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Development of an Effective Cure for River Blindness (Onchocerciasis) and Elephantiasis (Lymphatic Flariasis [LF]) and a New Tool for Control, Elimination and Morbidity Management

Summary of the impact

Scientists at the Liverpool School of Tropical Medicine (LSTM) have proven that targeting an essential bacterial symbiont, Wolbachia, with a course of antibiotics cures patients of their parasitic worms and improves disease pathology. This discovery in 1999 offers superior efficacy compared to existing anti-filarial drugs delivering prophylaxis, transmission blocking, safe macrofilaricidal activity and improved case management therapy. This approach has been endorsed by WHO elimination programmes for onchocerciasis, (Onchocerciasis Elimination Programme for the Americas, OEPA) and lymphatic filariasis (Global Programme to Eliminate Lymphatic Filariasis, GPELF). The Centre for Disease Control (CDC), also recommends this new strategy for elimination and morbidity management.

Submitting Institutions

University of Liverpool,Liverpool School of Tropical Medicine

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Clinical Sciences, Medical Microbiology

Eliminating blinding trachoma through single dose treatment

Summary of the impact

Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness. Research by Professors David Mabey and Robin Bailey, LSHTM, has shown that a single oral dose of azithromycin is an effective, feasible mass treatment and could eliminate trachoma from affected communities. As a result, the manufacturer Pfizer agreed to donate azithromycin to trachoma control programmes for as long as necessary and WHO established an Alliance for the Global Elimination of Blinding Trachoma by 2020. Since 2008, 205m azithromycin doses have been donated, and WHO elimination targets have been achieved in nine countries.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Clinical Medicine

Summary Impact Type

Technological

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

UOA01-07: Melioidosis: Managing Chronic Infection

Summary of the impact

Sustained research by the University of Oxford's Mahidol Oxford Tropical Medicine Research Unit in Thailand (MORU) has been the driving force behind the current World Health Organization recommendations for the management of acute and chronic infection in patients with melioidosis. This research has motivated improvements in treatments and provided new strategies to identify at-risk populations, enabling clinicians to make early diagnoses. Melioidosis is a major cause of severe illness in parts of Southeast Asia and there are increasing numbers of cases in India, China, and Brazil.

Submitting Institution

University of Oxford

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Clinical Sciences, Medical Microbiology

Rethinking Mass Drug Administration strategies for the control of Neglected Tropical Diseases

Summary of the impact

A research collaboration between LSE and Brunel University has demonstrated that large-scale programmes to control Neglected Tropical Diseases (NTDs) through Mass Drug Administration (MDA) can be ineffective, primarily because of flawed assumptions about local realities in developing countries. The research findings have helped shift the terms of debate and consolidate pressure for existing strategies to be revised. They have been discussed in the UK Parliament, the biomedical literature, and the news media. In addition, detailed fieldwork has facilitated treatment for specific groups of people in Tanzania and Uganda who would otherwise have been overlooked.

Submitting Institution

London School of Economics & Political Science

Unit of Assessment

Anthropology and Development Studies

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Public Health and Health Services

MASS DRUG ADMINISTRATION (MDA) FOR THE CONTROL OF NEGLECTED TROPICAL DISEASES (NTDS)

Summary of the impact

A research collaboration between Brunel University and LSE has demonstrated that large-scale programmes to control Neglected Tropical Diseases (NTDs) through Mass Drug Administration (MDA) can be ineffective, primarily because of flawed assumptions about local realities in developing countries. The research findings have helped shift the terms of debate and consolidate pressure for existing strategies to be revised. They have been discussed in the UK Parliament, the biomedical literature, and the news media. In addition, detailed fieldwork has facilitated treatment for specific groups of people in Tanzania and Uganda who would otherwise have been overlooked.

Submitting Institution

Brunel University

Unit of Assessment

Anthropology and Development Studies

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Public Health and Health Services

The Evidence-Based Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease (COPD)

Summary of the impact

COPD affects up to 3.5 million people in the UK and costs the NHS £700m pa. Over the last 15 years, research by Professor Calverley and colleagues at the University of Liverpool (UoL) has impacted significantly on the care of COPD patients. Specifically, this group showed that routine testing of COPD patients for the presence of bronchodilator reversibility was unreliable and did not predict clinical outcomes. This changed international guideline recommendations in 2007 and the Quality Outcomes Framework payments to GPs in 2009. They showed that oral corticosteroids accelerated recovery from exacerbations and that anti-inflammatory drugs, whether inhaled corticosteroids or PDEIV inhibitors, reduced exacerbations by 25% with a subsequent fall in the number and length of hospitalisations. This led to changed NICE guidance for corticosteroids in 2010 and drug registration with EMA and FDA for the PDEIV inhibitor treatment in 2011. Treatment in UK and Western Europe has changed as a result of this research.

