Dr. Keith Fowke and Dr. Mario Pinto with patient cohort at Nairobi research clinic.

Today, UM research in Kenya includes two major inter-related Rady Faculty of Health Sciences programs led by Keith Fowke, Department Head of Medical Microbiology and Infectious Diseases and James Blanchard, Executive Director of the Institute for Global Public Health. Responding to a need for public health advocacy from UM research partners in Kenya, Global Public Health programs expanded to Kenya in 2008 as an extension of successful projects originally started in India.

“Our programs in Kenya are a unique example of how laboratory-based researchers interested in molecules and cells are collaborating with researchers studying issues of stigmatization and together they make meaningful impacts for marginalized people,” said Keith Fowke.

As researchers began working with marginalized patient cohorts, increased need for community-based supports emerged, informing new programs developed by UM researchers Dr. Souradet Shaw Canada Research Chair (CRC) in Program Sciences & Global Public Health, Dr. Marissa Becker, Dr. Lisa Lazarus, Dr. Lisa Avery, Dr. Joshua Kimani, Dr. Larry Gelmon, Dr. Lyle McKinnon, Dr. Julie Lajoie, Dr. Leigh McClarty, Dr. Jason Kindrachuk CRC in Molecular Pathogenesis of Emerging and Re-Emerging Viruses and Dr. Rob Lorway, CRC in Global Intervention Politics and Social Transformation,. 

“When I first came to Kenya in 2009 there was a group of young men who were starting to attend clinics established for female sex workers, many of whom identified as gay and bisexual, which is criminalized in Kenya,” said Rob Lorway. “Some were young students, and some were older or married, but what was important is that they had a high HIV prevalence. They came to us because we provided safe spaces from Kenya’s public healthcare system that can be, at times, quite judgmental.”

A legacy of evidence-based support & patient directed research

Four decades ago in the early 1980s, after eradicating an outbreak of the sexually transmitted infection Chancroid in Manitoba, Dr. Allan Ronald was recruited to lead a similar program with the Department of Medical Microbiology at the University of Nairobi, Kenya. Dr. Francis Plummer, then an infectious disease fellow on Ronald’s team studying with a group of sex-workers, would gain global renown for the discovery of a link between the spread of sexually transmitted diseases and the emerging HIV/AIDS epidemic.

Among the patient cohort exposed to HIV/AIDS, Plummer and his team identified a group of women with a natural immunity to HIV-1, the virus that leads to AIDS. Over the following 17 years UM researchers, including Fowke, studied the immune system of these women leading to new approaches to HIV prevention. The women participating in the study had contributed to saving and improving the lives of tens of millions of people living with HIV around the world but continued to live a criminalized lifestyle at the fringes of society.

Dr Elizabeth Ngugi, a local public health nurse working with Plummer in managing the patient cohort in the 1980s and ‘90s, recognized the adversity these women and others like them endured each day. Through advocacy, a new patient-directed research model was developed to foreground the needs and voices of patients as fully recognized research partners, rather than research subjects.

Keith Fowke, who was a graduate student at UM labs in Kenya at that time, recalls of Dr. Ngugi, “she was a very direct and clear-thinking woman. Beginning in 1984, Dr. Ngugi developed a peer educator model to train sex workers and support them as informed and educated leaders within the community. Dr. Ngugi’s influence has been global and has resulted in a deep 40-year relationship with this community which has now evolved into the Sex Worker Outreach Program (SWOP) which has been adopted as a best-practice model by the World Health Organization, UN AIDS and countless others.”

Dr. Julie Lajoie (second from left), Dr. Mario Pinto, Joyce Adhiambo (pictured in SWOP t-shirt) and Dr. Keith Fowke pictured here.

Now in 2024, UM infectious disease research in Nairobi encompasses 10 SWOP clinics providing HIV prevention and care services to more than 30,000 female sex workers, about 9000 men who have sex with men and close to 1500 transgender individuals. Supported by Joshua Kimani and Larry Gelman who follows in the legacy left by Dr. Ngugi, some patient partners are now respected community organizers like Joyce Odhiambo with SWOP Ambassadors, who presented to EU Parliament in Brussels in 2018.

Current clinical programs funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) deliver HIV care and prevention services. However, due to the criminal status of sex work and homosexuality in Kenya, the mere presence of HIV medications or even condoms could provoke harassment or police response.

Members of the patient cohort meet at a Nairobi health clinic.

“In Kenya 4% of the general population is infected with HIV, and in sex workers it’s about 28%,” said Fowke. “Despite these high risks, many women in our cohort choose not to take anti-HIV drugs to prevent infection because of the stigma resulting from their association with being used to treat HIV infection. We are working on providing new approaches to HIV prevention that would be acceptable to these women, including the anti-inflammatory drug, aspirin, which may prevent the immune cell HIV infects from entering the vaginal mucosal environment thereby preventing infection.”

Community empowerment through global public health research

Members of the male patient cohort meet with Dr. Keith Fowke and Dr. Mario Pinto.

“We’re talking about marginalized and stigmatized people, whose lives and livelihoods are criminalized,” said Lorway. “Within the first year of our program 12% of men who have sex with men who originally tested negative for HIV were testing positive. So, despite clinicians doing everything they could at the time – providing risk reduction counseling, supplying condoms and lubricant – HIV infection was growing among these men in our cohort.”

Tourism in Kenya has influenced hotspots where gay and bisexual men can congregate and celebrate themselves. By mapping these hotspots, the Global Public Health team have provided local clinicians and community organizations the ability to establish program catchments and generate their own accurate community health data to inform program coverage targets that guide the funding priorities of donors and the Government of Kenya. Furthermore, by providing training to community leaders so that they can cultivate their own research agenda, now community leaders are coming to Lorway and the team for support with their own investigations.

These expanding partnerships have paved the way for organizations like SWOP Ambassadors, who provides legal aid training and support to sex workers and engages with police to ensure that the right to access healthcare services is respected. The internationally-funded community based organization, HOYMAS (Health Options for Young Men on HIV, AIDS, and Sexually transmitted infections) has now established a clinic in Nairobi which guarantees non-discriminatory care and runs anti-stigma campaigns focused on sexual health and human rights advocacy.

“The shifting scope of Global Public Health research in Kenya is a strong sign of transformational success,” said Mario Pinto, Vice-President (Research and International). “The work of these dedicated researchers and clinicians to advance health as a human right has empowered these underserved communities, not just in self-advocacy, but as entrepreneurs and leaders in their field on the international stage. We know that when people of sexual minorities live free of harassment and stigmatization, they are more likely to access life-saving medical care and be their authentic selves.”

CFI-Funded laboratory provides much-needed sex worker outreach programs

Dr. Keith Fowke and Dr. Mario Pinto pictured with Dr. Julius Oyugi, Director of the University of Nairobi Institute for Tropical and Infectious Diseases

In Kenya, UM has partnered with the University of Nairobi to build a Canada Foundation for Innovation funded lab on their campus and has now developed 10 different SWOP clinics across the city as part of ongoing sex worker outreach programs. “When we first started this program, there wasn’t much medical research infrastructure in Kenya, now I’m supervising Kenyan PhD students doing cutting edge research projects without having to leave their country and we are able to hire all staff locally through with grants available to African institutions,” said Keith Fowke.

