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Using Administrative Data To Estimate The Burden Of Chlamydia Among Medicaid Managed Care Enrollees In New York State, Lindsay W. Cogan

Legacy Theses & Dissertations (2009 - 2024)

Infection with Chlamydia trachomatis is of public health concern because of its adverse effects on reproduction. Women infected with Chlamydia can develop pelvic inflammatory disease, which can lead to serious reproductive system morbidity including ectopic pregnancy and infertility.

Effect Of Data Aggregation At Two Geographic Levels On The Association Between Absms And Gonorrhea Rates In Nys, 1999-2001, Christina Michelle Gray

Legacy Theses & Dissertations (2009 - 2024)

This study compared the association between residential area factors and gonorrhea, aggregated at both the census tract versus ZIP code levels. Prior research has found that census block groupings are most optimal in neighborhood-level studies, followed by census tracts and ZIP codes. Because several healthcare databases currently only provide ZIP code level data, the aim of this study was to examine whether there exists a meaningful difference between the interpretation of census tract and ZIP code aggregate data. Our study measured the association between socioeconomic factors and gonorrhea in New York State, exclusive of New York City (NYC), census tracts …

Data Mining And Pattern Discovery Using Exploratory And Visualization Methods For Large Multidimensional Datasets, Hsin-Fang Li

Theses and Dissertations--Epidemiology and Biostatistics

Oral health problems have been a major public health concern profoundly affecting people’s general health and quality of life. Given that oral health data is composed of several measurable dimensions including clinical measurements, socio-behavioral factors, genetic predispositions, self-reported assessments, and quality of life measures, strategies for analyzing multidimensional data are neither computationally straightforward nor efficient. Researchers face major challenges to identify tools that circumvent the processes of manually probing the data.

The purpose of this dissertation is to provide applications of the proposed methodology on oral health-related data that go beyond identifying risk factors from a single dimension, and to …

An Analysis Of The Association Between Animal Exposures And The Development Of Type 1 Diabetes In The Teddy Cohort, Callyn Hall

USF Tampa Graduate Theses and Dissertations

Research on exposure to animals and risk of type 1 diabetes (T1D) has had conflicting results with some researchers finding that animal exposure reduces the risk of T1D and others finding no association between animal exposure and T1D. Previously conducted studies on the association between animal exposure and T1D are case-control studies that have been limited by recall bias. The purpose of this study is to investigate the association between early life animal exposure and the risk of persistent, confirmed islet autoantibodies (IA) and T1D diagnosis among an eligible cohort of genetically high T1D risk participants enrolled in the international …

Exploring Potential Risk Factors Of Fetal Origins Of Diabetes: Maternal Stressors During Pregnancy And Birth Outcomes Among Women In A Hospital In The Municipality Of Caguas, Puerto Rico, Juan Pablo Arroyo

USF Tampa Graduate Theses and Dissertations

Puerto Rico has the highest prevalence of type 2 diabetes, low birth-weight, and the second highest prevalence of preterm-birth in all the U.S. and its non-incorporated territories. These conditions are related. Birth-weight at both ends of the spectrum and preterm-birth are associated with an increased risk for developing type 2 diabetes and immune-inflammatory dysregulations. Maternal psychosocial stressors during pregnancy have also been recognized as potential risk factors for type 2 diabetes, and have been consistently associated with preterm-birth and low birth-weight across populations. Current evidence points toward epigenetic fetal metabolic-programming as the mechanism that underlies the increased risk for the …

Associations Of Perceived Stress, Sleep, And Human Papillomavirus In A Prospective Cohort Of Men, Stephanie Kay Kolar

USF Tampa Graduate Theses and Dissertations

Introduction: Mucosal human papillomavirus (HPV) infection is the most common sexually transmitted infection (STI) and is associated with genitals warts, anogenital cancers, and oropharyngeal cancers. Most sexually active persons will become infected with HPV at some point in their lives, however few will develop HPV-related diseases such as warts, lesions, or cancer as a result of the infection. It is unclear why a minority of individuals fail to clear HPV infection and develop clinical disease. Due to initial associations with cervical lesions, much research has focused on women. Th1 type immune responses have been associated with successful response to HPV …

Using Box-Jenkins Modeling Techniques To Forecast Future Disease Burden And Identify Disease Aberrations In Public Health Surveillance Report, Larry C. Garrett

Dissertations

The analysis of public health surveillance data to identify departures from historical patterns of disease is required to facilitate the timely identification of potential outbreaks. Using the Box-Jenkins forecasting model, this study examines the potential to predict future disease burden based upon the historical record within local public health jurisdictions. Box-Jenkins forecasting was developed as a direct result of forecast problems in the business, economic, and control-engineering applications, yet it has not been systematically examined for use with public heath surveillance data.

