17 results on '"The PRECISE Network"'
Search Results
2. Microbiota dynamics, metabolic and immune interactions in the cervicovaginal environment and their role in spontaneous preterm birth
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Stanley Onyango, Jia Dai Mi, Angela Koech, Patricia Okiro, Marleen Temmerman, Peter von Dadelszen, Rachel M. Tribe, Geoffrey Omuse, and the PRECISE Network
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lactobacilli ,preterm births ,bacteriocins ,lactic acid ,pregnancy ,probiotics ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Differences in the cervicovaginal microbiota are associated with spontaneous preterm birth (sPTB), a significant cause of infant morbidity and mortality. Although establishing a direct causal link between cervicovaginal microbiota and sPTB remains challenging, recent advancements in sequencing technologies have facilitated the identification of microbial markers potentially linked to sPTB. Despite variations in findings, a recurring observation suggests that sPTB is associated with a more diverse and less stable vaginal microbiota across pregnancy trimesters. It is hypothesized that sPTB risk is likely to be modified via an intricate host-microbe interactions rather than due to the presence of a single microbial taxon or broad community state. Nonetheless, lactobacilli dominance is generally associated with term outcomes and contributes to a healthy vaginal environment through the production of lactic acid/maintenance of a low pH that excludes other pathogenic microorganisms. Additionally, the innate immunity of the host and metabolic interactions between cervicovaginal microbiota, such as the production of bacteriocins and the use of proteolytic enzymes, exerts a profound influence on microbial populations, activities, and host immune responses. These interplays collectively impact pregnancy outcomes. This review aims to summarize the complexity of cervicovaginal environment and microbiota dynamics, and associations with bacterial vaginosis and sPTB. There is also consideration on how probiotics may mitigate the risk of sPTB and bacterial vaginosis.
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- 2023
- Full Text
- View/download PDF
3. SARS-CoV-2 seroprevalence in pregnant women in Kilifi, Kenya from March 2020 to March 2022
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Angela Koech, Geoffrey Omuse, Alex G. Mugo, Isaac G. Mwaniki, Joseph M. Mutunga, Moses W. Mukhanya, Onesmus Wanje, Grace M. Mwashigadi, Geoffrey G. Katana, Rachel Craik, Peter von Dadelszen, Kirsty Le Doare, Marleen Temmerman, periCOVID-Africa, The PRECISE Network, Bridget Freyne, Kondwani Kawaza, Samantha Lissauer, Halvor Sommerfelt, Melanie Etti, Philippa Musoke, Robert Mboizi, Stephen Cose, Victoria Nankabirwa, Lauren Hookham, Joseph Ouma, Gordon Rukondo, Madeleine Cochet, Merryn Voysey, Liberty Cantrell, Patricia Okiro, Consolata Juma, Marvin Ochieng, Emily Mwadime, Esperança Sevene, Corssino Tchavana, Salesio Macuacua, Anifa Vala, Helena Boene, Lazaro Quimice, Sonia Maculuve, Eusebio Macete, Inacio Mandomando, Carla Carillho, Umberto D’Alessandro, Anna Roca, Hawanatu Jah, Andrew Prentice, Melisa Martinez-Alvarez, Brahima Diallo, Abdul Sesay, Sambou Suso, Baboucarr Njie, Fatima Touray, Yahaya Idris, Fatoumata Kongira, Modou F.S. Ndure, Gibril Gabbidon, Lawrence Gibba, Abdoulie Bah, Yorro Bah, Laura A. Magee, Hiten Mistry, Marie-Laure Volvert, Thomas Mendy, Lucilla Poston, Jane Sandall, Rachel Tribe, Sophie Moore, Tatiana T. Salisbury, Donna Russell, Prestige T. Makanga, Liberty Makacha, Reason Mlambo, Aris Papageorghiou, Alison Noble, Hannah Blencowe, Veronique Filippi, Joy Lawn, Matt Silver, Joseph Waiswa, Ursula Gazeley, Judith Cartwright, Guy Whitley, Sanjeev Krishna, Marianne Vidler, Jing (Larry) Li, Jeff Bone, Mai-Lei (Maggie) W Kinshella, Domena Tu, Ash Sandhu, Kelly Pickerill, and Ben Barratt
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SARS-CoV-2 ,COVID-19 ,seroprevalence ,pregnancy ,Kenya ,antibodies ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundSeroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya.MethodsWe obtained representative random samples of stored serum from a pregnancy cohort study for the period March 2020 to March 2022 and tested for antibodies against the spike protein using a qualitative SARS-CoV-2 ELISA kit (Wantai, total antibodies). All positive samples were retested for anti-SARS-CoV-2 anti-nucleocapsid antibodies (Euroimmun, ELISA kits, NCP, qualitative, IgG) and anti-spike protein antibodies (Euroimmun, ELISA kits, QuantiVac; quantitative, IgG).ResultsA total of 2,495 (of 4,703 available) samples were tested. There was an overall trend of increasing seropositivity from a low of 0% [95% CI 0–0.06] in March 2020 to a high of 89.4% [95% CI 83.36–93.82] in Feb 2022. Of the Wantai test-positive samples, 59.7% [95% CI 57.06–62.34] tested positive by the Euroimmun anti-SARS-CoV-2 NCP test and 37.4% [95% CI 34.83–40.04] tested positive by the Euroimmun anti-SARS-CoV-2 QuantiVac test. No differences were observed between the urban and rural hospital but villages adjacent to the major highway traversing the study area had a higher seroprevalence.ConclusionAnti-SARS-CoV-2 seroprevalence rose rapidly, with most of the population exposed to SARS-CoV-2 within 23 months of the first cases. The high cumulative seroprevalence suggests greater population exposure to SARS-CoV-2 than that reported from surveillance data.
