PTBi East Africa aims to conduct discovery research that informs the development of interventions to predict, prevent, and manage preterm birth in our settings. Over the past two years, we selected several studies through a competitive RFP process. We are committed to discovery research that is locally relevant and led by East African investigators. We hope to build strong collaborations and partnerships with UCSF investigators and beyond.
More accurate assessment of gestational age
With the lack of availability of early ultrasound, inaccurate LMP and fundal height measures, and various data quality issues, are there new innovations to more accurately capture gestational age throughout pregnancy and at birth?
Placental proteins as a clock for gestational age
The goal of this project is to use an innovative mass spectrometry-based method to identify placental-derived proteins that circulate in maternal blood at altered levels as a function of gestational age.
Understanding knowledge and perceptions about menstruation, preterm birth and related care seeking practices to inform new health interventions in rural Bondo, Western Kenya
The overall goal of the study is to explore the understanding of mothers and fathers about menstruation, preterm birth and related care seeking practices. This knowledge will inform the development of an intervention to help women better track their menstrual cycles as a means to knowing gestational age.
Gestational dating at birth by metabolic profile: Testing and adaptation in African settings
Using 35 metabolic markers analyzed by mass spectrometry from newborn heel stick blood samples, this team was able to identify term and preterm newborns with more than 95% accuracy in a cohort of 700,000 California babies. They were able to assign a week of gestation within two weeks in approximately 90% of newborns.
With co-funding from BMGF Grand Challenges and UCSF PTBi-EA, validation work is being conducted in Tororo to test the algorithm on more than 800 newborns, as well as existing banked biospecimens.
Understanding risk factors for preterm birth
With a complex interplay of various risk factors contributing to the syndrome of preterm birth, can we provide new insight into key risk factors that are common in our settings in order to inform appropriate interventions?
Maternal periodontal disease, bacterial pathogens and leukocyte telomere length as predictors for preterm birth among women in Kisumu County, Kenya
The objective of this study is to investigate the association between maternal periodontal disease, urogenital bacteria and leukocyte telomere length with the risk of developing preterm birth. This will be a prospective cohort study in Kisumu County, Kenya.
Exposure mapping of household and environmental toxicants associated with adverse pregnancy outcomes in Migori County, Kenya
Studies suggest that adverse pregnancy outcomes including low birth weight, small for gestational age, and preterm birth are associated with maternal exposure to environmental toxicants such as carbon monoxide, particulate matter and heavy metals. The overall goal of this study is to investigate and map the risk of exposure to indoor and outdoor environmental toxicants in women experiencing adverse pregnancy outcomes in Migori County, Kenya.
Nutrition and infection in relation to preterm delivery and other pregnancy outcomes in Rwanda
This prospective cohort study will provide novel insights into the potential relationship between micronutrient deficiencies, acute or chronic infection, and preterm birth among pregnant Rwandan women.
The prevalence of chorioamnionitis and Group B Streptococcus among HIV infected and uninfected pregnant Ugandan women and its association with preterm birth
GBS is linked to chorioamnionitis, and incidence of neonatal infection with GBS has decreased significantly in countries that provide intrapartum antibiotic prophylaxis after screening as standard of care. This algorithm is not currently part of clinical practice in Uganda, and its potential benefit to the population is unknown. This study is designed to generate data that could lead to practice changes, especially GBS carrier testing and prophylaxis.
Improving care for preterm infants
Up to ¾ of preterm infants can be saved with existing evidence-based interventions. Can novel, innovative strategies or technologies improve scale-up of key practices around feeding, breathing and warming?
Evaluation of the utility of CRP among preterm infants with sepsis in a resource-limited setting: a retrospective study
C-reactive protein (CRP) is a nonspecific, acute-phase protein that rises in response to infectious and non-infectious inflammatory processes. However, reports on influences of gestational age and birth weight on kinetics of CRP in infected and uninfected infants are limited. This study aims to evaluate the effect of gestational age on CRP values among newborns with sepsis at Nsambya Hospital in Kampala.
Feasibility and acceptability of NoviGuide – a mobile health device for the management of neonates
This mixed methods study will assess the feasibility and acceptability of NoviGuide in rural Uganda among midwives. NoviGuide guides users through the initial assessment and daily care of neonates focusing on respiratory support, glucose, fluid and feeding management, infection risk and management. This tablet-based software provides step-by-step prompts to guide users to enter data from history, physical exam and medical resources, as well as makes case-specific management recommendation.
Kangaroo mother care in Eastern Uganda: A feasibility study to assess the factors influencing uptake, adherence, and acceptability into routine healthcare
This study seeks to thoroughly understand the barriers and enabling factors influencing the practice of KMC in hospital and home settings. Data will be collected through Participatory Learning and Action activities with mothers of preterm babies, primary support persons, and health workers. Findings will be used to design a rapid Trial of Improved Practices to improve KMC uptake and adherence, and ultimately to improve neonatal outcomes.