Personal Statement of Research and Research Objectives

My research interests focus broadly on 3 major area’s, with my Pediatrics and Infectious disease back ground the first area focuses on understanding epidemiology, management, development and testing of intervention and/or Vaccines for Pediatric Infectious diseases of Public health Importance -Diarrhea, Pneumonia, Malaria, Measles, Typhoid, Tuberculosis – these by WHO estimates cause over 7.5 million preventable deaths in children in developing countries. My motivation for this research and shifting from a Pediatrician to Public health Researcher was that I would like to see my research prevent more deaths and morbidity than I could have prevented or treated as a physician. The second area focuses on malnutrition including maternal, fetal and child malnutrition especially micronutrient deficiencies and their interaction with the Infectious diseases in first area of focus. Defining the causal link between micronutrient deficiency and morbidity and mortality and testing interventions for prevention of these effects. The third area is methodological work focusing on pooled and meta-analysis of intervention trails in primary areas of first and second focus to inform policy or design new research, evaluation of analysis strategies for longitudinal data, development and evaluation of computer and palm based techniques to measure activity, social referencing, social environment of children, development of computer bases systems to record and analyze dietary data including 24 hour recalls and food frequency with special emphasis on measurement of bio-available intakes of micronutrients. Development (tests adaptable to field settings) and evaluation of diagnostic tests for diagnosis of iron deficiency, zinc deficiency, malaria, Tuberculosis, immune status. At present most of my research is focus in India and Tanzania. Expansion to South Africa and Cambodia is underway. Most of the work is multidisciplinary.

Some of the Research question currently being undertaken:

- Community based randomized clinical trails evaluating effects of iron/Folic acid supplementation on childhood mortality and severe morbidity in malaria endemic areas

- Evaluation of deliver of iron-folic acid supplementation in presence of anti-malarial/ antibiotic cover. Testing of program options

- Community based Randomized clinical trial for effect of zinc supplementation on mortality and severe morbidity in children

- Community based randomized trails or zinc and micronutrient supplementation in SGA born infants on Mortality morbidity, and development and both during supplementation period and a 4 year follow up of these children for long term effects on growth and child development.

- Community based Randomized trails evaluating effects of fortified of milk with micronutrients or Probiotics on child morbidity, growth and development including long term follow up for evaluating effects on cognitive development and school performance.

- Acceptability and compliance studies for home based fortification strategies with weaning food or sprinkles, and design of intervention trail for testing fortification strategy as a deliver mechanism for zinc and iron.

- Effect of iron deficiency and or Anemia on child development, activity and reversibility of these effects.

- Methodological work for a) activity assessment using active watch with observations using observer and palm based software, b) social referencing observer versus Palm bases program,

International Health, Disease Control, Community-based field trials, child health and development, meta-analysis, Diarrhea, Pneumonia, Malaria, Infectious diseases, Zinc, Iron, Micronutrients, Child development, Annamalai University India.

•Award of Merit 3rd Position in The Faculty of Medicine, University of Kashmir, 1993.

•Dr. S.T.Achar Gold Medal for best paper in Pediatrics, Indian Acadamy of Pediatrics 1989.

•Dr. Satya Gupta award for best paper in Preventive Pediatrics, Indian Academy Pediatrics, Delhi, 1990.

•Rockefeller Foundation Special Post Doctoral Fellowship in clinical epidemiology and advanced studies, 1990.

•Dr Harry Kruse award for academic performance and professional potential in nutrition research from Johns Hopkins University Committee on Honors and awards for 1995.

•Nutrition Society of India award for preventive and community nutrition, at XXVIII Annual Meeting, SNDT womens university Bombay 1995

•Phi Beta Kappa for Honors in academic performance 1996

1.Olney DK, Pollitt E, Kariger PK, Khalfan SS, Ali NS, Tielsch JM, Sazawal S, Black RE, Mast D, Allen LH, Stoltzfus RJ. Young Zanzibari children with iron deficiency, iron deficiency anemia, stunting, or malaria have lower motor activity scores and spend less time in locomotion. J Nutr. 2007 Dec; 137(12):2756-62.

2.Black RE, Sazawal S, Dhingra U, Dutta A. Malnutrition, Zinc deficiency, and Malaria in Africa. Lancet. 2007 Jun 30;369 (9580):2156-7.

3.Dhingra P, Sazawal S, Menon VP, Dhingra U, Black RE. Validation of Visual Estimation of Portion Size Consumed as a Method for Estimating Intake in Young Children. J Health Popul Nutr. 2007 Mar; 25(1):112-5.

4.Sazawal S, Black RE, Ramsan M, Chwaya HM, Dutta A, Dhingra U, Stoltzfus RJ, Othman MK, Kabole FM Effects of Zinc Supplementation on Mortality in Children 1–48 Months of Age: A Community-based Randomized Placebo-controlled Trial . Lancet. 2007 Mar 17; 369(9565):927-34.

5.Sazawal S, Dhingra U, Deb S, Bhan MK, Menon VP, Black RE. Effect of Zinc added to Multivitamin Supplementation Containing Low Dose Vitamin A on Plasma Retinol Level In Children - A Double Blind Randomized Controlled Trial. J Health Popul Nutr. 2007 Mar; 25(1):62-6.

6.Lozoff B, Corapci F, Burden MJ, Kaciroti K, Angulo-Barroso R, Sazawal S, Black M. Preschool-Aged Children with Iron Deficiency Anemia Show Altered Affect and Behavior. J Nutr. 2007 Mar; 137(3):683-9.

7.Sazawal S, Dhingra U, Hiremath G, Kumar J, Dhingra P, Sarkar A, Menon VP, Black RE. Effects of fortified milk on morbidity in young children in north India: community based, randomised, double masked placebo controlled trial. BMJ. Jan 2007; :334(7585):140. Epub 2006 Nov 28

8.Dhingra P, Sazawal S. Spring balance vs. SECA Balance as a Measure of Weight in Children. Indian Pediatr. 2006; 43(12):1091-2.

9.Sarkar A, Dutta A, Dhingra U, Dhingra P, Verma P, Juyal R, Black RE, Menon VP, Kumar J, Sazawal S. Development and use of behavior and social interaction software installed on palm handheld for observation of a child's social interactions with the environment. Behav Res Methods. 2006; 38(3):407-15.

10.Olney DK, Pollitt E, Kariger PK, Khalfan SS, Ali NS, Tielsch JM, Sazawal S, Black R, Allen LH, Stoltzfus RJ. Combined iron and folic acid supplementation with or without zinc reduces time to walking unassisted among Zanzibari infants 5- to 11-mo old. J Nutr. 2006 ; 136(9):2427-34.

11.Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials. Lancet Infect Dis. 2006 Jun;6(6):374-82.

12.Hiremath GS, Sullivan DJ Jr, Tripathi AK, Black RE, Sazawal S. Effect of Plasmodium falciparum parasitemia on erythrocyte zinc protoporphyrin. Clin Chem. 2006 Apr;52 (4):778-9.

13.Sazawal S, Black RE, Ramsan M, Chwaya HM, Stoltzfus RJ, Dutta A, Dhingra U, Kabole I, Deb S, Othman MK, Kabole FM. Effects of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community-based, randomised, placebo-controlled trial. Lancet. 2006 Jan 14;367(9505):133-43.

14.Olney DK, Pollitt E, Kariger PK, Khalfan SS, Ali NS, Tielsch JM, Sazawal S,Black R, Allen LH, Stoltzfus RJ. Combined iron and folic acid supplementation with or without zinc reduces time to walking unassisted among Zanzibari infants 5- to 11-mo old. J Nutr. 2006; 136(9):2427-34.

15. Sazawal S, Malik P, Jalla S, Krebs N, Bhan MK, Black RE. Zinc supplementation for four months does not affect plasma copper concentration in infants. Acta Paediatrica 2004; 93(5):599-602.

16. Black MM, Sazawal S, Black RE, Khosla S, Kumar J, Menon V. Cognitive and motor development among small-for-gestational-age infants: impact of zinc supplementation, birth weight, and care giving practices. Pediatrics 2004;113 (5):1297-305

17. Sazawal S, Black RE; Pneumonia Case Management Trials Group. Effect of pneumonia case management on mortality in neonates, infants, and preschool children: a meta-analysis of community-based trials. Lancet Infect Dis. 2003 Sep;3(9):547-56.

18. Zinc Investigators’ Collaborative Group (S. Sazawal and R.E. Black, coordinators). Prevention of diarrhea and pneumonia by zinc supplementation in children indeveloping countries: pooled analysis of randomized controlled trials.J Pediatr. 1999 Dec;135(6):689-97.

19. Sazawal S, Black RE, Menon VP, Dinghra P, Caulfield LE, Dhingra U, Bagati A. Zinc supplementation in infants born small for gestational age reduces mortality: a prospective, randomized, controlled trial. Pediatrics. 2001 Dec;108(6):1280-6.

20. Sazawal S; Black RE; Bhan MK; Bhandari N; Sinha A Jalla S. Zinc supplementation in young children with acute diarrhea in India [see comments]. N Engl J Med 1995 Sep 28; 333(13): 839-44.

21. Sazawal S; Black RE. Meta-analysis of intervention trials on case-management of pneumonia in community settings. Lancet 1992 Aug 29; 340(8818): 528-33.

Sunil Sazawal