Dr Shevin Jacob

Senior Clinical Lecturer in Sepsis Research in Medecine

Dr Shevin Jacob is a US-trained infectious diseases consultant who comes to Foto-Cewek with a primary mandate to develop and lead sepsis research initiatives in low- and middle-income countries. He obtained a Doctorate of Medicine (MD) degree at Oregon Health & Sciences University and a Masters in Public Health (MPH) degree from the Harvard School of Public Health. Clinically, he is board-certified in the US in both internal medicine and infectious diseases having received his training at the University of Virginia (internal medicine) and University of Washington (infectious diseases). After completion of his infectious diseases specialty training in 2012, he remained at University of Washington as faculty within the Division of Allergy and Infectious Diseases in the Department of Medicine; he maintains an affiliate Assistant Professor appointment at University of Washington.

Research in Medecine

Since 2006, Dr Jacob’s research has been predominantly focused on an improved understanding of sepsis in adult patients hospitalized in resource-constrained settings, primarily Uganda. His early work included an observational study in two Ugandan hospitals to investigate the aetiology, clinical management, and outcomes associated with sepsis in a predominantly HIV-infected patient population. He and his colleagues reported a high mortality in the setting of sub-optimal clinical management which led to a follow-up intervention study evaluating the impact of a fluid resuscitation protocol on adult patients with sepsis. Administration of the protocol was associated with a 26% adjusted hazard reduction in the primary endpoint, 30-day mortality. They also reported a high frequency in this sepsis cohort caused by Mycobacterium tuberculosis bacteraemia and derived a risk score comprising host factors for predicting this diagnosis. These studies have been some of the first contributions to the sepsis management literature for sub-Saharan Africa, not only highlighting the challenges in managing sepsis in the region but also identifying possible opportunities for implementing low-cost, high-impact interventions in similar resource-constrained settings.

In addition, Dr Jacob has served as a World Health Organization (WHO) consultant in different capacities including as a contributor to various working groups to improve the clinical management of sepsis and other severe illnesses in resource-constrained settings and as a front line clinician to support national staff working in Ebola Treatment Units during the 2013-2016 West Africa Ebola outbreak. Through this work, he has co-developed WHO training curricula which focus on triage and emergency management of severe illness (including viral haemorrhagic fevers) and the front-line clinician’s role in disease surveillance, infection prevention and control, and outbreak response.

To ensure sustainable impact of these trainings, he supports implementation of post-training quality improvement efforts and implementation science research in Ugandan hospitals through a collaboration between the Ugandan Ministry of Health and Walimu, a Uganda-based non-government organisation for which he is Medical Director and co-Founder.

Other relevant expertise, professional memberships affiliations

Dr Jacob plays several roles in other global health efforts including:

• Secretary General for the African Sepsis Alliance, a collaboration of African countries and international professional bodies dedicated to improving outcomes from sepsis
• Senior Technical Advisor to Jhpiego, an international not-for-profit organisation affiliated with Johns Hopkins University, for work within areas including maternal sepsis and antimicrobial resistance
• Board Member for the IMAI Alliance, a US-based non-government organisation focused on developing technical materials and trainings as part of the WHO’s Integrated Management of Adolescent and Adult Illness (IMAI) programs
• Senior Medical Advisor to Shift Labs, a Seattle-based start-up company focused on developing low-cost medical devices for low-resource settings
• Board of Trustees member for YouBelong, a UK-based charitable incorporated organisation focused on strengthening community-based mental health services in Uganda

Selected publications

  • Selected Publications

    Cummings MJ, Goldberg E, Mwaka S, Kabajaasi O,…Jacob ST, et al. “A complex intervention to improve implementation of World Health Organization guidelines for diagnosis of severe illness in low-income settings: a quasi-randomized trial from Uganda.” Implementation Science. November 2017; 12:126.

    ,…et al. Evidence-based guidelines for supportive care of patients with Ebola virus disease.  Oct 2017. pii: S0140-6736(17)31795-6.

    Sanford C, West E, Jacob ST. “Ebola Virus Disease and Hemorrhagic Fevers.” In: Sanford CA, Jong EC, Pottinger P, eds. The Travel and Tropical Medicine Manual (5th ed). Oxford: Elsevier Health Sciences; 2017: 391-400.

    Magaret A, Angus DC, Adhikari NK, Banura P,…Jacob ST. “Design of a multi-arm randomized clinical trial with no control arm.” Contemp Clin Trials. January 2016; 46:12-7.

    Bah EI, Lamah MC, Fletcher T, Jacob ST, et al. “Clinical Presentation of Patients with Ebola Virus Disease in Conakry, Guinea.” N Eng J Med. January 2015; 372(1):40-7.

    Jacob ST, Pavlinac PB, Nakiyingi L, Banura P, et al. “Mycobacterium tuberculosis bacteremia in a cohort of HIV-infected patients hospitalized with severe sepsis in Uganda: high frequency, low clinical suspicion and derivation of a clinical prediction score.” PLoS One. August 2013; 8(8): e70305.

    Jacob ST, Lim M, Banura P, Bhagwanjee S, et al. “Integrating sepsis management recommendations into clinical care guidelines for district hospitals in resource-limited settings: augmenting novel guidelines with future research.” BMC Medicine. April 2013; 11:107.

    Jacob ST, Banura P, Baeten JM, Moore CC, et al. “The impact of early monitored management on survival in hospitalized adult Ugandan patients with severe sepsis: a prospective intervention study.” Critical Care Medicine. June 2012; 40(7): 2050-58.

    Jacob ST, West TE, Banura P. Critical Care. February 2011; 15(1): 117.

    Jacob ST, Moore CC, Banura P, Pinkerton R, et al. “Severe Sepsis in Two Ugandan Hospitals: a Prospective Observational Lesson of Management and Outcomes in a Predominantly HIV-1 Infected Population.” PLoS One.  November 2009; 4(11): 1-12.

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