Africa Initiative awards pilot grants

In its second cycle, The Africa Initiative Pilot Grant Program, in partnership with the McDonnell International Scholars Academy and the Institute for Public Health, has awarded grants of up to $10,000 each to eight research projects. These grants will help WashU faculty initiate new collaborations with scholars at institutional partners in Africa.

The level of interest in the Pilot Grant Program this year was very high. Faculty from five WashU schools and 24 different departments applied for funding to conduct research in nine countries across the African continent. The eight funded projects will engage collaborators in five countries: Cameroon, Ghana, Nigeria, South Africa and Uganda.

View the Seed Grant Recipients below.

WashU PI	WashU Department/School	Partner Institution
Dennis Barbour	Biomedical Engineering, McKelvey School of Engineering	University of Pretoria, South Africa

Smart, Community-Based Audiometry for African Townships

Project Abstract: Many Africans live long distances from healthcare providers but do have access to wireless internet near their homes. Using real-time communication and cloud servers running advanced machine learning algorithms, we propose to evaluate the usability, speed and effectiveness of a sophisticated smartphone-based hearing screen in community populations in South African townships. This method should use extremely low bandwidths compatible with 2G cellular networks. The proposed technology will collect the minimal data necessary to arrive at an informed clinical referral or treatment plan. Anticipated efficiency gains over conventional procedures and successful mobile implementation will enable expanded community-based hearing healthcare for underserved populations in Africa.

WashU PI	WashU Department/School	Partner Institution
Cindy Brantmeier	Applied Linguistics, International and Area Studies, Arts & Sciences	University of Ghana, Ghana

Health Literacy, Linguistic Diversity and COVID-19 in Ghana

Project Abstract: Extreme social change brings great linguistic change. Global discourse is dominated by specialized terms for Covid-19 from the fields of medicine and epidemiology that are transmitted through government briefings, tele conferences and more. Long before the current pandemic, functional health literacy was an ongoing challenge for linguistically diverse patients who do not use the language of health care professionals. The present study will partner with scholars and professionals across disciplines inSt. Louis and Ghana to examine the design and implementation of Covid-19 information in the services used to manage language minority patients. Data will be collected from 250 health care providers, in regular hospitals and Covid-19 treatment centers in Ghana, and will explore communication and language use in the infection control procedures with the diverse cultures, languages and communication needs of Ghana. Findings will provide valuable insights and lessons for linguistically rich populations across the globe.

WashU PI	WashU Department/School	Partner Institution
Philip Budge	Infectious Diseases Division, School of Medicine	University of Yaoundé 1, Cameroon

Phenotypic diversity of serologic responses to Onchocerca volvulus in Cameroon

Project Abstract: Onchocerciasis (river blindness) remains endemic in Africa, including in many parts of Cameroon, despite decades of elimination efforts. This has led to conjecture that Onchocerca volvulus (Ov, the causative parasite) strains may differ in areas where elimination efforts have been unsuccessful. Genotyping of Ov isolates is impractical because this requires surgical removal of Onchocerca nodules from affected individuals. Recently, Norice-Tra et al. have proposed that multi-locus immunophenotyping (MI), a method to assess quantitative differences in serologic response to multiple antigenic Ov proteins may serve as an alternate method of distinguishing differences between O. volvulus isolates. We wish to test the hypothesis that MI will reveal characteristic differences among sera collected from onchocerciasis patients from different endemic areas in Cameroon.

WashU PI	WashU Department/School	Partner Institution
Christine Ekenga	Brown School	Nigerian Institute of Medical Research, Nigeria

Environment and Health in Nigeria:
Addressing Emerging Challenges though Research and Capacity Development

Project Abstract: In Africa, population growth, urbanization, and climate change are environmental health challenges of emerging concern.There are few locales in Africa where these emerging environmental health challenges are more apparent than in Lagos, Nigeria, Africa’s most populous city. Lagos’ coastal location makes it vulnerable to climate change-related weather extremes that may influence the health of its residents. However, there is a paucity of data on health impacts because of critical gaps in research capacity.The goal of this project is to promote collaborative research and capacity development in environmental epidemiology in Nigeria. Grant funding will be used to collect data on the physical and mental health impacts of weather extremes among residents of Lagos, Nigeria. We also propose to develop and evaluate an environmental epidemiology short course for Nigerian researchers.This project will improve public health by advancing knowledge about the nature and magnitude of environmental health hazards in Nigeria.

