Research at the Aga Khan University's, Medical College (AKU, MC) focuses on advancing knowledge across the health sciences spectrum – from bench to bedside to community.
AKU MC's research is particularly targeted towards making a difference in the six priority areas of the Medical College: Cardiometabolic Diseases; Neurosciences and Mental Health; Cancer; Reproductive, Maternal, Neonatal, Child Health (RMNCH); Communicable Diseases, and Trauma and Emergency. These areas intersect with foundational and cross-cutting themes of importance to the Medical College such as Data Science; Family Medicine and Community Health Sciences; and Genomics and Translational Research, with the objective of developing large-scale impact. Research priorities are aligned with national health needs, the University’s vision, and its comparative advantage in terms of expertise and infrastructure.
Though 2020 was unlike any other due to the COVID-19 pandemic, Medical College faculty continued to engage in critical research to produce high-quality investigation and unearth new knowledge.
“Overall, I observed a lot of energy and interest in research,” said Dr Asad Ali, Associate Dean of Research at the Medical College. “As an institution, we minimized the adverse effects of the pandemic by taking advantage of the opportunities in research it presented.”
1. Exploring the role of digital health in routine immunisations during the COVID-19 pandemic
Immunisation campaigns, across the world and in Pakistan, suffered due to disruptions in the delivery and uptake of immunisation services. As part of its routine immunisation programme, Pakistan vaccinates it population against 10 broad types of diseases from tuberculosis to measles. Dr Momin Kazi, Assistant Professor in the Department of Paediatrics and Child Health secured a grant from Sabin Vaccine Institute to understand the perception and barriers to routine immunisations in the pandemic, and how digital interventions can help bridge barriers. “We aim to come up with a solution that can be recommended to policymakers to devise strategies for effective immunisation in the future,” he said.
2. Impact of tOPV campaigns on P2 seroprevalence and stool shedding
Type 2 polio virus made a resurgence in Pakistan in 2019. Up until the eradication of the virus, the trivalent oral polio vaccine (tOPV) had been the vaccine of choice for polio eradication globally. When no more cases were reported, the vaccine was withdrawn and interventions shifted to a more potent bivalent, the Oral Polio Vaccine (bOPV) along with inactivated polio vaccines (IPV). “The resurgence of type 2 polio is a public health emergency coupled with the fact that a number of polio campaigns were adversely impacted due to the COVID-19 pandemic,” said Dr Ali Faisal Saleem, Associate Professor in the Department of Paediatrics and Child health and Principal Investigator of the study. His grant, awarded by the World Health Organization, will help evaluate the impact of the reintroduction of the tOPV by assessing the presence of antibodies in stool and blood. The results aim to provide vital data to help formulate future polio eradication strategies.
3. Fetal Dropper for Antenatal Stratification
Despite the commendable reduction in under-5 mortality across the world, stillbirths and newborn mortality have had a very slow decline and continue to contribute to a major proportion of the under-5 deaths. Pakistan has the highest stillbirth and death rate in the first 24 hours of life. Almost three quarters of these deaths are preventable if adequate antenatal, intrapartum, and postnatal care is ensured for the mother and newborn. “At present there is no predictive model that can identify pregnant women who are at risk of these adverse outcomes,” says Dr Zahra Hoodbhoy, Assistant Professor in the Department of Paediatrics and Child Health and Principal Investigator of the study. Funded by the Bill and Melinda Gates Foundation, her grant aims to develop and validate AI-based models using sociodemographic, clinical, and imaging data of pregnant women to predict these outcomes. Once validated, such a decision support system can assist with pregnancy risk stratification in low-and middle-income countries like Pakistan.
4. COVID-19 Household Transmission study in Pakistan
Funded by the Bill and Melinda Gates Foundation, the study on COVID-19 transmission aims to closely monitor contacts of positive cases of COVID-19 in district east of Karachi to study disease transmissibility within the community. Participants enrolled were followed up with over a 28-day period, during which nasal and blood samples were collected along with basic information on exposure and clinical history. In addition, a symptom diary was maintained for all participants through daily phone calls. “The findings of this study will contribute towards restraining the spread of COVID-19 and will influence future public health strategies,” said Dr Imran Nisar, Assistant Professor in the Department of Paediatrics and Child Health and the Principal Investigator of the research.