Decades of results in overcoming epidemics and securing international funding from partners including Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS has helped to foster good relationships with government. health officials have signaled a willingness to collaborate on efforts to prevent an emerging epidemic of anal cancer among men who have sex with other men resulting from the sexually transmitted infection HPV.

“We have begun addressing an epidemic of cervical cancer resulting from HPV among female sex workers, but a different approach is needed to provide care for men who have sex with men,” said Lorway. “Hate speech almost constantly enters the political theatre during times of economic disruption like the COVID-19 pandemic, so it’s often about quiet negotiations with health official — which can be frustrating because of the urgent need for care. Working with our local partners we’ve established new provisions for anal health care for men who have sex with men. Although working in such a prohibitive political climate can be challenging, these partnerships provide the room we need to discretely develop programs without provoking a negative public reaction.”

Research impacts at home in Manitoba

Joyce Adhiambo (left) and Victoria Were (right)

“There is a presumption that access to care and sex worker support programs are less advanced in the global south. However, in Canada, by criminalizing the clients, we push sex works even further underground,” said Lorway. “Criminalizing sex work makes it extremely difficult to deliver health services. In this case we have something to learn from our work in Kenya about how to provide services to those who are hardest to reach.”

Leading the way in sex work advocacy in Manitoba is the Sex Workers of Winnipeg Action Coalition (SWWAC)  who are partnering with UM infectious disease expert Julie Lajoie, to facilitate an ongoing information exchange between the sex worker communities in Nairobi and Winnipeg. Two community leaders came to Winnipeg in 2022 to discuss their role as grant co-applicants and to share strategies on getting organized in the face of criminalization and public stigma.

“In Canada, we have a parallel issue of Missing and Murdered Indigenous Women, and tragically, there are commonalities in the experiences of marginalized people on both sides of the ocean,” said Keith Fowke. “In Manitoba we’re at least a decade behind African programs in HIV prevention approaches. There are more new cases of HIV in Manitoba this year than in epidemic of the 1980s and ‘90s, and it’s mainly among women in indigenous communities.  We need to adapt global best-practices to prevent infections in Manitoba.”

The Winnipeg-based community resource center Sunshine House is leading the way in Manitoba by offering HIV and sexually transmitted disease testing services and have held a Science + Supper, often featuring presentations from UM Faculty members.

“Programs like those offered at Sunshine House, SWWAC and SWOP Ambassadors are foundational,” said Lorway. “Something we as researchers can always work toward is the de-monopolization of science, to put the power to make change into the hands of those who most urgently need it.”

In the Fall 2021 funding competition, the CIHR awarded a total of nearly $8 million to UM in the form of 11 grants.

“This is an excellent showing by our faculty members and their research partners in obtaining support for projects that will advance vital knowledge and benefit people’s health and well-being,” said UM Vice-President (Research and International) Dr. Digvir Jayas.

“It’s impressive to see the breadth of health research taking place at UM in areas such as trauma recovery, mental health, kidney disease, HIV, cancer, diabetes and chronic pain.”

Dr. Myrle Ballard

Dr. Myrle Ballard, assistant professor and Indigenous scholar of chemistry in the Faculty of Science, is Anishinaabe from Lake St. Martin First Nation (LSMFN). She leads a research project that received a five-year grant of $2,067,415.

The LSMFN community’s traditional homelands have been uninhabitable since a human-made flood destroyed them in 2011. LSMFN members experienced trauma when they were forced to evacuate.

With input from community members, Ballard’s project will focus on implementing an Elder-Youth mentorship program to promote health and well-being.

“The post-traumatic distress suffered by LSMFN members requires culturally appropriate research interventions to lessen their grief and heal into a healthy community,” the researchers wrote.

Dr. Garry Shen

Dr. Garry Shen, professor of internal medicine in the Max Rady College of Medicine, co-leads a team with First Nations partners that received a five-year grant of $1,155,150.

A recent study by Shen and partners showed that an online and locally broadcast prenatal education program significantly increased participation rates in prenatal programs and breastfeeding when it was piloted in three First Nations communities.

The new project will enhance the program, which is community-based and incorporates both Indigenous and non-Indigenous knowledge about healthy pregnancy and breastfeeding. The goal is to improve pregnancy outcomes and maternal/child health in rural and remote First Nations communities.

Here’s a look at the other funded studies. More information on the studies and research teams is available here.

Dr. Tracie Afifi, professor, community health sciences/psychiatry, Max Rady College of Medicine; Canada Research Chair in childhood adversity and resilience; researcher, Children’s Hospital Research Institute of Manitoba (CHRIM)

Grant: $75,000 (one year)

Afifi’s study focuses on adverse childhood experiences and peer bullying. She seeks to identify which protective factors during adolescence help to reduce the likelihood of substance use problems and mental or physical health conditions among those who have had these negative experiences.

Dr. Robert Lorway, professor, community health sciences, Max Rady College of Medicine; Canada Research Chair in global intervention politics and social transformation

Grant: $100,000 (one year)

Lorway’s community-based study in Nairobi, Kenya aims to understand and confront the role homophobia plays in men who have sex with men not seeking treatment for HPV-related and other anal diseases until their illness is extremely advanced. 

Dr. Dylan MacKay, assistant professor, community health sciences, Max Rady College of Medicine

Grant: $320,534 (three years)

MacKay will compare two groups of people with chronic kidney disease in a randomized feasibility trial of methods to reduce dietary acid. Half the patients will take baking soda pills, while the other half will have fruits and vegetables delivered to them to reduce acid through diet.

Dr. Lyle McKinnon, associate professor, medical microbiology and infectious diseases, Max Rady College of Medicine; researcher, CHRIM

Grant: $837,675 (five years)

McKinnon’s team has previously found that vaginal inflammation increases a woman’s risk of becoming HIV-infected if exposed. His study focuses on regulatory T cells and their potential to control female genital inflammation as an HIV prevention strategy.

Dr. Gerd Prehna, assistant professor, microbiology, Faculty of Science

Grant: $596,700 (five years)

Prehna will investigate how, during an infection, disease-causing bacteria kill beneficial bacteria by loading deadly toxins onto a “crossbow-like” secretion system. A detailed understanding of this process may make it possible to “disarm” many species of bacterial invaders.

Dr. Tanveer Sharif, assistant professor, pathology, Max Rady College of Medicine

Grant: $956,250 (five years)

Sharif’s study will build on the finding that metabolism plays a role in how a particular mutated gene promotes the spread of tumor cells in aggressive medulloblastoma brain tumors. His team will investigate using metabolism-targeting agents to suppress this process.

Dr. Roberta Woodgate, distinguished professor, College of Nursing; Canada Research Chair in child and family engagement in health research and healthcare; researcher, CHRIM

Grant: $600,524 (four years)

Woodgate will lead a cross-Canada study in which young people with chronic pain will be engaged as co-researchers. The goal is to better understand the experiences, needs and priorities of young people with chronic pain in order to provide better patient-centred care.

