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Research Centres in the College

The following research units/groups/centres function in the College:

 

Oculocutaneous Albinism

 

Eye movements are affected by various eye and systemic disorders. The Discipline of Optometry recently purchased a Chronos eye tracker which facilitates measurement of three dimensional eye movements. It is to be used in studying eye movements in various eye diseases and anomalies. One of the projects that are in preparation is the study of eye movements in albinism. Albinism is a group of inherited disorders of melanin, characterized by generalized reduction in pigment of hair, skin and eyes and is one of the most common inherited disorders in Africa. The deficiency in melanin has underlying associated neurological problems such as misrouting of the retino-cortical nerve fibres at the optic chiasma, which might cause reduced stereoscopic vision. Albinism is associated with several eye and visual anomalies which include foveal hypoplasia, refractive errors, poor visual acuity, poor contrast sensitivity, nystagmus and photophobia; all of which can degrade eye movements. 

 

Effective coordination of the vertical and horizontal saccadic eye movements ensure the location of object of regard on the fovea, which facilitates single binocular vision.  Abnormal routing of the retino-cortical fibres and visual impairments such poor visual acuity, poor contrast sensitivity, which are associated with albinism can influence binocular saccades and binocular coordination. Saccadic eye movement in individuals with albinism has not been studied. The quality of binocular saccadic eye movements in individuals with albinism is to be studied in this project.  Movements such as the vertical and horizontal saccades (right and left eyes) will be studied at various distances and eccentricities with the video oculography (chronos). This study has implications for functional eye movements in persons with albinism. The research group is headed by Professor Olalekan Oduntan

 

 

 

Anaesthetics

 

·                     SMART Centre (Simulated Modules in Anaesthesia and Resuscitation Training)

The SMART* Centre located in the Department of Anaesthetics at Inkosi Albert Luthuli Hospital has the latest in the state of the art hi-fidelity human patient simulators.  The centre is currently used in the training of medical students, physicians, nurses and other allied health professionals at our institution. Airway management, complex anaesthetic scenarios, advanced life support as well as ultra sound workshops are some of the exciting programmes currently being offered. High-fidelity patient simulation is an effective way to replicate real-life clinical scenarios. It is an excellent tool to evaluate the response of trainees to a wide array of programmed clinical scenarios. This method of teaching brings back the excitement of working on "real patients" without the risk of death or injury. In addition, the centre is actively involved in research into training and assessment methods.

 

·                     Perioperative Research Unit

The Perioperative Research Unit was established in 2010, its main goal being to promote African scholarship through relevant evidence-based perioperative clinical research to the benefit of our patients. The research focus is predominantly within the area of ‘Population Health’ and in the specialist areas of ‘Cardiovascular and metabolic disease and HIV/AIDS’ with particular reference to the perioperative period.

 

Under the leadership of Dr Bruce Biccard, the unit is currently actively involved in inter alia two major international projects. The unit is the only African site recruiting patients for the Vascular events In noncardiac Surgery patIents cOhort evaluatioN (VISION) Study, a major multicentre study that will recruit 40 000 patients worldwide, and will realistically rewrite perioperative medicine. The unit is also the principal site in South Africa for the PeriOperative ISchemic Evaluation-2 (POISE-2) Trial, an interventional trial of clonidine and aspirin for prevention of perioperative mortality and myocardial infarction in patients with, or at risk of, atherosclerotic disease who are undergoing noncardiac surgery.

 

The unit has multiple national and international collaborations, works closely with many other departments including Cardiology, and is providing a fertile ground for many Masters and PhD students.

 

 

Chemical Pathology

There are 3 focus areas:

·                     Metabolomics: Human metabolomics involves measuring biological fluids that consist of a mixture of metabolites of different concentrations, and this makes-up the over all biochemical profile. The molecules are measured in an unbiased manner and once the profile is obtained it is characterised and compared to other profiles. In doing so, one can then determine the physiological state of a person. Different biofluids, such as serum, urine, cerebrospinal fluid to name a few have been used successfully to identify different pathophysiological states.

In this group we are measuring and comparing profiles of biofluids to identify potential biomarkers of patients with infectious diseases as well as other metabolic diseases. We apply both nuclear magnetic resonance (NMR) and Mass spectra (MS) based metabolomics to measure the biochemical samples. We are also focused on more detailed mechanistic studies – measuring the metabolic profile of tissue cultures to gain a better understanding of the diseases and effects of drugs at a cellular level.

