GloCal Fellows 2017-2018
Gbenga Abiodun, Foundation for Professional Development (FPD)
Gbenga J. Abiodun, PhD is a young scientist whose research interest focuses on biomathematics, epidemiology and mathematical modelling of the impacts of climate (variability and change) on vector-borne and infectious diseases. He completed his Masters and Doctoral degrees in Mathematics at the University of the Western Cape (UWC) in 2012 and 2016, respectively. During his PhD studies, he was selected for the Young Scientist Summer Program (YSSP) at the International Institute for Applied Systems Analysis (IIASA) in Austria. He has also visited some international research centers like the International Centre for Theoretical Physics (ICTP) in Italy, and the Japan Agency for Marine-Earth Science and Technology (JAMSTEC) for research collaborations. He actively participated in the Japan and South Africa joint project on infectious Diseases Early-Warning System (iDEWS). Dr. Abiodun has worked extensively on infectious diseases and published peer-reviewed papers in high-profile international journals.
Investigating the influence of climate variability and change on malaria transmission in southern Africa using a mosquito-human malaria model
Malaria is one of the oldest and most devastating diseases in the world. It is estimated that approximately half of the world's population is vulnerable to malaria as Sub-Saharan Africa carries an unduly high share of the global malaria burden. The reasons for the prevalence in Africa in the last few years are yet to be well-established. Although the causes are often linked to both climate change and control failure, it is important to understand the impact of climate (variability and change) on the dynamics of the disease. Such understanding may foster an effective control of this deadly disease. For this reason, this project seeks to explore the potential impacts of climate variability and change on malaria epidemics in Southern Africa. It aims to evaluate and apply a climate-malaria model to examine the impact of climate variation on malaria transmission, and investigate how global warming could alter the malaria zone over Southern Africa in the future.
Mentors: Kevin Njabo, PhD (UCLA), Andrew Medina-Marino, PhD (FPD), Peter Witbooi, PhD (UWC)
Matthew Bramble, UCLA
Matthew S. Bramble, PhD, earned his Bachelor's degree in 2010 from Stevenson University, followed by several years at the United States Army Medical Research Institute of Infectious Disease (USAMRIID), where he focused on viral-host protein interactions.In 2017, he earned his doctoral degree in Human Genetics from UCLA, where he developed a model to better understand the genetic and hormonal influences contributing to sex-differences within the mammalian brain.During graduate school, he also worked closely with a team led by Dr. Anne Rimoin, investigating long-term immunological outcomes of Ebola survivors, along with disease susceptibility of health care worker populations in the Democratic Republic of the Congo (DRC). His current research interests lie in the coupling of genetics and epidemiology, in an attempt to identify novel genetic factors that influence various infectious disease progressions.
Exploring the Genetic and Transcriptional Influences Modulating Susceptibility or Resistance to Emerging Infectious Diseases
While in the DRC, Dr. Bramble will be working closely with the UCLA-DRC research program in an attempt to better understand immunological outcomes observed in Ebola survivors.He plans to collect a significant amount of biological samples from various survivor cohorts within in the DRC, spanning 0, 3, 20 and 40 years post-infection, in addition to their close contacts.Using modern genomic technologies, Dr. Bramble will focus on identifying novel genetic factors that perhaps influence survival from Ebola, or factors that contribute to maintaining long-term neutralization capabilities.He also plans on expanding genomic technology capacity within the DRC, in both laboratory and field settings.This technology expansion will enable the local Congolese scientists to better harness the power of modern genetics, which has the ability to greatly improve our understanding of emerging infectious diseases and expand the local diagnostic capability.
Mentors: Anne Rimoin, PhD (UCLA), Emile Okitolonda Wemakoy, MD, PhD (Kinshasa School of Public Health), Eric Vilain, MD, PhD (Children’s National Medical Center)
Elisa Juárez Chávez, Universidad Peruana Cayetano Heredia (UPCH)
Elisa Juárez Chávez, MD, MSPH is a researcher at UPCH and a member of the Center for Maternal and Child Research, “MAMAWAWA”, at UPCH. She obtained her MD at UPCH and her Masters in International Health, on the Social and Behavioral Interventions track, at Johns Hopkins Bloomberg School of Public Health (JHSPH). Dr. Juárez Chávez's previous research has mainly used qualitative tools to explore different aspects of living with HIV and experiences of violence among vulnerable populations. In the maternal and child health arena, she has participated in a number of projects both in Lima and at JHSPH, including projects related to long-term contraception and maternal mortality among adolescents. By carrying out this evaluation of “LIBRE”, an early reading intervention, Dr. Juárez Chávez will be able to use her previous experience and acquire new tools in a different and innovative field in her country.