Grant: $546,976 (three years)

Woodgate’s team will also implement a youth mental health program in Winnipeg, partnering high schools in the Seven Oaks School Division with NorWest, a community youth hub. Multiple data collection strategies, including arts-based methods, will be used to evaluate the program.

Dr. Jennifer Yamamoto, assistant professor, internal medicine, Max Rady College of Medicine; researcher, CHRIM

Grant: $609,835 (four years)

Yamamoto’s project builds on a previous study of glucose monitoring in mothers with Type I diabetes during pregnancy. It will examine the possible relationship between the blood sugar patterns of these mothers while pregnant and learning difficulties and behaviour problems in their children.

A total of more than $12 million was awarded in the form of project and bridge grants, with study durations ranging from one to five years.

“Congratulations to all the dedicated UM researchers who were successful in this Spring 2021 funding competition,” said UM Vice-President (Research and International) Dr. Digvir Jayas.

“These professors have shown leadership in their fields and are advancing knowledge in several important areas of Indigenous health, as well as in illnesses such as kidney disease, heart disease, HIV, diabetes, cancer and psychiatric disorders.”

The UM project that received the largest grant, more than $1.9 million over five years, is titled Qanuinngitsiarutiksait.2: Developing tools for the wellness and safety of Inuit.

DR. JOSEE LAVOIE

Led by Dr. Josée Lavoie, professor of community health sciences and director of Ongomiizwin Research, the project builds on a previous study of service use by the thousands of Inuit from Nunavut who come to Manitoba to access services.

The new study will focus on how Inuit concepts of wellness can be used to create healing programs in Winnipeg that reflect Inuit values. The researchers plan to develop and implement several programs, such as one tailored to the needs of Inuit families involved with Child and Family Services.

A five-year grant of more than $1.4 million was awarded to the project Oral microbiome and caries risk in young First Nations and Métis children in Manitoba.

DR. ROBERT SCHROTH

A team led by Dr. Robert Schroth, professor of preventive dental science in the Dr. Gerald Niznick College of Dentistry and researcher with the Children’s Hospital Research Institute of Manitoba (CHRIM), will examine the dental microbiome that is associated with the severe form of baby-tooth decay that affects many First Nations and Métis preschoolers.

The aim is to understand why only some dental microorganisms cause tooth decay, and the environmental factors that may influence this process.

Here’s a look at the other funded studies and lead investigators. More information on the studies and research teams is available here.

Dr. Marissa Becker, associate professor, medical microbiology & infectious diseases, Max Rady College of Medicine

Grant: $200,000 (two years)

Becker’s team will study sexually transmitted and blood-borne infections (STBBI) among military personnel in Ukraine, examining how they contribute to broader STBBI epidemics amid the armed conflict in that country.

Dr. David Collister, assistant professor, internal medicine, Max Rady College of Medicine

Grant: $321,300 (three years)

Collister seeks to determine which uremic toxins are responsible for individual disease symptoms in advanced chronic kidney disease, and which symptoms respond to dialysis. The findings will inform dialysis decision-making.

Dr. Kevin Coombs, professor, medical microbiology & infectious diseases, Max Rady College of Medicine

Grant: $100,000 (one year)

Coombs will examine human cells’ susceptibility to the Zika virus, which is transmitted by a mosquito that is becoming known in Canada. He aims to understand how cellular genes and proteins work to allow or inhibit Zika growth.

Dr. Sanjiv Dhingra, associate professor, physiology & pathophysiology, Max Rady College of Medicine; principal investigator, Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre

Grant: $960,076 (five years)

Dhingra’s study relates to the potential of using transplanted stem cells from healthy donors to treat heart disease. He will investigate why transplanted stem cells are ultimately rejected by the host’s immune system, and how to prevent this.

Dr. Vernon Dolinsky, associate professor, pharmacology & therapeutics, Max Rady College of Medicine; researcher, CHRIM

Grant: $822,376 (five years)

Dolinsky’s team has found that the offspring of mothers who had gestational diabetes are at risk of later heart failure. His study will investigate the role of a cellular protein that could prevent damage to the heart and allow it to pump better.

Dr. Krista Hardy, assistant professor, surgery, Max Rady College of Medicine

Grant: $470,475 (four years)

Hardy aims to better understand the experiences of Indigenous patients who undergo bariatric surgery in Manitoba as a treatment for obesity. Her project will incorporate and assess Indigenous healing and wellness practices in bariatric surgery care.

Dr. Richard Keijzer, professor, surgery, Max Rady College of Medicine; researcher, CHRIM

Grant: $233,324 (three years)

Keijzer’s team has created a database of more than 750 Manitobans who were born with a congenital anomaly that required surgery at birth. By linking this to population data, the team will conduct a follow-up study of the patients’ medical, educational and socio-economic outcomes.

Grant: $749,700 (five years)

Keijzer will also lead an international team of experts on congenital diaphragmatic hernia (CDH) to determine the role of circular RNAs in these infants’ abnormal lung development. The results will help to better predict outcomes in babies with CDH.

Dr. Dylan MacKay, assistant professor, community health sciences, Max Rady College of Medicine

Grant: $100,000 (one year)

MacKay will enrol patients with chronic kidney disease in a one-year, randomized study comparing methods of reducing dietary acid. Half the patients will take baking soda pills, while the other half will have fruits and vegetables delivered to them to reduce acid through diet.

Dr. Lyle McKinnon, associate professor, medical microbiology & infectious diseases, Max Rady College of Medicine; researcher, CHRIM

Grant: $300,000 (three years)

McKinnon’s team has previously found that vaginal inflammation increases a woman’s risk of becoming HIV-infected if exposed. His study focuses on regulatory T cells and their potential to control female genital inflammation as an HIV prevention strategy.

Dr. James Nagy, professor, physiology & pathophysiology, Max Rady College of Medicine

Grant: $742,050 (five years)

Nagy’s study builds on his previous research on how nerve cells in the brain communicate at electrical synapses, how protein components function in this transmission, and how malfunctioning of these mechanisms contributes to neurological disorders.

Dr. Marcus Ng, associate professor, internal medicine, Max Rady College of Medicine

Grant: $548,890 (five years)

Ng will analyze data from patients with epilepsy to compare the brain zone of epileptic activity during rapid eye movement sleep, other stages of sleep, and wakefulness. Better mapping of where seizures arise could allow more patients to undergo life-changing neurosurgery.

Dr. Tabrez Siddiqui, associate professor, physiology & pathophysiology, Max Rady College of Medicine

Grant: $983,026 (five years)

Siddiqui will investigate, in mice, how a type of altered biochemical signaling affects the brain, producing deficits such as those in autism and schizophrenia. The goal is to increase understanding of neuropsychiatric disorders so that drug targets can be identified.

Dr. Jörg Stetefeld, professor, biochemistry, Faculty of Science; Canada Research Chair in structural biology and biophysics

Grant: $742,050 (five years)

Stetefeld will pursue a molecular study of connective tissue growth factor (CTGF), a protein involved in cancerous tumor development and tissue fibrosis. He aims to develop new therapeutic targets based on understanding the role of CTGF.