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- 2023
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4. The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network’s first protocol: deep phenotyping in three sub-Saharan African countries
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Peter von Dadelszen, Meriel Flint-O’Kane, Lucilla Poston, Rachel Craik, Donna Russell, Rachel M. Tribe, Umberto d’Alessandro, Anna Roca, Hawanatu Jah, Marleen Temmerman, Angela Koech Etyang, Esperança Sevene, Paulo Chin, Joy E. Lawn, Hannah Blencowe, Jane Sandall, Tatiana T. Salisbury, Benjamin Barratt, Andrew H. Shennan, Prestige Tatenda Makanga, Laura A. Magee, and the PRECISE Network
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Pregnancy ,Africa south of the Sahara ,Biorepository ,Pre-eclampsia ,Biological specimens ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network is a new and broadly-based group of research scientists and health advocates based in the UK, Africa and North America. Methods This paper describes the protocol that underpins the clinical research activity of the Network, so that the investigators, and broader global health community, can have access to ‘deep phenotyping’ (social determinants of health, demographic and clinical parameters, placental biology and agnostic discovery biology) of women as they advance through pregnancy to the end of the puerperium, whether those pregnancies have normal outcomes or are complicated by one/more of the placental disorders of pregnancy (pregnancy hypertension, fetal growth restriction and stillbirth). Our clinical sites are in The Gambia (Farafenni), Kenya (Kilifi County), and Mozambique (Maputo Province). In each country, 50 non-pregnant women of reproductive age will be recruited each month for 1 year, to provide a final national sample size of 600; these women will provide culturally-, ethnically-, seasonally- and spatially-relevant control data with which to compare women with normal and complicated pregnancies. Between the three countries we will recruit ≈10,000 unselected pregnant women over 2 years. An estimated 1500 women will experience one/more placental complications over the same epoch. Importantly, as we will have accurate gestational age dating using the TraCer device, we will be able to discriminate between fetal growth restriction and preterm birth. Recruitment and follow-up will be primarily facility-based and will include women booking for antenatal care, subsequent visits in the third trimester, at time-of-disease, when relevant, during/immediately after birth and 6 weeks after birth. Conclusions To accelerate progress towards the women’s and children’s health-relevant Sustainable Development Goals, we need to understand how a variety of social, chronic disease, biomarker and pregnancy-specific determinants health interact to result in either a resilient or a compromised pregnancy for either mother or fetus/newborn, or both. This protocol has been designed to create such a depth of understanding. We are seeking funding to maintain the cohort to better understand the implications of pregnancy complications for both maternal and child health.
