During the past 5 years of her K24 award, the candidate has provided mentoring to 55 clinical research trainees, including 30 physician/nurse research trainees. For this K24 renewal application, Dr. John- Stewart proposes to mentor a new cadre of clinician-researchers focused on pediatric HIV-1 infected and exposed children. She has already identified 15 trainees, including pediatricians, internists, epidemiologists, and nurses for long-term mentorship in the K24 renewal. Using one-on-one in person meetings, group mentoring (formal weekly analyses meetings), distance-mentoring (for trainees in Nairobi) and peer and co- mentoring, Dr. John-Stewart anticipates investing 20% FTE in mentoring a cadre of clinical researchers committed to translational global pediatric HIV-1-related research. Research: During the 5 years of her K24 award, Dr. John-Stewart has been extremely productive, increasing from 43 to >120 publications in peer-reviewed journals and leads several research grants focused on women and children. For the K24 renewal, research will utilize existing cohorts to focus on pediatric HIV-1 in 3 inter- related domains - immunology, growth, and cognition. She proposes to extend follow-up of a cohort of children who received treatment during infancy >3 years, including previous randomization to interrupted vs. continued therapy. Extending this cohort will enable long-term comparisons of immune recovery and identification of immune correlates of more prolonged immune sustenance during interruption to inform potential future therapeutic vaccine strategies. This and other ongoing or historical cohorts will be used for analyses of growth, micronutrient levels, and nutritional supplementation in HIV-1 exposed and infected treated children. In ongoing cohorts, cognitive assessments will be incorporated for all participating children at annual intervals to identify prevalence and cofactor of cognitive delay and develop future studies. Research strategies used by mentored trainees will range from molecular epidemiology to implementation science and provide inter-disciplinary translational impact.

Public Health Relevance

Africa is home to >90% of pediatric HIV-1 infected children who require life-long therapy and may face growth and cognitive challenges. This K24 award will enable the candidate to mentor new leaders to contribute research advances in this area.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Special Emphasis Panel (ZRG1-AARR-F (03))
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Russo, Denise
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University of Washington
Public Health & Prev Medicine
Schools of Medicine
United States
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Onchiri, Frankline M; Pavlinac, Patricia B; Singa, Benson O et al. (2016) Low Bacteremia Prevalence Among Febrile Children in Areas of Differing Malaria Transmission in Rural Kenya: A Cross-Sectional Study. J Pediatric Infect Dis Soc 5:385-394
Richardson, Barbra A; John-Stewart, Grace; Atkinson, Claire et al. (2016) Vertical Cytomegalovirus Transmission From HIV-Infected Women Randomized to Formula-Feed or Breastfeed Their Infants. J Infect Dis 213:992-8
Bosire, Rose; Betz, Bourke; Aluisio, Adam et al. (2016) High Rates of Exclusive Breastfeeding in Both Arms of a Peer Counseling Study Promoting EBF Among HIV-Infected Kenyan Women. Breastfeed Med 11:56-63
Pavlinac, P B; Denno, D M; John-Stewart, G C et al. (2016) Failure of Syndrome-Based Diarrhea Management Guidelines to Detect Shigella Infections in Kenyan Children. J Pediatric Infect Dis Soc 5:366-374
LaCourse, Sylvia M; Cranmer, Lisa M; Matemo, Daniel et al. (2016) Tuberculosis Case Finding in HIV-Infected Pregnant Women in Kenya Reveals Poor Performance of Symptom Screening and Rapid Diagnostic Tests. J Acquir Immune Defic Syndr 71:219-27
Wagner, Anjuli D; Wachira, Cyrus M; Njuguna, Irene N et al. (2016) Active referral of children of HIV-positive adults reveals high prevalence of undiagnosed HIV. J Acquir Immune Defic Syndr :
Pintye, Jillian; Drake, Alison L; Kinuthia, John et al. (2016) A risk assessment tool for identifying pregnant and postpartum women who may benefit from pre-exposure prophylaxis (PrEP). Clin Infect Dis :
Wamalwa, Dalton; Benki-Nugent, Sarah; Langat, Agnes et al. (2016) Treatment interruption after 2-year antiretroviral treatment initiated during acute/early HIV in infancy. AIDS 30:2303-13
Wagner, Anjuli D; Mugo, Cyrus; Njuguna, Irene N et al. (2016) Implementation and Operational Research: Active Referral of Children of HIV-Positive Adults Reveals High Prevalence of Undiagnosed HIV. J Acquir Immune Defic Syndr 73:e83-e89
Ásbjörnsdóttir, Kristjana H; Slyker, Jennifer A; Maleche-Obimbo, Elizabeth et al. (2016) Breastfeeding Is Associated with Decreased Risk of Hospitalization among HIV-Exposed, Uninfected Kenyan Infants. J Hum Lact 32:NP61-6

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