Dr. Julia Uhanova, associate professor, internal medicine, Max Rady College of Medicine

Grant: $573,751 (two years)

Uhanova will explore whether adherence to a traditional First Nations land-based diet decreases the severity of non-alcoholic steatohepatitis, an aggressive form of fatty liver disease. This inflammatory disease has a high prevalence among First Nations.

Dr. Jude Uzonna, professor, immunology, Max Rady College of Medicine

Grant: $990,676 (five years)

Uzonna’s study focuses on how the body maintains immunity after recovery from leishmaniasis, a parasitic disease. Understanding factors that regulate the antigen-specific memory response to the disease will aid progress toward a vaccine.

Dr. Kristy Wittmeier, associate professor, pediatrics & child health, Max Rady College of Medicine; researcher, CHRIM

Grant: $240,976 (two years)

Building on her previous research, Wittmeier will study knowledge-sharing networks in child development and rehabilitation in Canada. Her team will make recommendations to improve these networks to better serve children’s needs.

Molecular epidemiological tools are gaining popularity among researchers as they can identify previously unlinked transmissions. The anonymized data can offer many insights, but the data is far removed from the lived experiences of those hindered by the disease, so any program developed from this data may not fit the “real world” circumstances of those needing help.

Robert Lorway, Co-Principal Investigator and professor of community health sciences and Canada Research Chair in Global Intervention Politics and Social Transformation.

Lyle McKinnon, Co-Principal Investigator and an associate professor in medical microbiology and infectious disease.

But for the UM team, led by Lyle McKinnon, an associate professor in medical microbiology and infectious disease in the Rady Faculty of Health Sciences, the big question is the ethical questions that emerge from using such tools, and how these can be harnessed to guide HIV programs. 

“Do these new powerful techniques for identifying transmission patterns represent a major breakthrough to effectively tackle HIV epidemics, or do they signify the emergence of a highly intrusive surveillance regime in HIV science,” he asks.

This new study, which received $250,000 in support from Canada’s New Frontiers in Research Fund – Exploration, opens a critical and engaged dialogue with a vibrant local activist community in Kenya, Nairobi, and will offer insight into the potential uses and anticipated abuses of using such information to sharpen the focus of HIV epidemic prevention. The outcome of this process holds major importance to the development of policy frameworks that will guide the next generation of the global response.

The UM team has used such molecular tools to analyze several hundred HIV sequences within a large sex worker prevention program and noted several large, mixed transmission networks. Now, with co-lead Robert Lorway, they are directly engaging communities of male and female sex worker activists living in Nairobi, Kenya, in a critical knowledge exchange process. This will answer how, or if, these data can be ethically used to inform existing programs.

The UM has long been a trailblazer in many areas of HIV/AIDS research, including the search for a vaccine against its spread, and this project builds upon this legacy of community partnership to bolster global public health.

This study will draw upon a community based participatory approach employed by feminist and postcolonial scholars. Its multidisciplinary team of basic and social scientists, policy-makers, and local community health activists will 1) work through lay technical summaries of the molecular data to explore the possibilities and limitations of employing network interventions, 2) co-design and test, under carefully controlled conditions, a targeted pilot intervention that combines molecular network data with community knowledge and 3) critically assess and identify the emergent ethical issues, advantages and disadvantages of the tested intervention (when compared to conventional approaches).

Opening up a critical and engaged dialogue with a vibrant local activist community, will offer insight into the potential uses and anticipated abuses of using such information to sharpen the focus of HIV epidemic prevention. The outcome of this process holds major importance to the development of policy frameworks that will guide the next generation of the global response.

Research team includes:

• Robert Lorway – Co-Principal Investigator, Professor and Canada Research Chair in Global Intervention Politics and Social Transformation, Community Health Sciences, Max Rady College of Medicine
• Souradet Shaw – Co-Applicant, Assistant Professor and Canada Research Chair in Program Sciences and Global Public Health, Community Health Sciences, Max Rady College of Medicine
• Parinita Bhattacharjee – Co-Applicant, Senior Technical Advisor, Partners for Health and Development in Africa, Technical Support, Kenya
• Joshua Kimani – Co-Applicant, Clinical Director, Partners for Health and Development in Africa, Key Populations Research, Kenya
• Marissa Becker – Co-Applicant, Associate Professor, Community Health Sciences, Max Rady College of Medicine
• Marianne Mureithi – Co-Applicant, Lecturer, University of Nairobi, Medical microbiology, Kenya

“Congratulations to the successful applicants in the Fall 2020 round of funding. This is an impressive showing by UM investigators,” said Dr. Peter Nickerson, vice-dean research of the Rady Faculty of Health Sciences. 

“Some of these projects focus on improving the lives of people with conditions such as kidney disease, Type 2 diabetes and mental health disorders. Others are lab studies that will advance knowledge about illnesses such as Ebola, leukemia, HIV and metabolic diseases.

“Our researchers are also analyzing data to reveal new evidence about interlinked social and health factors in Manitobans’ lives. And they’re studying areas such as Indigenous-led wellness programs and children’s rehabilitation knowledge sharing in order to identify and build on strengths.”

UM Today recently reported on two of the funded projects, which relate to COVID-19: a randomized trial of a home monitoring platform for patients with chronic kidney disease, led by Dr. Claudio Rigatto, and a study of the lived experiences of families with children who are immunocompromised, led by Dr. Roberta Woodgate.  

Here’s a look at the other projects:

Dr. Clara Bohm, associate professor, internal medicine, Max Rady College of Medicine

Grant: $439,874

Bohm’s team will conduct a randomized trial to assess whether stationary cycling during kidney dialysis treatments reduces heart “stunning” (poor pumping, which can cause heart damage) and improves symptoms such as fatigue. The trial involves participants in Canada, the U.S. and Australia.

Dr. Shay-Lee Bolton, assistant professor, psychiatry, Max Rady College of Medicine

Grant: $100,000

Bolton will evaluate whether a psychotherapy and mindfulness program that is delivered virtually helps public safety personnel, such as police officers and firefighters, cope with stress, maintain mental wellness and remain resilient.

Dr. Dan Chateau, assistant professor, community health sciences, Max Rady College of Medicine; research scientist, Manitoba Centre for Health Policy (MCHP)

Dr. Marni Brownell, professor, community health sciences, Max Rady College of Medicine; associate director, research, and senior research scientist, MCHP; researcher, Children’s Hospital Research Institute of Manitoba (CHRIM)

Grant: $432,226

Chateau’s team will use health data to investigate the effects of prescription opioid and psychotropic medication use during pregnancy, looking at patterns of prescription opioid use, short-term effects on children exposed in the womb, and longer-term outcomes for these children.

Dr. David Collister, assistant professor, internal medicine, Max Rady College of Medicine

Grant: $100,000

Collister’s project is a trial comparing oral and topical nabilone (a synthetic form of cannabis) to placebos to determine whether nabilone is safe and effective at reducing itching in patients who are on dialysis for kidney disease.

