9 activities 2017 with the combined value of USD 1.7 m, summarized by
AHRI 2016-2021, Research Support - AHRI-Core support,2016-2021 USD 1 019 890

Medical Research

Description

AHRI works to meet the reseach and capacity building demands of Ethiopia in biomedical fields. The aim of the current application is to work in areas of high quality research, capacity building towards national competence, information dicemination, innovation for "more health for the money" concept, and to strengthen AHRI as an institution in order to maintain already strong competencies.

Activity length

Delivery channel

Bilateral, core contributions to NGOs and other private bodies / PPPs

Granting agency

Swedish International Development Cooperation Agency

Activity identifier

SE-0-SE-6-5108013501-ETH-12182

AHRI 2016-2021, Research Support - AHRI 2016-2021 - ISP Forward funds, Coordination USD 355 446

Medical Research

Description

AHRI works to meet the reseach and capacity building demands of Ethiopia in biomedical fields. The aim of the current application is to work in areas of high quality research, capacity building towards national competence, information dicemination, innovation for "more health for the money" concept, and to strengthen AHRI as an institution in order to maintain already strong competencies.

Activity length

Delivery channel

Bilateral

Granting agency

Swedish International Development Cooperation Agency

Activity identifier

SE-0-SE-6-5108013506-ETH-12182

Randomized clinical trial to identify optimal pediatric efavirenz dosage to treat HIV infected infant and children in Africa USD 63 473

Medical Research

Description

More than 90% of the estimated 3.3 million HIV infected children worldwide live in Sub Saharan Africa. Efavirenz (EFV) is approved recently by US-FDA and WHO as part of first line combination ART for HIV infected children >3 years of age. Based on results from few clinical studies, the US-FDA approved the use of EFV in infant and children aged ≥3 months weighing >3.5 kg. Due to lack of efficacy, safety and pharmacokinetic data WHO continues to limit the use of EFV in children under <3 years of age. The current body weight-based EFV dose recommended (FDA and WHO) to treat HIV in infant and children is scaled-down prediction from population pharmacokinetic modeling of data obtained from adult subjects treated with the standard maximum EFV dose. Biochemical and physiological processes between children and adults such as metabolism are disproportionate to their body weight differences. Although adult data is helpful to decide a first-in-children dose to initiate a safety, efficacy and PK study, the appropriate way to determine pharmacokinetic and pharmacodynamic parameters in children for a given age group is to conduct a dose optimization studies in specific age groups. Our extensive EFV dose optimization studies in Sub Saharan Africa patients indicate the importance of pharmacogenetic variations for efavirenz plasma exposure and treatment outcome. Based on population PK modeling of observational data, we demonstrated that standard 600 mg daily adult dose is unnecessarily high and recommended a dose reduction to 400 mg daily for adults in black African populations, which is confirmed by recent randomized clinical trials. In the present study we aim to perform a similar EFV dose optimization study specific for pediatrics population in Africa. EFV crosses the blood brain barrier and high plasma EFV concentration is associated with CNS toxicity, which may result in untoward effect for the developing child brain. We hypothesize that with the current recommended EFV dose, the risk of under- or overdosing of EFV is eminent among black African children who exhibit significant nutritional, comorbidity and host-genetic diversity from populations where pharmacokinetic and safety studies are performed and data extrapolated with “one-dose-fit-all” principle. We aim to identify safe and effective efavirenz dosage recommendations specific for pediatric use to treat HIV infected infants and children in Sub Saharan Africa. A three-phase extensive efavirenz pharmacokinetics, pharmacogenetics and pharmacodynamics based EFV dose optimization study will be conducted in HIV and HIV-TB co-infected infant and children from two genetically diverse African populations (Uganda and Ethiopia) during 2016 – 2020. First (Phase-1): observational study will be conducted to evaluate EFV plasma exposure, safety (skin rash, liver and CNS toxicity) and efficacy (immunologic and virological outcomes) of EFV based ART using the current EFV dose approved by FDA (< 3 years of age) and WHO (> 3 years of age) treatment guidelines. Patients will be enrolled prospectively and followed for one year. Application and feasibility of bedside genotype testing for patient care to aid EFV dose adjustment in HIV pediatric clinic will be developed and evaluated. Secondly (Phase-2): Population pharmacokinetic, pharmacogenetic and pharmacodynamics modeling and simulation of the data we will be performed to identify the normal efavirenz therapeutic range and optimal predictive EFV dose recommendation for the various age group. Thirdly (Phase-3): In a randomized clinical trial, we will evaluate the safety and efficacy of the predicted optimal EFV dose and compare it against the current FDA/WHO approved EFV dose recommendations. The study, to be conducted through a well-established multidisciplinary collaboration, will provide evidence-based recommendation for policy makers to develop safe and effective HIV treatment guidelines for the most vulnerable pediatric population in