Submitting Institutions

University of Liverpool,Liverpool School of Tropical Medicine

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Clinical Sciences

UOA05-06: Effective treatment of chronic lymphocytic leukaemia

Summary of the impact

Research led by University of Oxford scientists has resulted in widespread use of the humanised therapeutic antibody, Campath (alemtuzumab), in patients with chronic lymphocytic leukaemia (CLL). Licensed by both the European and American regulatory authorities in 2004 for the treatment of CLL, Campath is used as first-line treatment for patients with aggressive forms of the disease and following relapse. It can induce long-term clinical remission even in cases resistant to other drugs. Campath has now been used in approximately 15,000 patients, and has generated revenues of approximately £750 million from the licensed treatment of CLL.

Submitting Institution

University of Oxford

Unit of Assessment

Biological Sciences

Summary Impact Type

Technological

Research Subject Area(s)

Medical and Health Sciences: Oncology and Carcinogenesis

Improved animal health and welfare and economic benefits for farmers from better management of parasites in livestock

Summary of the impact

Research conducted at the University of Bristol between 2003 and 2012 on the ecology, epidemiology and control of parasitic flies and worms has improved animal health and welfare in the UK and is addressing a major constraint on global food production — animal disease, particularly in the context of climate change. These are some of the impacts:

  • In 2011, industry benefited from research on blowfly strike which has provided scientific evidence that strategic early treatment of sheep reduces season-long disease risk and results in financial savings for farmers, particularly where earlier emergence of flies occurs in response to warming temperatures.
  • Between 2008 and 2012, farmers realised a 73% direct saving in the monitoring of gastrointestinal nematodes due to the development of a composite faecal worm egg count (FEC) test and a decrease of up to 75% in the number of treatments given to lambs.
  • Farmers and livestock benefited from the slower development of anthelmintic-resistant parasites as a result of targeted treatment using the composite FEC test developed.

Submitting Institution

University of Bristol

Unit of Assessment

Biological Sciences

Summary Impact Type

Environmental

Research Subject Area(s)

Agricultural and Veterinary Sciences: Animal Production, Veterinary Sciences
Medical and Health Sciences: Public Health and Health Services

2. Policies for Better Treatment for Employees with Disabilities and Long-term Health Problems

Summary of the impact

This research into treatment for employees with disabilities provides one of the UK's Equality Performance Indicators and recommendations from it have been incorporated into UK legislation. Hundreds of organisations have used the research to promote better treatment for employees with disabilities; public-sector employers, including government departments, have relied on it to meet their statutory duties and it has helped the UK to fulfil its international treaty and convention obligations in respect of people with disabilities. This research has helped the Equality and Human Rights Commission (EHRC) to fulfil its statutory role to promote equality and human rights.

Submitting Institution

Cardiff University

Unit of Assessment

Sociology

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Commerce, Management, Tourism and Services: Business and Management
Psychology and Cognitive Sciences: Psychology

Informing clinical policy on epilepsy treatment

Summary of the impact

A team at the University of Liverpool has undertaken research that has informed practice and policy worldwide in the management of patients presenting with newly diagnosed epilepsy, which has achieved international impact on health. Seizures are common and 3-5% of the population will be given a diagnosis of epilepsy during their lifetime. Decisions about when to start treatment, and if so with which drug are crucial and can have a significant effect on outcomes for the individual and have significant economic consequences for society. The research includes the undertaking and analysis of data from randomised controlled trials. The data analysis is based on the statistical research initiated by Dr Paula Williamson while in the Department of Mathematical Sciences at the University of Liverpool between 1996 and 2000. The research identified the most appropriate first line treatments for patients with newly diagnosed epilepsy, addressing both clinical and cost effectiveness. This work has underpinned national policy and triggered the most recent update of the NICE (National Institute for Clinical Excellence) epilepsy guidelines in 2012.

Submitting Institution

University of Liverpool

Unit of Assessment

Mathematical Sciences

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Neurosciences, Public Health and Health Services

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