NIHR Global Health Research Group on Physical Trauma from Injury & POsT Conflict; iPrOTeCT

Physical trauma resulting in serious, life changing injuries is endemic in Low- and Middle-Income Countries (LMICs). We will build on our prior work by understanding of the broader global burden of physical trauma from conflict, non-conflict events such as terror attacks and the growing burden of road traffic accidents due to rapid increases in urbanisation and motor vehicle use. iPrOTeCT focuses on saving limbs after these injuries (surgery and technology), and where limbs cannot be saved, ensuring the best possible functional outcomes (prosthetics). This healthcare provision saves lives, increases functional outcomes, provides independence and enhances quality of life. We will work across three continents and will collaborate with some of the largest humanitarian organisations to make change happen. Addressing the issue of the lack of robust data, Aim A will establish, for the first time, a global picture of the clinical burden of conflict and accidental injuries and the resulting long-term societal issues. We will collect, collate and analyse data on injuries to develop policy and understand patterns and relationships in the types of injuries, injury mechanism, treatments, prosthetic use required, distance from medical care, and details of age, gender and status of the injured. Stakeholder meetings will be held, case studies for different countries and contexts will be published, and training materials will be produced. Community Engagement Groups (CEGs) will provide a platform for the voices of patients to help the research team understand societal issues for the injured and their voices will feed into treatment and the design of prosthetic and rehabilitation technologies (Aim B). CEGs will directly feed into iPrOTeCT’s dissemination activities. Aim B will use our appropriate technology development pathway to identify, develop (using frugal principles) and clinically translate appropriate healthcare technologies in the areas of: surgical orthopaedic reconstruction and regenerative medicine technologies for surgeons in LMICs which will lead to faster recovery and reduce the number of procedures and interventions for physical trauma patients; and prosthetic and rehabilitation technologies for children and adults whose limbs could not be saved. We will create a Regulatory Hub to facilitate clinical and regulatory approvals. Aim C will co-create, evaluate and improve capacity building opportunities in research, education, global clinical collaboration and research management. This will focus on embedding trainees in interdisciplinary research, with first-hand experience of how medicine and engineering can work together to impact human health. A Virtual Clinical Network will be established to ensure LMIC teams’ voices are heard clearly in all aspects of iPrOTeCT and will feed into the identification of new technologies for development. A specific focus has also been put on research management and the development of a cohort of administrators across the grant who will train and learn from each other. iPrOTeCT builds on a foundation of strong international, interdisciplinary collaborations to embed research sustainability. By the end of the four years we will have held stakeholder meetings to engage policy makers and health practitioners, worked with community groups to ensure their voices feed into the research, and trained the next generation of interdisciplinary leaders.