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Our Lifecycle Approach to Research

At Global WACh our mission is to make scientific discoveries, cultivate leaders, and bridge disciplines to advance the tightly connected health of women, adolescents, and children. Global WACh approaches research, activities, and programs through a “lifecycle lens” that views target populations as interconnected instead of independent groups.

What exactly do we mean by “lifecycle lens?”  We sat down with Global WACh Director, Grace John-Stewart, MD, PhD, MPH to explain what it is and why it is important in the global health context.

Historically, global health research focused on women, adolescents, and children separately, or examined the maternal-child relationship. Within the last decade, however, adolescents have emerged as a critical population to understand and engage in order to improve health worldwide.  With the proliferation of adolescent health research and programs, Global WACh uses a lifecycle lens in which research explores potential impact and benefits throughout the lifecycle, from pregnancy, to neonate, to child, to adolescent, to next generation reproductive health.

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Dr. John-Stewart’s research career in mother-to-child HIV transmission involved linking pediatricians with obstetricians and caring for mothers and infants together, with studies to optimize outcomes in both. The questions surrounding how to prevent women and children from getting HIV led to recognizing adolescence as a critical area on which to focus. Adolescents in the pre-reproductive phase need to be incorporated into the lifecycle model – prevention and treatment of children can improve adolescent health and adolescent engagement can improve health in their later life and in the next generation.

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Grace John-Stewart MD, PhD Global WACh Center Director

“If we do something for women, could we have benefits for them that also benefit their children? If we do something for children, are there ways in which we benefit them moving into adolescence and later life? We’re trying to think about it together.”

 

Global WACh has three main core focuses of research: Infectious Diseases, Healthy Growth and Development, and Family Planning. All of these areas have elements that directly relate to the lifecycle. For example, healthy, planned pregnancies lead to healthy babies who, when provided with adequate infant nutrition and other interventions, can experience better health outcomes later in life.

Dr. John-Stewart acknowledges it is a challenge incorporate all three populations into any one study, but Global WACh wants researchers to think about how their work in any one of these populations could be linked to the other populations as they develop and implement studies.

“You have to understand the implications of actions in one area for the other, and if you can articulate that it’s good. If you’re doing a study on maternal depression, for example, not every time do you have to measure the child outcomes, but you may speculate or infer how this could benefit both the mother and child.”

You can read more about Global WACh’s mission, vision, and the work that we do here.

 

 

WACh Research Racks Up Awards at IAS Conference

In late July, Global WACh sent several team members to Vancouver for the 8th Annual IAS Conference on HIV Pathogenesis Treatment and Prevention. Our researchers presented posters highlighting woman, adolescent, and child health and Kristjana Asbjornstottir, Irene Njuguna, and Keshet Ronen took home awards recognizing their excellent work!

Kristjana received the The IAS/ANRS Lange-Van Tongeren Prize for Young Investigators for her project Immune Activation ped HIV.

Kristjana with Dr. Beyrer from Johns Hopkins and Dr. Delfraissy from ANRS France who presented her with the award
Kristjana with Dr. Beyrer from Johns Hopkins and Dr. Delfraissy from ANRS France who presented her with the award

Kristjana shared her thoughts about winning this prestigious award saying:

Giving a talk at IAS was an incredible opportunity in itself, and having our work recognized through the Young Investigator award on top of that is an enormous honor. I think it highlights the particular attention that was paid to pediatric research at the conference this year. Lots of UW research was featured in various tracks and sessions.

Irene Njuguna was the recipient of the CIPHER Award (Collaborative Initiative for Paediatric HIV Education and Research) which is granted to provide funding for research that addresses priority gaps in pediatric HIV. Without treatment, 50% of HIV infected children will die by the age of two so early diagnosis and treatment is crucial.

The Financial Incentives to increase HIV testing in children (FIT) study that Irene and the team have been working with wants to test to see if small financial incentives will increase HIV testing for children of HIV infected adults who are already in care.

This award is a result of hard work from the team, and I feel honored to be part of this team. This would not be possible without the excellent mentorship from Grace John-Stewart, Jennifer Slyker and Anjuli Wagner.

All of our Global WACh members gave poster presentations for the conference, and Keshet Ronen won an award for Best Poster for her research on Lower ANC Attendance and PMTCT Uptake in Adolescent versus Adult Pregnant Women in Kenya.

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Keshet Ronen and her award winning poster

Let’s hear it for our award winning Global WACh team!

 

Small Changes With Big Impact – Announcing the Global WACh Small Change Awards

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The University of Washington Center for Integrated Health of Women, Children and Adolescents (Global WACh) aims to contribute to scientific discoveries, develop and nurture future leaders in science and foster collaborative approaches to improving the health and well-being of women, children and adolescents.

As part of these commitments, Global WACh offers a Resource Awards to support efforts to improve the patient experience in LMIC by improving clinical care, patient satisfaction, workforce empowerment, and health service delivery for programs benefitting the health of women, adolescents and children.

For more information, and to download the current RFA, please visit our Small Change Awards page.

We’re looking forward to receiving your proposals!

Global WACh at IAS 2015

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UW Global Health and Global WACh will be attending the 8th IAS Conference on HIV Pathogenesis Treatment & Prevention July 19th – 22nd, and we’re there in full force. Below are the oral presentations you don’t want to miss!

