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January 16, 2011

School of Medicine researchers to lead worldwide study on links between malnutrition, intestinal infection and child development

Researchers at the University of Virginia School of Medicine will lead the largest-ever worldwide effort to investigate how malnutrition and intestinal infections lead to serious lifelong physical and mental problems in children living in developing countries. The five-year study is funded by a $30 million grant from the Bill & Melinda Gates Foundation made to the Foundation for the National Institutes of Health (FNIH).

Nearly one-third of all children in developing countries and more than one billion people worldwide suffer from malnutrition – a condition that has a severe and far-reaching impact on the global population.

“Malnutrition is a devastating condition which can ravage the human body. While it can be harmful to adults, children who are malnourished face a lifetime of challenges as they do not reach their full physical and mental potential,” says Richard L. Guerrant, MD, director of the University of Virginia’s Center for Global Health and lead researcher for the study.

Tachi Yamada, president of global health for the Bill & Melinda Gates Foundation, adds, “Understanding the complex relationships between malnutrition and intestinal infections is critical in order to improve children’s health. We hope this research network will make discoveries that will in turn help us save the lives of those most at risk.”

The FNIH, together with the Fogarty International Center (FIC) are coordinating the research effort, called the Global Network for Malnutrition and Enteric Disease Research (“Mal-ED” Network). Research will be conducted in collaboration with a number of partners, including universities in the United States and institutions in the developing world.  UVA is leading the efforts in Brazil, South Africa, Bangladesh and Tanzania.

In addition, UVA and Washington University in St. Louis, Mo., will study the genetic heterogeneity of human populations involved in the network, allowing collaborating investigators to study the host factors responsible for differential susceptibility to infectious pathogens and malnutrition.

“We don’t sufficiently understand the causes of malnutrition. It’s not solely the access to food, because there are many children who have enough to eat but are malnourished,” says William A. Petri, Jr., MD, PhD, chief of the Division of Infectious Diseases and International Health at the University of Virginia School of Medicine. “The ability of a person’s gut to absorb nutrients is influenced by the complex interaction among a person’s genetic makeup, the natural microbes in a person’s gut and their resistance to infections. This grant will allow us to explore this interaction on all levels.”

Petri has received a separate $6.8 million award from the Gates Foundation to chair the Malnutrition Biomarkers Discovery section of the Mal-ED Network. Stephen S. Rich, PhD, chair of the Center for Public Health Genomics at the UVA School of Medicine, will help lead UVA’s work in genetics, and Eric Houpt, MD, will develop molecular diagnostic tests for infections linked to malnutrition.

“We know that some people are better protected from malnutrition based on their genetic makeup. We want to identify which genes provide this protection,” explains Rich.

Poor nutrition in early childhood may lead to cognitive defects and poor physical development, increase susceptibility to and severity of infections, and diminish the effectiveness of childhood vaccines. Meanwhile, infections causing diarrhea can damage the intestines, impair nutrient absorption and impact the immune system.  Despite recent advances in treatment of diarrheal disease that have dramatically decreased deaths, the vicious cycle of diarrheal diseases and malnutrition negatively impacts the long-term health and development of tens of millions of children living in resource-poor areas of the world.

“With the establishment of this remarkable partnership, we hope to shed light on critical questions such as which organisms or infections disrupt growth and development, as well as identify the time in early life when those factors have the greatest impact on morbidity and mortality,” said Charles A. Sanders, MD, FNIH chairman.

The network will be coordinated by Co-Principal Investigators Michael Gottlieb, PhD, of FNIH, and Mark Miller, MD, of FIC.

“The interactions between diarrheal diseases and malnutrition produce a vicious cycle that has devastating developmental consequences for the world’s poorest children,” said FIC Director Roger I. Glass, MD, PhD.  “We have much to learn about this relationship and expect that the robust and expanding network that we are establishing will provide us with a wealth of useful information.”

The network’s main objectives are to create a standardized and harmonized set of epidemiological tools to accurately study the links between intestinal infections and gut physiology as risk factors for malnutrition across a number of diverse sites in the developing world. By mapping and modeling the data obtained from these and other studies, the network also will be able to quantify the global burden of disease and evaluate effective interventions in an effort to promote the health and well-being of children around the world.

For more information about the program, visit


Richard Guerrant, MD

Dr. Guerrant, the Thomas H. Hunter Professor of International Medicine at the UVA School of Medicine, is an internationally-recognized expert on enteric infections. He is the most recent recipient of the Walter Reed Medal from the American Society of Tropical Medicine and Hygiene (ASTMH).

William Petri, MD, PhD

Dr. Petri, the Wade Hampton Frost Professor of Epidemiology, is the chief of Infectious Diseases and International Health at the UVA School of Medicine. He is a worldwide leader in the study of Amebiasis.

The Foundation for the National Institutes of Health

The Foundation for the National Institutes of Health was established by the United States Congress to support the mission of the National Institutes of Health (NIH): improving health through scientific discovery. The foundation is transforming the way biomedical research is initiated, supported and conducted, and blazing the trail for a new era of discovery through innovative public-private collaborations. The foundation provides expertise, experience and an integrated infrastructure for creating new biomedical research and training initiatives across multiple disciplines in support of the mission and causes of NIH. It brings together industry, academia and the philanthropic community to collaborate, leverage resources and create unique opportunities to accelerate the pace of scientific discovery and biomedical research that may translate into successful healthcare solutions.

The Foundation for NIH is a nonprofit, 501(c) (3), corporation that actively seeks funding partners for a broad portfolio of groundbreaking programs and projects in support of biomedical research.

Fogarty International Center

Fogarty, the international component of the NIH, addresses global health challenges through innovative and collaborative research and training programs and supports and advances the NIH mission through international partnerships. For more information, visit: .

The National Institutes of Health

The National Institutes of Health (NIH) – The Nation’s Medical Research Agency – includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit .

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