Grand Challenges Africa Innovation Seed Grants Round One Winners

Kenya

Dahabo Adi Galgallo, Innovator, Marsabit County, Kenya

Dahabo Adi Galgallo is a Kenyan innovator based who is currently undertaking a residency in field epidemiology from the Kenya Field Epidemiology and Laboratory Training Programme (FELTP), sponsored by the US’ Centers for Disease Control and Kenya’s Ministry of Health. The holder of a diploma in medical laboratory sciences from the Kenya Medical Training College, Nakuru, has worked in the public health sector since 2009, serving in different capacities including sub-county disease surveillance coordinator and sub-county laboratory coordinator. She also worked for the Kenya Red cross for a year. She is a recipient of several awards and has conducted public health projects in antenatal care, cholera, typhoid and tuberculosis prevention as part of her FELTP residency. She is self-motivated and a leader with a passion for maternal health care.

Project- Integrated maternal mobile health care service for pastoralist mothers tracked via solar-powered GPS bracelets

Galgallo is developing a waterproof, coin-sized, solar-powered GPS-tracking device that will be fitted into cultural jewellery of expectant mothers in pastoralist and nomadic communities so health workers can easily locate and provide them with pre and antenatal care where they are. Integrated maternal mobile health delivered to pastoralist women will decrease maternal mortality, infant mortality and improve vaccination coverage, which will improve infant survival in this population because women can easily be traced and care given. This project will identify expectant women in Marsabit and immunise them against tetanus, which is the first step in saving baby’s life, conduct laboratory profiling to detect any diseases for early intervention and provide continuous antenatal care from the duration of the pregnancy to birth and then immunisation of new born up to 12-month in tandem with continous health education. Marsabit is one of the largest counties in Kenya with residents who are mainly pastoralist and nomadic, even crossing to Ethiopia and Somalia.


Jesse Gitaka, Lecturer/Research Fellow, Mount Kenya University

Jesse Gitaka is an experienced physician scientist, investigator and lecturer in the School of Medicine at Mount Kenya University. He holds Bachelors of medicine and surgery from the University of Nairobi and a master’s in tropical medicine and Doctorate of Philosophy in medical science from the Nagasaki University in Japan.  Gitaka has worked as a rural district hospital medical officer, a field based clinical researcher at the Kenya Medical Research Institute in Kilifi, for a children malaria vaccine trial, and as a consultant in Ebola setting health system strengthening in Liberia. He is a principal investigator on several studies spanning from the bench to field questions in the areas of maternal and newborn health and infectious diseases. Gitaka is also keenly interested in the role of innovative technology in health at scale. He is a recipient of multiple grants including the National Research Fund, Grand Challenges and County Innovations Challenge Fund and has published in peer reviewed journals, with active collaborations locally and internationally.

Project- Rapid and multiplex diagnosis of maternal bacterial infections
Gitaka will lead the development and deployment of a point of care diagnostic for bacterial infections that have been implicated in poor pregnancy outcomes such as premature deliveries, still births, maternal and newborn sepsis and deaths. Their project will enable quick detection of these bacteria allowing for prompt treatment. They will test whether treating for these bacterial infections, which are usually not diagnosed, improves pregnancy outcomes in field situation. This strategy has the potential to inform pregnancy monitoring and follow up practice and policy.

Christine Musyimi, Head of Research Ethics and Scientific Publications Office, Africa Mental Health Foundation

Christine Musyimi is a mental health researcher and the head of research ethics and scientific publications office at Africa Mental Health Foundation (AMHF). She obtained her Bachelor’s degree in Nursing and master’s in medical statistics from the University of Nairobi in Kenya and awaits her PhD defence on global mental health in November, 2017 at Vrije Universiteit, Amsterdam. She has been a recipient of two Grand Challenges Canada grants and a pioneer in Kenya to introduce evidence-based mental health practice among traditional and faith healers. Christine has written extensively on the challenges and opportunities available to initiate collaborative processes between formal and informal health sectors (traditional and faith healers) and has presented these findings in both local and international conferences and published in newsletters, books and several impact-rated journals. Her current work involves engagement of Traditional Birth Attendants to deliver conventional mental health care to mothers during the perinatal period.

Project- Engaging Traditional Birth Attendants to reduce maternal depression in rural Kenya (Engage-TBA)

Traditional Birth Attendants (TBAs) in rural Kenya are sought for maternal mental healthcare due to their accessibility and affordability. Therefore, they are an important resource for reducing gaps related to scarcity of mental health professionals and demanding workload due to the high number of patients in primary health care settings. ENGAGE-TBA will engage traditional birth attendants to provide psychosocial interventions to mothers during the perinatal period and refer complicated cases of depression to health facilities. This will promote a sense of belonging for TBAs and ensure accessible and acceptable basic mental health care in under-resourced areas while linking these mothers to primary health care, to ensure safe deliveries and promote their mental well-being and that of the baby even after birth. The far-reaching direct impacts on the baby such as complicated births, low birth weight; and incomplete schedules of immunisation in children will also be prevented.

