Indi Trehan, MD, MPH, DTM&H

Profile picture
Associate Professor, Emergency Medicine
Associate Professor, Infectious Diseases
Associate Professor, Patient Oriented Research Unit
Emergency Medicine

phone: (314) 454-2341

Clinical Interests

My clinical passion is in the care of children in resource-limited, particularly tropical, settings. As such, my primary interests within Emergency Medicine are diarrhea, respiratory distress, sepsis, shock, and trauma. I am also very interested in the application of bedside ultrasound to patient care, both in resource-rich and underserved settings. Within Infectious Diseases, my primary interests are in fevers of unknown origin, HIV/AIDS, malaria, neglected tropical diseases, parasitic infections, travel medicine, and tuberculosis.

My overall career goal is to contribute to a substantive improvement in childhood morbidity and mortality on a global level. To address this, my major academic interests are in the development of a better understanding of the pathophysiology underlying chronic and acute childhood malnutrition, improving the diagnosis and treatment of malnourished children, and improvements in the diagnosis and management of tropical infectious diseases. The majority of my experience in these domains has come in the conduct of large clinical trials in rural Malawi as well as in smaller hospital-based cohort studies to complement my clinical experience caring for children and adults in austere settings around the world.

After several years in a purely academic position, as of January 2017 I have moved abroad full-time to become more engaged in direct patient care in the tropics, educate local health care workers, conduct field research, and help strength local health systems. I maintain a part-time academic appointment at Washington University in order to improve patient care, research, and education in global health, but now spend most of my time serving as the Medical Director of the Lao Friends Hospital for Children, a tertiary care teaching hospital in northern Laos.


  • BS, Chancellor's Scholar, University of California, Berkeley1998
  • MD, Northwestern University2004
  • MPH, Northwestern University2004
  • DTM&H, Universidad Peruana Cayetano Heredia and Gorgas Memorial Institute of Tropical & Preventive Medicine2006


  • Research Fellowship, Howard Hughes Medical Institute2000 - 2002
  • Pediatrics Residency, Cincinnati Children's Hospital Medical Center2004 - 2007
  • Pediatric Emergency Medicine Fellowship, Washington University in St. Louis2007 - 2013
  • Pediatric Infectious Diseases Fellowship, Washington University in St. Louis2007 - 2013
  • Clinical Ultrasound in Tropical Infectious Diseases Course, Universidad Peruana Cayetano Heredia and Georgia Regents University2012
  • Pediatric Emergency Medicine and Critical Care Medicine Bedside Ultrasound Course, The Children's Hospital of Philadelphia2013
  • McMaster Evidence-Based Clinical Practice Teaching Workshop, McMaster University2016

Licensure and Board Certification

  • Certificate of Knowledge in Clinical Tropical Medicine and Traveler's Health, American Society of Tropical Medicine and Hygiene 2006
  • Diplomate, National Board of Medical Examiners 2007
  • Certificate of Knowledge in Travel Medicine, International Society of Travel Medicine 2007
  • MO, Physician and Surgeon License 2008
  • Diplomate in General Pediatrics, American Board of Pediatrics 2008
  • General Physician License, Medical Council of Malawi 2011
  • Diplomate in Pediatric Infectious Diseases, American Board of Pediatrics 2013
  • Specialist Physician License, Liberia Medical and Dental Council 2017