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- 2020
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5. PRECISE pregnancy cohort: challenges and strategies in setting up a biorepository in sub-Saharan Africa
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Rachel Craik, Donna Russell, Rachel M. Tribe, Lucilla Poston, Geoffrey Omuse, Patricia Okiro, David Chege, Mathurin Diatta, Abdul Karim Sesay, Inocencia Cuamba, Carla Carrilho, Esperança Sevene, Meriel Flint-O’Kane, Peter von Dadelszen, and The PRECISE Network
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Biorepository ,PRECISE ,Pre-eclampsia ,Preterm birth ,Hypertension ,Pregnancy ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background and objective PRECISE is a population-based, prospective pregnancy cohort study designed for deep phenotyping of pregnancies in women with placenta-related disorders, and in healthy controls. The PRECISE Network is recruiting ~ 10,000 pregnant women in three countries (The Gambia, Kenya, and Mozambique) representing sub-Saharan Africa. The principal aim is to improve our understanding of pre-eclampsia, fetal growth restriction and stillbirth. This involves the creation of a highly curated biorepository for state of the art discovery science and a rich database of antenatal variables and maternal and neonatal outcomes. Our overarching aim is to provide large sample numbers with adequate power to address key scientific questions. Here we describe our experience of establishing a biorepository in the PRECISE Network and review the issues and challenges surrounding set-up, management and scientific use. Methods The feasibility of collecting and processing each sample type was assessed in each setting and plans made for establishing the necessary infrastructure. Quality control (QC) protocols were established to ensure that biological samples are ‘fit-for-purpose'. The management structures required for standardised sample collection and processing were developed. This included the need for transport of samples between participating countries and to external academic/commercial institutions. Results Numerous practical challenges were encountered in setting up the infrastructure including facilities, staffing, training, cultural barriers, procurement, shipping and sample storage. Whilst delaying the project, these were overcome by establishing good communication with the sites, training workshops and constant engagement with the necessary commercial suppliers. A Project Executive Committee and Biology Working Group together defined the biospecimens required to answer the research questions paying particular attention to harmonisation of protocols with other cohorts so as to enable cross-biorepository collaboration. Governance structures implemented include a Data and Sample Committee to ensure biospecimens and data will be used according to consent, and prioritisation by scientific excellence. A coordinated sample and data transfer agreement will prevent delay in sample sharing. Discussion With adequate training and infrastructure, it is possible to establish high quality sample collections to facilitate research programmes such as the PRECISE Network in sub-Saharan Africa. These preparations are pre-requisites for effective execution of a biomarker-based approach to better understand the complexities of placental disease in these settings, and others.
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- 2020
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- View/download PDF
6. The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) database: open-access data collection in maternal and newborn health
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Laura A. Magee, Amber Strang, Larry Li, Domena Tu, Warancha Tumtaweetikul, Rachel Craik, Marina Daniele, Angela Koech Etyang, Umberto D’Alessandro, Ofordile Ogochukwu, Anna Roca, Esperança Sevene, Paulo Chin, Corssino Tchavana, Marleen Temmerman, Peter von Dadelszen, and The PRECISE Network
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Open-source ,Pregnancy ,DHIS2 ,Placental disorders ,eRegistry ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract In less-resourced settings, adverse pregnancy outcome rates are unacceptably high. To effect improvement, we need accurate epidemiological data about rates of death and morbidity, as well as social determinants of health and processes of care, and from each country (or region) to contextualise strategies. The PRECISE database is a unique core infrastructure of a generic, unified data collection platform. It is built on previous work in data harmonisation, outcome and data field standardisation, open-access software (District Health Information System 2 and the Baobab Laboratory Information Management System), and clinical research networks. The database contains globally-recommended indicators included in Health Management Information System recording and reporting forms. It comprises key outcomes (maternal and perinatal death), life-saving interventions (Human Immunodeficiency Virus testing, blood pressure measurement, iron therapy, uterotonic use after delivery, postpartum maternal assessment within 48 h of birth, and newborn resuscitation, immediate skin-to-skin contact, and immediate drying), and an additional 17 core administrative variables for the mother and babies. In addition, the database has a suite of additional modules for ‘deep phenotyping’ based on established tools. These include social determinants of health (including socioeconomic status, nutrition and the environment), maternal co-morbidities, mental health, violence against women and health systems. The database has the potential to enable future high-quality epidemiological research integrated with clinical care and discovery bioscience.
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- 2020
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- View/download PDF
7. Harnessing the PRECISE network as a platform to strengthen global capacity for maternal and child health research in sub-Saharan Africa
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Meriel Flint-O’Kane, Peter von Dadelszen, Prestige Tatenda Makanga, Esperança Sevene, Anna Roca, Peter Dukes, Saba Hinrichs-Krapels, Rachel Craik, Laura A. Magee, Marleen Temmerman, and The PRECISE Network
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Pregnancy ,Capacity building ,Global Health ,Leadership ,Africa south of the Sahara ,United Kingdom ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract It is widely acknowledged across the global health sector that research programmes need to be designed and implemented in a way that maximise opportunities for strengthening local capacity. This paper examines how the United Kingdom Research and Innovation (UKRI) Grand Challenges Research Fund (GCRF) funded PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network has been established as a platform to strengthen global capacity for research focused on the improvement of maternal, fetal and newborn health in sub-Saharan Africa. Best practice principles outlined in an ESSENCE on Health Research report have been considered in relation to the PRECISE Network capacity-building activities described in this paper. These activities are described at the individual, programmatic and institutional levels, and successes, challenges and recommendations for future work are outlined. The paper concludes that the PRECISE leadership have an opportunity to review and refresh activity plans for capacity building at this stage in the project to build on achievements to date.
