Global WACh

Research

July 18, 2016

Global WACh Family Planning Study Completes its First Day of Training

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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

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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

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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

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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

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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

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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.”

 

 

 

August 11, 2015

WACh Research Racks Up Awards at IAS Conference

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In late July, Global WACh sent several team members to Vancouver for the 8th Annual IAS Conference on HIV Pathogenesis Treatment and Prevention. Our researchers presented posters highlighting woman, adolescent, and child health and Kristjana Asbjornstottir, Irene Njuguna, and Keshet Ronen took home awards recognizing their excellent work!

Kristjana received the The IAS/ANRS Lange-Van Tongeren Prize for Young Investigators for her project Immune Activation ped HIV.

Kristjana shared her thoughts about winning this prestigious award saying:

Giving a talk at IAS was an incredible opportunity in itself, and having our work recognized through the Young Investigator award on top of that is an enormous honor. I think it highlights the particular attention that was paid to pediatric research at the conference this year. Lots of UW research was featured in various tracks and sessions.

Irene Njuguna was the recipient of the CIPHER Award (Collaborative Initiative for Paediatric HIV Education and Research) which is granted to provide funding for research that addresses priority gaps in pediatric HIV. Without treatment, 50% of HIV infected children will die by the age of two so early diagnosis and treatment is crucial.

The Financial Incentives to increase HIV testing in children (FIT) study that Irene and the team have been working with wants to test to see if small financial incentives will increase HIV testing for children of HIV infected adults who are already in care.

This award is a result of hard work from the team, and I feel honored to be part of this team. This would not be possible without the excellent mentorship from Grace John-Stewart, Jennifer Slyker and Anjuli Wagner.

All of our Global WACh members gave poster presentations for the conference, and Keshet Ronen won an award for Best Poster for her research on Lower ANC Attendance and PMTCT Uptake in Adolescent versus Adult Pregnant Women in Kenya.

Let’s hear it for our award winning Global WACh team!

 

July 17, 2015

Global WACh at IAS 2015

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UW Global Health and Global WACh will be attending the 8th IAS Conference on HIV Pathogenesis Treatment & Prevention July 19th – 22nd, and we’re there in full force. Below are the oral presentations you don’t want to miss!

Monday at 11:00am  Kristjana Asbjornsdottir will present  Immune activation and pediatric HIV during the Growing up on ART session (Ballroom B)

Wednesday at 11:00am Anjuli Wagner will present Pediatric HIV testing during the Children and Adolescents Living with HIV session (Room 211-214)

Wednesday at 11:00am Keshet Ronen will present Adolescent PMTCT engagement during the Children and Adolescents Living with HIV session (Room 211-214)

Global Health and Global WACh team members will also be at the poster presentations, and we even have a few award winners in the bunch! Kristjana Asbjornsdottir will be honored with the IAS Young Investigator Award, Irene Njuguna will receive a CIPHER Award, Keshet Ronen will be getting a Best Poster award for her Pediatric IAS Meeting poster. Congratulations to all of them!

Click here here for more information about IAS 2015.

July 10, 2015

2015 Global WACh – Coulter Foundation Seed Grant Awarded

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The Coulter Project and Global WACh teamed up again to offer a seed grant award.  The Bioengineering Solutions Seed Grant supports collaborative translational research in biomedical engineering addressing the clinical needs of women, adolescents, and children.

This year we received a fantastic pool of innovative applications and ultimately awarded funds to Drs. Wendy Thomas (UW Bioengineering) and Anthony Roche (Anesthesiology). Their project titled An Affordable, Portable Drawover Vaporizer  was selected for funding by a team of expert reviewers and we couldn’t be more excited!

The project aims to develop an affordable and easily portable anesthetic delivery device to help in low resource settings, particularly in Uganda. Most anesthetic delivery devices are bulky, difficult to transport, not sufficiently durable, expensive, or can’t function without reliable power sources making them an unrealistic solution in low resource settings.

PI Wendy Thomas says she volunteered to help with Bioengineers Without Borders (BWB) when they asked her to suggest a bioengineering co-advisor for the project. “They are hard-working, passionate about learning and helping people, and very capable. I want to particularly compliment David Peeler and Eric Swanson, the graduate BWB team members who put the most work into writing this proposal.”

This project is hoping to use a simplified design that requires no additional power source other than the patient’s breathing to draw anesthetic from the device.PI Anthony Roche also expressed his thanks to Global WACh and The Coulter Foundation for the support of the project. “I am constantly inspired by the vision and passion of our team, as well as their dedication and tireless effort to improve healthcare in low resource settings.”

The funding process served as a great catalyst for their team.  They have been working hard for months solidifying design constraints, identifying key engineering questions, and collaborating with experts at PATH. “All of this was done before the award was even made!” Dr. Roche says.

Eric Swanson, a 3rd year Bioengineering PhD student and team leader for BWB’s Anesthesia Device Team says the team is comprised entirely of undergraduate and graduate students. “My hope is that this funding will not only enable us to take steps towards developing a device that could have a significant impact on an important global health problem, but that it will also increase awareness of the Bioengineers Without Borders student group and promote future funding and collaboration opportunities for our other projects.”

Congratulations are in order for this dynamic team! Global WACh is proud to support such innovative work and can’t wait to share the results with you.

May 20, 2015

Global WACh In Focus: Patricia Pavlinac

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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. (more…)


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