 

·                     Proteomics

 

·                     Intracellular Signalling

 

 

Diabetes and Endocrinology

The Diabetes/Endocrine unit was set up in the 1970’s under the able leadership of Professor A.C. (Kader) Asmal, who in the early 1980’s, emigrated to the United States of America. Professor M.A.K.Omar was his protégé and successor until 1987. Since the early days, the unit has been active in research mainly in the area of diabetes.  In 2004, the unit changed to the Department of Endocrinology and in 2007 to the Department of Diabetes and Endocrinology.  

 

The Department offers Masters and PhD programme in the field of Diabetes and Endocrinology.

Current Clinical Research

  1. Epidemiology of diabetes, obesity and metabolic syndrome in rural South Africans of Zulu descent
  2. Audit on the outcomes of management of diabetes patients attending the diabetes clinic at Inkosi Albert Luthuli Central Hospital
  3. Epidemiology and pathogenesis of Diabetes Mellitus and its complications in South African Indians.
  4. Cardiovascular risk profile of an urban working class community.(Collaboration with Prof D.P. Naidoo)
  5. A genome-wide association study (GWAS) of type 2 diabetes mellitus susceptibility loci in African subjects of Zulu descent in Durban, KwaZulu-Natal.
  6. Measured glomerular filtration rate (mGFR) and estimated glomerular filtration rate (eGfR) in patients with diabetes mellitus at the Inkosi Albert Luthuli hospital (IALCH) diabetes clinic, Durban.

 

Current Postgraduate Research students

1. Radio-active Iodine in the management of Thyrotoxicosis

2. A prospective evaluation of the relationship between glycated serum albumin, urinary and serum  

    components of capillary basement membrane and diabetic nephropathy in type 1 diabetes.

3. The investigation of the genetic, biochemical, immunologic, clinical and diagnostic features  

     of coronary heart disease in African and Indian subjects with type 2 diabetes.

4.  Metabolic Complications of HAART in a South African Black Population.

5.  Acute Hyperglycaemic Emergencies at a District and Regional Hospital in KwaZulu-Natal, South Africa.

6.  Metabolic syndrome and severe mental illness in the Ethekwini district of KwaZulu-Natal,

     South Africa.

 

 

 

 

 

Human Performance Laboratory

The Human Performance Laboratory (HPL) was established in 2009 and is a cutting-edge and vibrant home of research activity within the Department of Biokinetics, Exercise and Leisure Studies as well as the School of Health Sciences. The HPL provides a research training environment with multiple opportunities for postgraduate research students and staff to develop their contextual academic, theoretical, technical and research methods skills. 

 

The aim of the Human Performance Laboratory (HPL) is to provide Research Training and Research Outputs of an international standard. Postgraduate students have access to state of the art research equipment. The HPL provides a focus for research activities ranging from studies at cellular level to whole-body responses to exercise and from elite athletes to novices at physical activity.  Current research groups include Cardiovascular Science, Muscle Physiology and Metabolism, Physical Activity, Recreation, Leisure, Exercise and Health, Sports Injury Prevention and Epidemiology, and Exercise Immunology.

 

The Discipline of Biokinetics, Exercise and Leisure Sciences has established numerous research collaborative agreements with National and International Institutions as well as other Departments within the University of KwaZulu-Natal. 

 

A few of the major research projects currently being conducted in the Discipline and the HPL include:

 

1) The examination of the impact of high intensity interval training on lipolysis and cardiovascular risk factors in obese individuals. This project is a collaboration between East Carolina University (Department of Kinesiology), the University of Zululand (Department of Biokinetics and Sport Science) and the UKZN Department of Anaesthetics. The project is funded by the South African National Research Foundation until 2014. Using a technique called microdialysis, numerous immune, inflammatory and cardiovascular risk biomarkers are being sampled from the interstitial fluid of subjects before and after participating in a 12 week high-intensity training programme. This project has important implications for understanding the mechanisms that can explain how exercise improves the health of obese individuals.

 

2) Immune, hormonal and fall risk responses to resistance training in the elderly. In collaboration with the Department of Geriatrics and the UKZN Research Office, this research project is examining whether a resistance training programme will have an impact on the immune system and anabolic hormone responses in the elderly as well as their fall risk. This project has implications relating to the benefits of strength training, specifically those individuals who are living in homes for the elderly.

