The SHINE Phase 3 Follow-Up study in rural Zimbabwe is a longitudinal birth cohort study assessing the long-term impacts of early-life infant and young child feeding (IYCF) and water, sanitation and hygiene (WASH) interventions. Children originally enrolled when their mothers were pregnant are now 10–11 years old, providing a unique opportunity to evaluate whether these early interventions yield sustained cognitive, physical, and health benefits into late childhood. In addition, the study is exploring the effects of early-life stunting and HIV exposure on long-term growth, physical and cognitive function.
A distinctive element of Phase 3 is the incorporation of advanced neurodevelopmental tools such as ultra-portable low-field MRI and EEG, alongside comprehensive cognitive assessments, physical fitness tests, anthropometry, body composition measurements, sample collection, renal and muscle ultrasound, peripheral quantitative CT of bone, echocardiography, and spirometry.
We have solarised our building to ensure that the Hyperfine is entirely ‘off grid’. To the best of our knowledge, this is the first instance of an MRI being powered by on-site solar panels, leading to our team being awarded the 2025 ‘Green Neuroscience’ prize from the British Neuroscience Association.
The following specific aims are being conducted as part of the neuroscience assessments being conducted in the SHINE follow-up study:
Aim 1:
Phenotype school-age brain function in children who are HIV-exposed uninfected, and children who are HIV-unexposed, by assessing cognition, executive function, academic ability, and neurophysiological measures (MRI and EEG).
Aim 2:
Define the biological pathways underlying impaired cognition in children who are HIV-exposed uninfected. This involves measuring inflammation, neuronal and glial disruption, and metabolites in stored plasma from early life (18 months of age) and at school-age (10 years), and assessing how these biological factors are associated with neurodevelopmental outcomes.
Aim 3:
Define psychosocial pathways underlying impaired cognition in children who are HIV-exposed uninfected by evaluating how adverse and supportive environmental exposures influence cognitive outcomes. An ecological systems approach will be used, assessing factors from individual child-level variables (stress, mental health, sleep) to broader social contexts (family relationships, socioeconomic status, community support).
Andrew Prendergast graduated from Cambridge and Imperial College, and undertook his paediatric training in London, specialising in paediatric infectious diseases and immunology. After undertaking a DPhil in Oxford, investigating immunological and clinical aspects of paediatric HIV infection, he was an Academic Clinical Lecturer in the Department of Paediatrics, University of Oxford, where he continued research into paediatric HIV infection in South Africa, and worked on HIV clinical trials in sub-Saharan Africa through the MRC Clinical Trials Unit at UCL. He was subsequently awarded a Wellcome Intermediate Clinical Fellowship, then a Senior Clinical Fellowship, and is now Professor of Paediatric Infection and Immunology at Queen Mary University of London, and Director of the Zvitambo Institute for Maternal and Child Health Research in Zimbabwe.
Michael Papasavva is an early-career cognitive neuroscientist based at Queen Mary University of London, and the Zvitambo Institute for Maternal and Child Health Research in Zimbabwe. His research integrates structural low-field Magnetic Resonance Imaging (MRI), Electroencephalography (ERP/EEG), and developmental assessments (e.g., Griffiths III) to examine cognition, neurodevelopment, and overall well-being in children. His work primarily explores how HIV exposure, growth trajectories, inflammatory biomarkers, and socio-economic determinants influence developmental outcomes in traditionally underserved populations.
Michael is a co-investigator and co-recipient of a UKRI Medical Research Council grant supporting the SHINE follow-up study, which investigates long-term developmental outcomes associated with early-life interventions.
In addition to his research activities, Dr Papasavva serves as a neurodevelopmental consultant listed on the roster of specialists for the United Nations' World Health Organization. He also holds adjunct lecturer positions at Barts and The London School of Medicine and Dentistry and the University of Zimbabwe, actively engaging in the education of medical and neuroscience students. Dr Papasavva is both a Chartered Psychologist with the British Psychological Society (BPS) and a member of the British Neuroscience Association (BNA). In 2025, he was co-awarded the Green Neuroscience Award by the BNA for his work in solarising the Zvitambo Hyperfine MRI building, the first of its kind.
Cynthia Kahari is a diagnostic radiographer with a PhD from the London School of Hygiene and Tropical Medicine (LSHTM), and a Masters and Bachelors’ degree from the University of Zimbabwe. She teaches and mentors undergraduate and postgraduate students within the department of Oncology, Medical Physics and Imaging Sciences at the University of Zimbabwe-Faculty of Medicine and Health Sciences. She is a medical imaging researcher, mostly utilising Dual Energy X-ray Absorptiometry (DXA), peripheral Quantitative computed tomography (pQCT) imaging methods, musculoskeletal ultrasound and Magnetic Resonance Imaging (MRI). She is interested in improving the health of Zimbabweans and other populations across sub-Saharan Africa through relevant and cutting-edge health research in medical imaging, musculoskeletal health and paediatric HIV. She is part of the SHINE team utilising a solarized MRI hyperfine, pQCT, and ultrasound to assess growth in children exposed to HIV.
Joe Piper is a paediatrician who is dedicated to improving child survival, health, and development through research on growth, malnutrition, and infectious diseases. He held a Wellcome Trust Global Health PhD Fellowship, during which he studied growth and physiological function among rural Zimbabwean children in the SHINE cohort, and completed an Academic Clinical Fellowship focused on malnutrition and body composition. His academic foundation includes an MSci in Physics and a second PhD in biophysical chemistry.
Dr Piper’s clinical experience in acute paediatrics was developed through specialty training in the UK, complemented by extensive international fieldwork and advanced qualifications in global health. In his current Academic Clinical Lectureship at Queen Mary University of London, he studies physiological, clinical, and body composition outcomes following early-life interventions designed to promote healthy growth and development. He coordinated the SHINE cohort school-age follow-up study and is current coordinating innovative assessments of psychological wellbeing in the same cohort at age 10 years.
As a dedicated and passionate research radiographer, Anabel Mutero is deeply committed to achieving expertise in the fields of musculoskeletal system and infectious diseases. She holds an Honours Degree in Radiography (Diagnostic) from the University of Zimbabwe, and a Master's Degree in Medical Ultrasound, from the National University of Science and Technology in Zimbabwe. With five years of experience in both clinical radiography and research, she has honed her skills in medical imaging, data collection, and patient care. Her unwavering goal is to continue excelling in these areas and make significant contributions to the field.
She says: “I am excited to be part of a pioneering team working on solarised Hyperfine MRI. The prospect of being part of this innovative project fills me with excitement and anticipation. Solarised hyperfine MRI represents a ground-breaking advancement in medical imaging, and I am eager to contribute to its development and application.”
Loyce Musiiwa is an enthusiastic research radiographer with a passion for advancing medical imaging technology. Specializing in research, she also leverages her expertise to enhance diagnostic accuracy and patient outcomes. She holds an Honours Degree in Radiography (Diagnostic), from the National University of Science and Technology in Zimbabwe, and is currently undertaking a Master’s in Technology in Medical Ultrasound at the Harare Institute of Technology.
She says: “I am committed to continuous learning and innovation in radiology. l am thrilled to explore the capabilities of the solarised hyperfine MRI machine and eager to contribute to ground-breaking research in medical diagnostics, enhancing patient care through innovative and sustainable solutions. The potential of this technology to enhance diagnostic capabilities and improve patient outcomes aligns perfectly with my professional aspirations. I look forward to collaborating with esteemed colleagues and pushing the boundaries of what is possible in radiography and medical research.”