Patricia 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.
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!
It’s that time of year again for our 3rd annual “Next Big Thing” end-of-year event. The evening will be dedicated to highlighting the achievements of our scholars, and certificate students. We will start off in Foege auditorium with Dr. Judith Wasserheit speaking, followed by brief highlights from our Scholars and their various projects around the world. We will then move upstairs to Vista Café to enjoy some refreshments while looking at the Global WACh certificate student posters. Click here to read more about a few of the great students that will be presenting.
Here are the details!
Date: Wednesday, May 27th 2015
Place: UW Campus | William H. Foege Building | Foege Auditorium
Annie Hoopes, MD (WHO Scholar)
Emily Robinson and Kate Fizenmaier (SCOPE Scholars)
Our recent Seed Grant Awardees
Dr. Judith Wasserheit, Chair, Department of Global Health
6:30-7:30 p.m. – Light Reception & Student Posters in the Vista Cafe.
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.
The Kenya Pediatric Studies (KPS) team has been working hard on an important study called CATCH (Counseling and Testing for Children at Home). The CATCH study does just what the name says by “catching” children ages 12 and under who have fallen through the cracks in HIV diagnosis systems.
There are 3.3 million children in the world living with HIV. Half of HIV-infected children that go untreated will die by the age of two. There are some great programs in place to help prevent mother-to-child transmission (PMTCT) during pregnancy, birth, and breastfeeding; but going through all the steps in these systems can be challenging, and medication is not always successful at preventing infection in babies.
Children born before PMTCT systems were widely available may not have had the chance to be tested. Additionally, if a mother finds out that she has HIV after her child has been born, there may be a missed opportunity to test her child. Many HIV-infected young children with a missed diagnosis are admitted to the hospital when they are already very sick and they don’t respond well to HIV treatment. The CATCH team aims to find children who may have missed diagnosis in PMTCT and get them the care they need before it’s too late.
CATCH is working to bridge the gap by approaching parents already in treatment and asking if they have any children who have not been tested and would like to have these children tested. CATCH offers testing both in clinics and at the home for those parents who prefer not to bring their children to the clinic. HIV-infected children are then linked to an HIV care clinic of choice, which ensures that children can live happy and healthy lives because of much needed care.
One issue that the CATCH team has run into is the issue of disclosure of HIV status to children. “Telling a child they have HIV is hard because you’re also potentially exposing the parents’ status as well. Kids also have a difficult time processing the news and will sometimes talk with friends, which can lead to possible stigma for the family,” says Anjuli Wagner, a PhD candidate in the Department of Epidemiology and member of the CATCH study team. Still, studies suggest that disclosure does seem to improve outcomes for infected children.
The CATCH study originally intended to focus on all children ages 0-18, but they discovered through discussions with bioethicists and their community advisory board that adolescents have a unique set of needs that are quite different from those of younger children. With adolescents, it’s challenging to decide who can give permission for the HIV test, who should receive the results of the test, and how best to support a young person who is gaining independence to cope with their diagnosis. To address these challenges inherent in adolescent HIV testing, another study called ‘DASH’ was created. DASH (Developing Adolescent Strategies for HIV testing) is focusing on voluntary counseling and testing for adolescents and is just another way the Kenya Pediatric Studies and Global WACh teams are making sure all the bases are covered for appropriate testing and treatment for children and adolescents.
CATCH currently has funding for 7 different sites in Nairobi and one in Western Kenya and we’re looking forward to seeing those results!
Annie Hoopes, MD, is one of our Global WACh Certificate Program students and a World Health Organization (WHO) Scholar. She is also a pediatrician and is currently completing a fellowship in adolescent medicine at the University of Washington and Seattle Children’s Hospital. Through her collaboration on a systematic review of adolescent sexual and reproductive health services with Dr. Donna Denno, Annie met co-author Dr. Venkatraman Chandra-Mouli, an international expert in adolescent health services with the WHO. Dr. Chandra-Mouli subsequently invited Annie to the WHO in Geneva to work as an intern in the Division of Reproductive Health and Research during summer 2014. This provided a great opportunity for mentorship forher, as she is interested in promoting adolescent sexual and reproductive health in resource-limited settings. At WHO, Annie worked with the Adolescents and At-Risk Populations Team where she gained an understanding of how agencies like WHO, World Bank, UNICEF, and UN work in partnership to promote sexual and reproductive health.
