Understanding patterns in urban disease

NSTF-TW Kambule-NSTF Award for an emerging researcher: post-doc in a period of up to six years after award of a PhD or equivalent (prize sponsor: proSET)

Health. It is often neglected, treasured when taken away and an area where research and understanding are desperately needed as disease patterns change and adapt to new environments and human dynamics.

Dr Tolu Oni’s research is driven by the issues of healthcare, urbanisation and rising rates of infection. Her work looks to address the challenges facing people and healthcare in the urban setting, and she aims to develop interventions that are designed to improve health in a holistic way.

“My research aims to contribute to the analysis of changing patterns of disease and the implications for the health and wellbeing of the population in the context of urbanisation,” explains Oni. “I have worked in the field of HIV and tuberculosis (TB) in the South African urban informal setting since 2007, and my current research focuses on urban health and equity.”

She says that she is especially interested in understanding the interaction between commonly co-occurring chronic infectious and non-infectious conditions, upstream health determinants and the unplanned urban environment.

Growing urban population

Growing urban population levels are impacting how disease is transmitted and how it affects the people living in these communities. The healthcare system today is not responsive enough to examine the factors which impact on a person’s health and how this can be addressed from the ground up.

“Many of the aspects which influence health lie outside the healthcare sector. I want to find ways of collaborating with other organisations, pulling in both health and non-health related institutions, to see how we can work together to make muchneeded changes,” says Oni.

It was while working as a researcher in TB and HIV, in the context of infection and how better to diagnose and understand the burdens and patterns of these diseases, that Oni was struck by two significant realisations.

The first was that they were waiting for people to come in with conditions and then trying to work out what factors caused them. Yet TB is a preventable disease. The second was that people were coming in with a myriad of other chronic conditions, not just those with which they were originally affected.

Tailored, holistic healthcare

“It struck me that we were not looking at patients and population in a holistic way — some HIV and TB patients had, for example, diabetes, and the healthcare system is structured so one specialist deals with one element while another deals with the other,” says Oni. “It made no sense to me. I left this role so I could look at the patterns and try to understand how these diseases co-exist. We need a healthcare system which is respon-