BSc, MSc, PhD
School of Tropical Medicine and Global Health, Nagasaki University, Japan
London School of Hygiene and Tropical Medicine, London, UK
I graduated from University College London with a BSc. (Biochemistry, First Class Hons) in 1996, followed by a postgraduate teaching qualification (1997), a Masters in Public Health Nutrition at the London School of Hygiene & Tropical Medicine [LSHTM] (1998) and finally a PhD, also at LSHTM (2003). My PhD comprised a clinical trial of low-dose maternal vitamin A supplementation to determine effects on immunity to malaria in pregnancy in Ghana. In 2002 I became a staff member at LSHTM within the MRC International Nutrition Group and worked on malaria and anemia in Gambian children. In 2007 I moved to be based in Dar es Salaam Tanzania, working mostly on sickle cell disease. In 2015 I was appointed as a Professor at School of Tropical Medicine & Global Health, Nagasaki University, where I am now based. I also hold a joint appointment at LSHTM.
I co-organise courses in Epidemiology and Statistics in semesters 1 and 3 for the TMGH MSc courses. These courses are based on those provided by the London School of Hygiene & Tropical Medicine masters programmes and are taught by Nagasaki and visiting LSHTM research staff. I also organise a module on Nutrition for Global Health in Semester 3 and teach individual sessions on in other modules on effects of both under and over-nutrition, diagnosis and management of acute malnutrition, nutrition and infection, causes and effects of anaemia in the tropics, epidemiology and field-based research methodology
Previously at the London School of Hygiene & Tropical Medicine, UK I taught and managed units within the MSc in Public Health Nutrition and I have been a tutor on distance based learning MSc courses: “Nutrition and Infection” & “Study Design: writing a grant application.
I am interested in how nutrition underpins human health and in particular in relation to interactions with infections, other conditions like sickle cell disease and maternal and child health. My research aims to provide an evidence base to support nutrition-based interventions to improve health outcomes in populations in low and middle income countries.
Current ongoing studies are summarized below:
Nutrition and TB
I am leading research on nutrition and diabetes in TB patients in the Philippines in both inpatient and outpatient populations in Metro Manila, Cebu and Negros Occidental. I collaborate with investigators from San Lazaro Hospital, Manila, the Nutrition Centre, Philippines and the National TB programme.
Malnutrition in children
In Nepal I am leading research assessing malnutrition in pediatric admissions and outpatient clinics (children of all ages). In Cambodia, we are investigating the determinants of malnutrition of young children within the NHAM birth cohort, with a focus on infections and the microbiome. In Burundi we are collaborating with Action Against Hunger to evaluate malnutrition diagnosis and referral within the integrated community case based management programme (iCCM).
Nutrition as a modulator of sickle cell disease
Within the Muhimbili Sickle Cohort in Tanzania, my previous research has focused on nutritional and genetic modulation of sickle cell disease (SCD).
The Philippines, Nepal, Bangladesh, Cambodia, UK, Japan, Tanzania, Kenya, The Gambia, India
- Lee N, Makani J, Tluway F, Makubi A, Armitage AE, Pasricha SR, Drakesmith A, Prentice AM & Cox SE. Decreased hepcidin levels are associated with low steady-state hemoglobin in children in the Muhimbili sickle cohort, Tanzania. EBioMed, 2018. In press
- Cox SE, Ellins EA, Marealle AI, Newton CR, Soka D, Sasi P, Di Tanna GL, Johnson W, Makani J, Prentice AM, Halcox JP & Kirkham FJ. Ready-to-use food supplement +/- arginine & citrulline with daily chloroquine in Tanzanian children with sickle cell disease: a double blind random order cross-over trial. Lancet Hematology, 2018 In press –
- Yamanashi H, Kulkarni B, Edwards T, Kinra S, Koyamatsu J, Nagayoshi M, Shimizu Y, Maeda T & Cox SE. Association between atherosclerosis and handgrip strength in non-hypertensive populations in India and Japan. Geriatrics & Gerontology International, in press –
- Marealle AI, Siervo M, Wassel S, Bluck L, Prentice AM, Minzi O, Sasi P, Kamuhabwa A, Soka D, Makani J, Cox SE. A pilot study of a non-invasive oral nitrate stable isotopic method suggests that arginine and citrulline supplementation increases whole-body NO production in Tanzanian children with sickle cell disease. Nitric Oxide. 2018 Jan 2;74:19-22. doi: 10.1016/j.niox.2017.12.009. [Epub ahead of print]
- Nkya S, Mgaya J, Urio F, Makubi A, Thein SL, Menzel S, Cox SE, Newton CR, Kirkham FJ, Mmbando BP, Makani J. Fetal Hemoglobin is Associated with Peripheral Oxygen Saturation in Sickle Cell Disease in Tanzania. EBioMedicine. 2017 Sep;23:146-149. doi: 10.1016/j.ebiom.2017.08.006. Epub 2017 Aug 8.
I propose that nutrition is one of the most important modifiable environmental factors underlying health and disease. Along with infections such as malaria, nutrition has been one of the strongest selection pressures over our recent evolutionary history. This has significant implications in relation to the rapid changes in diet and lifestyle that are occurring globally. Under and over-nutrition are increasingly occurring within the same population groups and in both low and high-income countries.
Nutrition is essential to consider at individual and community/population levels in order to ensure that health interventions are optimally successful.
My research focuses on understanding the mechanisms by which nutritional factors affect health outcomes, with a focus on low- and middle-income country settings and encompassing infectious and non-infectious disease processes.