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Strategies For Deriving A Single Measure Of The Overall Burden Of Antimicrobial Resistance In Hospitals, Alessandro Orlando

Theses and Dissertations

Background: Antimicrobial-resistant infections result in hospital stays costing between $18,000 and $29,000. As of 2009, Centers for Medicare and Medicaid Services no longer upgrade payments for hospital-acquired infections. Hospital epidemiologists monitor and document rates of individual resistant microbes in antibiogram reports. Overall summary measures capturing resistance within a hospital may be useful. Objectives: We applied four techniques (L1- and L2-principal component analysis (PCA), desirability functions, and simple summary) to create summary measures of resistance and described the four summary measures with respect to reliability, proportion of variance explained, and clinical utility. Methods: We requested antibiograms from hospitals participating in the …

When Volunteering Doesn’T Cut It: A Critical Examination Of Carbapenem-Resistant Enterobacteriaceae Surveillance And Trends In The United States., Erica E. Smith

Theses and Dissertations

Background. Carbapenem-resistant Enterobacteriaceae, including Escherichia coli and Klebsiella pneumoniae, are newly emerging pathogens of public health importance. Currently no nationally representative or mandatory surveillance or reporting system exists to examine trends of these important pathogens. Objective. The purpose of the current study was to estimate trends in overall microbial burden and carbapenem resistance in E. coli and K. pneumoniae and to understand the extent to which hospitals which report to voluntary surveillance systems represent all hospitals in the United States. Design. We conducted a descriptive study to compare the hospitals participating in voluntary reporting systems of the University HealthSystem Consortium …

Recent Diarrhea Is Associated With Elevated Salivary Igg Responses To Cryptosporidium In Residents Of An Eastern Massachusetts Community, A. I. Egorov, L. M. Montuori Trimble, L. Ascolillo, H. D. Ward, Deborah A. Levy, R. D. Morris, E. N. Naumova, J. K. Griffiths

Journal Articles: Epidemiology

BACKGROUND: Serological data suggest that Cryptosporidium infections are common but underreported. The invasiveness of blood sampling limits the application of serology in epidemiological surveillance. We pilot-tested a non-invasive salivary anti-Cryptosporidium antibody assay in a community survey involving children and adults.

MATERIALS AND METHODS: Families with children were recruited in a Massachusetts community in July; symptoms data were collected at 3 monthly follow-up mail surveys. One saliva sample per person (n = 349) was collected via mail, with the last survey in October. Samples were analyzed for IgG and IgA responses to a recombinant C. hominis gp15 sporozoite protein using a …

The Relationship Between Mosquito Abundance And Rice Field Density In The Republic Of Korea, Erin E. Richards, Penny Masuoka, David Brett-Major, Matthew Smith, Terry A. Klein, Heung Chul Kim, Assaf Anyamba, John Grieco

Journal Articles: Epidemiology

BACKGROUND: Japanese encephalitis virus (JEV), the causative agent of Japanese encephalitis (JE), is endemic to the Republic of Korea (ROK) where unvaccinated United States (U.S.) military Service members, civilians and family members are stationed. The primary vector of the JEV in the ROK is Culex tritaeniorhynchus. The ecological relationship between Culex spp. and rice fields has been studied extensively; rice fields have been shown to increase the prevalence of Cx. tritaeniorhynchus. This research was conducted to determine if the quantification of rice field land cover surrounding U.S. military installations in the ROK should be used as a parameter in a …

Racial /Ethnic Disparities In Hypertension In United States Residents: A Cross-Sectional Study Of Potential Explanatory Covariates, Franklin I. Opara

Walden Dissertations and Doctoral Studies

Racial/ethnic disparities persist in hypertension (HTN) prevalence in the United States, and African Americans are disproportionately affected. The incidence is more than two-folds in African Americans compared to Caucasians, and mortality is highest among African Americans. Understanding the risk factors in HTN and how these factors vary across racial/ethnic groups is essential to reducing the mortality among African Americans. This study examined the prevalence of HTN among a sample non-institutionalized U.S. residents (N = 30,852), assessed racial/ethnic disparities and determined factors associated with racial/ethnic variance in HTN. A cross-sectional design was used to address these aims, utilizing the National Health …