Activity length

Delivery channel

Bilateral

Granting agency

The Swedish Research Council

Activity identifier

SE-0-SE-29-2015-03295_2-238-12182

Implementation and evaluation of a smartphone teleconsultation system for acute burn injury care in resource-poor settings USD 63 473

Medical Research

Description

Burn injuries are a leading cause of premature death worldwide and are largely attributable to poor living conditions. Timely care is a prerequisite to reduce morbidity and mortality and it can be significantly improved in resource-poor settings by teleconsultation systems to support the provision of appropriate and timely care. A teleconsultation system for acute burn care is currently under implementation in the Western Cape, South Africa. An application (app) is installed on a smartphone located in each of the emergency services of 8 hospitals to transmit visual and textual information between emergency staff at point of care and a network of burn teleexperts. The burns specialist on call is informed via instant messaging that a case has been uploaded and can then review the visually transmitted information and images and provide diagnostic and treatment advice. The primary aim of the project is to assess how a teleconsultation system for acute burn injury care based on a smartphone application can impact on the delivery of emergency care for burns victims, both in terms of clinical management and site of care. Intermediate aims are to assess the clinical quality, clinical outcomes, user perspective, and costs and benefits of the teleconsultation system. The clinical quality will include assessments of diagnostic accuracy and patient management. Bedside diagnosis or image based diagnosis by burns experts will be used as gold standard. A historical cohort design will be used to assess the effect of the teleconsultation system on patient outcomes. The Health Information Technology Usability Evaluation Model will be used to assess how the users experience the system and the system’s cost-utility will be assessed in terms of cost per quality-adjusted life-year gained. A stepwise implementation of the system is planned in Tanzania and Ethiopia starting the beginning of 2016. The burn specialists already involved in South Africa will act as experts for the two additional countries and the existing south-south network of emergency specialists will safeguard the communication and implementation of the system. This proposal will build on the evaluation already started in South Africa and will allow a more robust and comprehensive evaluation of the whole system. Furthermore, the inclusion of other settings will add important contextual aspects to the evaluation. The first part of the evaluation will include the hospitals currently using the teleconsultation system in the Western Cape, South Africa and 2-3 hospitals where the system will be introduced in Tanzania. Later on, 2-3 hospitals in Ethiopia will be introduced to the system, informed by the process in Tanzania, and those hospitals will be included in the evaluation. Low cost and timely alternatives to burn injury control are a pressing need in many low- and middle-income settings and countries. This project is a determinant step in that direction and can lead to the implementation of a viable, inclusive, and environment friendly smartphone teleconsultation system to strengthen burn injury care in several resource poor settings, to benefit all, but mainly the poorest segments of the population.

Activity length

Delivery channel

Bilateral

Granting agency

The Swedish Research Council

Activity identifier

SE-0-SE-29-2015-03085_2-238-12182

Outdoor and household air pollution-exposure and effects on pregnant women in Africa USD 46 800