 

3) Impact of nutritional interventions on recovery from exercise-induced skeletal muscle damage. In collaboration with Florida State University (Department of Nutrition, Food and Exercise Sciences), the project is examining whether nutritional interventions or supplementation prior to muscle damaging exercise will improve recovery time after the exercise. This project has important implications for strength and conditioning practices in athletes and sports people.

 

4) Relationship between physical activity and immune and inflammatory markers in pre-adolescent children. Research has shown that childhood obesity is a major public health problem. Obese children are developing type 2 diabetes as well as cardiovascular disease. These chronic diseases are associated with chronic low-grade inflammation. The project aims to identify whether non-invasive saliva samples are useful for identifying low-grade inflammation in obese children.

 

5) Protein supplementation and resistance exercise for treating the metabolic syndrome in HIV patients. In collaboration with Florida State University (Department of Nutrition, Food and Exercise Sciences) this project will examine whether daily protein supplementation combined with resistance exercise will play a role in reducing the markers of the metabolic syndrome in HIV infected patients. It has been demonstrated that these patients are living longer than in the past but are developing chronic diseases such as cardiovascular disease and diabetes. The project has implications for promoting the use of protein supplements and/or resistance exercise in HIV patients.

 

6) Hydration status and thermoregulatory responses in multi-stage trail running. In collaboration with the UKZN, Department of Human Physiology, the project examined the core temperature, thermoregulatory and hydration responses over a three day trail run. Participants swallowed special "tablets" that contained a thermometer and heart rate telemetry device which provided important information relating to core temperature and heart rate responses of the trail-runners. The study has important implications for understanding how the body adapts to ultra-endurance exercise and the hydration practices that should be followed.

 

7) Relationship between health and recreational facility use and availability within KwaZulu-Natal. This project is important for understanding whether recreational facilities are having an impact on the health of individuals living within KwaZulu-Natal communities. This study has an implications for the design and development of recreational facilities in disadvantaged communities.

 

8) Two research projects are currently being performed in the area of musculo-skeletal epidemiology:

 

a) Acute musculoskeletal stress and strain due to back pack loading in primary school children. This project examined the impact that back pack loading has on musculoskeletal stress, strain and pain in primary school children. This has implications for guidelines regarding the "safe" load that children should be carrying.

 

b) Work-related musculoskeletal pain among general surgeons. Surgeons work for long hours under extremely stressful conditions. It is crucial that information is obtained regarding their working conditions and body positions that they have to maintain during surgery and whether this has an impact on musculoskeletal pain.

 

 

 

 

CAPRISA – Centre for the AIDS Programme of Research in South Africa

CAPRISA was established in 2002 under the NIH-funded Comprehensive International Program of Research on AIDS (CIPRA) by five partner institutions; University of KwaZulu-Natal, University of Cape Town, University of Western Cape, National Institute for Communicable Diseases, and Columbia University in New York.  CAPRISA is a designated UNAIDS Collaborating Centre for HIV Prevention Research.

 

The main goal of CAPRISA is to undertake globally relevant and locally responsive research that contributes to understanding HIV pathogenesis, prevention and epidemiology as well as the links between tuberculosis and AIDS care. 

 

To achieve this goal, CAPRISA conducts research in four main Scientific Programmes namely: HIV Pathogenesis and vaccines, HIV and TB treatment, Microbicides, and Prevention and Epidemiology. A fifth area of research on the prevention of mother-to-child transmission is conducted mainly in partnership with other Centres. Each program has a focused set of projects.  .

 

In striving to undertake globally relevant and locally responsive research on HIV prevention and treatment, CAPRISA has made several important scientific contributions in:

 

1.         Microbicides: conducted efficacy trials on Tenofovir gel and identified the role of genital immune activation in creating susceptibility to HIV infection. The finding that genital inflammation, through raised pro-inflammatory cytokines, and increased CD38+ T cells, is a potent predictor of HIV acquisition is central to the design of next generation microbicides.

 

2.         Epidemiology and Prevention: new information was generated on the epidemiology of HIV in the world’s most affected communities in KwaZulu-Natal, South Africa.  Gender inequity in HIV risk was a key finding - including one of the earliest descriptions of the centrality of young women’s high HIV risk when partnering with substantially older men, a key driver of the southern African HIV epidemic. The data generated by his team on the evolving epidemiology of HIV in South Africa, are widely used for national and local policy formulation and program development in South Africa. 