  • Chancellor's Scholarship, University of California, Berkeley1994 - 1998
  • Medical Student Research Training Fellowship, Howard Hughes Medical Institute2000 - 2004
  • Benzing / Lowe Award for Excellence in Critical Care, Cincinnati Children's Hospital Medical Center2007
  • Samuel Dalinsky Memorial Award for the Outstanding Graduating Pediatric Resident, Cincinnati Children's Hospital Medical Center2007
  • Outstanding Fellow Teaching Award, Washington University in St. Louis Pediatrics Residency Program2007 - 2008
  • Ruth L. Kirschstein National Research Service Award T32-HD049338, National Institute of Child Health and Human Development2009 - 2011
  • Pediatric Loan Repayment Program Award L40-HD066655, National Institute of Child Health and Human Development2010 - 2012
  • Best Fellow Abstract at 2011 Pediatric Academic Societies’ Annual Meeting, Academic Pediatric Association2011
  • Outstanding Lecturer of the Month for December 2012, Washington University in St. Louis Pediatrics Residency Program2012
  • Best Poster by a Postdoctoral Fellow at 2013 Center for Global Health and Infectious Disease Conference, Washington University in St. Louis Center for Global Health and Infectious Disease2013
  • Pediatric Clinical Educator Award, Washington University in St. Louis Emergency Medicine Residency Program2013 - 2014
  • Councilor, American Society for Tropical Medicine and Hygiene Committee on Global Health2013 - 2015
  • Outstanding Lecturer of the Month for December 2013, Washington University in St. Louis Children's Pediatrics Residency Program2013
  • Outstanding Subspecialty Teacher Award, Washington University in St. Louis Pediatrics Residency Program2014 - 2015
  • Keynote Speaker, Northwestern University Program in Public Health MD/MPH Graduation2015
  • Outstanding Commitment to Teaching Award, Washington University in St. Louis Pediatrics Residency Program2015 - 2016
  • Faculty Inductee, Gold Humanism Honor Society, Washington University in St. Louis School of Medicine2016
  • Humanism in Medicine Award, Washington University in St. Louis School of Medicine2016
  • Member, Society for Pediatric Research2018 - Pres
  • Society for Pediatric Research Outstanding New Member Award2018

Recent Publications view all (82)

