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Ukimwi : Hiv/Aids In Kenya, Virginia Wangui Gathua

Graduate Research Papers

This manuscript points out the deficiencies school counseling programs in Kenya for children/adolescents affected/infected by HIV/AIDS. In addition, the paper is intended to inform, guide, and encourage policy makers, program developers, and school counselors as they develop school counseling interventions for the disease. The focus of the paper is limited to children/adolescents because they bear the greatest burden of HIV/ AIDS infections. The paper also provides evidence for planning and implementation of culturally and developmentally relevant, school-based counseling interventions. The paper explores the impact of HIV/AIDS on Kenyan children/adolescents infected/affected by HIV/AIDS and points out the factors that hinder prevention …

How Should Health Departments Manage Prenatal Care?, Julianne Nesbit

Master of Public Health Program Student Publications

Objective: To compare how health departments in the southwest district of Ohio manage prenatal care, defined as preventative care provided immediately preceding, during, and following pregnancy, to determine if there is a better management technique based on cost and/or characteristics of jurisdictions.

Design: Qualitative descriptive analysis of prenatal services at local health departments in the southwest district of Ohio for 2004.

Setting and Participants: Health Departments in the southwest district of Ohio.

Main Outcome Measures: Comparison of the types of services currently being used to provide prenatal care services (i.e., direct, contracted, combination, or no service) including budgeting and cost …

The Case Of South African And Chilean Health Systems: Comparison Of Financial, Economic And Health Indicators, Alberto Coustasse, Peter Hilsenrath, Patricio Silva Rojas

Management Faculty Research

The purpose of this study is to identify similarities and differences between healthcare systems of South Africa and Chile. The World Health Report 2000, the Human Development Index, and financial indicators were used for comparison. Chile showed better performance than South Africa in most of the measures used. Significant progress has been made in South Africa, bringing better education, healthcare and housing to the deprived black majority. However, the HIV/AIDS epidemic, weighs heavily on health indicators. Chile decentralized its health services and implemented economic reforms during the 1980's and has had steady improvement in its healthcare indicators. Finally, these counties …

Prenatal Malnutrition And Risk Of Schizophrenia, Andria Timmer

International Journal of Global Health and Health Disparities

Characterized by delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, schizophrenia is a severe mental disorder that is estimated to have a lifetime risk of one percent (Liu et al., Allen 2002). Prevalence rates in different countries range from 0.2-2.0 percent with an average incidence rate of 28.1 per 100,000 remaining stable across a wide range of cultures, climates and ethnic groups (Thomas 2000). In the United States, at any given time there may be two to three million people who either have schizophrenia or are at risk of developing it (Allen 2002). The disease usually manifests itself in late …

Cover - Front Matter - Table Of Contents

International Journal of Global Health and Health Disparities

No abstract provided.

Barriers To Combating Infectious Disease Globally: A Look At Dengue Fever, Rob J. Fernandez

International Journal of Global Health and Health Disparities

Infectious disease remains one of the most important concerns in global health. Serious infectious diseases affect hundreds of millions of people worldwide each year. While attention is often focused on HIV/AIDS, malaria or TB, dengue fever and its more lethal variety dengue hemorrhagic fever (DHF) are also a risk for the more than 2.5 billion people living in tropical and sub-tropical regions across the globe, according to the World Health Organization (WHO). Approximately 50 million cases, about 400,000 of which are DHF, are documented each year, with some countries reporting it as a leading cause of child mortality (1). Although …

Genome Size And Organization In The Blacklegged Tick, Ixodes Scapularis And The Southern Cattle Tick, Boophilus Microplus, A. J. Ullmann, C. M. R. Lima, F. D. Guerrero, J. Piesman, W. C. Black Iv

