Research & Innovation
The African Brain Child Initiative pioneers ground-breaking research to advance our understanding of the brain in health and disease.
Children in Africa, and across the world, face a high burden of conditions that cause acute brain injury and which collectively account for the largest number of deaths and long-term disabilities. Key focus areas for our research include the following: Injury accounts for more deaths than tuberculosis, HIV and malaria combined (WHO Injury Report), and is a leading cause of death in children -importantly, traumatic brain injury (TBI) accounts for the highest number of these deaths. Tuberculous meningitis (TBM) is the most devastating form of TB disease and the most common cause of childhood meningitis in our region. Brain tumours are the leading cause of solid cancer-related deaths in children across the world. Epilepsy and hydrocephalus represent major burdens of childhood disease, often secondary to conditions such as trauma and infections that predominate in an African setting.
What leads to poor outcomes from these conditions is poorly understood because the brain is difficult to study. Without advancing our understanding of these mechanisms we cannot optimize therapies. The ABC group is focused on unravelling the pathophysiological mechanisms that perpetuate injury in the developing brain with the aim of identifying novel interventions tailored to the individual patient. In this mission we have adopted an interdisciplinary, translational approach which combines a sophisticated clinical infrastructure of multimodality brain monitoring, high frequency physiological data and site-of-disease sample collection with cutting-edge laboratory techniques like next-generation sequencing, various -omics approaches, flow cytometry, and pharmacokinetics (PK).
Like our surgeons, our research team hold numerous international leadership positions and are regular contributors to international consensus statements and treatment guidelines. Recent and current leadership positions include:
RESEARCH REPORTS
Traumatic Brain Injury
Cerebrovascular Pressure Reactivity Has a Strong and Independent Association With Outcome in Children With Severe Traumatic Brain Injury.
Claudia A Smith, Ursula K Rohlwink, Katya Mauff, Nqobile S Thango, Thembani S Hina, Shamiel Salie, Johannes M N Enslin, Anthony A Figaji. PMID: 36790173
Brain Tissue Oxygen Tension Monitoring in Pediatric Severe Traumatic Brain Injury: Part 1: Relationship with Outcome.
Anthony A Figaji , Eugene Zwane, Crispin Thompson, A Graham Fieggen, Andrew C Argent, Peter D Le Roux, Jonathan C Peter. PMID: 19214532
Brain Tissue Oxygen Tension Monitoring in Pediatric Severe Traumatic Brain Injury: Part 2: Relationship with Clinical, Physiological, and Treatment Factors.
Anthony A Figaji, Eugene Zwane, Crispin Thompson, A Graham Fieggen, Andrew C Argent, Peter D Le Roux, Jonathan C Peter. PMID: 19214533
Combining Brain Microdialysis and Translational Pharmacokinetic Modeling to Predict Drug Concentrations in Pediatric Severe Traumatic Brain Injury: The Next Step Toward.
Naomi Ketharanathan, Yumi Yamamoto, Ursula K Rohlwink, Enno D Wildschut, Ron A A Mathôt, Elizabeth C M de Lange, Saskia N de Wildt, Andrew C Argent, Dick Tibboel, Anthony A Figaji. PMID: 30019622.
Tuberculous Meningitis
Biomarkers of Cerebral Injury and Inflammation in Pediatric Tuberculous Meningitis.
Ursula K Rohlwink, Katya Mauff, Katalin A Wilkinson, Nico Enslin, Emmanuel Wegoye, Robert J Wilkinson, Anthony A Figaji. PMID: 28605426
Tuberculous Meningitis in Children Is Characterized by Compartmentalized Immune Responses and Neural Excitotoxicity.
Ursula K Rohlwink, Anthony Figaji, Katalin A. Wilkinson, Stuart Horswell, Abdul K Sesay, Armin Deffur, Johannes M N Enslin, Regan Solomons, Ronald Van Toorn, Brian Eley, Michael Levin, Robert J Wilkinson & Rachel P J Lai. DOI :10.1038/s41467-019-11783-9.
A Pilot Study of Inflammatory Mediators in Brain Extracellular Fluid in Paediatric TBM.
Nicholas W Loxton, Ursula K Rohlwink, Mvuwo Tshavhungwe, Lindizwe Dlamini, Muki Shey, Nico Enslin, Anthony Figaji. PMID: 33711020
More Key Papers
Anatomical and Physiological Differences between Children and Adults Relevant to Traumatic Brain Injury and the Implications for Clinical Assessment and Care
PMID: 29312119 DOI: 10.3389/fneur.2017.00685
Brain interstitial glycerol correlates with evolving brain injury in paediatric traumatic brain injury.
PMID: 33585956 DOI: 10.1007/s00381-021-05058-2
Checklists to guide the supportive and critical care of tuberculous meningitis.
PMID: 31984242 DOI: 10.12688/wellcomeopenres.15512.2
Comparative Effectiveness of Diversion of Cerebrospinal Fluid for Children With Severe Traumatic Brain Injury.
PMID: 35802371 DOI: 10.1001/jamanetworkopen.2022.20969
Consensus statement from the International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury.
PMID: 31134383 DOI: 10.1007/s00701-019-03936-y
The effect of increased inspired fraction of oxygen on brain tissue oxygen tension in children with severe traumatic brain injury.
PMID: 20232264 DOI: 10.1007/s12028-010-9344-3
Elevated Matrix Metalloproteinase Concentrations Offer Novel Insight Into Their Role in Pediatric Tuberculous Meningitis.
PMID: 30753686 DOI: 10.1093/jpids/piy141
International Survey Reveals Opportunities to Improve Tuberculous Meningitis Management and the Need for Standardized Guidelines.
PMID: 33209947 DOI: 10.1093/ofid/ofaa445
A management algorithm for adult patients with both brain oxygen and intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC).
PMID: 31965267 DOI: 10.1007/s00134-019-05900-x
The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring (2014).
DOI: 10.1007/s12028-014-0019-3
Rationale and Methods for Updated Guidelines for the Management of Penetrating Traumatic Brain Injury.
PMID: 35919507 DOI: 10.1089/neur.2022.0008
Tuberculous meningitis.
PMID: 28884751 DOI: 10.1038/nrneurol.2017.120
The International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care.
DOI: 10.1007/s12028-014-0077-6
The neurocritical care of tuberculous meningitis.
PMID: 31109897 DOI: 10.1016/S1474-4422(19)30154-1
The neurosurgical and acute care management of tuberculous meningitis: evidence and current practice.
PMID: 20970381 DOI: 10.1016/j.tube.2010.09.005
The relationship between intracranial pressure and brain oxygenation in children with severe traumatic brain injury.
PMID: 22134142 DOI: 10.1227/NEU.0b013e318243fc59
The Role of Registries in Neurotrauma Research: Translating Data Into Health Policy That Enhances Patient Care Comment on ‘Neurotrauma Surveillance in National Registries of Low-and Middle-Income Countries.
PMID: 37579434 DOI: 10.34172/ijhpm.2023.7521
Traumatic Brain Injury: Integrated Approaches to Improve Prevention, Clinical Care, and Research.
PMID: 29122524 DOI: 10.1016/S1474-4422(17)30371-X