2017 Global Health Seed Grants

Each year, with support from Rutgers Global, the Rutgers Global Health Institute awards Global Health Seed Grants to faculty conducting collaborative, interdisciplinary activities that will impact the health of communities at home and around the world. Below are summaries of projects that were awarded in March 2017 for implementation beginning in July 2017.

Support for Education, Training, and Capacity Building

Health Passport to Healthy Living

Karen WeiRu Lin, MD, MS, FAAFP, Rutgers Robert Wood Johnson Medical School

Peter Guarnaccia, PhD, Department of Human Ecology, Rutgers School of Environmental and Biological Sciences

Collaborative Partners: Rutgers Robert Wood Johnson Medical School, Rutgers HIPHOP-Promise Clinic, Elijah’s Promise

The Health Passport to Healthy Living project is to create a “Health Passport” booklet that will provide health information and education to the diabetic and hypertensive patients at the HIPHOP-Promise Clinic—a student-run free clinic sponsored by Rutgers Robert Wood Johnson Medical School—and the clients at Elijah’s Promise, a nonprofit organization in New Brunswick, New Jersey. The Health Passport is a tool to empower people in the ownership of their medical data. Participants’ health outcomes, satisfaction, appointment and medication compliance, and utilization of preventive health services will be assessed before and after the introduction of the program. Health Passports are anticipated to promote healthy living and a greater sense of ownership over one’s health.

Enhanced Capacity Building in Emergency and Surgical Care in Rural Ghana via eHealth Technology

Ziad Sifri, MD, Department of Surgery, Rutgers New Jersey Medical School

Harsh Sule, MD, Department of Emergency Medicine, Rutgers New Jersey Medical School

Collaborative Partners: Rutgers New Jersey Medical School, Tetteh Quarshie Memorial Hospital

In rural Ghana, treatable conditions lead to disability, poverty, and in extreme circumstances, death, due to the limited availability of specialists and specialty training, especially in emergency and surgical care. Tetteh Quarshie Memorial Hospital is a 100-bed district hospital in Mampong, Ghana, that acts as a training center for family medicine residents and where surgical cases are performed by just one surgeon. Associate Professor of Surgery Ziad Sifri has been involved in the hospital since 2013, leading a team of fellow New Jersey Medical School faculty in providing clinical support and training. This project is a collaboration between Tetteh Quarshie Memorial Hospital, the Rutgers New Jersey Medical School Department of Emergency Medicine, and the Rutgers New Jersey Medical School Department of Surgery. The eHealth approach, using technology to expand capacity in rural Ghana, recognizes the challenges inherent to global health development, such as limited time and funding for on-the-ground engagement. This model will be operationalized via semi-annual site visits to conduct/update needs assessments, and via on-site skills training coupled with online collaboration and training. The eHealth efforts will focus on building an eLibrary for local use, live-streaming of routine didactic/educational sessions conducted at Rutgers New Jersey Medical School, case-based teaching through online sessions, and other academic collaboration.

Support for Research

Health System Inequalities: An Empirical Assessment of São Paulo, Brazil

Michael Gusmano, PhD, Department of Health Systems and Policy, Rutgers School of Public Health

Collaborative Partners: Rutgers School of Public Health, New York University, Columbia University, Centro de Criogenia

In 1988, the Constitution of Brazil established a right to health care, and the country adopted the Unified Health System, also known as SUS, which is funded by taxes and social contributions. The program expanded, and by 1999, 82 percent of the country was covered by health insurance. SUS provides free health care at primary, secondary, and tertiary levels through a national health system. The project is investigating the degree to which Brazil’s commitment to universal access to health care, regardless of ability to pay, is reflected in access to public health and health care services within São Paulo, Brazil. This project involves an analysis of health system inequalities within São Paulo through examination of four health system performance indicators: infant mortality, amenable mortality, avoidable hospitalizations for ambulatory care sensitive conditions, and rates of revascularization adjusted for morbidity. The initial results from the project indicate that investments in the public health and health care system since 2000 have generated improvements in access to care in São Paulo, but geographic inequalities in access within the city have actually increased during this time period.

Poor Growth, Vitamin A Deficiency, and Microbiome in Children

Loredana Quadro, PhD, Department of Food Science, Rutgers School of Environmental and Biological Sciences

Collaborative Partners: Rutgers School of Environmental and Biological Sciences, University of São Paulo, Federal University of Alagoas

More than 150 million children worldwide are undernourished and experience permanently stunted growth. Undernourished children have impaired microbiome development that may limit nutrient absorption, promote inflammatory responses, and hinder healthy growth. Vitamin A-deficiency (VAD) affects hundreds of millions of children in developing countries, where VAD and general malnutrition are often linked. Vitamin A is an essential nutrient that modulates intestinal inflammation, immunity, and cell proliferation. Given that a healthy gut is the prerequisite for proper microbiome development during childhood, it is hypothesized that children consuming a diet poor in energy and micronutrients such as vitamin A will have impaired intestinal functions that ultimately affect microbiome development, hindering normal growth. The project will determine the relationship between vitamin A status, microbiome, and growth by studying the microbiome of vitamin A sufficient and deficient children admitted for undernutrition at the Center for Nutrition Recovery and Education in Maceio, Brazil.

Impacts of Air Pollution Exposure on M.tb Transmission in an Urban Slum Community in Kampala, Uganda – A Pilot Study

Stephan Schwander, MD, PhD, Department of Environmental and Occupational Health, Rutgers School of Public Health

Qingyu Meng, PhD, Department of Environmental and Occupational Health, Rutgers School of Public Health

Collaborative Partners: Makerere University, EASEUganda

According to the United Nations Human Settlements Programme, more than half of the world’s population lives in cities, with approximately a quarter of the world’s urban population living in slums. In Africa, over half of the urban population lives in slums. People living in slum areas face multiple environmental and health challenges, including air pollution and infectious diseases. Namuwongo is the largest urban slum area in Kampala, the capital city of Uganda, and has a high incidence of tuberculosis (TB). This slum can be seen as a model study site of major global environmental and public health significance as slum populations are expected to increase worldwide in the coming decades. The purpose of this study, which was conducted in August 2017, was to collect critical pilot data to assess personal air pollution exposures in the slum area in both TB households and healthy households, and to test cough aerosol sampling systems in the slum area. Successful protocols were developed for personal air pollution exposure assessments and the cough aerosol sampling. High peak exposures of atmospheric particulate matter (PM2.5) and carbon monoxide were detected. These results were used to strengthen an application for large-scale grant funding from the National Institute of Environmental Health Sciences, which is pending.