Publication Co-Authors

  1. Development of acute malnutrition despite nutritional supplementation in Malawi. J Pediatr Gastoenterol Nutr. 2019;68. 
  2. Bystander assistance for trauma victims in low- and middle-income countries: a systematic review of prevalence and training interventions. Prehosp Emerg Care. 2019;23. doi:10.1080/10903127.2018.1513104  PMID:30141702 
  3. The burden on emergency centres to provide care for critically ill patients in Addis Ababa, Ethiopia. Afr J Emerg Med. 2018;8(4):150-154. doi:10.1016/j.afjem.2018.07.006  
  4. Global emergency medicine: a review of the literature from 2017. Acad Emerg Med. 2018;25(11):1287-1298. doi:10.1111/acem.13456  PMID:29791967 
  5. Commitment to publication quality and integrity: a message from the journal's editorial board. J Trop Pediatr. 2018;64(5):355-359. doi:10.1093/tropej/fmy038  PMID:30060246 
  6. Effect of cowpea flour processing on the chemical properties and acceptability of a novel cowpea blended maize porridge. PLoS ONE. 2018;13(7):e0200418. doi:10.1371/journal.pone.0200418  PMCID:PMC6039016  PMID:29990380 
  7. The unbearable lightness of being malnourished: severe acute malnutrition remains a neglected tropical disease. J Trop Pediatr. 2018;64(3):169-173. doi:10.1093/tropej/fmx103  PMID:29315432 
  8. Children with poor linear growth are at risk for repeated relapse to wasting after recovery from moderate acute malnutrition. J Nutr. 2018;148(6):974-979. doi:10.1093/jn/nxy033  PMID:29726948 
  9. Breathprinting reveals malaria-associated biomarkers and mosquito attractants. J Infect Dis. 2018;217(10):1553-1560. doi:10.1093/infdis/jiy072  PMID:29415208 
  10. Household-level factors associated with relapse following discharge from treatment for moderate acute malnutrition. Br J Nutr. 2018;119(9):1039-1046. doi:10.1017/S0007114518000363  PMID:29502542 
  11. Management of Ebola virus disease in children. Infect Dis Clin North Am. 2018;32(1):201-214. doi:10.1016/j.idc.2017.10.010  PMID:29269191 
  12. Rotavirus vaccines: a social injustice story. J Trop Pediatr. 2018;64(1):1-3. doi:10.1093/tropej/fmx074  PMID:29401319 
  13. Additional common bean in the diet of Malawian children does not affect linear growth, but reduces intestinal permeability. J Nutr. 2018;148(2):267-274. doi:10.1093/jn/nxx013  PMID:29490090 
  14. Complementary feeding with cowpea reduces growth faltering in rural Malawian infants: a blind, randomized, controlled clinical trial. Am J Clin Nutr. 2017;106(6):1500-1507. doi:10.3945/ajcn.117.160986  PMID:29092882 
  15. Low serum ω-3 and ω-6 polyunsaturated fatty acids and other metabolites are associated with poor linear growth in young children from rural Malawi. Am J Clin Nutr. 2017;106(6):1490-1499. doi:10.3945/ajcn.117.164384  PMCID:PMC5698844  PMID:29070563 
  16. Intrapartum antibiotic chemoprophylaxis policies for the prevention of Group B Streptococcal disease worldwide: systematic review. Clin Infect Dis. 2017;65(S2):S143-S151. doi:10.1093/cid/cix654  PMCID:PMC5850619  PMID:29117324 
  17. Lactoferrin and lysozyme to reduce environmental enteric dysfunction and stunting in Malawian children: study protocol for a randomized controlled trial. Trials. 2017;18:523. doi:10.1186/s13063-017-2278-8  PMCID:PMC5674751  PMID:29110675 
  18. The nutrient and metabolite profile of three complementary legume foods with potential to improve gut health in rural Malawian children. Curr Dev Nutr. 2017;1(10):e001610. doi:10.3945/cdn.117.001610  PMCID:PMC5998778   PMID:29955682 
  19. Trial of ready to use supplemental food and corn soy blend in pregnant Malawian women with moderate malnutrition: a randomized, controlled clinical trial. Am J Clin Nutr. 2017;106(4):1062-1069. doi:10.3945/ajcn.117.157198  PMID:28793991 
  20. Severe childhood malnutrition. Nat Rev Dis Primers. 2017;3:17067. doi:10.1038/nrdp.2017.67  PMID:28933421 
  21. Global emergency medicine: a review of the literature from 2016. Acad Emerg Med. 2017;24(9):1150-1160. doi:10.1111/acem.13216  PMID:28474823 
