October 27, 2025
Dr. Irene Njuguna and Dr. Grace John-Stewart lead new study on the effects of HIV and environmental exposures on pediatric neurodevelopmental outcomes
The population of children who are HIV-exposed but uninfected (CHEU) is growing, and the majority live in Eastern and Southern Africa where exposure to environmental toxins (lead, heavy metals, and pesticides) is high. Understanding the combined impact of HIV and environmental exposures on child health outcomes is critical to identify approaches to mitigate risks and provide treatment for CHEU.
Global WACh Co-Directors, Dr. Irene Njuguna and Grace John-Stewart, are Multiple Principal Investigators of a new five-year National Institutes of Health award for “Impact of HIV and toxic metals exposure on neurodevelopment at school age (HOPE-X).” The study leverages an existing cohort of Kenyan children (HOPE) who were enrolled at 6 weeks of age and followed to 3 years, enabling the research team to extend follow-up to 8 years old to study the longer-term impact of HIV and environmental exposures on neurodevelopmental outcomes. The team will also explore the concentrations of pesticides and other toxic metals (mercury, cadmium, manganese and arsenic) in biological samples.
This research will provide rich data on the levels of toxic metals and pesticides in a large population of children in Kenya, which will help researchers better understand the extent of these neurotoxic exposures and may help identify common exposure points for children that may be amendable to future interventions.
The data will be shared with caregivers and families, national and global health leaders, community members, and policymakers to explore approaches to prevent, reduce or mitigate the impact of exposures for children and families and to motivate new studies to further characterize the exposures. Each stakeholder group – with their priorities, goals, and needs – can support efforts to ensure that valuable public health data is not just seen but understood and acted upon to improve health outcomes.