09 | Global Health

Respiratory diseases are one of the three leading causes of death globally. Despite this, knowledge and awareness of respiratory health is low, and it does not get the priority attention needed from health systems, policymakers and funding agencies. The NIHR Global Health Research Unit on Respiratory Health (RESPIRE) challenges this by developing and delivering low-cost, scalable policy and clinical interventions to reduce respiratory disease in Asia.

RESPIRE’s research focuses on four key areas: infectious diseases; non-communicable and chronic diseases; preventable risk factors and the climate crisis. Four supporting platforms (stakeholder and community involvement and engagement; capacity-building, training and education; open science, data and methodologies; digital health and innovation) as well as a Knowledge Mobilisation Hub support research teams to maximise the impact of their studies, both locally and globally.

Since RESPIRE’s inception in 2016, over 60 research projects have been implemented in Bangladesh, Bhutan, India, Indonesia, Malaysia, Pakistan and Sri Lanka. In April 2025, the RESPIRE team was awarded a NIHR Impact Prize for life-changing work. Visit this poster to meet members of the RESPIRE team based in Edinburgh, and learn about their approaches to improving global respiratory health.

Exhibitors: Dominique Balharry and Harry Campbell

• Visit RESPIRE's website

TIBA is an Africa-led, wide-ranging, multi-disciplinary research programme that explores and draws lessons from the ways that different African health systems tackle infectious diseases. TIBA aims to harness the expertise and technical capability in biomedical and social sciences at the University of Edinburgh and African partners to reduce the burden and threat of infectious diseases in Africa by informing and influencing health policy and strengthening health systems.

Exhibitor: Mark Woolhouse, Lorraine Pfavayi and Trisha Kerai

Background: Acute lower respiratory tract infections (ALRIs) are a leading cause of paediatric mortality in low- and middle-income countries. In recent years, substantial research has been done to enhance risk stratification of children presenting with ALRIs, in a bid to improve health outcomes in resource-limited settings. We sought to analyse the performance of several paediatric ALRI risk scores in the prediction of mortality among children hospitalised with ALRIs in Kenya.

Methods: We retrospectively analysed the data of 2182 children aged 2-24 months who were admitted to Kilifi County Referral Hospital, Kenya with severe ALRI between January 2015 and December 2024. We evaluated the performance of 6 ALRI risk scores (RISC (HIV-Negative), mRISC, RISC-Malawi, PERCH, PREPARE, ReSVinet) in this population. Additionally, we created and evaluated a modified version of the ReSVinet score by including nutrition status. Discrimination was assessed using the area under the receiver operating curve (AUROC).

Results: The mid-upper arm circumference (MUAC) version of the RISC-Malawi score showed the highest discrimination for the outcome of in-hospital mortality (AUROC: 0.83, 95% CI: (0.79 – 0.86)), whilst all other scores showed acceptable discrimination (AUROC: 0.70 – 0.79). The modification of ReSVinet to include nutrition status significantly improved its AUROC from 0.72 to 0.79.

Conclusion: All risk scores showed at least fair performance in the prediction of in-hospital mortality within our dataset. The RISC-Malawi (MUAC) score appears to be the most promising candidate for future implementation, however further research is needed to evaluate the calibration, feasibility and clinical utility of these scores.

Exhibitor: Becky Gordon

My poster displays the Strategic Healthcare Implementation Framework for Task Shifting, Sharing and Resource Enhancement (SHIFT-SHARE), built through my PhD research here at the Usher Institute.

With its six cyclical stages: Environmental Scanning, Priming, Risk Signal, Capacity Building, Monitoring and Evaluation, and Maintenance and Diffusion, SHIFT-SHARE is a practical approach to task reallocation and workforce optimisation in resource-constrained settings. My framework draws on popular change management theories, including Lewin's Three-stage Model, Kotter's Eight-step Process of Leading Change, principles of Lean Management and Diffusion of Innovation, alongside implementation frameworks such as the RE-AIM, CFIR, and the Calderdale Framework.

