Imperial College London

ProfessorKathrynMaitland

Faculty of MedicineDepartment of Medicine

Professor of Tropical Paediatric Infectious Diseases
 
 
 
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Contact

 

+44 (0)025 4417 525044k.maitland

 
 
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Assistant

 

Dr Peter Norsworthy +44 (0)20 7594 3891

 
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Location

 

Based full-time at KEMRI/Wellcome Programme, KenyaNorfolk PlaceSt Mary's Campus

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Summary

 

Summary

I am a consultant in Paediatric Infectious Diseases at Imperial College and an Honorary Fellow at the MRC Clinical trials Unit, London but am based full time in East Africa. My main areas of scientific interest are clinical investigative research and clinical trials in critical illness in resource poor settings and I have a research portfolio that includes severe malaria, sepsis, severe malnutrition and severe anaemia. I am a member of a number of international critical illness networks and am also a member of a number of international guideline committees.  

To date, my work has focused largely on clinical investigation to gain a better understanding of the pathophysiology of severe malaria and severe malnutrition as well as clinical trials of interventions that may improve outcome. My research group has recently completed the largest trial of critically ill children ever undertaken in Africa (FEAST trial: http://www.feast-trial.org), a trial that examined fluid resuscitation strategies in children with severe febrile illnesses (including malaria and bacterial sepsis). Contrary to expectation, the trial showed that fluid boluses were associated with an increased mortality compared to no-bolus (control), the greatest effect was in children with the most severe forms of shock. These findings are likely to lead to major changes in health policy in children with severe illness in sub-Saharan Africa and possibly beyond. The FEAST trial won the prestigious 2011 BMJ Research Paper of the Year award. In 2013 we will start a 4000-child controlled trial of transfusion and treatment strategies in Uganda and Malawi in children with severe anaemia (TRACT), funded by MRC. I am also the principal investigator on a controlled trial of oxygenation strategies in 4,800 African children with critical illness (COAST) funded by Wellcome Trust MRC DfiD Global Health).

At the KEMRI-Wellcome Trust Research Programme in Kilifi, Kenya, I am the lead investigator of a programme of prospective studies of severe malnutrition and have identified common factors associated with poor outcome and criteria for identifying high-risk patients, undertaken pharmacokinetic studies and am currently investigating the gut microbiome and gut-barrier dysfunction using metabolomics and metagenomics. 

Key References

 

Clinical TrialS

Maitland K, George EC, Evans JA, Kiguli S, Olupot-Olupot P, Akech SO, Opoka RO, Engoru C, Nyeko R, Mtove G et al: Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial. BMC Med 2013, 11:68.10.1186/1741-7015-11-68

Maitland K, Kiguli S, Opoka RO, Engoru C, Olupot-Olupot P, Akech SO, Nyeko R, Mtove G, Reyburn H, Lang T et al: Mortality after fluid bolus in African children with severe infection. The New England journal of medicine 2011, 364:2483-2495.10.1056/NEJMoa1101549

Maitland K, Akech SO, Russell EC: Mortality after Fluid Bolus in African Children with Sepsis: Reply. The New England journal of medicine 2011, 365:1348-1353.10.1056/NEJMc1108712

Dondorp AM, Fanello CI, Hendriksen IC, Gomes E, Seni A, Chhaganlal KD, Bojang K, Olaosebikan R, Anunobi N, Maitland K et al: Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial. Lancet 2010, 376:1647-1657.10.1016/S0140-6736(10)61924-1

Akech SO, Karisa J, Nakamya P, Boga M, Maitland K: Phase II trial of isotonic fluid resuscitation in Kenyan children with severe malnutrition and hypovolaemia. BMC pediatrics 2010, 10:71.10.1186/1471-2431-10-71

Akech SO, Jemutai J, Timbwa M, Kivaya E, Boga M, Fegan G, Maitland K: Phase II trial on the use of Dextran 70 or starch for supportive therapy in Kenyan children with severe malaria. Critical care medicine 2010, 38:1630-1636.10.1097/CCM.0b013e3181e81165

Akech S, Gwer S, Idro R, Fegan G, Eziefula AC, Newton CR, Levin M, Maitland K: Volume expansion with albumin compared to gelofusine in children with severe malaria: results of a controlled trial. PLoS clinical trials 2006, 1:e21.10.1371/journal.pctr.0010021

Maitland K, Pamba A, English M, Peshu N, Marsh K, Newton C, Levin M: Randomized trial of volume expansion with albumin or saline in children with severe malaria: preliminary evidence of albumin benefit. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2005, 40:538-545.10.1086/427505

Maitland K, Pamba A, English M, Peshu N, Levin M, Marsh K, Newton CR: Pre-transfusion management of children with severe malarial anaemia: a randomised controlled trial of intravascular volume expansion. British journal of haematology 2005, 128:393-400.10.1111/j.1365-2141.2004.05312.x

Malaria

 

