Congratulations to Dr. Irene Njuguna (PhD Candidate in UW Epidemiology; Infectious Disease Researcher, Kenyatta National Hospital) who is the recipient of the 2019 UW/Fred Hutch Center for AIDS Research (CFAR) Mentored International Investigator Award! Dr. Njuguna’s new two-year project entitled, “Causes and risk factors for death in HIV positive adolescents and youth in Kenya,” aims to fill critical gaps in understanding cause-specific and underlying contributing factors to adolescent and young adult (AYA) deaths. Despite improvements in recent years to link HIV positive AYA to treatment and management to keep viral loads low, they remain at high risk of dying for reasons not well documented at many low-resource health facilities.
Under the mentorship of Dr. Grace John-Stewart, Dr. Njuguna and her study team will characterize the causes and risk factors of AYA deaths, which is important to identify missed opportunities for intervention and guide the development of tailored targeted inventions to save lives. The study team includes talented investigators from Global WACh and the UW Department of Global Health, Dr. Anjuli Wagner and Dr. Kristin Beima-Sofie; Kenyatta National Hospital, Dr. Caren Mburu; and University of Nairobi, Drs. Anne-Marie Macharia and Dalton Wamalwa.
Dr. Njuguna is currently an investigator in the ongoing “Transitioning from Pediatric to Adult HIV Care in Kenya (ATTACH)” clinical trial (PI: John-Stewart), which is testing an intervention to support health care workers to disclose HIV status to adolescents and to track transition to adult care. In the new study, the team will leverage existing medical records of 100 AYA reported to have died to glean as much information as possible. They will conduct verbal autopsies with workers to determine each participant’s clinical signs and symptoms prior to death, health care sought, place of death, history of chronic illness, prior psychosocial history, including evidence of depression and substance use and timing of HIV diagnosis and ART initiation. They will also survey participants’ caregivers to learn where there might have been missed opportunities to intervene. These questions will help answer when the participant may have started experiencing difficulties in care and describe any influences of specific behavior risk factors, such as substance abuse, mental, psychosocial factors and adherence to treatment. We are thrilled for Dr. Njuguna’s award to support her growing HIV/AIDS research career and look forward to learning about the project’s results.