United States Public Health Resources

Genome sizes and the organization of repetitive DNA were determined in the hard ticks Ixodes scapularis and Boophilus microplus using reassociation kinetics. The I. scapularis genome contains ~ 2.15 pg (2.1 × 10 ³ Mbp) of DNA and consists of no foldback (FB), 27% highly repetitive (HR), 39% moderately repetitive (MR), and 34% unique DNA. The B. microplus genome contains 7.5 pg (7.1 × 10 ³ Mbp) DNA, and consists of 0.82% FB, 31% HR, 38% MR, and 30% unique DNA. In both species, repetitive sequences occur in a mixture of long and short period interspersion but most (65–80%) of …

Evolutionary Genetics Of A New Pathogenic Escherichia Species: Escherichia Albertii And Related Shigella Boydii Strains, Katie E. Hyma, David W. Lacher, Adam M. Nelson, Alyssa C. Bumbaugh, J. Michael Janda, Nancy A. Strockbine, Vincent B. Young, Thomas S. Whittam

United States Public Health Resources

A bacterium originally described as Hafnia alvei induces diarrhea in rabbits and causes epithelial damage similar to the attachment and effacement associated with enteropathogenic Escherichia coli. Subsequent studies identified similar H. alvei-like strains that are positive for an intimin gene (eae) probe and, based on DNA relatedness, are classified as a distinct Escherichia species, Escherichia albertii. We determined sequences for multiple housekeeping genes in five E. albertii strains and compared these sequences to those of strains representing the major groups of pathogenic E. coli and Shigella. A comparison of 2,484 codon positions in 14 …

Non-O157 Shiga Toxin–Producing Escherichia Coli Infections In The United States, 1983–2002, John T. Brooks, Evangeline G. Sowers, Joy G. Wells, Katherine D. Greene Greene, Patricia M. Griffin, Robert M. Hoekstra, Nancy A. Strockbine

United States Public Health Resources

Background. Shiga toxin–producing Escherichia coli (STEC) O157:H7 is a well-recognized cause of bloody diarrhea and hemolytic-uremic syndrome (HUS). Non-O157 STEC contribute to this burden of illness but have been underrecognized as a result of diagnostic limitations and inadequate surveillance.

Methods. Between 1983 and 2002, 43 state public health laboratories submitted 940 human non-O157 STEC isolates from persons with sporadic illnesses to the Centers for Diseases Control and Prevention reference laboratory for confirmation and serotyping.

Results. The most common serogroups were O26 (22%), O111 (16%), O103 (12%), O121 (8%), O45 (7%), and O145 (5%). Non-O157 STEC infections were …

Identification And Characterization Of Shigella Boydii 20 Serovar Nov., A New And Emerging Shigella Serotype, David L. Woodward, Clifford G. Clark, Richard A. Caldeira, Rafiq Ahmed, Geoff Soule, Louis Bryden, Helen Tabor, Pasquale Melito, Roger Foster, Julie Walsh, Lai-King Ng, Georgia B. Malcolm, Nancy Strockbine, Frank G. Rodgers

United States Public Health Resources

Analysis of 163 putative Shigella isolates from Canada and the USA showed biochemical reactions consistent with Shigella species, although none of the isolates reacted with antiserum raised against any of the well-established or provisional Shigella serotypes. All these isolates, provisionally designated serotype SH108, were positive for the ipaH gene and the invasion-associated locus. All fermented mannitol, were serologically indistinguishable from each other and showed no reaction in antisera prepared against Escherichia coli serotypes O1 to O181. PCR-RFLP analysis of the genes involved in O-antigen synthesis revealed a common pattern among these isolates that was distinct from recognized Shigella serotypes and …

Phylogenetic Analysis Of North American West Nile Virus Isolates, 2001–2004: Evidence For The Emergence Of A Dominant Genotype, C. Todd Davis, Gregory D. Ebel, Robert S. Lanciotti, Aaron C. Brault, Hilda Guzman, Marina Siirin, Amy Lambert, Ray E. Parsons, David W.C. Beasley, Robert J. Novak, Darwin Elizondo-Quiroga, Emily N. Green, David S. Young, Lillian M. Stark, Michael A. Drebot, Harvey Artsob, Robert B. Tesh, Laura D. Kramer, Alan D.T. Barrett

