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Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.

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The Power of TV in Triggering Feedback Through Mobile Phones

Evelyn KiptotWorld Agroforestry CentreNairobi, Kenya
Grand Challenges Explorations
Agricultural Programs
29 Oct 2014

Evelyne Kiptot from the World Agroforestry Centre in Kenya will evaluate whether television programs can teach innovative agricultural practices to dairy farmers, and whether mobile phones can be used to measure their performance. Rural farmers in sub-Saharan Africa have traditionally been told about improved farming practices in person, which is expensive and has limited coverage. They will film a series of four television programs in the field and air them on a popular TV station in Kenya. Viewers will be encouraged to provide feedback on their experiences and give their opinions via mobile phone, which will be responded to by experts. Their approach will be evaluated by surveying a population of farmers for changes in knowledge and agricultural practices.

BEMPU: The Newborn Temperature Monitoring Band

Ratul NarainBEMPU TechnologiesBengaluru, Karnataka, India
Grand Challenges Explorations
Behavior Change
28 Oct 2014

Ratul Narain of BEMPU Technologies Private Ltd. in India will develop and test a temperature monitoring baby bracelet to reduce the incidence of hypothermia in newborns. Newborns are unable to regulate their body temperature, and low temperatures can lead to life-debilitating illnesses. Skin-to-skin warming (kangaroo care) can maintain a healthy body temperature, but is not commonly practiced in resource-poor regions in India, where newborn hypothermia rates are high. To address this, they will further develop an inexpensive and simple bracelet to be worn by babies during the first two months of life that sounds an alarm when the baby's temperature gets too low to prompt the parent to respond. Sensitivity and specificity will be optimized, and the bracelet evaluated in field trials.

Inciting Healthy Behaviors Using a Human Computation Game

Eamonn KeoghUniversity of California, RiversideRiverside, California, United States
Grand Challenges Explorations
Behavior Change
28 Oct 2014

Eamonn Keogh from University of California, Riverside in the U.S. will design and test a human computational game for individuals in developing countries to encourage positive behavior such as taking medication or attending school. The game is played on mobile phones, and begins with an automatic prompt to perform a specific healthy behavior, which then requires the individual to respond by sending photographic evidence of the behavior to a randomly selected individual for evaluation, with rewards offered for compliance. They will develop the game, write the necessary open source software, and conduct a case study in the developed world to evaluate and refine the approach.

Introducing Group Prenatal Care (GPC) in Bangladesh

Abdur Razzaque SarkerInternational Centre for Diarrhoeal Disease Research, BangladeshDhaka, Bangladesh
Grand Challenges Explorations
Behavior Change
28 Oct 2014

Abdur Razzaque Sarker from the International Centre for Diarrhoeal Disease in Bangladesh will test whether group prenatal care for women has a positive effect on maternal and child health when compared with traditional one-on-one prenatal care. They hypothesize that prenatal classes with groups of 8-10 women will promote support networks and social interactions, and facilitate learning, thereby improving health outcomes. This will be tested using a prospective study in selected health centers in Bangladesh.

Deworming Reproductive Age Women for Helminth Elimination

Prasenjit MondalInternational Centre for Diarrhoeal Disease Research, BangladeshDhaka, Bangladesh
Grand Challenges Explorations
Community-Based Interventions
28 Oct 2014

Prasenjit Mondal of the International Centre for Diarrhoeal Disease Research in Bangladesh will test whether supplying deworming medication to women of reproductive age reduces the incidence of helminth infections and associated anemia. Current mass drug administration efforts to eradicate parasitic infections are fairly successful but focus predominantly on school children. The incidence of infection in women of fertility age remains high, which affects both maternal and child health. To reach this vulnerable population, they will exploit the infrastructure of a current government program, which provides folic acid tablets to pregnant women via Community Clinics, by also providing deworming medication and associated counseling. They will evaluate their approach by measuring its effect on helminth infection levels.

Combating STH via Integrated Child Health Services, Honduras

Romeo MontoyaPan American Health OrganizationWashington, District of Columbia, United States
Grand Challenges Explorations
Community-Based Interventions
28 Oct 2014

Romeo Montoya of OPS/OMS Honduras in Honduras will test an integrated approach of deworming, education, vitamin A supplements, and improved water quality and sanitation to decrease the incidence and effects of intestinal parasites in school children in Honduras. Intestinal worms are highly prevalent in Honduras and a significant cause of morbidity and mortality. By integrating several treatment strategies together with national vaccination campaigns they hope to broaden coverage to the entire population and reduce costs.

