Digital Commons Network^™

The Burden Of Hepatitis C Virus In New York State, Rachel Hart Malloy

Legacy Theses & Dissertations (2009 - 2024)

Hepatitis C virus (HCV) infection is estimated to be the most common chronic blood-borne infection in the United States (US). Annual incidence of HCV in the US peaked in the late 1980's, declined steadily through the 1990's and has plateaued since 2003 with approximately 18,000 new cases in 2008. The morbidity and mortality associated with HCV is expected to rise until at least 2015. Due to the high rate of asymptomatic cases, inherent limitations with target screening recommendations, limitations with screening technologies and scarce resources for surveillance nationwide, quantification of the burden is difficult. US estimates of disease burden have …

Influenza In The 21st Century : Assessment Of The 2009 H1n1 Pandemic Severity, Enhanced Surveillance Methods, And Pediatric Influenza-Associated Deaths, Dina M. Hoefer

Legacy Theses & Dissertations (2009 - 2024)

Influenza is among the most important of the endemic, epidemic, and pandemic diseases infecting humans. In June 2009, the World Health Organization raised the worldwide pandemic alert level to Phase 6 in response to the ongoing global spread of 2009 pandemic influenza A (H1N1) virus (pH1N1).1 The 2009 H1N1 influenza pandemic presented a unique opportunity and provided resources to monitor and study influenza in a way that would and could not be supported during a `typical' influenza season. Research objectives included: 1) characterizing the severity of illness among hospitalized patients infected with pH1N1; 2) assessing the utility of hospital discharge …

Detection And Epidemiological Patterns Of Drug Resistance Mutations In Nys Plasmodium Falciparum Clinical Malaria Specimens, Jennifer L. Conaway

Legacy Theses & Dissertations (2009 - 2024)

Plasmodium falciparum is a human-infective parasite that causes the most severe form of malaria. Resistance to a wide spectrum of antimalarials has been documented in this species, and single strains may be resistant to several drugs. A new technology, pyrosequencing, has been shown to be useful for the rapid detection of SNPs involved in drug resistance. It can be used in a clinical setting and readily detects new mutants, which frequently appear in this species due to strong selection for antimalarial resistance. In this study, a pyrosequencing protocol was developed to identify mutations in the Plasmodium falciparum genes Pfcrt, Pfdhps, …

Occupational Exposure And Risk Of Skin Cancer In A Multinational European Study, Simona Surdu

Legacy Theses & Dissertations (2009 - 2024)

Non-melanoma skin cancers (NMSC) comprise more than one third of all cancers, and are increasing worldwide. The most common NMSC are Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). Studies on humans and animals suggest that sunlight and arsenic play important roles in the pathogenesis of these skin malignancies. However, the number of epidemiological studies focusing on NMSC in workers exposed to ultraviolet (UV) radiation or airborne arsenic is limited, and the findings are contradictory.

Health Behind And Beyond Bars : Understanding The Link Between Incarceration And Health, Lauren C. Porter

Legacy Theses & Dissertations (2009 - 2024)

The primary aim of this dissertation is to better understand the link between incarceration and health. Drawing on a sample of young adults from the National Longitudinal Study of Adolescent Health (Add Health), the effect of incarceration on self-rated health, serious injury, STD infection, cold/flu symptoms, and blood pressure is assessed. The effect of incarceration on health behavior is also examined, including diet, smoking, binge drinking, and physical activity. In order to rule out selection bias, current and former inmates are compared to respondents who have been arrested (or arrested and convicted of a crime), but not incarcerated. Findings suggest …

Evaluating Retention In Medical Care And Its Impact On The Health Outcomes Of Individuals Living With Human Inmmunodeficiency Virus, Timothy N. Crawford

Theses and Dissertations--Epidemiology and Biostatistics

In the last few years, engagement in medical care among individuals living with HIV has become a major priority among HIV medical providers and public health researchers. Engagement in medical care is an important concept as it involves the process of linking newly diagnosed individuals into medical care and retaining those individuals in care throughout the course of their infection. Although there have been major advances in the management of HIV, like the advent of Highly Active Antiretroviral Therapy, morbidity and mortality due to HIV cannot be fully reduced if the individual does not optimally retain in care. Retention in …

A Pilot Online Survey Assessing Risk Factors For Hiv Acquisition In The Navy And Marine Corps, 2005-2010, Shilpa Hakre, Adam W. Armstrong, Robert J. O'Connell, Nelson L. Michael, Paul T. Scott, David Brett-Major

