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A Historical Perspective And Review Of The Evidence To Support Fruit Bats As The Natural Reservoir For Ebola Viruses, Zachary Reed

Public Health Theses

The Ebola viruses cause sporadic outbreaks of Ebola hemorrhagic fever (EHF) where origins have been traced to the continent of Africa and the Philippines. Since the initial discovery of Zaire and Sudan ebolavirus in 1976, the Ebola viruses have been responsible for severe hemorrhagic fever outbreaks in Africa with case fatality rates between 40-90%. The natural reservoir(s) of the Ebola viruses is currently unknown, but there is mounting evidence that fruit bats may play a key role. The goal of the current study is to screen a large variety of bat species from Africa and Asia where Ebola is known …

Evaluation Integrated Mass Drug Administrations (Mda) For Neglected Tropical Diseases, In Koza District, Cameroon, Christina B. Conrardy

Public Health Theses

Health education and preventive chemotherapy are main strategies to control or eliminate neglected tropical diseases (NTDs) such as lymphatic filariasis (LF), trachoma, onchocerciasis, schistosomiasis (SCH), and soil-transmitted helminthiasis (STH). Integrated MDA for LF, onchocerciasis, SCH, STH, and trachoma were organized in the Koza district of Cameroon from July to August 2011. Ivermectin (IVM) and albendazole (ALB) were distributed for LF to the entire population except pregnant or lactating women, children <90 cm in height, and the severely ill. Azithromycin was distributed at least one week after the LF MDA to all persons older than 6 months of age. Praziquantel (PZQ), targeting school age children (SAC), was only distributed in schools. In order to validate reported coverage and assess the knowledge and attitude of the population towards NTDs and MDAs, an independent coverage and Knowledge, Attitudes, and Practice (KAP) survey was administered. The WHO recommended population based 30-cluster coverage survey was implemented. Clusters were selected by Probability Proportional to Estimated Size and in each cluster, 10 houses were selected using the improved expanded program on immunization random walk. Coverage questions were administered by trained interviewers to each person living in selected houses and KAP questions were asked to a randomly selected adult in the house. A total of 1301 persons participated in the coverage survey and 149 adults answered the KAP questions. The survey coverage estimates for IVM /ALB and azithromycin are 76.9% (95% CI 72.0-81.9), 86.8% (95% CI 80.9-92.7), respectively, while the reported coverage is 80.3% and 93%, respectively. The survey coverage estimated for PZQ among SAC is 39.9% (95% CI 30.7-49.1), reported coverage is unknown. There was no significant association between participation in the MDA and age, gender, or knowing the disease. SAC who attended school were 269 times as likely to have taken PZQ and 3 times as likely to have taken LF drugs as SAC not attending school. Less than 50% of respondents had heard of LF and only 31.8% could mention at least one LF symptom. More than 70% of respondents had heard of STH, SCH, and trachoma, but only 52.3%, 40%, 30%, respectively, knew at least one way to prevent or treat STH, SCH, and trachoma. Despite low or incorrect knowledge of LF, SCH, STH, and trachoma, overall, MDA coverage was good except for the PZQ which was only distributed in school.

The Role Of Stress In Racial Disparities Of Preterm And Low Birth Weight Births In Georgia, Saida R. Sharapova

Public Health Theses

SAIDA SHARAPOVA

The role of stress in racial disparities of preterm and low birth weight births in Georgia

(Under the direction of Richard Rothenberg, MD, MPH)

Preterm birth (PTB) and low birth weight (LBW) are the leading causes of infant deaths in Georgia. Georgia PRAMS data (2004-2008) were analyzed for non-Hispanic White and non-Hispanic Black women with singleton births, using SAS 9.2 survey procedures. Thirteen stressful life events experienced in a year before delivery, socio-demographic, medical and behavioral risks were used as predictors of PTB and LBW. Significant racial disparity in birth outcomes and risks was found. In Whites stressful …

