The Strengthening Economic Evaluation for Multi-sectoral Strategies for Nutrition (SEEMS-Nutrition), a new three-year project funded by the Bill & Melinda Gates Foundation and directed by Dr. Carol Levin (Health Economist and Associate Professor, Global Health), aims to fill an information gap on costs, cost-effectiveness, and benefits of scaling up food system strategies in resource-constrained areas combating malnutrition. In the spirit of multi-sectoral collaboration, the SEEMS-Nutrition project is working in partnership with the Global Alliance for Improved Nutrition (GAIN), International Food Policy Research Institute (IFPRI), International Livestock Research Institute (ILRI) Helen Keller International (HKI), and Results for Development (R4P). Since launching in November 2018, the team is working hard to prepare the project for success. Their findings will allow program implementers and policymakers to make informed decisions about which nutrition interventions to prioritize to address healthy food systems, dietary intake, and improved nutritional status. Such interventions can help improve maternal and child health outcomes by promoting optimal dietary and feeding practices during critical windows of time when nutritional needs are the greatest.
In setting with high HIV prevalence, early antenatal care (ANC) visits are vital to optimize HIV testing and prevention services to reduce maternal and pediatric mortality and morbidity. Late ANC attendance limits timely identification and delivery of HIV prevention services including pre-exposure prophylaxis (PrEP) among pregnant women at high risk for HIV infection. To fill this gap, researchers are looking for ways to encourage pregnant women to seek ANC early and improve maternal and child health outcomes. In Kenya, community pharmacies, also known as drug shops or chemists, are playing an increasingly important role as sources of over-the-counter sexual and reproductive health products, including urine pregnancy tests and HIV self-testing kits. These pharmacies offer important and under-utilized access points to ANC and HIV prevention care for women and have the potential to inform a new innovative PrEP delivery model.
Dr. Melissa Mugambi (Assistant Professor, Department of Global Health, Implementation Science Program) received a National Institutes for Health (NIH) Diversity Supplement Award to lead a study on the feasibility of engaging community pharmacy providers in the distribution of pregnancy tests and subsequent referral of pregnant women to ANC, in order to promote early access to ANC and PrEP.
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.
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).
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, 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.
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!
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!
Global WACh is pleased to announce applicants selected for this year’s funding cycle of the Seeds for Change Resource Award to Strengthen Collaborative Sites. Congratulations to our three awardees!
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?