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- 2020
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8. The contribution of qualitative research within the PRECISE study in sub-Saharan Africa
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Marina A. S. Daniele, Melisa Martinez-Alvarez, Angela Koech Etyang, Marianne Vidler, Tatiana Salisbury, Prestige Tatenda Makanga, Peris Musitia, Meriel Flint-O’Kane, Tanya Wells Brown, Brahima Amara Diallo, Helena Boene, William Stones, Peter von Dadelszen, Laura A. Magee, Jane Sandall, and the PRECISE Network
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Gynecology and obstetrics ,RG1-991 - Abstract
Abstract The PRECISE Network is a cohort study established to investigate hypertension, fetal growth restriction and stillbirth (described as “placental disorders”) in Kenya, Mozambique and The Gambia. Several pregnancy or birth cohorts have been set up in low- and middle-income countries, focussed on maternal and child health. Qualitative research methods are sometimes used alongside quantitative data collection from these cohorts. Researchers affiliated with PRECISE are also planning to use qualitative methods, from the perspective of multiple subject areas. This paper provides an overview of the different ways in which qualitative research methods can contribute to achieving PRECISE’s objectives, and discusses the combination of qualitative methods with quantitative cohort studies more generally. We present planned qualitative work in six subject areas (health systems, health geography, mental health, community engagement, the implementation of the TraCer tool, and respectful maternity care). Based on these plans, with reference to other cohort studies on maternal and child health, and in the context of the methodological literature on mixed methods approaches, we find that qualitative work may have several different functions in relation to cohort studies, including informing the quantitative data collection or interpretation. Researchers may also conduct qualitative work in pursuit of a complementary research agenda. The degree to which integration between qualitative and quantitative methods will be sought and achieved within PRECISE remains to be seen. Overall, we conclude that the synergies resulting from the combination of cohort studies with qualitative research are an asset to the field of maternal and child health.
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- 2020
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9. Acceptability and Feasibility of a Low-Cost Device for Gestational Age Assessment in a Low-Resource Setting: Qualitative Study
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Koech, A, Musitia, PM, Mwashigadi, GM, Kinshella, MW, Vidler, M, Temmerman, Marleen, Craik, R, von Dadelszen, Peter, Noble, JA, Papageorghiou, AT, PRECISE, Network, and Network, PRECISE
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AI ,Africa ,LMIC ,acceptability ,antenatal ,artificial intelligence ,digital health ,eHealth ,feasibility ,fetal ,fetus ,gestation ,gestational age ,gynecologist ,gynecology ,handheld ,imaging ,low cost ,low income ,maternal ,maternity ,misconception ,obstetrician ,obstetrics ,portable ,pregnancy ,pregnancy dating ,pregnant ,prenatal ,remote ,remote location ,rural ,sub-Saharan Africa ,trust ,ultrasound ,women's health ,Medicine and Health Sciences ,Health Informatics ,Human Factors and Ergonomics - Abstract
Background Ultrasound for gestational age (GA) assessment is not routinely available in resource-constrained settings, particularly in rural and remote locations. The TraCer device combines a handheld wireless ultrasound probe and a tablet with artificial intelligence (AI)-enabled software that obtains GA from videos of the fetal head by automated measurements of the fetal transcerebellar diameter and head circumference. Objective The aim of this study was to assess the perceptions of pregnant women, their families, and health care workers regarding the feasibility and acceptability of the TraCer device in an appropriate setting. Methods A descriptive study using qualitative methods was conducted in two public health facilities in Kilifi county in coastal Kenya prior to introduction of the new technology. Study participants were shown a video role-play of the use of TraCer at a typical antenatal clinic visit. Data were collected through 6 focus group discussions (N=52) and 18 in-depth interviews. Results Overall, TraCer was found to be highly acceptable to women, their families, and health care workers, and its implementation at health care facilities was considered to be feasible. Its introduction was predicted to reduce anxiety regarding fetal well-being, increase antenatal care attendance, increase confidence by women in their care providers, as well as save time and cost by reducing unnecessary referrals. TraCer was felt to increase the self-image of health care workers and reduce time spent providing antenatal care. Some participants expressed hesitancy toward the new technology, indicating the need to test its performance over time before full acceptance by some users. The preferred cadre of health care professionals to use the device were antenatal clinic nurses. Important implementation considerations included adequate staff training and the need to ensure sustainability and consistency of the service. Misconceptions were common, with a tendency to overestimate the diagnostic capability, and expectations that it would provide complete reassurance of fetal and maternal well-being and not primarily the GA. Conclusions This study shows a positive attitude toward TraCer and highlights the potential role of this innovation that uses AI-enabled automation to assess GA. Clarity of messaging about the tool and its role in pregnancy is essential to address misconceptions and prevent misuse. Further research on clinical validation and related usability and safety evaluations are recommended.
