Gut Health and Child Survival

New NIH R01 will study effect of breast milk and gut microbiome to optimize growth in HIV-exposed uninfected children in Africa

Dr. Christine McGrath, PhD, MPH

Dr. Grace Aldrovandi, MD, CM









Congratulations to Principal Investigators, Dr. Christine McGrath (Assistant Professor, Global Health) and Dr. Grace Aldrovandi (Chief, Division of Infectious Disease at UCLA Mattel Children’s Hospital; Professor, Pediatrics, UCLA Geffen School of Medicine), who received a National Institutes of Health (NIH) R01 award for a new study entitled, “Effects of Human Milk Oligosaccharides and Gut Microbiome on Growth and Morbidity in HIV-Exposed Uninfected Infants.”  The study team includes investigators from the Department of Global Health, Drs. Grace John-Stewart (Global WACh Director; Professor), Donna Denno (Professor), Judd Walson (Professor), Barbra Richardson (Adjunct Research Professor) and from the Kenya Medical Research Institute, Dr. Benson Singa (Research Scientist; Affiliated Assistant Professor, Global Health).

Despite the success in global health efforts to prevent mother-to-child transmission of HIV, there is a growing and often overlooked HIV-exposed uninfected (HEU) population with a substantially higher risk of growth faltering, infectious morbidity, and mortality compared to HIV-unexposed uninfected (HUU) infants. The mechanisms responsible for poor growth and susceptibility to infection in HEU infants are unclear, but recent evidence suggests disturbances in the infant gut microbiome is a major cause.

DeWorm3 Project launches deworming activities at trial sites to improve nutrition and health

Over 1.5 billion people, including 835 million children, in the world’s poorest communities, are infected with soil-transmitted helminths (STH), commonly known as intestinal worms, and are in need of deworming medications.  A single deworming pill is a safe and effective solution to combat worm infections that interfere with the body’s nutritional intake and impair developmental growth, especially in children.  Periodic mass deworming protects a community by removing or reducing the worm burden of infected community members, thereby decreasing the risk of new individuals becoming infected.  In 2016, Dr. Judd Walson (Department of Global Health), in collaboration with the Natural History Museum London and the University of Washington, launched the DeWorm3 Project to test the feasibility of interrupting transmission of STH using intensified mass drug administration strategies.  DeWorm3 is a cluster randomized trial comparing community-wide deworming efforts of individuals of all ages to standard-of-care deworming of school-age children at schools.  Findings from the clinical trial and accompanying implementation science research can support the development of STH program guidelines and innovative delivery strategies.  Deworming activities launched in 2018 in trial sites in Benin, India, and Malawi.

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).

Global WACh Shares Novel Research Findings at International Conferences

Over Fall quarter, Global WACh researchers shared novel research findings from our three scientific priority areas (HIV Through the Lifecycle, Family Planning and Decision Support, and Gut Health and Child Survival) at several international conferences: The HIV Prevention for HIV Conference (HIVR4P), Union World Conference on Lung Health, and American Society of Tropical Medicine & Hygiene (ASTMH) Continue reading for conference highlights and photos!

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?