Social Capital Variables As Predictors Of Hiv Risk-Taking Behaviors Among Sub-Saharan African Immigrants In The United States, Gbadebo Ogundiran Ogungbade

Walden Dissertations and Doctoral Studies

Vulnerable populations, including immigrants, are often at risk for human immunodeficiency virus (HIV) infection because of their risk-taking behaviors. This study investigated risk-taking behavior for HIV infection among Sub-Saharan African (SSA) immigrants in United States. Using social capital as a theoretical foundation, the study aimed to address the question, is there any association between social capital assets of educational opportunity, employment, and eligibility for social assistance and HIV risk-taking behavior, defined as condom use before sex (CUBS) among SSA immigrant in the U.S? Potential participants were recruited through religious and social organizations in a southwestern US state. The survey generated …

Observer-Dependent Model For Analyzing Subjective Parameters In Epidemiology, Milad Zarei

Open Access Theses & Dissertations

Although medical technologies for preventing the contagion and spread of infectious diseases have improved steadily throughout the last century, new infectious diseases are still emerging and spreading swiftly. The modeling of infectious disease spread is crucial in addressing the lack of predictive ability in epidemiology. Managing the spread of infectious diseases requires processing quantitative epidemiological data and the ability to capture the dynamics of the infectious disease in order to provide a measure of control.

In this thesis, I have introducing cognitive biases in diseases spread modeling. For the first time, to the author's knowledge, the human subjective experience has …

Examining The Association Of Fruit And Vegetable Intake And Breast And Prostate Cancer Screening, Mark Yu

Theses and Dissertations

Breast and prostate cancer incidence and mortality have been steadily decreasing. Reasons for these reductions may be related to increased rates of cancer screening and other factors such as improvements in diet, including consumption of fruits and vegetables. We wanted to determine if individuals who get screened for breast and prostate cancer are more or less likely to consume adequate servings of fruit and vegetables. A cross-sectional study using the BRFSS survey was conducted. Individuals included in this study (n=26,222), were asked about their breast or prostate cancer screening history. They were also asked about their servings per day of …

The 2009 H1n1 Influenza A “Swine Flu” Virus Presentation In Virginia 2009, Tammie Smith

Theses and Dissertations

Objective: 2009 H1N1 influenza was first detected in the Northern Hemisphere in April 2009. National data have suggested that the novel influenza virus disproportionately causes severe illness in children and young adults, a somewhat different presentation from traditional seasonal flu which normally strikes hardest in the very young and older adults. This may or may not be the case in Virginia, which, if it is different, may suggest a need to alter flu prevention messages and vaccine policy as the outbreak continues through the fall 2009-10 influenza season. This report examined the early presentation of the new influenza virus in …

Gangguan Akibat Kekurangan Iodium Di Indonesia: Tinjauan Epidemiologis Dan Kebijakan Kesehatan, Laurentius Aswin Pramono

Kesmas

Gangguan Akibat Kekurangan Iodium (GAKI) merupakan penyebab retardasi mental terbesar di seluruh dunia yang dapat dicegah. Dewasa ini, GAKI masih merupakan masalah kesehatan masyarakat yang penting di Indonesia karena belum mampu mencapai kondisi eliminasi seperti yang diharapkan. Hasil survei tahun 2003 dan Riskesdas 2007 menunjukkan bahwa pencapaian program penanggulangan GAKI di Indonesia masih jauh dari target Universal Salt Iodization dan Indonesia Sehat 2010. Artikel ini bertujuan mengevaluasi berbagai eviden epidemiologi yang berhubungan dengan kebijakan GAKI di Indonesia. Pada masa mendatang, berbagai komitmen lintas sektoral sangat diperlukan bagi pencapaian kondisi eliminasi GAKI. Perhatian klinisi dan ahli epidemiologi terhadap permasalahan GAKI di …

Pengaruh Kemiskinan Keluarga Pada Kejadian Pneumonia Balita Di Indonesia, Rizanda Machmud