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- 2021
10. Calcium for pre-eclampsia prevention: A systematic review and network meta-analysis to guide personalised antenatal care.
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Woo Kinshella, Mai‐Lei, Sarr, Catherine, Sandhu, Akshdeep, Bone, Jeffrey N., Vidler, Marianne, Moore, Sophie E., Elango, Rajavel, Cormick, Gabriela, Belizan, José M., Hofmeyr, G. Justus, Magee, Laura A., von Dadelszen, Peter, Woo Kinshella, Mai-Lei, and PRECISE Network
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PREECLAMPSIA prevention ,META-analysis ,DIETARY supplements ,RESEARCH funding ,DIETARY calcium ,PRENATAL care ,CALCIUM ,PROBABILITY theory - Abstract
Background: Calcium supplementation reduces the risk of pre-eclampsia, but questions remain about the dosage to prescribe and who would benefit most.Objectives: To evaluate the effectiveness of high (≥1 g/day) and low (<1 g/day) calcium dosing for pre-eclampsia prevention, according to baseline dietary calcium, pre-eclampsia risk and co-interventions, and intervention timing.Search Strategy: CENTRAL, PubMed, Global Index Medicus and CINAHL, from inception to 2 February 2021, clinical trial registries, reference lists and expert input (CRD42018111239).Selection Criteria: Randomised controlled trials of calcium supplementation for pre-eclampsia prevention, for women before or during pregnancy. Network meta-analysis (NMA) also included trials of different calcium doses.Data Collection and Analysis: Two independent reviewers extracted published data. The meta-analysis employed random-effects models and the NMA, a Bayesian random-effects model, to obtain direct and indirect effect estimates.Main Results: The meta-analysis included 30 trials (N = 20 445 women), and the NMA to evaluate calcium dosage included 25 trials (N = 15 038). Calcium supplementation prevented pre-eclampsia similarly with a high dose (RR 0.49, 95% CI 0.36-0.66) or a low dose (RR 0.49, 95% CI 0.36-0.65). By NMA, high-dose (vs low-dose) calcium did not differ in effect (RR 0.79, 95% CI 0.43-1.40). Calcium was similarly effective regardless of baseline pre-eclampsia risk, vitamin D co-administration or timing of calcium initiation, but calcium was ineffective among women with adequate average baseline calcium intake.Conclusions: Low- and high-dose calcium supplementation are effective for pre-eclampsia prevention in women with low calcium intake. This has implications for population-level implementation where dietary calcium is low, and targeted implementation where average intake is adequate.Tweetable Abstract: A network meta-analysis of 25 trials found that low-dose calcium supplementation (<1 g/day) is as effective as high-dose calcium supplementation (≥1 g/day) in halving the risk of pre-eclampsia when baseline calcium intake is low. [ABSTRACT FROM AUTHOR]- Published
- 2022
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11. The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) database: open-access data collection in maternal and newborn health
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Magee, Laura A, Strang, Amber, Li, Larry, Tu, Domena, Tumtaweetikul, Warancha, Craik, Rachel, Daniele, Marina, Etyang, Angela Koech, D'Alessandro, Umberto, Ogochukwu, Ofordile, Roca, Anna, Sevene, Esperança, Chin, Paulo, Tchavana, Corssino, Temmerman, Marleen, von Dadelszen, Peter, and PRECISE Network
- Abstract
In less-resourced settings, adverse pregnancy outcome rates are unacceptably high. To effect improvement, we need accurate epidemiological data about rates of death and morbidity, as well as social determinants of health and processes of care, and from each country (or region) to contextualise strategies. The PRECISE database is a unique core infrastructure of a generic, unified data collection platform. It is built on previous work in data harmonisation, outcome and data field standardisation, open-access software (District Health Information System 2 and the Baobab Laboratory Information Management System), and clinical research networks. The database contains globally-recommended indicators included in Health Management Information System recording and reporting forms. It comprises key outcomes (maternal and perinatal death), life-saving interventions (Human Immunodeficiency Virus testing, blood pressure measurement, iron therapy, uterotonic use after delivery, postpartum maternal assessment within 48 h of birth, and newborn resuscitation, immediate skin-to-skin contact, and immediate drying), and an additional 17 core administrative variables for the mother and babies. In addition, the database has a suite of additional modules for 'deep phenotyping' based on established tools. These include social determinants of health (including socioeconomic status, nutrition and the environment), maternal co-morbidities, mental health, violence against women and health systems. The database has the potential to enable future high-quality epidemiological research integrated with clinical care and discovery bioscience.
