CoLab is pleased to collaborate in projects with investigators from low- and middle-income countries (LMIC).
PREPARE (Prematurity reduction by Pre-eclampsia care)
Funded by the Bill and Melinda Gates Foundation and the Brazilian Department of Health
2018 PREPARE meeting in Rio de Janeiro, Brazil
PREPARE is an implementation trial to reduce excessive preterm birth for preeclampsia in Brazil where almost 20% if preterm births are due to induced deliveries to treat preeclampsia. This is three times the rate in other countries and we are performing a stepped wedge randomized controlled trial to attempt to use objective criteria to avoid inappropriate premature deliveries for preeclampsia. This is accompanied by a knowledge transfer component to facilitate this trial but in addition to stimulate the use of the WHO guidelines for the management of hypertension in pregnancy. Finally, the study will recruit a group of lower socioeconomic women for the RCT but also to assemble a biorepository of plasma, serum, DNA, urine and placentas. The collection of plasma serum and urine will be carried out in 7000 women at four times during pregnancy. This has already resulted in an additional grant from pharma, AWARE (see below).
AWARE (Angiogenic factors Will Assist in Risk Evaluation)
Funded by Roche Pharmaceuticals
CoLab continues to work with Dr. Leandro Oliveira who received funding from Roche Diagnostics for a study using samples from the Pre-PARE biorepository to address the potential usefulness of PlGF to stratify risk in apparently low risk women at 28 to 32 weeks of gestation. The award provides supplementation for PREPARE and administrative support to CoLab.
ACT (All Children Thriving): South Africa
Funded by Saving Lives at Birth
The project with PATH and LifeAssay company of South Africa supported by a Saving Lives at Birth grant to LifeAssay company tests an inexpensive protein creatinine strip. This study enabled us to set up a biorepository at Stellenbosch University in Cape Town for long-term storage of samples from Africa at no additional expense to the Foundation.
The CAP Study team and CoLab collaborated with GSK Maternal and Neonatal Health Unit, Global Health R&D Unit, R&D Alternative Discovery & Development, who measured a comprehensive panel of putative preeclampsia biomarkers on a subset of CAP Study population. Laboratory analyses in the UK are complete. The GSK group has donated residual samples to be used by CoLab. Those samples are stored in the Stellenbosch biobank in South Africa.
Adipsin as an alternative to generic proteinuria
Funded by Saving Lives at Birth
Adipsin is a specific protein released into the urine of women with preeclampsia and correlates very well with the quantity of non-specific (generic) protein. As a specific protein it can be used to develop a qualitative and quantitative yes/no immunoassay for its presence. This study extends laboratory studies done by CoLab into the field. We believe that using a lateral flow immunoassay for UA we can provide a much more easily interpretable result (a line appearing on strip with urines containing the concentration of adipsin correlating with diagnostic protein concentrations) than with the qualitative determination of color on a strip in conventional assessment of generic protein determinations. This will be useful with minimally trained care providers but may also provide a test usable by the pregnant woman.
A training grant for LMIC investigators Sarah Manyame Zimbabwe (J. M. Roberts, mentor)