WashU PI	WashU Department/School	Partner Institution
James Gibson	Government, Arts & Sciences	Stellenbosch University, South Africa

The Normalization of Gender-Based Violence: A Survey Experiment Testing Hypotheses About the Context in Which Violence Becomes Acceptable in Rural South Africa

Project Abstract: As recognized by the United Nations and other agencies, gender-based violence is an affliction that threatens women throughout the world. While many explanations exist of why gender-based violence takes place, such violence is often abetted when it becomes normalized: when the norms of a community, embedded in widely shared patriarchal values, either explicitly or implicitly justify violence. While few openly endorse violence against women as a general norm, we hypothesize that many recognize contextual “exceptions” that justify violence. We address several contextual hypotheses using an experimental vignette, administered to a representative sample of the residents of the North West Province in South Africa, a rural and fairly traditional province. This pilot project will provide the basis for a larger grant proposal in which the hypotheses will be tested in both rural and urban communities, possibly enticing a multi-national survey project (such as the Afrobarometer) to administer our vignette more widely.

WashU PI	WashU Department/School	Partner Institution
Krista Milich & Penina Acayo Laker	Anthropology, Arts & Sciences; Sam Fox School	Makerere University, Uganda

Community-based participatory action research for human health and wildlife conservation in Uganda

Project Abstract: Human-wildlife conflict results in negative consequences for both human communities and wildlife conservation and is a common source of zoonotic disease transmission. An interdisciplinary, collaborative approach to addressing these conflicts is critical for developing an equitable and sustainable solution.Here, we propose a community-based participatory design research project to improve perceptions of wildlife, reduce human-wildlife interactions, and decrease the potential for zoonotic disease transmission around a protected area in Uganda.We will work with six communities that border Kibale National Park, Uganda, to engage in hands-on group design activities to craft messages and symbols to reinforce positive human-wildlife interactions.To assess the effectiveness of our work, we will conduct surveys before, during, and after the community activities.Our approach will not only build a collaboration between WUSTL and Ugandan scholars, but also between researchers and community members and will aim to truly develop a lasting partnership for future research.

WashU PI	WashU Department/School	Partner Institution
Brad Racette, Darrell Hudson & Susan Searles Nielsen	Neurology, School of Medicine; Social Work, Brown School	University of the Witwatersrand School of Public Health, South Africa

Social Determinants of Parkinsonism in Rural South Africa

Project Abstract: We will leverage the NIH-funded, population-based study, “Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community (HAALSI),” to investigate parkinsonism, the motor abnormalities found in Parkinson Disease (PD) and with aging. This cohort derives from ‘Agincourt,’ a well-established health and socio-demographic surveillance system established in 1992 in 31 villages in rural South Africa. Agincourt is one of the largest population-based cohorts of those of African ancestry in the world. HAALSI is a nested cohort of 5,059 participants age ≥40, ideally suited to investigate neurodegenerative diseases. One aim of HAALSI is to investigate Alzheimer disease/dementia, but parkinsonism and PD are beyond the scope of the funded study aims. With the ultimate goal of conducting studies focused on parkinsonism and PD, we propose here to obtain pilot data and demonstrate feasibility, including for associations with social determinants of health in 100 randomly-selected members of HAALSI.

WashU PI	WashU Department/School	Partner Institution
Lee Ratner	Department of Medicine and Molecular Microbiology, Siteman Cancer Center, School of Medicine	University of Ghana Medical Center, Ghana

Prevalence of AIDS-associated malignancies among HIV-infected patients in Ghana

Project Abstract: Due to their depressed immune system, people living with HIV (PLWH) are more prone to develop cancers such as Kaposi Sarcoma, lymphomas, cervical and lung cancer. Care for HIV cancer patients is challenging and even more daunting in Africa where there is often lack of research and treatment protocols. The NIH-sponsored AIDS Malignancy Consortium (AMC) seeks to bridge this gap by conducting clinical trials at sites in the USA and Africa. WU is an AMC site which seeks to partner with Ghana to obtain a site at the University of Ghana Medical School. The aim of this study is to determine the baseline prevalence, treatment protocols and risk factors for AIDS associated malignancies in Ghana. Data obtained will help improve care in Ghana and provide much needed preliminary data for an AMC and other large grant collaborative applications.