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Students Travel to Kenya

Thanks to a generous donation, five University of Washington students travelled to Kisumu, Kenya in September, where they engaged in independent research projects closely aligned with a current National Institutes of Health (NIH) R21 grant led by Drs. Ana Lucia Seminario and Whasun Chung with the UW DeRouen Center for Global Oral Health.

Two pictures, see caption
UW global oral health students with clinic staff.

In Kisumu’s Jaramogi Oginga Odinga Teaching and Referral Hospital and affiliated regional clinics, the students shadowed Dr. Immaculate Opondo (R21 grant study coordinator) and staff while they conducted R21 grant study activities and conducted their independent research projects on topics including HIV stigma, oral health education, and Kenyan pediatric diets. While visiting the clinics, the students engaged in conversations with clinic staff and collecting survey information, gaining valuable insights for their projects.

UW global oral health students with study staff (left) and at Obama Children’s Hospital in Kisumu, Kenya (right).
UW global oral health students with study staff (left) and at Obama Children’s Hospital in Kisumu, Kenya (right).

Beyond their academic pursuits, the students immersed themselves in Kenyan culture and cuisine, including visiting the Teme Impala Park, Giraffe Center, and taking a boat trip on Lake Victoria. Overall, the trip was successful in expanding student global oral health research engagement and expanding cultural competence.

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DeRouen Center Presents at IADR

DeRouen Center presentations at the 2023 IADR conference in Bogota, Colombia.
DeRouen Center presentations at the 2023 IADR conference in Bogota, Colombia.

The 2023 International Association for Dental Research (IADR) conference in Bogota, Colombia was an exciting event for the DeRouen Center. We had the honor of having five abstracts accepted for presentation at the conference, highlighting our research conducted by our dedicated international team. These abstracts represented a significant achievement for the DeRouen Center and demonstrated our continued success in advancing oral health on a global scale.

During the conference, the accepted abstracts from the DeRouen Center took center stage as interactive talks presented by Ana Lucia Seminario (University of Washington) entitled “Integrating oral health within Kenyan HIV research/policy structure: Stakeholder analysis”, Arthur Kemoli (University of Nairobi) entitled “Oral health status among visually impaired adolescents in Kenya”, Eraldo Pesaressi (Universidad Peruana Cayetano Heredia) entitled “Oral health perceptions in MSM alcohol consumers with HIV”, Johanna Belen Juarez (Universidad Peruana Cayetano Heredia) entitled “Dental utilization of refugee children is associated with area of resettlement”, and Sara Stanley (University of Washington) entitled “Implementing an app for data collection in a Peruvian HIV-clinic”. The presentations highlighted the research findings and innovative approaches to addressing oral health challenges in both Peru, Kenya, and the United States. The talks sparked engaging discussions, fostering collaboration, and knowledge sharing among fellow researchers and dental professionals in attendance.

The DeRouen Center’s presence at the conference demonstrates our continued commitment to international collaborations, knowledge exchange, and the pursuit of excellence in oral health research. We look forward to attending the next IADR conference in New Orleans, USA in 2024.

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Kickoff of the NIH R21 project in Kenya

The kickoff of the UW DeRouen Center’s NIH R21 grant entitled “Dynamics of HIV-infection, Oral Innate Immunity and The Development of Oral Diseases in Children” took place in Kisumu, Kenya in February 2023.

The event brought together researchers and healthcare professionals to launch the grant’s research activities. Among the key individuals present were Dr. Ana Lucia Seminario (principal investigator, and Co-PI with Dr. Whasun Chung), Dr. Arthur Kemoli, (Kenyan site director), Dr. Immaculate Opondo (study coordinator), Maureen Aluoch (research assistant) Mercyline Muhonja (research assistant), and Dr. Caitlin Fehlinger, (pediatric dental resident). Our dedicated team spent four days testing and initiating the grant at Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu.

Dr. Ana Lucia Seminario, Moureen Aluoch, and Dr. Arthur Kemoli at Jaramogi Oginga Odinga Teaching and Referral Hospital at the NIH R21 grant kickoff.
Dr. Ana Lucia Seminario, Moureen Aluoch, and Dr. Arthur Kemoli at Jaramogi Oginga Odinga Teaching and Referral Hospital at the NIH R21 grant kickoff.

Oral diseases are among the most prevalent non-communicable diseases worldwide. Despite significant successes in the treatment for HIV, children with HIV continue to experience more oral diseases compared to uninfected children. This exploratory study assesses the extent to which HIV infection influences the occurrence and progression of oral diseases among HIV/AIDS Kenyan children and to create research capacity in global oral health.

