Awards

Does the message matter? UW Royalty Research Fund awarded to characterize effect of Mobile WACh’s SMS content and participant engagement and care seeking outcomes

Dr. Jennifer Unger, MD, MPH

Dr. Keshet Ronen, PhD

 

 

 

 

 

 

 

 

 

 

As more households in low-income countries own a mobile phone than have access to electricity or adequate sanitation, health care providers are progressively utilizing mobile health (mHealth) platform approaches to provide guidance and support to patients between clinic visits.  Evidence shows mobile short message service (SMS) programs improve HIV and maternal-child health outcomes, but there is less understanding about the types of messages that engage recipients and the mechanisms that lead to changes in health behavior.  We are pleased to announce that Drs. Jennifer Unger (Assistant Professor, OB/GYN and Global Health) and Keshet Ronen (Clinical Assistant Professor, Global Health) are the principal investigator and co-investigator, respectively, of a UW Royalty Research Fund award to analyze participant messages, and yield an understanding of how recipients use these systems and how care seeking is impacted by SMS conversations.

Dr. Patty Pavlinac awarded UW Royalty Research Fund to examine antibiotic-resistance in enteric bacteria in children

Congratulations to Dr. Patty Pavlinac (Assistant Professor, Global Health) and her team of co-investigators, who received a competitive UW Royalty Research Fund award to study antibiotic resistance in E.coli, Salmonella, and Shigella among children in limited-resource settings.   Dr. Pavlinac is co-director of Global WACh’s Gut Health and Child Survival scientific priority and is an emerging expert in pediatric enteric disease epidemiology.  This new one-year project will be an extension of her ongoing research in diarrheal disease and antibiotic therapy in sub-Saharan Africa.  This close examination of the genetic determinants of antibiotic resistance among recently hospitalization children in Kenya offers much needed insight into documenting the burden, risk factors, and transmission of antibiotic resistance in Kenya.

Antibiotics have revolutionized the treatment of common bacterial infections and currently play a crucial role in reducing childhood mortality.  However, the alarming increase in antibiotic resistance among bacteria is becoming a global concern and it threatens to undo progress made in childhood survival.  In this new project, Dr. Pavlinac and her study team will genetically characterize the antibiotic resistance patterns of bacteria isolated from the stool of Kenyan children who were recently discharged from hospitals, a population at high risk of death and re-hospitalization, as part of the ongoing NIH-funded Toto Bora trial (PI: Dr. Judd Walson).  Information on prevalent resistance genes in E. coli, Salmonella, and Shigella could reveal transmission patterns of antimicrobial-resistant pathogens that spread to vulnerable communities and windows of intervention opportunities.  The findings will be important to inform clinical management and strategic planning policies to reduce the burden of antibiotic-resistant infections in Kenya and across sub-Saharan Africa.

Dr. Pavlinac’s team includes a multidisciplinary team of investigators, Dr. Olusegun Soge (Assistant Professor, Global Health and Medicine),  Dr. Judd Walson (Professor, Global Health, Medicine, Pediatrics, and Epidemiology [Adjunct]), Dr. Ferric Fang (Professor, Laboratory Medicine; Director, Clinical Microbiology Laboratory at Harborview Medical Center), Dr. Benson Singa (Research Scientist, Kenya Medical Research Institute [KEMRI]), and Research Assistants Stephanie Belanger (PhD Candidate in Epidemiology, UW) and Doreen Rwigi (MS Student in Microbiology, KEMRI).

New R01 grant to discover immune mechanism responses in HIV and TB co-infected children in Kenya

Dr. Grace John-Stewart, MD, PhD

Dr. Cheryl Day, PhD

 

 

 

 

 

 

 

 

Principal Investigators, Drs. Grace John-Stewart (Global WACh Director; Professor, Global Health, Epidemiology, Medicine, and Pediatrics) and Cheryl Day (Assistant Professor, Emory University School of Medicine, Microbiology and Immunology) received a NIH/NIAID R01 award that supports research to discover changes in immune mechanisms and markers of the Mycobacterium tuberculosis (Mtb), the pathogenic bacteria that causes tuberculosis (TB), in children exposed to or infected with HIV.  As the number of TB cases rise in parallel to the HIV/AIDS pandemic in developing countries, there is an urgent need to understand the complex biological interaction between Mtb and HIV, particularly children with immune systems weakened by HIV.  The World Health Organization estimates that there are over one million new cases of TB and 239,000 TB-related deaths every year.