Perceptions Of Water, Sanitation And Hygiene Interventions In Select Communities In Central America. Recommendations To Explore The Issue Of Sustainability, Arlyn Nathalia Gleaton

Public Health Theses

Background: Estimations from the Joint Monitoring program for Water Supply and Sanitation (JMP, 2012) reveal that “less than five percent of water and sanitation interventions are revisited once they have been completed and less than one percent are monitored over the long term”. Since 2000, the Centers for Disease Control and Prevention(CDC) has been working with the American Red Cross (ARC) to evaluate the long-term sustainability of post-disaster water, sanitation and hygiene interventions (WASH) provided in Guatemala, Honduras, Nicaragua and El Salvador. Sustainability assessments were conducted in 2006, 2009 and most recently in 2012. In the 2012 evaluation, a qualitative …

Positive Impact Program Evaluation, Hannah Oloyede

Public Health Theses

Description of program

Positive Impact is a non-profit organization established in 1992. The organization’s focus was ‘to eliminate the risk of HIV transmission and to empower those affected by HIV through culturally competent and inclusive prevention, education, mental health and substance abuse treatment services’.¹

Evaluation questions and explanation

The purpose of this evaluation was to determine how satisfied the clients were with the HIV mental health-counseling program. Overall, the survey and evaluation were conducted to enhance the effectiveness of service delivery as well as overall agency operations. The following questions were the focus of the evaluation:

1. Are the clients …

Comparison And Analysis Of Youth Tobacco Surveillance Systems: Lessons Learned And Future Implications, Ichhya Pant

Public Health Theses

Background: Tobacco use either in the form of smoking or smokeless tobacco is typically initiated or established behaviorally for adult smokers before 18 years of age. Given that data from monitoring and surveillance systems drives every policy and program, accurate surveillance of tobacco consumption by adolescents is a major part of curbing tobacco addiction.

Methodology: The consistency and reliability of youth smoking prevalence data was assessed by investigating discrepancies within versions of the Global Youth Tobacco (GYTS) as well as between GYTS and the Global School-based Health Survey (GSHS). Sources of errors and biases were examined in order to determine …

The Test For H2s Production: Analysis Of Correlation To Fecal Indicators And Risk Of Diarrheal Disease In Bonao, Dominican Republic., Angela Hardin

Public Health Theses

Background: Access to improved water and sanitation are key measures of the World Health Organizations. However, while a community can be classified as having access to improved water and sanitation, the possibility of microbiological contaminations exists. Globally, there is a need to assess the quality of drinking water to better classify levels of microbiological quality in attempts to reduce diarrheal disease burden. Utilizing the test for hydrogen sulfide (H₂S) producing bacteria test is a cost effective and easy to use method that may be comparable to the traditional yet more costly method (IDEXX Colilert Quantitray). Due to a …

Evaluation And Determination Of The Sensitivity And Specificity Of A Treponema Pallidum Dried Blood Spot Method For Serologic Diagnosis Of Syphilis, David K. Turgeon

Public Health Theses

EVALUATION AND DETERMINATION OF THE SENSITIVITY AND

SPECIFICITY OF A Treponema pallidum DRIED BLOOD SPOT (DBS) METHOD FOR

SEROLOGIC DIAGNOSIS OF SYPHILIS

Background:

Syphilis is a sexually transmitted infection (STI) caused by Treponema pallidum subspecies pallidum. Syphilis is known as the "great imitator" due to the similarity of clinical signs and symptoms to other infectious diseases. The primary diagnosis of syphilis relies on clinical findings, including the examination of treponemal lesions, and/or serologic tests. Serologic tests are divided into nontreponemal and treponemal tests. Nontreponemal tests are useful for screening, while treponemal tests are used as confirmatory tests.