The kickoff event in Kisumu was an exciting milestone for the DeRouen Center, marking the beginnings of oral health HIV research in western Kenya.

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Waranuch Pitiphat highlighted at Fogarty International Center

Dr. Waranuch Pitiphat is a Thai oral health researcher at Khon Kaen University
Dr. Waranuch Pitiphat is a Thai oral health researcher at Khon Kaen University

Dr. Waranuch Pitiphat, former Dean of the School of Dentistry at Khon Kaen University, is a renowned Thai researcher who has made significant contributions to the field of oral health, with her work receiving recognition and support from the United States’ National Institutes of Health (NIH). As highlighted on the Fogarty International Center’s website at the NIH, Dr. Pitiphat’ s research endeavors in Thailand have focused on cultivating oral health research and addressing the disparities prevalent in the oral health domain.

One notable achievement in Dr. Pitiphat’ s career is her success in obtaining NIH grants, specifically the D71 and D43 training grants for southeast Asia. These grants awarded have enabled her to establish a research training program that integrates oral health research into the curriculum of Thai dental schools. By equipping dental students with research skills and fostering a research-oriented mindset, Dr. Pitiphat aims to enhance their capabilities and contribute to advancements in oral health research. She has organized workshops, seminars, and collaborative projects that bring together oral health professionals from Thailand and other international partners. These initiatives not only facilitate the sharing of research findings and best practices but also foster interdisciplinary collaborations, strengthening the oral health research community within Thailand.

Dr. Pitiphat’ s achievements with D71 and D43 awards highlight her dedication to advancing oral health research and capacity-building efforts in Thailand. By empowering future dental professionals with research skills and promoting collaboration among researchers, she has significantly contributed to improving oral health outcomes and strengthening the research landscape throughout southeast Asia.

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TABASAMU Research Team Travels to Kenya

In February 2023, as part of the National Institutes of Health (NIH) grant named “TABASAMU” awarded to the University of Washington (UW) and University of Nairobi (UoN), a team of researchers and professionals embarked on an international trip to Kenya. The purpose of the trip was to conduct focus groups and meet with potential oral health research trainees in four cities: Kisumu, Eldoret, Nairobi, and Mombasa. The trip involved a team of six travelers including Dr. Ana Lucia Seminario (UW), Dr. Frank Roberts (UW), Dr. Jenipher Ober-Oluoch (University of Rwanda), Dr. Arthur Kemoli (UoN), Dr. Immaculate Opondo (Maseno University), and Sara Stanley (UW). The TABASAMU project (Grant # 1D71TW011823-01) is the precursor planning grant that prepares the path for a future interdisciplinary research training program in Kenya.

Dr. Ana Lucia Seminario (UW) and George Wambiri Ndamaiyu (UoN) in Nairobi, Kenya
Dr. Ana Lucia Seminario (UW) and George Wambiri Ndamaiyu (UoN) in Nairobi, Kenya

Led by Dr. Jenipher Ober-Oluoch and Sara Stanley, the team conducted a series of focus groups to gather data on oral health research capacity in Kenya, with the opportunity to meet with potential oral health research trainees in each of the four cities. These meetings allowed the team to identify promising individuals for future trainee and research opportunities.

Members of the TABASAMU research team at Coast General Hospital in Mombasa, Kenya
Members of the TABASAMU research team at Coast General Hospital in Mombasa, Kenya

In addition to the focus groups, the team attended the Kenya Medical Research Institute’s (KEMRI) Annual Scientific and Health (KASH) Conference in Nairobi. Dr. Frank Roberts was a speaker at the conference and gave a lecture on periodontal disease and HIV. Attending the conference allowed the team to connect with other researchers and professionals and learn about the latest developments in oral health research.

This second TABASAMU trip to Kenya was another productive and enriching experience for the team and has laid the groundwork for a future NIH training grant to enhance oral health research capacity in Kenya, and future collaborations between University of Washington, University of Nairobi, and other partners within the country.

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UW’s Dr. Frank Roberts presents at KASH conference

Dr. Frank Roberts presenting at the 2023 KASH conference
Dr. Frank Roberts presenting at the 2023 KASH conference

This past February, Dr. Frank Roberts from University of Washington’s (UW) School of Dentistry, was invited to give a talk at the 2023 KEMRI Annual Scientific and Health (KASH) conference. The KASH conference is an annual event organized by the Kenya Medical Research Institute (KEMRI). KEMRI is a leading medical research organization in Africa that conducts research on various health issues, including infectious diseases, non-communicable diseases, health systems research, and public health. The conference brings together scientists, researchers, policymakers, and other stakeholders from the health sector to discuss and share the latest research findings, innovations, and best practices in health research.