New Smartphone Platform for Rapid Point-of-Care Brain Diagnostics

Stephen ChouPrinceton UniversityPrinceton, New Jersey, United States
Grand Challenges Explorations
Brain Function/Gestational Age
27 Oct 2014

Stephen Chou of Princeton University in the U.S. will further develop a simple and inexpensive assay for diagnosing fetal brain injury using smartphones to detect biomarkers from a drop of blood that can be used by untrained individuals. Biomarkers of brain function have been identified, but technological limitations mean their detection requires expensive assays and trained professionals. They have developed special nanostructures known as D2PA (disk-coupled dots-on-pillar antenna- array) to enhance the fluorescence emitted on a small assay plate by over one million fold thereby substantially increasing sensitivity. The plate can then be photographed with a smartphone and the result sent to a doctor. They will develop and test the assay for accurately and rapidly detecting several biomarkers in single drops of blood.

School Versus Community-integrated Deworming and WASH for STH Control

Susana NeryThe Australian National UniversityActon, Australian Capital Territory, Australia
Grand Challenges Explorations
Community-Based Interventions
27 Oct 2014

Susana Nery of the University of Queensland in Australia will test whether soil transmitted helminth infections in school children from developing countries can be better controlled by providing deworming and improved hygiene practices to an entire community as opposed to just the schools, which is the current WHO recommendation. They will conduct a pilot study in Timor-Leste by recruiting primary schools and providing the recommended anti-helminthic drug albendazole along with access to improved water and hygiene practices either within the schools or to the local community. The incidence of parasite infections in the school children and the comparative cost of each approach will be evaluated.

Infant Movement Analysis for Atypical Brain Development

Beth SmithUniversity of Southern CaliforniaLos Angeles, California, United States
Grand Challenges Explorations
Brain Function/Gestational Age
27 Oct 2014

Beth Smith from the University of Southern California in the U.S. will determine whether monitoring the arm movements of infants can be used to as a non-invasive proxy for neural development to help identify defects and aid treatment. They will perform a longitudinal study of 45 children, including preterm infants, who will be assessed monthly from one to six months of age. Motion sensory equipment will measure the type and quality of their arm movements, which will be correlated with cortical brain activity measured via electroencephalography (EEG). These data will then be used to generate standard curves of brain function based on movement that may be able to identify children with impaired neural development.

Working Together for Our Health: Community Mobilization Against NTDs in Yemen

Hesham Al-MekhlafiUniversity of MalayaKuala Lumpur, Malaysia
Grand Challenges Explorations
Community-Based Interventions
26 Oct 2014

Hesham Al-Mekhlafi of the University of Malaya in Malaysia in collaboration with Azal University for Human Development in Yemen will recruit and train youths and young researchers from rural areas in Yemen to teach their communities about preventing and treating specific enteric diseases. Although effective drugs exist for treating intestinal parasitic diseases such as soil-transmitted helminthiasis, many remain endemic in Yemen, particularly in rural populations where knowledge and attitudes towards these diseases are poor. They will select four communities and meet with local leaders to garner support for their project and help raise awareness. The effect of their approach will be evaluated on the incidence and severity of infections.

Maternal Blood Biomarkers to Assess Fetal Neurodevelopment

Laura GoetzlTemple UniversityPhiladelphia, Pennsylvania, United States
Grand Challenges Explorations
Brain Function/Gestational Age
23 Oct 2014

Laura Goetzl of Temple University in the U.S. will analyze whether the presence of specific microRNAs in maternal blood during early pregnancy can act as biomarkers of fetal neurodevelopment. Although the causes of neurological disorders such as autism are mostly unknown, they likely involve early defects in neurodevelopment. However, there is no simple, low-cost method for monitoring fetal neurodevelopment. They will identify candidate microRNA molecules at different stages of pregnancy in the blood of women who have elected termination that correlate with neurodevelopmental parameters in fetal brain tissue such as cell types and levels of cell death. They will also analyze blood from women exposed to alcohol during pregnancy to identify the microRNAs associated with abnormal neurodevelopment.

Priming HIV-Infected Patients to Adhere to Treatment

Sandra McCoyUniversity of California, BerkeleyBerkeley, California, United States
Grand Challenges Explorations
Behavior Change
22 Oct 2014

Sandra McCoy from University of California, Berkeley in the U.S. will analyze whether behavioral priming methods such as associational cues and social influence can promote adherence to HIV treatment in Tanzania. HIV prevalence in Tanzania is high, at 5.1%, and poor adherence to antiretroviral therapy is a major problem due in part to long patient waiting times and stigmatizing attitudes. Behavioral priming involves using a stimulus to indirectly or subconsciously influence behavior. They will hold group discussions with HIV patients and healthcare workers to identify several behavioral priming strategies such as positive feedback cues on health cards, and conduct a pilot study to evaluate their effect on adherence.

