November 20, 2017
Global WACh’s Gut Health & Child Survival researchers at the 2017 ASTMH Conference
From November 5th-9th, researchers from the Global WACh Gut Health and Child Survival team attended the 66th American Society of Tropical Medicine and Hygiene (ASTMH) Conference in Baltimore, Maryland. ASTMH is the largest international scientific organization of experts dedicated to reducing the worldwide burden of tropical infectious diseases and improving global health. At the conference, our researcher gave oral presentations and shared research findings, which support the global goal towards eliminating tropical diseases and saving lives. Meet our researchers and learn about their work below!
The team’s co-leaders, Dr. Judd Walson and Dr. Patty Pavlinac, along with Kirk Tickell, participated in a symposium session centered on mechanisms of post-discharge mortality and interventional targets. Hospital discharge represents a critical time period where highly vulnerable children can access interventions to reduce the risk of dying. The talk presented evidence from the ongoing work of Global WACh’s Childhood Acute Illness and Nutrition Network (CHAIN) and the Toto Bora trial in Kenya, which is testing the efficacy of certain antibiotics in reducing illnesses and the risk of death among children after hospital discharge. In a separate talk at ASTMH, Dr. Walson presented on the DeWorm3 Project, a global effort to test the feasibility of eliminating soil-transmitted helminths, a type of intestinal worm, using intensified mass drug administration strategies. Dr. Pavlinac also presented data from a study in Kenya in which stool was collected from children and caregivers to identify potential sharing of gut pathogens that can cause diarrhea and malnutrition, such as Cryptosporidium. This study found evidence of household transmission of Cryptosporidium infection, which highlights the need for interventions to target both children and caregivers to achieve maximal benefit.
Dr. Arianna Rubin Means, PhD, works on the DeWorm3 Project with Dr. Walson. The World Health Organization (WHO) estimates more than 1.5 billion people are infected with STHs worldwide. Dr. Rubin Means shared a review of strategies that community-based public health programs used to increase treatment coverage for health campaigns, such as child immunizations and drug administration for neglected tropical diseases, and evaluate their influence on improving coverage. The review revealed the strategies with the highest influence of coverage included community-based delivery programs, and programs managed by community members or NGOs. These findings support the DeWorm3 project’s model to administer community-wide deworming drugs to people of all ages. DeWorm3 will perform within existing STH elimination programs in Asia and Africa in partnership with governments, research institutes, and global disease experts.
Stephanie Tornberg-Belanger, MS is a Research Assistant for the CHAIN study and PhD Student in the Department of Epidemiology. Prior to recruiting patients, multiple CHAIN study sites in Bangladesh, Kenya, Pakistan, and Uganda underwent a baseline assessment of inpatient antibiotic prescription practices. Stephanie and her team aimed to determine if sites followed the study’s prescription guidelines. Their findings revealed that 82% of sites followed prescription guidelines, and emphasize the need for new or existing diagnostics to improve antibiotic stewardship.
Rebecca Brander, MPH, is a PhD Epidemiology student and a Research Assistant for the Toto Bora trial. Her study poster focused on linear growth faltering, or stunting (low height-for-age ratio), among young children 0-59 months old with moderate-to-severe diarrhea. According to WHO, stunting in early life impairs growth and development, and can lead to negative socioeconomic and health consequences in adulthood. Rebecca’s study identified critical windows of opportunity for nutritional interventions in early life and during hospitalization for diarrhea. Younger children, particularly under the age of 3 months; children suffering from severe diarrhea and malnutrition who may be at the highest risk of stunting; and children not considered stunted during their diarrhea period, but at risk of stunting from other causes, may all be most likely to benefit from nutritional interventions.
Research Assistant to the ABCD trial and PhD Epidemiology student, Emily Deichsel, MPH, presented a poster on the role of maternal and infant diarrhea in early childhood stunting (low height-for-age ratio) among HIV exposed, uninfected (HEU) children. The study followed and collected data from the HIV-infected mothers and their HEU newborns for 12 months after birth. 17% of HEU children were stunted at 12 months old and 8% were stunted at 2 weeks old. Emily’s study concluded that mother and infant diarrheal episodes and household crowding were risk factors for stunting among HEU children. By identifying children at risk of stunting and intervening early, these infants may have the opportunity for better health throughout all stages of life.
CHAIN Research Coordinator, Dorothy Mangale, MPH, presented a poster on the high frequency of HIV exposure among malnourished children with acute illness in western Kenya. This study highlighted the overlapping burden of HIV-exposure and malnutrition which suggests that HIV and malnutrition programs need to address the two conditions simultaneously. With the absence of nutritional management guidelines of HIV exposed, uninfected (HEU) children, and lack of consideration of HIV exposure in malnutrition guides there is a crucial need to integrate nutritional programs with HIV services.
Congratulations to the team for contributing their successful research discoveries that work towards the goal of improving child survival!