Clinical Research Awards List

2019 Awards

INVESTIGATING THE PREVALENCE AND PRACTICES OF HERBAL MEDICINE USE IN ANTENATAL CARE IN MUKONO, UGANDA

Principal Investigator: Mackenzie Carlson, Department of Pediatrics, School of Medicine and Public Health

Prenatal herbal or traditional medicine use is common and plays a key role for pregnant women in low-income countries. In African countries, up to 87 percent of women use herbal medicine as a part of their antenatal care. Despite widespread use, potential maternal and fetal side effects of herbal medicine remain understudied. This proposal aims to describe herbal medicine practices in pregnant women seeking antenatal care in the Mukono District of Uganda. Study goals include collecting qualitative data using a standardized questionnaire to evaluate the herbal medicine prevalence and practices in pregnancy, identifying ways in which herbal medicines are obtained and prepared for use in pregnancy and identifying the concordance between what recommendations and medications are given to pregnant women by traditional birth attendants versus government midwives. Interviews will be completed using a standardized questionnaire with randomly selected women who present for antenatal care at the Mukono District Health Center IV. Additional interviews will be conducted with midwives and with traditional birth attendants or people who prepare and sell the herbal medicines. A literature review will be conducted to categorize these herbs based on the safety of their use in pregnancy and this information will be shared with antenatal care providers in the Mukono District.

Key personnel: Ryan McAdams, SMPH

ETIOLOGY AND ANTIMICROBIAL RESISTANCE PATTERNS OF NEONATAL SEPSIS IN JIMMA, ETHIOPIA

Principal Investigator: Daniele Gusland, Department of Pediatrics, School of Medicine and Public Health

With 4.5 million deaths attributable to antimicrobial resistance (AMR) in Africa every year, the need for effective antimicrobial stewardship is urgent. An understanding of both bacterial epidemiology of infection and antimicrobial resistance patterns will ultimately further efforts to develop antimicrobial stewardship programs. To that end, we propose to develop a profile of causative organisms in neonatal serious bacterial infections and local antimicrobial resistance patterns associated with infants treated at Jimma University Hospital, the primary referral hospital for southwest Ethiopia. By adding survey and clinical data collection methods to the current standard of care, we will provide an expanded empiric framework of local epidemiology and AMR patterns that have not yet been studied in this location and context. We hypothesize that bacterial etiologies of serious neonatal infections at Jimma Hospital will be comparable to those of other low- and middle-income countries; however, we hypothesize that antimicrobial resistance patterns will be unique to the local area. These findings will allow for an empiric evaluation of current prescribing practices, will promote the development of more clinically effective empiric antibiotic guidelines tailored to the local epidemiology, and will serve as an important first step towards improving long-term antimicrobial stewardship capacity within Ethiopian healthcare facilities.

Key personnel: Dawd Siraj, Department of Medicine, SMPH; Jim Conway, Department of Pediatrics, SMPH; Alemseged Abdissa, Ministry of Health; Melkamu Berhane, Department of Pediatrics at Jimma University Hospital; Mekdes Shimekit, Department of Pediatrics at Jimma University Hospital

COMPARING SELF-PRESCRIBED ANTIBIOTIC USAGE ACROSS RURAL POPULATIONS IN SAN LUCAS TOLIMAN, GUATEMALA

Principal Investigator: Emma Svenson, Department of Population Health Sciences, School of Medicine and Public Health

Bacterial resistance represents an increasing public health threat. Multiple interconnected factors can contribute to the rise of antibiotic resistance, such as physician and veterinary prescription patterns, individual medication practices, agricultural use and environmental degradation. Self-medication is integral to this process. Self-medication is the behavior of using medical products without a prescription to alleviate minor diseases or symptoms recognized by medical customers. The purpose of this study is to investigate the self-medication practices in a rural Guatemalan population and to compare self-prescribing practices in rural and semi-urban populations. This will be a cross-sectional study conducted in San Lucas Tolimán Guatemala and surrounding communities. A random sample of adults living in each community will be asked to complete a questionnaire to collect information on demographics, personal antibiotic usage and knowledge, and antibiotic usage and knowledge in pet and livestock populations. We hypothesize that 1. basic knowledge of the risks of self-medication will exist, 2. antibiotic self-medication practices will be decreased in a community with access to a physician and pharmacy compared to communities without access to a physician and pharmacy, though there will be no difference in self-medication practices in animal populations, and 3. there will be differences in self-medication practices between genders and socioeconomic classes.

Key personnel: James Svenson, Department of Emergency Medicine