Drs. Anjuli Wagner, Irene Njuguna receive CFAR Int’l Pilot Award to engage hard-to-reach adolescents via WhatsApp

Drs. Anjuli Wagner, PhD (left) and Irene Njuguna, PhDc (right)

Congratulations Drs. Anjuli Wagner (Postdoctoral Research Fellow, Global Health) and Irene Njuguna (PhDc Epidemiology; Infectious disease researcher, Kenyatta National Hospital)!  They received a CFAR International Pilot Award for their project entitled, “WhatsApp focus group and respondent-driven sampling: novel approaches to engage diverse adolescents,” which aims to test new technology-based approaches to engage adolescents who do not typically seek HIV preventative and treatment services.  This one year project will take place in Nairobi, Kenya in collaboration with Kenyatta National Hospital.

Dr. Sarah Benki-Nugent awarded UW Global Innovation Fund to launch environmental health research collaborative to reduce childhood neurotoxic exposures

Every year, the UW Office of Global Affairs’ Global Innovation Fund receives dozens of proposals from UW researchers and offers seed funding to the most outstanding projects that spark cross-continental and multi-disciplinary research collaborations, innovative study abroad programming, and more.  We are so pleased that Dr. Sarah Benki-Nugent (Clinical Assistant Professor, Global Health) and her team (listed below) is one of 20 awardees this year!

Global WACh Student Researchers Feature Posters at the 2019 Global Healthies

Photo credit: UW School of Public Health

On January 23rd, the University of Washington Department of Global Health held its annual Global Healthies Opportunities Fair and Poster Competition, which seeks to strengthen connections and start new collaborations for better global health impacts.  It was an exciting evening with a large presence of Global WACh faculty, staff, students and colleagues engaging around our Center’s research and training opportunities.

This year, 12 Global WACh research assistants and Certificate students competed in the poster competition across four distinct categories (Discovery and Development, Education and Training, Implementation and Application, and Public Health Service and Direct Care).  Research assistant, Danae Black (PhD Candidate in Epidemiology), had the winning poster in the Public Service and Direct Care category!  Her research unveiled new data in an area not well studied—the burden of tuberculosis (TB) and utilization of TB preventative therapies for HIV-infected adolescents in Kenya.  These therapies entail daily oral medication taken for up to six months without interruption to effectively prevent TB.  Danae’s findings identified frequent medication shortages across 101 HIV care facilities, meaning that a large number of patients exposed to TB have started therapy, but few have completed it.  The gaps leave patients, whose immune systems are weakened by HIV, at higher risk of developing potentially severe forms of TB.  The impact of Danae’s findings can help researchers better understand the current TB prevention efforts in Kenya and find ways to systematically improve health outcomes in this vulnerable population.

We are so proud of all our student researchers and their achievements.  Well done!

Drs. Christine McGrath, Kirk Tickell receive a Thrasher Award for innovative strategy to train and support mothers to identify early childhood malnutrition

Dr. Christine McGrath, PhD, MPH

Dr. Kirk Tickell, MBBS, MPH

 

 

 

 

 

 

 

 

 

Malnutrition programs in limited-resource settings currently rely on community health workers to screen children for acute malnutrition by measuring their mid-upper arm circumference (MUAC), which is the circumference of a patient’s arm at the midpoint between the shoulder and elbow.  MUAC uses a simple, color-coded plastic band to provide an assessment of nutritional status and is an effective tool to predict mortality.  Recruiting and retaining community-based providers who are adequately trained and equipped to perform this screening is challenging and can result in high costs, low screening coverage, and late identification of malnourished children.  What if mothers had the tools and training to quickly determine their child’s nutritional status in their own homes and rapidly engage with nutritional services, if needed?

