Overview

I am a public health researcher with an interest in improving long term outcomes for children with sepsis. In countries like Uganda, as many children die following hospital discharge as die during the initial hospitalization. Most of these deaths occur at home, and are largely preventable. The last point of contact with the health system for most children who go on to die is during the discharge period. However, the discharge process is often not considered a critical period of the illness, and is not conducted in a way that allows for appropriate monitoring for recurrent illness. Over the past decade my research team has developed tools to allow health workers to rapidly predict which children at highest risk of dying after discharge, and also have developed our “Smart Discharges” approach to care during and after discharge. Our approach focuses on both patient counselling and education, as well a risk guided referral for appropriate post-discharge care for those most likely to benefit from this. This individualized approach ensures both affordability to the health system as well as attention to the most vulnerable.

Publications

Derivation and internal validation of a data-driven prediction model to guide frontline health workers in triaging children under-five in Nairobi, Kenya [version 2; peer review: 1 approved]
Alishah Mawji and Samuel Akech and Paul Mwaniki and Dustin Dunsmuir and Jeffrey Bone and Matthew O. Wiens and Matthias Görges and David Kimutai and Niranjan Kissoon and Mike English and Mark J. Ansermino
DOI: 10.12688/wellcomeopenres.15387.2
12/2020

Derivation and internal validation of a data-driven prediction model to guide frontline health workers in triaging children under-five in Nairobi, Kenya
Wellcome Open Research
Alishah Mawji and Samuel Akech and Paul Mwaniki and Dustin Dunsmuir and Jeffrey Bone and Matthew O. Wiens and Matthias Görges and David Kimutai and Niranjan Kissoon and Mike English and Mark J. Ansermino
DOI: 10.12688/wellcomeopenres.15387.1
08/2019

Paediatric postdischarge mortality in developing countries: a systematic review
BMJ Open
Brooklyn Nemetchek and Lacey English and Niranjan Kissoon and John Mark Ansermino and Peter P Moschovis and Jerome Kabakyenga and Susan Fowler-Kerry and Elias Kumbakumba and Matthew O Wiens
DOI: 10.1136/bmjopen-2018-023445
12/2018

A Locally Developed Electronic Health Platform in Uganda: Development and Implementation of Stre@mline
JMIR Formative Research
Li Liang and Matthew O Wiens and Phaisal Lubega and Ian Spillman and Samuel Mugisha
DOI: 10.2196/formative.9658
09/2018

A transformation of oxygen saturation (the saturation virtual shunt) to improve clinical prediction model calibration and interpretation
Guohai Zhou and Walter Karlen and Rollin Brant and Matthew Wiens and Niranjan Kissoon and J Mark Ansermino
DOI: 10.1101/391292
08/2018

Individual, maternal and household risk factors for anaemia among young children in sub-Saharan Africa: a cross-sectional study
BMJ Open
Peter P Moschovis and Matthew O Wiens and Lauren Arlington and Olga Antsygina and Douglas Hayden and Walter Dzik and Julius P Kiwanuka and David C Christiani and Patricia L Hibberd
DOI: 10.1136/bmjopen-2017-019654
05/2018

Development and Implementation of Stre@mline, a Locally Developed Electronic Health Platform in Uganda (Preprint)
Li Liang and Matthew O Wiens and Phisal Lubega and Ian Spillman and Samuel Mugisha
DOI: 10.2196/preprints.9658
12/2017

PHARMACOKINETICS OF BENZNIDAZOLE IN CHAGAS DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Antimicrobial Agents and Chemotherapy
Matthew O. Wiens and Steve Kanters and Edward Mills and Alejandro A. Peregrina Lucano and Silvia Gold and Dieter Ayers and Luis Ferrero and Alejandro Krolewiecki
DOI: 10.1128/AAC.01567-16
08/2016

The PAediatric Risk Assessment (PARA) Mobile App to Reduce Postdischarge Child Mortality: Design, Usability, and Feasibility for Health Care Workers in Uganda
JMIR mHealth and uHealth
Lauren Lacey English and Dustin Dunsmuir and Elias Kumbakumba and John Mark Ansermino and Charles P Larson and Richard Lester and Celestine Barigye and Andrew Ndamira and Jerome Kabakyenga and Matthew O Wiens
DOI: 10.2196/mhealth.5167
02/2016

Research

Evaluation of a counselling and referral-based intervention to improve post-discharge mortality for infants and children in Uganda
We are conducting two independent multisite, prospective before-and-after studies at 6 hospitals in Uganda to evaluate a counseling and referral-based intervention to improve post-discharge survival for (1) infants under 6 months of age and (2) children 6 months to 60 months of age. Briefly, these studies consist of two phases. The first phase is a model validation phase where previously derived prediction algorithms are validated and calibrated. This phase is enrolling approximately 3000 children under 6 months and 3800 children who are 6 – 60 months of age. These studies began in 2017 (6m-60m age group) and 2018 (0-6m age group) and the first phase of both of these studies has been completed. The second phase of these studies is an interventional phase, enrolling a similar number of children. This interventional phase uses the validated prediction algorithm and implements the Smart Discharges intervention, with intervention intensity based on risk. Those with lower vulnerability receive discharge counselling focused on understanding vulnerability, education on preventative practices (hygiene, mosquito net use, etc.), danger signs, and appropriate health seeking. Children at high risk receive referrals for post-discharge follow-up with community health workers or at a health facility near their residence.

Development of models to predict post-discharge outcomes among mother-baby dyads discharged after routine hospital delivery
It is a global priority to improve health of mothers and infants and to lower their mortality rates. Countries in sub-Saharan Africa bear the largest burden of maternal and newborn death, and the majority of these deaths are preventable. One third of maternal (30%) and more than half of newborn (55%) deaths occur during the first 6 weeks after birth, after a mother-newborn dyad has returned home from the hospital. To address this issue we are conducting a prospective cohort study among mothers and their newborn babies who have been discharged following a routine hospital birth. We are enrolling 3200 dyads and completing 6-week follow-up to assess post-discharge readmission and mortality. The use of dyads in this context is unique since the health of the mother and child are so intricately linked. Using candidate predictors selected through a systematic review and expert opinion we will derive a parsimonious model to identify vulnerable infant/mother pairs. This work will lead to future studies to (1) externally validate our model and (2) develop and test a Smart Discharge approach to improving outcomes in this vulnerable
group.

Grants

Thrasher Research Fund, $525,094 USD. Role: Principal Investigator. Project: Smart Discharges to improve post-discharge survival following admission for infection in young infants. Dec 1, 2020 – Nov 30, 2022.

Grand Challenges Canada, Transition to Scale, $1,000,000 CAD. Role: Principal Investigator. Project: Smart Discharges to improve post-discharge health outcomes in Uganda. Dec 1, 2017 – Jun 30, 2021.

Thrasher Research Fund, $400,000 USD. Role: Co-Principal Investigator. Project: Smart Discharges to improve post-discharge survival following admission for infection in newborns and young infants. May 2018 – Aug 2020.