Research
September 30, 2016
Breakfast with WACh welcomes Drs. Ghayda Mirzaa and Kristina Adams Waldorf
Categories: Research, Talks and Events
Tags: Breakfast with WACh, maternal health, Zika
Join us for breakfast and a lecture on Tuesday, October 11th with Drs. Ghayda Mirzaa, MD, FAAP, FACMG and Kristina Adams Waldorf, MD.
The Zika Epidemic: An Unprecedented Health Threat for Pregnant Women
October 11th, 9-10 AM
University of Washington, Harris Hydraulics Laboratory, Large Conference Room
September 20, 2016
SPEED study aims to better meet adolescent HIV care needs
Categories: Research
Tags: adolescent health, HIV, SPEED
Despite enormous expansion of HIV testing and treatment services in resource-limited settings, adolescents continue to be disproportionately affected by HIV. Lack of access to acceptable HIV testing, counseling, and treatment has been cited as a barrier to HIV care among adolescents. Additionally, health workers tasked with providing adolescent HIV services report feeling inadequately prepared to cope with the needs of this age group.
The SPEED study improves quality and accessibility of HIV care to meet the unique needs of adolescents. SPEED (Simulated Patient Encounters to promote Early Detection) uses patient actors to portray adolescent HIV patients as part of a clinical training intervention. This gives nurses and doctors in Kenya an opportunity to practice their skills diagnosing, caring for, and engaging adolescents living with HIV. The simulated encounters utilize a standardized patient script and provide opportunities for the trained actor and a faculty observer to deliver immediate feedback and support to the clinician.
Simulated patient interactions show great promise as a mechanism for health workers in low-resource settings to improve critical decision-making, patient interaction, and communication skills in working with adolescents. SPEED’s ultimate aim is for this increased provider confidence to in turn increase uptake and retention in adolescent HIV care.
This week, SPEED has been busy training a new group of patient actors in Nairobi, Kenya. Actor training is part of the study’s first year of progress. Led by Global WACh and UW School of Nursing researcher Dr. Pamela Kohler and managed by Dr. Kate Wilson, SPEED’s interventions and analyses will be conducted over the next four years.
September 12, 2016
Making strides in HIV testing and counseling
Categories: Research
Tags: HIVTesting, Kenya, KNH, Pediatrics
Irene Njuguna and Jill Neary are MPH Candidates in Epidemiology at the UW School of Public Health. With mentorship from Global WACh researcher Jenn Slyker and Kenyatta National Hospital VCT Director Dr. David Bukusi, they developed a new tool to track provider initiated HIV testing and counseling for children admitted to hospitals in Kenya. Read about their work below.
In line with the World Health Organization recommendations, the Kenya National HIV testing guidelines recommend universal provider initiated HIV testing and counseling (PITC) for all children in sub Saharan Africa who come in contact with health care facilities. However, in many settings universal PITC is not routinely implemented, with ward transfers, weekend admissions, and discharges resulting in some missed testing opportunities. This results in late diagnosis of HIV infected children, who are at high risk of mortality and do not benefit fully from HIV treatment.
This project began with the intent to intervene in this cycle of unmet HIV care needs. The team looked to Kenya’s national referral hospital: Kenyatta National Hospital (KNH). Working with the PITC team at KNH, the team established an important framework for developing easy to use, acceptable tools to track and improve PITC coverage. In partnership with the KNH pediatric ward PITC counselors, a system was developed to track each individual child admitted, confirm testing completion, identify reasons any children missed testing, and flag children requiring testing.
The tool was successfully piloted in the pediatric department, and at the end of the practicum period, the PITC team recommended that the tool also be used in the adult in-patient medical wards.
Congratulations Irene, Jill, and the entire KNH team for your accomplishment! We can look forward to hearing about the continued success of PITC at Kenyatta National Hospital.
August 8, 2016
Success for CATCH at Nairobi Innovation Week
Categories: Research, Talks and Events
Tags: CATCH, HIV, Pediatrics
Last week at Nairobi Innovation Week, members of the CATCH study team spent three days showcasing their innovative visions for pediatric HIV care. This was an important opportunity for the team to highlight the successes and findings of CATCH: Counseling and Testing for Children at Home.
The CATCH study accomplishes what’s in its name by “catching” children ages 12 and under who have fallen through the cracks in HIV diagnosis systems. CATCH offers parents infected with HIV the opportunity to have their children tested, both in clinics or in the home. HIV-infected children are then linked to an HIV care clinic of choice, which ensures that children can receive much needed care. CATCH has been working and gathering data since the start of 2014, with funding for seven different sites in Nairobi and one in Western Kenya.
