Uganda RoadBright blue skies, lush green fields, jungle and red earth were among the sites Kathleen Bongiovanni saw on her recent trip to Uganda.  She visited this country in East Africa as part of a month-long research trip.  Bongiovanni, a program manager in the Center for Developmental Therapeutics at Seattle Children’s Research Institute, went to determine whether or not a foam stability test would be acceptable to clinicians, birth attendants and mothers in Uganda, particularly in rural areas.  The test—a simple process conducted with fluid suctioned from a newborn’s mouth—would be a new way for doctors and other trained healthcare workers to easily and inexpensively diagnose lung immaturity in premature infants.

 

Bongiovanni said that field research like this is essential prior to introducing a new test or tool in developing countries.  “It’s a concern that’s come up with other diagnostics, that you create this great tool, it works really well in a lab and when you take into the field, you encounter unanticipated problems or some kind of barrier,” she said.  People may not feel comfortable with blood tests, as an example, or decision-makers are not involved in the education process and a new diagnostic test fails.  “I wanted to avoid that pitfall and tailor education based on the needs of the population we’ll be helping,” said Bongiovanni.

Uganda mom with babyShe conducted 12 focus group discussions and additional one-on-one interviews in Uganda.  Focus groups were held with new mothers, specifically women who had given birth in the last 24 months.  Bongiovanni and her team spent time predominately in rural areas.  Researchers asked the mothers if they would be comfortable with oral fluids taken from the baby’s mouth, and then used in a diagnostic test.  “The most important question, then was:  If you were comfortable with those two things, would a diagnostic test cause you to change your behavior?” she said.  “It doesn’t do any good if the mothers allow the test, but then aren’t inclined to follow through with medical care if needed.” 

In addition to interviews with mothers, Bongiovanni and crew conducted interviews with six midwives, two pediatricians and six traditional birth attendants, a specific group of women who are an important part of the healthcare system.  Traditional birth attendants help educate women and others in the community and are a major resource in villages.

Interview notes are currently being translated, but Bongiovanni said from what she learned and observed, there are no major cultural barriers to implementing the foam stability test in Uganda.  “Women are okay with some kind of clinician conducting the test,” she said.  “They are concerned about other potential barriers, including transportation and long wait times at medical facilities.  But overall, it sounds like it was a success.”

What’s next?  Bongiovanni will oversee a clinical trial of the foam stability test at Texas Children’s Hospital.  “The foam stability test really hasn’t been used before in this exact way,” she said.  “We want to make sure it’s specific enough and sensitive enough to be useful in a clinical setting.”  The clinical trial, which will launch in August, will include up to 70 patients and should be complete within six months.

As part of Global Health Month, Bongiovanni will be at Agency (formerly Party with a Purpose), on Saturday, July 14, from 9 p.m. to 1 a.m. at McCaw Hall.  She’ll demonstrate the foam stability test and will share videos and photos collected during her recent trip.  She’ll also field questions about her work.

Staff from the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) will also be on hand at Agency, and they’ll showcase the Perinatal Interventions Program (PIP), an innovative healthcare solution aimed at improving birth outcomes in low-resource communities and healthcare clinics.

Other global health events with Seattle Children’s researchers and clinicians taking place in July and August include: 

  • Groundswell: A Night For Global Health, Saturday, July 14, 7:30 – 9:00 p.m. at McCaw Hall.  Melinda French Gates will serve as keynote speaker.  Groundswell will also feature Christy Turlington Burns (founder, Every Mother Counts) and Dr. Craig Rubens, GAPPS executive director. The event is free.
  • Pathways to Global Health Activity Tent – Saturday, July 21, Seattle Center. The activity tent will be open through August, but visit on Saturday, July 21, to learn how Seattle Children’s pediatric residents are combating malnutrition in the developing world through the UW School of Medicine’s Global Health Pathway program.
  • Global Health Experience – Now until Sunday, August 19, Seattle Center.  The Seattle Center’s Next 50 Plaza includes a family-friendly, free global health exhibit, highlighting four personal stories with a focus on maternal, newborn and child health, malaria, diabetes and cancer. Children’s Sea-PAP and Hansen Ventilator devices are featured in the Innovation Room as part of the Global Health Experience.