- Published
- 2020
12. The contribution of qualitative research within the PRECISE study in sub-Saharan Africa.
- Author
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Daniele, MAS, Martinez-Alvarez, M, Etyang, AK, Vidler, M, Salisbury, T, Makanga, PT, Musitia, P, Flint-O'Kane, M, Brown, TW, Diallo, BA, Boene, H, Stones, W, von Dadelszen, P, Magee, LA, Sandall, J, PRECISE Network, Daniele, MAS, Martinez-Alvarez, M, Etyang, AK, Vidler, M, Salisbury, T, Makanga, PT, Musitia, P, Flint-O'Kane, M, Brown, TW, Diallo, BA, Boene, H, Stones, W, von Dadelszen, P, Magee, LA, Sandall, J, and PRECISE Network
- Abstract
The PRECISE Network is a cohort study established to investigate hypertension, fetal growth restriction and stillbirth (described as "placental disorders") in Kenya, Mozambique and The Gambia. Several pregnancy or birth cohorts have been set up in low- and middle-income countries, focussed on maternal and child health. Qualitative research methods are sometimes used alongside quantitative data collection from these cohorts. Researchers affiliated with PRECISE are also planning to use qualitative methods, from the perspective of multiple subject areas. This paper provides an overview of the different ways in which qualitative research methods can contribute to achieving PRECISE's objectives, and discusses the combination of qualitative methods with quantitative cohort studies more generally.We present planned qualitative work in six subject areas (health systems, health geography, mental health, community engagement, the implementation of the TraCer tool, and respectful maternity care). Based on these plans, with reference to other cohort studies on maternal and child health, and in the context of the methodological literature on mixed methods approaches, we find that qualitative work may have several different functions in relation to cohort studies, including informing the quantitative data collection or interpretation. Researchers may also conduct qualitative work in pursuit of a complementary research agenda. The degree to which integration between qualitative and quantitative methods will be sought and achieved within PRECISE remains to be seen. Overall, we conclude that the synergies resulting from the combination of cohort studies with qualitative research are an asset to the field of maternal and child health.
- Published
- 2020
13. The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network's first protocol: deep phenotyping in three sub-Saharan African countries.
- Author
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von Dadelszen, P, Flint-O'Kane, M, Poston, L, Craik, R, Russell, D, Tribe, RM, d'Alessandro, U, Roca, A, Jah, H, Temmerman, M, Koech Etyang, A, Sevene, E, Chin, P, Lawn, JE, Blencowe, H, Sandall, J, Salisbury, TT, Barratt, B, Shennan, AH, Makanga, PT, Magee, LA, PRECISE Network, von Dadelszen, P, Flint-O'Kane, M, Poston, L, Craik, R, Russell, D, Tribe, RM, d'Alessandro, U, Roca, A, Jah, H, Temmerman, M, Koech Etyang, A, Sevene, E, Chin, P, Lawn, JE, Blencowe, H, Sandall, J, Salisbury, TT, Barratt, B, Shennan, AH, Makanga, PT, Magee, LA, and PRECISE Network
- Abstract
BACKGROUND:The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network is a new and broadly-based group of research scientists and health advocates based in the UK, Africa and North America. METHODS:This paper describes the protocol that underpins the clinical research activity of the Network, so that the investigators, and broader global health community, can have access to 'deep phenotyping' (social determinants of health, demographic and clinical parameters, placental biology and agnostic discovery biology) of women as they advance through pregnancy to the end of the puerperium, whether those pregnancies have normal outcomes or are complicated by one/more of the placental disorders of pregnancy (pregnancy hypertension, fetal growth restriction and stillbirth). Our clinical sites are in The Gambia (Farafenni), Kenya (Kilifi County), and Mozambique (Maputo Province). In each country, 50 non-pregnant women of reproductive age will be recruited each month for 1 year, to provide a final national sample size of 600; these women will provide culturally-, ethnically-, seasonally- and spatially-relevant control data with which to compare women with normal and complicated pregnancies. Between the three countries we will recruit ≈10,000 unselected pregnant women over 2 years. An estimated 1500 women will experience one/more placental complications over the same epoch. Importantly, as we will have accurate gestational age dating using the TraCer device, we will be able to discriminate between fetal growth restriction and preterm birth. Recruitment and follow-up will be primarily facility-based and will include women booking for antenatal care, subsequent visits in the third trimester, at time-of-disease, when relevant, during/immediately after birth and 6 weeks after birth. CONCLUSIONS:To accelerate progress towards the women's and children's health-relevant Sustainable Development Goals, we need to understand how a variety of social, chronic disease