 

3.         HIV pathogenesis and vaccines: unraveling the mechanisms of viral immune escape in acute infection and how this impacts on HIV disease progression have led to two patented inventions which have been made publicly available and are part of four candidate HIV vaccines. The team has played a leading role in HIV vaccine research and development, including conducting the first HIV vaccine trial in South Africa.

 

4.         Treatment of TB-HIV co-infection: the current WHO treatment guidelines on integrated treatment of TB-HIV co-infection draw upon the results of CAPRISA 003 TB-HIV treatment trial. With rapid scale-up of integration of antiretroviral therapy into TB treatment, a new challenge has emerged – nosocomial spread of TB from co-infected individuals to susceptible HIV-positive patients in crowed waiting rooms. This is being addressed in the CAPRISA 005 study on risks of TB acquisition in HIV-positive patients.

 

CAPRISA’s clinical research is undertaken at three well established clinical research sites, including  the eThekwini Clinic, located in central Durban; the Vulindlela Clinic, located in rural KwaZulu-Natal; and the Umbilo Clinic, located at the Nelson R Mandela School of Medicine. Research activities at CAPRISA are supported by eight research support cores including, administration, statistics, data management, laboratory, community, pharmacy, bioethics, and information systems.

 

 

Breastfeeding and HIV/AIDS

Previously headed by the Victor Daitz Chair in HIV/Aids research, Professor Jerry Coovadia, this unit has produced pioneering work that now informs the World Health Organisation’s guidelines on breastfeeding. In 2007, UKZN’s Professor Coovadia, Professor Marie-Louise Newell, Professor Anna Coutsoudis and Dr Nigel Rollins found that HIV-1 infection was significantly reduced from mother to child through exclusive breastfeeding during the first six months of life. The World Health Organisation adopted the findings which have been included in their breastfeeding guidelines.

 

 

Antimicrobial  Resistance

The Antimicrobial Resistance Research Proto-Unit was established in Pharmaceutical Sciences by Professor Sabiha Essack, who is Chapter Leader for the South African Chapter of Alliance for the Prudent Use of Antibiotics (an international NGO).  The Unit has as its overarching objective the optimisation of antimicrobial therapy in the face of escalating resistance within a public health system facing an ever-increasing incidence of infections and infectious diseases corresponding with the HIV/AIDS prevalence in the country. The research conducted takes a pharmacovigilance perspective and impacts on the National Health Policy in terms of amendments to standard treatment guidelines (STGs) and the essential drugs list (EDL). 

 

The research encompasses surveillance within state hospitals in KwaZulu-Natal, the molecular epidemiology of antimicrobial resistance and the delineation of resistance phenotypes and genotypes ranging from sensitivity testing to DNA sequencing of resistant genes and the genetic determinants of resistance.  Resistance to beta-lactam antibiotics, amino glycosides, fluoroquinolones and macrolides is prioritized, as is resistance in Acinetobacter spp., Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus spp., Pseudomonas aeruginosa and Staphylococcus aureus.

 

Resistance as a consequence of qualitative and quantitative antibiotic use is also investigated as are related aspects such as risk factors, clinical significance, infection control, pharmaco-economics and dose optimization in the context of population-specific drug pharmacokinetics and pharmacodynamics.

 

 

Pregnancy and HIV/AIDS

Ongoing studies within the Department of Paediatrics and Child Health and Obstetrics and Gynaecology have surveyed the transmission of HIV-1 infection from mother to child during pregnancy and at birth. These studies transcend across Africa. A major finding has been the increased number of still-births in communities where the epidemic has been present over long periods. In the rural population of KwaZulu-Natal, the group found that adverse pregnancy outcomes such as maternal antenatal deaths, spontaneous abortions and stillbirths were significantly common among HIV infected women.

 

 

The Enhancing Care Initiative (ECI)

The Enhancing Care Initiative (ECI) was established in 1998 as a multi-country programme.  It started as a partnership between Harvard School of Public Health AIDS Initiative, the François Xavier Bagnoud Centre for Health and Human Rights and the Department of International Health at the Harvard School of Public Health, as well as the ECI sites in Puerto Rico, Sao Pãolo Brazil, Senegal, and Thailand. ECI has established itself as an independent, self-funded Programme within the College. The goal of ECI is to create concrete improvements in the care of people living with HIV and AIDS in resource constrained settings. Under the Executive Directorship of Professor Umesh Lalloo, ECI focuses on providing research, teaching and training to improve the quality of HIV and AIDS care in the Province of KwaZulu-Natal (KZN) and beyond.

