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Principal Investigator: Ellen Christina Caniglia
Organization: UNIVERSITY OF PENNSYLVANIA
Fiscal Year: 2024
Award: $132,705
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
PROJECT SUMMARY
Background. The risk of stillbirth, preterm delivery, low birthweight and other adverse pregnancy outcomes is
extremely high in Sub-Saharan African countries including Botswana, especially among HIV-positive women.
Daily iron and folic acid supplementation during pregnancy could reduce adverse pregnancy outcomes by
reducing maternal anemia. However, the effectiveness of supplementation in subgroups defined by HIV status,
anemia, gestational age, and other clinical, demographic and geographic factors remains unknown and
compliance with supplementation guidelines is variable (<50% in Botswana). Cost-effective interventions to
provide supplementation to pregnant women in Botswana and other resource-limited settings should be
designed to address key barriers to successful supplementation and to reach subgroups that would benefit
most from intervention. This K01 provides a unique opportunity to address this gap in the literature.
Candidate Overview. My long-term career objective is to become an independent investigator who specializes
in interventions to improve maternal and child health in resource-limited settings. My background is in
applications of epidemiologic methods to evaluate effects of HIV treatment strategies in adults and infants. A
K01 award will provide the necessary additional training and experience needed to become an expert in the
design, implementation, and evaluation of interventions to improve pregnancy outcomes in HIV-positive
women and underserved populations.
Career Development and Training Plan. My education program includes structured course work,
professional conferences, directed readings, and a research project with specific aims timed to coincide with
these activities. My mentorship team includes international experts who specialize in areas related to my
training goals: Dr. Scott Braithwaite (decision science), Dr. Roger Shapiro (HIV and maternal and child health
in Botswana), Dr. Donna Shelley (intervention development and implementation), and Dr. Carolyn Berry
(qualitative methods).
Environment. NYU School of Medicine provides an exceptional environment for me to conduct the proposed
study, obtain additional training and mentorship, and successfully transition to an independent investigator.
Research Strategy. Using the data and infrastructure from an ongoing birth outcomes surveillance study in
Botswana consisting of data from over 130,000 births, my study will: 1) estimate the effect of iron and folic acid
supplementation during pregnancy on adverse pregnancy outcomes by HIV status, anemia, gestational age,
and other key subgroups to identify populations that would benefit most from intervention; 2) assess barriers to
supplementation during and prior to pregnancy; 3) optimize a hypothetical intervention to provide
supplementation using computer simulation; and 4) develop and test the feasibility of an intervention to provide
supplementation to pregnant women in Botswana.
Terms: <0-11 years old><0-4 weeks old><1st trimester><21+ years old><AIDS Virus><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Address><Adherence><Adult><Adult Human><Affect><African><Anemia><Anti-HIV Positivity><Area><Bechuanaland><Berry><Birth><Botswana><Cause of Death><Child><Child Youth><Children (0-21)><Chronologic Fetal Maturity><Clinic><Clinical><Communicable Diseases><Communities><Computer Simulation><Computer based Simulation><Conceptions><Country><Data><Demographic Factors><Development and Research><Drugs><Early Placental Phase><Economic Income><Economical Income><Education><Educational aspects><Effectiveness><Environment><Epidemiologic Methods><Epidemiological Methods><Epidemiological Techniques><Evaluation><Fe deficiency><Fe element><Fetal Age><First Pregnancy Trimester><First Trimester><Folate><Folate fortification><Folic Acid><Folic acid fortification><Formulation><Fortification><Geographic Area><Geographic Factor><Geographic Locations><Geographic Region><Geographical Location><Gestation><Gestational Age><Goals><Guidelines><HIV><HIV Positive><HIV Positivity><HIV Seroconversion><HIV Seronegativities><HIV Seronegativity><HIV Seropositivity><HIV antibody positive><HIV negative><HTLV-III Seroconversion><HTLV-III Seronegativities><HTLV-III Seronegativity><HTLV-III Seropositivity><Health Benefit><Health system><Human Immunodeficiency Viruses><Income><Individual><Infant><Infectious Disease Pathway><Infectious Diseases><Infectious Disorder><Infrastructure><International><Intervention><Intervention Strategies><Intervention Studies><Interview><Investigators><Iron><K01 Award><K01 Mechanism><K01 Program><Knowledge><LAV-HTLV-III><LMIC><Link><Literature><Low Birth Weight Infant><Low-resource area><Low-resource community><Low-resource environment><Low-resource region><Low-resource setting><Lymphadenopathy-Associated Virus><Malaria><Malnutrition><Maternal and Child Health><Measures><Medication><Mentored Research Scientist Development Award><Mentored Training Award><Mentors><Mentorship><Methods><Methods Epidemiology><Micronutrients><Modification><Neural Tube Defects><Neural Tube Developmental Defects><Newborn Infant><Newborns><Nutritional Deficiency><Outcome><Paludism><Parturition><Pharmaceutical Preparations><Plasmodium Infections><Policies><Population><Predisposition><Pregnancy><Pregnancy Outcome><Pregnant Women><Premature Birth><Prematurely delivering><Preterm Birth><Proxy><Pteroylglutamic Acid><Qualitative Evaluations><Qualitative Methods><Qualitative Research><R & D><R&D><R-Series Research Projects><R01 Mechanism><R01 Program><Recommendation><Research><Research Grants><Research Personnel><Research Project Grants><Research Projects><Research Resources><Research Scientist Development Award><Researchers><Resource-constrained area><Resource-constrained community><Resource-constrained environment><Resource-constrained region><Resource-constrained setting><Resource-limited area><Resource-limited community><Resource-limited environment><Resource-limited region><Resource-limited setting><Resource-poor area><Resource-poor community><Resource-poor environment><Resource-poor region><Resource-poor setting><Resources><Risk><Risk Factors><Sampling><Science><Sepsis><Small for Gestational Age Infant><Structure><Subgroup><Supplementation><Susceptibility><Time><Training><Undernutrition><Underserved Population><Underweight><United Nations><Virus-HIV><Vitamin M><Woman><Work><World Health Organization><adulthood><adverse pregnancy outcome><antenatal><antenatal care><antepartum><blood infection><bloodstream infection><career><career development><compare effectiveness><computational simulation><computerized simulation><conference><convention><cost effective intervention><design><designing><develop therapy><dietary deficiency><drug/agent><expectant mother><expecting mother><experience><feasibility testing><folate supplementation><folic acid supplement><folic acid supplementation><geographic site><high risk><high risk group><high risk individual><high risk people><high risk population><improved><incomes><intervention development><intervention research><interventional research><interventional strategy><interventional study><interventions research><iron deficiency><kids><low and middle-income countries><low birth weight><low birthweight><malnourished><maternal weight><medical college><medical schools><newborn child><newborn children><nutrition deficiency><nutrition deficiency disorder><nutritional deficiency disorder><pregnant mothers><premature childbirth><premature delivery><prenatal><preterm delivery><prevent><preventing><programs><qualitative reasoning><research and development><school of medicine><side effect><small for gestational age><stillbirth><stillborn><summit><supplementation with folate><supplementation with folic acid><supply chain><surveillance data><surveillance study><symposia><symposium><therapy development><treatment development><treatment strategy><unborn><under served group><under served individual><under served people><under served population><underserved group><underserved individual><underserved people><uptake><vitamin Bc><youngster>