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Bangladesh

Site Institution: iccddr,b (formerly International Centre of Diarrhoeal Diseases, Bangladesh)
Research Areas: Planetary Health, Child Health, Maternal and Childhood Malnutrition, Enteric and Respiratory Infections, Transmission Dynamics of Multi-Drug Resistant E. Coli, Emerging and Reemerging infections, Noncommunicable Diseases, Health consequences of climate change

Site Description:

Dedicated to saving lives, icddr,b is a leading international health research organization located in Dhaka, Bangladesh. Through translation of research into treatment, training and policy advocacy, this organization addresses some of the most critical health concerns facing the world today. Research programs include nutrition, child health, reproductive health, chronic diseases, infectious diseases, vaccine sciences, health systems, HIV/AIDS and climate change. Alongside its extensive research agenda, icddr,b provides humanitarian services to some of Bangladesh’s most vulnerable people-160,000 of whom visit its clinical facilities every year. Drawing on over 40 years of experience, icddr,b’s hospitals and clinics have also become an invaluable training ground, not only for the routine treatment of diarrheal diseases, such as cholera, but also for its epidemic response teams, who use their expertise in the field, both in Bangladesh and abroad.

The urban Dhaka and rural Matlab Hospitals at icddr,b provide the clinical services to complement the development of lifesaving solutions. Dhaka Hospital was set up in 1962 and quickly became a refuge for the neediest in Bangladesh, offering treatment that would otherwise be beyond their means. The hospital currently treats around 140,000 patients in a year and maintains extremely low mortality rates and a very low average treatment cost per patient- around 40,000 of them would have died if not efficiently treated. In addition to treating those immediately in need of care, the hospital provides the research opportunities and information scientists need to battle enteric diseases on a larger scale. The most common diseases among the admitted patients are pneumonia, severe pneumonia, typhoid fever, persistent diarrhea, meningitis, hyperthermia, febrile convulsions, severe protein energy malnutrition, electrolyte imbalance, sepsis and hypoglycemia. About 5-6% of the patients admitted to the General Ward become critical during their treatment and those are referred to Special Care Unit for more intensive treatment and observation. The Special Care Unit provides specialized personnel and resources for the care of the critically ill infants, children and adults. The Special Care Unit combines the Special Care Ward and the recently established Isolation Room with negative-pressure system. On average, 1,600 patients are provided care in the Special Care Unit every year, and 81% of them are children under the age of 5 years.

The Matlab Hospital houses the Health and Demographic Surveillence System, which is one of the most comprehensive longitudinal data resources in a low/middle-income country, producing continuous demographic and health data information on a population of over 200,000 people since 1945. Matlab is the major rural field site, and a major public health resource for the world. The surveillance system's key role is to monitor population exposure accurately over time to derive health and demographic rates and ratios and assess impacts of health and social interventions.

Mentors

  • U.S. Mentor

    Senior Fellow - Stanford Woods Institute for the Environment; Sr. Fellow, Freeman Spogli Inst. for International Studies; Research Deputy Director for the Stanford University Center for Innovation in Global Health; Prof. of Medicine, Infectious Diseases

