Pediatric Infectious Diseases, Enteric Health and Malnutrition in Pakistan (PIDEMP) Research Training Program

项目摘要/摘要 在巴基斯坦，大约一半的儿童发育迟缓，15%的儿童消瘦，40%的儿童体重不足。发育迟缓 作为终生身体、免疫(包括减量疫苗)损害的临床标志 免疫原性)、神经认知和社会经济潜力。环境肠道功能障碍(EED)是 被认为是导致营养不良和随后发育迟缓的一个关键因素，居住在低收入和低收入地区的儿童 中等收入国家(LMIC)，如巴基斯坦。EED是一种获得性、亚临床的小肠疾病 归因于通过粪便-口腔暴露于肠道病原体而持续的免疫刺激负担导致 持续的急性期反应和慢性炎症。EED是一个很好的例子，说明了 传染病和慢性营养不良。专业知识有限，缺乏正规的培训计划 巴基斯坦的儿科传染病以及胃肠病和营养正在阻碍在解决 这一重大的疾病负担。通过这项提议，我们的目标是在儿科领域建立可持续的能力 传染病、胃肠病学和营养学研究，特别与EED及其并发症有关 例如疫苗失败、营养不良和随后居住在巴基斯坦的儿童的生长障碍。培训 通过这笔赠款，将利用正在进行的合作研究项目和教学(博士和研究生) 目前在巴基斯坦阿加汗大学(AKU)提供的课程。我们将通过三个培训来实现这一目标 不同持续时间的路径。第一轨道将包括一系列短期课程和讲习班。 主题涵盖高级湿工作台实验室技术、流行病学、临床营养学和生物伦理学，所有这些主题都包含 传染病的焦点。第二轨道将利用流行病学研究生课程(硕士)和 AKU和美国弗吉尼亚大学数据科学专业的生物统计学和临床研究培训 候选人。Track III将培养致力于粘膜免疫学、有机化合物、 健康和疾病的发育起源以及临床营养。之前的两个成功周期 格兰特为AKU的传染病研究奠定了坚实的基础。我们计划利用此框架 在接下来的五年里，通过培养一批当地的独立科学家来研究传染病的相互作用 和非传染性疾病，这在全世界仍然是一个被忽视的研究领域，以及 特别是在巴基斯坦等低收入国家。这一培训方案的总体影响将是增强国内的能力 当地研究人员将显著减轻EED的负担，总体目标是儿科感染 巴基斯坦的疾病、胃肠病和营养研究。

Project Summary/Abstract Approximately half of all children in Pakistan are stunted, 15% are wasted, and 40% are underweight. Stunting serves as a clinical marker for lifelong impairments in physical, immunological (including reduced vaccine immunogenicity), neurocognitive, and socioeconomic potential. Environmental Enteric Dysfunction (EED) is thought to be a key factor underlying malnutrition and subsequently stunting in children residing in low-and- middle income countries (LMICs) such as Pakistan. EED is an acquired, subclinical, small intestinal condition attributed to a continuous burden of immune stimulation by fecal-oral exposure to enteropathogens leading to a persistent acute phase response and chronic inflammation. EED is an excellent example of the interplay between infectious diseases and chronic malnutrition. Limited expertise and a paucity of formal training programs in pediatric infectious diseases and gastroenterology and nutrition in Pakistan are impeding progress in addressing this significant burden of disease. Through this proposal, we aim to build sustainable capacity in pediatric infectious disease and gastroenterology and nutrition research, specifically related to EED and its complications such as vaccine failure, undernutrition and subsequent growth failure in children residing in Pakistan. Training through this grant will leverage ongoing collaborative research projects and didactic (doctoral and graduate) programs currently offered at the Aga Khan University (AKU), Pakistan. We will achieve this via three training pathways of varying durations. Track I will include a series of short-term courses and workshops to be conducted on topics covering advanced wet bench laboratory skills, epidemiology, clinical nutrition and bioethics, all with an infectious diseases focus. Track II will leverage graduate programs (Master’s) in Epidemiology and Biostatistics and Clinical Research at AKU and in Data Science at the University of Virginia, USA for training candidates. Track III will produce PhD scholars working in the fields of mucosal immunology, organoids, developmental origins of health and diseases as well as clinical nutrition. Two prior successful cycles of this grant have firmly laid the foundation of infectious diseases research at AKU. We plan to leverage this framework in the next five years by producing a cadre of local, independent scientists studying the interplay of communicable and non-communicable diseases, which remain a neglected area of research throughout the world, and particularly in LMICs such as Pakistan. The overall impact of this training program will be to empower in-country local researchers to significantly reduce the burden of EED with an overarching goal of pediatric infectious disease and gastroenterology and nutrition research in Pakistan.