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      "description_narrative":["There are more deaths each year from injuries than from HIV, TB and malaria combined.  Worldwide, about ten million people are killed or hospitalised because of a head injury every year. Most head injuries are caused by road traffic crashes, and because car use is increasing, the number of people suffering a head injury is increasing. Amongst those who survive a head injury, many are left severely disabled for the rest of their lives. For example, there is a high likelihood that Michael Schumacher will be permanently disabled as a result of his recent head injury. Most victims of head injury are young adults living in low and middle income countries. Because many of the victims are also breadwinners for their families, head injuries can also result in loss of income which, along with medical costs, can increase household debt and lead to a fall in living standards for the whole family. When the head is injured there is often bleeding inside the brain, which can continue for some time and worsen after hospital admission. This bleeding increases pressure inside the skull causing further damage to the brain, which can be fatal or result in serious disability for the patient. We think that we can prevent some of these deaths and disability by reducing the amount of bleeding in the brain after head injury. Tranexamic acid is a cheap drug that reduces bleeding in other conditions. A large trial in accident victims (other than those with head injury) found that it reduces the chances of bleeding to death. If this drug also works in patients with head injury and bleeding into the brain, this would be important to know because it could save lives at a very low cost.  We have already done two preparatory studies to see if tranexamic acid can help people who have bleeding inside the brain because of a head injury. Together, the results of the studies suggest that tranexamic acid should reduce the amount of bleeding inside the brain and could reduce their chances of dying or being disabled. However, because these studies were small, we are not very certain about the accuracy of their results. Also, they were not designed to find out whether tranexamic acid reduces disability. Because doctors are still unsure about whether tranexamic acid works, it is not given to patients with traumatic brain injury. But if a new clinical trial showed that it worked, this would change very quickly. We want to find out if tranexamic acid saves lives and reduces disability in people with traumatic brain injury.  We plan to study 10,000 patients with traumatic brain injury in countries throughout the world. We will give half of them tranexamic acid and the other half a dummy medicine called a placebo. To make sure that the two groups are the same apart from tranexamic acid, we will decide who gets tranexamic acid and who gets placebo using the modern equivalent of the toss of a coin (this is called randomisation). Everyone will of course get all the treatments that doctors usually give to traumatically brain injured patients. At the end of the trial we will see if giving tranexamic acid on top of all the usual treatments improves survival and other patient outcomes. The study will be carried out by a team of researchers with lots of experience in doing clinical trials. In fact, it will be the same team that did the successful study of tranexamic acid in accident victims. The trial will cost several million pounds but if it shows (as we hope it will) that tranexamic acid works, we will have a very cheap way of reducing the number of people who die and are disabled after a head injury. The start up phase of trial is underway and over a thousand patients have been recruited. The trial procedures work well. This application is for funds to continue recruitment to 10,000 patients.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"],
      "title_narrative":["MICA: Performance evaluation of a point-of-care whole blood viral load test (SAMBA) to optimize HIV treatment in resource-limited settings"],
      "description_narrative":["As of 2012, 9.7 million individuals were receiving antiretroviral therapy (ART) for treatment of HIV-1 infection in low- and middle-income countries. However, among patients receiving first-line ART, 20-30% will have a detectable viral load after 12 months. The long-term success of ART programmes is heavily dependent on accurate, available and timely viral load monitoring to document viral suppression or indicate the need for second line ART switch.    Existing HIV viral load assays require significant infrastructure and highly trained personnel to perform, thus only a few centralised laboratories are capable of viral load testing in most developing countries. Centralised testing leads to poor access to those in need, long turn-around times, delay of results and subsequent loss of patients, all of which lead to sub-optimal ART treatment outcomes, which can cause significant morbidity and mortality.  The University of Cambridge, in partnership with Diagnostics for the Real World, has developed an innovative point-of-care nucleic acid amplification test for the diagnosis monitoring the efficacy of HIV treatment by determining of the amount of circulating virus  is above or below the threshold for treatment failure. The SAMBA HIV-1 Semi-Q Test allows the patient to be tested and treated in the same visit, thus improving access and treatment outcomes. The plasma-based semi-automated (SAMBA I) assay has received product approval in Malawi, Kenya, Zimbabwe and Uganda and has been used for testing of over 35,500 patients at Médecins sans Frontières (MSF) sites in Malawi and Uganda to date.   