Impact evaluation of “early reading” on the socio-emotional development and quality of mother-child interactions among children living in an impoverished setting of Lima, Perú
A great amount of evidence confirms the benefits of early reading practices at home to potentiate the cognitive development and learning processes of children. Such activities also have an impact on their social and emotional development and bonding with their mothers. Reading to infants has been associated with better caregiver-child interactions and improved social-emotional understanding. However, this evidence has been generated primarily in developed and high-income settings, with limited evidence in low- and middle- income settings.For her project, Dr. Juárez Chávez will use qualitative and quantitative methods to evaluate the impact of an “early reading” intervention on the socio-emotional development, mother-child interactions, and bonding among children from an impoverished area of Lima, .
Mentors: Angela Bayer, PhD, MHS (UCLA), Andrés Lescano, PhD (UPCH), Kelika Konda, MHS, PhD (UCLA)
Noah Kojima, UCLA
Noah Kojima is a medical student attending the David Geffen School of Medicine at the University of California, Los Angeles, where he has held leadership roles in the Medical Student Council, Global Health Elective, Medical Student Research Committee, and Infectious Diseases Interest Group. He received a Bachelor's of Science degree in Biochemistry from the University of California, Davis where he also participated in the Education Abroad Program in Kyoto, Japan. His research focuses on understanding, preventing, and managing the spread of human immunodeficiency virus and other sexually transmitted infections under the mentorship of Dr. Jeffrey D. Klausner. His scholarly work has been supported by the Infectious Diseases Society of America, West Los Angeles Japanese American Citizens League, and Japanese American Medical Association.
Nasopharyngeal microbiota composition of newborns among a cohort of HIV-positive mothers with and without chlamydia infection
Human Immunodeficiency Virus (HIV) and Chlamydia Trachomatis (CT) infection are common among pregnant women in South Africa. Among infants born to mothers with untreated genital CT infection, many newborns develop CT conjunctivitis or CT pneumonia from vertically transmitted bacteria. With growing evidence supporting the hypothesis that the composition of the nasopharyngeal microbiome has a large role in training mucosal and systemic immune system responses, it is still unknown how CT infection effects the nasopharyngeal microbiota composition of newborns. Mr. Kojima aims to describe the nasopharyngeal microbiota composition of newborns at different time points among a cohort of HIV-positive mothers both with and without chlamydia infection. Additionally, he will search for candidate nasopharyngeal microbiota compositions that may be associated with adverse health outcomes among those newborns. He will conduct his research in South Africa.
Mentors: Jeffrey D. Klausner, MD, MPH (UCLA), Andrew Medina-Marino, PhD (FPD), Mamadou Kaba, MD, PhD (University of Capetown)
Tariro Mawoza, University of Zimbabwe (UZ)
Tariro Mawoza, PhD, is a pharmacist and pharmacologist working at the University of Zimbabwe (UZ) in the Clinical Pharmacology department. Her primary research interests are the use of traditional medicines by women, as well as the effects that these medicines have on global health. Most recently, her focus has been on the use of traditional medicines by HIV positive women to treat various reproductive diseases. Currently, she is doing a UZ based research project on the use of traditional medicines by women during pregnancy, birth and for postpartum care. She is a graduate of both the UZ and the University of KwaZulu-Natal. At the University of Zimbabwe, Dr. Mawoza has been involved in teaching, designing and implementing various research projects, as well as mentoring undergraduate students.
Prevalence and outcomes associated with using traditional medicines during pregnancy and birth by pregnant HIV positive women in Zimbabwe
Traditional medicines are used during pregnancy and birth by women of varying ages worldwide because it is believed that they help to prevent perineal lacerations, augment labor and achieve a safe delivery process. HIV-positive women however, run the risk of possible drug interactions especially if they use these medicines with their antiretroviral drugs (ARVs). Since globally, HIV and complications associated with pregnancy and birth remain the leading causes of death for women, Dr. Mawoza's project aims to determine if the concomitant use of these medicines has any effect on the birth outcomes of either the mother and/or newborn child. This study could help to reduce both maternal and infant mortality, especially in HIV-infected women.
