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James Berkley

Global childhood infection & immunity

Jay Berkley is based at the KEMRI Centre for Geographic Medicine Research – Coast and Wellcome Trust Research Programme in Kilifi, Kenya. Jay leads a research group focusing on infection and inflammation in childhood malnutrition, and on perinatal health.

Jay joined the KEMRI/Wellcome Trust Collaborative Research Programme in Kilifi, Kenya in 1997. He undertook a Wellcome Trust Research Training Fellowship on invasive bacterial infections and their relationships with malaria, HIV and malnutrition. After completing specialist training in paediatrics and sub-specialist training in paediatric clinical immunology and infectious diseases in the UK, Jay returned to Kilifi. His current Wellcome Trust Intermediate Clinical Research Fellowship is on tackling infection and inflammation to prevent mortality in malnourished children. Jay is involved in the Kenyan national training programme on integrated management of severe acute malnutrition and is an expert adviser to the Ministries of Health and the World Health Organisation.

Major themes

  • A randomized trial of daily cotrimoxazole prophylaxis during and after nutritional rehabilitation among HIV-uninfected children with severe malnutrition at 4 sites in Kenya. This project aims to test the hypothesis that mortality among Kenyan children with severe malnutrition following initial stabilisation is due to ongoing vulnerability to infectious disease, and inflammation, and that cotrimoxazole prophylaxis will reduce mortality. The primary endpoint is death and secondary endpoints include toxicity, the effects on growth, the frequency and causes of hospital re-admission, pathogens isolated, antimicrobial resistance in carriage and invasive isolates and changes in the gut microbiota:
  • Describing, and developing novel strategies for tackling immunity and inflammation in childhood malnutrition. In the cotrimoxazole trial and other cohorts of children with severe acute malnutrition, markers of gut inflammation, immune activation, microbial translocation, gut microbiota, and immune function are being examined. A randomized trial of therapeutic feeds enhanced with fish oil to correct polyunsaturated fatty acid deficiencies has been funded by the Bill & Melinda Gates Foundation through a Grand Challenges Explorations award. A trial of a gut-specific anti-inflammatory drug for environmental enteropathy in malnourished children is being developed.
  • Jay heads the Kilifi Perinatal and Maternal Health (KIPMAT) research programme, which is using hospital-embedded surveillance to identify the prevalence, causes and risk factors for adverse maternal and newborn outcomes such as delivery complications, stillbirth, prematurity, sepsis and neonatal death: The group is contributing to the international Interbio 21st study of the determinants of foetal growth and preterm birth:

Additional areas of work include simplifying anthropometry and its interpretation, including in infants

He is currently supervising PhD students working on:

  • Anthropometry, assessment and mortality risks of malnutrition amongst infants less than 6 months old (Martha Mwangome).
  • Outcomes of anti-retroviral treatment and the development of anti-retroviral drug resistance (Amin Hassan).
  • Innate immunity, microbial pattern recognition and response to pathogens in children during and following rehabilitation for severe acute malnutrition (Kelsey Jones).
  • The burden and risk factors for Group B Streptococcal carriage in mothers and its effects on perinatal outcomes in rural and urban Kenya (Anna Seale).