CANDIDATE: Dr. Leon has completed his first year as a junior faculty at the Hubert Department of Global Health at Emory University. He plans a successful career as an independent translational investigator in the multidisciplinary fields of immunology, epidemiology and statistical modeling. His long-term research goal is to identify effective interventions to optimize a population's natural and vaccine-acquired immunity to diarrhea-inducing enteric viruses like rotavirus (RV) and norovirus (NoV) and thereby protect children from diarrhea. ENVIRONMENT: Drs. Reynaldo Martorell and Usha Ramakrishnan, two established, NIH-funded leaders in global nutritional epidemiology will mentor Dr. Leon. BACKGROUND: Newly introduced RV vaccines could have a significant impact on preventing childhood diarrhea, a leading cause of morbidity and mortality worldwide. We postulate that child nutrition, with other susceptibility (e.g. maternal influences like breastfeeding) and exposure (e.g. socio-demographic) factors, directly modulate immune-competence, including RV vaccine-acquired immune-competence. Adequate immune-competence, in turn, protects a child from diarrhea. This five-year mentored K01 research proposal will test this model through epidemiologic and statistical modeling approaches to quantify the combined effects of nutrition, immune-competence, and RV vaccination on pediatric diarrhea.
SPECIFIC AIMS : 1) To understand how immune-competence and nutrition influence pediatric diarrhea. 2) To identify the mechanisms through which nutrition affects immunecompetence. 3) To quantify the influence of severe malnutrition and immune-competence on RV infection and diarrhea after RV vaccination. TRAINING: Dr. Leon will complement his strong laboratory immunology background with mentored training in epidemiologic and statistical modeling. He will be trained, in Aim 1-2, at Emory University, through coursework and by studying clinical specimens and data from an ongoing cohort study, at the Instituto Nacional de Salud Publica in Mexico, of over 800 Mexican mothers-infant pairs. He will also acquire mentored field experience in the design and execution of prospective cohort studies. He will be trained, in Aim 3, at the Rotavirus Surveillance Vaccine Program in Bolivia, by recruiting and collecting data and specimens from over 200 infants for one year after RV vaccination.
Models to test the combined effect of these fixed and modifiable risk factors could provide much needed and timely scientific evidence for pediatric diarrhea interventions and global rotavirus vaccination policy. Our goal, in this five-year mentored K01 proposal, is to use advanced epidemiologic and statistical modeling approaches to quantify the combined effects of nutrition, immune-competence, and the rotavirus vaccine on pediatric diarrhea. The useful predictive models of the effect of nutrition, host susceptibility and exposure, immune-competence, and rotavirus vaccine on pediatric diarrhea would inform public health pediatric diarrhea interventions and global rotavirus vaccination policy.
|Burke, Rachel M; Leon, Juan S; Suchdev, Parminder S (2014) Identification, prevention and treatment of iron deficiency during the first 1000 days. Nutrients 6:4093-114|
|Burke, Rachel M; Smith, Emily R; Dahl, Rebecca Moritz et al. (2014) The economic burden of pediatric gastroenteritis to Bolivian families: a cross-sectional study of correlates of catastrophic cost and overall cost burden. BMC Public Health 14:642|
|Forney, Kristen M; Polansky, Lauren S; Rebolledo, Paulina A et al. (2014) Evaluation of a residential nutrition rehabilitation center in rural Bolivia: short-term effectiveness and follow-up results. Food Nutr Bull 35:211-20|
|Mues, Katherine E; Deming, Michael; Kleinbaum, David G et al. (2014) Impact of a community-based lymphedema management program on episodes of Adenolymphangitis (ADLA) and lymphedema progression--Odisha State, India. PLoS Negl Trop Dis 8:e3140|
|Rivera, Rosario; Forney, Kristen; Castro, Maria Rene et al. (2013) Rotavirus genotype distribution during the pre-vaccine period in Bolivia: 2007-2008. Int J Infect Dis 17:e762-7|
|Burke, Rachel M; Rebolledo, Paulina A; Embrey, Sally R et al. (2013) The burden of pediatric diarrhea: a cross-sectional study of incurred costs and perceptions of cost among Bolivian families. BMC Public Health 13:708|
|Bitler, E J; Matthews, J E; Dickey, B W et al. (2013) Norovirus outbreaks: a systematic review of commonly implicated transmission routes and vehicles. Epidemiol Infect 141:1563-71|
|Matthews, J E; Dickey, B W; Miller, R D et al. (2012) The epidemiology of published norovirus outbreaks: a review of risk factors associated with attack rate and genogroup. Epidemiol Infect 140:1161-72|
|Desai, Rishi; Hembree, Christal D; Handel, Andreas et al. (2012) Severe outcomes are associated with genogroup 2 genotype 4 norovirus outbreaks: a systematic literature review. Clin Infect Dis 55:189-93|
|Smith, Emily R; Rowlinson, Emily E; Iniguez, Volga et al. (2011) Cost-effectiveness of rotavirus vaccination in Bolivia from the state perspective. Vaccine 29:6704-11|
Showing the most recent 10 out of 12 publications