Project Lead(s): David Goldfarb, Jeffrey Pernica
Building off the successful completion of two proof-of-concept projects funded by Grand Challenges Canada, Canadian innovators will develop a potentially transformative way to manage childhood diarrhea in low-resource settings.
Diarrhea is the second-leading cause of death of children under five, with the majority of deaths occurring in low-income countries. It is also a major contributor to stunting, malnutrition, cognitive dysfunction, and reduced adult human capital and economic productivity.
With new funding from Grand Challenges Canada, the researchers will develop and test a ‘test and treat’ method of addressing childhood diarrhea.
The new management algorithm has the potential to displace existing guidelines for the testing and treatment of childhood diarrhea, which recommend antimicrobial therapy if blood is found in a child’s stool. Studies funded by Grand Challenges Canada’s Point of Care Diagnostics and Stars in Global Health programs showed that these guidelines may leave significant numbers of cases untreated where death could be averted.
Published by the Journal of the Pediatric Infectious Disease Society, one study documented that over one-third of 671 babies hospitalized with severe diarrhea – including 17 of 26 (65%) who ultimately died – were infected with a treatable pathogen, infections that had gone unrecognized at the hospital and therefore generally went untreated. The pilot trial also demonstrated that Lactobacillus reuteri treatment of children with gastroenteritis showed much promise for the mitigation of damage caused by acute diarrhoeal disease.
The researchers say that the ‘treatment gap’ revealed in their Botswana research uncovers a major opportunity to make a big long-term impact in child health worldwide.
Now, led by David Goldfarb, MD (formerly of McMaster University, now at the University of British Columbia), along with Jeffrey Pernica, MD (McMaster) and collaborators Tonya Arscott-Mills, MD (Botswana-UPenn Partnership), Margaret Mokomane, MSc (Botswana National Health Laboratory), and Loeto Mazhani, MD (University of Botswana) the researchers will test the new management algorithm through a randomized control trial.
Results from the trial, to be carried out over 12 months across four hospitals in Botswana, could have a significant long term impact on the way childhood diarrhea is tested and treated in low-resource settings. The evidence could inform policy, change regulations and impact the development of future diagnostics in low-income countries.
Partners include the Botswana Ministry of Health, the Botswana-UPenn Partnership, bioMérieux, BioGaia, and Copan Italia.