March 7, 2022

Student-led Fogarty project helps new moms ID signs of jaundice in Ghana

A medical student’s extended research project in Ghana was a success despite the COVID-19 pandemic.

Ann Wolski celebrating her birthday with Ghanaian colleagues
UMMS student Ann Wolski celebrating her birthday with Ghanaian colleagues.

M4 Ann Wolski spent the majority of 2021 in Kumasi on a project that aims to help new moms identify signs of jaundice so treatment can begin early. Her fellowship, funded by the Fogarty International Center, has already resulted in three accepted abstracts in the upcoming Consortium of Universities for Global Health (CUGH) conference and will find Wolski returning to Ghana this spring to continue the work.

“I definitely want to stay involved. I have a little time off before residency and I realized that I really wanted to be back there to help keep this going in whatever way I can,” Wolski said.

Fogarty Global Health Fellows typically spend a full year abroad conducting clinical research. U-M is part of a five-institution consortium—along with the Universities of Washington, Hawaii, Indiana and Minnesota—that facilitates connections between fellows and mentors at longtime partner institutions overseas.

Wolski was part of a research team at Suntreso Government Hospital working under physician Ashura Bakari. They are exploring the potential use of icterometers to detect jaundice in newborns. A simple tool with gradient color swatches to compare against skin tone, the icterometer could be a low-cost, reliable way identify jaundice early in a home setting—if mothers can be taught to use it.

The first phase of the project found Wolski reviewing paper medical records for 1,000 recent births to identify the prevalence of jaundice and any associated demographic factors: geography, age, first-time moms versus subsequent births.

“What we found, interestingly, was that there were no associations with anything,” she said. “That seemed frustrating at first, but we realized that the random nature presented a pretty good argument for the devices: we need something cheap to target everyone and the icterometer is exactly that.”

A nurse providing postnatal education at the hospital
A Suntreso nurse provides postnatal education to a group of new moms as part of the project.

Phase two involved engaging groups of mothers and caregivers in focus group conversations about jaundice and the willingness to utilize the icterometers. Use involves blanching the tip of the baby’s nose and comparing the color against the swatches on the device. Wolski helped produce a short instructional video about it to show to moms, with versions in both English and Twi, the local language.

“We realized the need for a standardized ​demonstration to show these women,” Wolski said. “Since everyone has a smart phone, a two-minute video seemed like a good idea.”

Her initial program, delayed and condensed by the pandemic, was to be six months, but Wolski extended her stay to nine months, conducting residency interviews remotely from Kumasi via zoom.

“I did 14 interviews, and that I was speaking to them from Ghana almost always became a topic of conversation,” she said. “They were very interested in why I was there, what I was doing. I hope it made me stand out.”

Bakari, the project’s leader, is carrying the project forward with her own Fogarty fellowship experience this year. The Fogarty International Center opens applications for new fellowships each summer for experiences to take place the following year.

“I learned so much about doing research in a global setting, maintaining partnerships, and also what good mentorship looks like,” said Wolski. “I feel like I’m a better person for the experience. It confirmed what I was hoping would be my career path in terms of global health and I can see myself focused on Ghana for a long time, given the opportunity.”