Global Health International Research

Brittany Simpson, MD

Division of Human Genetics, Resident Physician
Global Research Opportunities Worldwide (GROW) award recipient

Dengue fever (DF) is an increasing contributor to morbidity and mortality worldwide. Susceptibility and severity of dengue viral infection vary and have been linked to both viral and host genetic background. Despite this knowledge, treatments and identification of those individuals most at risk are not well established. Thus, we aimed to investigate genomic SNPs related to DF severity within well-characterized individuals in the Dominican Republic and Paraguay. As of April 2020, 1,179 participants have been enrolled. Within our initial pilot sampling, targeted analysis found significant risk of severe DF associated with PLCE1 and RXRA polymorphisms, genes which are involved in inflammatory cascades. Next steps will involve further genotyping of collected samples as well as an untargeted approach for polygenic risk score development. Furthermore, we have exposed residents and medical students to collaborative, international global health research as well as established collaborations within the DR and Paraguay to encourage global health genomics. With further funding, we will develop an easily deployable, efficient screening method in resource-poor settings to help triage patients more efficiently when they present to the emergency room with suspected dengue fever.

Tarun Aurora, MD

Resident, Pediatric Residency Training Program
Global Research Opportunities Worldwide (GROW) award recipient

Having a keen interest in hematology and global health, I was motivated to learn more about the impact sickle cell disease has on the health care system and on families in Sub-saharan Africa. My experience in rural Uganda gave me a better idea of the current infrastructure for testing, treating, and public awareness of sickle cell anemia. I both conducted research and clinical work while at the Mbale Regional Referral Hospital in eastern Uganda. For my research, I analyzed the use of a new point of care anemia test on patients who were at high risk for severe anemia. With the financial support of the GROW award, I had an opportunity to understand the significant impact sickle cell disease has on the community at large in Uganda. It was humbling to be a part of the local Mbale clinical staff that works tirelessly every day to both treat and prevent complications of this disease. I hope to stay connected with the Mbale community and continue and expand my research moving forward into fellowship.

Amy RL Rule, MD, MPH, FAAP

Assistant Professor of Pediatrics
Neonatal and Pediatric Hospitalist, Perinatal Institute, Hospital Medicine

My work focuses on partnering to better understand how to address neonatal mortality disparities from East Africa to Avondale through research, quality improvement and education. My early work focused on preventing intrapartum events at a rural maternal-neonatal referral hospital in East Africa using the Helping Babies Survive program and quality improvement methodology. My current work is at the same site exploring prevention of neonatal sepsis through reprocessing innovation and quality improvement (funded through the Cincinnati Children's Hospital Medical Center Place Outcomes Award and a grant from Laerdal).

Nationally, I am on the steering committee for the Global Health sub-section of the Association of Pediatric Program Directors. I am a contributing author for PEARLS (procedures for GH), SPACK (pre-departure) and the forthcoming IPACK (immigrant health) through the Midwest Consortium. Locally I am the creator and editor of the Newborn parent education guides created to address parent education disparities. I lead the annual Helping Babies Survive courses in Cincinnati and continue to teach HBS courses around the world. I founded and lead the Su Casa-pediatric resident partnership and am the faculty adviser for the immigrant-refugee health interest group in the Cincinnati Children's Pediatric Residency program.

Meera Kotagal, MD

Assistant Professor
Division of Pediatric General and Thoracic Surgery

Dr. Kotagal has a long-standing connection to east and central Africa, having begun her work in global health in Rwanda in 2007. Her current work in global surgery focuses in Uganda. Dr. Kotagal began her partnership in 2019 with Dr. John Sekabira, Dr. Nasser Kakembo, and Dr. Martin Situma, who were the active pediatric surgeons in Uganda at the time. Drs. Sekabira, Kakembo and Situma are now three of the six active pediatric surgeons in the country of just over 42 million. Dr. Kotagal’s work, in partnership with the Uganda surgeons, focuses on health system strengthening and clinical and research capacity building. She works actively with the pediatric surgery fellowship program to help train Ugandan fellows – both in and out of the operating room – and is also engaged in health system strengthening in both Kampala and Mbarara. She is currently working with Dr. Situma and his new partner Dr. Anne Shikana, as well as their fellow Dr. Felix Oyania, to develop a bowel management program in western Uganda for the management of fecal incontinence and constipation in patients with congenital colorectal anomalies. Dr. Kotagal is also helping to supervise and guide research projects with fellows at both sites.

Andrea Beaton, MD

Associate Professor, Cardiology Clinic

• Strep A bacteria kills half a million a year. Why don’t we have a vaccine?
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Anne White, MD

Clinical Fellow, Neonatology

Anne White is a third-year neonatal fellow who has been engaged in global health work for over 10 years. She has been working on decreasing neonatal infections in low-resource settings by improving disinfection of resuscitation equipment. She is grateful for funding for her work from a Laerdal Foundation Grant as well as a Strauss Global Health Award and looks forward to continuing her research as an Assistant Professor at the University of Minnesota following graduation.