Dr. Robert’s presentation topic was focused on the interaction between HIV and periodontal diseases. Periodontal disease (gum disease) is an inflammatory condition that affects the tissues and bone that support the teeth. It is caused by a bacterial infection and can lead to tooth loss if left untreated. HIV infection can increase the risk of developing periodontal disease and can also make the disease more severe. Research has shown that people with HIV are more likely to have periodontal disease than those without HIV. This may be due to the fact that HIV weakens the immune system, making it harder for the body to fight off the bacterial infection that causes periodontal disease. In addition, some antiretroviral medications used to treat HIV can cause dry mouth, which can increase the risk of developing other oral health problems including caries (cavities). Periodontal disease can also have an impact on HIV disease progression, with studies suggesting that periodontal disease may lead to increased HIV viral load and decreased T-cell counts, which are key indicators of HIV disease progression.  Fortunately, current treatment strategies to control HIV infection (HAART, etc.) also reduce the ravages of HIV-periodontitis.  Dr. Roberts lectured to physicians, nurses, and other Kenyan healthcare workers on the importance of oral health examinations and interventions to improve general health.

Members of the TABASAMU research team at the 2023 KASH conference
Members of the TABASAMU research team at the 2023 KASH conference

Dr. Roberts is the Associate Dean for Regional Affairs, Acting Chair of the Department of Periodontics, and is the Program Director for the Regional Initiatives in Dental Education (RIDE) program at the University of Washington.  He also serves as the Staff Periodontist for the Seattle Veterans Administration Dental Clinic. He accompanied the University of Washington and University of Nairobi’s TABASAMU research group to Kenya to meet with key project stakeholders, assist with trainee focus groups, and attend the KASH conference.

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Trainee Focus Groups Held in Kenya

In February 2023, as part of the National Institutes of Health (NIH) D71 TABASAMU grant (1D71TW011823-01) awarded to the University of Washington and University of Nairobi, a series of focus groups were conducted in Kenya to explore the potential trainees’ knowledge, attitudes, perceptions, and barriers of oral health research capacity within the country. The focus groups took place in four cities including Kisumu, Eldoret, Nairobi, and Mombasa.

Dr. Jenipher Ober-Oluoch (far right) with the focus group attendees in Kisumu, Kenya
Dr. Jenipher Ober-Oluoch (far right) with the focus group attendees in Kisumu, Kenya

Dr. Jenipher Ober-Oluoch facilitated the groups and used the nominal focus group technique to explore potential future trainees’ perceptions of oral health research capacity. The nominal group technique involved the identification of two key themes or concepts related to oral health research capacity, which were then used to guide the discussion among participants. This technique has advantages over traditional focus groups such as including everyone in the exercise, and it reduces the possibility of conflict within groups.

Some of the focus group attendees in Nairobi, Kenya
Some of the focus group attendees in Nairobi, Kenya

Overall, the focus groups provided valuable insights into the oral health providers’ beliefs and attitudes towards oral health research capacity in Kenya. The data collected will be used to inform the development of a D43 NIH training grant aimed at increasing opportunities for trainees to engage in research training and projects within Kenya.

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International workshop on research methodology in global oral health

The Universidad Continental in Huancayo, Peru, recently hosted a research methodology workshop on oral health, which offered courses in various topics related to dental research. The workshop aimed to equip participants with the necessary skills and knowledge to conduct high-quality research in oral health. The courses covered a range of topics, including epidemiological methods, grant preparation, evidence-based dentistry, ethics, biostatistics, and study design. The workshop was an excellent opportunity for dental professionals and researchers to enhance their research skills and knowledge.

Dr. Francisco Ramos Gomez
Dr. Francisco Ramos Gomez
Dr. Ana Lucia Seminario
Dr. Ana Lucia Seminario
Dr. Joanna Scott
Dr. Joanna Scott

The Universidad Continental is a leading higher education institution in Peru that offers a range of undergraduate and graduate programs. The university is committed to providing high-quality education and research opportunities to its students and the wider community. The research methodology workshop on oral health is an example of the university’s commitment to promoting research excellence in dental health. The workshop was led by experienced dental researchers and educators who provided participants with expert guidance on various aspects of dental research including Dr. Ana Lucia Seminario (University of Washington), Francisco Ramos-Gomez (University of California Los Angeles), and Joanna Scott (University of Missouri).