Behavioral Change and WASH are Essential for Control of NTD

Zvi BentwichBen-Gurion University of the NegevBeer-Sheva, Israel
Grand Challenges Explorations
Community-Based Interventions
22 Oct 2014

Zvi Bentwich of Ben Gurion University in Israel will support mass drug eradication efforts against parasitic worm infections in Ethiopia by implementing in parallel a health education campaign run by local students and the provision of clean water and sanitation facilities. They will test their approach on a region in Ethiopia containing 30 schools, which is connected to a wider population of 200,000. Families will be treated with anti-parasitic drugs, and they will mentor local students to provide health education explaining the causes and symptoms of the diseases, and how to avoid contracting them. They will also provide water and latrines to schools. The effect of their approach on infection rates will be evaluated over an 18-month period.

Early Markers to Predict Cognition and Brain Development

Damien FairOregon Health and Science UniversityPortland, Oregon, United States
Grand Challenges Explorations
Brain Function/Gestational Age
22 Oct 2014

Damien Fair of Oregon Health & Science University in the U.S. will determine whether combinations of prenatal and early postnatal stress markers can be used to predict the developmental trajectories of specific cognitive processes known as executive functions, which underlie goal-directed behavior and are important for many social and academic skills. They will use their maternal-infant macaque model to identify stress markers such as maternal nutrition, heart rate, and cortisol levels that correlate with the later development of specific behaviors in offspring, and with brain connectivity at different developmental stages as measured by magnetic resonance imaging. The identified brain imaging and stress markers will also be analyzed using their dataset derived from maternal-infant humans.

EarlySigns: A New Screening Tool for Neurodevelopment

Maitreyi MazumdarChildren's Hospital BostonBoston, Massachusetts, United States
Grand Challenges Explorations
Brain Function/Gestational Age
22 Oct 2014

Maitreyi Mazumdar of Boston Children's Hospital in the U.S. will use existing data from epidemiology studies in Bangladesh, Mexico City, and Oklahoma to develop a scoring system to identify children at high risk of developing cognitive impairments also beyond childhood. The data were derived from prospective studies of individuals across the prenatal, early childhood and adolescent time periods, and include anthropomorphic measurements, full scale IQ, and other clinical and nutritional data. They will sort through these measures to identify those that best predict the likelihood of cognitive impairment, and generate a simple scoring system that can be used on different populations and in low resource settings.

Neurobiological Resilience Predicted with Salivary Stressome

Patrick De BoeverVITOMol, Belgium
Grand Challenges Explorations
Brain Function/Gestational Age
22 Oct 2014

Patrick De Boever of VITO in Belgium will study the effects of stress on neurodevelopment in children by building a database of biological markers of the stress response detected in saliva. They will generate comprehensive genetic and epigenetic profiles, such as DNA methylation patterns, of salivary samples taken after laboratory-controlled or environmental stress events from over 1000 children of a range of ages and backgrounds. The aim is to capture developmental changes in stress reactivity over time and use the profiles to predict the course of neurological development.

Longitudinal Trajectories in Brain Function in Infancy

Silvia RigatoUniversity of EssexColchester, United Kingdom
Grand Challenges Explorations
Brain Function/Gestational Age
22 Oct 2014

Silvia Rigato and Karla Holmboe of the University of Essex in the United Kingdom will track the development of attention and social skills in infants over time to enable the early identification of children with impairments. They will recruit 60 infants and analyze attention skills such as alertness monitored by heart rate, and social skills such as face perception monitored by eye tracking, from the last trimester of pregnancy through to 10 months old. In the future, these developmental trajectories will be used to help identify infants at risk of poor intellectual and social abilities.

Go Baby Go!

Nana ColemanWorld VisionFederal Way, Washington, United States
Grand Challenges Explorations
Brain Function/Gestational Age
22 Oct 2014

Nana Coleman of World Vision in the U.S. will teach positive parenting skills such as hugging, reading, and playing to parents in Armenia to promote healthy childhood development. They will exploit their existing network of health care providers and parent support groups to teach better parenting behavior, and integrate it with another program they have been running to improve child and maternal health. They will test whether this holistic strategy is more effective at changing parental behavior and improving childhood nutrition and development than the individual approaches.

Handheld Retinal Measurements to Assess Early Brain Growth

Farrah MateenGeneral Hospital CorporationBoston, Massachusetts, United States
Grand Challenges Explorations
Brain Function/Gestational Age
21 Oct 2014

Farrah Mateen of Massachusetts General Hospital in the U.S. will measure the thickness of the retina in children from Zimbabwe over the first five years of life using a handheld optical coherence tomography device to determine whether they can identify abnormal brain development in low-income settings. Optical coherence tomography is noninvasive and should be easy for community health workers to use. They will recruit 300 children and correlate retinal layer thicknesses with parameters including weight, height, and gestational age at birth, as well as HIV status. In parallel, the correlation between retinal thickness and cortical volume will be measured using volumetric MRI and optical coherence tomography on 25 children from the U.S.

