Erika Phelps Nishiguchi, MD
Nominated From: University of Washington
Research Site: Uganda
Research Area: Child Development, Malaria Pathophysiology
Primary Mentor: Chandy John
Pathophysiology of severe malaria: Understanding long-term neurodevelopmental outcomes and risk factors for hospital readmission
Malaria remains a substantial threat to Sub-Saharan African children despite global advances in prevention and treatment. Over two hundred million children are infected with malaria each year, and although mortality has decreased early 30% since 2010, significant morbidity continues (WHO.int). Two important anifestations of malarial morbidity are short-term vulnerability to recurrent illness and longer-term neurodevelopmental impairment affecting cognition and behavior. Recently published data confirm that Ugandan children with some forms of severe malaria are at increased risk of recurrent morbidities (Opoka 2017). An ongoing cohort study of children in Kampala and Jinja, led by Drs. John, Opoka and Bangirana, is designed to assess the risks of and propose pathophysiologic mechanisms for neurodevelopmental impairment in children suffering from five different forms of severe malaria. Interim analysis has revealed that the children in Jinja suffer an exceptionally high rate of readmission, making this population an ideal source for study of the risks and interplay between short and long-term morbidities of severe malarial infection. The research capabilities of the team on site also make it an excellent site for assessment of different methods of testing for executive function and fluid processing capacity in Ugandan children.
Sequelae of childhood infections have ramifications throughout the lifespan, impacting children’s ability to prosper, thrive, and contribute to the advancement of their communities. Malaria is especially malign due to its global reach, profound infectious burden, and devastating contribution to both short term and long-term morbidity. By identifying the specific risk factors associated with readmission in the short term and neurodevelopmental impairment in the long term, targeted interventions may be identified and tested to protect children from the most disabling of these effects.
Advice for Potential Candidates
First, identify your specific research and learning goals, then browse the mentors list and see who’s doing work that interests you. Schedule phone meetings if in-person is impossible, and find out where you overlap. Often, that first meeting helps provide direction for the next round of potential mentors to reach out to. I also found meeting with the site PI (in my case, Joe Zunt) very helpful for a jumping off point.
- Dr. Chandy John, Indiana University School of Medicine, Department of Pediatrics, Indiana University, USA
- Dr. Robert Opoka, Department of Pediatrics and Child Health, Makerere University, Uganda
- Dr. Maneesh Batra, Department of Global Health, Pediatrics, University of Washington, USA
- Dr. Paul Bangirana, Makerere University College of Health Sciences, Psychiatry, Makerere University, Uganda/a>