Mentors: Joelle Brown, PhD (UCSF), Mike Mbizvo, PhD (UZ), Matthew Taylor, PhD (University of Colorado)
Michael Mwachiro, Tenwek Hospital / Kenya Medical Research Institute (KEMRI)
Michael Mwachiro, MBChB, is currently a surgical endoscopist at Tenwek Hospital in Bomet, Kenya whose area of interest is early detection, surgical treatment and palliation of esophageal cancer. He successfully carried out the first endoscopic screening for esophageal cancer with Lugol's chromoendoscopy in Africa. He has also been working on efforts to make palliative esophageal stenting available at affordable costs. He has been studying risk factors for esophageal cancer that are particular to East Africa, to identify factors that can be targeted in prevention studies. He recently received the 2017 Merit Award for excellence in research from the Surgical Society of Kenya. He is a member of the inaugural class of the African Cancer Leaders Institute (ACLI) of the African Organization for Research and Training in Cancer (AORTIC) and is also a founding member of the African Esophageal Cancer Consortium (AfrECC). He has multiple publications on his esophageal cancer work.
Genomic analysis of Esophageal Squamous Cell Carcinoma in Bomet County, Kenya
Esophageal Squamous Cell Carcinoma (ESCC) is the dominant histological subtype of esophageal cancer in most high risk areas globally. It is one of the top causes of cancer morbidity and mortality in both men and women in Eastern Africa. In Kenya, it is the 3rd most common cancer in females and the 2nd most common cancer in males. ESCC is the most common cancer seen at Tenwek Hospital, which is a 300-bed referral facility. The hospital offers both curative and palliative care for ESCC. Dr. Mwachiro's GloCal project will perform whole genome sequencing and RNA sequencing of tumor samples to identify molecular determinants of ESCC in Kenya. It will evaluate the somatic mutational rate, mutational pattern, and copy number profiles. It will identify recurrently mutated genes, and look for evidence of pathogens in tumor specimens obtained from ESCC patients at Tenwek Hospital. The proposed study will also form the foundation for a unique biospecimen repository for newly diagnosed cases of ESCC in Kenya.
Mentors: Katherine Van Loon, MD (UCSF), Elizabeth Bukusi, MBChB, MMed, MPH, PhD (KEMRI), Sanford Dawsey, MD (National Cancer Institute)
Clotilde Nhatave, Universidade Eduardo Mondlane (UEM)
Clotilde Nhatave, MD, is an early career Internal Medicine Physician who is currently working as a hospital assistant and a member of the Maputo Central Hospital Therapeutics and Antibiotics Committees. She also provides internal medicine training modules for medical students. Currently, she is a Masters student in Tropical Medicine and Global Health at Lúrio University. In her previous short experience, she collaborated on some research projects related to bacteremia and toxoplasmosis. Most recently, her focus has been on developing skills as a researcher in the global health field, with emphasis on infectious disease and antimicrobial resistance. As a short term career goal, she aims to help develop antibiotic stewardship programs that will positively impact policies to regulate and promote rational use of antimicrobials and to enhance infection prevention and control overall. Beyond this fellowship, Dr. Nhatave aims to become a leading investigator in the infectious disease field.
Interventions to improve antibiotic prescribing practices in HIV infected patients at Maputo Central Hospital
Dr. Nhatave's project intends to address the issue of antibiotic prescription practices at the main teaching hospital in Maputo, Maputo Central Hospital.The main goal is to see if the use of simple strategies can be prospectively audited with subsequent intervention and if feedback can reduce the inappropriate use of antimicrobials without negative effects on hospital morbidity and mortality. These strategies will include the use of tools such as antibiotic stewardship ward rounds, a dedicated prescription chart, periodic active and passive physician education, and improvements in communication strategy between clinicians and the microbiology laboratory. The ultimate benefit of this research is to identify key interventions and test strategies that will shape national hospital policies and increase clinicians' engagement in antimicrobial prescription and management to prevent misuse and its consequences.