United States Public Health Resources

The distribution of West Nile virus has expanded in the past 6 years to include the 48 contiguous United States and seven Canadian provinces, as well as Mexico, the Caribbean islands, and Colombia. The suggestion of the emergence of a dominant genetic variant has led to an intensive analysis of isolates made across North America. We have sequenced the premembrane and envelope genes of 74 isolates and the complete genomes of 25 isolates in order to determine if a dominant genotype has arisen and to better understand how the virus has evolved as its distribution has expanded. Phylogenetic analyses revealed …

Effect Of Cirrhosis On Antibiotic Efficacy In A Rat Model Of Pneumococcal Pneumonia, Laurel C. Preheim, Keith M. Olsen, Mei Yue, Mary U. Snitily, Martha J. Gentry-Nielsen

United States Public Health Resources

A rat model was used to study the effects of cirrhosis on antibiotic therapy of pneumococcal pneumonia. Cirrhotic and control male Sprague-Dawley rats were infected transtracheally with type 3 Streptococcus pneumonia. Treatment began 18 h later with phosphate-buffered saline (PBS), azithromycin (50 mg/kg), trovafloxacin (50 mg/kg), or ceftriaxone (100 mg/kg) injected subcutaneously twice daily for 5 days. Antibiotic concentrations were measured by high-performance liquid chromatography. Azithromycin, trovafloxacin, and ceftriaxone were all equally effective at preventing mortality in both cirrhotic and normal rats. Free fraction area under the curve to minimum inhibitory concentration ratio (AUC/MIC) and maximum calculated serum concentration …

Graduate Public Health Education In Africa: An Innovative Distance-Learning Model, Emmanuel Rudatsikira, Patricia Johnston, Richard Hart

International Journal of Global Health and Health Disparities

This article describes the development and implementation of a distance graduate public health education program in Africa by Loma Linda University, Loma Linda, California, U.S.A. The program started in March 2000 and ended in September 2003 with formal teaching sessions on-site held twice a year at the University of Eastern Africa, Kenya. The instruction was given in English and French. Of the cohort of 67 students from 20 African countries who started the program, 57 received an M.P.H. degree and six received a certificate in public health. The experiential learning model allowed students to immediately put into practice what they …

A Pilot Randomized, Controlled Trial Of An In-Home Drinking Water Intervention Among Hiv + Persons, John M. Colford, Sona R. Saha, Timothy J. Wade, Catherine C. Wright, Mai Vu, Sandra Charles, Peter Jensen, Alan Hubbard, Deborah A. Levy, Joseph N. S. Eisenberg

Journal Articles: Epidemiology

Although immunocompromised persons may be at increased risk for gastrointestinal illnesses, no trials investigating drinking water treatment and gastrointestinal illness in such patients have been published. Earlier results from San Francisco suggested an association (OR 6.76) between tap water and cryptosporidiosis among HIV + persons. The authors conducted a randomized, triple-blinded intervention trial of home water treatment in San Francisco, California, from April 2000 to May 2001. Fifty HIV-positive patients were randomized to externally identical active (N = 24) or sham (N = 26) treatment devices. The active device contained a filter and UV light; the sham provided no treatment. …

International Trade Agreements: Vehicle For Better Public Health?, David P. Fidler, Jason Sapsin, Ann Marie Kimball

Articles by Maurer Faculty

No abstract provided.

The Effect Of Community Nurses And Health Volunteers On Child Mortality: The Navrongo Community Health And Family Planning Project, Brian Wells Pence, Philomena Nyarko, James F. Phillips, Cornelius Debpuur

Poverty, Gender, and Youth

This report presents the child mortality impact of a trial of primary health-care service-delivery strategies in rural Ghana. After adjustment for sociodemographic factors, under-five mortality in areas with village-based community-nurse services fell by 16 percent during the five years of program implementation compared with mortality before the intervention. Reductions were observed in infant (6 percent), early child (20 percent), and late child (41 percent) mortality. Community involvement and training of a local health volunteer were associated with an 11 percent increase in mortality, primarily driven by a 124 percent increase in early child mortality. Areas with both nurses and volunteers …