Methods:

A …

Financial Exploitation Of The Elderly: A Policy Review And Recommendations For Georgia, Melissa C. Haberlen

Public Health Theses

Eleven percent of Georgians and 13.3% of all Americans are currently over the age of 65. The segment of elderly adults in the United States is the fastest growing subpopulation, attributed to both average lifespan increases and a significant aging of "the baby boomer generation". Thus it is increasingly important that health and policy professionals give attention to issues of health and well-being faced by the aging population. One such issue, financial exploitation of the elderly, has received a large amount of media attention and public concern over the last several years, due to a large increase in the recorded …

Suicide Ideation And Its Associated Risk Factors Among Adolescent Students In The Eastern Mediterranean Region, Rabia Khalid

Public Health Theses

ABSTRACT

Purpose: The intention of this study is to examine and compare the prevalence and correlates of suicide ideation among the youth in four Eastern Mediterranean Region (EMR) countries, namely Morocco, Jordan, United Arab Emirates and Lebanon. The results from this study are a valuable resource for further understanding suicidal behavior among youth in a region where the subject is often understudied and considered taboo. Additionally, findings from the study are important in prevention efforts in order to reduce suicide related behaviors and injuries among youth in EMR countries. The study also examined the correlates and variables associated with suicide …

An Examination Of Secondhand Smoke In A Sample Of Atlanta Hospitality Venues And Their Compliance With The Georgia Smokefree Air Act, Eli W. Nachamkin

Public Health Theses

Introduction: Despite the known consequences of cigarette smoking, almost 20% of adults in the United States smoke. Smoking has been shown to harm nearly every organ of the body. Its detrimental effects have been seen not only in smokers themselves but also in those exposed to secondhand smoke (SHS) at work and in other public places.

Methodology: The purpose of this thesis was to examine compliance with the signage requirement of the Georgia Smokefree Air Act (GSAA) of 2005 among 99 hospitality venues located in Atlanta. Photographs of bars and restaurant entrances were taken and raters then classified …

The Effects Of Intimate Partner Violence On Child Maltreatment Risk: Exploring Moderators And Mediators, Melissa A. Cowart

Public Health Theses

Intimate partner violence (IPV) is a public health problem that affects millions every year across the U.S., including families with young children. Children exposed to IPV can suffer consequences such as negative developmental and psychological outcomes and sometimes physical harm. Previous research has found an association between IPV victimization and risk of child maltreatment. In addition to further examining the relation between IPV and child maltreatment risk, this study tested maternal depression and parental stress as mediators and social support as a moderator in the IPV-child maltreatment risk relation. The research was conducted using data from a study of low-income, …

Survival And Inactivation Of Bacteriophage ?6 On N95 Respirator Material, Betelhem Waka

Public Health Theses

Introduction: Preventing healthcare professionals from acquiring occupational infectious diseases is very important in maintaining healthcare delivery systems. For protection in the work place, healthcare professionals use PPE which helps prevent exposure to pathogens during patient care. N95 respirators protect healthcare workers against airborne pathogens that are known to be associated with different respiratory diseases. Since previous studies have shown that viruses can survive on PPE surfaces, it is important to examine the survival of viruses on respirators to determine if reuse of the same N95 respirator is possible when PPE shortages occur.

Goal: The goal of this research …

Grant Proposal For Constructing A Platform To End Sexual Harassment In Cairo’S Public Spaces, Nada Doraid

Public Health Theses

Sexual harassment in Cairo's public spaces is a symptom of infringement upon women’s rights in Egypt. Which is ingrained in the socioeconomic context, cultural, and traditional norms of the society. This grant proposal and background research proposes the construction of an extensive anti-sexual harassment infrastructure base in Egypt. The infrastructure platform is built on an evidence-based strategy and guided by recognized best practices.