Dr. Shyamala Dakshinamurti, professor, pediatrics and child health, Max Rady College of Medicine; researcher, CHRIM

Grant: $784,125

This study looks at newborn pulmonary hypertension, which prevents some babies from getting enough bloodflow to their lungs. By focusing on a system of signals in the body called the adenylyl cyclase pathway, Dakshinamurti aims to help these infants’ lungs relax and hearts pump strongly.

Dr. Allison Dart, associate professor, pediatrics and child health, Max Rady College of Medicine; researcher, CHRIM

Dr. Brandy Wicklow, associate professor, pediatrics and child health, Max Rady College of Medicine; researcher, CHRIM

Grant: $1,300,500

Dart and Wicklow will study biopsychosocial risk factors for worsening kidney disease in children and teens with Type 2 diabetes. They will also test a skills-based mental health program to help Indigenous youth with Type 2 diabetes manage their emotions and their disease.

Dr. Andrew Hatala, associate professor, community health sciences, Max Rady College of Medicine; researcher, CHRIM

Dr. Sabina Ijaz, family physician; Giigewigamig health advisor

Elder Dave Courchene, founder, Turtle Lodge

Grant: $1,748,025

This team will conduct an Indigenous-led study of the Turtle Lodge in Sagkeeng First Nation as a model of Indigenous education, wellness and flourishing. The objectives include developing a framework for stronger relationships between Indigenous Knowledge Holders and biomedical practitioners.

Dr. Jason Kindrachuk, assistant professor, medical microbiology and infectious diseases, Max Rady College of Medicine; Canada Research Chair in molecular pathogenesis of emerging and re-emerging viruses; researcher, CHRIM

Grant: $726,750

Kindrachuk’s project focuses on the fact that some men who have recovered from Ebola continue to carry the virus in their reproductive tracts. The study will investigate how the virus persists in the testes and is sexually transmitted. It will also look at Ebola’s long-term effects on reproductive health.

Dr. Ted Lakowski, associate professor, College of Pharmacy

Grant: $699,975

Lakowski’s study aims to develop new cancer therapies that target the specific genes involved in a type of leukemia. These treatments are expected to be more effective and cause fewer side effects than current therapies. The strategy could lead to gene-specific treatments for other cancers.

Dr. Lyle McKinnon, assistant professor, medical microbiology and infectious diseases, Max Rady College of Medicine; researcher, CHRIM

Grant: $100,000

McKinnon will study the role of regulatory T cells, a type of immune cell, in controlling female genital inflammation. Because this inflammation puts women at higher risk of HIV infection, the study is relevant to finding better prevention strategies for women who are at risk of HIV exposure.

Dr. Suresh Mishra, professor, internal medicine, Max Rady College of Medicine

Grant: $100,000

Mishra will focus on prohibitin, a protein that plays an important role in sex differences in fat and immune cells. Using mouse models, he will investigate why men and women display differences in susceptibility and resistance to metabolic and immune diseases.

Dr. Rae Spiwak, assistant professor, surgery, Max Rady College of Medicine

Grant: $60,000

Spiwak will use Manitoba data to investigate what social factors place children at greater risk for physical injury. The study will look at a cohort of children who were hospitalized for traumatic physical injury and compare them with uninjured children, examining factors such as parental socioeconomic status and education.

Dr. Elizabeth Wall-Wieler, assistant professor, community health sciences, Max Rady College of Medicine; research scientist, MCHP; Canada Research Chair in population data analytics and data curation

Dr. Marilyn Bennett, assistant professor, Faculty of Social Work

Dr. Marni Brownell, professor, community health sciences, Max Rady College of Medicine; associate director, research, and senior research scientist, MCHP; researcher, CHRIM

Dr. Marcelo Urquia, associate professor, community health sciences, Max Rady College of Medicine; research scientist, MCHP; Canada Research Chair in applied population health

Grant: $393,976

Wall-Wieler’s team will analyze Manitoba data to determine whether parents with specific health conditions are more likely to have a child taken into care, and how having a child taken into care affects parents’ health. The study will compare First Nations, Métis and all other Manitoban parents.  

Dr. Jun-Feng Wang, associate professor, pharmacology and therapeutics, Max Rady College of Medicine

Grant: $623,475

Wang will investigate the role of a protein, Txnip, in chronic stress-induced neuronal dysfunction. The research will use an animal model for depression, aiming to determine if inhibiting Txnip could be used in treating human depression.

Dr. Brandy Wicklow, associate professor, pediatrics and child health, Max Rady College of Medicine; researcher, CHRIM

Grant: $100,000

Wicklow will examine beta cell and kidney function in First Nations children whose mothers were diagnosed as children with Type 2 diabetes. The offspring will be studied in early childhood and compared with children not exposed to Type 2 diabetes in the womb. The results will contribute to strategies for early intervention.  

Dr. Kristy Wittmeier, assistant professor, pediatrics and child health, Max Rady College of Medicine; researcher, CHRIM

Grant: $100,000

Wittmeier’s team will study how knowledge about research and treatments is shared via networks between researchers, therapists and families of children with development or rehabilitation needs. The goal is to identify strengths and gaps in these knowledge-sharing networks and make recommendations to improve them.

Dr. Roberta Woodgate, distinguished professor, College of Nursing; Canada Research Chair in child and family engagement in health research and healthcare; researcher, CHRIM

Grant: $761,176

Woodgate’s study will involve young immigrants and refugees in co-designing culturally sensitive mental health supports for youth like themselves. Parents and community-based organizations will also participate. The researchers will develop a digital mental health self-management prototype.

“Congratulations to the U of M applicants who were successful in this highly competitive national funding process,” said Dr. Peter Nickerson, vice-dean research of the Rady Faculty of Health Sciences.

“These projects represent a number of colleges and departments across the Rady Faculty. They demonstrate innovative and collaborative approaches to health research. Each of these exciting studies has the potential to advance health care in meaningful ways.”        

Here’s a look at the projects:

Dr. Allan Becker, professor, pediatrics and child health, Max Rady College of Medicine; researcher with Children’s Hospital Research Institute of Manitoba (CHRIM)

Dr. Meghan Azad, Canada Research Chair in Developmental Origins of Chronic Disease; assistant professor, pediatrics and child health; researcher with CHRIM

Project Grant: $1,220,940

Becker and Azad seek to understand why asthma is more common in boys than girls, but shifts to being more common in women than men. The researchers will assess 1,000 children who are part of an ongoing cohort study, measuring whether changes in body fat, inflammation or sex hormones in puberty explain the “sex shift.” This knowledge will contribute to better prevention and treatment of asthma in all children.

Dr. Christine Kelly, assistant professor, community health sciences, Max Rady College of Medicine

Project Grant: $726,750

Kelly will study directly funded (also known as “self-managed”) home care, which is expanding across Canada. Under this model, individuals receive government funds to pay for their own home care. Kelly will examine policy issues such as the role of home-care agencies in delivering these services and how this kind of home care can best be adapted to rural contexts. The aim is to generate insights about how directly funded home care can most equitably serve users, their families/supporters and home-care workers.

