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

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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. Public Health Relevance: In developing countries, a major health problem is malnutrition; the most obvious manifestation in children is stunting of growth. Stunting often begins in early infancy and may be caused by environmental enteropathy. We propose a multi-national study of a strategy to reduce stunting in infancy that includes the early identification and treatment of intestinal parasites, a common cause of environmental enteropathy.