Setting priorities for development of emerging interventions against childhood diarrhoea

An expert panel exercise was conducted to assess feasibility and potential effectiveness of 10 emerging health interventions against childhood diarrhoea. Twelve international experts were invited to take part in a CHNRI priority setting process. This group used 12 different criteria relevant to successful development and implementation of the emerging interventions, nine of which were retained in the final analysis. They showed most collective optimism towards developing household or community-level water treatment, followed by sustainable, affordable latrine options; those two emerging interventions were followed by antibiotic therapy of Cryptosporidium diarrhoea, and oral or transcutaneous enteric vaccine development

Setting priorities for development of emerging interventions against childhood pneumonia, meningitis and influenza

WAcute lower respiratory infections, which broadly include pneumonia and bronchiolitis, are still the leading cause of childhood mortality. ALRI contributed to 18% of all deaths in children younger than five years of age in 2008, and the main pathogens responsible for high mortality were Streptococcus pneumoniae, Haemophilus influenzae and respiratory syncytial virus. In addition, meningitis was estimated to contribute up to 200 000 deaths each year, and influenza anywhere between 25 000 and 110 000. It is widely acknowledged that a major portion of this mortality should be avoidable if universal coverage of all known effective interventions could be achieved. However, some evaluations of the implementation of World Health Organization’s (WHO) Integrated Management of Childhood Illness (IMCI) strategy, which promotes improved access to a trained health provider who can administer “standard case management”, have shown somewhat disappointing results. Only a minority of all children with life-threatening episodes of pneumonia, meningitis and influenza in developing countries have access to trained health providers and receive appropriate treatment. Thus, novel strategies for control of pneumonia that balance investments in scaling up of existing interventions and the development of novel approaches, technologies and ideas are clearly needed

Systematic review of birth cohort studies in Africa

In sub-Saharan Africa, unacceptably high rates of mortality amongst women and children continue to persist. The emergence of research employing new genomic technologies is advancing knowledge on cause of disease. This review aims to identify birth cohort studies conducted in sub-Saharan Africa and to consider their suitability as a platform to support genetic epidemiological studies

From Genomic Advances to Public Health Benefits: The Unbearable Lightness of Being Stuck

Genetic determinants of common human diseases are still poorly understood. Due to large investments, many small successes have been made and the research field is rapidly expanding. However, genetic susceptibility variants showing repeatable associations with common diseases are usually of small effect. They are therefore unlikely to individually explain substantial share of disease burden in any community or provide new insights into disease pathogenesis that could lead to development of new drugs effective in considerable portion of the disease cases in a population. Genetic architecture of common diseases is beginning to reveal an incredible diversity of potential genetic causes that act through somewhat limited number of mechanisms with important contribution of environmental interactions. In light of these findings, we present current understanding of genetic architecture of a spectrum of human diseases. We address the encountered problems in susceptibility gene identification, review the success of leading gene identification strategies and discuss current prospects for translating genomic advances into measurable public health benefits

Setting health research priorities using the CHNRI method:II. Involving researchers

Large groups of researchers who agree to offer their research ideas and then score them against pre–defined criteria are at the heart of each CHNRI priority–setting exercise. Although the roles of funders and other stakeholders are also very important, much of the exercise is focused on selecting and engaging a large group of researchers, obtaining their input and analysing it to derive the initial results of the process. In a sense, a CHNRI exercise serves to “visualise” the collective knowledge and opinions of many leading researchers on the status of their own research field. Through a simple “crowdsourcing” process conducted within the relevant research community, the CHNRI approach is able to collate a wide spectrum of research ideas and options, and come to a judgement on their strengths and weaknesses, based on the collective knowledge and opinions of many members of the research community. In doing so, it provides valuable information to funders, stakeholders and researchers themselves, which is obtained at low cost and with little time necessary to conduct the exercise