Kirk Tickell
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Judd Walson, Vice Chair of the Department of Global Health, is the principal investigator on a $3.5 million grant from the Bill and Melinda Gates Foundation. The grant, titled The CHAIN Consortium, will analyze samples collected from an observational study at nine sites in Africa and South Asia with the purpose of gaining a better understanding of risk factors to child mortality rates that could be targeted by interventions. 

The CHAIN (Childhood Acute Illness and Nutrition) Network features hospital sites worldwide, two coordination centers, and eight laboratories, with the Seattle location working in conjunction with the Department of Global Health and Kenya Medical Research Institute. Kirk Tickell, the network research fellow for CHAIN, received a Masters of Public Health at UW before joining CHAIN, and explained some of the public health implications of this grant, which is focused primarily on “wasted” children. The term wasted (also known as acute malnutrition), refers to children of a low weight-for-height ratio. 

“52 million children living in low and middle income countries become wasted each year. If these wasted children catch a common childhood illness, like diarrhea or a lower respiratory tract infection, they are very vulnerable to adverse outcomes during that illness episode,” Tickell explained. “Wasting is an underlying factor in approximately one-third of all child deaths caused by infectious diseases. The CHAIN Consortium grant is applying cutting edge laboratory techniques, coupled with biological system modeling, to understand why these children suffer such high mortality rates and to design novel interventions to prevent these deaths.”

Other DGH faculty members, including Walson, Alyson Shumays, and Jodi Greathouse, are included in the project as well. The project’s ultimate goal is to improve evidence for the care of ill, undernourished children to improve survival outcomes and healthy growth and development. 

“We have collected blood and stool samples from over 4,000 children with and without wasting in six different countries. Now, we are sending them to top laboratories across the world to perform broad scope cutting edge tests to understand why these children suffer such high mortality,” Tickell said. “For example, one laboratory is running a proteomics panel that will measure the quantity of over 5,000 proteins in the blood, giving us a detailed look at everything from the child’s immune system to their nutritional health. After understanding why they die, we will design new interventions that we hope will save child lives.” 

In addition to identifying subgroups of children likely to benefit from specific interventional approaches, CHAIN is also planning a Nested Case Cohort analysis to compare children who die to those who do not. The ability to study, examine, and prevent childhood deaths is what led to CHAIN’s creation in the first place. 

“We observed that children with wasting make up a huge proportion of the children who die, and while the prognosis for many childhood illnesses had really improved in the last 20 years, these children were not doing any better,” Tickell said. “That, and a lack of recent innovation, drove us all to form the CHAIN Network.” 

To learn more about the CHAIN Network, click here