5. Evaluating the use of drug ‘Rifampicin’ in the treatment of pulmonary tuberculosis
Tuberculosis is highly epidemic in Pakistan. The current treatment of tuberculosis of the lungs involves taking anti-TB drugs, such as Rifampicin, daily for six months or more. Studies have shown that increasing the dose of Rifampicin may result in better and effective treatment against the disease. In this clinical trial, funded by St George’s University of London, Dr Bushra Jamil, Professor in the Department of Medicine, is evaluating the effects of administering the drug Rifampicin in patients for a varying duration of time. “Shorter treatments can lead to better compliance and cure rates, cost effectiveness and reduction in drug resistance. The trial will help us in evaluating the most effecting way of managing the disease,” she said.
6. Role of viral infection in the development of prostate carcinoma
Prostate cancer is one of the most prevalent cancers in men worldwide. There are many factors, such as genetics and environment that can lead to progression of the disease. The anatomical position of the prostate makes it prone to infection by certain pathogens, particularly viruses. “The grant by the Higher Education Commission helps us understand how viral infections can cause genetic and cellular changes leading to onset of prostate cancer in men,” said Dr Syed Hani Abidi, Assistant Professor, Department of Biomedical and Biological Sciences and the lead of the study.
7. Comparative study of commercially available typhoid tests to evaluate current and emerging tools
Typhoid infection is endemic in many low and middle-income countries(LMIC). Over the past three decades, increasing antimicrobial resistance has made infection management difficult. Diagnosis of the infection is a key step in effectively managing the disease. Although numerous tests are available for typhoid diagnosis, at present the only recommended test is a blood culture. Blood cultures, however, require considerable laboratory infrastructure: a requirement that limits access to quality-assured diagnosis of typhoid across LMICs including Pakistan. As part of a multicentre study supported by The Foundation of Innovative New Diagnostics, the research team is evaluating currently available rapid tests for typhoid. “The aim of the study is to identify tests that would qualify for approval towards increasing access to typhoid diagnostics particularly in low resource settings,” said Dr Rumina Hasan, Professor in the Department of Pathology and Laboratory Medicine and the Principal Investigator of the study.
8. Assessment of psychosocial and mental health needs of healthcare workers managing the COVID-19 outbreak
The COVID-19 pandemic continues to pose a serious challenge for healthcare workers across the world. To ascertain the challenges and needs of professionals across different levels of the public healthcare system in provinces of Punjab and Sindh, a study was conducted to inform on standard intervention packages. “Some of the major challenges for healthcare professionals include a lack of skills to provide services, dealing with psychosocial needs of infected patients and families, and community mistrust and stigma toward the disease,” explained Dr Waqas Hameed, Senior Instructor at the Department of Community Health Sciences and Principal Investigator of the study. The study has called for immediate measures in improving mental health, safety, and performance of health workers, particularly those directly involved in providing services to COVID-19 patients.
9. Treatment of Hepatitis Delta Virus with a new drug ‘Lonafarnib’
The virus, Hepatitis Delta, infects patients suffering from hepatitis B, and causes the severest form of liver disease that can be deadly in many cases. There is no approved treatment for HDV infection yet. The drug Lonafarnib, if proven to be effective in this global study funded by Eiger BioPharmaceuticals, Inc, may become the first approved oral treatment for HDV infection.
“In Pakistan, the HDV disease is widespread in areas of upper Sindh and Balochistan. By participating in the trial, these populations could be the first ones to benefit from this new treatment in future,” said Dr Saeed Hamid, Professor in the Department of Medicine and Director of Clinical Trials Unit at AKU.
10. Phase III Clinical Trial of the Ad5-nCoV, Vaccine by Cansino Biotech
The grant awarded by AJM Pharma (Pvt) Ltd and led by Dr Faisal Mahmood, Associate Professor and Section Head of Infectious Diseases in the Department of Medicine, encouraged AKU – in partnership with Government of Pakistan- to be among of the few sites in the country to participate in the vaccine trial. Volunteers from AKU and outside participated in this historical scientific breakthrough. The study is underway and more information is expected in the coming months.