Children hospitalized with severe illness in sub-Saharan Africa (SSA) are at high risk of morbidity and mortality following discharge from hospital, but mechanisms driving this vulnerability are poorly understood and there are no recommended interventions specifically targeting the post-discharge period. Dr. Patty Pavlinac, Assistant Professor in the Department of Global Health and Co-Director of Global WACh’s Gut Health and Child Survival Priority Area, is the Principal Investigator of a newly awarded National Institutes of Health (NIH) R01 grant to explore the mechanisms underlying this risk, including how azithromycin—an antibiotic commonly used to treat pediatric infections—affects children’s health and nutritional outcomes in SSA. The findings will inform the development of interventions to reduce the risk of death, re-hospitalization, and growth faltering following hospitalizations among this vulnerable group of children.
The study titled, “The role of enteric pathogens and antimicrobial resistance in driving clinical and nutritional deterioration, and azithromycin’s potential effect, among children discharged from hospital in Kenya,” is a five-year study that builds on Global WACh’s recent Toto Bora trial in Kenya, a double-blind, placebo-controlled randomized clinical trial testing the effect of a 5-day course of azithromycin to reduce post-discharge morbidity and mortality among children under five years of age. Dr. Pavlinac and a team of researchers will utilize Toto Bora’s cohort samples (stool and Escherichia coli isolates) and data to characterize enteric pathogens and antibiotic resistance using highly sensitive molecular diagnostic tools. The results will offer insight into the role of these enteric pathways on children’s post-discharge outcomes and azithromycin’s effect on this pathway.
Dr. Pavlinac will be working in close collaboration with co-investigators from the University of Washington Drs. Donna Denno, Ferric Fang, Grace John-Stewart, Barbra Richardson, Judd Walson, and Epidemiology PhD Student Kirk Tickell; Drs. Sam Kariuki and Benson Singa from the Kenya Medical Research Institute (KEMRI); and Drs. Eric Houpt, James Platt-Mills, and Jie Liu from the University of Virginia. Congratulations to this team!