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Pneumonia is the leading infectious cause of death among children under 5. Clinical trials, observational studies, and systematic reviews to inform guidelines for the care of children with pneumonia in hospitals aim to determine how to best preserve existing treatments, and look for new alternatives. Working in hospitals with practicing clinicians provides a unique insight applicable in real world settings.

My name is Ambrose Agweyu, I am a pediatrician and epidemiologist working at the KEMRI Wellcome Trust Research Programme as a clinical research fellow with the Health Services Unit. I joined in 2009, developing an emerging area of work around childhood pneumonia. Since then I have been involved in clinical trials, observational studies, and systematic reviews to inform guideline development for the care of children with pneumonia in hospitals.

My research can help us fight tropical illnesses, because pneumonia is the leading infectious cause of death among children aged under 5. Almost 900,000 children die of it every year, and most of these deaths occur in low and middle income countries. The research I am involved in aims at understanding the effectiveness of currently recommended treatments and looking for new alternative treatments for pneumonia, which is particularly important in fighting tropical illnesses.

Our current work is funded by DFID/ NIHR/ MRC/ & Wellcome Trust Joint Global Health Trials scheme. It is a large study that is taking place in 12 sites, recruiting over 4,000 children to investigate alternative antibiotic treatments for pneumonia in hospitalised children. It also looks at approaches to giving supportive care for these children with pneumonia.

While new drugs are being developed, it’s also important to consider research around approaches to preserving currently existing treatments. I believe work around vaccines, work around antimicrobial resistance and understanding ways in which we can reduce resistance to currently available treatments is particularly important now. I also think that research in health systems is also an emerging area of importance. All these new treatments which we develop will eventually be delivered in hospitals with various levels of resources. Health systems research aims at improving and optimising the delivery of these interventions within contexts which might not be optimal necessarily.

My line of research is important because infectious diseases remain a leading cause of illness and death in children. The work I am involved in we refer to it as “pragmatic” because it aims at generating evidence that is applicable in real world settings. Settings where you might have health worker shortages which is common in our hospitals, settings where treatments may not necessarily be delivered in the ideal way. The work I’m involved with, working in hospitals and doing research with practicing clinicians provides a unique type of evidence which is applicable in real world settings.

My research fits in with translational medicine because we work very closely with hospitals where care is delivered. I am also part of technical panels in the Ministry of Health, where we’ve been sharing our findings and working with them on how to translate that evidence into policy. A good example is a research we conducted in 2011-2013, which was discussed by a guideline panel convened by the Ministry of Health in 2014, and eventually contributed to a major guideline revision for the care of children with pneumonia. I also sit on a technical panel with the WHO, and recently they convened a meeting where they specifically discussed some of the evidence which we had generated, and its relevance to a possible change in their global guidelines for treating children who present with signs of pneumonia in hospitals.

This interview was recorded in May 2019

Ambrose Agweyu

Ambrose Agweyu is a paediatrician and clinical epidemiologist with broad interests in pragmatic clinical trials, childhood respiratory illnesses, and clinical guideline implementation. He leads a large Phase III trial to study alternative injectable antibiotics and approaches to providing supportive care for children hospitalised with severe pneumonia.

Translational Medicine

From bench to bedside

Ultimately, medical research must translate into improved treatments for patients. At the Nuffield Department of Medicine, our researchers collaborate to develop better health care, improved quality of life, and enhanced preventative measures for all patients. Our findings in the laboratory are translated into changes in clinical practice, from bench to bedside.