Box-Jenkins forecast models are constructed by stratifying 84,029 disease reports from the State of Utah by year (n …

Timeliness Of Electronic And Traditional Laboratory Reporting In Southern Nevada, 1999-2012, Jennifer Anne Lucas

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study compares the timeliness of Electronic Laboratory Reporting (ELR) with traditional reporting. ELR has been implemented in parts of the United States, and is perceived to be faster than traditional reporting. Faster reporting leads to faster public health response to prevent outbreaks, and to reduce the burden of infectious disease in communities. Nevada State law requires that diseases be reported within certain time frames. Timeliness of laboratory reporting at the Southern Nevada Health District (SNHD) from 1999-2012 was assessed by analyzing cases of four common diseases in this retrospective secondary analysis of extant data.

The difference in timeliness regarding …

Multivitamin Supplementation In Hiv Infected Adults Initiating Antiretroviral Therapy In Uganda: The Protocol For A Randomized Double Blinded Placebo Controlled Efficacy Trial., David Guwatudde, Amara E. Ezeamama, Danstan Bagenda, Rachel Kyeyune, Fred Wabwire-Mangen, Henry Wamani, Ferdinand Mugusi, Donna Spiegelman, Molin Wang, Yukari C. Manabe, Wafaie W. Fawzi

Journal Articles: Epidemiology

BACKGROUND: Use of multivitamin supplements during the pre-HAART era has been found to reduce viral load, enhance immune response, and generally improve clinical outcomes among HIV-infected adults. However, immune reconstitution is incomplete and significant mortality and opportunistic infections occur in spite of HAART. There is insufficient research information on whether multivitamin supplementation may be beneficial as adjunct therapy for HIV-infected individuals taking HAART. We propose to evaluate the efficacy of a single recommended daily allowance (RDA) of micronutrients (including vitamins B-complex, C, and E) in slowing disease progression among HIV-infected adults receiving HAART in Uganda.

METHODS/DESIGN: We are using a …

Epidemiology Of Tuberculosis In Ohio, Usha Bala Vayuvegula

Master of Public Health Program Student Publications

Background: Tuberculosis (TB) is a global infectious disease often associated with HIV. Study of the distribution and epidemiologic trends may help target prevention and control measures towards high risk areas and groups.

Objective: To determine TB trends in four counties in Ohio, i.e. Franklin, Cuyahoga, Hamilton and Montgomery counties, and to explore differences in distribution of cases across gender, age groups and races.

Methods: TB surveillance data was collected from the Ohio Department of Health website for 12 years (1999-2011). Mean TB rates across gender were compared using the two sample t-test. One way ANOVA was used to compare means …

Stubborn, Persistent, Dangerous C.Difficile Infections. Is Improvement Possible?, Sara Townsend

Master of Science in Healthcare Quality and Safety Capstone Presentations

C.difficile also known as C.diff or CDI has developed into a dangerous infection for the United States’ health care system. While much work has been done to improve C.diff rates, health care teams have not been successful in reducing C.difficile infections. Many studies have focused on the mode of transmission of C.difficle, yet there still is not consensus on understanding how this infection is spread. Bryn Mawr Hospital, a community hospital in the suburbs of Philadelphia, Pa, has struggled to improve their C.diff rates like their peers throughout the country. While their infection rates for C.diff are …

Fall In C-Peptide During First 2 Years From Diagnosis: Evidence Of At Least Two Distinct Phases From Composite Type 1 Diabetes Trialnet Data., Carla J. Greenbaum, Craig A. Beam, David Boulware, Stephen E. Gitelman, Peter A. Gottlieb, Kevan C. Herold, John M. Lachin, Paula L. Mcgee, Jerry P. Palmer, Mark D. Pescovitz, Heidi Krause-Steinrauf, Jay S. Skyler, Jay M. Sosenko

Epidemiology Faculty Publications

Interpretation of clinical trials to alter the decline in β-cell function after diagnosis of type 1 diabetes depends on a robust understanding of the natural history of disease. Combining data from the Type 1 Diabetes TrialNet studies, we describe the natural history of β-cell function from shortly after diagnosis through 2 years post study randomization, assess the degree of variability between patients, and investigate factors that may be related to C-peptide preservation or loss. We found that 93% of individuals have detectable C-peptide 2 years from diagnosis. In 11% of subjects, there was no significant fall from baseline by 2 …

Refining The Global Spatial Limits Of Dengue Virus Transmission By Evidence-Based Consensus, Oliver J. Brady, Peter W. Gething, Samir Bhatt, Jane P. Messina, John S. Brownstein, Anne G. Hoen

Dartmouth Scholarship

Background: Dengue is a growing problem both in its geographical spread and in its intensity, and yet current global distribution remains highly uncertain. Challenges in diagnosis and diagnostic methods as well as highly variable national health systems mean no single data source can reliably estimate the distribution of this disease. As such, there is a lack of agreement on national dengue status among international health organisations. Here we bring together all available information on dengue occurrence using a novel approach to produce an evidence consensus map of the disease range that highlights nations with an uncertain dengue status.

