The new and innovative WE CARE Solar Suitcase is a simple, user-friendly technology that provides a sustainable source of power, allowing health workers to provide life-saving interventions 24 hours a day. The Solar Suitcase makes solar-power accessible, affordable, and useful in developing rural communities. This program ensures Solar Suitcases for 200 health centers and additionally provides an innovative package of interventions to improve service delivery, including a fetal Doppler to detect fetal well-being, phone charging to enhance patient referrals, and a computer to for data entry in the electronic Health Management Information system.

Asad Ali of Aga Khan University in Pakistan and co-­investigators will test a selected group of candidate biomarkers to identify and monitor environmental enteropathy, which causes malnutrition and stunting. The biomarkers, which include markers of inflammation and enteric pathogens, will be tested in blood, urine and stools, and correlated with structural features of the small bowel using biopsies from malnourished children. They will also attempt to identify new candidate biomarkers in these biopsies using mRNA sequencing. Their results will provide important insight into disease pathophysiology and enable the development of evidence-­based interventions.

Richard Guerrant of the University of Virginia in the U.S. and co-­investigators will develop and validate non-­invasive metabolic biomarkers of gut health to identify children at risk of environmental enteropathy and developmental impairment, in order to assess interventions. They will use ongoing MAL­-ED (malnutrition and enteric diseases) and NIH­-supported clinical studies in malnourished and control children, and their own studies in novel murine models, along with a nuclear magnetic resonance approach to perform metabolic profiling of urine, plasma and feces samples. Their goal is to improve the growth, nutrition and development of children at high risk of environmental enteropathy that can lead to morbidity and mortality.

Mark Manary of Washington University in the U.S. and colleagues will develop a strategy for the non-­invasive diagnosis of environmental enteropathy, which causes malnutrition and growth failure in young children in the developing world. They will devise a robust protocol to isolate human RNA of the small bowel from samples of stool, and will test a broad panel of candidate biomarkers for their ability to identify environmental enteropathy with high sensitivity using samples from at risk Malawian children. These tools will be critical for studying disease etiology and for the development of effective intervention strategies.