Recipient organisationUniversity of SheffieldSource-published name: The University of Sheffield
Funding£2.4M
PeriodApr 2018 — Sept 2022
In plain English
AI plain-English summary
A team at the University of Sheffield is launching a global research network to tackle preterm birth in low- and middle-income countries (LMICs), where the problem is most severe. Preterm birth is the leading cause of death in children under five worldwide, yet most research and clinical guidelines come from wealthy nations. The PRIME group will first map what is known—and what is not—about preterm birth in LMICs, including its true prevalence, the role of infections, and which interventions actually work in these settings. They will also test a new approach: using electrical impedance spectroscopy (a technique already used in cervical cancer screening) and vaginal fluid metabolites to predict preterm birth earlier and more accurately. If successful, the research could shift prenatal care in resource-limited settings from reactive emergency management to proactive prevention. It might also produce low-cost, portable diagnostic tools that fit into existing health systems. The group is committing two funded PhD studentships and two Masters scholarships to build local research capacity, ensuring the work outlasts the grant.
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a) The University of Sheffield (UoS) has an internationalisation “think global” initiative that seeks to promote research and innovation offering real solutions to global issues: one aspect of this objective is to develop transformational change in healthcare through multidisciplinary and multi-country research collaborations. This proposal brings together leading researchers in the Social Sciences, Reproductive Medicine, Health Economics, Public Health, Immunology and Pathology, Engineering, and Evidence Synthesis. This presents an ideal opportunity to combine their skills and expertise to address health challenges in LMICs. The UoS approach is underpinned by our global reputation in bioimpedance and health services research, strengths which are brought together in this bid. b) We are global leaders in bioimpedance research, having developed the clinical application of electrical impedance spectroscopy (EIS) to the detection of cervical (1, 2) and oral (3) cancer, and more recently to assess pre-labour cervical remodeling (4-6) and PTB prediction (7). A CE-marked cervical cancer screening device (the ZedScan™) is now marketed globally through a spin-out company affiliated to the UoS. DA’s group is a global research leader of EIS technologies for predicting PTB, holding two related international patent filings (PCT/GB2016/054013 and PCT/GB2016/054008, (8, 9)). We have reported, for the first time globally, that a panel of metabolites in cervicovaginal secretions (10-12) are predictive of PTB. If funded, we will undertake pilot studies of vaginal metabolites for predicting PTB in LMICs and engage stakeholders to prioritise what research is most likely to improve PTB care in LMIC settings. c) The research track record of the University’s School of Health and Related Research (ScHARR) is internationally recognised in applied public health and health services research. In the 2014 Research Excellence Framework, ScHARR was ranked 4th in the UK for the metric which combines research quality and volume. ScHARR has a critical mass of world-leading expertise in three core areas of applied public health research: health economics & modelling (SD); development & evaluation of complex public health interventions (SS, JB); and getting research into practice (FC, SS). These strengths are now being applied to global health issues, with the aspiration to build collaborations of global significance. UoS ORGANISATIONAL SUPPORT FOR THE PROJECT IF FUNDED: Two funded PhD studentships Two scholarships on the Masters in Public Health or the Health Technology Assessment Distance Learning course run by ScHARR Home/EU fees for an MSc programme in the Faculty of Medicine Office space and laboratory experience for PRIME Group visitors to Sheffield. d) Working with all partners, research priorities for the Group will be developed through a series of activities as outlined below: 1. Evidence synthesis a Mapping review and mixed methods systematic review to synthesise current knowledge and define the evidence gap in LMICs regarding the prevalence, pattern, and perinatal management of PTB, addressing the following questions: what is the true magnitude and impact of PTB, what prenatal care philosophies, guidelines, and outcome data exist, what infections contribute to PTB in LMICs, what is the evidence of effectiveness of PTB care interventions in LMICs? b Network Research Events (NREs): these will adopt a holistic health systems approach to explore factors that shape approaches and access to care, and the processes operating within families, communities, at the patient-provider interface, and within the health workforce and organization in LMICs. The NREs will focus on understanding differential access, experiences and outcomes in advantaged and deprived populations. They will be held in a minimum of two sites in each LMIC, one of which will capture slum areas and “underprivileged” communities. c The findings f
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