The platform is geared towards alleviating the symptoms of sexual harassment in Cairo's public spaces by constructing the urgently required, but currently missing, national mechanisms which are necessary to prevent, report, prosecute, and provide survivor services for …

Botswana’S Adult Identity Mentoring Program (Aim) Public Health Evaluation: The Importance Of Counseling And Education To Reduce The Psychosocial Impact On Asymptomatic Youth Diagnosed With Herpes Simplex Virus Type 2, Carolina Granados

Public Health Theses

Background: The Division of Global HIV/AIDS at the Centers for Disease Control and Prevention (CDC) is working on a public health evaluation (PHE) in the eastern districts of Botswana. This PHE aims to evaluate the effectiveness of Project AIM, a group-level intervention designed to reduce HIV risk behaviors in youth ages 11 to 14, when combined with the regular Botswana Skills for Life Curriculum, a standard HIV prevention education curriculum in Botswana schools. In order to evaluate Project AIM, a self-report survey and a biological testing for herpes simplex virus type 2 (HSV-2) will be conducted.

Methodology: Based on studies …

Comparison Of Social Networks, Perceived Risk And Hiv Risk Behaviors Between Older And Younger African Americans Living In High Hiv Prevalence Zip Codes Of Atlanta, Georgia, Theint Theint Hlaing

Public Health Theses

The prevalence of HIV/AIDS in the United States is still high despite advances in prevention and therapies. Among all races and ethnic groups, African Americans are the most severely affected and face a disproportionate burden. African Americans account for a higher proportion of HIV infections and deaths than other races and ethnicities. In addition, one of the fastest growing segments of AIDS cases is patients more than 50 years of age. This segment receives little attention concerning HIV infection and as the U.S. population continues to age, it is important to be aware of specific HIV-related risks faced by these …

An Evaluation Of The State Tobacco Activities Tracking And Evaluation (State) System: Cross-Promoting Healthy People 2020, John B. Kenemer

Public Health Theses

The State Tobacco Activities Tracking and Evaluation (STATE) System is an interactive web-based application and data tool providing up-to-date state-level information related to tobacco use. Indicators in STATE present data related to current and former tobacco use, smoking cessation, funding, tobacco-related health costs, and tobacco control policies. The STATE System also serves as a primary data source for many objectives in Healthy People 2020’s Tobacco Use chapter. Currently, there is no common thread between access to information pertaining to Healthy People 2020 objectives and STATE System data. For this reason, a comprehensive evaluation was conducted of the STATE System’s individual …

Assessing The Impact Of The Department Of Health (Dhs) Division Of Aging Services’ At-Risk Adult Crime Tactics (Act) Certification On Professionals, Tanya L. Parker

Public Health Theses

Background: Adults over 60 years of age in the United States are increasing in total percentage of the population and will continue to do so as each wave of the post-war, baby-boom generation enters older adulthood. Though elder mistreatment (EM) has undoubtedly been a public health problem for years, only recently has it been recognized as such. Violence prevention programs that focus on EM are needed to curb this rising epidemic. One such program, the At-Risk Adult Crime Tactics (ACT) Certification Training, is an at-risk, adult (elderly or disabled adults) prevention program designed to increase professional awareness of this population …

Assessing The Relationship Between Safecare Fidelity And Competence Measures, Rebecca Palmer

Public Health Theses

As more evidence-based programs are implemented in community settings, there is a strong need to ensure those models are implemented with integrity. Implementation of programs should be evaluated for fidelity, the degree of adherence to treatment protocols, and competence, the level of skill in implementation (Schoenwald et al., 2011). The purpose of this study was to review audio recordings of SafeCare home visiting sessions to discover the relationship between the measures of fidelity and competence. Six coders were assigned 209 SafeCare home visiting audiotapes to be coded for fidelity and competence. A sample of audios were double coded to evaluate …

Chronic Conditions Of Us-Bound Cuban Refugees: October 2008-September 2011, Sarah Ward

Public Health Theses

Background: Historically, most refugees have originated from countries with high rates of infectious diseases. However, non-communicable diseases are becoming increasingly more common in refugee populations resettling in the United States.

