Other Diseases and Conditions
Diarrhea and Sepsis
Scale Up of Zinc Treatment of Childhood Diarrhea:
This project aims to support the effective and sustained scale-up of the treatment of childhood diarrhoea with zinc and ‘low osmolarity Oral Rehydration Salts (ORS), so as to contribute in turn to the reduction of diarrhea-related child morbidity and mortality in Senegal. This support will be used to improve both the health-seeking behaviour of caregivers during diarrhea episodes of children and the accessibility, utilization, and coverage of high quality diarrhoea treatment with zinc and low osmolarity ORS.
Interrupting Pathways to Childhood Sepsis:
Early detection and interruption of pathways to sepsis among women, newborns and young children in least developed countries has been a largely neglected and misunderstood issue. Sepsis is the final common pathway to death for nearly all serious childhood infectious illnesses. Of the nearly 8 million under-five children who die each year, it is estimated that 50 to 70% of these deaths will be the result of children entering this pathway. In partnership with several Bangladeshi and Canadian organizations, this project will establish demonstration sites in which integrated innovations will be implemented and evaluated that involve the coordinated actions of communities, midwives, and primary or hospital care providers in adopting and strengthening mHealth communication and diagnostic innovations, early intervention [detection + referral/transport + treatment] of childhood infections and strengthened health systems.
Pertussis (Whooping Cough)
Surprisingly little is known about how B. pertussis colonizes previously vaccinated (or immune) people, but it is becoming increasingly apparent that the organism has a repertoire of immune evasion tactics. Among these, is the ability to circumvent or dampen the complement system. In addition, B. pertussis has the ability to modify the lipid A moiety of its lipopolysaccharide (also called lipo-oligosaccharide), a property associated with immune modulation.
My laboratory also studies a family of bacterial surface proteins that represent a large class of virulence factors in Gram-negative bacteria, including B. pertussis. These proteins, called autotransporters, appear to encode their own channel to enable them to cross the bacterial outer membrane. How this happens is the subject of much debate.
My laboratory seeks to:
- Understand the mechanisms by which B. pertussis resists the complement pathway
- Determine the mechanism by which B. pertussis modifies its lipid A with glucosamine and how this impacts pathogenesis
- Elucidate the mechanisms by which the autotransporter family of proteins are secreted by the bacterium
Peter von Dadelszen
Prediction in Pre-Eclampsia:
PIERS (Pre-eclampsia Integrated Estimate of RiSk) We are investigating a range of potential predictors of adverse maternal outcomes in women admitted to hospital with pre-eclampsia. We identified the feasibility of, and need to perform, a prospective outcome prediction model development and initial validation study, which was completed in seven centres internationally with CIHR support. This model, the PIERS model, is now being re-validated in two versions.
The first version, fullPIERS, is for use in well-resourced settings and is being validated in level I-III units in Canada, New Zealand, Australia, and the UK in women with pre-eclampsia and the other hypertensive disorders of pregnancy. The validation of fullPIERS has the support of the CIHR.
In parallel, we are also validating the miniPIERS model, which is symptom and signed-based, for use in rural and remote communities and low and middle income countries. The re-validation of miniPIERS has the support of the World Health Organization and the CIHR, and is taking place in Brazil, Pakistan, Mali, China, Uganda, South Africa, and Fiji.
EMMA (Evaluating Maternal Markers of Acquired risk for pre-eclampsia)
We also received CIHR support to develop a screening test to predict the development of pre-eclampsia. This model, the EMMA model, was developed in a high risk cohort of women and identifies women of incremental risk for the later development of pre-eclampsia and the other placental complications of pregnancy (gestational hypertension, IUGR, abruption, stillbirth, and preterm birth).