Journal Articles: Epidemiology

The Department of Defense policy Don't Ask, Don't Tell (DADT) ended in September, 2011. The Navy Bloodborne Infection Management Center conducted a post-DADT pilot survey of HIV seroconverters identified when the DADT policy was in effect. Sailors and Marines newly diagnosed as HIV positive from 2005 to 2010 were invited to participate in an online survey. A structured questionnaire elicited risk information about the 3-year period before HIV diagnosis. Respondents reported engaging commonly in same sex sexual activity, having concurrent partners, and poor condom use for anal sex. In this first post-DADT repeal report of self-reported behaviors, male-to-male sexual contact …

Epidemiology Of Contemporary Seroincident Hiv Infection In The Navy And Marine Corps, David Brett-Major, Shilpa Hakre, Neal A. Naito, Adam Armstrong, Eric A. Bower, Nelson L. Michael, Paul T. Scott

Journal Articles: Epidemiology

Human Immunodeficiency Virus (HIV) infection continues at a steady rate among U.S. Sailors and Marines. This study provides the first service-specific description of HIV infection demographics. All Sailors and Marines identified as HIV infected between January 2005 and August 2010 were included. The project compared personnel and epidemiologic data, and tested reposed sera in the Department of Defense Serum Repository. This group comprised 410 Sailors and 86 Marines, predominantly men. HIV infected Marines were more likely to be foreign born than their Navy counterparts, 42% versus 10%, p < 0.001. Approximately half of the patients had deployed including to the wars in Iraq or Afghanistan. Nearly half of each group was infected by the age of 25. Similar to the U.S. epidemic, Black race was over-represented. Unlike national rates, Hispanic Sailors and Marines were not over-represented. Demographics were distinct for those of specific occupational specialties. Certain ship classes carried lower incidences. Clustering of HIV infection risk occurred around deployment. The Navy and Marine Corps have different patterns of HIV infection, which may merit distinct approaches to prevention. The Navy may have unique targets for prevention efforts to include pipeline training and first assignment as well as particular occupational environments.

Cervical Human Papillomavirus Infection Among Young Women Engaged In Sex Work In Phnom Penh, Cambodia: Prevalence, Genotypes, Risk Factors And Association With Hiv Infection, Marie-Claude Couture, Kimberly Page, Ellen S. Stein, Neth Sansothy, Keo Sichan, John Kaldor, Jennifer L. Evans, Lisa Maher, Joel Palefsky

Nursing and Health Professions Faculty Research and Publications

Background

Although cervical cancer is the leading cancer in Cambodia, most women receive no routine screening for cervical cancer and few treatment options exist. Moreover, nothing is known regarding the prevalence of cervical HPV or the genotypes present among women in the country. Young sexually active women, especially those with multiple sex partners are at highest risk of HPV infection. We examine the prevalence and genotypes of cervical HPV, as well as the associated risk factors among young women engaged in sex work in Phnom Penh, Cambodia.

Methods

We conducted a cross-sectional study among 220 young women (15–29 years) engaged …

Constrained Optimal Control For A Multi-Group Discrete Time Influenza Model, Paula Andrea Gonzalez Parra

Open Access Theses & Dissertations

During the last decades, mathematical epidemiological models have been used to understand the dynamics of infectious diseases and guide public health policy. In particular, several continuous models have been considered to study single in uenza outbreaks and the impact of dierent control policies. In this dissertation, a discrete time model is introduced in order to study optimal control strategies for in uenza transmission; since epidemiological data is collected on discrete units of time, a discrete formulation is more ecient. From a mathematical point of view, continuous time model are easier to analyze, however, the numerical solution of discrete-time models is …

Components Of The Indirect Effect In Vaccine Trials: Identification Of Contagion And Infectiousness Effects, Tyler J. Vanderweele, Eric J. Tchetgen, M. Elizabeth Halloran

COBRA Preprint Series

Vaccination of one person may prevent the infection of another either because (i) the vaccine prevents the first from being infected and from infecting the second or because (ii) even if the first person is infected, the vaccine may render the infection less infectious. We might refer to the first of these mechanisms as a contagion effect and the second as an infectiousness effect. In this paper, for the simple setting of a randomized vaccine trial with households of size two, we use counterfactual theory under interference to provide formal definitions of a contagion effect and an infectiousness effect. Using …

Spatio-Temporal Modeling Of Arthropod-Borne Zoonotic Diseases: A Proposed Methodology To Enhance Macro-Scale Analyses, Stephen Jones