Medical Research

Description

In 2012, one in eight deaths worldwide resulted from air pollution. For Africa lack of data is a barrier to estimate effects. Satellite images indicate detrimental levels, but monitoring and high resolution outdoor air pollution modelling is lacking. Household air pollution is also a major source of exposure, more knowledge on how different cook stoves, fuels and habits affect exposure is crucial. No high quality study of the effect of outdoor and indoor air pollution on pregnant women in Africa has so far been conducted. We will investigate consequences of air pollution in a prospective cohort of women recruited during pregnancy at public health facilities in Ethiopia. Outdoor air pollution will be assessed by high quality modelling which combines measurements with Geographical Information System tools and aerial and topographical imaging. Individual exposure will be linked to the model by residential address. Indoor exposure will be assessed by questionnaires and validated by measurements. Emission factors from different fuels and cooking methods, and particle characteristics will be assessed in our Aerosol Lab in Lund. Data on pregnancy outcomes, exposures and confounders will be compiled and epidemiological studies on the effect of outdoor and household air pollution on pregnancy complications will be done. This study, which will increase knowledge of not only health impact but also of source characteristics, will provide important knowledge for appropriate policy making.

Activity length

Delivery channel

Bilateral

Granting agency

The Swedish Research Council

Activity identifier

SE-0-SE-29-2016-05677_2-238-12182

A knowledge translation through complex interventions - Improving health and care for children and adolescents living with long-term illnesses in Ethi USD 46 800

Medical Research

Description

We aim to develop and evaluate models of complex interventions to improve the health of children and adolescents. The collaboration has two components; a course in complex interventions and two research studies focusing on children and adolescents living with HIV in Ethiopia. The project will build on an integrative synthesis of previous and ongoing research projects using a framework for complex interventions. The training will focus on translating knowledge and skills from well experienced Swedish and Ethiopian scholars to different collaboration projects building on the fruitful collaborations between Lund University and Addis Ababa University but include additional universities in Ethiopia and Iceland. The course will be delivered in workshops and seminars, alternating between Swedish and Ethiopian institutions and thereby forming a knowledge translation between different contexts in both countries. Two complex interventions will proceed during the three- year period; the effectiveness of interactive text messaging in improving compliance to care among children and adolescents receiving HIV treatment. The collaboration includes competences from three countries including a wide range of scientific disciplines and will result in 6-12 collaborating research projects that will enhance the possibilities for a mutual multi-scientific long-term collaboration in research for improving children's and adolescents' health in low income countries.

Activity length

Delivery channel

Bilateral

Granting agency

The Swedish Research Council

Activity identifier

SE-0-SE-29-2016-05706-238-12182

Strengthening the grip on HIV in Ethiopia - tracing transmission and antiretroviral drug resistance in the era of scaling up HIV care USD 45 630

Medical Research

Description

The overall purpose of this project is to strengthen the ongoing collaboration between the Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia and Lund University, Sweden. We outline a collaborative HIV research project, using technology and transfer from Sweden to enable laboratory assays and data analysis to be established and conducted at EPHI. The project also includes knowledge transfers and training opportunities for EPHI investigators in laboratory based investigations, sequence data management and analysis, and in disseminating research findings in international forums, with the aim of increasing scientific publications in peer-reviewed journals with EPHI scientists as first author. The partnership will allow us investigate patterns of antiretroviral drug resistance in Ethiopian human immunodeficiency virus (HIV) positive individuals – both before and during antiretroviral therapy (ART) – through virological, molecular epidemiology and socio-demographic characteristics. It will also allow us to extend our studies to include state-of-the art molecular epidemiology investigations of HIV to specifically address transmission routes between high-risk populations (female sex workers and long distance truck drivers) and the general population. This will be the first large-scale population study of antiretroviral drug resistance since the roll-out of ART in Ethiopia and it will provide valuable information on the current status of the HIV epidemic in the country.