Purpose: Examine the prevalence of selected chronic conditions among newly arriving adult Cuban refugees and compare the results to the prevalence of the same chronic conditions among the other top five incoming refugee populations: Burmese, Bhutanese, Iranians, Iraqis, and Somalis

Methods: Data used in this study were derived from the Department of State’s Medical History and Physical Examination Worksheet and included all adult (≥20 years) Cuban, Burmese, Bhutanese, Iranian, Iraqi, …

Body Mass Index As A Parameter To Evaluate The Prevalence Of Hypertension In Nh White, Nh Black, And Hispanic Americans, Shaun Newsome

Public Health Theses

Over the past 30 years, obesity has been primarily identified by the body mass index (BMI). Due to its ease of calculation, the BMI has become the most widely used diagnostic tool to identify weight problems. This study examined the association between hypertension and BMI in White, Black, and Hispanics in the United States. The study’s hypothesis was that this relationship was weaker in Blacks than in the other groups. Data for the study came from the 2007-2008 and 2009-2010 National Health and Nutrition Examination Surveys. The association was weaker in Black men than in Whites or Hispanics on a …

Chronic Disease Control: Factors Associated With Adherence To Physicians' Recommendations, Jeremy Chartash

Public Health Theses

Background: Recently across the United States, chronic diseases have been becoming more prevalent and compliance rates to recommendations have been declining. Non-adherence to health professionals recommendations creates a greater risk of complications for the patient.

Objective: The objective of this study is to discover which populations have the highest prevalence of chronic disease and compare adherence to physicians’ recommendations throughout those populations. If a physician tells a patient to complete a certain behavioral change to improve health, a physician would assume that the adherence level should be nearly 100%, but it is clear adherence levels do not reach those levels. …

The Relationship Between Ventriculoperitoneal Shunts And Shunt Revisions Versus Visual Complaints Among Patients With Spina Bifida In The Arkansas Spina Bifida Research Project, Regina Sullivan

Public Health Theses

Many patients with Spina Bifida suffer from hydrocephalus as a complication of their developmental disability and surgeons commonly treat this condition with ventriculoperitoneal shunts. Surgeons have speculated for years that these shunts may cause some type of visual disturbance because of their close proximity to the visual pathways in the brain. Little research has been done, however, to support or discourage this commonly held belief. Questions and data from the Arkansas Spina Bifida Research Project were used to examine whether ventriculoperitoneal (VP) shunts and VP shunt revisions increase reports of visual complaints for the individuals participating in this research project. …

Perceived Risk For Hiv Among High Risk Individuals: A Comparison Of Adolescents And Adults, Akele Jeffers

Public Health Theses

The United States continues to be affected by the HIV/AIDS epidemic, and now public health is faced with new challenges in mitigating the spread of the disease. African-Americans are disproportionately affected by HIV and a further understanding about the factors that influence high risk sexual behaviors needs to be continuously examined. The aim of this study was to understand and compare the the perception of HIV risk and factors associated with risk perception in high risk adult and adolescent groups. After multivariate analysis, having multiple partners was the only predictor of an increased risk perception among adults. Among adolescents, no …

Consumption Of Rainwater And Diarrheal Disease In Children Under Five In The Dominican Republic From 2002 To 2007, Andrea Mpogui

Public Health Theses

Background: With the MDG 7 target deadline approaching to halve the global population lacking access to improved water and sanitation by 2015, many nations find the need to explore alternative water sources. Rainwater may be a viable alternative water source. However, there have been concerns raised in recent decades as to the quality of rainwater harvested for potable use.

