Browsing by Author "Gutierrez, Marcelo M"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Open Access
    Prevalence of rheumatic heart disease in Zambian school children
    (BioMed Central, 2018-07-03) Schwaninger, Sherri; Musuku, John; Engel, Mark E; Musonda, Patrick; Lungu, Joyce C; Machila, Elizabeth; Mtaja, Agnes; Mulendele, Evans; Kavindele, Dorothy; Spector, Jonathan; Tadmor, Brigitta; Gutierrez, Marcelo M; Van Dam, Joris; Colin, Laurence; Long, Aidan; Fishman, Mark C; Mayosi, Bongani M; Zühlke, Liesl J
    Background The large global burden of rheumatic heart disease (RHD) has come to light in recent years following robust epidemiologic studies. As an operational research component of a broad program aimed at primary and secondary prevention of RHD, we sought to determine the current prevalence of RHD in the country’s capital, Lusaka, using a modern imaging-based screening methodology. In addition, we wished to evaluate the practicality of training local radiographers in echocardiography screening methods. Methods Echocardiography was conducted on a random sample of students in 15 schools utilizing a previously validated, abbreviated screening protocol. Through a task-shifting scheme, and in the spirit of capacity-building to enhance local diagnostic and research skills, general radiographers based at Lusaka University Teaching Hospital (UTH) were newly trained to use portable echocardiography devices. Students deemed as screen-positive were referred for comprehensive echocardiography and clinical examination at UTH. Cardiac abnormalities were classified according to standard World Heart Federation criteria. Results Of 1102 students that were consented and screened, 53 students were referred for confirmatory echocardiography. Three students had definite RHD, 10 had borderline RHD, 29 were normal, and 11 students were lost to follow-up. The rates of definite, borderline, and total RHD were 2.7 per 1000, 9.1 per 1000, and 11.8 per 1000, respectively. Anterior mitral valve leaflet thickening and chordal thickening were the most common morphological defects. The pairwise kappa test showed fair agreement between the local radiographers and an echocardiographer quality assurance specialist. Conclusion The prevalence of asymptomatic RHD in urban communities in Zambia is within the range of results reported in other sub-Saharan African countries using the WHF criteria. Task-shifting local radiographers to conduct echocardiography was feasible. The results of this study will be used to inform ongoing efforts in Zambia to control and eventually eliminate RHD. Trial registration The study was registered on clinicaltrials.gov ( #NCT02661763 ).
  • Thumbnail Image
    Item
    Open Access
    The Next Generation Scientist program: capacity-building for future scientific leaders in low- and middle-income countries
    (BioMed Central, 2018-10-10) Pillai, Goonaseelan; Chibale, Kelly; Constable, Edwin C; Keller, Akiko N; Gutierrez, Marcelo M; Mirza, Fareed; Sengstag, Christian; Masimirembwa, Collen; Denti, Paolo; Maartens, Gary; Ramsay, Michèle; Ogutu, Bernhards; Makonnen, Eyasu; Gordon, Richard; Ferreira, Carlos G; Goldbaum, Fernando A; Degrave, Wim M S; Spector, Jonathan; Tadmor, Brigitta; Kaiser, Hedwig J
    Background Scientific and professional development opportunities for early career scientists in low- and middle- income countries (LMICs) are limited and not consistent. There is a disproportionately low number of biomedical and clinical researchers in LMIC’s relative to their high burden of disease, a disparity that is aggravated by emigration of up to 70% of scientists from their countries of birth for education and employment elsewhere. To help address this need, a novel University-accredited, immersive fellowship program was established by a large public-academic-private network. We sought to describe the program and summarize progress and lessons learned over its first 7-years. Methods Hallmarks of the program are a structured learning curriculum and bespoke research activities tailored to the needs of each fellow. Research projects expose the scientists to state-of-the-art methodologies and leading experts in their fields while also ensuring that learnings are implementable within their home infrastructure. Fellows run seminars on drug discovery and development that reinforce themes of scientific leadership and teamwork together with practical modules on addressing healthcare challenges within their local systems. Industry mentors achieve mutual learning to better understand healthcare needs in traditionally underserved settings. We evaluated the impact of the program through an online survey of participants and by assessing research output. Results More than 140 scientists and clinicians from 25 countries participated over the 7-year period. Evaluation revealed strong evidence of knowledge and skills transfer, and beneficial self-reported impact on fellow’s research output and career trajectories. Examples of program impact included completion of post-graduate qualifications; establishment and implementation of good laboratory- and clinical- practice mechanisms; and becoming lead investigators in local programs. There was a high retention of fellows in their home countries (> 75%) and an enduring professional network among the fellows and their mentors. Conclusions Our experience demonstrates an example for how multi-sectoral partners can contribute to scientific and professional development of researchers in LMICs and supports the idea that capacity-building efforts should be tailored to the specific needs of beneficiaries to be maximally effective. Lessons learned may be applied to the design and conduct of other programs to strengthen science ecosystems in LMICs.