Epidemiological and statistical research on health problems of developing countries: MRC Tropical Epidemiology Group

Lead Research Organisation: London Sch of Hygiene and Trop Medicine
Department Name: Infectious and Tropical Diseases

Abstract

While there have been major improvements over the past century in the health of populations all over the world, there are still deep inequalities in health between the rich and poor nations. Gains in health in many of the poor countries have been reversed recently due to the global epidemic of HIV/AIDS and steep increases in TB and malaria. There is an urgent need to find effective means of controlling these major killer infections in order to bring down the high burden of mortality and ill health.

The MRC Tropical Epidemiology Group (TEG) is a group based at the London School of Hygiene and Tropical Medicine whose main aim is to conduct research on these infections in Africa and other parts of the developing world. We collaborate with scientific groups overseas, assisting especially with the planning and analysis of research studies. These studies are designed to improve our understanding of risk factors for these diseases, and to evaluate the impact of different control measures. We give special priority to MRC-sponsored research.

Over the next five years we will focus especially on HIV, TB and malaria, which between them cause around eight million deaths each year. We will study various methods of preventing HIV infection, as well as approaches to providing treatment for HIV-positive people in Africa where resources are very limited. We will also study new approaches to the prevention and treatment of TB and carry out research on risk factors for developing this disease. In malaria, our research will focus on the effects of treatment with combinations of drugs that are designed to overcome problems caused by drug resistance. We will also carry out work to develop and evaluate new methods that can be used to study these health problems in developing countries.

As well as reporting our work in scientific journals, we frequently write articles aimed at a non-specialist audience, as well as contributing to radio and television programmes on key findings.

Technical Summary

The MRC Tropical Epidemiology Group initiates and collaborates in research on the epidemiology and control of major public health problems of developing countries. We contribute statistical and epidemiological expertise, giving priority to support for MRC-funded research. In the next five years we will expand our support for MRC Units in The Gambia and Uganda, and MRC-related work in Jamaica, while continuing to develop collaboration with other groups conducting high-quality research overseas.

In the area of HIV prevention, we will conduct randomised trials of behavioural interventions, control of sexually transmitted infections and vaginal microbicides, and explore opportunities for trials of male circumcision and vaccines. We will also conduct research on appropriate care for HIV-positive subjects and expand our HIV-related research in Asia. We will collaborate in studies of risk factors for progression to TB disease and trials of novel approaches to TB prevention and treatment. We will also collaborate in trials of new antimalarial drugs and drug combinations, necessitated by increasing drug resistance. We will participate in a major trial of a conjugate pneumococcal vaccine in The Gambia and in research on trachoma, filariasis and sickle cell disease.

We will develop and adapt statistical and epidemiological methods for tropical health research. Our mathematical modelling work will continue to elucidate the effects of risk factors and interventions on the incidence of HIV and be extended to explore the effects of combination therapy on the spread of antimalarial drug resistance. Other methodological research will focus on genetic epidemiology, cluster randomised trials, verbal autopsies and the combined use of quantitative and qualitative methods to collect sensitive data. We propose to establish a small number of training fellowships to counteract the severe shortage of medical statisticians and epidemiologists in Africa.
 
Description EC: FP7 Health 2012 Innovation 1
Amount € 316,216 (EUR)
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 01/2013 
End 12/2016
 
Description EDCTP: Call for the support of clinical trials, capacity building and networking on treatment of HIV/AIDS
Amount £474,902 (GBP)
Organisation Sixth Framework Programme (FP6) 
Department European and Developing Countries Clinical Trials Partnership
Sector Public
Country European Union (EU)
Start 03/2011 
End 03/2015
 
Description EDCTP: Call for the support of clinical trials, capacity building and networking on treatment of HIV/AIDS
Amount £267,222 (GBP)
Organisation Sixth Framework Programme (FP6) 
Department European and Developing Countries Clinical Trials Partnership
Sector Public
Country European Union (EU)
Start 12/2010 
End 01/2015
 
Description Global Mental Health: Integrated Innovations to Improve Treatments and Expand Access to Care - Round 1
Amount $830,714 (CAD)
Organisation Government of Canada 
Department Grand Challenges Canada
Sector Public
Country Canada
Start 10/2012 
End 09/2015
 
Description MRC research grant (Development of Mwanza Intervention Trials Unit as a centre of excellence in HIV/STI prevention research)
Amount £1,090,982 (GBP)
Funding ID G0901756 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 01/2010 
End 12/2013