Date of Award

Summer 8-8-2017

Degree Type

Capstone Project

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Matthew Magee

Second Advisor

Dr. Alawode Oladele

Abstract

INTRODUCTION: This capstone project is modeled after a National Institutes of Health R21 grant application to evaluate the relationship between tuberculosis (TB) antibiotic treatment and 1) gut microbiota and 2) long-term metabolic functions among pediatric patients less than five years old or greater than five years old, residing in Dekalb county.

AIM: The proposed study specific aims are to 1) determine the relationship between standard drug-sensitive antibiotic TB regimens on the gut microbiota (total density and taxa) at the time of TB treatment completion and one-year after treatment completion; 2) determine the relationship between standard drug-sensitive antibiotic TB regimens and metabolic biomarkers (Short Chain Fatty Acids (SCFAs), amino acids (Branched Chain and Aromatic), cholesterol, and glucose) at the time of treatment and one-year follow-up.

SIGNIFICANCE: In the last ten years, antibiotic use has increased substantially, correlating with the increase incidence of childhood obesity and diabetes. This trend may partially be explained by an association between broad-spectrum antibiotic usage during childhood and the dysbiosis of the gut microbiome. The disruption of the gut microbiota induces the dysregulation of metabolic pathways, which may lead to the increased risk of developing obesity and diabetes. In 2015, TB accounted for 1 million incident cases in children. Given antibiotic treatment for TB requires exposure to multiple antibiotics for more than six consecutive months, this proposal intends to understand the extent to which exposure to TB treatment may impact the gut microbiome and whether antibiotic induced dysbiosis in the gut microbiome has long-term impact on pediatric metabolic function.

APPROACH: Eligibility criteria includes all TB pediatric patients (< 15 years of age) residing in DeKalb county, receiving care for drug-susceptible pulmonary TB by the DeKalb Refugee Clinic within the Dekalb County Board of Health. Patients with previous history of diabetes, obesity, or HIV will be excluded.

STUDY DESIGN: We will perform a prospective cohort study of N=50 pulmonary drug-susceptible pediatric TB patients from 2018-2020. At the time of baseline, TB treatment completion, and one-year follow-up the primary measures collected will be total density and taxa distribution of the gut microbiome. We will also collect SCFA, branched chain and aromatic amino acids, fasting glucose, A1c, and fasting cholesterol. Baseline measures will act as an internal comparison group for each patient.

Available for download on Saturday, July 28, 2018

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