Methods/Principle Findings: …

A Geographical Analysis Of Hiv/Aids Infection In Nigeria, 1991-2001, Chinekwu Azuka Obidoa, Robert G. Cromley

Journal of Social, Behavioral, and Health Sciences

Abstract

Objectives: Within the gradually accumulating literature on the Acquired Immune Deficiency Syndrome (AIDS) in Nigeria, investigations concerning the spatial dimensions of the infection are virtually non-existent. An understanding of the spatial dimensions of the epidemic is central in the development and implementation of appropriate intervention strategies. This study is a geographic analysis of HIV/AIDS infection in Nigeria from 1991 – 2001. The three objectives of this study were: 1) to examine the geographic pattern of the epidemic, 2) to examine the spatial-temporal trend and diffusion pattern of the epidemic, and 3) to explore the factors associated with the spatial …

Two Boundaries Separate Borrelia Burgdorferi Populations In North America, Gabriele Margos, Jean I. Tsao, Santiago Castillo-Ramirez, Yvette A. Girard, Anne G. Hoen

Dartmouth Scholarship

Understanding the spread of infectious diseases is crucial for implementing effective control measures. For this, it is important to obtain information on the contemporary population structure of a disease agent and to infer the evolutionary processes that may have shaped it. Here, we investigate on a continental scale the population structure of Borrelia burgdorferi, the causative agent of Lyme borreliosis (LB), a tick-borne disease, in North America. We test the hypothesis that the observed d population structure is congruent with recent population expansions and that these were preceded by bottlenecks mostly likely caused by the near extirpation in the 1900s …

Selective Impact Of Hiv Disease Progression On The Innate Immune System In The Human Female Reproductive Tract., Timothy Lahey, Mimi Ghosh, John V. Fahey, Zheng Sheng, Lucy R. Mukura, Yan Song, Susan Cu-Uvin, Kenneth H. Mayer, Peter F. Wright, John C. Kappes, Christina Ochsenbauer, Charles R. Wira

Epidemiology Faculty Publications

Background

We have previously demonstrated intrinsic anti-HIV activity in cervicovaginal lavage (CVL) from HIV-infected women with high CD4 counts and not on antiretroviral therapy. However, the impact of HIV disease progression on CVL innate immune responses has not been delineated.

Methods

CVL from 57 HIV-infected women not on antiretroviral therapy were collected by washing the cervicovaginal area with 10 ml of sterile normal saline. We characterized subject HIV disease progression by CD4 count strata: >500 cells/µl, 200–500 cells/µl, or <200 cells/µl of blood. To assess CVL anti-HIV activity, we incubated TZM-bl cells with HIV plus or minus CVL. Antimicrobials, cytokines, chemokines and anti-gp160 HIV IgG antibodies were measured by ELISA and Luminex.

Results

CVL exhibited broad anti-HIV activity against multiple laboratory-adapted and transmitted/founder (T/F) viruses, with anti-HIV activity ranging from 0 to 100% …

Surveillance Of Infectious Diseases Among American Indians And Alaska Natives, Jeanne Bertolli, Amy Roussel, Jennie Harris, Dan Lentine, Julia Gable, Ron Fichtner, Joann Kauffman, Michael Landen, Ralph T. Bryan

Journal of Health Disparities Research and Practice

We assessed participation in public health surveillance networks among Indian Health Service, tribal, and urban (I/T/U) Indian health facilities for a group of infectious diseases, and barriers to participation. We conducted surveys of I/T/U facilities and key informant interviews with representatives of tribal, urban, and national American Indian/Alaska Native (AI/AN) agencies. For the surveys, frequencies and percentages of responses in each response category were calculated. Qualitative methods were used to analyze interview content. The proportion of facilities participating in case reporting is suboptimal across facility types and diseases. Even when reporting is occurring, there is little feedback to tribal agencies. …

