PAASIM Study
Evidence shows that repeated exposures to diarrheal pathogens change the microbiome of a person's gut. Water supply improvements limit exposure to pathogens via drinking water and improving water access for hand-washing and food hygiene. A five-year, $140 million World Bank-funded project is being implemented in Mozambique to improve piped water supply for over 800,000 people in urban areas.
Emory University and University of Washington and collaborators at the University of Nevada-Reno, Georgia Institute of Technology, University of North Carolina - Chapel Hill, the World Bank, and Mozambican water and health agencies are executing a four-year study to research the ways in which improvements to the water supply affect children's gut function and impact general pathogen infection. In the PAASIM study (Pesquisa Sobre o Acesso à Água e a Saúde Infantil em Moçambique - Research on Access to Water and Children's Health in Mozambique), we are testing if and how improvements in water supply in urban areas of Beira, Mozambique reduce or delay enteric pathogen infection, alter gut microbiome composition, and affect enteric dysfunction and other health outcomes in infants.
This study will evaluate the effects of community-level water system improvements on health outcomes in young children. We will test whether improvements in household piped water supplies are effective in controlling child:
Acute enteric pathogen infections and diarrhea – organisms that cause infection of the gut or intestinal track
Altered gut microbiome – distresses that can increase susceptibility to enteric infections
Enteric dysfunction – inflammation and reduced absorptive capacity and function in the small intestines
Chronic gut dysfunction – conditions preventing development of a healthy gut microbiome
Growth faltering – slower rate of weight gain that may result from undernutrition from gut dysfunction
With the collection of these data, we will examine how access to household connections and improved water network impacts the gut health of young children, by comparing households with and without improved water access. The results of the project will contribute novel findings to inform Mozambican and global policies on how to optimize water infrastructure investments to improve child health in low-income, urban settings.
Publications:
In the press:
Timeline
2019-2023
Study Location
Beira, Mozambique
Study timeline
2019-2023
Target Population
Mothers and their children in low income neighborhoods
Principal Investigators
Emory University: Matthew Freeman
University of Washington: Karen Levy
National Health Institute (INS), Ministry of Health, Mozambique: Rassul Nala
Funders
National Institutes of Allergy and Infectious Diseases (NIAID)
IMPLEMENTING partners
National Health Institute (INS), Ministry of Health, Mozambique: Jose Paulo Langa, Veronica Casmo
Centro de Investigação Operacional da Beira - CIOB: Joao Manuel, Nelson Bitone
Project Staff
Jedidiah Snyder, Sandy McGunegill, Christine Fagnant-Sperati, Sydney Hubbard, Courtney Victor, Molly Miller-Petrie, Becky Kann, Lilly O’Brien, Becky MacKay, Nicolette Zhou, Joana Falcao, Denisse Vega Ocasio
Co-Investigators
Emory University: Thomas Clasen, Lance Waller, Colleen Kraft
Georgia Tech: Kostas Konstantinidis
University of Reno, Nevada: Joshua Garn
University of North Carolina: Joe Brown
Consultants
WeConsult: Zaida Adriano, Bacelar Muname, Antonio Junior, Roel Toonen, Ivânia Cossa
Enumerators
Mario Mungoi, Isabel Chiquele, Ricardina TimoteoMaria Cazonda, Milauzia de Melo, Milton Fragoso, Gizela Brito, Marcelo FernandesGerson de Melo, Ligia JorgeGenifa Banze, Agostinho Barros
Water Lab Staff
Arnaldo Amenosse Cumbana, Aniceto Mendes Calisto Lourenço Muailime, Eunice Maria Cláver Dias, Ginate Budane Mepimba, Helena do Rosário Cipriano, Ilídio Daniel Dava, José Coma Fraquesa, Rufino Marcos Sebastião
Parasitology Lab Staff
Lucrecia Uelemo, Paula Macumbane, Monica Boja, Tomé Matole
Nurses
Avelina José Sambo, Maria Sonia Airone