Eric Ogola, Epidemiologist, Jaramogi Oginga Odinga University of Science & Technology and PhD Student, University of Nairobi

Eric Ogola is an epidemiologist trained at the University of Nairobi and Makerere University in Kampala. He has been involved in research and control of diseases at the human-animal-ecosystem interface for nine years under the collaboration between the Kenya Medical Research Institute and the US Centers for Disease Control. He previously worked as the deputy head of the Integrated Human-Animal Health Programme at the Kenya Medical Research Institute. Ogola is a disease -detective at the human-animal-ecosystem interface. He has been involved in various outbreak investigations against emerging infections including rabies, polio and others. He was part of the WHO National supervisory team during the Kenyan polio outbreak response in 2010. He currently teaches public health students at a state university in Western Kenya. His current research interest is in the area of neonatal sepsis and antimicrobial resistance.

Project – Rational antibiotic use for treatment of sick children in local health facilities
Ogola proposes to reduce deaths in young children by developing an easier way to decide which antibiotic to use in blood-borne infections in children less than one month old. This will reduce deaths in children as a result of blood-borne infections. It will also lead to judicious use of antibiotics and prevent the development of drug resistance. Clinicians in health facilities without laboratories will be able to make an educated guess on the best treatment that is likely to give an effective outcome. Authorities will also be able to monitor the rate of treatment failure and recommend new guidelines in time, thereby preventing more deaths over time.

Angela Koech Etyang, Physician Scientist, Centre of Excellence in Women and Child Health and Instructor, Department of Obstetrics and Gynaecology, Aga Khan University – Nairobi
Angela Koech Etyang is a physician scientist at the Centre of Excellence in Women and Child Health and an Instructor in the Department of Obstetrics and Gynaecology, Aga Khan University – Nairobi.She is a medical doctor and holds a master’s of medicine (Obstetrics and Gynaecology) degree from the Aga Khan University and an MSc in epidemiology from the London School of Hygiene and Tropical Medicine. She has seven years’ experience in clinical care and over three years’ experience in clinical research in maternal and newborn health. Her research interests are in preeclampsia and the role of infections and inflammation in preterm labour and preterm pre-labour rupture of membranes.

Project-Integration of a package of point of care tests into rural primary care facilities to improve access to basic antenatal screening

Many women in rural Africa visit dispensaries and health centres for care during pregnancy. Despite this, many do not receive recommended screening tests as many of these facilities do not have laboratories. Referring women to off-site laboratories for tests results in delays in testing, starting treatment for women with abnormal results and in some cases women missing tests altogether.

The project aims to make basic screening tests available to pregnant women at dispensaries and health centres that do not have laboratory facilities. These tests screen for conditions such as HIV, syphilis and anaemia. These conditions can be harmful to mother and child but are treatable once detected. We will employ simple existing technologies that enable these tests to be carried out during the clinic visit quickly, easily and by the nurse who is providing the care in pregnancy.We will evaluate whether introducing these tests as a package will integrate well with routine provision of care in these facilities and whether this will result in earlier screening and wider coverage of screening for pregnant women. This is expected to reduce the negative impact of the conditions screened for on pregnancy outcomes.

Madagascar

Niaina Rakotosamimanana, Head of the Mycobacteria Unit, Pasteur Institute of Madagascar

Niaina Rakotosamimanana is the Head of the Mycobacteria Unit at the Pasteur Institute of Madagascar. He has a PhD in microbiology obtained in Paris, France and in Madagascar in 2010. Niaina is in charge of the tuberculosis (TB) research programme, which includes applied and operational projects to evaluate new TB diagnostic tools, molecular epidemiology of the disease, new vaccines trials and drug resistance surveys in collaboration with the National Tuberculosis Program of the Malagasy Ministry of Public Health.

His main research activities are about the host immune responses against tuberculosis and the factors associated to the TB clinical strains diversities. He is also mentoring Bsc, MSc, and PhD international candidates and is a lecturer at the Faculty of Sciences and the School of Medicine of the University of Antananarivo, Madagascar.

