Research
AHRI’s research combines population, basic and translational, social, and clinical sciences to understand and intervene in the health and well-being of South African communities
Research at AHRI
Africa Health Research Institute’s research is organised around four broad scientific domains – population science, basic and translational science, implementation science, and clinical trials – and around four intersecting scientific content areas: HIV, TB, emergent or re-emergent infection, and adolescent mental health. AHRI’s 30 faculty members have the freedom to pursue their own research agendas within the institute’s broader strategy.
AHRI’s research responds to urgent health challenges facing South African communities. In our research setting, >30% of the population is living with HIV, while lifetime TB disease prevalence exceeds 40% and the annual TB incidence – nearing 1% – is one of the highest in the world. In adolescent women, anxiety and depression (rate: 22%; 33% among 22-year-olds) cluster with violence, food poverty, alcohol use and HIV infection. Globally, mental health disorders impact HIV and TB control and commonly have an onset in adolescence.
AHRI’s HIV research strategy is focussed on prevention, with discovery of biological and social drivers of transmission, and translation of findings into interventions; surveillance, to discover critical trends in the HIV epidemic and understand the longer-term impact of health policy and interventions; and understanding the HIV reservoir, or HIV persistence, in adults and children, followed by testing of tailored interventions in clinical trials.
TB research at AHRI is organised around four components: TB pathogenesis through examining excised human lung, accessed via long-term collaborations with local hospitals; surveillance for TB via our HDSS, with the aim to understand transmission on a population basis; understanding, diagnosing, and intervening in subclinical, or asymptomatic TB disease; and finally, targeted clinical trials of novel TB drugs and vaccines.
AHRI’s emergent or re-emergent infection research area uses the institute’s SARS-CoV-2/Covid-19 strategy as a model to rapidly mobilise our population and laboratory infrastructure to understand short- and long-term consequences of an emergent or re-emergent infection, particularly within the context of HIV immune dysfunction and prevalent TB. It additionally harnesses world-leading, South Africa-driven collaborative structures, AHRI’s clinical trials unit and HDSS infrastructure to conduct clinical trials of novel drugs and vaccines.
AHRI’s adolescent mental health research area builds on our current studies of depression in pregnancy, and on well-established implementation research programmes in adolescent health. AHRI is uniquely placed to explore adverse childhood events, prolonged exposure to violence and economic hardship, as well as the effect of parenting and social protection in childhood against poor mental health outcome.
Multiple scientific platforms and core business structures support AHRI’s research endeavours, including a data science unit, and a clinical trials unit. AHRI’s public and community engagement model encourages research participants to be active partners in the development of a research agenda that is meaningful and directly relevant to their lives.
AHRI is committed to providing a research environment that develops good research practice and nurtures a culture of research integrity.
We also welcome the wide variety of opportunities for research and cross-disciplinary innovation in working collaboratively or in partnership with other institutions in South Africa and elsewhere in Africa and the world.
If you want to collaborate or discuss our research we would love to hear from you. Please get in touch via communication@ahri.org.
AHRI research support
Support for AHRI's research is structured through multiple scientific platforms and core business structures, including a clinical trials unit, and a data science unit.
Experimental Science Laboratory
The experimental science laboratory (ESL), which falls under AHRI’s basic and translational science programme, is responsible for maintaining the infrastructure required by AHRI’s laboratory-based scientists. It also provides specialised core services with high-end instrumentations, relevant technical expertise and specialised facilities to accommodate highly variable research requirements and design from the AHRI researchers. The experimental science lab is led by Dr Hollis Shen.
Apart from providing general laboratory support, the ESL also has four services cores, each specialised in specific assay technologies or applications that can be provided to the researchers and contribute to their scientific questions or objectives.
Core services include:
- Pharmacology: mass spectrometry analytical service
- Optics and imaging: imaging microscopy and histology support
- Animal research: small animal research model support
- Immunology: flow cytometry-based immune characterisation
Data Science Unit
The data science unit (DSU) is a team of data scientists and researchers engaged with all stages of the data life-cycle. The DSU designs, configures and develops data collection systems so that data generated from AHRI’s studies are efficiently integrated, managed and curated in accordance with the best research data management practices. The DSU aims to provide an infrastructure that ensures high quality, accurate and reusable research data in support of AHRI’s science mission. The unit is led by AHRI faculty member, Dr Kathy Baisley.
The unit is organised into three sections:
- Research Data Management is led by Dickman Gareta and comprises a team of 10 staff experienced in data collection systems, quality checks, data linkage and integration, extraction, documentation and archiving
- Biostatistics is led by Kathy Baisley and comprises four staff who specialise in the design and analysis of epidemiological studies and intervention trials. They provide statistical support and advice to AHRI researchers, as well as conducting their own research
- Health Informatics is led by Dr Palwasha Khan. Her team’s role is to integrate health service utilisation data from AHRI studies with electronic health records and other routine data sources from the Department of Health
For any support or enquiries, please contact the data team via rdmservicedesk@ahri.org and the biostatistics team via stats.servicedesk@ahri.org.
Clinical Science Core
The clinical science core focuses on the management and oversight of the clinical research process from concept development to study conclusion. The department works at both health facilities (clinics and hospitals in Somkhele and eThekwini) as well in the community/field at Somkhele, where mobile clinical teams allow for greater community access. The department is involved with recruitment of healthy participants as well as those who have specific diseases which include HIV, TB and non-communicable diseases. The studies the department provides support for range from explorative studies, observational cohort studies and clinical trials. AHRI has also established a network of relationships with clinicians and collaborators for supply of fresh tissue samples for explorative basic research on HIV and TB.
Social Science Core
The social science core at AHRI is engaged in a range of research projects, both led by members of the core and collaborating on projects led by other groups. Core members include senior social scientists, social science coordinators and social science research assistants, skilled in the use of both qualitative and quantitative data collection methods, analysis and writing. The team also has skills in community and public engagement.
Health and Demographic Surveillance System Core
AHRI’s health and demographic surveillance system (HDSS) core provides world class, coordinated research operational support for population-level research studies including development and implementation of innovative, efficient, and cost-effective field-based and telephonic data collection systems, anchored on robust quality assurance and quality control practices.
The department is organised into five functional sections:
- A fieldwork team experienced in home-based paper and electronic data collection, anthropometry measurements, collection of dry blood spots (DBS) and capillary blood through finger prick, urine and saliva, and rapid HIV testing
- A special task team of staff specialising in tracking hard-to-reach populations such as migrants
- A data processing team responsible for quality control, data capture, and telephonic data collection through a call centre that is also able to reach study participants through SMS services.
- A document management team responsible for printing, control and digital archiving of data documents
- GIS services, including production of maps and collection of spatial data
Clinical Trials Unit
Africa Health Research Institute’s clinical trials unit (CTU) aims to bring the latest experimental health products to the people that need them most, first. The unit, which was established in 2021, works in collaboration with local and international stakeholders. The CTU is initially supporting phase three and four clinical trials, aiming to address questions around real world effectiveness, and will also link with implementation research. The fully equipped CTU building is based on AHRI’s Somkhele campus, and includes a pharmacy, and counselling and medical examination rooms. This is complemented by a fleet of mobile clinics and supported by AHRI’s sophisticated laboratory infrastructure. The CTU is led by Dr Limakatso Lebina (MBChB, MPH, PhD).