Clinical studies on enteric fever in Kathmandu Nepal. (360G-Wellcome-083186_Z_07_Z)

With the spread of drug resistance in some areas of the world but an apparent return to sensitivity in other areas the treatment of enteric fever is becoming more complicated and trials conducted over the last decade have not provided all the answers. The main goals of the period of research (18 months after my MSc) are to investigate the optimal treatment for enteric fever. I will achieve this by conducting randomised controlled trials in enteric fever (the first trial will compare Chlorampheniciol vs Gatifloxacin) and by working with the International Group in Enteric Fever to help design rational future clinical trials in enteric fever. The second aim will be achieved by establishing a unified database of clinical trials in enteric fever and an Individual patient Database Meta-analysis. I will initiate a pilot study to investigate the feasibility of a establishing a community based epidemiological surveillance of Styphi and Sparatyphi in Lalitpur District in Kathmandu. I hope to use this work as part of my PhD which will also include work on allied laboratory studies (either directed at the molecular biology work on the pathogen or in the area of host susceptibility to enteric fever in collaboration with the Wellcome Trust MOP in Viet Nam) to complement this clinical work. This additional laboratory work will start in 02/2010 following the initial 18 month period of research funded by this Fellowship. Details of this work will be developed during this Fellowship.