All Dissertations

Zoonotic diseases are infectious diseases that can be transmitted from or through animals to humans, and arthropods often act as vectors for transmission. Emerging infectious diseases have been increasing both in prevalence and geographic range at alarming rates the last 30 years, and the majority of these diseases are zoonotic in nature. Many zoonotic diseases are considered notifiable by the Centers for Disease Control and Prevention (CDC). However, though state regulations or contractual obligations may require the reporting of certain diseases, significant underreporting is known to exist. Because of the rich volume of information captured in health insurance plan databases, …

Evaluation Of The Pilot Program, Pediatric Early Warning Sentinel Surveillance Program (Pewss), And Its Efficacy In Monitoring Pediatric Illness In Clark County, Nevada, Michelle Lee Lutman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The influenza outbreak that occurred during 2009 stimulated the formation of several surveillance programs throughout the country. The majority monitor only influenza; however, there are several other circulating respiratory pathogens, especially within the pediatric community. These other respiratory pathogens cause a variety of illnesses, such as bronchitis, pneumonia, croup, etc. Prior research has provided the medical community with valuable information about respiratory illnesses, especially those which afflict pediatric patients. Areas of knowledge including seasonality, demographics, signs and symptoms, prevention measures, and pathogenicity, have been greatly expanded over the years. This information has been of tremendous help to the medical community …

Analysis Of The Morbidity And Mortality Of Severe Influenza Infection In Clark County, Nevada For The 2010--2011 Influenza Season, Kindra Maureen St. Jacques

UNLV Theses, Dissertations, Professional Papers, and Capstones

Influenza circulates in the community in a fairly predictable manner each year; however, throughout the duration of any influenza season, influenza strains have the ability to evolve through antigenic mutations, viral reassortment, development of anti-viral resistance, and alterations in virulence. These changes are likely to cause illness among the unimmunized and can result in severe illness or death. Therefore, it is especially important to closely monitor severe influenza-associated hospitalizations and deaths. The University of Nevada, Las Vegas in collaboration with the Southern Nevada Health District (SNHD), Office of Epidemiology (OOE) analyzed data from the severe hospitalized influenza morbidity and mortality …

Large-Scale Use Of Mosquito Larval Source Management For Malaria Control In Africa: A Cost Analysis, Eve Worrall, Ulrike Fillinger

All Peer-Reviewed Publications

Background: At present, large-scale use of two malaria vector control methods, long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) is being scaled up in Africa with substantial funding from donors. A third vector control method, larval source management (LSM), has been historically very successful and is today widely used for mosquito control globally, except in Africa. With increasing risk of insecticide resistance and a shift to more exophilic vectors, LSM is now under re-evaluation for use against afro-tropical vector species. Here the costs of this intervention were evaluated. Methods. The 'ingredients approach' was used to estimate the economic and …

Hiv And Concurrent Sexual Partnerships: Modelling The Role Of Coital Dilution, Larry Sawers, Alan G. Isaac, Eileen Stillwaggon

Economics Faculty Publications

Background: The concurrency hypothesis asserts that high prevalence of overlapping sexual partnerships explains extraordinarily high HIV levels in sub-Saharan Africa. Earlier simulation models show that the network effect of concurrency can increase HIV incidence, but those models do not account for the coital dilution effect (nonprimary partnerships have lower coital frequency than primary partnerships).

Methods: We modify the model of Eaton et al (AIDS and Behavior, September 2010) to incorporate coital dilution by assigning lower coital frequencies to non-primary partnerships. We parameterize coital dilution based on the empirical work of Morris et al (PLoS ONE, December …

Characterization Of The Serologic Responses To Plasmodium Vivax Dbpii Variants Among Inhabitants Of Pursat Province, Cambodia, Samantha Jones Barnes

USF Tampa Graduate Theses and Dissertations

The Plasmodium vivax Duffy Binding Protein (DBP) is the ligand in the major pathway for P. vivax invasion of human reticulocytes, making it an appealing vaccine candidate. Region II of DBP (DBP-RII) is the minimal portion of the ligand that mediates recognition of the Duffy Antigen Receptor for Chemokines (DARC receptor) on the reticulocyte surface and constitutes the primary vaccine target. Analysis of natural variation in the coding sequences of DBP-RII revealed signature evidence for selective pressure driving variation in the residues of the putative receptor-binding site. We hypothesize that anti-DBP immunity in P. vivax infections is strain-specific and hindered …

Tuberkulosis Paru Di Palembang, Sumatera Selatan, Hery Unita Versitaria, Haryoto Kusnoputranto