Project summary: A low-cost tuberculosis diagnostic test for pregnant women
Rakotosamimanana is developing a low-cost tuberculosis diagnostic and molecular test for pregnant women using dried blood samples drawn from finger pricks. This dried-blood spot based test is minimally invasive, can be used in remote areas where people lack access to all-weather roads and lack of infrastructure that has direct impact on health outcomes. The DBS can be sent via mail to the health centres for testing without established cold chain and meets several of the criteria set by the World Health Organization regarding quality of TB diagnostic tools. Dried-blood samples have a wide range of diagnostic capacity and have been shown to have advantages over other biological samples in terms of cost, ease of collection, transport, and storage.

Senegal

Diawo Diallo, Medical Entomologist, Institut Pasteur de Dakar, Senegal

Diallo is a research scientist at the Medical Entomology Unit of the Institut Pasteur de Dakar. His main objective is to better understand the ecology and epidemiology of arboviruses and theirs vectors in order to prevent their spill over to human and domestic animals. Diallo has over 14 years of scientific experience mainly at the Institut Pasteur de Dakar and two other internationally recognised institutions working on mosquito vectors of malaria and several arboviruses (Rift valley fever, West Nile fever, yellow fever, dengue, chikungunya and zika). He has a broad background in medical entomology, with specific training and expertise in arbovirus vectors biology and ecology, virus-vectors interactions, diseases epidemiology and transmission and a substantial experience with field and laboratory methods. He has proven success in scientific research and public health expertise as evidenced by more than 32 publications in internationally recognised peer-reviewed journals. He has served as a reviewer in prestigious international scientific journal. He has an extensive knowledge on emerging vector-borne diseases and a dense network of collaborators at the Pasteur International Network and in the world of international research.

Project – Tracking Zika infected mosquitoes: A novel portable system for rapid field detection of the virus to improve maternal and neonatal health
Diallo will validate and implement a timely and up-to-date surveillance system of zika virus prevalence in the mosquito population in the Kédougou area using an innovative integrated device developed by Gopaul from Institut Pasteur in Paris. This 3-in-1 device includes: 1) a mosquito trap, an analysis station that will carry an antibody based detection system with an easy to read colour change result and 3) a mapping software to create a real-time map of arbovirus infected mosquitoes. The final outcome will be the production of tools that can be used to implement focused and ecofriendly vector control interventions to improve maternal and neonatal health.

Muriel Vray, Epidemiologist, Institut Pasteur of Dakar, Senegal

Muriel Vray is an epidemiologist who specialises in clinical research. She is involved in the methodology of pragmatic trials, studies of treatment strategy and evaluation of diagnostic tests. Based at the Institut Pasteur of Dakar since 2015, as head of the Unit of Epidemiology of Infectious Diseases, she collaborates with the epidemiologists of the international network of the Institut Pasteur in order to develop clinical research in the field of infectious diseases. She sits in several committees of drug evaluation and is teaches courses in the methodology of clinical trials and evaluation of diagnostic tests at PhD and MSc level. Vray has been a principal investigator in several epidemiological studies in infectious disease on AIDS, hepatitis B, malnutrition, neonatal infectious and severe diarrhoea in childhood in Africa.

Project- Evaluating a loop-mediated isothermal amplification assay to quantify/semi-quantify hepatitis B virus DNA levels in Senegal

Given the high disease burden associated with hepatitis B virus (HBV) infection, HBV now constitutes one of the health targets in the United Nation’s Sustainable Development Goals. Consequently, the WHO has developed a global strategy to eliminate HBV by 2030, and the prevention of perinatal mother-to-child transmission (PMTCT) became a core intervention in achieving this goal. Since 2009, WHO recommends administering HBV vaccine to all neonates within 24 hours of birth for the PMTCT. However, this strategy alone is unlikely to be adequate because 20-30% of women with high viral load still infect their infants despite the timely vaccination. In resource-rich countries, antenatal screening to identify women with high HBV DNA and subsequent antiviral therapy during pregnancy, a strategy similar to the HIV prevention, has become a recommendation, in addition to the universal birth dose vaccine. However, this strategy is difficult to implement in sub-Saharan Africa because a majority of African women have limited access to the HBV DNA measurement, which is expensive and requires a sophisticated laboratory environment. Here, we propose to evaluate a loop-mediated isothermal amplification assay (LAMP), a simple, robust and inexpensive nucleic acid amplification assay, to quantify/semi-quantify HBV DNA levels in Senegal. In the first step, we will validate the assay in a reference laboratory in Dakar, compared with the reference standard PCR assay. In the second step, we will validate the assay in a decentralised context at a rural health centre in Senegal. We will also evaluate the feasibility and acceptability of the use of LAMP. After the completion of this preliminary evaluation phase of the study using the funding from the Grand Challenge Africa, we plan to further assess the impact of integrating this assay in the PMTCT programme in the prevention of HBV transmission in sub-Saharan Africa.