Shivika Marwaha, awarded the inaugural Malawi eHealth Research Centre Scholarship
Malawi eHealth Research Centre Scholar, Shivika Marwaha
Background: The Malawi eHealth Research Centre, is a dedicated eHealth education and research facility. It is designed to act as an international hub for academic and industry partners with an overall aim to enhance the delivery of healthcare across Malawi. In 2020, Shivika Marwaha a Medical Student at University College Cork (UCC) has been awarded the inaugural Malawi eHealth Research Centre Scholarship. This scholarship will provide Shivika with research and travel support as part of the Risk Assessment using Practical and Innovative Diagnostic Diabetes tools (RAPID Diabetes Study) with dedicated assistance from the ASSERT Research Centre, UCC. The Malawi eHealth Research Centre Scholarship will provide Shivika with an opportunity to extend on her previous research activities in India regarding the socioeconomic factors influencing the risk of developing obesity, hypertension and diabetes in rural and urban Indian women. Shivika is co-supervised by Dr Patrick Henn and Dr John O’Donoghue along with an international advisory panel:
Simon Taylor-Robinson, Imperial College London,
Siobhan O’Connor, University of Edinburgh,
Mala Mawkin, Imperial College London,
Griphin Baxter Chirambo, Mzuzu University,
Bo Andersson, Lund University.
The supervisory panel and the international advisory panel very much look forward to working with Shivika as part of her clinical and research studies within the area of global health.
RAPID Diabetes Study: The global prevalence of Non-Communicable Diseases including Diabetes has doubled since 1980 and continues to be one of the leading causes for deaths worldwide. Type II Diabetes Mellitus (T2DM) is the most common onset of Diabetes and is of particular concern in Low-Middle Income Countries (LMICs) such as Malawi and India due to increasing urbanisation and inconsistent dietary habits. Malawi is a small landlocked country situated in the southern-central part of the African subcontinent. Although reports claim that the adult prevalence of Diabetes in Malawi is 2.7%, this is said to be masked by the lack of diagnosis due to poor risk assessment. Thus, the underlying premise of the RAPID Diabetes Study is to investigate the extent to which manual clinical parameters (such as thermometers and measuring tapes) are used within risk assessment scores in LMICs, compared to digital clinical parameters (such as glucometers and oximeters) in detecting Type II Diabetes Mellitus. Moreover, we intend to carry out a retrospective analysis of a previously conducted out-patient survey regarding the perception T2DM in LMICs.
A risk score is defined as an objective assessment of the probability of the presence or future development of an adverse health condition. Diabetes risk scores specifically range from simple logistic regression models to more complex machine learning algorithms but their underlying principal remains consistent, i.e., the conversion of relevant variables into a value corresponding to the risk of developing Diabetes. However, with the advancement of clinical tests and the identification of new variables, we believe that some criteria in risk scores may need to be revaluated. The studies we will be including in our review will identify data regarding the year of publication, type of risk score test, risk score obtained, the socioeconomic status of the country used in the case study alongside the manual, digital and hybrid (combination of manual and digital clinical variables) variables collected and the devices on which they were collected on. Expanding on that, we also intend to assess the self-management variables that T2DM patients employed in the studies we will include in our review.
The 2020 Malawi eHealth Research Centre Scholarship: An initial step with Shivika’s research will be a rapid systematic review of existing diabetes risk scores in LMICs, specifically those that only utilised available clinical variables. We aim to identify practical and innovative diagnostic tools for T2DM to compensate for the lack of resources available in these countries. Moreover, we aim to identify gaps in the treatment guidelines published with regard to preventive measures taken by renowned international organisations. One of the proposed key contributions of this research will be the eHealth component, as we intend to identify the most commonly collected variables for risk assessment in LMICs which would provide easier access to mHealth developers for Diabetes monitoring applications. As part of validity testing, this rapid review will be followed up with a multi-country survey instrument in Ireland, India and Malawi. This study will allow Shivika to conduct a comparative analysis of the risk assessment factors in low, middle and high income countries.