Improving childhood mortality with limited resources

To improve outcome for critically ill children, healthcare workers need to be trained to better work together. In addition, guidelines are often quite strict but not always tested by clinical trials. Fluid interventions for critically ill children with severe malaria or sepsis in African hospitals actually worsen the outcome. Researchers working in large consortia can also make better impact for patients and to policy makers.

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Over the last 20 years Kathryn has been based full-time at the East Africa, where she leads a research group that have highlighted the unique importance of emergency-care research as a highly targeted and cost-effective means of tackling childhood mortality in resource-limited sub-Saharan Africa hospitals. Her major research portfolio includes severe malaria, bacterial sepsis and severe malnutrition.

Her team conducted the largest trial in critically children ever undertaken in Africa (FEAST trial) examining fluid resuscitation strategies in children with severe febrile illness, showing that fluid boluses increased mortality. Her team has recently completed Phase III factorial trial of transfusion and other treatment strategies in 4000 African children with severe life-threatening anaemia (TRACT) and she is now leading the COAST (Children’s Oxygenation Administration Strategies Trial) investigating who needs oxygen and how best to administer it in 4200 children.

Through a collaborative award in science from Wellcome (2018) she leads SMAART (A Severe Malaria Africa – A consortium for Research and Trials) consortium - a multi-disciplinary team whose membership includes world leaders in severe malaria and experts in clinical trials. The overarching aim of SMAART is to improve outcomes from severe malaria in African children by conducting an umbrella trial, investigating multiple interventions in parallel, to enable evidence-based updates of treatment guidelines for severe malaria.