 

The teaching/training component offers two primary University qualifications namely, a Diploma in Clinical HIV/AIDS Management and a Masters in Clinical HIV/AIDS Management. The programme commenced in 2004 and is offered to doctors, nurses and other relevant health care professionals. This is the only Coursework programme of its kind in South Africa and has attracted candidates from all over the country and other parts of Africa. In order to reach the most rural and distant health care workers, the programme was approved as a mixed mode programme and adapted to a video-conferenced format. An IT platform was set up by the Department of Telehealth and the KZN Department of Health in various parts of KZN and the Course is conducted as a distant-based programme utilising this IT infrastructure, thereby allowing access to individuals from the most distant rural areas.

 

ECI has been awarded a grant from the National Institute for Mental Health (NIMH) to conduct research in developing a prevention strategy for HIV and integrating this into clinical care. This is a collaborative study between ECI, University of Connecticut, University of West Ontario and Yale University. The OPTIONS Study seeks to develop and deliver a behaviour modification strategy that is easily administered in routine clinical care among people living with HIV and Aids. The study is opportune given the increasing focus on prevention among HIV infected individuals. The South African Government’s five year strategic plan includes a focus on prevention among HIV positive people. The OPTIONS Study is headed by Professor Umesh Lalloo and Dr Sandy Pillay and is conducted in the uMgungundlovu and uMkhanyakhude Districts of KZN. The grant received for the OPTIONS Study is the largest single grant awarded by the NIMH for a prevention study among HIV positive people.

 

ACTG and IMPAACT

The Aids Clinical Trials Group (ACTG), funded by the National Institutes of Health (NIH) Division of Aids is housed within ECI. Internationally, the ACTG is the largest clinical trials organisation in the world and continues to set standards for the treatment of HIV globally. The NIH recently awarded a grant to this site to form the Durban International Clinical Trials Unit (DICTU). DICTU is funded by the ACTG and the International Maternal Paediatric Adolescent AIDS Clinical Trials Group (IMPAACT) Networks to conduct clinical trials in both Adult and Paediatric fields of HIV and AIDS care.

DICTU has clinical research facilties in King Edward VIII and Wentworth Hospitals and has completed 6 Adult and 2 Paediatric studies in HIV and TB. DICTU is one the most successful international sites of ACTG and IMPAACT with a high research output. Most recently, this site was one of the largest contributors to the Strategy Study of Immediate Versus Deferred Initiation of ART (STRIDE) Trial, which addressed the issue of timing of ART in HIV and TB co-infected patients.

DICTU’s recent acquisition of a research facility at the Wentworth Hospital has heralded new opportunities in HIV and TB Research. A collaborative study with the KwaZulu-Natal Research Institute for HIV and TB (K-RITH) is at an advanced stage and many new research studies are imminent.

 

 

Nutrition and HIV/AIDS

A number of research projects are focused on the link between nutrition and HIV infection, in conjunction with the guidelines set by the World Health Organisation and the realities of poverty-stricken South African communities. Studies have found there is a significant link between HIV and nutrition which manifests itself in the following two ways: (1) HIV causes wasting and defines the macronutrient and micronutrient requirements of adults and children affected with the virus; and (2) the food insecurity may increase risk transmission behaviours and susceptibility to HIV once exposed.

 

Paediatric HIV/AIDS

This group based within the Department of Paediatrics and Child Health focuses on the management of paediatric HIV infection from antiretroviral drug adherence to nutrition.

 

 

HIV Pathogenesis Programme

Headed by Professor Thumbi Ndung’u, the HIV Pathogenesis Programme is engaged in pioneering work in HIV vaccine design. A vaccine is viewed as the best solution to combating the disease as drugs used to treat the disease are toxic and cause negative side effects.

 

Another expert in the programme is Dr William Carr, an Instructor in Medicine at the Ragon Institute of the Massachusetts General Hospital (MGH) at Harvard and MIT in Boston, who has a joint appointment as a Senior Lecturer in the Department of Paediatrics at the University of KwaZulu-Natal.

 

Since 2006 Dr Carr has initiated a research program on innate immunity within the HIV Pathogenesis Programme. The mission of his research group is to do good, cutting-edge science and build capacity in South Africa through teamwork.