The SAMBA HIV-1 Semi-Q Test has recently been improved to enable the use of small volume whole blood, using a patented method of filtration. This removes the need for plasma separation, thus increasing utility at lower cadre health clinics and reduces the time to result. In addition a fully automated SAMBA instrument system has been developed, called SAMBA II. The key aims of this proposal are: 1) integrate the whole blood SAMBA HIV-1 Semi-Q Test onto the fully automated SAMBA II instrument, 2) perform an evaluation in house, in Africa and in Europe to evaluate its perforce compared to another  CE-marked test and 3) submit for CE-mark. Although the SAMBA test will most likely be used in Africa, a CE-mark is required to allow it to be procured by NGO's.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["Rapid diagnosis of onchocerciasis using urinary biomarkers"],
      "description_narrative":["GCRF Foundation Infections 2016 to identify and validate biomarkers in urine from participants in Cameroon. That could indicate the presence of a viable, adult female Onchocerca volvulus worm in a patient suffering from onchocerciasis (river blindness).\n","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["Human Decoy Trap; operational and social acceptability of novel tool to improve surveillance and control of mosquitoes and other disease vectors"],
      "description_narrative":["Malaria infects over 200 million people every, mostly in sub-Saharan Africa. Nearly half a million people died from the disease in 2015, the majority of deaths being in children under the age of five. The malaria parasite is spread by infected mosquitoes and the most effective way to monitor the disease is to monitor populations of these mosquitoes. However, current tools for sampling malarial mosquitoes are time-consuming and labour intensive, making them expensive and difficult to standardize. Accordingly, data between countries and regions cannot be reliably compared. To solve this problem, we have developed a mosquito trap that exploits the blood-seeking behaviour of mosquitoes by mimicking the sensory stimuli that a mosquito follows when searching for a person to bite. These include the look, smell and temperature of warm-blooded hosts. We have incorporated these stimuli into a trap that lures mosquitoes towards it and then captures them when they land. Our project will test this \"Human Decoy\" Trap against current methods used in mosquito monitoring to determine whether the Human Decoy Trap can overcome the limitations of existing tools. We will evaluate if Human Decoy Trap catches are suitably similar to those of current traps in terms of numbers of mosquitoes and other important data related to malaria that can be extracted from mosquitoes caught by traps, such as the proportion of caught mosquitoes infected with malaria parasites. Over 90 countries, mostly low and middle income, are malaria-endemic. We will work in Burkina Faso, Benin and Cameroon, three West African countries where malaria causes thousands of deaths every year, but differing in intensity and seasonality of transmission and with different mosquito species involved. This will help us to understand whether there are differences in trap performance in a wide range of malaria settings. In addition, we will work with end-users of the trap, namely local communities, public health operatives and field technicians, to better understand their perspectives and needs regarding mosquito sampling and control. During the course of the project, we will use data we collect to optimize and improve the trap's performance and design. This will help us to develop a commercial prototype that is effective and acceptable to end-users, maximising the likelihood the trap will be adopted into the communities and sectors that need it the most. Longer-term, we envision a version of the Human Decoy Trap that can be deployed as a mosquito control tool. The most effective way of controlling malaria is to reduce the number of infective mosquito bites a person receives. This is currently achieved by providing people with insecticide-treated bed nets to protect them from bites whilst they sleep and spraying the walls inside houses thus killing mosquitoes that rest there. However, neither of these options protects people from mosquitoes that may bite them outdoors during the day or just before they go to bed at night. Data from this current project will be used to provide preliminary evidence for the suitability of the Human Decoy Trap as a control tool that is specifically targeted at malaria mosquitoes biting outdoors, which may also be effective against other species of mosquitoes that can carry other infectious diseases, such as dengue fever, chikungunya and Zika viruses. Such an improved sampling method would enhance the quality of data necessary for efficient targeting and evaluation of malaria control intervention activities and reduce the cost of collecting it. A successful outdoor mosquito control device would help to reduce the population of infected mosquitoes that cause malaria. Ultimately, the combined effect of these tools would be a reduction in the human suffering and death caused by malaria to millions of people every year and an improvement in the social and economic prospects of the 3.2 billion people living at risk of malaria.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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