Kpong

Monday, August 16

Early this morning I met Susana (another girl from Davis who arrived last night) and the two of us met up with Anna, the project director, to head out to the field site. The site is about 2 hours outside of Accra in a town called Kpong (pronounced “pong”). During our drive out to Kpong Anna updated me on study, letting me know that the field workers had been trained the previous week and that we would actually be trying out the protocol today-great news! Since we are trying to get about 90 infants through the study in 3 short weeks, it is really beneficial to begin as soon as possible.

For those who are curious, here is a short description of what I am doing while here:

We are ultimately looking at the acute effect of consumption of a lipid-based micronutrient supplement on the cortisol response in infants. We are interested in the cortisol response of infants because the development of the hypothalamic-pituitary-adrenal (HPA) axis, a key component of the system that controls stress response, seems particularly sensitive to maternal nutrition during pregnancy. This dysregulation of the HPA axis has in turn been linked to low birth weight, depression, diabetes, and possibly heart disease and stroke. However, given the lack of data on basal cortisol levels and stress responsivity among infants in the context of developing countries, there is a need to better understand the potential variability in the proposed outcome measures. So, we are examining cross-sectional predictors of stress response in a small sample of infants here in Ghana. The resulting data can then be used to plan for a future, larger study.

Upon arrival at the study house, we quickly dropped off our bags and met with the local field workers to head to the clinic. The space where we will be conducting the trial is at a Catholic-run hospital about 10 minutes from where we are staying. Almost immediately after we got set up, our first mother arrived and we were able to run her through the protocol with minimal difficulties. There were a few inevitable questions and kinks to be worked out, but the field workers were all very well trained and everything ran smoothly. As a side note: the infants did NOT like me collecting their saliva. In order to collect a small amount of saliva, I use a tiny sponge on the end of a stick that puffs up as it is saturated with saliva (called a sorbette). I have to place two of these under the infant’s tongue for about 60 seconds each. Meanwhile, the baby is crying and kicking (mostly accidently aimed at my stomach…good thing the little guys can’t kick hard!). Most of them figure out that it’s not too bad during the second sorbette, and stop fighting, but they still aren’t very happy about it! I follow the collection by giving the infants little toffee candies that seem to cheer them up a bit. (I’m still making babies cry, but they do seem to like me up until I get out the sorbettes, so maybe it’s not me…).

I was also able to see one of the places where we are recruiting the mothers. There is a women’s clinic at the hospital where new mothers come to get birth certificates (about 30% give birth at home), mothers come to bring infants for check ups, or if their baby is ill. Since we are looking for older infants (about 1 ½ yr olds), only a few of the babies from the large group of women are eligible for our study. The room was packed with women- all with little babies strapped to their backs with brightly colored cloths-very cool!

After we finished for the day, we packed up and Anna took us out to lunch-more authentic (spicy!) Ghanaian food! We also stopped by a bead shop. This area is known for their beads, which they make from collected glass bottles. Later we returned to the site where I will be staying for the next three weeks and I was able to get settled in and shower (I’m beginning to think the shower part of my day is truly the highlight, if not for me, then definitely for the people around me!)