In a previous edition of the Cambridge Independent you may have seen the familiar faces of Dr Louise Allen and Dr Tamsin Brown who featured in an article regarding funds being raised for COVID-19 research and other supported projects. As the article has not been published online, we asked the Team for an update regarding their current projects.
Rapid Assay for Sick Children with Acute Lung Infection Study (RASCALS)
Dr Nazima Pathan
Lung infections are one of the biggest causes of children needing intensive care. There are many causes, and some of them respond to antimicrobials, but some are caused by viruses such as Coronavirus-19, Influenza or Bronchiolitis where antimicrobials make no difference. ACT is funding a study to help identify the cause of infection far more quickly than can be done presently (called the Rapid Assay for Sick Children with Acute Lung Infection Study, RASCALS). It is hoped this will allow doctors to treat severe lung infections with the right medicines for the right length of time and reduce unnecessary antimicrobial prescriptions. The team are looking at samples of blood and samples taken from the breathing tube (lung fluid), to run tests looking for multiple bacteria and viruses simultaneously (multiplex assays using a rapid polymerase chain reaction testing kit) as well as seeing how the body’s inflammatory response in the lung and blood varies according to the type of infection.
The funding provided by the charity has allowed the work to progress rapidly with the hard work of the Paediatric research team, Dr John Clark (a Gate-Cambridge PhD scholar), Dr Iain Kean (a post-doctoral scientist), Debbie White and Esther Daubney the PICU research nurses. It is supervised by Dr Nazima Pathan, who leads research on the PICU and Professor Stephen Baker from the Cambridge Institute of Therapeutic Immunology and Infectious Disease.
The Effects of Covid-19 in Children
Dr John Clark
With the support of Addenbrooke’s Charitable Trust, the Paediatrics Team is working on their understanding of COVID-19 in children. Discovering what is different in the way children are affected compared to adults could unlock important information needed to treat this disease. They are also testing new rapid technology used to detect chest infections and antibiotic resistance markers in critically ill children. This will provide doctors with crucial information that will help decide the best possible infection fighting treatment in hours rather than the days it takes with standard tests.
Glue Ear, Cytomegalovirus
Dr Tamsin Brown
Dr Tamsin Brown is currently working on a fast-tracked project about interventions for children with glue ear during Covid. Glue ear is where fluid builds up behind the ear drum in pre-primary and primary school aged children. The fluid interferes with the transfer of sound, meaning many children with glue ear cannot hear well. Grommet operations are performed by Ear Nose and Throat surgeons when glue ear persists: surgeons drain the fluid away and leave a small tube across the ear drum to aerate the middle ear. Grommet operations were nationally placed in the lowest priority category for operations.
This research project identified children who had been waiting on the grommet operation list during COVID and invited them to be part of the study. Families who agreed to be part of the study have been sent a headset (to help their child to hear) which has been previously trialled and details of the ‘Hear Glue Ear’ app. The Hear Glue Ear app aims to help the child to work on speech and language enrichment at home with speech, language, listening games, free audiobooks, as well as a hearing screen to help parents track their child’s hearing at home. (The app was also separately trialled with families in 2019 and accepted for publication in the Digital Health journal last year.) Families in the study are being followed up with telephone or video consultations. This study has also attracted attention from the NIHR to inform a position paper led by the Remote Trial Working Group. Further information regarding this study may be found here.
In 2019 a new way of detecting CMV (cytomegalovirus) in newborn babies was set up and established across Addenbrookes, NNU and Peterborough Hospitals. It attracted some media attention at the time. The team wrote the East of England Guidelines about management of CMV. During COVID children who had been identified with CMV were nationally prioritised to have a hearing test in children’s hearing services, which led to other hospitals across the UK adopting the East of England guidelines for earlier detection of CMV. This finding was presented at the RCPCH annual conference Oct 2020.
DigiVis and DigiBel project
Dr Louise Allen
Ophthalmology and audiology departments usually have the highest footfall in the hospital but this has been decimated by the limitation of clinical appointments to ensure adequate social distancing in clinics. Additionally, many patients are worried about attending hospital during the COVID pandemic. There is a clinical need to be able to test and monitor patients’ vision and hearing in the community to ensure they are not coming to harm.
DigiVis and Digibel are two novel web-apps designed by Dr Tamsin Brown and Dr Louise Allen which enable self-testing of visual acuity and hearing thresholds in children and adults using a patient’s or school’s own digital devices. The software is CE marked and currently undergoing clinical trials at CUH to determine accuracy and usability. DigiVis is already being used to inform telephone consultations and has had excellent feedback from the parents and children who have used it. The aim is for these apps to be used in the NHS for hospital and screening both during and after the COVID pandemic.
For further information and to support Paediatrics and charities mentioned in this article, please see the below:
Support ACT: https://www.act4addenbrookes.org.uk/donate
Paeds donation page: https://www.philanthropy.cam.ac.uk/give-to-cambridge/paediatrics?table=departments&id=39#
Children’s Hospital donation page: https://donate.act4addenbrookes.org.uk/childrenshospital/
Included within the article:
- Hyperlink to the paper: https://journals.sagepub.com/doi/full/10.1177/2331216519858303
- CMV Awareness Interview BBC One: https://youtu.be/LFr-eAeD_6c
- Dr Louise Allen, Department of Paediatrics Staff Profile: https://paediatrics.medschl.cam.ac.uk/about-us/staff/associate-lecturers/dr-louise-allen/
- Preprint of Management of conductive deafness from Otitis Media with Effusion (known as ‘glue ear’) in children using bone conduction headsets when grommet operations were unavailable during COVID-19: https://www.medrxiv.org/content/10.1101/2021.01.21.21249496v1