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Pathogens and Childhood Undernutrition: Physiologic Mechanisms Mediating Stunting and Wasting

Award Number: K01AI202988
ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2031

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Pathogens and Childhood Undernutrition: Physiologic Mechanisms Mediating Stunting and Wasting - PROJECT SUMMARY/ABSTRACT The overall goals of this proposal are to advance our understanding of the physiological mechanisms by which infections contribute to stunting and wasting in young children and to advance the career development of the candidate. In low- and middle-income countries (LMICs), the overlapping burdens of infection and undernutrition have significant health consequences for infants and children, including stunting and wasting. Stunting affects a third of children living in LMICs and can lead to life-long impacts on educational outcomes, economic productivity, and birth outcomes for women. Child wasting is the life-threatening result of poor nutrient intake and/or recurrent illnesses and is associated with weakened immunity, long-term developmental delays, and an increased risk of death. In children, schistosomiasis is known to cause undernutrition, however, the physiological mechanisms are not well understood. Understanding the mechanistic role of intestinal schistosomiasis in the pathogenesis of undernutrition will offer opportunities for early intervention to reduce these infection-related morbidities in young children. The proposed research will leverage the well- characterized samples and clinical data from a completed NIH-funded randomized, controlled phase II trial (R01 HD095562) of praziquantel (PZQ) treatment in N=354 children under age four with Schistosoma mansoni infection in the Lake Albert region of Uganda. The parent trial hypothesized that key morbidities related to schistosomiasis (undernutrition, anemia of inflammation, and linear growth stunting) are in part driven by environmental enteric dysfunction (EED) with consequent malabsorption and systemic immune activation. In this cohort, 19% of participants were stunted at baseline and preliminary findings reveal an indirect association between higher parasite burden, increased systemic inflammation, and an increased risk for stunting. The proposed research will add measurements of malaria, enteric infections, and endocrine growth hormones in samples collected from the parent trial to examine mechanisms through which infection, EED, and inflammation disrupt endocrine function and impair growth. The proposed research aims to 1) Elucidate the mechanistic pathways by which schistosomiasis and other co-infections contribute to stunting and wasting in young children using baseline data and samples collected from the parent trial and 2) Determine how PZQ treatment for schistosomiasis and natural reinfection impact child growth trajectories over 12 months using longitudinal data and samples from the same cohort. This work will address innovative hypotheses regarding the mechanistic role of intestinal schistosomiasis in the pathophysiology of stunting and wasting in children and offer opportunities for early intervention for children living in regions with overlapping burdens of infection and undernutrition. The career development goals of this proposal are to gain expertise in the physiology of impaired child growth specific to infection, expand on laboratory techniques and statistical methodology, and strengthen scientific career skills specific to communication, mentoring, and clinical research design.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $195,475 )
2026	2026	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Allergy and Infectious Diseases Research	000	1	8/24/2026	NEW	$195,475
														Subtotal = $195,475

Grand Total All Awards = $195,475

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Pathogens and Childhood Undernutrition: Physiologic Mechanisms Mediating Stunting and Wasting

Award Number: K01AI202988

ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2031

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