Mentors: Robert T. Schooley, MD (UC San Diego), Sam Patel, MD (UEM), Randy Taplitz, MD (UC San Diego)
Ogechukwu Agatha Offorjebe, UCLA
O. Agatha Offorjebe is a medical student at Charles R. Drew University and the David Geffen School of Medicine at UCLA. She is passionate about health system strengthening and the delivery of primary care services to underserved communities across the globe. As a former Medical Coordinator for the Mobile Clinic Project at UCLA, she ran a weekly street-side clinic providing medical evaluation and community referrals to homeless clients in the West Hollywood area. She has been actively engaged in global health activities through the UCLA Center for World Health serving as Co-Founder and Co-Director of the Los Angeles Global Health Conference. During medical school, she traveled to Botswana to study partner notification and treatment for STIs among pregnant women in the country's capital. Prior to medical school, she spent 5 years working in public health, education, and international development in the U.S. and Sub-Saharan Africa. Ms. Offorjebe holds an AB from Princeton University.
The Role of Self-Testing in Identifying HIV-Infected Individuals in Malawi
Partner notification services are successful strategies to augment HIV case finding and can result in earlier diagnosis of individuals, earlier initiation of antiretroviral therapy (ART), and prevention of HIV transmission. However, in routine settings the implementation and acceptance of partner notification strategies is low. One way to address low use of partner identification strategies is through self-test kits. Furthermore, while self-testing and partner notification strategies have been studied separately, these strategies have not been examined jointly as a means to improve partner disclosure and testing. Ms. Offorjebe's study will examine the acceptability of HIV self-testing in clinic waiting areas and outpatient department locations and evaluate if self-test kits are a feasible and acceptable strategy to facilitate partner disclosure and partner testing.
Mentors: Risa Hoffman, MD, MPH (UCLA/Partners in Hope), Alan Schooley, MD (UCLA/Partners in Hope), Dan Namarika, MD (Partners in Hope)
Juliet Okoroh, UCSF
Juliet Okoroh, MD, MPH was born and raised in Nigeria and immigrated to the United States at the age of 18. Being in the United States has afforded her many opportunities that she would not have otherwise had if she were back home. This realization has fueled her interest in global heath and meeting the needs of communities similar to the one she was raised in. Her ultimate goal is to work on policies related to expanding coverage and access to surgical care in resource limited settings. Her prior experience working as a congressional staffer in D.C. exposed her to the complexities of how policies are made. Furthermore, complementing her training in medical school with an MPH in health policy has broadened her perspective on how policy research can change clinical practice.
Does Insurance Protect Women Against Catastrophic Health Expenditures for Surgical Care? An Analysis of National Health Insurance Claims and of Patients at Korle-Bu Teaching Hospital Accra, Ghana
The basis of Dr. Okoroh's project is to describe the unmet need and costs associated with the provision of surgical care in Ghana.Ghana has a unique experience with health insurance and began healthcare reform in 2004. The insurance plan (NHIS) currently covers 36% of the population and it provides a wide range of inpatient and outpatient services including medicines and supplies. Despite such progress by the government, out-of-pocket costs still remain a significant barrier to achieving universal health coverage. Healthcare expenditures represented approximately 29% of average household income in 2014 and are still considered catastrophic according to the World Health Organization. Dr. Okoroh will provide a comparative analysis of out-of-pocket cost for surgical care by insurance status and subsequently provide recommendations to the government on expanding coverage.
Mentors: Hobart Harris, MD, MPH (UCSF), Samuel Essoun, MD (Korlebu Teaching Hospital), Robert Riviello, MD, MPH (Brigham and Women’s Hospital)
Melissa Salm, UC Davis
Melissa Salm is a sociocultural anthropologist whose research areas include anthropology of global health, science & technology studies, multi-species ethnography, and health informatics. Salm's academic training in the social sciences is interdisciplinary: she is currently a PhD candidate in the anthropology department at UC-Davis; an MSc in critical & creative analysis from the sociology department at the University of London - Goldsmiths College; and a BA from the Gallatin School of Individualized Study at New York University. Her interests in global health governance and epistemologies of epidemiology were formed during her experiences as a research assistant to epidemiologists and physicians at the HIV Center for Clinical & Behavioral Studies at Columbia University. As the field of global health becomes increasingly interdisciplinary, Salm is committed to the possibility that anthropologists can contribute valuable ethnographic insights into the social processes by which global health develops agendas and networks around the world.