Kesmas

Indonesia tercatat memiliki 304.787 penderita tuberkulosis yang menempatkannya pada peringkat ketiga terbanyak di dunia. Penyakit tuberkulosis merupakan penyebab kematian nomor 3 setelah penyakit kardiovaskuler dan penyakit saluran pernafasan pada semua kelompok usia serta nomor 1 dari golongan penyakit infeksi. Angka kepadatan hunian rumah di Kota Palembang 5,84 lebih tinggi daripada angka ideal kepadatan hunian rumah. Penelitian ini bertujuan mengetahui hubungan antara sumber penular serumah, faktor lingkungan dalam rumah, dan karakteristik individu terhadap kejadian tuberkulosis paru basil tahan asam (BTA) (+) di Kota Palembang. Penelitian yang menggunakan desain kasus kontrol ini membandingkan kelompok kasus (BTA(+)) dan kelompok kontrol (BTA (-)) yang …

Medical Encounter Characteristics Of Hiv Seroconverters In The Us Army And Air Force, 2000–2004, Shilpa Hakre, David Brett-Major, Darrell E. Singer, Robert J. O'Connell, Warren B. Sateren, Jose L. Sanchez, Brian K. Agan, Nelson L. Michael, Paul T. Scott

Journal Articles: Epidemiology

BACKGROUND AND METHODS: Active duty US Army and Air Force military personnel undergo mandatory biennial HIV antibody screening. We compared pre- and post-HIV seroconversion health status by conducting a case-control study, which evaluated all medical encounters and sociodemographic factors among incident HIV seroconverters and HIV-negative controls from June 2000 through February 2004.

RESULTS: A total of 274 HIV seroconverters and 6205 HIV-negative personnel were included. In multivariate analysis restricted to male personnel (cases = 261, controls = 5801), single marital status (adjusted odds ratio [AOR] = 14.37), clinical indicators or symptoms within four years of HIV diagnosis (AOR = 6.22), …

Epidemiology Of Blood-Borne Infections Among Georgian Health Care Workers, Maia Butsashvili

Legacy Theses & Dissertations (2009 - 2024)

INTRO: The prevalence of hepatitis in central Asia is considered high (>8% endemnicity) by the World Health Organization. Universal precautions among healthcare workers (HCWs) and newborn vaccination programs are important public health interventions to reduce the spread of hepatitis and other blood borne pathogens. This comprehensive evaluation of the risk of blood borne pathogen exposure among HCWs in the Republic of Georgia measures the following: 1) nosocomial risk events; 2) prevalence of HIV, HBV and HCV among Georgian HCWs; 3) predictive factors for HCWs recommending HBV vaccination for children; 4) prevalence of and willingness to report behavioral risk factors …

Preventing Mother-To-Child Transmission Of Human Immunodeficiency Virus-1 (Hiv-1): Effects Of Intrapartum And Neonatal Single-Dose Nevirapine Prophylaxis And Subsequent Hiv-1 Drug Resistance At Antiretroviral Treatment Initiation, Amanda L. Harmon

CMC Senior Theses

The prevention of mother-to-child transmission is one of the most powerful tools in human immunodeficiency virus type 1 (HIV-1) prevention and has huge potential to improve both maternal and child health. In the absence of any preventative measures, infants born to and breastfed by their HIV-positive mothers have roughly a one-in-three chance of acquiring the infection themselves. HIV can be passed on from mother-to-child during pregnancy, during labor and delivery, and even after during breastfeeding.

Intrapartum and neonatal single-dose nevirapine (sd-NVP) is the foundation of preventing mother-to-child transmission in lower resource settings where it has been used alone or as …

Assessing The Influence Of Socioeconomic Factors, Knowledge Level, Attitudes, And Practices On Malaria Prevention Among The Gusii People Of Kenya, Christopher Nyakundi Arori

Walden Dissertations and Doctoral Studies

Global morbidity and mortality associated with malaria is rampant, and most of the clinical malaria cases are found in sub Saharan Africa. Previous and current research show that malaria is both preventable and treatable and that socioeconomic variables have a profound influence on how persons in rural Africa respond to malaria infections and the associated preventive strategies. This study assessed two key research questions for malaria cases in the Gusii region of Kenya regarding: First, whether a community education program on malaria has an impact in changing malaria preventive behaviors; and, second, if a relationship exists between socioeconomic factors and …

Decision Aid Models For Resource Sharing Strategies During Global Influenza Pandemics, Alfredo Santana Reynoso

