Researchers at Aga Khan University are partnering with faculty at the University of Virginia and Massachusetts General Hospital, an affiliate of Harvard Medical School, to study the usefulness of a series of technological innovations that will deliver the first-ever insights into the gut health of pregnant women.
Malnourished women and children have a different set of bacteria in their stomach and an unusual gut structure that compromises their growth potential and reduces immunity to disease.
Until now, assessments of the gut health of expecting mothers were not possible due to the risks involved in administering anaesthesia during pregnancy. Since a malnourished mother is much more likely to give birth to a malnourished child, the study will shed light on an unexplored area of child health in a country where 4 out of 10 children are stunted, according to the National Nutrition Survey 2018.
Researchers will use novel trans-nasal imaging technologies which consists of a tube that will be moved down the nose, through the throat and to the gut. Passing the tube through the nose removes the need for anaesthesia and offers a safer and less-invasive way to assess whether a mother’s gut has been damaged to the extent that it can harm her child’s health.
The use of the trans-nasal route also opens up the possibility of imaging a newborn or infant’s gut which wasn’t possible in older technologies that required a capsule to be swallowed. The trans-nasal imaging technology consists of a range of devices which are contained within a thin tube such as:
1. A camera to capture images of the gut
2. A brush at the end of the tube to collect tissue samples
3. A device that sends small electrical pulses through the intestine to assess nutrient absorption capacity
4. Cryobiopsy technology that can instantly freeze a sample to preserve it for analysis
Researchers will test the technology on 150 pregnant mothers and infants in the US and Pakistan in order to determine which of the four above interventions provides the most useful insights into malnutrition. The feasibility of technology will also be assessed in rural and urban settings with part of the trial being conducted at the Aga Khan University’s Matiari Research and Training Centre which is based in an area where malnutrition is common.
“Our ultimate goal is to take this technology to the doorstep of communities,” said Professor Asad Ali, associate dean of research at Aga Khan University. “This will enable us to easily assess the severity of malnutrition in women and children living in high-risk areas. In the long-term, we hope to use this imaging technology to test the success of different nutrition interventions by capturing before and after images of an individual’s intestine.”
The most successful nutrition interventions could then be scaled up to prevent the birth of malnourished children and to enable public health officials to take action in the vital first three years of a child’s life when the effects of stunting and malnutrition can be addressed.
The trial’s goals are in line with targets under goal 2 of the global Sustainable Development Goals: end hunger, achieve food security and improved nutrition, and promote sustainable agriculture, which call for special efforts to end all forms of malnutrition and stunting in children under the age of five by 2030.
The study is being funded through a US $2.8 million grant from the Bill and Melinda Gates Foundation.