Department of Pediatrics

Global and Immigrant Health


Baylor College of Medicine / Texas Children's Hospital (BCM/TCH) is revolutionizing global pediatric emergency care. In sub-Saharan Africa, children have a 12 times higher chance of dying by their 5th birthday compared to the United States. Latin America is the continent which exhibits the highest disparities in child mortality rates between countries in the world. Although there have been significant improvements to global child survival over the last 20 years through improved access to care and stabilizing the HIV/AIDS epidemic, children still die of preventable, treatable diseases and injuries at staggeringly high numbers (5.9 million each year or >16,000/day). We know that interventions aimed at early recognition and management of injury and illness can profoundly decrease child mortality.

Launched in 2005, the BCM/TCH Global Pediatric Emergency Medicine (PEM) program, through ethical and committed bidirectional partnerships, aims to develop initiatives that promote collaboration and foster partnerships with existing BCM/TCH Global Health (GH) programs and external domestic and global partners focused on training and education, health systems strengthening, clinical care and treatment, advocacy, and research to improve emergency care of children worldwide.

With over 15 years of experience working in a variety of low-middle income countries (LMICs), endorsements by Latin American and African healthcare leaders, and in collaboration with the Pan American Health Organization (PAHO) and local Ministries of Health, Global PEM has had dramatic success providing over 25,000 hours of clinical care and shoulder-to-shoulder mentoring for emergently ill children alongside our global partners and training over 5,000 health professionals in 25 countries. Nearly 50% of Division faculty have contributed clinically or academically to the PEM-GH program since 2015. Collaboratively with our fellows (we have 1 PEM / global health fellow each year), this Global PEM work has resulted in 62 distinct manuscripts, 71 academic presentations and service on 41 local, national, and international GH-related committees.

Our group currently works in Argentina, Belize, Colombia, Cote d'Ivoire, El Salvador, Guatemala, Malawi, Nicaragua, Panama, Puerto Rico, Rwanda, and South Africa. In addition, our clinicians provide care to newly arrived immigrant children at the South Texas border through the Texas Children's Hospital Program for Immigrant and Refugee Child Health (PIRCH).

Since 2005, funding for this program has been supported through a combination of extramural grants totaling more than $4 million with approximately $1 million coming directly to the institution, internal grants as well as generous division, department and institutional support.

Faculty with a research focus on global and immigrant health:

McCollum ED, Ahmed S, Roy AD, Islam AA, Schuh HB, King C, Hooli S, Quaiyum MA, Ginsburg AS, Checkley W, Baqui AH, Colburn T. Risk and accuracy of outpatient-identified hypoxaemia for death among suspected child pneumonia cases in rural Bangladesh: a multifacility prospective cohort studyLancet Respir Med. 2023. PMID 37037207.

Lonquich B, Camp E, Fredricks K, Russell EA. Medicaid/CHIP Eligibility and Insurance Status in Foreign-Born Children Living in the United States. J Health Care Poor Underserved. 2023.

Hooli S, King C, McCollum ED, Colubourn T, Lufesi N, Mwansambo C, Gregory CJ, Thamthitiwat S, Cutland C, Madhi SA, Nunes MC, Gessner BD, Hazir T, Mathew JL, Addo-Yobo E, Chisaka N, Hassan M, Hibberd PL, Jeena P, Lozano JM, MacLeod WB, Patel A, Thea DM, Nguyen NTV, Zaman SM, Ruvinsky RO, Lucero M, Kartasasmita CB, Turner C, Asghar R, Banajej S, Iqbal I, Maluen-Radovan I, Mino-Leon G, Saha SK, Santosham M, Singhi S, Awasthi S, Bavdekar A, Chou M, Nymadawa P, Pape JW, Paranhos-Baccala G, Picot VS, Rakoto-Andrianarivelo M, Rouzier V, Russomando G, Sylla M, Vanhems P, Wang J, Basnet S, Strand TA, Neuman MI, Arroyo LM, Echavarria M, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Gentile A, Chadha M, Hirve S, O'Grady KF, Clara AW, Rees CA, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Qazi SA, Nisar YB; Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) study group. In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) datasetInt J Infect Dis. 2023. PMID 36805325.

Hooli S, Makwenda C, Lufesi N, Colbourn T, Mvalo T, McCollum E, King C. Implication of the 2014 World Health Organization Integrated Management of Childhood Illness Pneumonia Guidelines with and without pulse oximetry use in Malawi: A retrospective cohort study. Gates Open Research. 2023. DOI: 10.12688/gatesopenres.13963.1

Hooli S, Schuh HB, Ahmed S, King C, Roy AD, Lufesi N, Ashraful Islam ASM.D., Mvalo T, Chowdhury NH, Ginsburg AS, Colbourn T, Checkley W, Baqui AH, McCollum ED. Clinical hypoxemia score for outpatient child pneumonia care lacking pulse oximetry in Africa and South Asia. medRxiv .2023. 