- Published
- 2020
14. The contribution of qualitative research within the PRECISE study in sub-Saharan Africa.
- Author
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Daniele, Marina A. S., Martinez-Alvarez, Melisa, Etyang, Angela Koech, Vidler, Marianne, Salisbury, Tatiana, Makanga, Prestige Tatenda, Musitia, Peris, Flint-O'Kane, Meriel, Brown, Tanya Wells, Diallo, Brahima Amara, Boene, Helena, Stones, William, von Dadelszen, Peter, Magee, Laura A., Sandall, Jane, the PRECISE Network, D'Alessandro, Umberto, Roca, Anna, Jah, Hawanatu, and Oguchukwu, Ofordile
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CHILD health services ,MATERNAL health services ,MENTAL health ,PLACENTA diseases ,RISK assessment ,QUALITATIVE research ,DISEASE risk factors - Abstract
The PRECISE Network is a cohort study established to investigate hypertension, fetal growth restriction and stillbirth (described as "placental disorders") in Kenya, Mozambique and The Gambia. Several pregnancy or birth cohorts have been set up in low- and middle-income countries, focussed on maternal and child health. Qualitative research methods are sometimes used alongside quantitative data collection from these cohorts. Researchers affiliated with PRECISE are also planning to use qualitative methods, from the perspective of multiple subject areas. This paper provides an overview of the different ways in which qualitative research methods can contribute to achieving PRECISE's objectives, and discusses the combination of qualitative methods with quantitative cohort studies more generally. We present planned qualitative work in six subject areas (health systems, health geography, mental health, community engagement, the implementation of the TraCer tool, and respectful maternity care). Based on these plans, with reference to other cohort studies on maternal and child health, and in the context of the methodological literature on mixed methods approaches, we find that qualitative work may have several different functions in relation to cohort studies, including informing the quantitative data collection or interpretation. Researchers may also conduct qualitative work in pursuit of a complementary research agenda. The degree to which integration between qualitative and quantitative methods will be sought and achieved within PRECISE remains to be seen. Overall, we conclude that the synergies resulting from the combination of cohort studies with qualitative research are an asset to the field of maternal and child health. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
15. Harnessing the PRECISE network as a platform to strengthen global capacity for maternal and child health research in sub-Saharan Africa.
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Flint-O'Kane, Meriel, von Dadelszen, Peter, Makanga, Prestige Tatenda, Sevene, Esperança, Roca, Anna, Dukes, Peter, Hinrichs-Krapels, Saba, Craik, Rachel, Magee, Laura A., Temmerman, Marleen, The PRECISE Network, D'Alessandro, Umberto, Jah, Hawanatu, Oguchukwu, Ofordile, Prentice, Andrew, Martinez-Alvarez, Melisa, Diallo, Brahima, Sesey, Adbul, Lette, Kodou, and Bah, Alpha
- Subjects
CHILD health services ,CLINICAL medicine research ,LEADERSHIP ,MATERNAL health services ,PLACENTA diseases ,RISK assessment ,DISEASE risk factors - Abstract
It is widely acknowledged across the global health sector that research programmes need to be designed and implemented in a way that maximise opportunities for strengthening local capacity. This paper examines how the United Kingdom Research and Innovation (UKRI) Grand Challenges Research Fund (GCRF) funded PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network has been established as a platform to strengthen global capacity for research focused on the improvement of maternal, fetal and newborn health in sub-Saharan Africa. Best practice principles outlined in an ESSENCE on Health Research report have been considered in relation to the PRECISE Network capacity-building activities described in this paper. These activities are described at the individual, programmatic and institutional levels, and successes, challenges and recommendations for future work are outlined. The paper concludes that the PRECISE leadership have an opportunity to review and refresh activity plans for capacity building at this stage in the project to build on achievements to date. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
