Fighting Malaria Collaborative Research with Kilifi Malaria Project, Kenya

1. FightingMalaria 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 clarifythe 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. 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 non-traumatic paediatric encephalopathies. Map from: www.go2africa.com 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 transformshave been used on physiological signals but have not been applied to our non-invasive 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,