Dr. Gilbert Kirouac, neuroscientist; professor, oral biology, Dr. Gerald Niznick College of Dentistry

Project Grant: $707,625

Kirouac will study how a region of the brain called the paraventricular nucleus of the thalamus interacts with other brain regions to produce excessive anxiety. Using rodent models, Kirouac will apply innovative techniques to better understand the neural circuitry of stress-induced anxiety. The goal is to gain knowledge that will lead to new treatments for anxiety disorders.

Dr. Lily Lim, assistant professor, pediatrics and child health, Max Rady College of Medicine; researcher with CHRIM

Project Grant: $321,300

Lim will study employment experiences and challenges among young adults aged 18 to 30 who have lupus. People with lupus often deal with fatigue, chronic pain and mental health issues that can make working difficult. Lim’s findings will contribute to developing new ways to help young people with lupus obtain and keep employment. Dr. Eleanor Pullenayegum of the University of Toronto is co-principal investigator.

Dr. Jillian Stobart, assistant professor, College of Pharmacy

Project Grant: $504,900

Stobart will use advanced fluorescence microscopes and genetic tools to study pericytes – blood vessel cells – and blood flow in animal models. Blood flow in the brain decreases with age, and this may cause cognitive decline and Alzheimer’s disease. Abnormal pericytes may account for these blood flow changes. Stobart’s objective is to understand how pericyte signaling changes with age or during Alzheimer’s disease, and how this affects blood flow.  

Dr. Dan Chateau, assistant professor, community health sciences, Max Rady College of Medicine; research scientist, Manitoba Centre for Health Policy

Priority Announcement Bridge Grant: $100,000

Chateau will use anonymized health data to investigate the effects of prescription opioid and psychotropic medication use during pregnancy. The study will look at patterns of prescription opioid use among pregnant women, short-term effects on children exposed in the womb (such as neonatal abstinence syndrome) and longer-term outcomes for these children, such as readiness for school.

Dr. Robert Lorway, Canada Research Chair in Global Intervention Politics and Social Transformation; associate professor, community health sciences, Max Rady College of Medicine

Dr. Lyle McKinnon, assistant professor, medical microbiology/infectious diseases and community health sciences; researcher with CHRIM

Dr. James Blanchard, Canada Research Chair in Epidemiology and Global Public Health; professor, community health sciences

Dr. Marissa Becker, associate professor, medical microbiology/infectious diseases and community health sciences

Priority Announcement Bridge Grant: $100,000

Lorway’s team will study human papillomavirus (HPV) infection among men who have sex with men in Nairobi, Kenya. Members of this group are stigmatized and are often diagnosed with HPV-related disease, including anal cancer, at a late stage of illness. This research will provide evidence to support a community-led early screening, prevention and treatment program.

Dr. Frederick Zeiler, assistant professor, neurosurgery, Max Rady College of Medicine

Dr. Jai Jai Shankar, professor, radiology, Max Rady College of Medicine

Priority Announcement Bridge Grant: $100,000

Zeiler and Shankar will research the use of an advanced type of brain scan, computed tomographic perfusion, to diagnose brain death in patients with severe traumatic brain injury at the time of hospital admission. Currently, patients with this kind of injury often receive intensive treatment because it is not recognized that their injuries are fatal. The goal is to better understand patients’ prognosis and optimize the use of health-care resources.

As an international hub for infectious disease research, MMID has been involved in many international breakthroughs. More recently, in the case of the Ebola outbreak in West Africa, it was researchers from the NML and MMID who developed the vaccine to treat the virus. However, the genesis of how MMID got onto the international stage for infectious disease research is often unrecognized.

MMID’s response to the outbreak of a sexually transmitted infection known as chancroid (caused by Haemophilus ducreyi) was the prominent impetus that forged international ties to the University of Nairobi (UoN) in Kenya. Amid Winnipeg’s local chancroid outbreak in the 70s, the
active department head, Dr. Allan Ronald, and his colleague, Dr. Gregory Hammond, sought to identify the causative agent by developing conducive growth media and subsequently assessed antibiotic susceptibility. Their efforts were rewarded in the capacity to treat and eradicate this local outbreak, ultimately becoming experts in the management of chancroid.

In 1979, while attending a meeting of the United Nations, Dr. Ronald learned of a large chancroid outbreak in Kenya. He met the then Head of the Department of Medical Microbiology at the University of Nairobi, Dr. Herbert Nsanze, who invited him to assist with the chancroid outbreak in Kenya. In 1980, they worked at a Nairobi City clinic called the ‘Casino clinic’ in downtown Nairobi to study chancroid which mainly catered to male clients. This was the first international collaboration for MMID and one that is still ongoing.

In 1984, Frank Plummer, a medical fellow of Dr. Ronald’s, joined the clinic to study gonorrhea caused by Neisseria gonorrhoeae. For his research project Frank started a cohort of female sex workers from Pumwani District in Nairobi. Working alongside (the late Prof) Elizabeth Ngugi, a nurse with the project, they used a community engagement (peer engagement) model in which the sex workers themselves came up with ways of communicating STI prevention approaches. This led to the birth of the Majengo clinic where the MMID team is still providing health care for the sex workers. Initial research at this clinic focused on N. gonorrhoeae and its sensitivity to antibiotics.

Since then, the number of studies that have been carried out by students at the U of M and the UoN, as well as faculty from both institutions, and other research facilities based at the UoN. 

The U of M/UoN collaboration has greatly contributed to Kenya’s fight against HIV; especially among high risk populations as well as undertaking research other areas of infectious diseases.

One of the first demonstrations and publication of heterosexual HIV transmission of HIV in women in Africa was from the Nairobi cohort. Dr. Joanne Embry and Dr. Frank Plummer described mother-to-child transmission of HIV through breast milk, and the team also showed higher risk of HIV infection in men with foreskin. To translate their research into the community, they utilized the peer engagement model; a model where select community members work as peer educators to explain and translate key research on HIV. This model has been adopted by clinics in India.

Dr. Keith Fowke’s laboratory focuses on immune responses in individuals who, though exposed to HIV frequently, appear to be resistant to infection with the virus, known as highly exposed seronegative (HESN). They are currently conducting studies focused on blocking inflammation
as a new approach to HIV prevention.

Dr. Blake Ball’s research focuses on immune responses and susceptibility to HIV and TB; Dr. Lawrence Gelmon’s research interest is in HIV/ AIDS, STIs in relation to epidemiology and health policies; Dr. Kelly MacDonald’s research combines basic science and clinical aspects of HIV vaccines. Drs. Ma Luo and Frank Plummer are also working on an HIV vaccine based on studies from the HESN Nairobi sex workers. Dr. Lyle McKinnon’s research combines epidemiology with basic science studies of transmission among cohorts of men who have sex with men (MSM), female sex workers (FSW), and adolescent girls and young women (AGYW) in several countries including Kenya. Dr. Elijah Songok, is tackling HIV protection by the identification of novel biomarkers in HIV-resistant sex workers of the long standing Pumwani cohort of Nairobi for HIV drug development in the future. His position as head of Graduate Studies at the U of Nairobi, has enabled him to bridge international research capacity between U of Nairobi and U of M trainees with the Kenya Medical Research Institute (KEMRI)- the Kenyan equivalent of Canada’s NML. Dr. Jason Kindrachuk, Canada Research Chair in Molecular Pathogenesis of Emerging and Re-emerging Viruses, whose research focus is emerging infectious diseases, also leads science outreach activities in Africa that focus on building capacity and expertise in emerging virus preparedness at the local level.