16. PRECISE pregnancy cohort: challenges and strategies in setting up a biorepository in sub-Saharan Africa.
- Author
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Craik, Rachel, Russell, Donna, Tribe, Rachel M., Poston, Lucilla, Omuse, Geoffrey, Okiro, Patricia, Chege, David, Diatta, Mathurin, Sesay, Abdul Karim, Cuamba, Inocencia, Carrilho, Carla, Sevene, Esperança, Flint-O'Kane, Meriel, von Dadelszen, Peter, The PRECISE Network, D'Alessandro, Umberto, Roca, Anna, Jah, Hawanatu, Ogochukwu, Ofordile, and Prentice, Andrew
- Subjects
FETAL growth retardation -- Risk factors ,RISK factors of preeclampsia ,PERINATAL death ,BIOMARKERS ,COMMUNICATION ,INTERPROFESSIONAL relations ,LONGITUDINAL method ,MATERNAL health services ,EVALUATION of medical care ,MEDICAL protocols ,PLACENTA diseases ,PREGNANCY ,PREGNANT women ,RISK assessment ,ADULT education workshops ,DISEASE risk factors - Abstract
Background and objective: PRECISE is a population-based, prospective pregnancy cohort study designed for deep phenotyping of pregnancies in women with placenta-related disorders, and in healthy controls. The PRECISE Network is recruiting ~ 10,000 pregnant women in three countries (The Gambia, Kenya, and Mozambique) representing sub-Saharan Africa. The principal aim is to improve our understanding of pre-eclampsia, fetal growth restriction and stillbirth. This involves the creation of a highly curated biorepository for state of the art discovery science and a rich database of antenatal variables and maternal and neonatal outcomes. Our overarching aim is to provide large sample numbers with adequate power to address key scientific questions. Here we describe our experience of establishing a biorepository in the PRECISE Network and review the issues and challenges surrounding set-up, management and scientific use. Methods: The feasibility of collecting and processing each sample type was assessed in each setting and plans made for establishing the necessary infrastructure. Quality control (QC) protocols were established to ensure that biological samples are 'fit-for-purpose'. The management structures required for standardised sample collection and processing were developed. This included the need for transport of samples between participating countries and to external academic/commercial institutions. Results: Numerous practical challenges were encountered in setting up the infrastructure including facilities, staffing, training, cultural barriers, procurement, shipping and sample storage. Whilst delaying the project, these were overcome by establishing good communication with the sites, training workshops and constant engagement with the necessary commercial suppliers. A Project Executive Committee and Biology Working Group together defined the biospecimens required to answer the research questions paying particular attention to harmonisation of protocols with other cohorts so as to enable cross-biorepository collaboration. Governance structures implemented include a Data and Sample Committee to ensure biospecimens and data will be used according to consent, and prioritisation by scientific excellence. A coordinated sample and data transfer agreement will prevent delay in sample sharing. Discussion: With adequate training and infrastructure, it is possible to establish high quality sample collections to facilitate research programmes such as the PRECISE Network in sub-Saharan Africa. These preparations are pre-requisites for effective execution of a biomarker-based approach to better understand the complexities of placental disease in these settings, and others. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
17. Interactions between the Physical and Social Environments with Adverse Pregnancy Events Related to Placental Disorders-A Scoping Review.
- Author
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Dube YP, Nyapwere N, Magee LA, Vidler M, Moore SE, Barratt B, Craik R, von Dadelszen P, Makanga PT, and The Precise Network
- Subjects
- Africa epidemiology, Female, Humans, Male, Maternal Age, Pregnancy, Social Environment, Cesarean Section, Placenta Diseases epidemiology, Premature Birth
- Abstract
Background: Due to different social and physical environments across Africa, understanding how these environments differ in interacting with placental disorders will play an important role in developing effective interventions., Methods: A scoping review was conducted, to identify current knowledge on interactions between the physical and social environment and the incidence of placental disease in Africa., Results: Heavy metals were said to be harmful when environmental concentrations are beyond critical limits. Education level, maternal age, attendance of antenatal care and parity were the most investigated social determinants., Conclusions: More evidence is needed to determine the relationships between the environment and placental function in Africa. The results show that understanding the nature of the relationship between social determinants of health (SDH) and placental health outcomes plays a pivotal role in understanding the risk in the heterogenous communities in Africa.
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- 2020
- Full Text
- View/download PDF
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