A Wits University medical microbiologist/epidemiologist in the School of Pathology was recently awarded one of seven five-year UK National Institute for Health and Care Research (NIHR) Global Research Professorships.
Professor Nelesh Govender’s proposed research on bacterial and fungal infections in people with advanced HIV disease (or Aids) will now, with this NIHR funding, be applied to assess a World Health Organisation package of care.
Specifically, this package of care for people with Aids could be refined or expanded to prevent deaths from bacterial or fungal infections, he said.
The NIHR Global Research Professorship scheme funds researchers to promote effective translation of research and to strengthen research leadership at the highest academic levels. It funds research that aims to specifically and primarily benefit people in low- and middle- income countries (LMICs).
Govender, whose research topic is Refining Interventions to Reduce AIDS Mortality from Bacterial and Fungal Infections in Africa, said at least one-third of the 630 000 global Aids-related deaths are due to bacterial and fungal infections, which include cryptococcal meningitis, Pneumocystis jirovecii pneumonia (PCP), pneumococcal and Salmonella infections and histoplasmosis.
“From autopsy studies, we know that people with Aids often die with multiple co-infections,” he said.
Some Aids-related infections are unique to southern Africa, he added. “We first described a fungus – Emergomyces africanus – causing a life-threatening infection in people with Aids in 2013. Histoplasmosis, although found worldwide, is under-diagnosed in Africa because there is no access to simple accurate diagnostic tests.”
Histoplasmosis can be also mistaken for TB. Opportunistic infections, such as PCP, pneumococcal and non-typhoidal Salmonella infections, occur everywhere in the world but are much more common in low-to-middle-income countries with a high prevalence of Aids.
“We used to see Aids-related infections in people who were newly diagnosed with HIV. But we are increasingly seeing these in people who were previously diagnosed with HIV and started antiretroviral therapy (ART), but who then disengaged from care and stopped their ART.”
Award develops researchers
Researcher-recipients of the NIHR Global Research Professorship scheme receive five-year awards of up to £2m. This includes funding for early-career research and support posts. Researchers are also able to access a leadership and development programme.
Govender will collaborate with colleagues and partners in South Africa, Tanzania, the Democratic Republic of Congo, Mozambique and Guinea.
“With the award, I can work full time on this research for five years. A team of postdoctoral and PhD students will also boost the Wits Mycology Research Division’s work,” he said.
Entrenched in the Global South
Govender's NIHR Research Professorship will be led from the Faculty of Health Sciences at Wits and his research division at Wits Health Consortium. It will be conducted in partnership with the National Institute for Communicable Diseases (NICD).
Govender will leverage his national and international networks, including the NIHR Global Health Research Group on HIV-associated Fungal Infections (IMPRINT), the EFFECT clinical trial, and GERMS-SA.
The work will be divided into three broad areas:
1. A three-tiered cohort of adults with advanced HIV disease will be set up in South Africa to document the incidence, causes and outcomes of serious bacterial and fungal infections compared to tuberculosis (ADVANCE GERMS-SA).
2. Patients with HIV will participate for researchers to understand their lived experience of being diagnosed and treated for serious bacterial and fungal infections and so that researchers can help answer questions about the acceptability and feasibility of a combination antifungal treatment regimen for cryptococcal disease being tested in the EFFECT clinical trial in SA and Tanzania.
3. New lab tests, which detect traces of bacterial and fungal pathogens in body fluids, will be applied to cohort study patient samples and evaluated as diagnostic tools for serious infections among people living with advanced HIV disease
Throughout the project, the IMPRINT Community Advisory Board will oversee, guide and help to engage communities of people living with HIV in the research.
NIHR Director of the Global Health Research Programme Professor Kara Hanson, said: “The Global Research Professorship is our flagship award. It funds researchers to translate discoveries into enhanced interventions, diagnoses and treatments. This year, our Global Research professors are working across a range of pertinent areas including sexual health, HIV/Aids, mental health and multi-morbidities. I look forward to seeing how their research progresses and the difference their research will make to communities across the world.”
Applying for the Global Research Professorship award
The next round of the Global Research Professorship opens in late September 2024. It is open to health, public health and social care researchers. The NIRH welcomes applicants employed by any Higher Education Institution (HEI) or Research Institute in a LMIC.
See more from MedicalBrief archives:
Silent epidemic of deadly fungal infections in Africa
Africa bears the brunt of antimicrobial-resistant bacterial infections
Initiating ART reduces risk of bacterial infection in HIV+ patients