Fighting Malaria
Collaborative Research with Kilifi Malaria Project, Kenya
Robert J. Marchbanks, & Tony Birch
Department of Medical Physics and Bioengineering, Southampton General Hospital.
THE FACTS:
•Around the world 40 per cent of the world’s population are at risk from Malaria.
•90 per cent of the 300-500 million cases of malaria that occur each year are in Africa.
•Every year more that 10 million children under the age of five die in developing countries,
nearly a million from Malaria alone.
•Every day more than 2500 people die of malaria, most of them children.
These statistics are the driving force behind the work of the
Wellcome-KEMRI (Kenya Medical Research Institute) research
program that is located at various sites in Kilifi, Kenya.
This program undertakes large-scale studies of the paediatric
admissions so as to clarify the range of diseases affecting young
children in Kilifi. The Kilifi District hospital sees more than 5000
paediatric admissions a year and the hospital is closely linked to the
KEMRI-Wellcome program. This work is helping to improve
treatments for severely ill children in Kilifi and district, and the
findings are known throughout the scientific world.
Map from: www.go2africa.com
Cerebral malaria is probably the most common paediatric
encephalopathy in sub-Saharan Africa. This condition accounts for
many of the estimated 1000 000 childhood deaths from falciparum
malaria each year and it produces neurological deficits in a further
40 000 children per year. Intracranial hypertension is an important
determinant of poor outcome in cerebral malaria other nontraumatic paediatric encephalopathies.
The Role for Southampton
Accurate intracranial pressure (ICP) measurements are vital for treatment and monitoring
of seriously ill patients. However, surgical methods of measuring this pressure are not an
option for the majority of children in Kalifi due to logistical and ethical reasons.
Fortunately there is a non-surgical technique that shows great promise and this method
has been investigated through research within Southampton Hospitals and at the
University over the past 20 years.
The development of the ‘MMS-11 Cerebral and
Cochlear Fluid Pressure (CCFP) Analyser’ by Marchbanks Measurement Systems has
provided the opportunity for non-invasive measurements by studying the movement of
the eardrum as induced by intracranial pressure waves and in response to various stimuli.
Goals of the Collaboration
We know that cerebral malaria and other non-traumatic paediatric encephalopathies
cause raised intracranial pressure and are associated with abnormal intracranial pressure
waves. The aim is to use the CCFP Analyser for long term monitoring of intracranial
pressure in children suspected to be suffering from cerebral malaria. The challenge is to
find the best method of analysing the pressure signals so as to extract underlying
baseline pressure shifts and the different types of pressure waves -- we need to
recognise pressure signatures that precede critical and life threatening changes in
pressure.
Finding a means of analysis and visualisation will provide major clinical
benefits and potential may help save lives. Methods including spectrograms and wavelet
transforms have been used on physiological signals but have not been applied to our noninvasive intracranial pressure recordings and have not been used to help this patient
population.
The Need for Signal Processing Expertise
The Kilifi Collaboration is seen as a particularly important application of the CCFP
technique and presents the opportunity to work with a multi-disciplinary team experts.
Data should be collected during the year, and there is the potential for staff time to be
made available at the hospital to carry out analysis under suitable guidance. It is believed
that this work will provide the opportunity for publications in principal medical journals
and collaborative research on an international basis.
All pictures from the ‘African Malaria
Partnership’ photo library.
http://www.gsk.com/malaria
If you are interested in collaborating with us, or discussing the potential application of signal processing techniques to this
problem, please contact us via Robert.Marchbanks@suht.swest.nhs.uk,