We want to ensure that ever-shrinking resources for adolescent health are being directed toward programs with proven adolescent health and psychosocial benefits.”
Annie’s passion to ensure adolescents get the resources they need was central to her task at WHO of reviewing the effectiveness of programs in countries implementing adolescent-friendly services. She began with systematic review of adolescent health initiatives in India. She also studied how adolescents are addressed in national reproductive health policies, using South Africa as a case study.
Annie is back in Seattle now for her final year of fellowship and public health training and is looking forward to applying these experiences for the next steps in her career.
When we know 2.1 million adolescents age 10-19 are living with HIV in low- and middle-income countries and one in five women worldwide has a child before age 18, it is undeniable that our health systems must ensure that age- and context-appropriate preventive and treatment interventions reach this vulnerable population”
There are 1.8 billion adolescents in the world today. That’s a tremendous number of youth that are at a crucial point of transition in their lives. 1.4 million adolescents die each year from causes such as early pregnancy, sexual violence, unsafe abortions, and HIV and other STIs. Yet adolescence is often overlooked in policy making, particularly in low income, high risk settings, and the global health of adolescents is not improving at the rate it should.
Last night Global WACh was proud to sponsor the launch of a Special Supplement of the Journal of Adolescent Health. This marks the 20th anniversary of the the landmark Cairo International Conference on Population and Development (ICPD).
We had some truly amazing speakers on hand to have a conversation on ways of improving the health and well-being of adolescents globally. The speakers and a tremendous student panel shared their experiences and discussed how investing in adolescent friendly health services, comprehensive sex education, supportive environments, violence prevention, and youth participation can help adolescents transition into happy and healthy adults.
If you missed our livestream of the event, you can go to the following link and watch the recorded version. Thanks to all our speakers, students, and attendees that helped make this launch a great success!
Please join Global WACh for two fantastic events focusing on the health of adolescents and women.
Journal of Adolescent Health Special Issue Launch With Drs. Donna Denno, Annie Hoopes, Grace John-Stewart, and Judy Wasserheit.
Thursday, December 11, 2014
4:00 p.m. – 5:00 p.m. Event | 5:00 p.m. – 5:30 p.m. Reception
W.H. Foege Building | Room N130
3720 15th Ave NE Seattle, WA 98105
Join authors Drs. Donna Denno and Annie Hoopes, along with Global WACh Director Dr. Grace John-Stewart and UW’s Department of Global Health Chair Dr. Judy Wasserheit, for a discussion about the global status of adolescent sexual and reproductive health and rights. The event will include a series of presentations and a panel of global health professionals with first-hand experience discussing the realities in settings around the world, followed by a short reception.
Migration/Mobility and Early Sex Exchange as Social Determinants of Marginalized Women and Adolescents’ Health With Dr. Shira Goldenberg
Tuesday, December 16th 1:00 p.m. – 2:00 p.m.
Harborview Ninth and Jefferson Building | 13th floor | Room 1360
325 Ninth Ave, Seattle, WA 98104
This lecture will illustrate the critical roles of early sex exchange and migration/mobility patterns in shaping health inequalities related to HIV/STIs, substance use, and access to care for marginalized women and adolescents. Drawing on evidence from epidemiological and qualitative studies conducted with women and adolescents involved in the sex industry in Mexico, Guatemala, and Canada, this lecture will highlight the need for policy changes and multi-level interventions to promote the health of migrant/mobile women and adolescents who exchange sex.
Lisa Shawcroft, a 2014 Global WACh Certificate Program Alum, was selected as one of 128 fellows withGlobal Health Corps. She is currently a Communications Specialist for Marie Stopes International (MSI)- US in Washington DC, and is blazing a trail for future Global Health Corps fellows to be able to work with the organization in sexual and reproductive health.