Kesmas

Pneumonia merupakan penyakit infeksi saluran pernapasan akut yang menjadi kausa utama kematian balita. Di Indonesia, pada akhir tahun 2000, angka kematian balita akibat pneumonia diperkirakan 4,9/1000 balita. Faktor sosio-ekonomi berkontribusi besar terhadap penyakit saluran pernapasan. Tujuan penelitian ini adalah mengetahui faktor sosio-ekonomi yang paling berpengaruh terhadap pneumonia pada balita. Penelitian dengan dengan disain krosseksional ini menggunakan sumber data sekunder Benefit Evaluation Study (BES) II oleh Pusat Penelitian Kesehatan Universitas Indonesia bekerja sama dengan Proyek Intensifikasi Pemberantasan Penyakit Menular, Departemen Kesehatan. Sampel diambil berdasarkan multilevel statistical frameworkdari 7.170 ba-lita pada 10.900 rumah tangga di 27 kabupaten di tujuh provinsi. Metode analisis …

Complexity, Cofactors, And The Failure Of Aids Policy In Africa, Eileen Stillwaggon

Economics Faculty Publications

Global AIDS policy still treats HIV as an exceptional case, abstracting from the context in which infection occurs. Policy is based on a simplistic theory of HIV causation, and evaluated using outdated tools of health economics. Recent calls for a health systems strategy – preventing and treating HIV within a programme of comprehensive health care – have not yet influenced the silo approach of AIDS policy.

Evidence continues to accumulate, showing that multiple factors, such as malnutrition, malaria and helminthes, increase the risk of sexual and vertical transmission of HIV. Moreover, complementary interventions that reduce viral load, improve immune response, …

Modeling And Analysis Of The Spread Of Japanese Encephalitis With Environmental Effects, Ram Naresh, Surabhi Pandey

Applications and Applied Mathematics: An International Journal (AAM)

A nonlinear mathematical model for the spread of Japanese Encephalitis, caused by infected mosquito feeding on susceptible human population incorporating demographic and environmental factors is proposed and analyzed. In the modeling process, it is assumed that the growth rates of reservoir animal population and vector mosquito population are enhanced due to environmental discharges caused by human population related factors. The model is analyzed by stability theory of differential equations and computer simulation. Both the disease-free and the endemic equilibria are found and their stability is investigated. It is found that whenever the disease-free equilibrium is locally asymptotically stable, the endemic …

Tuberculosis In San Bernardino County, 1993-2004 : Lifestyle And Environmental Factors, Anuj Bhatia

Loma Linda University Electronic Theses, Dissertations & Projects

An observational retrospective study was conducted for tuberculosis (TB) cases between San Bernardino County (SBC), Riverside County, and the state of California from 1996 to 2004. A univariate comparison between San Bernardino County and California indicated a higher proportion of U.S. born cases in SBC. Additionally, it was found that San Bernardino had a higher proportion of non-injection drug using TB cases, compared with California in 1996. Further comparisons were made along country of birth between TB cases in San Bernardino County from 1993 to 2004. Notable differences were observed for injection drug use, non injection drug use, alcohol abuse, …

Determinants Of Hepatitis B Vaccination Among Adults In The United States: Nhanes 1999-2006, Conschetta Wright

Theses and Dissertations

Purpose: The primary objective of this study was to estimate the prevalence of vaccination and HBV infection status of adults and to evaluate the trend in self reported vaccination and seroprevalence for Hepatitis B for this population. Additionally, this study sought to assess the association between vaccination rates, seroprevalence (HBsAg, anti-HBc, and anti-HBs), demographic (age, gender, location of birth, race/ethnicity), and socioeconomic (annual household income, education level, insurance coverage and access to care, marital status) characteristics. Methods: Eight years, 1999-2006, of the National Health and Nutrition Examination Survey (NHANES) data were used. NHANES participants aged 20-59 years who contributed data …

Molecular Epidemiology Of Methicillin-Resistant Staphylococcus Aureus (Mrsa), Ilene Bautista

UNLV Theses, Dissertations, Professional Papers, and Capstones

Staphylococcus aureus is a frequent cause of a myriad of infections in hospitals, healthcare facilities and community settings. It is often related to skin and soft tissue infection, but it can also cause other diseases varying from food poisoning to endocarditis and toxic shock syndrome. According to a study by Kuehnert et al. (2006) there has been a strong association between Staphylococcus aureus (S. aureus) carriage and risk factors for subsequent infections. Subsequent infection from S. aureus , including methicillin-resistant S. aureus (MRSA) infection, can be projected by looking at the presence of S. aureus nasal colonization. The purpose of …

