Paediatric cardiologist Associate Professor Liesl Zühlke has recently won the prestigious SA Medical Research Council/ UK Department of International Development(MRC/DFID) African Research Leader Award. The award, valued at £750 000 (R14.565 million) over 5 years, will assist Prof Zühlke in continuing her research of children with heart disease in Africa, in partnership with Prof Bernard Kheavney (UK) as well as local partners Prof Mark Engel, Dr Gasnat Shaboodien, Prof Raj Ramasar, Prof Mpiko Ntsekhe, Dr Blanche Cupido and Prof Ntobeko Ntusi.
This MRC/ DFID jointly funded scheme aims to strengthen research leadership across sub-Saharan Africa (SSA) by attracting and retaining exceptionally talented individuals who will lead high quality programmes of research on key global health issues pertinent to SSA.
“There is a great need to focus on children with heart disease in Africa, an undeserved area of need”, says Liesl. The research, which will include large-scale programmes of work which incorporate clinical, genetics, cost-effectiveness and quality improvement projects, has the objective to achieve a renewed focus on children with heart disease in Africa.
“We will examine specific scientific questions relating to healthcare delivery and how diseases occur, which are directed towards providing better care for children with heart disease in Africa. We plan to work on three heart diseases causing major health problems in millions of children and young adults in Africa and other parts of the developing world”, says Liesl.
It will build on the current work being done by Prof Zühlke and will tackle three unmet needs in children with heart disease. The first is rheumatic heart disease (RHD), where children develop sore throats caused by a bacterial infection with an organism called Group A Streptococcus (GAS). A third of sore throats in children is caused by GAS, and children living in conditions of poverty, overcrowding and repeated infection, are particularly vulnerable due to weakened immune systems. The next area of focus is those children born with heart problems, congenital heart disease (CHD). The third area of focus will be cardiac diseases (CD) associated with HIV/ART. HIV can affect many different aspects of cardiovascular health including causing weakness of the heart muscle and heart failure.
All these studies will have several sample groups (cohorts) in each of the research areas. The results achieved by Prof Zühlke and her team will be linked to capacity building in five other African countries (Namibia, Malawi, Egypt, Zambia and Ghana) and will attempt to provide new datasets, novel genetic explorations and facilitate post-graduate studies in all six (including our own) countries.
The key areas of impact include the advancement in scientific and health knowledge; development of clinical, imaging and laboratory expertise in Africa; addressing the contribution of RHD, CHD and HIV associated heart disease to adverse outcomes in children and young people's health; delivering highly skilled people to the labour market in participating countries; engaging the public on the value of prompt diagnosis and treatment in GAS infection and facilitating their uptake of services; conducting patient and family-informed and accountable research ;consolidating international and continental networks; and direct improved patient benefit in a transitional country.
Prof Liesl Zühlke has received numerous awards over the years including a US National Institutes of Health Fogarty Fellowship, an academic excellence award from the Discovery Foundation, a Welcome Clinical Disease Initiative Fellowship award as well as the Hamilton Naki Clinical Scholarship, an award given to clinical scholars of excellence. She is NRF-rated and has over 100 publications to date.
*RHD: RHD is a condition in which the body's own immune system mounts an abnormal and potentially catastrophic response to a common and usually self-limiting health problem, a sore throat. Around a third of sore throats are caused by a bacterial infection with an organism called Group A Streptococcus (GAS). Particularly in conditions of poverty, overcrowding and repeated infection, the body can react to the GAS infection by producing an immune response which attacks a number of the patient's own organs - this is called acute rheumatic fever (ARF)
*CHD: CHD comprises a group of conditions in which the heart is not formed properly during the baby's development in the womb. CHD affects nearly 1% of births and is a major cause of childhood death and lifelong disability. In developed countries, there has been a dramatic improvement in survival of patients with CHD thanks to advances in care. Access to similar levels of care in Africa is, and will likely remain, unavailable for the vast majority of the population. So, healthcare teams caring for African CHD patients need to formulate and adopt strategies which will deliver the best outcomes in a setting of severe resource restriction. There is an absolute lack of an African-specific evidence base in CHD to inform such a process
* Heart disease associated with HIV in children and young adults: South Africa has the world's largest HIV epidemic; some 7 million people are currently living with HIV infection. Babies can be infected with HIV by their mothers around the time of birth. Although rates of mother to child transmission have dropped considerably due to treatment of HIV positive mothers, as recently as 2010, around 20% of HIV positive mothers passed on HIV to their baby. Therefore, there is a substantial number of HIV positive children who need long-term treatment with Anti-Retroviral Therapy (ART) to contain the virus. HIV can affect many different aspects of cardiovascular health including causing weakness of the heart muscle and heart failure. We will investigate this in a group of HIV infected adolescents taking long-term ART, using advanced imaging technologies to show the effect of the virus and its treatment.