Ofcom, 2014; Nielsen, 2013). Therefore smartphone applications enable a 24-hours access to the information and reach an important part of the population (Bradbury, et al., 2014). Several smartphone applications related to pregnancy already exist (Tripp, et al., 2014), but there are few applications concerning immunisation during pregnancy (The American College of Obstetricians and Gynecologists, 2014). 

In the context of the maternal immunisation as a tool to protect vulnerable neonates against vaccine-preventable infections in early life (MatImms) study, Imperial College London has developed a smartphone application to provide pregnant women with information about the immunisation programme during pregnancy in the United Kingdom. 

This type of digital intervention could be cost-effective as the same intervention can be used several times by the same person without having the HCP involved, and compared to paper based leaflets, it avoids extra cost for production, printing and distribution (Bradbury, et al., 2014). As mentioned above, pregnant women could access it any time for an unlimited amount of time at their convenience. They could use the app as a reliable source of information.

MatImms smartphone application is a free app designed by leading experts of paediatric infectious diseases at Imperial College London. Many pregnant women are not currently taking up the options of getting vaccinated during pregnancy as they have concerns regarding safety or do not have sufficient information. However, they can possibly protect their babies against important infections. This app provides parents with information about the vaccination programme during pregnancy and immunisation in early childhood in the United Kingdom. The app enables to set reminders adjusted to the due date and the actual date of birth.

This information will help them to make an informed choice regarding recommended vaccines.

The application can be directly linked to the smartphone calendar to keep users up to date with the vaccines in pregnancy and subsequently receive alerts of when vaccines are due throughout the pregnancy and the first year of the postnatal period. The user is able to register her due date then the actual date of birth for accurate reminders of the vaccination schedule.

The app is currently supported on iPhone and android devices.

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