PROJECT SUMMARY
Candidate: Dr. Karen du Preez has dedicated herself to a research career focused on improving health care for
children in low and middle income countries (LMIC). Her overall career development goal is to become an
independent clinician scientist with a comprehensive, interdisciplinary skill set and research network to efficiently
answer high priority public health questions, and have the ability to translate research findings into meaningful
policy and implementation changes to improve health care for children in South Africa, and globally. This overall
goal is supported by three specific training aims: 1) To understand and apply specialized analytical skills to public
health research, specifically disease estimation modelling techniques and spatial analytic methods; 2) To
strengthen clinical, management and leadership expertise; and 3) To develop the ability to translate research
into meaningful policy changes and implementation. Dr. du Preez has the full support of the Desmond Tutu TB
Centre, an internationally recognized research center at Stellenbosch University, Cape Town, South Africa and
has assembled a mentoring team highly experienced in all facets of pediatric TB research, and actively involved
at both national and international level contributing to scientific steering committees and supporting pediatric TB
program implementation.
Research: The lack of reliable surveillance data for the disease burden and spectrum of pediatric tuberculosis
(TB) is a challenge that limits our ability to appropriately manage the disease globally. TB meningitis (TBM) is a
severe form of pediatric tuberculosis with very poor outcomes and often consequent lifelong neurological
disability if not diagnosed and treated early. Very little childhood TBM surveillance data exist and the overall
goal of this research is therefore to determine the burden, incidence and outcomes of childhood TBM at three
levels: global, national (South Africa) and sub-national (Cape Town district), whilst identifying opportunities for
prevention, earlier diagnosis and treatment. Mathematical modelling techniques will be used to estimate the
global burden of childhood TBM disease and attributable mortality, by country and WHO region (Specific Aim 1).
Routine TB surveillance data from South Africa, spanning 14 years (2004-2017), will be used to determine the
spatiotemporal heterogeneity of the national disease burden and treatment outcomes of childhood TBM and
identify population-level drivers of high burden locations and unfavorable outcomes (Specific Aim 2).
Prospective, complementary surveillance strategies will identify all diagnosed and undiagnosed childhood TBM
cases (<15 years) within the Cape Town health district over a 2-year period. All identified children will be eligible
for enrolment in an observational cohort study that will collect data on diagnostic certainty, disease severity,
comorbidities, outcomes and missed opportunities for both TB preventive therapy and earlier diagnosis, with the
aim of informing earlier diagnosis (diagnostic algorithms) and targeted interventions for improved TBM
prevention and care (Specific Aim 3).
