Mentor and advisors are leaders, critical thinkers, expert in their own field of specialisation that guide, give research direction, motivator and provide support to other researchers and students in the process facilitating and ensuring good research is done

Professor Exnevia Gomo

Professor Gomo is an Associate Professor (Immunology) in the Department of Laboratory Diagnostic and Investigative Sciences, Medical Laboratory Sciences Unit, and Director of the Research Support Centre (RSC), University of Zimbabwe Faculty of Medicine and Health Sciences (UZ-FMHS) since 2011. He holds a MSc in Applied Immunology (UK), PhD in Immunology (Denmark) and a Postgraduate Diploma in Research Methodology (Denmark). Prof Gomo has extensive experience in health research in Zimbabwe with regional and international collaboration. He has held several senior research and management positions. From 1998 – 2003 he was a Principal Medical Scientist and Head of the HIV/AIDS Research Unit at the Blair Research Institute (now National Institute of Health Research). In 2003 he joined the UZ as Associate Professor. He has continued to supervise Masters and PhD students. From 2016-2018, he was South Africa Research Chair in Indigenous Health Care Systems at University of KwaZulu-Natal College of Health Sciences. Prof Gomo has over 80 publications in peer reviewed journals.

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Professor Simbarashe Rusakaniko

Professor Rusakaniko is a Professor at the University of Zimbabwe Faculty of Medicine and Health Sciences. He holds a DPhil degree in Reproductive Health (UZ), MSc Epidemiology and Biostatistics 1997, University of Newcastle, Australia. To date he has over 120 publications published in peer reviewed journals.

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Leolin Katsidzira

Dr Leolin Katsidzira (Leo) is a gastroenterologist in Internal Medicine, Faculty of Medicine and Health Sciences, University of Zimbabwe. He did his undergraduate, and specialist training in internal medicine at the University of Zimbabwe in Harare, Zimbabwe, and trained in gastroenterology at the University of Cape Town and Groote Schuur hospital in Cape Town, South Africa. His PhD thesis was on the epidemiology, and genetics of colorectal cancer in African populations. He started the Gastroenterology Clinic at Parirenyatwa Hospital in Harare and runs the endoscopy service at the same institutions. His main research interests are in the interplay of diet, the environment, the gut microbiota, and mucosal immunity in the emergency of inflammatory bowel disease, and colorectal cancer in Africa, and in the genesis and complications of environmental enteropathy. He maintains an active research interest in helicobacter pylori, chronic Hepatitis B & C in Africa and is actively involved in the development of clinical and academic gastroenterology in Africa. He is the current President of the National Physicians Association of Zimbabwe, and a council member of the East, Central and Southern Africa College of Physicians (ECSACOP). 

Prof Zijenah

Professor MZ Chirenje

Professor M Chidzonga

Professor Nathoo

Professor Chitsike

Principal Investigator (PI)

Professor Kerina Duri

PhD, Virology-Immunology, University of Oslo, Norway.

MSc, Biotechnology, University of Zimbabwe (UZ).

BSc (Hons), Biochemistry, UZ.

Prof Kerina Duri is an associate professor at the University of Zimbabwe, Faculty of Medicine and Health Science. Her research interest is in understanding how maternal comorbidities such as HIV, Helicobacter pylori, intestinal helminth infections, malnutrition and mental health affect pregnancy outcomes, infant growth and health. She also has interest in immune development and dysregulation due to gut microbiota profile variations from birth to adolescence, with a special focus on HIV-exposed but uninfected infants and children. Using modest funding received from the Wellcome Trust for her postdoctoral work, the University of Zimbabwe birth cohort study (UZBCS) was established in January 2016 with the aim to understand why these HIV-exposed but uninfected babies were at higher risk of dying. The hypothesis was that their immunity was impaired during foetal development due to maternal exposure to HIV and the baby’s exposure in utero and during the breastfeeding period to the mother’s lifelong antiretroviral therapy (ART).

1208 mother-infant pairs were recruited from high density residential areas in Harare. There has been an incredible accumulation of data. Mother –infant /children are now being followed up at year seven. The main strengths of this study are the relatively large sample size with appropriate controls and HIV-infected pregnant women, alongside HIV-uninfected pregnant women, recruited simultaneously from the same community. Thus, all research participants reside in highly similar environmental conditions in high-density areas of Harare, resulting in an unusually homogenous study population.

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Co-Principal Investigator

Professor Felicity Zvanyadza Gumbo

Professor Gumbo holds an MBChB degree from the University of Zimbabwe (UZ) in 2000, Master of Medicine degree in Paediatrics-UZ (2006) and PhD with the University of Oslo in Norway (2012).

She is involved in running academic programmes, research, and clinical teaching. She is driven to continue designing useful innovative programmes and research to reduce child mortality and morbidity. She aims to develop robust collaborative research programmes and promote quality teaching in the short term for the country.