Five generations of Canadian and Kenyan researchers have now been training through this collaboration. Together, from a modest start, the collaboration between MMID and the U of Nairobi has resulted in several highly significant research findings and improved health to populations globally.

Toby Le, M.Sc student, MMID

Shifa Mohideen, M.Sc student, MMID

Florence Mutual, Ph.D. candidate, MMID

Ruth Mwatelah, Ph.D. candidate, MMID

This investment will support 251 researchers leading 186 projects at 43 universities across Canada. JELF aims to help universities attract and retain top talent from around the globe by providing researchers with the highly specialized infrastructure they require to be leaders in their field.

“Since 1997, the Canada Foundation for Innovation has been ensuring Canadian researchers have the tools they need to push the frontiers of knowledge in all disciplines,” the minister said. “The stable, long-term funding we are celebrating today will help Canada continue to be an international destination for research and innovation.”

As part of this funding, the University of Manitoba is receiving more than $1.1 million in support of seven projects in areas such as disease, food processing and supercomputers. Dr. Janilyn Arsenio, for example, will use the funding to help with her research in developing new strategies for vaccine design and in improving the treatment of infections, cancer and autoimmune diseases.

“I congratulate these researchers on their exceptional work being recognized today with this new investment. The advancements they make will contribute to health and economic well-being in Manitoba and beyond,” says Digvir Jayas, Vice-President (Research and International) and Distinguished Professor at the University of Manitoba

The U of M recipients are:

Janilyn Arsenio

Janilyn Arsenio

Canada Research Chair in Systems Biology of Chronic Inflammation, Assistant Professor, Internal Medicine, Rady Faculty of Health Sciences, is receiving $156,834 for project titled: Single-cell transcriptomics analysis of the immune system during infection and chronic inflammation.

An effective immune system provides protection against infection and prevents immune dysregulation. Dysregulation can lead to conditions of chronic inflammation. This includes heightened immune responses in autoimmune diseases and transplant rejections, or to a loss of immune function (exhaustion) in chronic infections and cancer. This research aims to understand how single T cells become functional immune regulators. Single-cell transcriptomics will be used to define the molecular programs which form functional versus dysfunctional T cells during infection and conditions of chronic inflammation. Information from this research will be used to develop novel vaccines and immunotherapies to prevent and treat infectious and non-infectious diseases. Advancing single-cell systems based research in biomedicine to be transformative into the development of next generation therapeutic strategies to treat diseases will positively impact the economic, health, and training sectors in Canada.

Meghan Azad

Meghan Azad and Nathan Nickel

Azad is Canada Research Chair in Developmental Origins of Chronic Disease, Assistant Professor, Pediatrics and Child Health, Rady Faculty of Health Sciences and Scientist with Children’s Hospital Research Institute of Manitoba, is receiving $165,464 for project titled: Manitoba Interdisciplinary Lactation Centre (MILC): a provincial infant feeding database and human milk biorepository.

Nickel is assistant professor, community health sciences; Manitoba Centre for Health Policy, Rady Faculty of Health Sciences.

Nathan Nickel

Funds will be used to establish a new one-of-a-kind research centre: the Manitoba Interdisciplinary Lactation Centre (MILC). MILC will combine a provincial infant feeding database and a human milk biorepository that will be linked with a wealth of health and social services data at the Manitoba Population Research Data Repository.

MILC will provide unrivaled opportunities to conduct interdisciplinary research on the impact of policies on breastfeeding, the biology of human milk, and the influence of social factors on breastfeeding biology and behaviours.

Filiz Koksel

Assistant Professor, Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, is receiving $160,000 for project titled: Tailoring quality during processing of protein rich plant-based food materials.

Filiz Koksel

The proposed innovative research program aims to develop techniques to manufacture high quality plant protein-rich foods under a wide range of process conditions and to

formulate nutritionally dense and palatable foods with appealing, novel structures. Through value added processing of Canadian cereals and pulses into products such as meat extenders, meat analogs and protein-rich snacks, the findings of this program will increase the availability of healthy alternatives to animal-based foods. Trainees involved in this research will receive exceptional interdisciplinary training in food engineering and materials science, so they are skilled to non-destructively characterize and assess the structure and texture of foods and then be able to control food quality in real-time during processing.

Lyle McKinnon

Lyle McKinnon

Assistant Professor, Medical Microbiology and Infectious Disease with a cross-appointment in Community Health Sciences, Rady Faculty of Health Sciences is receiving $155,942 for project entitled: Enhancing capacity for cellular phenotyping for HIV prevention and cure research.

Understanding the underlying biology of virus entry at a mucosal level is believed to be key to designing better HIV prevention. This research will focus on defining the cellular determinants of HIV transmission and pathogenesis, with the goal of improving HIV prevention options that are available in the clinic. This research will lead to the training of personnel at multiple levels, from undergraduate students to principle investigators, including Canada’s future leaders in HIV prevention research. The benefits to Canadians and world-wide extend beyond fighting HIV, by increasing knowledge of immunology that is “taught by viruses” — advances in HIV have frequently provided insight into the host immune system that the virus attacks, shedding light on other medical conditions with an immunological basis.

Gerd Prehna

Gerd Prehna

Assistant Professor, Microbiology, Faculty of Science is receiving $159, 028 for project titled: High-yield Protein Production Suite for Structural Biology.

Gram-negative bacteria have evolved a macromolecular machine termed the type VI secretion system (T6SS) to communicate directly with each other, competing micro-organisms, and with eukaryotic hosts. The human gut flora use the T6SS to maintain a mutualistic relationship with their host, whereas pathogens such as Salmonella use it as a weapon. At the molecular level the T6SS is adaptable and modular to allow bacteria to perform numerous functions. As Salmonella species have multiple divergent T6SS adapted for specific hosts (human, chicken, reptile), the research program will investigate T6SS versatility in detail at the molecular level. A detailed molecular understanding of the Salmonella T6SS will not only reveal targets for the development of new antibiotics, but given its versatility further research could allow it to be developed into a tunable drug delivery system.

Robert Stamps

Robert Stamps

Professor and Head, Physics and Astronomy, Faculty of Science is receiving $114,046 for project titled: Desktop Supercomputers for the Design of Advanced Functional Materials.

This research will create a resource essential for the development of advanced functional materials. The focus will be on materials with potential to enable new opportunities for next generation energy efficient information and communication technologies, nanoscale sensing devices for biomedical applications, and novel quantum technologies. This research will provide needed computational tools for the design of next generation multifunctional and smart materials whose unique electric and magnetic properties do not exist in the current stockpile of material options. Useful models for the design and exploitation of these materials require a multi-scale modelling approach that poses enormous computational challenges. These challenges can be addressed with computational resources recently available in low-cost desktop platforms and moderate sized clusters made possible with accelerations using the multiple cores of high end graphics cards.