Olupot-Olupot P, Urban BC, Jemutai J, Nteziyaremye J, Fanjo HM, Karanja H, Karisa J, Ongodia P, Bwonyo P, Gitau EN et al: Endotoxaemia is common in children with Plasmodium falciparum malaria. BMC infectious diseases 2013, 13:117.10.1186/1471-2334-13-117

Yacoub S, Lang HJ, Shebbe M, Timbwa M, Ohuma E, Tulloh R, Maitland K: Cardiac function and hemodynamics in Kenyan children with severe malaria. Critical care medicine 2010, 38:940-945.10.1097/CCM.0b013e3181cd114a

Ogetii GN, Akech S, Jemutai J, Boga M, Kivaya E, Fegan G, Maitland K: Hypoglycaemia in severe malaria, clinical associations and relationship to quinine dosage. BMC infectious diseases 2010, 10:334.10.1186/1471-2334-10-334

Malnutrition

Talbert A, Thuo N, Karisa J, Chesaro C, Ohuma E, Ignas J, Berkley JA, Toromo C, Atkinson S, Maitland K: Diarrhoea complicating severe acute malnutrition in Kenyan children: a prospective descriptive study of risk factors and outcome. PloS one 2012, 7:e38321.10.1371/journal.pone.0038321

Thuo N, Ungphakorn W, Karisa J, Muchohi S, Muturi A, Kokwaro G, Thomson AH, Maitland K: Dosing regimens of oral ciprofloxacin for children with severe malnutrition: a population pharmacokinetic study with Monte Carlo simulation. The Journal of antimicrobial chemotherapy 2011, 66:2336-2345.10.1093/jac/dkr314

Bejon P, Mohammed S, Mwangi I, Atkinson SH, Osier F, Peshu N, Newton CR, Maitland K, Berkley JA: Fraction of all hospital admissions and deaths attributable to malnutrition among children in rural Kenya. The American journal of clinical nutrition 2008, 88:1626-1631.10.3945/ajcn.2008.26510

Seaton C, Ignas J, Muchohi S, Kokwaro G, Maitland K, Thomson AH: Population pharmacokinetics of a single daily intramuscular dose of gentamicin in children with severe malnutrition. The Journal of antimicrobial chemotherapy 2007, 59:681-689.10.1093/jac/dkl561

Maitland K, Berkley JA, Shebbe M, Peshu N, English M, Newton CR: Children with severe malnutrition: can those at highest risk of death be identified with the WHO protocol? PLoS medicine 2006, 3:e500.10.1371/journal.pmed.0030500

Berkley J, Mwangi I, Griffiths K, Ahmed I, Mithwani S, English M, Newton C, Maitland K: Assessment of severe malnutrition among hospitalized children in rural Kenya: comparison of weight for height and mid upper arm circumference. JAMA : the journal of the American Medical Association 2005, 294:591-597.10.1001/jama.294.5.591

Selected Publications

Journal Articles

Maitland K, 2015, Management of severe paediatric malaria in resource-limited settings., Bmc Med, Vol:13

Church J, Maitland K, 2014, Invasive bacterial co-infection in African children with Plasmodium falciparum malaria: a systematic review., Bmc Med, Vol:12

Kiguli S, Akech SO, Mtove G, et al., 2014, WHO guidelines on fluid resuscitation in children: missing the FEAST data., Bmj, Vol:348

Maitland K, George EC, Evans JA, et al., 2013, Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial, BMC Medicine, Vol:11, ISSN:1741-7015

Dondorp AM, Fanello CI, Hendriksen ICE, et al., 2010, Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial, The Lancet, Vol:376, ISSN:0140-6736, Pages:1647-1657

Maitland K, Akech SO, Russell EC, 2011, Mortality after Fluid Bolus in African Children with Sepsis REPLY, New England Journal of Medicine, Vol:365, ISSN:0028-4793, Pages:1351-1353

Maitland K, Kiguli S, Opoka RO, et al., 2011, Mortality after Fluid Bolus in African Children with Severe Infection, New England Journal of Medicine, Vol:364, ISSN:0028-4793, Pages:2483-2495

Akech S, Ledermann H, Maitland K, 2010, Choice of fluids for resuscitation in children with severe infection and shock: systematic review, British Medical Journal, Vol:341, ISSN:0959-535X

Khor CC, Vannberg FO, Chapman SJ, et al., 2010, CISH and Susceptibility to Infectious Diseases, New England Journal of Medicine, Vol:362, ISSN:0028-4793, Pages:2092-2101

Akech SO, Jemutai J, Timbwa M, et al., 2010, Phase II trial on the use of Dextran 70 or starch for supportive therapy in Kenyan children with severe malaria, Critical Care Medicine, Vol:38, ISSN:0090-3493, Pages:1630-1636

Maitland K, Pamba A, Newton CR, et al., 2003, Response to volume resuscitation in children with severe malaria., Pediatric Critical Care Medicine, Vol:4, ISSN:1529-7535, Pages:426-431

More Publications