Dr. Brandon Guthrie receives award for mHealth intervention to improve transition from pediatric to adult HIV care

Congratulations to Dr. Brandon Guthrie, PhD, MPH, Assistant Professor of Global Health and Epidemiology, who received a NIH R34 Clinical Trial Planning Grant award to develop and test a mobile health technology (mHealth) based intervention to support youth transitioning from pediatric to adult HIV care in Kenya!  He is leading a team of researchers from the University of Washington, whoinclude Drs. Jennifer Unger, PhD (Assistant Professor, Obstetrics and Gynecology), Keshet Ronen, PhD (Research Scientist, Global Health), and Kristin Beima-Sofie, PhD (Research Scientist, Global Health). The team is also partnering with Dr. Megan Moreno, MD, from the University of Wisconsin School of Medicine and Public Health Pediatrics Department, and with long-time collaborators from Kenyatta National Hospital.

The mCUBE study, funded by Grand Challenges Explorations, seeks to understand women’s contraceptive preferences and behaviors in Kenya

Written by Alison Drake, Assistant Professor of Global Health, and Claire Rothschild, Epidemiology PhD student and mCUBE Research Assistant

As mobile phone ownership is rapidly growing around the world, crowdsourcing – asking questions to solicit information from large groups of people – is an increasingly attractive way to conduct global health research. In Kenya, nearly 90% of the population has access to a mobile phone,[1] and capturing data through mobile phones may provide a low-cost and effective solution for tracking health outcomes over time.

In 2017, Global WACh’s Dr. Alison Drake, Assistant Professor of Global Health, was awarded a Gates Grand Challenges Explorations grant to explore this idea – how mobile phones might be used to understand Kenyan women’s experience using family planning over time. Women and girls face major challenges using family planning, including side effects, stigma, cost, and barriers to access. Overall, 1 in 3 women starting a modern method of contraception stop using it within 1 year, and over half stop within 2 years.[2] This phenomenon is called the “leaking bucket”[3]  in family planning coverage, making efforts to achieve universal access to family planning worldwide extremely difficult.

In partnership with PATH-Kenya, the Mobile Data Collection of Contraceptive Use, Behaviors, and Experiences (mCUBE) study is collecting information from Kenyan women using family planning in real-time through surveys distributed directly to their phone via short message system (SMS). The survey technology, developed by the Kenya-based mobile technology firm mSurvey, allows SMS questions to be personalized based on language, family planning method, and prior SMS responses.

Dr. Alison Drake and the mCUBE research team at a January 2018 training in Kisumu, Kenya

The team developed short and simple SMS surveys in four languages (English, Swahili, Luo, and Kisii) that could easily be completed in 5-10 minutes, and could capture important information on women’s experiences and challenges using family planning methods. This task was challenging, as SMS questions need to be clear and straightforward enough to ensure women can complete surveys on their own, but within a 160 character count limit. In some instances, when text is translated from one language to another, the length of the translated text can differ. The team consulted with members of the Global WACh Family Planning Working Group and staff from Global WACh’s collaborating institution, UW-Kenya, to further simplify questions as much as possible.  The mCUBE study team enrolled participants from February 2018 to April 2018 from 10 public facilities across 5 counties in Western Kenya. A total of 1,270 women were enrolled, including 12% who didn’t have their phones at the time of enrollment and completed SMS registration remotely.

mCUBE Kenya Study Coordinator, Peninah Kithao, (right) meets with research assistant, Benard Otieno (left)

Once enrolled in the study and the SMS system, women receive weekly SMS surveys about their experience using family planning over the next 6 months.  mCUBE is also using SMS to collect information about the health facilities where women and girls are seeking their family planning care. Together, this information can be connected to individual participants, providing insight into the quality of family planning services and the impact quality may have on family planning use and satisfaction.

We look forward to seeing the results of the study, with completion of follow-up anticipated in October 2018!


[1] http://www.ca.go.ke/index.php/what-we-do/94-news/366-kenya-s-mobile-penetration-hits-88-per-cent
[2] Castle S, Askew I. Contraceptive discontinuation: reasons, challenges, and solutions. FP2020, Population Council. 2016 [cited 12 September 2017]. Available from: <http://www.familyplanning2020.org/microsite/contraceptivediscontinuation>
[3] Jain AK. Fertility reduction and the quality of family planning services. Stud Fam Plann. 1989;20(1):1-16.