Monday at 11:00am  Kristjana Asbjornsdottir will present  Immune activation and pediatric HIV during the Growing up on ART session (Ballroom B)

Wednesday at 11:00am Anjuli Wagner will present Pediatric HIV testing during the Children and Adolescents Living with HIV session (Room 211-214)

Wednesday at 11:00am Keshet Ronen will present Adolescent PMTCT engagement during the Children and Adolescents Living with HIV session (Room 211-214)

Global Health and Global WACh team members will also be at the poster presentations, and we even have a few award winners in the bunch! Kristjana Asbjornsdottir will be honored with the IAS Young Investigator Award, Irene Njuguna will receive a CIPHER Award, Keshet Ronen will be getting a Best Poster award for her Pediatric IAS Meeting poster. Congratulations to all of them!

Click here for the full Global WACh IAS schedule and here for more information about IAS 2015.

Global WACh In Focus: Patricia Pavlinac

pattyPatricia Pavlinac, PhD, was trained in epidemiology and began working within the Department of Global Health on tuberculosis-related research projects in January 2010. Through coordinating a diarrheal and febrile illness surveillance study for Judd Walson, she developed a dissertation to determine the potential etiologies of acute diarrhea among Kenyan children, to determine how these etiologies associate with HIV-infection and HIV-exposure, and to evaluate the appropriateness of current international diarrhea management guidelines in correctly indicating antibiotics.  She found that specific enteric pathogens, namely enteropathogenic Escherichia coli (EPEC) and Cryptosporidium are associated with HIV-infection and HIV-exposure, respectively, a finding that builds upon recent evidence that these two pathogens are independently associated with mortality in children with diarrhea.  Additionally, she found that the indications for antibiotic use in current World Health Organization management guidelines miss most treatable bacteria. To give a bit of context to her research, over 3% of children under 5 years of age who present to a Western Kenya health facility with a moderate to severe form of diarrhea will die within the subsequent 60-days, despite receiving oral rehydration solution and zinc,  a risk of death 5-times higher than a healthy similarly aged child living in the same community. This knowledge, combined with her research in understanding the role of host and management factors in diarrheal disease consequences, have inspired her to focus her career on pediatric diarrheal disease in sub-Saharan Africa.

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Patricia is passionate about developing evidence for the management of diarrheal illness in pediatric populations. She is conducting an evidence review of diarrhea management strategies for pediatric populations in resource-limited settings, an endeavor commissioned by the Bill & Melinda Gates Foundation and presented at the World Health Organization in October 2014. The most rewarding thing about this area of work, she says, is that there is a huge renewed interest in diarrheal disease in the global research community. This priority settings comes at the heels of the recently published Global Enteric Multicenter Study (GEMS), which highlighted the continued risk of death associated with diarrheal illness and challenged existing thinking about the major causes of diarrheal disease in sub-Saharan Africa and Asia.

It feels exciting and I feel really lucky to have found this field at this stage.

Patricia is especially interested in the consequences of diarrhea that extend beyond the acute period. Research is showing that even though a child may survive the acute consequences of diarrhea, namely dehydration, many go on to die soon after. She is hoping to design interventions that target this post-acute diarrhea phase and prevent the downward health spiral that occurs after a significant episode of diarrhea.

Patricia is confident in the possibility of a real impact, and there are funders, researchers, and institutions that are coming together to support these efforts. We are excited to have such a dynamic and passionate researcher in the Global WACh family!

Dr. Venkatraman Chandra-Mouli of WHO Presents at Global WACh

This week we were pleased to have Dr. Venkatraman Chandra-Mouli here at Global WACh for an amazing presentation on adolescent and sexual reproductive health.

Since the International Conference on Population and Development (ICPD) in 1994 there have been tremendous changes made throughout the world in which adolescents live. Lowered infant mortality, a decrease in poverty, and better access to clean drinking water are just a few examples of things that have improved. Progress where it comes to adolescent sexual health however hasn’t been quite as successful, and often inadequate commitment, discomfort, or limited funding and resources stand in the way of such changes.

“When you have huge fires burning like childhood or maternal mortality, or HIV, adolescent sexual and reproductive health is talked about as one of the many priorities but is not given the attention it needs.”

Dr. Chandra-Mouli  works in the World Health Organization’s Department of Reproductive Health and Research and seeks to create evidence based policy changes and programs. You can view his entire presentation below.

Mobile WACh Engages Women in Their Own Maternal Care

UngerGlobal WACh Associate Director Dr. Jennifer Unger gave a great talk last week about the implementation of mobile phones in the care of pregnant women in Mathare, Kenya. Three hundred women are currently participating in the study, which aims to use SMS text messaging as a means to keep the expectant mothers informed and involved in the health of themselves and their babies.

Text messages from a nurse at the clinic offer tips and general information, as well as answers for any health questions the participants may have. The messaging system also provides appointment reminders and a way to check in to see how they’re feeling. Perhaps most importantly according to the women in the study, the messages offer encouragement and support while allowing them to feel cared for and empowered.

Many countries have some version of mHealth in place, and Dr. Unger stressed the importance of working together and also making the messages culturally appropriate and tailored to each individual community. This particular study is completely free for the participants.

The findings in Mathare, Kenya will lay the foundation for a larger Global WACh study on using mHealth to enhance the prevention of mother to child transmission of HIV. The results of the Mobile WACh study should be available in the spring, and we’re certainly looking forward to sharing them.