During her studies at the Evans School of Public Affairs, Lisa was drawn to the conversations about health systems and hospital cases. She had taken the Global WACh Law & Policy Solutions course; which according to her, compliment her Masters in Public Administration coursework very well. She had previously been involved with a few non-profits here in Seattle and wanted to broaden her horizons. After graduating from the UW with an MPA and certificates in Non-profit Management as well as the Global WACh Certificate, Lisa identified MSI-US as an opportunity to put her recently acquired skills into practice.
“It’s hard to put a border on health,” she says, emphasizing that everything is interconnected and that borders are fluid. Global health is truly global. “I’m an American born, somewhat privileged woman who speaks English. If I have problems accessing the care I need–how hard must it be for someone who doesn’t have those same privileges and is coming from a total different cultural background and trying to adjust—to access care?”
Lisa’s Global WACh Certificate Capstone focused on community-based asset building with Latino children and adolescents in Federal Way. She focused on strengths of this community as reported by these populations in an effort to better connect these populations to needed health services.
Lisa hopes to use her fellowship year with Global Health Corps and MSI-US as a stepping stone to working with refugees and immigrants to Washington state, specifically in the field of reproductive health. While researching potential Global WAch capstone projects, she struggled to identify a particular organization that tackles refugee family planning, so she says that’s what pushes her to fill that gap. For Lisa, global is local, and the Global WACh certificate helped her learn the skills necessary to work with resource scare settings—both internationally and domestically.
We here at Global WACh wish Lisa all the best and know that she’s doing some fantastic work to change people’s lives for the better.
On October 27th, Global WACh co-sponsored a series of presentations entitled: “Birth Defects in Iraq: The Consequences of War.” Dr. Muhsin Al-Sabbak, an obstetrician at Basra Maternity Hospital and Mozhgan Savabieasfahani, an environmental toxicologist, shared their knowledge of the devastating effects of war on the children of Iraq.
Dr. Al-Sabbak began by describing his experiences as a physician in Iraq, followed by statistics and figures to help the audience understand the gravity of the situation. One of the more impactful statistics was the rate of birth defects, which in 1995 stood at 1.37 per 1,000 births and in 2003 had risen to 23 per 1,000 births. There has been an estimated increase of 60% in the last decade. He shared pictures and stories from his hospital about the children born there with life threatening defects. “I have thousands of these pictures,” he said, later revealing his own personal tragedy of his young nephew who had died from Leukemia, likely as a result of the environmental poisoning.
Mozhgan Savabieasfahani spoke next, explaining the causes of the environmental pollution in more detail. The main issue, she says is the waste from weapons, explosives, and munitions left by the US military in “burn pits” the size of football fields. Iraqi citizens are exposed to chemicals and toxins, often distributed by dust storms in the area, and the effects may be shown for generations to come.
Iraqi mothers and children are not the only ones in danger. Many U.S. soldiers came home with ailments directly related to the negligence associated with these burn pits, and some are even seeking justice. This gives Savabieasfahani hope that one day accountability will drive cleanup efforts.
“We will keep reaching out to people like you,” she said, emphasizing the need for word to spread. Both Al-Sabbak and Savabieasfahani have been on a speaking tour in the U.S. in hope that the issue will gain more attention.
The two also spoke at an event at UW on October 24th entitled “Environmental Poisoning of Iraq: Why Academics Must Speak Out.” Here is the video.
There are 7 billion people in the world and nearly 2 billion are undernourished and 2 billion are overweight or obese. Last week, the team at Global WACh held a fascinating and informative learning symposium at the Bill and Melinda Gates Foundation. Experts from The University of Washington, Seattle Children’s Hospital, PATH, and 1,000 Days came together for a full day of discussion and presentation on the global burdens of malnutrition.
There were three main sessions throughout the day: Basic Science and Discovery; Implementation; and National Systems Building, each including impactful presentations with quite a few staggering facts and figures. Throughout the day we were presented with new ideas, innovative techniques for testing, all with a healthy air of hopeful idealism. To see the presentations, you can view the slides on our Nutrition Think Tank webpage. It was wonderful to have a day to discuss what we can do to help ensure healthy, happy, and nourished lives around the world.
Thanks to all of our speakers and to the Gates Foundation for hosting!