Activity length

Delivery channel

Bilateral

Granting agency

The Swedish Research Council

Activity identifier

SE-0-SE-29-2015-05842-238-12182

Prevention of severe respiratory infections among children below 5 years in Ethiopia. USD 28 665

Medical Research

Description

Pneumococcal infections are the leading cause of death among children below 5 year worldwide.Ethiopia is among the 10 countries with the highest disease burden. A pneumococcal conjugate vaccine (PCV) has given to all children in Ethiopia since 2011, but the effect on the disease is not known. The good response seen in USA and Europa may not be repeated because of diferences in serotype distribution and virulence among strains of some serotypes. We plan to investigate the serotype distribution and resistance among pneumococci from children with clinical infections and asymptomatic carriers. Clinical data and level of antibiotic resistance will be related to the serotypes in available vaccines. Indoor air pollution has been found to be a leading cause of morbidity where the food is cooked on open fire with insufficient ventilation. The children in the houses are exposed to smoke, which is likely to be a risk factor for respiratory infections. The air quality will be determined by measuring the carbon monoxide (CO) concentration since CO is a known tracer of incomplete combustion. However, the relation between carbon monoxide levels, airway inflammation and bacteriology in children has not been studied. 100 children living in homes where the food is cooked indoors on open fire without chimney will be compared with 100 children from homes with other forms of cooking. We also plan to study the effect of an intervention with a sun-powered fan.

Activity length

Delivery channel

Bilateral

Granting agency

The Swedish Research Council

Activity identifier

SE-0-SE-29-2014-4330-238-12182

A clinical scoring tool for point-of-care diagnosis of tuberculosis - a cluster randomized trial for the use of TBscore USD 20 475

Medical Research

Description

The WHO estimate that at least 3 million people with tuberculosis (TB) remain undiagnosed. In a previous network project between Sweden, Ethiopia, Denmark and Guinea Bissau, we have developed a clinical scoring tool (TBscore) aimed for low resource settings, which may increase the diagnostic yield of TB. The tool is an immediately assessable clinical index which accurately describes the risk of active TB disease and mortality prognosis, requiring only limited training and no use of expensive reagents. We plan to conduct a cluster-randomised trial in 2017-19 at health care facilities in Ethiopia and Guinea Bissau to evaluate the TBscore for increasing the diagnostic yield of TB among TB suspects compared with standard care. The main outcomes will be increase in number of patients diagnosed with TB compared with baseline and standard care in nonintervention clinics and 6-month mortality. A central part is to maintain the link in the network which will be a strong benefit for all partners and will enable this multi-center randomized trial and build capacity for future clinical trials. The interaction will involve several capacity building parts such as training of post docs and PhD students as well as training in TB diagnosis, GCP and statistical methods. New case finding strategies adopted for high endemic areas are essential in order to reach the goal of reducing TB world-wide.

Activity length

Delivery channel

Bilateral

Granting agency

The Swedish Research Council

Activity identifier

SE-0-SE-29-2016-05608_1-238-12182

Year Value (SEK) Value (USD)
2019 SEK 1,9 m USD 220 k
2018 SEK 18,7 m USD 2.2 m
2017 SEK 14,5 m USD 1.7 m
2016 SEK 13,3 m USD 1.6 m
2015 SEK 1,1 m USD 130 k
2014 SEK 13,5 m USD 2.0 m
2013 SEK 19,5 m USD 3.0 m
2012 SEK 3,9 m USD 578 k
2011 SEK 16,1 m USD 2.5 m
2010 SEK 18,5 m USD 2.6 m
2009 SEK 5,1 m USD 665 k
2008 SEK 160 t USD 24.0 k
2007 SEK 3,2 m USD 472 k
2006 SEK 4,9 m USD 664 k
2005 SEK 6,9 m USD 920 k
2004 SEK 5,5 m USD 743 k
2003 SEK 6,6 m USD 816 k
2002 SEK 13,2 m USD 1.4 m
2001 SEK 5,3 m USD 513 k
2000 SEK 17,9 m USD 2.0 m
1999 SEK 12,6 m USD 1.5 m
1998 SEK 18,1 m USD 2.3 m

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Ethiopia

Human Development Index
174
(Ranking 187 countries, 2015)
Gross Domestic Product (GDP)
573.6
(Per capita in USD, 2014)
World’s aid (ODA) as percentage of GDI
8.0 %
(ODA, 2014)
Swedish part of total aid (ODA)
1.0 %
(ODA, 2014)

Health

Health sector policy, public health administration, education, training and research, laboratories, clinics, hospitals and ambulances. Dental sevices, mental care, drug and substance abuse control, and medical rehabilitation.