Pump-Priming Studies

//Pump-Priming Studies
Pump-Priming Studies 2019-12-19T13:04:46+00:00

Pump-Priming Surgical Research Awards

The NIHR Global Health Research Unit on Global Surgery is committed to building and strengthening research capacity in areas specifically relevant to patients in our low and middle income (LMIC) partner hub countries.

Each year as part of our annual research prioritization workshop, researchers from our partner countries are invited to submit research proposals for consideration for seed funding from the NIHR Global Surgery Unit.

The best conceived bids receive pump-priming funding together with mentoring from academics at the Unit in order to develop and conduct their research projects. It is anticipated that this initial funding will generate early pilot data that will be used to inform applications for future grant funding and so develop these projects in to larger studies and trials across the NIHR Global Surgery Unit network.

Studies funded to date are outlined below

The STARFISH study

SToma cARe For Improvement reSearcH (STARFISH):  Epidemiologic study of stoma cases in Lower- and Middle-Income Countries and qualitative research on the challenges on stoma care

The STARFISH study plans to use a mixed methods approach to assess the burden and challenges of stoma care in low and middle income studies.

Based at the NIHR Global Surgery Unit Centre in the Philippines and led by Dr Maria Carmela Lapitan at the University of the Philippines in Manilla, Starfish will comprise 3 separate sub-studies

1.A survey at selected healthcare facilities to collect data on stoma incidence, types, indications and complications.

2.Focus groups and one-to-one interviews with patients, carers and health care providers involved in stoma care

3.Development of a questionnaire for stoma patients in low and middle income to collect standardised data on stoma care.

The TIGER Study

TIGER: Task shifting Inguinal hernia Repair between surgeons and technicians: development of a randomised trial in low and middle income countries

Can technicians perform mesh inguinal hernia repair safely and cost-effectively in rural surgical settings in low and middle income countries?

This pilot trial aims to investigate delivery of a standardised, measurable training programme for technicians to perform a mesh inguinal hernia repair.

The project, led by Professor Stephen Tabiri from the NIHR Global Surgery Unit hub in Ghana, will be coordinated from Tamale Teaching Hospital. A further 11 district hospitals in Ghana will act as a ‘test bed’ to investigate whether 3 month outcome data can be reliably tested in rural surgical settings, whether post-operative pain assessment tools are transferable to Low and Middle income settings and if cost analysis data can be captured in rural hospitals.

Results of this first pilot trial will inform the design of much larger trial aiming to increase safe and affordable inguinal hernia repair across 5 Sub-Saharan African countries including Ethiopia, Benin, Sierra Leone, Rwanda and Zambia

Educational visits

As part of the pump-priming funding stream, the Global Surgery Unit is supporting educational visits for researchers between our international partners, sharing knowledge and experience.

Honey wound dressings for the management of chronic wounds in Ghana

Honey is well documented to have anti-bacterial and anti-fungal properties, however there is currently insufficient evidence to demonstrate that honey wound dressings are effective in the treatment of chronic wounds.

Medical grade honey is currently available but not yet in use in Ghana. Initially, this project will fund an educational trip for Dr Edwin Yenil and Dr Etch Ighohwo from the NIHR Global Surgery Unit hub in Ghana to visit colleagues at our South African hub in order to observe wound care at specialized units. This will help determine the feasibility of carrying out a trial testing different wound dressings in patients with chronic wounds in Ghana.

To read a full report on Dr Yenil and Dr Ighohwo’s visit please click here.

The WHO Surgical Safety Checklist

In the 10th anniversary year of the WHO Surgical Safety Checklist WHO SSC), this project aims to determine usage and compliance with the WHO SSC in referral and district hospitals

In Rwanda and Malawi.

Led in partnership by Dr JC Allen Ingabire from The NIHR Global Surgery Unit hub in Rwanda and Dr Vanessa Msosa at Kamuzu Central Hospital in Malawi, the study will audit knowledge and usage of the WHO SSC amongst approximately 1000 theatre users at 24 rural and district hospitals in Rwanda and 10 in Malawi.

During a defined 3-day data collection period, operations taking place in general surgical and obstetrics & gynaecology theatres will be audited to investigate if the WHO SSC is available to the whole surgical team and being used to record key variables during every operation performed.

The LION Study

LaparoscopIc Versus Open AppeNdectomy: Cost comparison in a lower- middle income setting

This study aims to compare the outcome and cost of conventional open and laparoscopic appendectomy for clinically confirmed, uncomplicated, acute appendicitis in a low resource setting. Although the cost effectiveness of laparoscopic surgery has been investigated previously in high human development index (HDI) countries, similar studies are lacking in low and middle HDI countries.

Led by Dr Adewale Adisa at the NIHR hub in Nigeria, this study will compare outcomes following open and laparoscopic appendectomy in approximately 150 patients at 3 hospitals in Nigeria.

Burns Care

Burns are a significant contributor to the burden of disease in low- and middle-income countries (LMIC). Although current guidelines recommend treatment in specialized treatment centres, such centres are few or non-existent in LMIC

Led by Dr Chikwendu Ede and Dr Rachel Moore from the NIHR Global Surgery Unit hub in Johannesburg, South Africa, this is a prospective observational study comparing outcomes of burns treatments between non-specialised and specialised burns units. 90 day mortality will be collected over a 6 month period at up to 9 non-specialised hospitals treating adult burns patients and compared to outcomes for patients at a dedicated burns unit at Chris Hani Baragwanarth Academic Hospital in Soweto, South Africa.

Wound dressing practices to decrease Surgical Site infections in low and middle income countries

Led by Dr Faustin Ntirenganya and Dr Christophe Mpirimbanyi  from the NIHR Global Surgery Unit hub in Rwanda,

this mixed methods study will assess knowledge, attitudes and practices around surgical wound dressing amongst nurses, general practitioners and surgeons in Rwanda.

The study, conducted at 3 hospitals in Rwanda, will determine types of commonly used dressings and indications for dressing change, evaluate cost implications of wound dressings,  and investigate patients’ and health professionals beliefs/perspectives regarding the feasibility of a future the proposed RCT.

Primary outcome measure will be surgical site infection at 30 days; secondary outcome measures will include length of hospital stay, dressing costs, patient satisfaction and complication rates.

The safety and effectiveness of current management strategies for sigmoid volvulus in LMICs

Sigmoid volvulus is a common cause of intestinal obstruction especially in the “volvulus belt” which runs through South America, Africa, Middle East and India.

Although the WHO standard recommended treatment is initial de-torsion with a sigmoidoscope followed by elective resection and primary anastomosis, different management strategies are often necessitated in low and middle income countries due to the lack of endoscopic equipment, late presentation of patients, and social acceptability of stomas.

Led by Dr Mayaba Maimbo at the NIHR Global Surgery Unit Centre in Zambia, this prospective cohort study aims to explore variation in surgical management of sigmoid volvulus in approximately 100 patients at 5 hospitals in Zambia.

Countries registered to take part in GlobalSurg II

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