Medicine and Health Sciences Commons^™

Aflatoxin Contamination Of Commercial Maize Products During An Outbreak Of Acute Aflatoxicosis In Eastern And Central Kenya, Karen E. Gieseker, Lauren Lewis, Mary Onsongo, Henry Njapau, Helen Schurz Rogers, George Luber, Stephanie Kieszak, Jack Nyamongo, Lorraine Backer, Abdikher Mohamud Dahiye, Ambrose Misore, Kevin Decock, Carol Rubin, Kenya Aflatoxicosis Investigation Group

Public Health Faculty Publications

n April 2004, one of the largest aflatoxicosis outbreaks occurred in rural Kenya, resulting in 317 cases and 125 deaths. Aflatoxin-contaminated homegrown maize was the source of the outbreak, but the extent of regional contamination and status of maize in commercial markets (market maize) were unknown. We conducted a cross-sectional survey to assess the extent of market maize contamination and evaluate the relationship between market maize aflatoxin and the aflatoxicosis outbreak. We surveyed 65 markets and 243 maize vendors and collected 350 maize products in the most affected districts. Fifty-five percent of maize products had aflatoxin levels greater than the …

Effects Of Screening And Brief Intervention Training On Resident And Faculty Alcohol Intervention Behaviours: A Pre- Post-Intervention Assessment, J. Paul Seale, Sylvia Shellenberger, John M. Boltri, Ike S. Okosun, Barbara Barton

Public Health Faculty Publications

Background: Many hazardous and harmful drinkers do not receive clinician advice to reduce their drinking. Previous studies suggest under-detection and clinician reluctance to intervene despite awareness of problem drinking (PD). The Healthy Habits Project previously reported chart review data documenting increased screening and intervention with hazardous and harmful drinkers after training clinicians and implementing routine screening. This report describes the impact of the Healthy Habits training program on clinicians' rates of identification of PD, level of certainty in identifying PD and the proportion of patients given advice to reduce alcohol use, based on self-report data using clinician exit questionnaires.

Methods: …

Characterization Of An Outbreak Of Acute Hemorrhagic Conjunctivitis In Mexico, 2003., Gerardo Chowell, Carlos Castillo-Chavez, Porfirio Diaz-Duenes

Public Health Faculty Publications

Abstract: Objective To estimate the number of secondary cases generated by a primary case of acute hemorrhagic conjunctivitis using epidemic curve data and report on the relative frequency of the symptoms presented, the spatial, the age-specific incidence, and the time from onset of symptoms to diagnosis distributions.

Methods: We analyzed 886 cases of acute hemorrhagic conjunctivitis for which clinical symptoms were fully recorded by public health clinics of the Mexican Institute of Public Health (IMSS) in the state of Colima, Mexico during the period of September - November 2003.

Results: We estimate the number of secondary cases generated by a …

Case-Control Study Of An Acute Aflatoxicosis Outbreak, Kenya, 2004, Karen E. Gieseker, Eduardo Azziz-Baumgartner, Kimberly Lindblade, Helen Schurz Rogers, Stephanie Kieszak, Henry Njapau, Rosemary Schleicher, Leslie F. Mccoy, Ambrose Misore, Kevin Decock, Carol Rubin, Lawrence Slutsker, Aflatoxin Investigative Group

Public Health Faculty Publications

OBJECTIVES: During January-June 2004, an aflatoxicosis outbreak in eastern Kenya resulted in 317 cases and 125 deaths. We conducted a case-control study to identify risk factors for contamination of implicated maize and, for the first time, quantitated biomarkers associated with acute aflatoxicosis.

DESIGN: We administered questionnaires regarding maize storage and consumption and obtained maize and blood samples from participants.

PARTICIPANTS: We recruited 40 case-patients with aflatoxicosis and 80 randomly selected controls to participate in this study.

EVALUATIONS/MEASUREMENTS: We analyzed maize for total aflatoxins and serum for aflatoxin B1-lysine albumin adducts and hepatitis B surface antigen. We used regression and survival …

The Role Of Vaccination In The Control Of Sars, Julijana Gjorgjieva, Kelly Smith, Gerardo Chowell, Fabio Sanchez, Jessica Snyder, Carlos Castillo-Chavez

Public Health Faculty Publications

We assess pre-outbreak and during-outbreak vaccination as control strategies for SARS epidemics using a mathematical model that includes susceptible, latent (traced and untraced), infectious, isolated and recovered individuals. Scenarios focusing on policies that include contact tracing and levels of self-isolation among untraced infected individuals are explored. Bounds on the proportion of pre-outbreak successfully vaccinated individuals are provided using the the basic reproductive number. Uncertainty and sensitivity analyses on the reproductive number are carried out. The final epidemic size under different vaccination scenarios is computed.