 

Dr. Carr received his Doctorate of Veterinary Medicine (D.V.M.) degree in 1992 and a Ph.D. in immunology in 2004 from Stanford University where he trained in immunogenetics with mentorship from Professor Peter Parham. His research interests are in understanding the genetic basis of naturally occurring innate immune mechanisms underlying prevention of HIV-1 transmission and protection from HIV-1 disease progression among South Africans.

 

To address these questions he has initiated studies with cohorts of exposed, uninfected individuals (mother-child cohorts and adult cohorts), cohorts of acutely infected infants and adults as well as cohorts of chronically infected adults in South Africa.

 

His work is supported by grants from the National Institutes of Health (NIH), the Ragon Institute, MGH, and the South African AIDS Research Platform (SHARP). He currently is supervising postgraduate students (1 Ph.D. student, 1 Masters student, 1 research fellow, and 1 Durban University of Technology in-service trainee) at UKZN and has two research technicians. To address his scientific questions he uses genetic typing and sequencing, molecular biology approaches (recombinant proteins, reporter constructs and qRT-PCR), multiparametric (LSRII) flow cytometry, and cellular immunology techniques as well as in vitro virus inhibition assays. The aim of his work is to develop novel strategies for HIV vaccine development which exploit mechanisms of naturally occurring immunity.

 

 

HIV and spinal co-infection

Novel research into the relationship between HIV and spinal infections has prompted work among orthopaedic surgeons, specialists in infectious diseases, radiologists, rehabilitation personnel, psychologists and social services. More recently the high incidence of HIV and TB co-infection amongst the KwaZulu-Natal population has initiated research into the pathogenesis of spinal tuberculosis.

 

 

African Traditional Medicine

National Research Foundation Chair in Indigenous Health Care Systems, Professor Gqaleni, has spearheaded research and a strong relationship between traditional healers in the province and the university. Several international collaborations exist where medical doctors, medical scientists and traditional healers have partnered to study the medicinal properties, safety and efficacy of several African plants used by traditional healers.

 

 

Rehabilitation

The Disciplines of Physiotherapy and Occupational Therapy have embarked on various research projects into the effects of HIV/AIDS treatments on physical and psychological rehabilitation. Studies have found that patients in hospitals in Durban on Highly Active Anti-Retroviral Treatment (HAART) tend to present new clinical manifestations. Due to the changing profile of these patients, physiotherapy and other modes of rehabilitation are often required. The discipline of occupational therapy has recently opened a Vocational Assessment Centre which will provide substantial opportunities for research in the field of occupational injuries.

 

 

 

Sexually Transmitted Diseases (STIs)

Several projects on the transmission, treatment and prevention of STIs are conducted within the College. The Centre for the Aids Programme of Research in South Africa (CAPRISA) has an established clinical research site in eThekwini which has recorded approximately 40 000 cases of STIs annually.

 

 

Biomedical Resource Unit (BRU)

The BRU is one of the largest laboratory animal facilities in South Africa. Opened in 1988, the intention was to meet the scientific needs of teachers and researchers in the area of biomedical sciences. The Unit houses and breeds a variety of research animal modes under the highest ethical and international standards. Currently the Unit breeds minimal diseased animals.

 

 A unique feature of the Unit is a barrier system to ensure the disease-free status of the animals by means of a computer controlled access system. The Unit assists in the sterilization programme of feral cats on the Westville campus and provides veterinary expertise to the Mitchell Park Zoo and the Natal Sharks Board. It also assists fellow institutions such as the Durban Institute of Technology, the University of Western Cape, the University of the Free State and the University of Zululand.

 

Rural Health

The Centre for Rural Health exists to facilitate the realisation of optimal health care and quality of life for undeserved and marginalized rural communities through the health system, rural community and the University of KwaZulu-Natal. The centre was formed in 1987. Some of the Centre’s programmes involve capacity building of hospital managers, health equity, antiretroviral roll-out in rural areas, improving KwaZulu-Natal neo-natal care, prevention of mother-to-child transmission of HIV and the development of research skills among health professionals in Uthungulu, Zululand and Umkhanyakude.

 

Health Outcomes Research Unit

The Health Outcomes Research Unit (HORU) was established to carry out outcomes research for all sectors of the healthcare industry and to strengthen capacity within the fields of health outcomes and in particular health- and pharmaco-economics.

The Unit has a large research portfolio and since its inception has been associated with a series of projects and research applications which have been submitted to a wide range of funding bodies including the Medical Research Council (MRC), the Provincial and National Departments of Health, PEPFAR and the European Union.

