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Neurodevelopment and Vector-borne Diseases: Building Research Capacity in the Tropics, Stanford (September 1, 2016 - 8/31/2018)

Vector-borne diseases (VBD) pose a significant economic and public health threat throughout developing
tropical regions worldwide, including the Caribbean. The introduction in December 2013 and rapid spread of
the chikungunya virus (CHIKV) throughout all the Caribbean nations, and more recently the emergence of the
zika virus in Suriname and Martinique highlights the need to develop regional capacity to investigate, predict,
contain, and respond to VBD. For example, recent evidence from la Réunion suggests that CHIKV can
negatively impact neurodevelopment among infants born to mothers who were infected with the virus during
pregnancy. However, these results have not yet been replicated in other sites internationally – such as the
Caribbean – nor have any longitudinal studies been carried out to follow children who have experienced
neurocognitive delay related to CHIKV infection. To address the paucity of data while building VBD research
capacity in tropical LMICs where these diseases are endemic and the burden of impaired neurodevelopment is
felt most, researchers from St. George’s University (SGU) in Grenada will partner with researchers from
Stanford University, Oxford University, and the Université de La Réunion to: (1) Determine the prevalence of
mother to child transmission of CHIKV in Grenadian pregnant mothers; (2) Measure the neurodevelopment of
children at 2 years of age exposed at different trimesters in utero to CHIKV and compare them with unexposed
children; (3) Assess the burden of confounding factors to better understand the specific impact of VBD on
neurodevelopment and inform public health priorities; (4) Build local capacity for arboviral and
neurodevelopmental testing at SGU. To achieve Aim 1, 379 moms and their infants who were born during the
CHIKV outbreak in Grenada, 473 moms and their infants who were born after the outbreak and may have been
exposed to the virus in utero, and 190 moms and their infants who were born at least nine months after the
outbreak (and thus, very unlikely to be exposed to the virus in utero) will complete a survey detailing the onset
and symptoms related to their CHIKV infection and will then be tested for exposure to CHIKV by ELISA. Non
CHIKV-exposed infants and moms, CHIKV-exposed moms but not infants, CHIKV-exposed moms and infants,
and time of exposure during pregnancy will be used to divide groups for neurocognitive comparison at 2-years
of age. To achieve Aims 2 and 3, we will administer the intergrowth 21st Neurodevelopment Assessment – a
holistic assessment of early child development developed at Oxford University – while controlling for
confounding neurodevelopmental factors. To achieve Aim 4, we will establish a Regional Center for Child
Neurodevelopment while addressing seven key areas of needed research support: (1) Financial (i.e., granting);
(2) Expertise; (3) On-the-ground human resources; (4) Student trainees to build local capacity; (5) Equipment,
IT, and facilities support; (6) On-the-ground university and research institute administrative support; and (7)
Local and regional government, relevant NGO, and professional/academic institutional support.

Location

Grenada

Principal Investigator:

Angelle Desiree LaBeaud

Current Research Interests: 
Arthropod-borne viruses are emerging and re-emerging infections that are spreading throughout the world. Our laboratory investigates the epidemiology of arboviral infections, focusing on the burden of disease and the long-term complications on human health. In particular, Dr. LaBeaud investigates dengue, chikungunya, and Rift Valley fever viruses in Kenya, where outbreaks cause fever, arthritis, retinitis, encephalitis, and hemorrhagic fever. Our main research questions focus on the risk factors for arboviral infections, the development of diagnostic tests that can be administered in the...
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