Marcella Alsan, MD, PhD, knows that the division of labor among men and women starts at a young age in the developing world.
“Anecdotally, girls must sacrifice their education to help out with domestic tasks, including taking care of children, a job that becomes more onerous if their younger siblings are ill,” Alsan, a core faculty member at the Center for Health Policy/Center for Primary Care and Outcomes Research (CHP/PCOR) within the Freeman Spogli Institute of International Studies, recently told me.
More than 100 million girls worldwide fail to complete secondary school, despite research that shows a mother’s literacy is the most robust predictor of child survival. So Alsan is analyzing whether medical interventions in children under 5 tend to lead their older sisters back to school. She’ll compile data from more than 100 Demographic and Health Surveys covering nearly 4 million children living in low- and middle-income countries. The surveys ask about episodes of diarrhea, pneumonia and fever in children under 5 and record data on literacy and school enrollment for every child in the household.
“My proposed work lays the foundation for a more comprehensive understanding of how illness in households and early child health interventions impact a critical determinant of human development: an older girl’s education,” Alsan, the only infectious-disease trained economist in the United States, said.
Alsan is one of two winners of this year’s Rosenkranz Prize for Health Care Research in Developing Countries, awarded by CHP/PCOR. Her Department of Medicine colleague, Jason Andrews, MD, is the other recipient of the $100,000 prize, which is given to young Stanford researchers to investigate ways to improve access to health care in developing countries.
In the current scientific climate, most National Institutes of Health grants go to established researchers. The Rosenkranz Prize aims to stimulate the work of Stanford’s bright young stars – researchers who have the desire to improve health care in the developing world, but lack the resources.
While Alsan is researching how older girls in poorer countries are impacted by the health of their younger siblings, Andrews is focusing his attention on cheap, effective diagnostic tools for infectious diseases.
“I began working in rural Nepal as an undergraduate student and as a medical student founded a nonprofit organization that provides free medical services in one of the most remote and impoverished parts of the country,” Andrews said. “As I became a primary physician, and then an infectious diseases specialist, one of the consistent and critical challenges I encountered in this setting was routine diagnosis of infectious disease.”
He said those routine diagnostics were typically hindered by lack of electricity, limited laboratory infrastructure and lack of trained lab personnel. So he has been collaborating with engineers to develop an electricity-free, culture-based incubation and identification system for typhoid; low-cost portable microscopes to detect parasitic worm infections; and most recently an easy-to-use molecular diagnostic tool that does not require electricity.
“The motivation for these projects was not to develop fundamentally new diagnostic approaches, but rather to find simple, low-cost means to make established laboratory techniques affordable and accessible,” he told me.
The Rosenkranz Prize will allow him to continue to develop a simple, rapid, molecular diagnostic for cholera that is 10 times more sensitive than the tests that are currently available. The diagnostic tool uses paper for DNA extraction, in contrast to traditional approaches that rely on expensive instruments requiring electricity and maintenance.
Andrews will enroll 250 patients with suspected cases of cholera in Nepal, using the new diagnostic tools and adapting as many local supplies as possible.
Beth Duff-Brown is communications manager for the Center for Health Policy and Center for Primary and Outcomes Research. A modified version of this piece originally appeared on the centers’ website.
Previously: Reporting and treating cholera: Soon, there could be an app for that
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