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A global impact: University physician-researchers' work is making a difference far beyond Minnesota's borders

Chandy John, M.D., M.S., shows a medical officer in Uganda how to look for changes in the retina caused by malaria. There are places in the world where nearly seven in 100 newborns do not live more than a month, where a vast majority of births take place without skilled birth attendants, and where one in five children never lives to see his or her fifth birthday.

These stark realities fuel the drive of physicianscientists in the Department of Pediatrics at the University of Minnesota Medical School.

“When you actually visit these countries and see firsthand the tremendous health issues children face, it’s life-changing,” says Chandy John, M.D., M.S., director of the department’s Division of Global Pediatrics. “You can’t do this kind of work and not be moved by it.”

Understanding malaria

Working with colleagues in Uganda and Kenya, John and his team have made the University an international leader in the study of malaria, a disease that accounts for approximately one in five of all childhood deaths in Africa.

“We’re seeking to find answers to basic questions—such as how malaria occurs and progresses, whether it can be prevented, and how it’s best treated,” says John.

In Kenya, his research is focused on understanding why malaria is more prevalent in the country’s highlands than in other regions.

“These areas don’t have year-round transmission where people are exposed to malaria every day, but they can have severe epidemics,” he says. “Determining why epidemics occur should provide more clues about what we can do to prevent them.”

In Uganda, John is studying cerebral malaria, an acute type of malaria that affects the brain. His studies have shown that one in four children with this type of malaria develops long-term cognitive impairment.

Exactly how this happens and what can be done to reverse or minimize the damage is an emerging area of study. If researchers can identify treatments that help protect children’s cognitive abilities, John says, they’ll have a better quality of life and a greater chance of reaching their full potential as contributing members of society.

Pediatrics resident Geoffrey Oburu, M.D., talks with a Ugandan teenager about managing her type 1 diabetes.

Making diabetes manageable

While the widespread impact of malaria in developing countries demands considerable resources, other diseases that are generally considered manageable in the United States contribute to the global children’s health crisis.

One such illness is type 1 diabetes. With the leadership and expertise of University pediatric endocrinologist Toni Moran, M.D., a long-term, collaborative relationship with Mulago Hospital in Kampala, Uganda, is addressing the need for better diagnosis and treatment of type 1 diabetes in children.

The actual incidence of diabetes in Uganda is likely five times higher than what is reported because children aren’t always brought to medical facilities, Moran says.

“The majority of children with diabetes are dying without being treated,” she says. “A modest amount of education can make a huge difference.”

At Mulago Hospital, University physicianresearchers are helping to create health care teams to treat chronic illnesses, train providers to become diabetes educators, establish pediatric insulin protocols, and develop basic medical record systems.

“Our work indicates that physicians from developing nations can make a difference in improving the care of chronic illness without an unrealistically large investment of time or money,” says Moran.

Surely that’s an investment worth making.

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