 

 

Optics and Imaging Centre

The objectives of the Optics and Imaging Centre (OIC) includes the provision of an active and dynamic program of collaborative research between the various academic and clinical disciplines in the College. It provides visual confirmation of scientific facts and findings conforming to the old adage: a picture paints a thousand words.   

 

The Centre serves three main areas of activity in microscopy: (1) the development and application of analytical ultra-structural tools for cellular biology, virology and microbiology in studies requiring both standard electron microscopy procedures as well as specialised techniques such as immuno-gold labelling and cell cultures; (2) other types of microscopy such as brightfield, fluorescent, phase contrast, immunocyto chemistry and image analysis, and (3) teaching and training activities.

 

KwaZulu-Natal is considered the epicentre of the global HIV pandemic.  Prof T Naicker, the Head of the OIC, and her postgraduate students are involved in different aspects of the aetiology of HIV associated preeclampsia. The occurrence of both HIV/AIDS and preeclampsia is high in South Africa and other developing countries.  Whether HIV lowers the rate of preeclampsia is controversial? 

 

 

Drug Delivery Systems and Nanotechnology

Headed by Professor Thirumala Govender of the School of Pharmaceutical Sciences, this research group has been recognised both nationally and internationally for their work in the development of novel drug delivery systems for the buccal route. A recent study investigated the potential of the buccal route for the delivery of antiretroviral drugs to overcome their many side effects. The group also focuses on research into nanomedicine to prevent, diagnose, treat and monitor disease.

 

 

 

The Columbia University-Southern African Fogarty AIDS Training and Research Programme

This training and research programme, led by Professor Quarraisha Abdool Karim, builds scientific capacity in HIV and AIDS and Tuberculosis research in several countries in Southern Africa to enhance continuing efforts to counter HIV and TB epidemics.

 

 

 

Occupational and Environmental Health

The Centre for Occupational and Environmental Health (COEH) was formally launched in 2003 but its roots go as far back as the mid-1980s. It was granted a Department status in 2007. The Department brings together some of the more experienced practitioners in occupational and environmental health in the country.

 

Headed by Professor Rajen Naidoo, the DOEH brings together extensive academic training skills, research experience, community and trade union relationships as well as key national and international initiatives. It is a leading organisation in the promotion of worker and community health addressing critical issues in occupational and environmental health. In total, DOEH has a combined experience of about 40 years in the field of Occupational and Environmental Health.

 

Childhood TB and indoor air pollution

Indoor air pollution has been associated with increased risk for lung diseases. The number of cigarette pack years has been associated with the risk of acquisition and development of TB in adults.  Passive smoke and other air pollutants exposures are associated with a 1 to 5 fold increased risk of acquisition of childhood tuberculosis as determined by questionnaires about the use of biofuels in cooking, heating and lighting in households. No studies to date have measured the exposure of indoor pollutant levels directly.  This study investigates the association between exposure to indoor air pollutant level and childhood tuberculosis by quantifying pollutant levels.

 

A case controlled study households of children 14 years and younger with and without culture confirmed PTB is being undertaken.  Five hundred and thirty four will serve as a pollutant to optimise the study methodology.  Environmental assessment of the children’s homes is being conducted using walkthrough checklist and indoor monitoring of air pollutants (particulate matter, sulphur dioxide, nitrogen dioxide and metals) for a 24 hour period at least three times in each household.  Socioeconomic conditions of the children’s households are assessed as well.  Statistical models, such as logistic regression, are used to determine the association between PTB as an outcome variable and indoor pollution levels as independent variables. Covariates, such as socioeconomic status, crowding, etc. are factored in. It is believed that the level of indoor pollutants will be directly related to the risk of acquisition of TB as a result of direct injury of the respiratory epithelia by air pollutants. This allows easy entry of TB bacillus.  The outcomes of this study will include understanding the dose-response relationship of PTB and indoor pollutant levels in homes.  This will in turn highlight some mechanisms that maybe useful in understanding the disease.

 

 

Molecular Pharmacology Research Unit

Situated in Pharmacology, the unit which was conceptualized in 2008, is headed by Dr Peter Owira. Currently the research thrust is focused on pharmacological profiling of the grapefruit in the management of Diabetes and Cardiovascular Diseases. The unit’s research thrust is on isolating and characterizing bioactive chemicals in the grapefruit juice that may be responsible for its apparent pharmacological actions, elucidating the molecular mechanisms involved and developing them into putative therapeutic agents.