Marcelo Urquia

Marcelo Urquia and Alyson Mahar

Assistant Professors, Community Health Sciences and Manitoba Centre for Health Policy, Rady Faculty of Health Sciences is receiving $240,000 for the project titled: Social Determinants of Health Digital Library.

To effectively address the social determinants of health there is a need for richer information across sectors (combining information from health, education, social services, and the justice systems), a greater focus on families, and development of new analytic tools to optimize the use of the available data.

Alyson Mahar

Urquia and Mahar will create a laboratory to study these important contributors to health and well-being, bringing together new and existing data at the University of Manitoba with key stakeholders to support Canadians who face challenges to achieving optimal health. Urquia will focus on integration to Canadian society, gender equity initiatives, and navigating the health system for Canadian immigrant families working to support the development of solutions to issues affecting their well-being. Mahar will help strengthen Canadian Armed Forces families by studying the short and long-term effects of military service, including Post Traumatic Stress Disorders, following soldiers’ transition to civilian life. Her program will also work to ensure all Canadians have equal opportunity to benefit from advances in cancer treatment, especially marginalized populations.

The funding is made possible by the gift of $30 million made in 2016 by philanthropists Ernest and Evelyn Rady in support of health sciences at the university. The fund will allocate a total of $1 million over three years to support collaborative research by faculty members.

The one-year grants are designed to seed short-term projects that combine the expertise of researchers from various departments and colleges of the Rady Faculty of Health Sciences.

“All four of these interdisciplinary teams have proposed cutting-edge science,” said Dr. Peter Nickerson, vice-dean research of the Rady Faculty. “These are exciting projects that cover the spectrum from basic to clinical research, each with the potential for high impact in the short term.”

Here are the projects chosen for funding in 2019:

Analyzing medications in human milk

Dr. Lauren Kelly

Dr. Lauren Kelly, assistant professor of pediatrics/child health in the Max Rady College of Medicine and scientist with the Children’s Hospital Research Institute of Manitoba (CHRIM), will lead a study of breast milk. Mothers who take medications, and their health-care providers, are often concerned about infants’ exposure to drugs in breast milk. This can deter breastfeeding or deny moms safe use of medicines.

Kelly’s team includes researchers from the College of Nursing, College of Pharmacy, Manitoba Centre for Health Policy and CHRIM. After reviewing what medicines breastfeeding women in Manitoba use, they will conduct a pilot project to collect and analyze breast milk. The evidence obtained will advance the understanding of medication safety during breastfeeding.

A further goal is to develop methods for storing anonymized medication data with milk samples, allowing for follow-up research.

Applying artificial intelligence to health research

Dr. William Leslie

A team led by Dr. William Leslie, professor of internal medicine and radiology in the Max Rady College of Medicine, has already had success at harnessing artificial intelligence. The team has “taught” a machine to find vertebral fractures on bone-density scans. This helps to identify patients at high risk for another fracture.  

The new study will continue this machine-learning research, enhance the infrastructure for it, and promote machine-learning collaborations within and beyond the Rady Faculty of Health Sciences.

Leslie’s team, which includes researchers from the department of radiology and the College of Pharmacy, will share lessons they have derived from “teaching” machines, in terms of requirements such as image processing and computer programming. A key goal is to help other researchers enter this fast-paced field.

Understanding a non-invasive thyroid tumour

Dr. Sabine Mai

Dr. Sabine Mai, professor of physiology, biochemistry/medical genetics and human anatomy/cell science in the Max Rady College of Medicine, Canada Research Chair in genomic instability and nuclear architecture in cancer, and senior investigator at the Research Institute in Oncology and Hematology, leads a team that will investigate a type of thyroid tumour called a “non-invasive follicular thyroid neoplasm with papillary-like nuclear features” (NIFTP).

Because this tumour is non-invasive, it may be over-treated if it is diagnosed as aggressive cancer. This study will compare NIFTP to other sub-types of thyroid cancer in order to predict its behaviour and tailor its clinical management.

With team members from pathology/immunology and surgery, the study will examine NIFTP at the genetic level. It will look, for example, at the 3D organization of telomeres (the ends of chromosomes). The project aims to refine the diagnostic criteria for NIFTP.

Investigating the genetics of HIV risk

Dr. Lyle McKinnon

A study led by Dr. Lyle McKinnon, assistant professor of medical microbiology and community health sciences in the Max Rady College of Medicine, will build on the previous finding that vaginal inflammation in women increases HIV susceptibility. The underlying reasons why some women have this inflammation are unclear.

The team recently analyzed the genetic profiles of more than 200 young women in South Africa. They found several gene variants that are associated with genital inflammation and/or HIV acquisition.

With team members from medical microbiology/infectious diseases, immunology and community health sciences, this study seeks to validate this finding in a larger sample of South African and Kenyan women, and to investigate more precisely how genes influence inflammation and HIV susceptibility. The ultimate goal is to develop new HIV prevention strategies.

VIEW FULL PROJECT DESCRIPTIONS.

The 2018 Rady Innovation Fund recipients, Dr. Thomas Klonisch, Dr. James Nagy and Dr. Kathryn Sibley, will present their findings on December 17, click for event info. 

A new study by scientists at the Centre for the AIDS Programme in Research in South Africa (CAPRISA), published in Nature Medicine this week, shows that genital inflammation significantly reduces the effectiveness of tenofovir gel in preventing HIV infection in women. These findings indicate that both genital inflammation and adherence need to be addressed to improve the effectiveness of topical pre-exposure prophylaxis strategies for HIV prevention in women.

The researchers measured small proteins, known as cytokines, in the vagina. Raised cytokines levels in the vagina indicate the presence of inflammatory immune responses, even in the absence of clinical symptoms. In this study, HIV infection rates and cytokine levels as a marker of genital inflammation were studied longitudinally in 774 women over 2.5 years.

Lead authors of the study, Lyle McKinnon, an adjunct professor of medical microbiology at the University of Manitoba, and Lenine Liebenberg, University of KwaZulu-Natal, found that women with genital inflammation were at higher risk of subsequently contracting HIV compared to women without inflammation.

“Reducing inflammation of the genital tract in women may augment the HIV prevention in women,” McKinnon says.  

The study highlights the major role of genital inflammation in HIV risk and in modifying the efficacy of HIV prevention strategies. Current and future attempts to improve topical PrEP efficacy would benefit from knowing the causes of inflammation, and developing new strategies to treat genital inflammation, co-author Liebenberg notes.

One such effort is currently underway at the University of Manitoba, where a study is being led by Keith Fowke to use the anti-inflammatory, Acetylsalicylic acid (known commonly as aspirin), to reduce inflammatory responses in the female genital tract.

In the meantime, Liebenberg and McKinnon’s study shows that tenofovir gel provided 57 per cent protection against HIV acquisition in women who had no evidence of vaginal inflammation but provided no protection in women with genital inflammation, even if they used the gel consistently.

“This study gives us an important clue to enhance HIV prevention in women. It is not only adherence-related behaviours, but also biological processes in the vaginal that need to be addressed to prevent HIV and enhance the effectiveness of topical PrEP,” said Professor Salim Abdool Karim, Director of CAPRISA and CAPRISA Professor of Global Health at Columbia University.