A Randomized, Controlled Trial Of In-Home Drinking Water Intervention To Reduce Gastrointestinal Illness, John M. Colford, Timothy J. Wade, Sukhminder K. Sandhu, Catherine C. Wright, Sherline Lee, Susan Shaw, Kim Fox, Susan Burns, Anne Benker, M. Alan Brookhart, Mark Van Der Laan, Deborah A. Levy

Journal Articles: Epidemiology

Trials have provided conflicting estimates of the risk of gastrointestinal illness attributable to tap water. To estimate this risk in an Iowa community with a well-run water utility with microbiologically challenged source water, the authors of this 2000-2002 study randomly assigned blinded volunteers to use externally identical devices (active device: 227 households with 646 persons; sham device: 229 households with 650 persons) for 6 months (cycle A). Each group then switched to the opposite device for 6 months (cycle B). The active device contained a 1-microm absolute ceramic filter and used ultraviolet light. Episodes of "highly credible gastrointestinal illness," a …

How Many Years Of Life Could Be Saved If Malaria Were Eliminated From A Hyperendemic Area Of Northern Ghana?, Ayaga A. Bawah, Fred N. Binka

Poverty, Gender, and Youth

For some time, Chinese government policies have treated rural and urban areas very differently, and a by-product of China’s rapid development seems to be an even greater differentiation between urban and rural social and economic life. Over the next several decades, in part because of rapid fertility declines and in part as a result of mortality declines at older ages, China and other developing countries will experience enormous increases in the proportion of older adults and the proportion of the “oldest-old.” It is reasonable to expect that these age structure changes will alter the provision of health care, making an …

Feasibility Of Introducing A Comprehensive Package Of Antenatal Care Services In Rural Public Clinics In South Africa, Jane Chege, Ian Askew, Nzwakie Mosery, Mbali Ndube-Nxumalo, Busi Kunene, Mags Beksinska, Janet Dalton, Ester Snyman, Wilem Sturm, Preshny Moodley

Reproductive Health

The Maternal, Child and Women’s Health Unit, in collaboration with the Population Council’s FRONTIERS in Reproductive Health (FRONTIERS) program, the Reproductive Health Research Unit of the University of Witwatersrand, and the Department of Medical Microbiology and Infectious Diseases of the Nelson Mandela School of Medicine, University of Natal, developed and then pilot-tested this revised model in KwaZulu-Natal, South Africa. The project’s objective was to develop and test an improved and integrated antenatal care program for public-sector clinics that would increase the range and quality of services received by pregnant women and improve their reproductive health behavior and status. Various problems, …

Long-Term Consequences Of West Nile Virus In Virginia., Diana Cruz Ocampo

Theses and Dissertations

Objective: The purpose of this investigation was to describe the long-term effects and functional outcomes of patients in Virginia who were reported to the Virginia Department of Health with West Nile virus (WNV) non-neuroinvasive and neuroinvasive disease. The study identified the duration of symptoms after initial illness, the number of persons who fully recovered versus the number who continue to be symptomatic and how patients' quality of life differed after illness.Methods: The study population was drawn from 60 human cases that met the surveillance case definition for non-neuroinvasive and neuroinvasive WNV illness in Virginia between 2002-2004. Information was collected during …

African American Breast Cancer Health Disparities, Theresa Lynn Gaul

Honors Program Theses

Health disparities are "the differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States" (National Cancer Institute [NCI], 2002). Racial and ethnic minorities experience serious disparities in health access and outcomes. Disparities in the burden of death and illness experienced by African Americans in particular, as compared with our nation's population as a whole, are particularly striking. There are a variety of factors contributing to these inequalities. The purpose of this report is to examine these factors and the consequential effects on the African American's …

An Evaluation Of The Human Pathogen Transmission Potential Of Selected Wastewater Treatment Systems, With The Development Of A Rating System For Public Use In Selecting A System For Home Installation., Joseph Stanley Jablecki

All ETDs from UAB

No abstract provided.

