Jobs & Fellowships

MD PhD Clinical Fellowship

Description of the overall project:

The COAST trial (Children’s oxygenation administration strategies trial) is currently evaluating two related oxygenation interventions (targeted use of oxygen with respect to the optimal oxygen saturation threshold for treatment and mode of delivery) to reduce shorter-term mortality at 48-hours (primary endpoint), and one nutritional intervention (RUTF given for 56 days to children after 48 hours) to improve longer-term morbidity and mortality to 90 days in 4200 African children with putative pneumonia at 5 centres in Kenya and Uganda.

Description of the Nested Sub-study:

Current WHO clinical criteria for severe pneumonia are very broad and non-specific, resulting in the over diagnosis of severe pneumonia, particularly in sub-Saharan Africa, as they encompass the critically sick children with a much broader range of aetiologies, and thus less likely to respond to the supportive care and specific antimicrobial guidelines recommended for pneumonia. In order to inform a policy targeting treatments being tested in the COAST trial this study aims to establish whether incorporating within into the COAST trial an evaluation of previously-validated point-of-care tests and other biomarkers (c-reactive protein, procalcitonin; neutrophil gelatinase-associated lipocalin(NGal) specific for bacterial infection and pneumonia to investigate whether these can be used alone or in combination with clinical signs to classify individual into groups with defined characteristics eg radiographic pneumonia for refining clinical endpoints for the trial. The biomarkers studies will use the stored admission plasma samples included in the protocol. The biomarkers will be batch-assayed retrospectively at KWTRP and Mbale laboratories in Kenya and Uganda respectively.

The project will be supervised by Prof. Kathryn Maitland (KWTRP) and Prof. Job vanWoesnel (Paediatric Critical Care Group, AMC, Amsterdam). A period of training and ICU exposure at AMC is also nested into the training element of the PhD.

Applicants will be expected to have completed their Bachelor of Surgery and Bachelor of Medicine with a Masters Qualification as an added advantage.

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