GHES Alumni

  • Dr. Amin spent fellowship year at the International Centre for Diarrheal Disease Research, Bangladesh (TCDDR,B) under the mentorship of Lee Riley, MD and Dinesh Mondal, MD. His research focused on community associated methicillin resistant Staphylococcus aureus isolated from clinical specimens of patients attending icddr,b diagnostic areas. Dr. Amin completed his PhD in Biochemistry from Hamamatsu University School of Medicine, Japan. His graduation and MS were from the department of Biochemistry and Molecular Biology, University of Dhaka, Bangladesh. Tn his professional career, Dr. Amin received a young researcher grant from the Swedish International Development Cooperation Agency (STDA) in 2019-2020. Currently, he, as a PT, is conducting a research project entitled "identifying fecal pathogens in aquaculture value chains and evaluation of various risk reduction strategies" funded by Feed the Future Innovation Lab for Fish, USATD. His overall research goal is to find solutions to public health problems in developing countries through research on food safety and transmission dynamics of antimicrobial resistance using One Health approach.
  • Fellowship Site: Iccrd,B, BangladeshUS Institution: UC BerkeleyProject Title: Contribution of gut microbiome and nutritional status in clinical outcome of intravenous immunoglobulin (IVIg)-treated patients with Guillain-Barré syndrome in BangladeshGuillain-Barré syndrome (GBS) is a post-infectious, immune-mediated neurological disease. Currently, intravenous immunoglobulin (IVIg) is one of the standard treatments for GBS patients; but, one-third of GBS patients did not response with IVIg treatment. Therefore, it is utmost importance to find a biomarker of treatment response that, preferably, can be determined within the first 2 weeks after the disease onset to enable a personalized medicine approach. The gut microbial diversity and gut microbiome specially the V4 region of the 16S rRNA gene may give us a new insight in searching “hidden” dysbiosis in IVIg-responder or non-responder GBS patients with respect to healthy controls. In addition, poverty and poor nutritional status may also have influence on gut microbiome community and subsequent treatment with IVIg in patients with GBS. We will investigate the relationship between IVIg responsiveness in association with variation in gut microbiome and host nutrition in GBS that would possibly provide new information regarding effectiveness of IVIg and could lead to develop new preventative methods employing bacteria as therapeutic probiotics. Blood and fecal samples along with the clinical, demographic, anthropometric data will be collected from 25 patients with IVIg-treated GBS patients and 25 age/sex matched healthy controls from Bangladesh for microbiome study and nutritional status analysis. DNA will be extracted from all fecal samples and V4 region will be amplified by polymerase chain reactions using universal primers. The V4 region of 16S rRNA gene will be sequenced using Illumina MiSeq and sequences will be analyzed using QIIME2-DADA2 pipeline. Data comparisons, alignment, assembling, phylogenetic trees, diversity check will be done using web resources through bioinformatics tools. Data will be analyzed through unpaired t-test, one way ANOVA test and logistic regression analysis. Written informed consent from all participants and approval of the study will be obtained from Institutional Review Board (IRB) of icddr,b. Bangladesh. Data obtained from this prospective case-control study will be helpful to determine the possible roles of gut microbiome and nutritional factors in IVIg-responsiveness and to select future personalized strategies of healthcare for poor patient who will unable to bear the high expense treatment of IVIg
  • Mr. LeBoa will spend his fellowship year at the International Centre for Diarrhoeal Disease Research (iccdr,b) in Bangladesh under the mentorship of Nadia Rimi, MS, Layla Kwong, PhD, and Jay Graham, PhD, MBA, MPH. His research will focus on preventing airborne spillover of highly pathogenic avian influenza in Bangladeshi live poultry markets. Mr. LeBoa is a PhD student at the University of California, Berkeley. He hopes to work between government and non-government actors globally to implement interventions meant to reduce infectious disease spillover, especially in areas of migration and displacement. He believes that the way work happens and the relationships between people are as important as the goals of the research itself. He is influenced by scholars like Sibyl Diver and Emily Polk in their work organizing multidisciplinary teams. He will walk in the footsteps of Drs. Steve Luby and Jason Andrews who work between government and academics fluidly.
  • Dr. Sultana will spend her fellowship year at the International Centre for Diarrhoeal Disease Research (icddr,b) in Bangladesh under the mentorship of Dr. Firdausi Qadri, PhD and Dr. Layla Kwong, MS, PhD. Her research will focus on assessing the willingness-to-pay of consumers of poultry in the live bird markets of Dhaka city to understand the determinants for improved poultry-handling practices to advance biosecurity. Dr. Sultana is an Associate Scientist at icddr,b. She is a Cultural Epidemiologist with 22 years of experience in social and public health research and development, training and program implementation on emerging and re-emerging infectious diseases (e.g., Nipah, avian influenza, Japanese encephalitis, COVID-19), water and sanitation (e.g., hepatitis-E, diarrheal diseases), maternal and child health, and gender and development in Bangladesh. In addition, she has 17 years of extensive experience in public health research that includes anthropological research, quantitative survey administration, program monitoring and evaluation, policy focused research, economic burden studies, implementation of community-based preventive interventions, and outbreak investigation of diseases. She aims to continue her career as a public health researcher with a particular focus on infectious and emerging infectious diseases.