  22. Effect of a package of health and nutrition services on sustained recovery in children after moderate acute malnutrition and factors related to sustaining recovery: a cluster randomized trial. Am J Clin Nutr. 2017;106(2):657-666. doi:10.3945/ajcn.116.149799  PMID:28615258 
  23. African children with severe pneumonia remain at high risk for death even after discharge. Paediatr Perinat Epidemiol. 2017;31(3):243-244. doi:10.1111/ppe.12350  PMID:28387423 
  24. Environmental enteric dysfunction is associated with altered bile acid metabolism. J Pediatr Gastroneterol Nutr. 2017;64(4):536-540. doi:10.1097/MPG.0000000000001313  PMCID:PMC5164860  PMID:27322559 
  25. Environmental enteric dysfunction is associated with carnitine deficiency and altered fatty acid oxidation. EBioMedicine. 2017;17:57-66. doi:10.1016/j.ebiom.2017.01.026  PMCID:PMC5360565   PMID:28122695 
  26. Environmental enteric dysfunction and the fecal microbiota in Malawian children. Am J Trop Med Hyg. 2017;96(2):473-476. doi:10.4269/ajtmh.16-0617  PMCID:PMC5303055  PMID:27956653 
  27. A combined package of zinc, multiple micronutrients, and albendazole does not ameliorate environmental enteric dysfunction or stunting in rural Malawian children in a double-blind, randomized, controlled trial. J Nutr. 2017;147(1):97-103. doi:10.3945/jn.116.237735  PMID:27807040 
  28. Metabolomic changes in serum of children with different clinical diagnoses of malnutrition. J Nutr. 2016;146(12):2436-2444. doi:10.3945/jn.116.239145  PMCID:PMC5118769  PMID:27807038 
  29. Environmental enteric dysfunction is associated with poor linear growth and can be identified by host fecal mRNAs. J Pediatr Gastroenterol Nutr. 2016;63(5):453-459. doi:10.1097/MPG.0000000000001315  PMCID:PMC5084633  PMID:27347722 
  30. Global emergency medicine: a review of the literature from 2015. Acad Emerg Med. 2016;23(10). doi:10.1111/acem.12999  PMID:27146277 
  31. A courageous report on the management of malnutrition Nutrients. 2016;8(10):603. doi:10.3390/nu8100603  PMCID:PMC5083991  PMID:27690090 
  32. Perspective: the potential role of essential amino acids and the mechanistic target of rapamycin complex 1 (mTORC1) pathway in the pathogenesis of child stunting. Adv Nutr. 2016;7(5):853-865. doi:10.3945/an.116.013276  PMCID:PMC5015042  PMID:27633102 
  33. Antibiotics as part of the management of severe acute malnutrition. Malawi Med J. 2016;28(3):123-130. doi:10.1056/NEJMoa1202851  PMCID:PMC5117002  PMID:27895846 
  34. New insights into environmental enteric dysfunction. Arch Dis Child. 2016;101(8):741-744. doi:10.1136/archdischild-2015-309534  PMID:26933151 
  35. Amoxicillin for severe acute malnutrition in children. N Engl J Med. 2016;375(2):191. doi:10.1056/NEJMc1605388  PMID:27410940 
  36. An important chapter in the infection-malnutrition story. Lancet Glob Health. 2016;4:e430-e431. doi:10.1016/S2214-109X(16)30110-3  PMID:27289200 
  37. The association of serum choline with linear growth failure in young children from rural Malawi. Am J Clin Nutr. 2016;104(7):191-197. doi:10.3945/ajcn.115.129684  PMCID:PMC4919529  PMID:27281303 
  38. Metabolic alterations in children with environmental enteric dysfunction. Sci Rep. 2016;6:28009. doi:10.1038/srep28009  PMCID:PMC4904796  PMID:27294788 
  39. Child stunting is associated with low circulating essential amino acids. EBioMedicine. 2016;6:246-252. doi:10.1016/j.ebiom.2016.02.030  PMCID:PMC4856740  PMID:27211567 
  40. Moving towards a more aggressive and comprehensive model of care for children with Ebola. J Pediatr. 2016;170(1):28-33.e7. doi:10.1016/j.jpeds.2015.11.054  PMID:26778094 
  41. Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: a randomized, double-blind clinical trial. Am J Clin Nutr. 2016;103(3):926-933. doi:10.3945/ajcn.115.124636  PMID:26864368 
  42. The Harvard-LSHTM panel on the global response to Ebola report. Lancet. 2016;387(10021):848. doi:10.1016/S0140-6736(16)00509-2  PMID:26972075 
  43. Gut bacteria that prevent growth impairments transmitted by microbiota from malnourished children. Science. 2016;351(6275):aad3311. doi:10.1126/science.aad3311  PMCID:PMC4787260  PMID:26912898 
