Hope is on the horizon for some Ugandan school children, thanks to a grant from the Alliance for African Partnership (AAP), a new initiative at MSU aimed at developing a collaborative and cross-disciplinary platform for addressing today’s global challenges.
Amara Ezeamama, Michigan State University assistant professor of psychiatry, is the recipient of one of 11 grants recently awarded by the AAP. She will use her $100,000, one-year grant for her project “Micronutrient Deficiency and Long-Term Functional Deficit in School-Aged Ugandan Children with and without Chronic HIV Infection.”
This study builds upon a project funded by a small grant from the International AIDS Society (IAS) to study how vulnerable Ugandan children 6 to 10 years old with HIV can survive and thrive while being treated for HIV disease. The project focuses on HIV and toxic stress as determinants of educational loss and impaired psychosocial adjustment during early school-age years. However, the IAS funding did not include support for nutritional assessment.
“Nutrition plays a crucial role in functional survival for all children. This AAP grant will allow us to add a robust nutritional component to the IAS study,” she said. “One of the things we know we can change to enhance functional survival is nutrition. In particular, we are looking at key nutrients that we believe have a strong impact on long-term function. One group of nutrients includes fatty acids, which have implications for cognitive function for a range of important developmental outcomes; the other is vitamin D.”
She is partnering with the Kampala Capital City Authority Hospital to study approximately 300 children, along with each child’s caregiver. The study will include HIV-infected children of HIV-positive women, HIV-uninfected children of HIV-positive women and a community control group that has never been exposed to HIV.
“We don’t understand the long-term consequence of HIV in children as well as we should,” Ezeamama said. “A child’s first 1,000 days of life—when development is so crucial—is tremendously affected by HIV whether they are infected themselves or exposed without infection. We are studying these children to learn how can we improve their function.
“Strategic investments have been made in HIV research over the years, so there is hope on the horizon. We now know that HIV is not an immediate death sentence. There are so many treatments available now; if people are adherent, their quality of life can improve.” We are now looking to determine whether the gained lifespan is matched with functionality – i.e. normal psychosocial adjustment, cognitive function and quality of life.
“One of our priorities is to look at the role of toxic stress. These children have probably experienced the death of HIV-infected family members, and some are orphaned due to HIV,” Ezeamama said. “The field is moving toward bio-psychosocial interventions that look at children holistically in the biological, physiological, social and cultural context as opposed to thinking that you just give a pill and things get better. A pill may help in some circumstances—but that might be in conjunction with targeted behavioral and culturally appropriate therapy.”
Ezeamama just returned from Kampala in March and plans to be back in the field in June.
“I couldn’t be more grateful for this AAP grant, for the vote of confidence that MSU has expressed in our work,” she said.
In addition to Ezeamama, serving as co-principal investigator is Sarah K. Zalwango, M.D., Kampala Capital City Authority, Kampala, Uganda. Co-investigators are Philippa Musoke, M.D., Makerere University, Kampala, Uganda; and Michael Boivin, professor in MSU’s Department of Psychiatry and Department of Neurology and Ophthalmology. Ezeamama will also collaborate with Jenifer Fenton, associate professor in MSU’s Department of Food Science and Human Nutrition.