Molecular Epidemiology Of Hiv-Associated Tuberculosis In Dar Es Salaam, Tanzania: Strain Predominance, Clustering, And Polyclonal Disease, Lisa V. Adams, Barry N. Kreiswirth, Robert D. Arbeit, Hanna Soini, Lillian Mtei, Mecky Matee, Muhammad Bakari, Timothy Lahey, Wendy Wieland-Alter

Dartmouth Scholarship

Molecular typing of Mycobacterium tuberculosis can be used to elucidate the epidemiology of tuberculosis, including the rates of clustering, the frequency of polyclonal disease, and the distribution of genotypic families. We performed IS6110 typing and spoligotyping on M. tuberculosis strains isolated from HIV-infected subjects at baseline or during follow-up in the DarDar Trial in Tanzania and on selected community isolates. Clustering occurred in 203 (74%) of 275 subjects: 124 (80%) of 155 HIV-infected subjects with baseline isolates, 56 (69%) of 81 HIV-infected subjects with endpoint isolates, and 23 (59%) of 39 community controls. Overall, 113 (41%) subjects had an …

A Mathematical Model For Dengue Fever In A Virgin Environment, Jason K. Bowman

Senior Honors Projects

Dengue is a mosquito-borne viral infection found in tropical and subtropical regions around the world. The disease was named in 1779 and the first recorded epidemic of it occurred simultaneously on three continents within the following decade. Dengue is characterized by flu-like symptoms and, while its symptoms are generally reported as quite unpleasant, is rarely fatal. However, in some cases patients can contract a more serious form of the disease, known as Dengue Hemorrhagic Fever, which is far more dangerous. The World Health Organization estimates that today over 2.5 billion people are at risk for Dengue (over 40% of the …

Variables Associated With Critical Illness Among Clark County Residence Hospitalized With H1n1 Influenza A Virus During The 2009 Influenza Season., Jonathan P. Hyatt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background:In 2009, a novel H1N1 Influenza A virus was detected in the population. Because it can potentially affect a different population than the influenza strains circulating for the past 35 years, it is critical for physicians, practitioners and public health organizations to understand who is susceptible to this disease, and which sub-populations are most likely to suffer critical illness. The objective of this study was to examine the factors unique to 2009 H1N1 infection, with the goal of finding the variables associated with ICU admission (Critical Illness) in the Clark County 2009 H1N1 patient.

Methods:Factors that were assessed in this …

Modeling The Effects Of Substance Dependence On General Self-Reported Health Using Nominal Regression, Taylor Moseley

UNLV Theses, Dissertations, Professional Papers, and Capstones

The goal of this research project was to produce a model of the effects of drug dependence on general self-rated health. Due to power issues, two additional models, one for cocaine and one for heroin, were required. The models used data from the 2005-2009 National Survey on Drug Use and Health. The result of this effort was a ranking of the effects of drug dependence on general health for individuals and for the study population. The model controlled for infectious, chronic and mental illness as well as sociodemographic variables. Significantly increased odds ratios were found for alcohol, marijuana, analgesics, and …

Kadar Interferon Gamma Pada Kontak Serumah Dengan Penderita Tuberkulosis, Sri Andarini Indreswari, Suharyo Suharyo

Kesmas

Menurut World Health Organization sekitar sepertiga penduduk dunia telah terinfeksi kuman tuberkulosis dan deteksi dini pada kontak serumah dengan penderita memungkinkan upaya pengobatan dan pencegahan dilakukan dengan efektif. Penelitian ini bertujuan untuk membandingkan hasil pemeriksaan tes Mantoux dengan pemeriksaan serologis kadar interferon gamma (IFN - γ) pada kelompok kontak serumah dengan penderita tuberkulosis yang mempunyai hasil pemeriksaan basil tahan asam (BTA) positif. Penelitian ini menggunakan desain kohort pada kelompok terpajan dan tidak terpajan pada penderita tuberkulosis (umur > 15 tahun). Pemilihan subjek dilakukan secara acak sederhana dan jumlah yang digunakan adalah 34 orang pada masing-masing kelompok. Penelitian ini menggunakan tes Mantoux …

Demographics And Survival Of Aids Cases With Cancer, Washington, Dc, 1996-2006, Heather A. Young, Eric Engels, Anne-Marie Sufian-Kargbo, Alicia Vargas, Kathleen Rogers, Tiffany West, Amanda D. Castel

Epidemiology Faculty Publications

Background

Washington, DC (DC) has one of the highest HIV/AIDS rates in the U.S and cancer is the second leading cause of death among DC residents. This study sought to examine the demographic characteristics and survival of persons with AIDS defining cancers (ADCs) compared to those with non-AIDS defining cancers (NADCs) between the early HAART era (1996-2001) and the late HAART era (2002-2006) in DC.