  44. Environmental enteric dysfunction includes a broad spectrum of inflammatory responses and epithelial repair processes. Cell Mol Gastroenterol Hepatol. 2016;2(2):158-174.e1. doi:10.1016/j.jcmgh.2015.12.002  PMCID:PMC4769221  PMID:26973864 
  45. Common beans and cowpeas as complementary foods to reduce environmental enteric dysfunction and stunting in Malawian children: study protocol for two randomized controlled trials. Trials. 2015;16(1):520. doi:10.1186/s13063-015-1027-0  PMCID:PMC4650393  PMID:26578308 
  46. Gut DNA viromes of Malawian twins discordant for severe acute malnutrition. Proc Natl Acad Sci U S A. 2015;112(38):11941-11946. doi:10.1073/pnas.1514285112  PMCID:PMC4586842  PMID:26351661 
  47. Global emergency medicine: a review of the literature from 2014. Acad Emerg Med. 2015;22(8):976-984. doi:10.1111/acem.12733  PMID:26223901 
  48. Can children with uncomplicated acute appendicitis be treated with antibiotics instead of an appendectomy? Ann Emerg Med. 2015;66(2):119-122. doi:10.1016/j.annemergmed.2015.01.025  PMID:25724624 
  49. High-oleic ready-to-use therapeutic food maintains docosahexaenoic acid status in severe malnutrition. J Pediatr Gastroenterol Nutr. 2015;61(1):138-143. doi:10.1097/MPG.0000000000000741  PMCID:PMC4483140  PMID:25633498 
  50. Balancing omega-6 and omega-3 fatty acids in ready-to-use therapeutic foods (RUTF). BMC Med. 2015;13(117). doi:10.1186/s12916-015-0352-1  PMCID:PMC4433071  PMID:25980919 
  51. Research priorities to improve the management of acute malnutrition in infants aged less than six months (MAMI). PLOS Med. 2015;12(4):e1001812. doi:10.1371/journal.pmed.1001812  PMCID:PMC4405387  PMID:25898252 
  52. Diagnosis and treatment of severely malnourished children with diarrhoea. J Paediatr Child Health. 2015;51(4):387-395. doi:10.1111/jpc.12711  PMID:25196813 
  53. Extending supplementary feeding for children younger than 5 years with moderate acute malnutrition leads to lower relapse rates. J Pediatr Gastroenterol Nutr. 2015;60(4):544-549. doi:10.1097/MPG.0000000000000639  PMCID:PMC4380557  PMID:25419681 
  54. Management of severe acute malnutrition in low-income and middle-income countries. Arch Dis Child. 2015;100(3):283-287. doi:10.1136/archdischild-2014-306026  PMID:25421910 
  55. Functional characterization of IgA-targeted bacterial taxa from undernourished Malawian children that produce diet-dependent enteropathy. Sci Trans Med. 2015;7(276):276ra24. doi:10.1126/scitranslmed.aaa4877  PMCID:PMC4423598  PMID:25717097 
  56. Multiple micronutrient supplementation transiently ameliorates environmental enteropathy in Malawian children aged 12-35 months in a randomized controlled clinical trial. J Nutr. 2014;144(12):2059-2065. doi:10.3945/jn.114.201673  PMID:25411039 
  57. Zinc or albendazole attenuates the progression of environmental enteropathy: a randomized controlled trial. Clin Gastroenterol Hepatol. 2014;12(9):1507-13. doi:10.1016/j.cgh.2014.01.024  PMID:24462483 
  58. Global emergency medicine: a review of the literature from 2013. Acad Emerg Med. 2014;21(7):810-7. doi:10.1111/acem.12414  PMID:25040254 
  59. The impact of antibiotics on growth in children in low and middle income countries: systematic review and meta-analysis of randomised controlled trials. BMJ. 2014;348:g2267. doi:10.1136/bmj.g2267  PMCID:PMC3988318  PMID:24735883 
  60. Review of the safety and efficacy of vitamin A supplementation in the treatment of children with severe acute malnutrition. Nutr J. 2013;12(1):125. doi:10.1186/1475-2891-12-125  PMCID:PMC3850897  PMID:24028603 
  61. Antibiotics for uncomplicated severe malnutrition. N Engl J Med. 2013;368(25):2436-7. doi:10.1056/NEJMc1304407  PMID:23782188 
  62. Children successfully treated for moderate acute malnutrition remain at risk for malnutrition and death in the subsequent year after recovery. J Nutr. 2013;143(2):215-20. doi:10.3945/jn.112.168047  PMCID:PMC3735907  PMID:23256140 