UC Huancayo

Overall, the research methodology workshop on oral health held at the Universidad Continental in Huancayo, Peru, was a highly informative and beneficial event for dental professionals and researchers. The workshop covered a range of important topics related to dental research and provided participants with the necessary skills and knowledge to conduct high-quality research in oral health. The Universidad Continental’s commitment to promoting research excellence in dental health is evident through events like this, and it is hoped that similar workshops will continue to be held in the future to advance dental research in Peru and beyond.

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Dr. Yan Wang’s work on CHOMP study

A DeRouen Center collaborator, Dr. Yan Wang, is taking part in the Center’s Children’s Healthy Oral Management Project (CHOMP) grant in Kenya. Dr. Wang is studying the oral microbiome of Kenyan children and adolescents who are living with HIV and taking antiretroviral therapy (ART). The collected samples were sent to Dr. Aldrovandi’s Microbiology Lab at University of California Los Angeles for analysis. The aims of the CHOMP study are to measure the association between oral and systemic inflammation in the Kenya Pediatric Studies (KPS) cohort, and to assess the impact of oral diseases and inflammation on children’s quality of life. The secondary aim is to assess acceptability and feasibility of integrating routine oral health care in the setting of routine Pediatric HIV care.

Drs. Yan Wang and Irene Njuguna
Drs. Yan Wang and Irene Njuguna

Dr. Wang is an Adjunct Assistant Professor in the Public and Population Health department at the UCLA School of Dentistry. She received her PhD in Biostatistics at Fielding School of Public Health, UCLA, and subsequently completed both a one-year NIH T37 postdoc and a two-year T32 postdoc.

The CHOMP study has furthered the study of HIV in children and adolescents, and has yielded two published manuscripts – “Oral Diseases and Oral Health–Related Quality of Life among Kenyan

The Aldrovandi lab at UCLA
The Aldrovandi lab at UCLA

Children and Adolescents with HIV”, and “The effect of antiretroviral therapy initiation on vitamin D levels and four oral diseases among Kenyan children and adolescents living with HIV”. We are happy to have Dr. Wang working with us and look forward to her continued collaboration in furthering oral health research.

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Grant to assess how HIV affects the occurrence and progression or oral diseases among Kenyan children with HIV/AIDS

Oral diseases are among the most prevalent non-communicable diseases (NCDs) worldwide. Salivary antimicrobial peptides (AMPs) are proteins regulated by our immune system that disrupt the membrane integrity of bacteria. There is very limited data on AMPs in young children living with HIV. In Kenya, where about 5% of the population is HIV positive, there are an estimated 105,000 infected children and adolescents aged 0-14. A newly awarded National Institute of Health (NIH) grant entitled “Dynamics of HIV-infection, Oral Innate Immunity and The Development of Oral Diseases in Children” aims to assess the extent to which HIV infection influences the occurrence and progression of oral diseases among HIV/AIDS Kenyan children and to create research capacity in global oral health by expanding current lab infrastructure to allow local analysis of salivary AMPs in the context of HIV. This University of Washington (UW) and University of Nairobi (UoN) award is led by Drs. Ana Lucia Seminario and Whasun Chung at UW, and Arthur Kemoli at UoN.

Ana Lucia Seminario and Caitlin Fehlinger at Jaramogi Oginga Odinga Teaching and Referral Hospital.”
Ana Lucia Seminario and Caitlin Fehlinger at Jaramogi Oginga Odinga Teaching and Referral Hospital.”

This longitudinal study will be conducted in a cohort of children who receive care at Jaramogi Oginga Odinga Teaching & Referral Hospital (and other affiliated HIV clinics in the Kisumu area), the largest local teaching and referral hospital in western Kenya. Over 12 months, we will recruit and follow a cohort of approximately 300 children (3-4 years old) stratified by presence of HIV. We will assess participants for anti-retroviral therapy (ART) adherence, length and regimen; dental plaque; CD4; HIV-1 RNA; and additional medications. Our aims are to: 1) Describe the impact of HIV infection on the secretion of salivary antimicrobial peptides at baseline and over a 12-month follow-up period. 2) Determine the associations between salivary AMPs and oral diseases in the context of HIV. 3) Enhance existing HIV research capacity. We will expand current human and infrastructure resources to include oral health research. While currently the study of salivary AMPs is conducted out of Kenya, we will build upon existing lab assets allowing locals to conduct these analyses, thus starting a line of research that increases Kenyan research opportunities.

Moureen Aluoch and Arthur Kemoli working on protocols for the DeRouen Center’s new NIH R21 grant.
Moureen Aluoch and Arthur Kemoli working on protocols for the DeRouen Center’s new NIH R21 grant.

In February 2023, researchers traveled to Kisumu, Kenya to kick-off the grant and begin enrollment.

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