Methods

Cases reported from 1996-2006 to the DC Cancer Registry and the AIDS Surveillance Registry were linked using a probabilistic matching algorithm. Cases were included if the cancer occurred from 4 months to 60 months …

Exploring The Social Determinants Of Sexually Transmitted Disease And High-Risk Sexual Behaviors, River Pugsley

Theses and Dissertations

Abstract 1: A multi-level assessment of disproportionate population sex ratios and high-risk sexual behaviors among STD clinic patients Low male-to-female sex ratios in a population may influence high-risk sexual behaviors, such as multiple sex partners and inconsistent condom use, which facilitate the transmission of STDs. This study used multi-level modeling to assess whether population sex ratios were associated with these two individual-level behaviors. All analyses were stratified by gender. Interview data were collected from patients (N = 9,203, 48% male) attending participating STD clinics. Interviews included information on socio-demographics and sexual behavior, including number of sex partners in the previous …

A Social Controversy: Autism Spectrum Disorder's Correlation To The Measles-Mumps-Rubella Vaccination, Lindsay A. Frye

Senior Honors Theses

A 1998 research study lead by Dr. Andrew Wakefield linked the measles-mumps-rubella (MMR) vaccination as a probable cause to autism spectrum disorder. This publication has started a significant debate among healthcare professionals and instigated an anti-vaccination movement within the general population. This vaccination controversy was started by parents who readily accepted Wakefield’s findings as truth and frequently would choose to withdrawal the administration of vaccinations from their children’s care plans. There has also been disapproval by healthcare professionals over Wakefield’s study since numerous research teams have been unable to replicate his findings. This disagreement surrounding the MMR vaccination is likely …

Facing An Epidemic: An Analysis Of Hiv/Aids, Antiretroviral Drug, And International Response To The Aids Pandemic, Michael Tate

Annual Undergraduate Conference on Health and Society

More than 33 million people are living with HIV/AIDS around the globe with 68% of all cases occurring in sub-Saharan Africa. The global prevalence rate is shocking considering that the disease was relatively unknown just 30 years ago. After reviewing medical, health policy, and health statistical journals, I will argue in this paper that international aid to nations struggling with AIDS needs to be redirected and refocused on supplying antiretroviral therapy to afflicted nations because ARV has been proven to be effective in managing the disease in countries that can afford the costs of treatment. International aid to countries that …

Antibiotics For Leptospirosis, David Brett-Major, Rodney Coldren

Journal Articles: Epidemiology

BACKGROUND: Leptospirosis has a wide-ranging clinical and public health impact. Leptospira are globally distributed. Case attack rates are as high as 1:4 to 2:5 persons in exposed populations. In some settings mortality has exceeded 10% of infected people. The benefit of antibiotic therapy in the disease has been unclear.

OBJECTIVES: We sought to characterise the risks and benefits associated with use of antibiotic therapy in the management of leptospirosis.

SEARCH METHODS: We searched the The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded …

Tropical Medicine Training In The Department Of Defense, Rodney L. Coldren, David Brett-Major, Patrick W. Hickey, Eric Garges, Peter J. Weina, Paula Corrigan, Gerald Quinnan

Journal Articles: Epidemiology

No abstract provided.

Malaria And Related Outcomes In Patients With Intestinal Helminths: A Cross-Sectional Study, Abraham Degarege, Mengistu Legesse, Girmay Medhin, Abebe Animut, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: The effects of helminth co-infection on malaria in humans remain uncertain. This study aimed to evaluate the nature of association of intestinal helminths with prevalence and clinical outcomes of Plasmodium infection.

METHODS: A cross-sectional study involving 1,065 malaria suspected febrile patients was conducted at Dore Bafeno Health Center, Southern Ethiopia, from December 2010 to February 2011. Plasmodium and intestinal helminth infections were diagnosed using Giemsa-stained blood films and Kato-Katz technique, respectively. Haemoglobin level was determined using a haemocue machine.

RESULTS: Among 1,065 malaria suspected febrile patients, 28.8% were positive for Plasmodium parasites (P. falciparum =13.0%, P. vivax =14.5%, P. …

Prognostic Implications Of Oral Health Status In Hiv-Positive Women In St. Petersburg, Russia, Anna Vinogradova

Legacy Theses & Dissertations (2009 - 2024)

Objective: To assess state of oral health in HIV-positive women in St. Petersburg, Russia and to study the association of oral health with pregnancy status and other factors in this sample.