Elizabeth P. Schlaudecker, MD, MPH

Associate Professor of Pediatrics
Division of Infectious Diseases

Helping Babies Breathe (HBB) is a very effective neonatal resuscitation educational method

With the support of the Cincinnati Children's Place Outcomes Award and with Principal Investigator Dr. Amy Rule’s leadership, we have been investigating the recommended reprocessing of HBB equipment at Tenwek Hospital in Bomet, Kenya, hoping to improve reprocessing in low-resource settings. We are also looking at neonatal sepsis outcomes after different equipment reprocessing methods. We plan to continue implementation coaching and final data analysis in the coming months.

Conrad R. Cole MD, MPH, MSc

Professor of Pediatrics
Medical Director, Division of Gastroenterology, Hepatology and Nutrition
Medical Director, Intestinal Rehabilitation Program, Intestinal Care Center

Endoscopy and GI services in West Africa (Nigeria, Ghana and Sierra Leone)

Gastrointestinal disorders are becoming an increasing contributor to morbidity and mortality worldwide. Susceptibility and severity vary and have been linked to both environmental and host background. Despite this knowledge, wide scale use of both diagnostic and therapeutic endoscopy was not well established in Nigeria, Ghana and Sierra Leone.

Dr. Cole has a long-standing connection to these 3 countries in West Africa. He is a visiting Professor at the Korle Bu Teaching Hospital, University of Ghana and Adjunct Professor in the College of Medicine and Allied Health Sciences, University of Sierra Leone. His current work focuses on establishment of Pediatric Gastroenterology as a subspecialty service for children in Nigeria and Ghana and a world class endoscopy program for all ages in Sierra Leone. As a result of this collaboration, Cincinnati Children's Division of Gastroenterology, Hepatology and Nutrition has hosted a NCD fellow from Nigeria (Dr. Agozie Ubesie), two NCD observers (Dr. Finda Ngongou and Ese Thomas-Macauley) from Sierra Leone and one observer (Dr. Taiba Afaa) from Ghana. During visits to both Ghana and Sierra Leone annually, Dr. Cole is also actively involved in teaching medical students and post graduate trainees. Dr. Cole’s work, in partnership with the local physicians focuses on health system strengthening including clinical and research capacity building. He is involved in developing physicians as endoscopists and strengthening the delivery of Gastroenterological care in both countries. Ongoing collaboration with Dr. Ubesie has led to five publications and Dr Ubesie presenting his work at the Congress for Intestinal Rehabilitation and Transplantation, Oxford, England.

Luke Smart, MD

Clinical Fellow, Hematology/Oncology, Cancer and Blood Diseases Institute

Before he came to Cincinnati for hematology/oncology fellowship, Dr. Luke R. Smart lived in Mwanza, Tanzania, and worked at Bugando Medical Center (BMC), a Tanzanian teaching and referral hospital where he completed a Fogarty Global Health Fellowship with Weil Cornell Medicine and developed an interest in global hematology, particularly sickle cell disease. He continues to partner with the faculty at Bugando, particularly Dr. Emmanuela Ambrose, MD, MMed (Fig1). Together they have described the birth prevalence and clinical spectrum of sickle cell disease birth in Mwanza (Fig 2), performed a large surveillance study describing district level birth prevalence in the northwest portion of the country, and conducted a field study of two novel point-of-care tests used to detect anemia and sickle cell disease. Dr. Smart helped Dr. Ambrose launch a therapeutic trial called “Stroke Prevention with Hydroxyurea Enabled through Research and Education (SPHERE)” (NCT03948867) that uses transcranial Doppler ultrasound to identify children who are at high risk for stroke and will determine whether hydroxyurea can decrease the risk and incidence of stroke. Dr. Smart obtained a Strauss Fellowship for Global Health to support his role in the study.

Carlos Enrique Prada, MD

Associate Professor of Clinical Pediatrics and Human Genetics
Co-Director, Rasopathy Program
Co-Director, Neurofibromatosis Program
Director, Clinical Biochemical Genetics Fellowship Training Program

Dr. Prada has developed a partnership with the Centro de Ginecologia y Obstetricia to follow children with complex rare diseases via telemedicine in Santo Domingo, Dominican Republic. This program has allowed us to diagnosis and treat over 100 children with genetic disorders. I have also partnered with local foundations to help raise awareness about rare diseases and participate in local meetings for education of health providers.

Dr. Prada is the founder of a genetic center in Colombia at the Fundación Cardiovascular de Colombia. This program started in 2012 and has facilitated access to newborn screening and genetic diagnosis to the northeast region of the country. We also integrated genetic diagnosis to inpatient ICU management and participated in the education of trainees. I am also working with colleagues in Colombia to develop a clinical residency program for genetics in the south of the country. Dr. Prada was also the vice-president of the Asociación Colombiana de Genetica Humana to help develop policy that allowed for the access to care for patients with rare diseases.