I have extensive research experience in several areas of Human immunodeficiency virus research; including being the first to describe pneumocystis jirovecii and cytomegalovirus pneumonia in HIV infected African children. For nearly 20 years my work has focused on acute and chronic lung infections in HIV infected children and we are currently completing data analysis on the pathogenic role of Cytomegalovirus disease and infection among children admitted to the ICU with very severe pneumonia. I have worked with Dr Bruce Walker and Dr Philip Goulder on cytotoxic T Cell assays amongst HIV infected children and we evaluated the role of structured treatment interruption of antiretroviral therapy among HIV infected infants. I have also been involved with work on the environmental risk factors for transmission, the pathogenic characteristic and cytokine responses among children infected with mycobacterium tuberculosis. A manuscript on the pharmacodynamics and pharmacokinectics of first line anti-tuberculosis agents among children with symptomatic Mtb has been for publications.
These experiences and accomplishments have resulted in my being named Director of the Paediatric Critical Care Unit and Head of Paediatric Pulmonology in Durban, South Africa. I also served as Chair of the Essential Drugs Program for Children in South Africa and a member of the South African National Aids Council. I have serve as an independent expert to International Union against tuberculosis and lung disease on the care of HIV infected children with tuberculosis and a member of the advisory committee of WHO on acute respiratory infections.
I am clinical researcher whose main research area involves clinical issues. This application provides me with an excellent platform to collaborate with basic science researchers from the USA, the Africa centre as well as other clinical specialties i.e. obstetricians and neonatologists. The current research proposal would extend my own passion to creating an understanding of the pathogenic mechanism involved in the birectional relationship between HIV and CMV infections. Understanding this might provide the key for reducing the transmission of both pathogens. Evaluation risk factors for transmission of these pathogens and the impact of antiviral agents would be most useful. Most importantly studying the role of CMV infection/disease among HIV exposed but uninfected children will be extremely important as this group of cases would carry the bulk of the burden of disease as we improve prevention of mother to transmission of HIV infection.
The burden of HIV infection in the area drained by the Prince Mysheni Memorial Hospital is substantial and given that there is an NIH research site at this venue, we would be able to recruit the patients require number to complete this study. Obtaining an adequate and relevant history among mother who have recently delivered a baby would be possible after informed consent is obtained. The taking of blood and saliva samples for the molecular recognition and measurement of CMV loads at birth or soon tghereafter (first 4 days) would be feasible. Follow up of enrolled cases would be possible given that the site has been involved in previous studies where follow up rates have exceeded 90%. Data from the proposed study, would be useful to expand knowledge on the concepts of burden of CMV INFECTION/DISEASE among HIV infected, exposed uninfected and uninfected children. Working with Prof S. Boppana and Deenan (laboratory component and Dr’s S. Knight and Ben Sartorius (epidemiologist) should be a rewarding experience. I am sure with the strength of having a comprehensive team would add to expected success of this project. I have no doubt that providing we are granted funding we would be able to share new and important data in the years to come. Hopefully our endeavors would result in less suffering of the children infected by HIV and CMV.
Position and honours
Career Employment Positions:
HEAD: Paediatric section -Respiratory unit KEH- 01/01/1994- 30/06/2002
Head: Paediatric Pulmonologist KEH/IALCH 01/02/1996- to Current
Head: ICU4 IALCH: 01/07/2002 to current
Associate Professor in Paediatrics: University of Kwazulu-Natal 01/07/2001 to current
- Chairperson of an international data safety and monitoring board BCG trial: randomized controlled trial comparing efficacy of percutanous and intradermal vaccination with Japanese (Tokyo) 172 BCG in the prevention od TB in infants vaccinated at birth P.I Prof G. Hussey AND Dr L. Geiter.
- By minister of health as member of the national essential drug program of the country
- President for the national asthma education 2001-2003. Congress and diploma course in asthma organizer in 2004- provision of course lectures and examinations
- Chairperson of ministerial appointed subcommittee of essential drug program –hospital based paediatric book 2013
- Appointed by the national minister of health as member of national advisory group for immunization 2005-2011 and co-opted in 2012
- Advisor to the health directorate on PMTCT policy revision 2004-6.
- WHO EXPERT ON ARI POLICY FOR HIV INFECTED CHILDREN – IN HARARE AND GENEVA 2003
- Expert member on the WHO subcommittee for essential medicines in children
- Advisor on vaccine related issues on the African continent
- Ministerial invited expert on the national quarternary drug list committee of South Africa -2007 to current
- International delegation developing guidelines for the management of acute respirations in childhood in Harare and Geneva under the guidance of the WHO.
- Secretary for the South African Pulmonology Society-1998-2000
- Member of the South African Asthma and Allergic Rhinitis working group
- Head of Infectious disease at Clairwood Hospital 1993 to 2001.
- Member of the task team draft national policy on paediatric critical care for South African children.
- Editor/guest editor/chief editor
South African Respiratory Journal
South African Paediatric Reviews Journal
The Paediatric Quarterly Journal
The Paediatric Focus
- Best senior presentation at the faculty research day 2004- Study on the care of HIV infected children with severe pneumonia
- Best publication in critical care for 2005- Paper on utilization of scarce ICU resources in a developing world
- Mary Weston research of the year 2005- University of Kwazulu Natal