USF Tampa Graduate Theses and Dissertations

Pandemic influenza outbreaks have historically entailed significant societal and economic disruptions. Today, our quality of life is threatened by our inadequate preparedness for the imminent pandemic. The key challenges we are facing stem from a significant uncertainty in virus epidemiology, limited response resources, inadequate international collaboration, and the lack of appropriate science-based decision support tools. The existing literature falls short of comprehensive models for global pandemic spread and mitigation which incorporate the heterogeneity of the world regions and realistic travel networks. In addition, there exist virtually no studies which quantify the impact of resource sharing strategies among multiple countries. This …

Optimal Control Applied To A Discrete Time Influenza Model, Paula Andrea Gonzalez Parra

Open Access Theses & Dissertations

For the last decades, mathematical epidemiological models have been used to understand the dynamics of infectious diseases and guide public health policy.

In particular, several continuous models have been considered to study influenza outbreaks and their controls policies. However, most epidemiological data is discrete; therefore, a discrete formulation is more convenient to compare collected data with the output of the model. We introduce a discrete time model in order to study optimal control strategies for influenza transmission.

In our model, we divide the population into four classes: susceptible, infectious, treated, and recovered individuals.

In particular, we evaluate the potential effect …

An Investigation Of The Subtype Diversity Of Clinical Isolates Of Irish Clostridium Difficile Ribotypes 027 And 078 By Repetitive-Extragenic Palindromic Pcr, Denise Drudy, K. Solomon, S. Murray, L. Scott, S. Mcdermott,, A. Martin, C. O’Donoghue, M. Skally, K. Burns, L. Fenelon, F. Fitzpatrick,, L. Kyne, S. Fanning

Articles

A repetitive-extragenic palindromic PCR (rep-PCR) subtyping method (DiversiLab) in conjunction with ribotyping, toxinotyping and antimicrobial-susceptibility testing was used to detect subtypes within Clostridium difficile ribotypes 027 and 078. Clinical isolates of ribotypes 027 (toxinotype III) (n530) and 078 (toxinotype V) (n523) were provided by health-care facilities across the Republic of Ireland over 2 months in 2006 and 1 month in 2009. Ribotype 027 isolates were significantly more related to each other (9 different subtype profiles) when compared to ribotype 078 isolates (14 different profiles) (P50.001; cut-off .90 % similarity). Almost half of ribotype 078 isolates (45.5 %) showed no relationship …

Assessing The Relationship Of Monocytes With Primary And Secondary Dengue Infection Among Hospitalized Dengue Patients In Malaysia, 2010: A Cross-Sectional Study, Benjamin Glenn Klekamp

USF Tampa Graduate Theses and Dissertations

Dengue, a group of four similar viruses transmitted through the bite of a mosquito, is estimated to infect upwards of 100 million annually in over 100 nations throughout the global equatorial belt. Distribution of global dengue is highly skewed as Southeast Asian and Western Pacific regions endure 75% of the global dengue burden. Similar to other regional countries, Malaysia has been rapidly urbanizing, which has supported a hyperendemic dengue state.

The biological pathway by which dengue infection causes a wide range of clinical manifestations, spanning asymptomatic to life-threatening severe complications, is not comprehensively understood. Historically, severe dengue complications have primarily …

Mathematical Modeling, Simulation, And Time Series Analysis Of Seasonal Epidemics., Eric Shu Numfor

Electronic Theses and Dissertations

Seasonal and non-seasonal Susceptible-Exposed-Infective-Recovered-Susceptible (SEIRS) models are formulated and analyzed. It is proved that the disease-free steady state of the non-seasonal model is locally asymptotically stable if R_v < 1, and disease invades if R_v > 1. For the seasonal SEIRS model, it is shown that the disease-free periodic solution is locally asymptotically stable when R̅_v < 1, and I(t) is persistent with sustained oscillations when R̅_v > 1. Numerical simulations indicate that the orbit representing I(t) decays when R̅_v < 1 < R_v. The seasonal SEIRS model with routine and pulse vaccination is simulated, and results depict an unsustained decrease …

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Contextualizing The Health Belief Model And The Social Epidemiology Theories In The Study Of Aids In Malawi, Kumbirai Madondo

All Theses

The association between HIV/AIDS knowledge, risk perception and risky sexual behavior remains a valuable area of study among scholars seeking to understand the AIDS epidemic in Africa. Past research has focused only on either the Health Belief Model or social epidemiology ideas to understand AIDS but never combined the two. The current study is unique and adds to the body of knowledge by making use of both the Health Belief Model and social epidemiology ideas to understand these relationships more clearly and, more importantly, to explore the role that keeping AIDS a secret has in the contexts of risk perception, …

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …