A Strategy to Reduce Stunting of Growth in Early Infancy: a Global Network Study

描述（申请人提供）：刚果民主共和国（DRC）是世界上最贫穷的国家之一，健康状况也相应较差。迫切需要进行创新研究，以发现循证干预措施，改善低收入国家的健康状况。刚果民主共和国的卫生保健环境和成果是许多低收入国家遇到的问题的象征，使刚果民主共和国成为制定和测试改善这些国家妇女和儿童健康战略的理想环境。位于查佩尔山的北卡罗来纳州大学和刚果民主共和国的金沙萨公共卫生学院建立了长期的伙伴关系，其总体目标是扩大与改善健康结果有关的科学知识。该伙伴关系由Antoinette Tshefu博士（KSPH）和Carl Bose博士和Frieda Behets博士（KSPH）领导，在广泛的医院和社区研究中富有成效，并拥有解决孕产妇和儿童健康各个领域研究问题的专业知识和资源。因此，UNC-KSPH伙伴关系是恢复在全球网络成员资格的理想候选者。该伙伴关系最近的一个研究兴趣是幼儿营养不良问题，这种问题往往在生命的头六个月开始。在这个脆弱年龄营养不良的后果包括线性生长发育迟缓、神经发育受损和一些长期健康问题。6个月之前发育迟缓的一个可能原因是继发于肠道寄生虫感染的环境性肠病。作为GN的一员，我们建议开展一项多国研究，研究减少婴儿早期发育迟缓的策略，包括识别和治疗肠道寄生虫。在这项研究中，我们将使用抗寄生虫药甲苯咪唑。由于对该药物（或任何其他抗寄生虫药物）在婴儿中的药代动力学（PK）和安全性知之甚少，我们还将进行PK和 治疗的安全性研究。

DESCRIPTION (provided by applicant): The Democratic Republic of Congo (DRC) is among the poorest nations in the world with correspondingly poor health outcomes. Innovative research is urgently needed to discover evidence-based interventions to improve health outcomes in low income countries. The health care environment and outcomes in the DRC are emblematic of problems encountered in many low income countries making the DRC an ideal environment in which to develop and test strategies for improving the health of women and children in these countries. The University of North Carolina at Chapel Hill (UNC) and the Kinshasa School of Public Health (KSPH) in the DRC have had a longstanding partnership whose overall goal has been to expand scientific knowledge relevant to improving health outcomes. The Partnership, led by Dr. Antoinette Tshefu (KSPH), and Drs. Carl Bose and Frieda Behets (UNC), has been highly productive in a wide range of hospital and community-based research studies, and has the expertise and resources to address research questions in a variety of areas of maternal and child health. Therefore, the UNC-KSPH Partnership is an ideal candidate to resume membership in the GN. A recent research interest of the Partnership has been early childhood malnutrition, which often begins during the first six months of life. The consequences of malnutrition at this vulnerable age include stunting of linear growth, impaired neurodevelopment and a number of long term health problems. A possible cause of stunting prior to 6 months of age is environmental enteropathy secondary to intestinal parasitic infection. As a member of the GN, we propose a multi-national study of a strategy to reduce stunting in early infancy that includes the identification and treatment of intestinal parasites. In this study, we will use the ati-parasitic drug, mebendazole. Because there is little knowledge about the pharmacokinetics (PK) and safety of this drug (or any other anti-parasitic drugs) in infants, we will also perform PK and safety studies of the treatment.