Throughout the three-day event, CATCH presented posters, modeled pediatric test kits, and engaged visitors with their approaches and ideas about HIV testing in children. “There was a great amount of enthusiasm for the translation of research findings into policy, particularly from senior University of Nairobi visitors and local media,” said Anjuli Wagner, a postdoctoral fellow in the Department of Global Health and member of the study team.
Each day, members from the CATCH team, including Anjuli Wagner, Cyrus Mugo, and Verlinda Otieno spoke with over 40 individuals interested in continuing to be part of the discussion about CATCH’s work. The team also visited with nearby stands and discovered valuable new connections with other pediatric health advocates.
We’re sending CATCH our congratulations for their engagement and innovation in Nairobi!
For more information about CATCH, take a look at this animated depiction of the project.
July 18, 2016
Global WACh Family Planning Study Completes its First Day of Training
Categories: Research
Tags: Family Planning, Mobile WACh
The unmet need for contraception in Kenya in the postpartum period, or months following childbirth, is high. This unmet need contributes to poor maternal and child health outcomes, and impedes women’s empowerment.
Mobile WACh XY is a two-arm randomized controlled trial (RCT) comparing the effect of bidirectional SMS dialogue vs. control on highly effective contraceptive use at 6 months postpartum among individual women and couple dyads in Nyanza Province, Kenya. The study builds upon the experience of other Global WACh mHealth studies using a text messaging platform that pushes automated messages containing critical information at crucial times and allows users to respond and converse with a health professional about their individual needs. Mobile WACh XY differentiates itself in the family planning arena by including an emphasis on male partner involvement and couple communication. Male partners need to be invited to participate in the study, given the desire to include men while continuing to promote women’s reproductive autonomy.
The XY team is led by Drs. Elizabeth Harrington, Jennifer Unger and John Kinuthia. This Global WACh study team completed its first week of training in Kisumu, Kenya last week.
Over the next 6 months they will enroll 220 women in the study, and up to 220 men—depending on female participants’ preferences. Information gathered will provide insight into the effectiveness of an mHealth strategy to help meet women’s and couples’ postpartum contraceptive needs, and have policy implications for postpartum family planning programming.
Congratulations to everyone involved! We look forward to sharing your progress.
June 28, 2016
Global WACh Toto Bora Trial aims to reduce childhood mortality
Categories: Nutrition, Research
Tags: Ethiopia, malnutrition, microbiome, Pediatrics, Tota Bora
Toto Bora, an expression meaning “healthy baby” in Kiswahili, enrolled its first pediatric patient today in a research trial aimed at reducing childhood morbidity and mortality in the months after a hospitalization.
In sub-Saharan Africa, childhood mortality remains unacceptability high. Children who are hospitalized and subsequently discharged are a group of children at particularly high risk, yet few interventions exist for the post-discharge period. A recent trial found that the mass drug administration of azithromycin reduced childhood mortality by half among children in Ethiopia in communities receiving the intervention. The Toto Bora team, led by Drs. Judd Walson, MD, MPH and Patricia Pavlinac, PhD MS, believes that children being discharged from hospital represent an accessible high-risk population in which targeted use of this broad-spectrum antibiotic may have dramatic impact.
In this double-blind, placebo-controlled trial, children discharged from hospitals in Kisii and Homa Bay counties of Kenya are randomized to a 5-day course of azithromycin or placebo and followed for six months to determine the efficacy of azithromycin in reducing post-discharge morbidity and mortality. Stool, nasopharyngeal swabs, and blood samples are also being collated from children to evaluate the effect of the intervention on enteric and nasopharyngeal infections, malaria, the gut microbiome, and systematic inflammation. The emergence of antibiotic resistance among treated individuals and their primary caregivers will also be assessed and cost-effectiveness analyses performed to inform policy decisions.
The Toto Bora Trial began enrollment on June 28, 2016 and is estimated to be complete data collection in June 2019. Congratulations to this Global WACh team for launching this important study to generate evidence on effective interventions to reduce childhood mortality in Kenya!
Read more about Toto Bora on the clinicaltrials.gov website: https://clinicaltrials.gov/ct2/show/NCT02414399
May 5, 2016
Current Topics and Methods in Microbiome Research Workshop
Categories: Research, Talks and Events
Tags: microbiome, nutrition
Event Date & Time
May 26, 2016 – 8:30am to 5:00pm
Check-in begins at 8am. The workshop starts at 8:30 and continues until 5pm.
Location
Seattle Children’s Research Institute, Westlake Conference Room
West 8th Building (2001 8th Ave), Seattle, WA
Goal: The goal of the workshop is to share ongoing microbiome research being conducted by the University of Washington and partnering institutions and in doing so, to identify synergies and shared interests to strengthen research and build new collaborations.
