A research team led by University of Iowa College of Public Health investigators has received a $2.5 million grant over five years to study how societal development affects the transmission of diarrheal disease among infants in urban Kenya. The funding comes from the Fogarty International Center, part of the U.S. National Institutes of Health.
Enteric (intestinal) infections remain the second leading cause of diarrheal illness and death globally in children, despite significant improvements in access to latrines and safe water sources in countries with high rates of diarrheal disease.
“Our study is focused on tracking how ongoing rises in the middle class in low-income countries induces a collapse in infectious diarrheal pathogen transmission and disease in infants,” says Kelly Baker, co-principal investigator of the study and assistant professor of occupational and environmental health in the University of Iowa College of Public Health.
“Our statistical developments will allow us to understand points of vulnerability for children susceptible to enteric infections, teasing apart the different pathways of infection,” adds co-principal investigator Dan Sewell, assistant professor of biostatistics in the University of Iowa College of Public Health.
The team’s previous research has shown that the “enteric pathome” — the communities of viral, bacterial, and protozoan pathogens transmitted by human and animal feces in the environment — ingested by children living in low-income urban neighborhoods of Kenya is complex and varies by how it moves through the environment from a source to a point of contact with people.
Specifically, the new study aims to develop statistical models to understand the complex exposure risks for infants from the enteric pathome; collect environmental, behavioral, spatial, economic, and microbial data to characterize the enteric pathome along pathways for disease diffusion and the intersection of humans and animals with these pathways; and develop and validate models for predicting which social and environmental urban developmental interventions (e.g. penning animals, building latrines or drains, replacing dirt floors in homes with concrete floors) best prevent multi-pathogen transmission to infants in high disease burden countries.
The statistical and modeling tools developed through this project in urban Kenya will be widely applicable to studying multi-pathogen infectious disease transmission dynamics in other low- to middle-income countries, and will address global needs for evidence to prioritize urban development interventions.
Additional co-investigators include Sriram Pemmaraju with the University of Iowa Department of Computer Science, and Blessing Mberu, Sheillah Simiyu, and Abdhalah Ziraba with the African Population Health Research Center.