Towards a Global Concept of Global Health - Definitions, Practices, and Goals among NIH Fogarty Researchers in Latin America & the Caribbean
Salm will conduct a qualitative health study to compare how health practitioners in Latin America define and practice what comes to count as "global health". This study will use three ethnographic data-gathering methods: semi-structured & open-ended interviews; on-site participation-observations; and analysis of documentary sources. Ethnographic analysis of global health practices at different local levels will provide an empirical basis for better understanding the priorities and concerns for those who are closest to (global) health problems. This will provide a much-needed compliment to one-size-fits-all, top-down models for determining global health agendas. The project will generate robust qualitative data that can help guide the creation of an empirically demonstrable definition of the global health concept – one that recognizes the plurality of differences in enactments of global health, and in that sense, is truly more global.
Mentors: Joseph Dumit, PhD (UC Davis), Andrés (Willy) Lescano, PhD (UPCH), Patricia Conrad, DVM, PhD (UC Davis), Kelika Konda, PhD (UPCH)
Catherine Shari, Muhimbili University of Health and Allied Sciences (MUHAS)
Catherine Shari, MD, MMED, is among few emergency medical physicians in Tanzania, completing her training in September, 2016, at MUHAS. She served as a chief resident, leading fellow residents and graduated with the highest marks in her class. She received awards as the best student in her class. Currently she is based at MUHAS as a faculty member doing clinical and academic research in different capacities. Her research interests include pediatric global health, trauma and health education. She has been receiving research mentorship since her residency from a UCSF-led consortium of visiting academic faculty from the USA, South Africa and local faculty members. She was able to develop and execute her own research which won the African Federation for Emergency Medicine (AFEM) best African Poster Award at the International Conference on Emergency Medicine in2016. She is a member of the Emergency Medicine Association of Tanzania and the AFEM.
The feasibility and efficacy of nasal bubble continuous positive airway pressure (CPAP) in the management of children under the age of five years presenting with respiratory distress at a tertiary urban public emergency department in Tanzania.
Dr. Shari will conduct a research project to assess the feasibility and efficacy of nasal bubble CPAP among children less than five years of age presenting with respiratory distress at the emergency department (ED) in Tanzania. At the first full capacity ED in Tanzania, respiratory distress is a common pediatric presentation with substantial mortality. Ventilatory support is not readily available and these patients die due to lack of appropriate treatment options. Dr. Shari's research will look into non-invasive ventilation using nasal bubble CPAP as a cheap alternative since it has been proven to improve survival rates and vital signs in pediatric ICU and inpatient settings. The results of this study will help to bridge a knowledge gap to find out whether this mode of treatment is feasible and efficacious in EDs of hospitals in low income countries to prevent deterioration and avoid intubation in these children.
Mentors: Ellen Weber, MD (UCSF), Hendry Sawe, MD, MMed, MBA (MUHAS), Heike Geduld, MBChB, FCEM (University of Cape Town)
Adriane Wynn, UC San Diego
Adriane Wynn is receiving her PhD in Health Policy and Management from the UCLA Fielding School of Public Health in 2017. Her research focuses on improving public policies related to maternal and child health and sexually transmitted infections (STIs) by providing unbiased estimates of the effect of policy changes on system and health outcomes. She has been the Associate Director of the Policy Core at the UCLA Center for HIV Identification, Prevention, and Treatment Services. In this capacity, she has worked on projects to assess policy impacts on access to HIV testing and quality care. She has also worked for the United States Senate and the California State Legislature.
Assessing the Costs and Benefits of Testing and Treating HIV-infected Pregnant Women for Sexually Transmitted Infections in Southern Africa
Wynn's project will assess the health and economic outcomes of routine antenatal testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) among HIV-infected pregnant women in low resource settings. She will compare the cost-effectiveness of a test and treat strategy for CT/NG compared to the standard of care (diagnosis based on symptoms). Outcome measures will include cost per person tested, cost per infection resolved, and the incremental cost per preterm birth, mother-to-child transmission (MTCT) of HIV, and disability-adjusted life years (DALY) averted. Using the estimates of avoided costs per adverse outcome averted due to testing, she will also calculate the avoided costs per thousand tested women. This research will provide evidence needed to assess the feasibility of implementing targeted antenatal CT/NG testing in a low resource limited setting.
Mentors: Steffanie A. Strathdee, PhD (UCSD), Chelsea Morroni, MD (University of Botswana), Jeffrey Klausner, MD, MPH (UCLA)