Environmental Health Practitioners In Alabama: An Assessment Of The Practice Of The Ten Essential Services And Abilities In The Fourteen Core Competencies., Christie Mccullum-Hill

All ETDs from UAB

No abstract provided.

The Relationship Between Breastfeeding And The Development Of Asthma In Early Childhood, River Anne Pugsley

Theses and Dissertations

Purpose: Asthma can have significant adverse effects on the health and quality of life of children, and the prevalence of this condition continues to rise. Breastfeeding may protect against asthma, but some uncertainty remains. The purpose of this study was to further examine the relationship between breastfeeding and the risk of developing asthma in early childhood. Methods: Data were collected from the State and Local Area Integrated Telephone Survey: National Survey of Children's Health, 2003. The study population consisted of 33,315 children ages 0 to 5 years. Prevalence rates of asthma and breastfeeding ,were calculated, as were crude and Mantel-Haenszel …

The Un And The Responsibility To Practice Public Health, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

From International Sanitary Conventions To Global Health Security: The New International Health Regulations, David P. Fidler

Articles by Maurer Faculty

In May 2005, the World Health Organization adopted the new International Health Regulations (IHR), which constitute one of the most radical and far-reaching changes to international law on public health since the beginning of international health cooperation in the mid-nineteenth century. This article comprehensively analyses the new IHR by examining the history of international law on infectious disease control, the IHR revision process, the substantive changes contained in the new IHR and concerns regarding the future of the new IHR. The article demonstrates why the new IHR constitute a seminal event in the relationship between international law and public health …

A Descriptive Study Of Ethical Procedures That Maintain Cultural Security When Conducting Health Research With Aboriginal And Torres Strait Islander School Children In Western Australia, Dionne Paki

Theses : Honours

Cultural security is the maintenance of values and beliefs and the celebration of diversity unique to different cultures. This honours thesis developed a proposed framework to guide collaborative ethics procedures that demonstrate the Aboriginal values relevant to health research for use in Western Australia (WA). These values of reciprocity, respect, equality, responsibility, survival and protection, and spirit and integrity have been identified in the National Health and Medical Research Council's Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. Ethical procedures for maintaining cultural security when conducting health research among Aboriginal people throughout Australia …

Public Health Abstracts 2004

Florida Public Health Review

No abstract provided.

Quality Improvement In Maryland: Partnerships And Progress, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-and-a-half-day site visit to Easton, Maryland, explored the activities of the Delmarva Foundation, the Quality Improvement Organization (QIO) for Maryland and the District of Columbia. The program reviewed Delmarva’s responsibilities under their Medicare contract and the initiatives they have undertaken with hospitals and other providers to improve health care outcomes and to define, collect, and report quality data. Local hospital officials added their perspective on quality programs and working with Delmarva. Topics of particular interest were health information technology, patient safety, and quality reporting both to government agencies and to consumers.

West Nile Virus Blood Transfusion-Related Infection Despite Nucleic Acid Testing, Alexandre Macedo De Oliveira, Brady D. Beecham, Susan P. Montgomery, Robert S. Lanciotti, Jeffrey M. Linnen, Cristina Giachetti, Larry A. Pietrelli, Susan L. Stramer, Thomas J. Safranek

United States Public Health Resources

BACKGROUND: A case of West Nile virus (WNV) encephalitis associated with transfusion of blood that did not react when tested for WNV by minipool (MP) nucleic acid testing (NAT) is described. A Nebraska man developed clinical encephalitis 13 days after surgery and transfusion of 26 blood components. Antibody testing confirmed WNV infection. An investigation was initiated to determine the source of this infection.
STUDY DESIGN AND METHODS: The patient’s family members were interviewed to identify risk factors for WNV infection. Residual samples were retested for WNV RNA using transcription-mediated amplification (TMA) assay and two polymerase chain reaction (PCR) assays. Blood …