Speakers from the University of British Columbia, the Forsyth Institute, University of Washington, Fred Hutchinson Cancer Research Center, Children’s Hospital, and Institute for Health Metrics and Evaluation will present short talks and engage in panel discussions on topics including:
- The gut microbiome and its role in enteric health and disease
- The oral microbiome and its role in oral health and disease
- The genital microbiome and its role in sexual and reproductive health
- Statistical methods for microbiome data
- Research priorities for women, adolescents, and children: thinking across the host microbiome
May 2, 2016
Preparing for an Emerging Zika Virus Epidemic
Categories: Research, Talks and Events
Tags: Panel Discussion, Zika Virus
Join us for an expert panel drawn from public health, medicine, and bioengineering to discuss what we know, what we don’t know, and how to prepare
The University of Washington Global Center for the Integrated Health of Women, Adolescents and Children (Global WACh) is pleased to host an expert panel discussion to disseminate up-to-date information about Zika virus, its public health impact locally and globally, and what the general public and health care professionals need to know about preventing infection and minimizing the risk of birth defects due to Zika virus infection in pregnancy.
Event Details
Friday, May 6, 2016
3:00-5:00PM
Hogness Auditorium
Health Sciences Building, UW Medical Center (more…)
October 14, 2015
Spotlight on Global WACh Seed Grant Recipient Deepa Rao
Tags: maternal health, preterm birth, South India
We took a few moments to catch up with Dr. Deepa Rao, an Associate Professor in the Department of Global Health and recipient of a Global WACh integrated health seed grant. Dr. Rao’s grant funding was awarded to explore the impact of domestic violence and depressive symptoms on preterm birth in South India. India has a very high domestic violence rate in addition to having the highest number of maternal deaths, preterm birth, and under 5 mortality in the world. Global WACh viewed this proposal as an opportunity to understand more about the relationship between the two.
“We need to look at the person holistically and realize a mother’s mental health is connected to their baby’s health and it’s not a solely biological process. In my training I’ve always seen the social, interpersonal connected to the biological.”
Dr. Rao was awarded $25,000 to estimate the prevalence of depressive and PTSD symptoms in pregnant women in South India and examine the effects of these symptoms on birth outcomes. Dr. Rao’s team also conducted interviews with key informants to gather information on how therapeutic techniques could be adapted to be culturally relevant. (more…)
September 3, 2015
Our Lifecycle Approach to Research
Categories: Research
Tags: Lifecycle Lens
At Global WACh, our mission is to make scientific discoveries, cultivate leaders, and bridge disciplines to advance the tightly connected health of women, adolescents, and children. Global WACh approaches research, activities, and programs through a “lifecycle lens” that views target populations as interconnected instead of independent groups.
What exactly do we mean by “lifecycle lens?” We sat down with Global WACh Director, Grace John-Stewart, MD, PhD, MPH to explain what it is and why it is important in the global health context.
Historically, global health research focused on women, adolescents, and children separately, or examined the maternal-child relationship. Within the last decade, however, adolescents have emerged as a critical population to understand and engage in order to improve health worldwide. With the proliferation of adolescent health research and programs, Global WACh uses a lifecycle lens in which research explores potential impact and benefits throughout the lifecycle, from pregnancy, to neonate, to child, to adolescent, to next generation reproductive health.
Dr. John-Stewart’s research career in mother-to-child HIV transmission involved linking pediatricians with obstetricians and caring for mothers and infants together, with studies to optimize outcomes in both. The questions surrounding how to prevent women and children from getting HIV led to recognizing adolescence as a critical area on which to focus. Adolescents in the pre-reproductive phase need to be incorporated into the lifecycle model – prevention and treatment of children can improve adolescent health and adolescent engagement can improve health in their later life and in the next generation.
“If we do something for women, could we have benefits for them that also benefit their children? If we do something for children, are there ways in which we benefit them moving into adolescence and later life? We’re trying to think about it together.”
Global WACh has three main core focuses of research: Infectious Diseases, Healthy Growth and Development, and Family Planning. All of these areas have elements that directly relate to the lifecycle. For example, healthy, planned pregnancies lead to healthy babies who, when provided with adequate infant nutrition and other interventions, can experience better health outcomes later in life.
Dr. John-Stewart acknowledges it is a challenge incorporate all three populations into any one study, but Global WACh wants researchers to think about how their work in any one of these populations could be linked to the other populations as they develop and implement studies.
“You have to understand the implications of actions in one area for the other, and if you can articulate that it’s good. If you’re doing a study on maternal depression, for example, not every time do you have to measure the child outcomes, but you may speculate or infer how this could benefit both the mother and child.”
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