 

Groundbreaking findings have been published in peer-reviewed, high impact factor international journals such as Cardiovascular Journal of Africa, Methods and Findings in Clinical and Experimental Pharmacology and the Journal of Cardiovascular Pharmacology.

 

The unit was recently awarded a Career Development Award of R1 million over the next four years by the Medical Research Council of South Africa (MRC).

 

 

Urology

·                     Long-term follow-up of 70 spinal cord injury patients. Several projects are running concurrently:

1.       Metabolic indicator changes.

2.       Changes in levels of Testosterone over time since injury

3.       Comparison of bladder hostility factors and renal function preservation.

Facets of this study is done with Rand Mutual Assurance, Men’s Health of SA and South African spinal Cord Association.

 

·                     Comparison between erectile function and penile blood flow in patients with other vascular dysfunction.

·                     Various techniques of managing the renal pedicle during laparoscopic nephrectomy. This study is supported by the International Endourological Society.

 

 

The Doris Duke Medical Research Institute (DDMRI)

The R40 million Doris Duke Medical Research Institute provides multi- and trans-disciplinary research and training facilities for scientists to investigate and find solutions to the diseases of Africa, specifically those that medically and socially afflict the poorest and most vulnerable in South Africa and sub-Saharan Africa.

 

The institute’s facilities include ten specialised laboratories housing molecular virology, biochemistry, infectious diseases and immunology sciences; a P3 laboratory; a clinical trials unit; several multi-disciplinary research centres, a conference facility and an HIV-AIDS library.

 

 

The Africa Centre for Health and Population Studies

The Africa Centre for Health and Population Studies was established in 1997 by the University of KwaZulu-Natal, the South African Medical Research Council, and the UK based charity, the Wellcome Trust. The Centre was created by these bodies to conduct and support research addressing pressing population and reproductive health questions affecting people in sub-Saharan Africa.  The Centre has been based since its inception in the Umkhanyakude district of KwaZulu-Natal, where the burden of disease from HIV is immense.  Its currently has its headquarters at Somkhele in KwaZulu-Natal, with access to laboratories and offices at the University in Durban. The Centre is a two-hour drive from Durban where a cohort of 90 000 households are part of the on-going data collection. The innovative building housing this Centre has won numerous architectural awards.

 

Over the past few years, the Centre has evolved from a Research Centre focused on description to one focused on intervention and treatment. The detailed knowledge of the local community - based on the Africa Centre Demographic Information System as well as the well-resourced Hlabisa Health Sub-District Anti-Retroviral Treatment (ART) programme - places the Africa Centre in a unique position to measure the long-term impact of a population with access to well-functioning and comprehensive ART in a resource-poor, rural setting.

 

 

KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH)

A ground-breaking partnership between the University of KwaZulu-Natal and the Howard Hughes Medical Institute (HHMI) in the United States has established a US$60 million (R480) research centre focused on making major scientific contributions to the worldwide effort to control the devastating co-epidemic of HIV and Tuberculosis (TB). This is the largest infrastructural investment by the HHMI outside the USA. The cross Atlantic partnership reflects a shared view that direct and substantial investment in basic, clinical and translational research in the heart of the pandemics of HIV and TB will yield significant discoveries that will alleviate human suffering caused by these diseases.

 

K-RITH housed at the medical campus will feature a six storey facility with two floors of high level biosafety (BSL-3) laboratories equipped for TB research. HHMI investigators and UKZN scientists collaborate with colleagues at TB centres throughout KwaZulu-Natal in research efforts that focus on the diagnosis, pathogenesis, treatment and prevention of TB and HIV.

 

KwaZulu-Natal, home to more than 10 million people, has the highest burden of disease with more than 40% of its population infected with HIV/AIDS. The region became an international focus with the outbreak of Extremely Drug Resistant TB (XDR-TB) in the rural area of Tugela Ferry.

 

TeleHealth

 

The Department of TeleHealth was formed in 2002 and provides postgraduate programmes in both Telemedicine and Medical Informatics. The Department is actively involved in international initiatives in capacity development in Medical Informatics in sub-Saharan Africa through a Fogarty International Training Program Grant. This involves teaching students and staff in other African Universities using videoconferencing. eLearning is one of the research themes and the department has over 10 years’ experience in videoconference and asynchronous eLearning. Other research themes are e-Health economics, legal and ethical issues of telemedicine in sub-Saharan Africa, e-Health implementation research and the use of machine learning to predict HIV mutation and CD4 count.


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