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James A Berkley "Jay"
Jay Berkley is the Principal Investigator of the CHAIN Network and co-directs the Network with Judd L. Walson. Jay is based full-time at the KEMRI/Wellcome Trust Research Programme in Kilifi, Kenya. Jay is a Professor of Paediatric Infectious Diseases at the University of Oxford in the UK and Affiliate Professor in Global Health at the University of Washington. Dr. Berkley is an expert adviser to the Ministries of Health and the World Health Organization on child health, malnutrition and antimicrobials.
Jay lead a research group working on serious infection and survival in highly vulnerable groups of infants and children. Major achievements include the largest systematic study of invasive bacterial infection in children worldwide; the first comprehensive study of viral causes of pneumonia in Africa; risks for pneumonia treatment failure; diagnostic strategies for meningitis and the performance of simple clinical syndromes in targeting of antimicrobial treatment. These have been important contributors to the introduction of conjugate vaccines in Africa, and have directly informed WHO and national management guidelines.
Current trials include a large multicentre RCT in Kenya and Uganda aiming to improve empiric first-line antimicrobial treatment in severely malnourished children (FLACSAM). Phase 1 is determining pharmacokinetics in malnourished children, and the presence and acquisition of ESBL and other forms of antimicrobial resistance influencing. Phase II examines efficacy on mortality, nutritional recovery, costs to health services and families, and consequences of antimicrobial resistance. A multicentre RCT in Kenya and Malawi is examining modified F75 therapeutic feeds for severe malnutrition to address re-feeding syndrome and osmotic diarrhoea from carbohydrate malabsorption. This RCT is being done together with Dr Robert Bandsma and Dr Wieger Voskuijl from the CHAIN Network. On breastfeeding, a pilot trial is ongoing which exploits approaches known to be successful in neonates to optimize the lactation for infants under 6 months old with acute malnutrition. We will determine if exclusive breastfeeding can be attained and retained after discharge; and if breastmilk alone is sufficient for recovery of acutely malnourished infants, together with Dr Martha Mwangome from the CHAIN Network.
Other work within the research group includes a longitudinal community birth cohort on the onset of environmental enteric dysfunction and small intestinal bacterial overgrowth in relation to mode of feeding, acquisition of intestinal pathogens, diarrhoea episodes and antimicrobial usage; inflammatory activation and functional immune responses to ex vivo pathogen challenge in severely malnourished children; spatiotemporal modelling to examine proximate and environmental determinants of malnutrition; risk factors for adverse birth outcomes and neonatal infection; aetiology, clinical and molecular epidemiology of newborn serious bacterial infection; and antimicrobial resistance in community and hospital-acquired neonatal sepsis.
Maureen Kelley is Associate Professor of Bioethics at The Ethox Centre in Nuffield Department of Population Health, University of Oxford. She serves as an ethics advisor and collaborating social scientist for CHAIN. Dr. Kelley is a moral philosopher and qualitative researcher by training, specializing in reproductive, maternal, newborn and child health. Her research addresses practical ethical challenges that adversely impact the health of women and children considered to be vulnerable due to social, economic, or political circumstances. In particular, she is interested in improving care for preventable diseases and adverse health outcomes, such as malnutrition, stillbirth, preterm birth, infection, and maternal-neonatal death during childbirth. In child health she has focused on improving access to health care for children living without parents—orphans, migrant children, foster children, and homeless youth. Dr. Kelley has worked extensively in international settings, conducting research and helping to develop clinical and research ethics training programs in maternal-child health. She is leading a new collaborative initiative, sponsored by the Wellcome Trust, across the major overseas programs in tropical medicine at Oxford on the ethical inclusion of vulnerable women, children, and families in research. The REACH project will explore ways to mitigate vulnerability and develop strategies for promoting agency and resilience among women, children and families through research.
The Childhood Acute Illness and Nutrition Network (CHAIN) is a multinational research group that aims to optimize the management and care of highly vulnerable children in resource-limited settings to improve survival, growth and development.