Predictive Model

The goal of this project is to improve newborn survival among low birth weight (LBW) infants through a daily prophylactic dose of bovine lactoferrin (bLF). A two-stage project will be conducted with formative research followed by randomized controlled trial (RCT) to evaluate the appropriate daily dose of bLF and its efficacy in preventing neonatal infections.

In a rigorous cluster randomized controlled trial, we propose to evaluate the impact of promoting waterless hand cleansing with chlorhexidine on hand cleansing behavior of mothers, birth attendants, and others during the peripartum and neonatal periods. To inform future scaling up, we will assess the acceptability, barriers and motivators to chlorhexidine for hand cleansing. An evidence-based chlorhexidine hand cleansing intervention represents a robust low-technology solution to address the unconscionably high rates of preventable neonatal mortality worldwide.

Training approaches relying on conventional models are limited to large, group-based training requiring health workers to leave their sites for long periods. Jhpiego and Laerdal Global Health will address these challenges by demonstrating the efficacy and potential of a new PPIUD simulation model and a self-paced, blended learning approach through field-testing among trainers, providers and clients at facilities in Pakistan in collaboration with key stakeholders.

Tania Maria Ruffoni Ortiga from the Universidade Federal do Rio de Janeiro in Brazil will measure the levels of so-called ABC transporters throughout pregnancy, and during normal and preterm labor, and how they are influenced by infections such as malaria and influenza, to determine whether they might increase the risk of preterm labor. ABC transporters sit in the outer membranes of cells and actively transport drugs, toxins and immune signaling molecules out of them.

Joao Guilherme Bezerra Alves from the Instituto de Medicina Integral Professor Fernando Figueira in Brazil will perform a randomized controlled trial to assess whether a daily oral supplement of magnesium citrate can prevent placental vascular disease, which can lead to preterm birth. Placental vascular disease restricts the flow of nutrients to the fetus and can cause growth restriction and maternal hypertensive disorders. Magnesium is known to promote placental vascular flow, and magnesium citrate is safe, inexpensive and easily absorbed in the body.

Antonio Fernandes Moron from the Universidade Federal de São Paulo in Brazil will investigate whether the presence of specific bacterial populations in the vagina can predict preterm birth, which could form part of an inexpensive test suitable for low resource settings. Preterm birth leads to major short- and long-term health problems for the child. The causes are largely unknown, making it hard to identify pregnant women at increased risk who need monitoring and might benefit from treatment.

José Guilherme Cecatti from the Universidade Estadual de Campinas in Brazil will develop a predictive algorithm to identify early in pregnancy those at increased risk of preterm birth so that if possible they can be treated. There are likely to be many causes of preterm birth, and it is a major cause of both short and long term life-threatening complications for infants.

Teresa Woodruff of Northwestern University in the U.S. is developing automated, high-throughput tools using mouse ovarian follicles and endocrine loops between interacting organs integrated with a series of microfluidic and microdynamic systems to identify improved contraceptives with longer-term action and lower cost for low-resource settings.

Charles Easley of the University of Georgia Research Foundation in the U.S. is developing a complete human spermatogenesis model system for high-throughput drug screens to identify new compounds that reversibly block the maturation of sperm and could be used as male contraceptives. A simple oral male contraceptive would lessen the burden on women, particularly those who suffer from adverse side-effects of hormonal contraceptives.

Chelsea Marie of the University of Virginia in the U.S. will perform a genetic screen using CRISPR-Cas9 gene knockout technology to identify the human genes required for infection by the parasite Cryptosporidium, which causes severe childhood diarrhea in developing countries, in order to develop new treatments. They will create pooled libraries of knockout human cells where all the genes in the genome are disrupted to enable high-throughput screens, and infect them with Cryptosporidium hominis, which is the strain causing major health problems in many regions including Brazil and India.