  63. Gut microbiomes of Malawian twin pairs discordant for kwashiorkor. Science. 2013;339(6119):548-54. doi:10.1126/science.1229000  PMCID:PMC3667500  PMID:23363771 
  64. Antibiotics as part of the management of severe acute malnutrition. N Engl J Med. 2013;368(5):425-35. doi:10.1056/NEJMoa1202851  PMCID:PMC3654668  PMID:23363496 
  65. Investigation of food acceptability and feeding practices for lipid nutrient supplements and blended flours used to treat moderate malnutrition. J Nutr Educ Behav. 2013;45(3):258-63. doi:10.1016/j.jneb.2012.08.001  PMCID:PMC3644177  PMID:23246175 
  66. Human gut microbiome viewed across age and geography. Nature. 2012;486(7402):222-7. doi:10.1038/nature11053  PMCID:PMC3376388  PMID:22699611 
  67. A novel fortified blended flour, corn-soy blend "plus-plus," is not inferior to lipid-based ready-to-use supplementary foods for the treatment of moderate acute malnutrition in Malawian children. Am J Clin Nutr. 2012;95(1):212-9. doi:10.3945/ajcn.111.022525  PMCID:PMC3238461  PMID:22170366 
  68. Challenges in the management of HIV-infected malnourished children in sub-Saharan Africa. AIDS Res Treat. 2012;2012:790786. doi:10.1155/2012/790786  PMCID:PMC3353143  PMID:22606378 
  69. The duration of diarrhea and fever is associated with growth faltering in rural Malawian children aged 6-18 months. Nutr J. 2011;10(1):25. doi:10.1186/1475-2891-10-25  PMCID:PMC3068082  PMID:21418600 
  70. Factors associated with protective antibody levels to vaccine preventable diseases in internationally adopted children. Vaccine. 2010;29(1):95-103. doi:10.1016/j.vaccine.2010.09.098  PMCID:PMC3022417  PMID:21036132 
  71. A ready-to-use therapeutic food containing 10% milk is less effective than one with 25% milk in the treatment of severely malnourished children. J Nutr. 2010;140(12):2248-52. doi:10.3945/jn.110.123828  PMCID:PMC2981006  PMID:20980648 
  72. Serologic testing to verify the immune status of internationally adopted children against vaccine preventable diseases. Vaccine. 2010;28(50):7947-55. doi:10.1016/j.vaccine.2010.09.069  PMCID:PMC2991403  PMID:20937322 
  73. Evaluation of the routine use of amoxicillin as part of the home-based treatment of severe acute malnutrition. Trop Med Int Health. 2010;15(9):1022-8. doi:10.1111/j.1365-3156.2010.02580.x  PMCID:PMC2962695  PMID:20545919 
  74. Mango contact allergy. J Travel Med. 2010;17(4):284. doi:10.1111/j.1708-8305.2010.00420.x  PMCID:PMC2907543  PMID:20636606 
  75. A randomized, double-blind, placebo-controlled trial of rifaximin, a nonabsorbable antibiotic, in the treatment of tropical enteropathy. Am J Gastroenterol. 2009;104(9):2326-33. doi:10.1038/ajg.2009.270  PMCID:PMC2758482  PMID:19491826 
  76. Group B Streptococcus vertebral osteomyelitis-discitis in an immunocompetent adolescent. Pediatr Infect Dis J. 2009;28(6):552-3. doi:10.1097/INF.0b013e3181a4ce6e  PMID:19483527 
  77. Neonatal respiratory distress due to bilateral dacrocystoceles. J Pediatr. 2008;153(3):438. doi:10.1016/j.jpeds.2008.03.042  PMID:18718265 
  78. Tuberculosis screening in internationally adopted children: the need for initial and repeat testing. Pediatrics. 2008;122(1):e7-14. doi:10.1542/peds.2007-1338  PMID:18595977 
  79. Collaboration between medical students and NGOs: a new model for international health education. Med Educ. 2003;37(11):1031. doi:10.1046/j.1365-2923.2003.01642.x  PMID:14629424 
  80. Using steric hindrance to design new inhibitors of class C beta-lactamases. Chem Biol. 2002;9(9):971-80. doi:10.1016/S1074-5521(02)00211-9  PMID:12323371 
  81. Structural milestones in the reaction pathway of an amide hydrolase: substrate, acyl, and product complexes of cephalothin with AmpC beta-lactamase. Structure. 2002;10(3):413-24. doi:10.3945/an.116.013276  PMCID:PMC5015042  PMID:12005439 
  82. Inhibition of AmpC beta-lactamase through a destabilizing interaction in the active site. Biochemistry. 2001;40(27):7992-9. doi:10.1021/bi010641m  PMID:11434768 
Last updated: 12/01/2018
© 2018 by Washington University in St. Louis
One Brookings Drive, St. Louis, MO 63130