Nonparametric Incidence Estimation From Prevalent Cohort Survival Data, Marco Carone, Masoud Asgharian, Mei-Cheng Wang

COBRA Preprint Series

Incidence is an important epidemiologic concept particularly useful in assessing an intervention, quantifying disease risk, and planning health resources. Incident cohort studies constitute the gold-standard in estimating disease incidence. However, due to material constraints, data are often collected from prevalent cohort studies whereby diseased individuals are recruited through a cross-sectional survey and followed forward in time. We discuss the identifiability of measures of incidence in the context of prevalent cohort survival studies and derive nonparametric maximum likelihood estimators and their asymptotic properties. The proposed methodology accounts for calendar-time and age-at-onset variation in disease incidence while also addressing common complications arising …

Sand Fly Fever: What Have We Learned In One Hundred Years?, David Brett-Major, David M. Claborn

Journal Articles: Epidemiology

Sand fly fever has severely impacted military missions in southern Europe and the Middle East for hundreds of years. After a brief respite following the malaria eradication programs of World War II, it has returned as a significant disease among residents in and travelers to the Mediterranean rim. It is a more severe disease now, with potential vectors in the United States. Sand fly fever is discussed in terms of its viruses, vectors, disease, control, and potential domestic impact.

Ua94/6/1 Student / Alumni Personal Papers Western Kentucky University Small Collections, Wku Archives

WKU Archives Collection Inventories

Small collections of personal papers and oral histories relating to the Western Kentucky University.

Antibiotic Prophylaxis For Leptospirosis, David Brett-Major, Robert J. Lipnick

Journal Articles: Epidemiology

BACKGROUND: Leptospira infection is a global zoonosis with significant health impact for agricultural workers and those persons whose work or recreation takes them into endemic areas.

OBJECTIVES: This systematic review assessed the current literature for evidence for or against use of antibiotic prophylaxis against Leptospira infection (leptospirosis).

SEARCH STRATEGY: The authors searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and SCI-Expanded as well as relevant professional society meeting abstracts until January 2009.

SELECTION CRITERIA: Prospective, randomised clinical trials studying antibiotic prophylaxis against leptospirosis were selected.

DATA …

When To Spray: A Time-Scale Calculus Approach To Controlling The Impact Of West Nile Virus, Diana Thomas, Marion Weedermann, Lora Billings, Joan Hoffacker, Robert Washington-Allen

Department of Mathematics Faculty Scholarship and Creative Works

West Nile Virus (WNV) made its initial appearance in the New York City (NYC) metropolitan area in 1999 and was implicated in cases of human encephalitis and the extensive mortality in crows (Corvus sp.) and other avian species. Mosquitoes were found to be the primary vectors and NYC’s current policy on control strategies involved an eradication program that depends on the synchronicity of the summer mosquito population’s increases with the occurrence of cases in humans. The purpose of this paper is to investigate whether this is the most effective control strategy because past mathematical models assumed discrete behavior that …

War Of The Worlds: Our Worlds Are Colliding And Infectious Disease Is Winning - Emerging Diseases And The One Health Initiative, Richard French

The University Dialogue

No abstract provided.

Validation Of Inverse Seasonal Peak Mortality In Medieval Plagues, Including The Black Death, In Comparison To Modern Yersinia Pestis-Variant Diseases, Mark R. Welford, Brian H. Bossak

Earth, Environment & Sustainability: Faculty Publications

Background: Recent studies have noted myriad qualitative and quantitative inconsistencies between the medieval Black Death (and subsequent ‘‘plagues’’) and modern empirical Y. pestis plague data, most of which is derived from the Indian and Chinese plague outbreaks of A.D. 1900615 years. Previous works have noted apparent differences in seasonal mortality peaks during Black Death outbreaks versus peaks of bubonic and pneumonic plagues attributed to Y. pestis infection, but have not provided spatiotemporal statistical support. Our objective here was to validate individual observations of this seasonal discrepancy in peak mortality between historical epidemics and modern empirical data.

