Chan Laboratory Research Overview

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Our collaborative team of scientists, epidemiologists, statisticians, clinicians, public health professionals, policymakers, and change makers are engaged in the following projects with the goal of advancing the health of mothers, newborns, and children.

Estimates of morbidity and mortality are limited in low- and lower-middle income countries (LLMICs) because of the gaps in available data sources and quality. An estimated 15 million preterm births occur each year ranging from 5% to 18% of live births with an increasing incidence in low- and middle-income countries. The risk of dying is ten times higher among preterm (i.e., less than 37 weeks gestation) newborns compared to term newborns.

Our team has collected routine health and demographic data, as well as longitudinal maternal and child health data on exposures and health outcomes throughout the BIRHAN field site in Ethiopia.

We have generated more accurate measures of morbidity and mortality in hard-to-reach low-resource areas and developed models of risk for key newborn outcomes, such as preterm birth, and antenatal care coverage. In this way, we can better target resources to higher risk populations. In addition, we are expanding in the field of data science, leveraging our wealth of data and technologies/advancement in machine learning, to develop models for additional key child health outcomes.

Neonatal infections account for nearly a quarter of the world’s 2.4 million annual neonatal deaths. A significant proportion of deaths, up to 42%, in the first week of life occur from infections, which presents a small window of opportunity for critical interventions. We have found that more than 90% of neonatal sepsis isolates were resistant to first-line antibiotics ampicillin and gentamicin. Our results have been incorporated into international guidelines for neonatal sepsis treatment and influenced local strategies to reduce antimicrobial resistance by focusing on infection prevention and antibiotic stewardship. We are studying how to prevent neonatal sepsis and reduce antimicrobial resistance through the development of maternal vaccinations.

A significant proportion of the 5 million under five deaths and 2.4 million neonatal deaths that occur each year could be prevented with known cost-effective interventions, particularly by increasing the survival of preterm newborns. Implementation of known cost-effective interventions has been limited in LLMICs where these interventions show promise to reduce neonatal and child mortality. We have scaled Kangaroo Mother Care, a cost-effective intervention that includes prolonged skin-to-skin contact and frequent or exclusive breastfeeding, that can reduce up to 40% of deaths among preterm and low birth weight newborns. These findings have influenced the global guidelines and national policies on the care of preterm and low birth weight infants. Building on work on neonatal sepsis, we are conducting the largest clinical trial on the efficacy of probiotics on neonatal mortality, growth, and serious bacterial infections in collaboration with WHO. We are also exploring interventions to mitigate the effects of climate change on child health.

View selected publications from the Chan Lab.