Methods: Data from the Demographic and Health Surveys database which included 50,579 household surveys between 2002 and 2007 from the Dominican Republic were examined. STATA 8 was used for data analysis. Descriptive statistics were computed, and logistic regression analysis was used …

Examining The Impact Of The Safecare Parent-Infant Interaction Module On The Quantity And Content Of Maternal-Infant Directed Utterances, Sanjana S. Mammen

Public Health Theses

Abstract

Sanjana S. Mammen

Examining the SafeCare Parent-Infant Interaction Module’s Impact on the Quantity and Content of Maternal-Infant Directed Utterances

(Under the direction of Shannon Self Brown, PhD)

Positive parenting skills reduce risk for child maltreatment. The Parent-Infant Interaction (PII) module of SafeCare was designed to promote positive parent-child relationships; however, little research has examined its impact on parent-infant utterances. Past research has indicated that a rich parent-child language environment predicts literacy skills and academic achievement, so the present research studies how PII impacts positive maternal infant-directed utterances. Three dyads with various risk levels with infants aged younger than 9-months …

An Analysis Of Geography Project Data To Determine Hiv And Behavioral Risk For High Risk Zip Codes And Low Risk Zip Codes In Fulton County, Ga, Jamaal B. Marshall

Public Health Theses

INTRODUCTION: HIV disease is thought to be cluster in specific areas rather than be evenly distributed. A study to show a significantly higher HIV risk in certain geographical areas would be beneficial for resource allocation purposes. AIM: The purpose of this study is to describe the demographics of the study population, describe the demographics of those participants that tested HIV-positive, and determine the associations between zip code of residence, HIV infection, and risky behavior. METHODS: Data were collected by Georgia State University’s Center of Excellence for Health Disparities Research for The Geography Project. Univariate and multivariate binary logistic regression analyses …

Examining Disparities Related To The Use Of Hospice Care: Cancer Vs. Non-Cancer Diagnoses, Justin Davis

Public Health Theses

Americans often face end-of-life with ineffective pain/symptom control. While hospice care prevents suffering for the terminally ill, only around 40% of individuals access services. Although few studies describe differences in terms of cancer vs. non- cancer diagnoses, hospice utilization/access disparities appear to exist. Analyzing 14 sociodemographic and clinical variables for 3,905 hospice discharge cases, this study highlights observed disproportions between cancer and non-cancer groups, identifying significant relationships amongst patient characteristics and hospice diagnosis. Factors found significantly related to diagnosis include components of the following: age, primary payment source, mortality status at discharge, hospice initiation location, length of stay, physical function, …

Could Low Vitamin D Status Explain The Increased Rates Of Hypertensive Disorder In Pregnancy In The Us Population And In Non-Hispanic Black Women? An Examination Of Nhanes 2001-2006, Michelle V. Leander-Griffith

Public Health Theses

Background: The incidence of Hypertensive Disorders in Pregnancy (HDP) is increasing in the US and is linked to serious long and short-term health problems for both mother and fetus. Vitamin D has been shown to have direct influence on molecular pathways involved in pregnancy. However a link between vitamin D status and HDP in Pregnant women has not been established.

Objectives: The purpose of this study is to determine (1) the association between vitamin D deficiency and the occurrence of (HDP) and (2) whether non-Hispanic Black women (NHB) are at greater risk for HDP due to low vitamin …

A Systematic Review Of Bacillus Anthracis In Pregnant And Postpartum Women, Dana Meaney-Delman

Public Health Theses

Objective: To describe the worldwide experience of Bacillus anthracis infection reported in pregnant and postpartum women.

Data Sources: Studies were identified through MEDLINE, WEB OF SCIENCE, EMBASE, and GLOBAL HEALTH databases from inception until April 2012. The keywords [(“anthrax” or “anthracis”) and (“pregna*” or “matern*” or “post partum” or “postpartum” or “puerperal” or “lact*” or “breastfed*” or “fetal” or “fetus” or “neonate” or “newborn” or “abort*” or “uterus”)] were used. In addition, all references from selected articles were reviewed, hand searches were conducted and relevant authors were contacted.

Methods of Study Selection: The inclusion criteria were: 1) published articles referring …