Martin H, Falconer J, Addo-Yobo E, Aneja S, Arroyo LM, Asghar R, Awasthi S, Banajeh S, Bari A, Basnet S, Bavdekar A, Bhandari N, Bhatnagar S, Bhutta ZA, Brooks A, Chadha M, Chisaka N, Chou M, Clara AW, Colbourn T, Cutland C, D'Acremont V, Echavarria M, Gentile A, Gessner B, Gregory CJ, Hazir T, Hibberd PL, Hirve S, Hooli S, Iqbal I, Jeena P, Kartasasmita CB, King C, Libster R, Lodha R, Lozano JM, Lucero M, Lufesi N, MacLeod WB, Madhi SA, Mathew JL, Maulen-Radovan I, McCollum ED, Mino G, Mwansambo C, Neuman MI, Nguyen NTV, Nunes MC, Nymadawa P, O'Grady KF, Pape JW, Paranhos-Baccala G, Patel A, Picot VS, Rakoto-Andrianarivelo M, Rasmussen Z, Rouzier V, Russomando G, Ruvinsky RO, Sadruddin S, Saha SK, Santosham M, Singhi S, Soofi S, Strand TA, Sylla M, Thamthitiwat S, Thea DM, Turner C, Vanhems P, Wadhwa N, Wang J, Zaman SM, Campbell H, Nair H, Qazi SA, Nisar YB; World Health Organization Pneumonia Research Partnership to Assess WHO Recommendation (PREPARE) study group. Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: methodology and applicationsJ Glob Health. 2022. PMID 36579417.

Moher JM, Morales-Perez L, Chiume M, Crouse HL, Mgusha Y, Betchani F, D'Amico BM, Pediatric Alliance for Child Health Improvement in Malawi at Kamuzu Central Hospital and Environs (PACHIMAKE) Consortium. Point-of-care ultrasound needs assessment in a paediatric acute care setting in Malawi. Trop Med Int Health. 2023. PMID 36416491.

Raees M, Hooli S, et al. An exploratory assessment of the management of pediatric traumatic brain injury in three centers in AfricaFront Pediatr. 2022;10:936150. PMID 36061402.

Rees CA, Colbourn T, Hooli S, et al. Derivation and validation of a novel risk assessment tool to identify children aged 2-59 months at risk of hospitalised pneumonia-related mortality in 20 countriesBMJ Glob Health. 2022. PMID 35428680.  

Kortz TB, Nielsen KR, Mediratta RP, Reeves H, O'Brien NF, Lee JH, Attebery JE, Bhutta EG, Biewen C, Coronado Munoz A, deAlmeida ML, Fonseca Y, Hooli S, et al. The burden of critical illness in hospitalized children in low- and middle-income countries: protocol for a systematic review and meta-analysisFront Pediatr. 2022;10:756643. PMID 35372149.

Abbas Q, Holloway A, Caporal P, Lopez-Baron E, Agulnik A, Remy KE, Appiah JA, Attebery J, Fink EL, Lee JH, Hooli S, et al. Global PARITY: study design for a multicentered, international point prevalence study to estimate the burden of pediatric acute critical illness in resource-limited settingsFront Pediatr. 2022;9:793326. PMID 35155314.

Keating EM, Robison JA, Chiume M, Taddie M, VanDerslice JA, Benson LS, Fitzgerald E, Crouse HL, Eckerle M.D., Ciccione EJ, Porucznik CA. Relationship between distance of referring facilities and haemoglobin change in children in MalawiPaediatr Int Child Health. 2021. PMID 35230927.

Vonasek BJ, Mhango S, Crouse HL, Nyangulu T, Gaven W, Ciccone E, Kondwani A, Patel B, et al. Improving recognition and management of children with complicated severe acute malnutrition at a tertiary referral hospital in Malawi: a quality improvement initiativePaediatr Int Child Health. 2021. PMID 34494509.

McHenry MS, Tam RP, Nafiseh AA, Etling MA, Barnes EA, Rule ARL, Crouse HL, et al. Global partnerships during the COVID-19 pandemic: perspectives and insights from international partnersAm J Trop Med Hyg. 2021. PMID 34181576.

Keating EM, Chiume M, Fitzgerald E, Mgusha Y, Mvalo T, Fino N, Crouse HL, et al. Blood transfusion and mortality in children with severe anaemia in a malaria-endemic regionPaediatr Int Child Health. 2021. PMID 33874852.

Rees CA, Hooli S, King C, McCollum ED, Colbourn T, Lufesi N, Mwansambo C, Lazzerini M, Madhi SA, Cutland C, Nunes M, Gessner BD, Basnet S, Kartasasmita CB, Mathew JL, Zaman SMAU, Paranhos-Baccala G, Bhatnagar S, Wadhwa N, Lodha R, Aneja S, Santosham M, Picot VS, Sylla M, Awasthi S, Bavdekar A, Pape JW, Rouzier V, Chou M, Rakoto-Andrianarivelo M, Wang J, Nymadawa P, Vanhems P, Russomando G, Asghar R, Banajeh S, Iqbal I, MacLeod W, Maulen-Radovan I, Mino G, Saha S, Singhi S, Thea DM, Clara AW, Campbell H, Nair H, Falconer J, Williams LJ, Horne M, Strand T, Qazi SA, Nisar YB, Neuman MI; World Health Organization PREPARE study group48. External validation of the RISC, RISC-Malawi, and PERCH clinical prediction rules to identify risk of death in children hospitalized with pneumoniaJ Glob Health. 2021. 34737862.

