Anna Seale

Graduate Research Prize Winners Autumn 2014

Anna Seale

Before reading medicine, I spent a year working in Uganda, which shaped what were to become my research interests: paediatrics and infectious diseases. I undertook research placements in The Gambia and Uganda, and spent a year working at the KEMRI-Wellcome Trust Research Programme (KWTRP) in Kilifi, Kenya. Observing a very high burden of neonatal mortality, I developed a particular interest in maternal and new-born health, and helped set up a surveillance platform to study risk factors for adverse maternal and perinatal outcomes.

My subsequent research training fellowship has been based at the KWTRP and aimed to investigate maternal colonisation with Group B Streptococcus (GBS) and association with adverse perinatal outcomes in coastal Kenya. In order to answer my study questions, I undertook several clinical epidemiological studies, including a cohort study of 8000 mothers and their newborns, across four urban and rural sites; a nested-case control study to investigate GBS as a cause of stillbirth; a sub-study of maternal to neonatal GBS transmission, and a retrospective study of neonatal GBS disease cases. With advances in large scale pathogen genomics I was able to use whole genome sequencing to examine the GBS isolates from these clinical studies, with collaboration from colleagues at the University of Oxford. 

During my fellowship I also undertook training at the London School of Hygiene and Tropical Medicine (LSHTM) through a Masters in Epidemiology by distance learning. I used the skills from this course, as well as advice from colleagues, in my epidemiological analyses of GBS. I also developed collaborative work with LSHTM, and established a network of investigators to estimate cases of neonatal infection, and its neurological sequelae, in high burden regions.My subsequent research training fellowship has been based at the KWTRP and aimed to investigate maternal colonisation with Group B Streptococcus (GBS) and association with adverse perinatal outcomes in coastal Kenya. In order to answer my study questions, I undertook several clinical epidemiological studies, including a cohort study of 8000 mothers and their newborns, across four urban and rural sites; a nested-case control study to investigate GBS as a cause of stillbirth; a sub-study of maternal to neonatal GBS transmission, and a retrospective study of neonatal GBS disease cases. With advances in large scale pathogen genomics I was able to use whole genome sequencing to examine the GBS isolates from these clinical studies, with collaboration from colleagues at the University of Oxford.

GBS is an important cause of perinatal and neonatal disease in Kenya. Improving our understanding of the burden and pathogenesis of GBS in high burden regions is essential, as GBS vaccines are in development. The GBS studies in Kenya, to which many have contributed, will inform prevention methods, and in the longer term mortality and morbidity from GBS disease in this important group can be reduced.

Publications (selected)

Seale AC, Blencowe H, Manu AA, et al. Estimates of possible severe bacterial infection in neonates in sub-Saharan Africa, south Asia, and Latin America for 2012: a systematic review and meta-analysis. The Lancet Infectious diseases 2014; 14(8): 731-41.

Seale AC, Blencowe H, Zaidi A, et al. Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010. Pediatric research 2013; 74 Suppl 1: 73-85.

Seale AC, Berkley JA (2012) Managing severe infection in infancy in resource poor settings. Early Hum Dev 88: 957-960.

Seale AC, Toussaint FS, Finn A, Fraser JI. Prescribing in a pandemic: best use of oseltamivir in paediatric intensive care. Archives of disease in childhood 2011; 96(9): 902-3.