Project: Proteomic-based Etiological biomarkers of Acute pneumonia in Kenyan children

Acronym	PEAK (Reference Number: TMA2018CDF-2360)
Duration	01/08/2019 - 31/07/2021
Project Topic	Pneumonia is second only to malaria as a cause of infant and early childhood mortality in sub-Saharan Africa. Over 90% of the mortality attributed to pneumonia infection occurs in developing countries. The treatment of pneumonia depends on its microbial etiology. Care of most viral pneumonia infections is restricted to symptomatic management since most licenced antivirals such as ribavirin are only minimally effective. On the other hand, antibiotics are an effective way of treating bacterial pneumonia and timely administration of antimicrobial therapy has been associated with positive clinical outcomes. In developed countries, these infections are often diagnosed using sophisticated platforms including multiplex real-time PCR for virus diagnosis and blood cultures for the diagnosis of bacterial pneumonia. However, these platforms are generally unavailable typical health facilities in low resource countries, where the toll of pneumonia infection is greatest. The lack of these diagnostic platforms means that clinicians in these settings do not have sufficient clinical information to determine the underlying microbial etiology of pneumonia and whether antibiotic treatment is appropriate. This has led to the widespread presumptive use of antibiotics as empiric treatment and has resulted in antibiotics being administered to vast numbers of children with viral pneumonia who do not need them. This overuse of antibiotics has been implicated in the alarming spread of antimicrobial resistance (AMR), which is estimated to be the leading cause of paediatric death by 2050 if corrective measures are not devised. To address this problem, we propose to validate host-level biomarkers that can rapidly and reliably distinguish viral and bacterial pneumonia and that be formulated into a rapid point of care test. In a previous study of airway proteomics, we identified 15 host proteins that could distinguish between viral and bacterial pneumonia in African children with high sensitivity and specificity. In this study, we propose to validate these results using an independent retrospective cohort of infants and children who were previously admitted to hospital with severe pneumonia and whose airway samples were archived in a biobank. By measuring the expression levels of the candidate biomarker proteins in these samples, we hope to select the three that are most discriminative of pneumonia etiology for further testing in a prospective cohort. If successful, the results of this study will contribute to the fight against AMR by providing clinicians with a robust tool for guiding decisions to administer antibiotics.
Network	EDCTP2
Call	Career Development Fellowships 2018

Project partner

Number	Name	Role	Country
1	African Research Collaboration for Health Ltd.	Partner	Kenya