Full-use of Guinea Worm Eradication Plans to Address NTDs

James RansomAfrican Field Epidemiology NetworkAbuja, Nigeria
Grand Challenges Explorations
Community-Based Interventions
21 Oct 2014

James Ransom of IFETP in the U.S. will promote detection and treatment of five neglected tropical diseases in South Sudan by exploiting and further developing an existing health infrastructure that has successfully reduced the incidence of guinea worm disease. They will target two regions with particularly high incidences of the targeted diseases, and train the local health surveillance officers on preventative methods and to provide comprehensive care and treatment. They will also work to educate the public and media about these diseases.

Imaging Healthy Infant Brain Myelination

Sean DeoniBrown UniversityProvidence, Rhode Island, United States
Grand Challenges Explorations
Brain Function/Gestational Age
21 Oct 2014

Sean Deoni of Brown University in the U.S. will evaluate whether mapping myelination in the infant brain can predict their subsequent levels of cognitive ability such as language and motor functioning, which emerge later in childhood. Myelin is a lipid that is deposited around neuronal axons during development. Twenty-four infants between four and six months old will be recruited to a controlled pilot study. At six and 12 months the children will be evaluated for brain myelin content, using magnetic resonance imaging and neurocognitive functions, to link specific myelination levels with cognitive ability. In the future, this approach could also be used to measure the impact of the environment, such as diet, on brain development.

Voices that Count

Steff DeprezVredeseilandenLeuven, Belgium
Grand Challenges Explorations
Agricultural Programs
21 Oct 2014

Steff Deprez of Vredeseilanden in Belgium will develop an approach utilizing pattern detection software (SenseMaker) to translate feedback from smallholder farmers directly into quantitative data that can be easily queried by agricultural development program managers and evaluators. They will test their approach on rice, passion fruit and coffee smallholder farmers in sub-Saharan African to evaluate whether they should be included in modern markets. A so-called signification framework will be developed that comprises specific questions for the farmers in a format that allows them to supplement their feedback with additional narrative to facilitate conversion into statistical data. Participatory feedback sessions will also be organized. The entire approach will be cost-effective and designed for up to 3000 participants.

Newborn Face and Foot Analysis to Determine Gestational Age

Don SharkeyUniversity of NottinghamLoughborough, United Kingdom
Grand Challenges Explorations
Brain Function/Gestational Age
20 Oct 2014

Don Sharkey of the University of Nottingham in the United Kingdom will develop a software-based analysis tool to automatically calculate gestational age from simple videos of newborn faces and feet. Knowing the gestational age, particularly for babies born preterm, is critical for ensuring their healthy development. However, current dating procedures are expensive and/or require trained personnel, and as such are often unavailable in low-middle income countries. They will create a face and foot video database of newborns with known gestational ages of between 23 and 42 weeks, and use automated methods to extract specific features and generate a gestational algorithm. This algorithm will then be validated in a separate group of newborns.

Gestational Dating at Birth by Metabolic Profile

Laura Jelliffe-PawlowskiUniversity of California San FranciscoSan Francisco, California, United States
Grand Challenges Explorations
Brain Function/Gestational Age
16 Oct 2014

Laura Jelliffe-Pawlowski of the University of California, San Francisco in the U.S. is developing an algorithm to measure gestational age from metabolic markers taken during routine newborn screening. Measuring accurate gestational age is important for assessing infant health such as brain development, but it is challenging in developing countries without specialized equipment and expertise. In Phase I, they developed a statistical model using data on 51 metabolic markers from around 730,000 newborns in the U.S. that predicted gestational age at birth within around an average of one week margin of error. In Phase II, they will further adapt and test their algorithm for use in Malawi and Uganda by using existing data from 500 pregnancies in Malawi and 1000 in Uganda, and also determine its value for identifying newborns at risk of neonatal death or complications.

Low-cost Quantitative Assessment of Brain Maturation

Vasily YarnykhUniversity of WashingtonSeattle, Washington, United States
Grand Challenges Explorations
Brain Function/Gestational Age
16 Oct 2014

Vasily Yarnykh from the University of Washington in the U.S. will test whether measuring myelin content in the brain using a low-cost magnetic resonance imaging method can act as a reliable biomarker for brain maturation. They will build on a method involving the measurement of the macromolecular proton fraction by magnetic resonance. This method will be converted to a non-image-based and non-localized method that can be more easily and inexpensively used to measure myelin content in developing countries. The new method will be tested for accuracy compared to the standard method, and used on children of a range of ages to see if it can differentiate brain maturation level.

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