Healthy Growth and Development Core

HG&D
The Healthy Growth and Development Core improves the growth and development of infants, children, and adolescents living in resource-limited settings through collaborative multidisciplinary scientific research. This core discovers, develops, and evaluates interventions and programs in the following priority areas:
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LEADERSHIP

The Healthy Growth and Development Team is led by Drs. Patricia Pavlinac and Judd Walson and supported by a steering committee.

Patricia Pavlinac is an epidemiologist and Acting Assistant Professor in the UW Department of Global Health. Dr. Pavlinac’s research aims to identify interventions to halt the nutritional and developmental sequelae of enteric and diarrheal diseases.

Judd Walson is a clinical researcher and Associate Professor in the UW Departments of Global Health, Medicine, Pediatrics, and Epidemiology. Dr. Walson’s research focuses on the treatment and prevention of enteric infections and diarrheal diseases and the role of environmental enteropathy and the gut microbiome in childhood nutrition.

Steering Committee members:

Sarah Benki-Nugent, PhD, MS
Cecilia Breinbauer, MD, MPH
Claudia Crowell, MD
Donna Denno, MD, MPH
Christine McGrath, PhD, MPH
Kirkby Tickell, MBBS, MPH

Patty Pavlinac

Patricia Pavlinac, PhD, MS

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Judd Walson, MD, MPH

RESEARCH

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Building the evidence base for care of acutely-ill, undernourished children in limited resource settings – CHAIN Network
Jay Berkley (director), Judd Walson (co-director), Donna Denno, Kirk Tickell & the CHAIN Network investigators
(Kenya, Malawi, Pakistan, Bangladesh, Uganda)
The CHAIN Network is a collaboration of clinical research centers from Sub-Saharan Africa, South East Asia, the UK and USA dedicated to reducing childhood mortality caused by co-morbid severe illness and malnutrition. The Network will conduct studies in Kenya, Malawi, Pakistan, Bangladesh and Uganda to identify modifiable risk factors for death, during and after hospitalization, and prioritize potential interventions.
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Optimal use of antibiotics in young children at high risk of diarrhea associated mortality (World Health Organization)
Judd Walson Patricia Pavlinac (Kenya site)
The purpose of this double-blind placebo-controlled clinical trial is to determine the efficacy of two antibiotics in reducing risk of death and linear growth faltering in children under two years of age presenting with diarrhea and either dehydration or malnutrition. Fifteen thousand children will be enrolled from 7 study sites (Kenya, Mali, Malawi, Tanzania, Bangladesh, India, and Pakistan), randomized to a three day directly observed course of azithromycin, ciprofloxacin, or placebo, and followed for 90-days.
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Impact of HIV, immune activation, and ART on child neurodevelopment in Kenya (NIH/NINDS K01)
Sarah Benki-Nugent
This study aims are to determine the extent to which early ART started in infancy preserves long-term neurocognition in HIV-infected children, to determine prevalence and correlates of neurocognitive deficits in children diagnosed later in childhood who initiate ART and are followed thereafter, and to determine the relative influence of viral, immunologic and immune activation on neurocognitive outcomes in HIV-infected and treated children.
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Azithromycin to prevent post-discharge morbidity and mortality in Kenyan children, (NIH/NICHD R01)
Judd Walson
The aim of this randomized, double-blind, placebo-controlled trial is to determine the efficacy of azithromycin provided to children at hospital discharge, compared to placebo, in reducing mortality, re-hospitalization, and linear growth faltering in children age 1-59 months in Kenya. The study will also investigate potential mechanisms by which azithromycin may reduce morbidity and mortality in this population and will assess the emergence of antibiotic resistance among treated children and their caregivers.
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Improving neurodevelopmental outcomes of HIV-infected children in Kenya
(Clinical Research Scholar’s Program Seattle Children’s Hospital)

Claudia Crowell
In this 3-arm randomized controlled trial we will determine the effectiveness of an early childhood intervention aimed at improving neurodevelopment by facilitating caregiver directed mediated learning and caregiver-child interactions.
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Diarrhea management review (Bill & Melinda Gates Foundation)
Patricia Pavlinac
Approximately 600,000 children die each year from diarrheal disease, most in low resource settings in sub-Saharan Africa and South Asia. These series of systematic reviews will contribute to a growing body of literature highlighting the need for updated evidence around diarrheal disease management in pediatric populations and will hopefully catalyze an evidence-based approach to research priority setting.
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Infectious Disease and Nutrition