SHIFT-SHARE is being refined using stakeholder experiences and feedback from my fieldwork in India, where I have been examining task shifting and sharing in action across areas of primary care, emergency medical services, and mental health. Through the display, I want to have conversations with attendees where we could identify task shifting or task sharing possibilities within their programs or services and map out implementation considerations using our framework-based approach.

I will facilitate this through prompts positioned around the SHIFT-SHARE to have meaningful dialogues on potential applications. Attendees will also have access to a QR code that will take them to a workbook for them to explore the SHIFT-SHARE in their own time. 

Exhibitor: Shukanto Das

Background: In clinical trials, recently introduced respiratory syncytial virus (RSV) immunisation products have shown high efficacy in preventing severe RSV outcomes. Implementing successful immunisation programmes is however key to realising these benefits in real-world settings. We aimed to investigate uptake of the long-acting monoclonal antibody nirsevimab, the RSV maternal vaccine, and RSV vaccines for older adults in countries where immunisation programmes have been introduced, and to explore how uptake varies between countries and population subgroups.

Methods: In this living systematic review and meta-analysis, we carried out four monthly searches in Medline, Embase, and Global Health databases for studies reporting uptake of nirsevimab, the RSV maternal vaccine, and RSV vaccines for older adults. We included population-based studies published between December 1, 2022, and February 5, 2025. Two independent reviewers screened studies, extracted data, and completed a risk of bias assessment using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. We assessed uptake stratified by country and socio-demographic and clinical subgroups. Meta-analyses were conducted using random-effects modelling.

Findings: We screened a total of 1267 studies, 43 of which met the inclusion criteria reporting data on over 1.38 million individuals from six countries. Nirsevimab uptake data were reported in 34 studies: 16 from Spain, eight from the United States, seven from France, one with combined data from Andorra and Spain, and one from each of Italy and Luxembourg. Our pooled estimates showed that nirsevimab uptake on population level was 90.1% (95% confidence interval (CI): 86.4-92.9) in Spain and 51.2% (95% CI: 29.3-72.7) in the United States during the 2023/24 RSV season. Uptake data for the RSV maternal vaccine and RSV vaccines for older adults were reported in five and eight studies, respectively, all from the United States. Meta-analysis showed population-level uptake of 30.5% (95% CI: 20.6-42.6) and 18.2% (95% CI: 10.8-28.9), respectively. Uptake varied across subgroups.

Interpretation: Uptake of nirsevimab varied substantially between the countries that have implemented infant RSV immunisation programmes. The low uptake estimates for RSV maternal vaccine and RSV vaccines for older adults are concerning. There is an urgent need for national, clinical, and public health initiatives to increase uptake of RSV immunisation products and ensure maximum benefit to people currently at risk of severe RSV outcomes.

Exhibitor: Daira Trusinska

This poster will highlight the academic activities of the Young group, which span research and teaching.

Our research focuses on evolutionary, population and functional genomics across populations. We are particularly interested in the role of promoters, the site of gene transcription initiation which frequently harbour regulatory variants important for regulating medical phenotypes and disease risk. Ongoing projects in this area are (1) studying the functional role of genetic variants at promoters identified within the VIKING Health Study and (2) comparing the promoter landscape in diseases regulated by diverse genetic variants across global populations. With researchers at the Centre of Cardiovascular Science, we are also investigating the role of phenotype-associated variants in post-transcriptional regulatory mechanisms.

Several group members are also involved in our affiliation at the Zhejiang University – University of Edinburgh (ZJE) Institute in Haining, China. ZJE is the largest transnational educational partnership at the University of Edinburgh and won the ‘Educational Partnership of the Year’ award at the 2024 China-Scotland Business Awards. Our main responsibility is to organise a first-year course (‘Introduction to Biomedical Informatics 1’) which introduces students to computer programming and its applications in biomedicine. We deliver research-led teaching in a number of related courses in data science, statistics, and genomics and also contribute to supervision of postgraduate students at ZJE.

Exhibitors: Rob Young, Shenyi Zhang, Caitlin McNiff, & Natasha Arzoo