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Co-Investigators

Dr Mazengera

Dr Chimhuya

Dr Kuona

Dr Kandawasvika

Dr Marere

Dr Ziruma

Preamble

The emergence of new pathogens, climate change affecting food security, the dynamic movements of people coupled with risky sexual behavioral tendencies and sedentary lifestyle have exerted tremendous stress on health delivery system. This is further exacerbated by scarcity of both human and financial resources, more so for Africa where a paltry 3% of the global health workers man the African health delivery system, where ironically more than double the burden of preventable infectious diseases exist. There is urgent need to address such inequalities. This situation calls for training of innovative health professionals who are responsive to the ever-changing health care needs with capacities to timeously extract and synthesize essential information. This is in tandem with the University of Zimbabwe vision and goals of rebranding post-graduate programmes coupled with relevant research that benefit the society.

The HIV/AIDS pandemic remain a challenge, and has eroded health gains made in the past seventy years. On average 74% of Africans are exposed to two or more parasitic, bacterial and viral infections, whilst a quarter is grappling with three or more diseases including non-communicable diseases (NCDs), of which some are side effect(s) attributed to the sedentary lifestyle, ever increasing life stressors, malnutrition or due to the intake of antiretroviral therapy. This situation is exacerbated by poverty, limited access clean water and good sanitation facilities. Relative to single pathogen infections, co-infections and NCDs (comorbidities) may alter transmission dynamics of infections. Despite existence of constellation of comorbidities in our population, single pathogen researches are common and generally carried out in silos. Research findings from such studies may be misleading taking cognisance that in real local life situation solitary infections are rare in our setting. In addition, how different comorbidities’ combinations impact on host/pathogen genetics and treatment outcomes remains poorly described.

Establishing the nature, burden and consequences of comorbidities requires integrated research of diverse infectious diseases and NCD including the respect behavioral aspects over time. This is important for safer and more effective individualized medical care especially for the vulnerable population especially pregnant women and their infants. The existing adverse conditions can reduce the life expectancy and severely affect infant growth and neurodevelopment, especially within the first 1000 days with babies never reaching their full development potential. Sustainable multidisciplinary global networks are more likely to be solution to these myriad challenges. However, this does not come cheap as appropriate funding structure, infrastructure, research policies, equipment and enthusiastic research support staff need to be put in place.

Our Work

Full study title:

HIV EXPOSURE, DISEASE ACQUISITION AND PROGRESSION AMONG CHILDREN: ROLE OF MATERNAL IMMUNOGENETICS, VIRAL GENETIC DIVERSITY, HAART EXPOSURE, CO-MORBIDITIES AND PSYCHO-SOCIAL STATUS; THE UZ-CHS BIRTH COHORT (MRCZ/A/1968, JREC 15/18).

Short title: The University of Zimbabwe Birth Cohort Study (UZBCS)

Background to the study

Commencing lifelong antiretroviral therapy (ART) immediately following HIV diagnosis (Option B+), has greatly improved maternal-infant health. Thus, large and increasing numbers of HIV-infected women are on ART during pregnancy. Whilst the numbers of HIV exposed and infected (HEI) infants are dwindling by the day, courtesy of the current effective prevention of mother to child transmission of HIV (PMTCT) programs, the opposite is true for HIV exposed but uninfected (HEU) infants. Compared to their HIV-unexposed-uninfected (HUU) counterparts, HEU infants/children show higher rates of adverse outcomes, including mortality due to infectious and/or non-communicable diseases, impaired growth and (neuro)cognitive development. Understanding why and how this constantly growing population of HEU infants is at high risk of acquiring comorbities is critical as their problems will be of major public health importance in the near future. Therefore, there is an urgent need to understand the impact of HIV and early life ART exposures, immune-metabolic dysregulation, comorbidities and environmental confounders on adverse paediatric outcomes.

Method

600 HIV-infected and 600 HIV-uninfected pregnant women ≥20 weeks of gestation were enrolled from four primary health centres in high-density residential areas of Harare. Participants were followed as mother-infant-pairs at delivery, week(s) 1, 6, 10, 14, 24, 36, 48, 72 and 96 after birth. Clinical, socio-economic, nutritional and environmental data were collected and babies assessed for adverse birth outcomes, impaired growth, immune/neurodevelopment, vertical transmission of HIV, hepatitis B/C viruses, cytomegalovirus and syphilis. Maternal urine, stool, plasma, cord-blood, amniotic-fluid, placenta and milk including infant plasma, dried blood spots and stool were collected at during pregnancy and at follow-up visits.

Endpoints

The composite primary endpoint was stillbirth and infant mortality and morbidity within the first two years of life, and if possible into adolescents comparing HEU versus HUU infants. Maternal mortality and morbidity in HIV-infected versus -uninfected women is another primary outcome. Secondary endpoints include a range of maternal and infant outcomes. Sub-studies addressing maternal stress and malnutrition, maternal-infant latent tuberculosis, Helicobacter pylori infections, immune-metabolomic dysregulation including gut and breast-milk microbial dysbiosis.

Protocol registration; www.clinicaltrials.gov,trial registration number: NCT04087239.