BEED Study Validating non-invasive biomarkers of EED and identify potential biological pathways for interventions to control EED and stunting.
Tahmeed Ahmed, Judd Walson (Bangladesh)
The goal of this study is to validate non-invasive biomarkers of EED and identify biological pathways for interventions to control EED and stunting using a community based interventions approach. Specifically, UW is collaborating with the International Center for Diarrheal Disease Research, Bangladesh to assess maternal perceptions of infant feeding behaviors and neuro-hormonal markers of appetite and satiety to identify novel interventional targets.
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Optimal use of antibiotics in young children at high risk of diarrhea associated mortality (World Health Organization)
Judd Walson, MD, MPH, Patricia Pavlinac PhD (Kenya site)
The purpose of this double-blind placebo-controlled clinical trial is to determine the efficacy of two antibiotics in reducing risk of death and linear growth failure in children under two years of age with diarrhea and dehydration or malnutrition. A total of fifteen thousand children will be enrolled from 7 study sites (Kenya, Mali, Malawi, Tanzania, Bangladesh, India, and Pakistan) and randomized to a three day directly observed course of azithromycin, ciprofloxacin, or placebo and followed for 90-days.
IDnutr

Azithromycin to prevent post-discharge mortality and morbidity in Kenyan children (NIH/NICHD R01)
Judd Walson, MD, MPH
The aim of this randomized, double-blind, placebo-controlled trial is to determine the efficacy of azithromycin provided to children at hospital discharge, compared to placebo, in reducing mortality, re-hospitalization, and linear growth faltering in children age 1-59 months in Kenya. The study will also investigate potential mechanisms by which azithromycin may reduce morbidity and mortality in this population and will assess the emergence of antibiotic resistance among treated children and their caregivers.
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A novel approach to evaluate caregiver to child transmission of Cryptosporidium (Bill & Melinda Gates Foundation)
Judd Walson, MD, MPH
Cryptosporidium is a leading cause of diarrheal disease in children and is associated with poor growth and cognitive disabilities. This study will elucidate whether caregiver to child transmission is a significant source of the high burden of Cryptosporidium infection in Kenyan children and thereby inform control measures.
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Diarrhea management review (Bill & Melinda Gates Foundation)
Patricia Pavlinac, PhD, MS
Approximately 600,000 children die each year from diarrheal disease, most in low resource settings in sub-Saharan Africa and South Asia. These series of systematic reviews will contribute to a growing body of literature highlighting the need for updated evidence around diarrheal disease management in pediatric populations and will hopefully catalyze an evidence-based approach to research priority setting.
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Planning for the development of a research consortium and platform for conducting clinical trials in the treatment and prevention of enteric dysfunction and childhood stunting (Bill & Melinda Gates Foundation)
Judd Walson, MD, MPH
This clinical trials platform in Kenya and Bangladesh will be used to evaluate interventions to reduce/prevent long term growth failure and associated morbidity in high-risk children.
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Infectious Disease and Brain Development

Impact of HIV, immune activation, and ART on child neurodevelopment in Kenya (NIH/NINDS K01)
Sarah Benki-Nugent, PhD, MS
This study aims are to determine the extent to which early ART started in infancy preserves long-term neurocognition in HIV-infected children, to determine prevalence and correlates of neurocognitive deficits in children diagnosed later in childhood who initiate ART and are followed thereafter, and to determine the relative influence of viral, immunologic and immune activation on neurocognitive outcomes in HIV-infected and treated children.
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HIV and Child Neurodevelopment in Kenya (UW/FHCRC New Investigator Award)
Sarah Benki-Nugent, PhD, MS
This study aims are to determine the extent to which early ART started in infancy preserves long-term neurocognition in HIV-infected children, to determine prevalence and correlates of neurocognitive deficits in children diagnosed later in childhood who initiate ART and are followed thereafter, and to determine the relative influence of viral, immunologic and immune activation on neurocognitive outcomes in HIV-infected and treated children.
IDbrain

Improving Neurodevelopmental Outcomes of HIV-Infected Children in Kenya
(Clinical Research Scholar’s Program Seattle Children’s Hospital)

Claudia Crowell, MD
In this 3-arm randomized controlled trial we will determine the effectiveness of an early childhood intervention aimed at improving neurodevelopment by facilitating caregiver directed mediated learning and caregiver-child interactions.
IDbrain

ACTIVITIES

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Healthy Growth and Development Annual Symposium

 

Global Health Data Toolkit