Infectious diseases are the most common cause of illness in children in low-income countries. Children who survive infectious diseases often suffer long-term neurodevelopmental morbidity. Nutrition, and in particular micronutrient deficiency, also frequently interact with infection to alter neurodevelopment. However, accurate estimates of infection-related neurocognitive morbidity are largely unavailable, and the pathogenesis of this morbidity remains poorly characterized. In this renewal application, a partnership between Makerere University, Uganda and Indiana University, we focus on training in the epidemiology and pathogenesis of infection-related neurocognitive impairment, a neglected training area in infectious disease, and include training in assessment of the interactions of micronutrient deficiency and infection. Innovative aspects of this proposal include: the emphasis on infection-related long-term morbidity, a diverse mix of trainees from multiple disciplines, required integrated core training for all degree and post-doctoral trainees, development on a post- doctoral ?pipeline? for faculty positions, and training in research administration. The goal of this application is to establish a core of Ugandan researchers who advance the understanding, prevention and treatment of long- term neurocognitive disability associated with infectious diseases and micronutrient deficiency. We propose to accomplish this goal through long- and short-term training for trainees in neuropsychology, immunology and epidemiology, including nutrition epidemiology; training in research administration; and development of lab and data center infrastructure. Long-term training includes training of 3 PhD students (in epidemiology, immunology and neuropsychology) and 3 post-doctoral fellows (in infectious disease epidemiology, nutrition epidemiology, and neuropsychology). All research studies will include a component related to neurodevelopment. Short-term training will include workshop and short-course and hands-on training in lab, clinical and neuropsychology assessment, testing and techniques. Lab capacity will be expanded through new equipment for molecular biology studies, technician training in immunology testing, and lab technologist leadership training. Data center capacity will be expanded through improved internet access and individualized database development training for two senior data managers. Research administration capacity will be developed through Masters training of 2 research managers in management studies and business administration. The proposed training will produce a team of research and public health leaders and administrators who are well equipped to work together to understand, prevent and treat infection-related neurocognitive impairment.

Public Health Relevance

In low-income countries, many children who have infections not only suffer the short-term effects of the infection, but also have long-term brain injury that affects functions like intelligence, language, speech, and movement. Training doctors and scientists to discover how often this occurs and why it occurs, and to treat the problem or, even better, prevent it from occurring, could improve the lives of millions of children.

National Institute of Health (NIH)
Fogarty International Center (FIC)
International Research Training Grants (D43)
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Special Emphasis Panel (ZRG1)
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Sina, Barbara J
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Indiana University-Purdue University at Indianapolis
Schools of Medicine
United States
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Opoka, Robert O; Ssemata, Andrew S; Oyang, William et al. (2018) High rate of inappropriate blood transfusions in the management of children with severe anemia in Ugandan hospitals. BMC Health Serv Res 18:566
Cusick, Sarah E; Jaramillo, Ericka G; Moody, Emily C et al. (2018) Assessment of blood levels of heavy metals including lead and manganese in healthy children living in the Katanga settlement of Kampala, Uganda. BMC Public Health 18:717