I propose a novel approach to institute model-based feedback control to seek a rational, and optimal, framework to reduce neonatal sepsis (NS) in developing countries. In addition to reducing deaths from NS, one of the leading global killers of children worldwide, this will reduce the sequelae in the survivors of NS such as postinfectious hydrocephalus (PIH) - likely the dominant cause of hydrocephalus in children worldwide. I presently am a PI on a Phase III NIH sponsored randomized controlled surgical trial in Africa seeking to optimize treatment of PIH (clinical trial # NCT01936272). However, as an alternative to surgical treatment of children with irreparable brain damage, I am now in a unique position to learn how to more effectively treat NS in this setting, and thereby better prevent the large numbers of infants with PIH in this part of the world that we would otherwise need to surgically palliate. Although a pediatric neurosurgeon, I have acquired considerable expertise in both control engineering and physics. I recently wrote the first book on Neural Control Engineering, published by the MIT press in 2012. This Pioneer Award seeks to leverage my knowledge of control engineering and apply this to an entirely new avenue of research for me - seeking to impact in a sustainable way both the morbidity and mortality of NS. I have put in place a unique infrastructure in Uganda to enable this project. I have secured Ugandan medical licensure. I have organized two pilot projects with two key institutions: a pediatric neurosurgery specialty hospital in Mbale (the CURE Children's Hospital of Uganda), and a major referral hospital in Mbarara (at the Mbarara University of Science and Technology). At Mbale, most of the hydrocephalus in Uganda is now treated, and the majority of these cases are postinfectious following NS. At Mbarara, the most common admission to their infant ward is NS, and all of their hydrocephalus is referred to Mbale. At each i

Public Health Relevance

Neonatal sepsis kills over 1 million newborn infants each year, with cases highly concentrated between sub-Saharan Africa and southern Asia, and in survivors accounts for most of the world's infant hydrocephalus requiring neurosurgery. I am a pediatric neurosurgeon who has acquired a considerable amount of expertise in control engineering, and have created a unique infrastructure to enable a project in a sub- Saharan African country employing control engineering to reduce the mortality from neonatal sepsis and lessen hydrocephalus in the survivors. The framework created from carrying out this project can be sustainably adapted to other countries, with the potential for a substantial impact on global infant health.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
NIH Director’s Pioneer Award (NDPA) (DP1)
Project #
5DP1HD086071-04
Application #
9417954
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Russo, Denise
Project Start
2015-04-24
Project End
2020-01-31
Budget Start
2018-02-01
Budget End
2019-01-31
Support Year
4
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Pennsylvania State University
Department
Neurosurgery
Type
Schools of Medicine
DUNS #
129348186
City
Hershey
State
PA
Country
United States
Zip Code
17033
Zhang, Yu Shrike; Santiago, Grissel Trujillo-de; Alvarez, Mario Mois├ęs et al. (2017) Expansion Mini-Microscopy: An Enabling Alternative in Point-of-Care Diagnostics. Curr Opin Biomed Eng 1:45-53
Bebell, Lisa M; Ayebare, Arnold; Boum 2nd, Yap et al. (2017) Prevalence and correlates of MRSA and MSSA nasal carriage at a Ugandan regional referral hospital. J Antimicrob Chemother 72:888-892
Schiff, Steven J; Kiwanuka, Julius; Riggio, Gina et al. (2016) Separating Putative Pathogens from Background Contamination with Principal Orthogonal Decomposition: Evidence for Leptospira in the Ugandan Neonatal Septisome. Front Med (Lausanne) 3:22
Lother, Steffen; Schiff, Steven J; Neuberger, Thomas et al. (2016) Design of a mobile, homogeneous, and efficient electromagnet with a large field of view for neonatal low-field MRI. MAGMA 29:691-8