Methodology/Principal Findings: …

A Concentrated Look At Hiv/Aids: Transmission To Low Risk Women Through Intravenous Drug Users And Female Sex Workers In Da Nang City, Vietnam, Danielle A. Depeau

Independent Study Project (ISP) Collection

Female sex workers (FSW) and intravenous drug users (IDU) whom were living in Da Nang City, Vietnam, along with the women and children associated with these individuals, were interviewed to study the effects of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). In addition, an understanding how the epidemic was spreading from high-risk populations to the general population was explored. This was achieved by learning the history of sexual behaviors in regards to sexual partners and regularity of condom use, as well as drug injection practices, HIV/AIDS education, treatment, gender status and socio-demographic characteristics.

Informal interviews were conducted …

Economics, Epidemics & Eradication: A Case Study Of Malaria In Madagascar, Kathleen Minton

Independent Study Project (ISP) Collection

Despite effective techniques for preventing and treating malaria, the malaria burden in Madagascar remains quite high, particularly in rural areas where poor villagers are more isolated from health services, and less likely to be able to afford prevention methods or treatment. In response to this challenge, Madagascar’s government has made malaria eradication a high priority, stating that it hopes to reduce the incidence of malaria from its current level of 1,234,520 to 320,000 by 2012, and to eliminate the disease entirely by 2018. Ultimately, though, it remains to be seen if their efforts will be sufficient to meet these ambitious …

Partner Communication And Factors Associated With The Decision To Obtain An Hiv Test Among Chinese/Chinese American Community College Students In Northern California, Sang Leng Trieu

Loma Linda University Electronic Theses, Dissertations & Projects

HIV testing and counseling is considered the cornerstone of a comprehensive approach to HIV prevention and education. Little is known, however, about HIV prevention, including HIV testing rates for Asian Pacific Islander (API) women, because data for this ethnic group is aggregated, thus limiting specific data for Chinese/Chinese American population or other API subgroups. This dissertation research examined factors associated with the decision to obtain an HIV test among Chinese/Chinese American community college women and explored the association among relationship status, partnership communication, and discussions of HIV testing.

Using constructs of the health belief model, an online and paper-pencil, crosssectional …

Doubly Robust Ecological Inference, Daniel B. Rubin, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

The ecological inference problem is a famous longstanding puzzle that arises in many disciplines. The usual formulation in epidemiology is that we would like to quantify an exposure-disease association by obtaining disease rates among the exposed and unexposed, but only have access to exposure rates and disease rates for several regions. The problem is generally intractable, but can be attacked under the assumptions of King's (1997) extended technique if we can correctly specify a model for a certain conditional distribution. We introduce a procedure that it is a valid approach if either this original model is correct or if we …

Socioeconomic Determinants Of Hiv Status In Kenya, Kimberly Fletcher

Masters Theses & Specialist Projects

The spread of Human Immunodeficiency Virus (HIV) is one of the greatest threats to stability and development in Kenya. The country's infection rate is estimated between seven and eight percent, making it one of the highest in the world. Several studies have been done that examine subpopulations such as truck drivers, sex workers, and migrants. However, to date there is little research that examines who, across the country, is contracting HIV. Kenya's 2003 Demographic and Health Survey includes data that make it possible to determine which groups have the highest odds of being infected. The question of who is contracting …

Foreign-Body Reaction Mimicking Postneurosurgical Infection After Cranioplasty, David Brett-Major, Sean M. Baraniak, Jonathan E. Gilhooly, Rebecca L. Christensen, Gerald T. Grant, Rocco A. Armonda, Anuradha Ganesan

Journal Articles: Epidemiology

The case of a 57-year-old woman who suffered a fall is presented. After a polymethyl malacrylate revision cranioplasty, she presented with signs, symptoms, and intraoperative findings consistent with postneurosurgical infection. Dural foreign-body reaction was diagnosed, and parenteral antibiotic therapy was discontinued successfully.

Global Stability Results Of An Sis Age-Structured Epidemic Model With Vertical Transmission, M. El-Doma

Applications and Applied Mathematics: An International Journal (AAM)

An SIS age-structured epidemic model for a vertically as well as horizontally transmitted disease is investigated when the fertility, mortality and cure rates depend on age and the force of infection of proportionate mixing assumption type. We determine the steady states and prove the global stability for the endemic equilibriums.