McCollum ED, King C, Ahmed S, Hanif AAM, Roy AD, Islam AA, Colbourn T, Schuh HB, Ginsburg AS, Hooli S, Chowdhury NH, Rizvi SJR, Begum N, Baqui AH, Checkley W. Defining hypoxaemia from pulse oximeter measurements of oxygen saturation in well children at low altitude in Bangladesh: an observational study. BMJ Open Respir Res. 2021. PMID 34728475.

Colbourn T, King C, Beard J, Phiri T, Mdala M, Zadutsa B, Makwenda C, Costello A, Lufesi N, Mwansambo C, Nambiar B, Hooli S, French N, Bar Zeev N, Qazi SA, Bin Nisar Y, McCollum ED. Predictive value of pulse oximetry for mortality in infants and children presenting to primary care with clinical pneumonia in rural Malawi: a data linkage studyPLoS Med. 2020. PMID 33095763.

Crouse HL, Watts J, St Clair NE, Batra M, McGuinness G, Keating EM, Russ CM, Farr KM, Steenhoff AP, Schubert CJ, Leslie LK, Woods SK, Wilson KA, Camp EA, Butteris SM. Global Health Opportunities in Pediatric Fellowships.  Pediatrics. 2020. PMID: 32001489.

Ciccone EJ, Tilly AE, Chiume M, Mgusha Y, Eckerle M, Namuku H, Crouse HL, Mkaliainga TB, Robison JA, Schubert CJ, Mvalo T, Fitzgerald E. Lessons learned from the development and implementation of an electronic paediatric emergency and acute care database in Lilongwe, Malawi. BMJ Glob Health. 2020. PMID: 32675067.

Genisca AE, Sampayo EM, Mackey JM, Johnson L, Crouse HL. Assessment of Attitudes Toward the Emergency Triage System in Belize. Glob Pediatr Health. 2020. PMID: 32313821. 

Colbourn T, King C, Beard J, Phiri T, Mdala M, Zadutsa B, Makwenda C, Costello A, Lufesi N, Mwansambo C, Nambiar B, Hooli S, French N, Bar Zeev N, Qazi SA, Bin Nisar Y, McCollum ED. Predictive value of pulse oximetry for mortality in infants and children presenting to primary care with clinical pneumonia in rural Malawi: A data linkage study.  PLoS Med. 2020. PMID: 33095763.

Ahmed S, Mvalo T, Akech S, Agweyu A, Baker K, Bar-Zeev N, Campbell H, Checkley W, Chisti MJ, Colbourn T, Cunningham S, Duke T, English M, Falade AG, Fancourt NS, Ginsburg AS, Graham HR, Gray DM, Gupta M, Hammitt L, Hesseling AC, Hooli S, Johnson AB, King C, Kirby MA, Lanata CF, Lufesi N, Mackenzie GA, McCracken JP, Moschovis PP, Nair H, Oviawe O, Pomat WS, Santosham M, Seddon JA, Thahane LK, Wahl B, Van der Zalm M, Verwey C, Yoshida LM, Zar HJ, Howie SR, McCollum ED. Protecting children in low-income and middle-income countries from COVID-19. BMJ Glob Health. 2020. PMID: 32461228. 

Hooli S, King C. Generalizability of Coronavirus Disease 2019 (COVID-19) Clinical Prediction Models. Clin Infect Dis. 2020. PMID: 32271865. 

Hooli S, King C, Zadutsa B, Nambiar B, Makwenda C, Masache G, Lufesi N, Mwansambo C, Malla L, Costello A, Colbourn T, McCollum ED. The Epidemiology of Hypoxemic Pneumonia among Young Infants in Malawi. Am J Trop Med Hyg. 2020. PMID: 31971153.

Russell EA, Daza Atehortua C, Attia SL, Genisca AE, Palomino Rodriguez A, Headrick A, Solano L, Camp EA, Galvis AM, Crouse HL, Thomas JA. Childhood malnutrition within the indigenous Wayuú children of northern Colombia. Glob Public Health. 2020. PMID: 31944923.

Thomas VA, Crouse HL, Murray KO, Hsu DC, Camp EA, Cruz ATEmergency medicine providers' knowledge and management of pediatric tropical diseases: a needs assessmentPediatr Emerg Care. 2020. PMID 29538263.

Russell EA, Tsai C, Linton JM. Children in Immigrant Families: Advocacy Within and Beyond the Pediatric Emergency DepartmentClin Pediatr Emerg Med. 2020. PMID: 32922213.