Robert (RJ) Williams, MD, an infectious disease fellow working with the Infectious Diseases Epidemiology and Ecology Lab (IDEEL), has been building a research program that bridges clinical medicine, epidemiology, and global health, to improve the outcomes for children with severe malaria.
As part of the Burroughs Wellcome Fund Postdoctoral Fellowship in Tropical Infectious Diseases, Williams collaborated with an international consortium that includes the IDEEL lab, the Johns Hopkins Malaria Research Institute, and the Southern and Central Africa International Center of Excellence for Malaria Research (ICEMR). Together, the team has been expanding an ongoing randomized clinical trial in Zambia that investigates the benefits of whole blood transfusion in children suffering from severe malaria complicated by respiratory distress and thrombocytopenia.
Williams’s work has centered on advancing the analytic framework of the trial, including a mediation analysis to better understand how thrombocytopenia contributes to mortality risk in severe malaria, as well as a clustering analysis to identify which clinical phenotypes respond most favorably to whole blood transfusion. These insights could help clinicians better tailor treatment strategies for critically ill children.
This international collaboration grew out of discussions with Michael Herce, MD, MPH, and UNC infectious diseases faculty deeply engaged in implementation research in Zambia. From there, Jon Juliano, MD, MSPH, and Jessica Lin, MD, MSCR, connected with colleagues at Johns Hopkins who lead the ICEMR work in Zambia—Matthew Ippolito, MD, PhD, and William Moss, MD, MPH,—laying the groundwork for the current partnership.
In parallel, Williams is also working with Lin on innovative approaches to malaria surveillance, including the use of mosquito salivary antigens as biomarkers of malaria exposure in low-transmission settings. Traditional methods for estimating malaria risk can be labor-intensive and imprecise, particularly in regions approaching elimination. Mosquito salivary antigens offer a promising alternative, with the potential to provide more sensitive and accurate measures of exposure—strengthening efforts to monitor and accelerate malaria control. This work is described in a recently published paper:
👉 Read the study in Parasites & Vectors
In addition to support from the Office of Global Health Education, Williams received the Burroughs Wellcome Fund Postdoctoral Fellowship, providing critical resources and mentorship to support long-term career development.
As part of this research, Williams spent a month in Zambia this past September and witnessed firsthand the devastating toll malaria continues to take—particularly on children under five. While global malaria burden has declined over recent decades, progress in understanding the pathogenesis of severe malaria has lagged behind.
The experience aligns closely with Williams’s long-term goal of becoming an independent physician-scientist. The Burroughs Wellcome fellowship represents a pivotal step toward that goal, supporting the development of expertise in malaria pathophysiology and spatial epidemiology. As part of the award, Williams will return to Zambia to continue expanding the randomized clinical trial and to conduct follow-up analyses on clinical phenotypes and treatment response—work with the potential to meaningfully improve care for children most at risk.