Digital Commons Network^™

Optimal Medical Care And Coronary Flow Capacity-Guided Myocardial Revascularization Vs Usual Care For Chronic Coronary Artery Disease: The Century Trial, K Lance Gould, Nils P Johnson, Amanda E Roby, Richard Kirkeeide, Mary Haynie, Tung Nguyen, Linh Bui, Monica B Patel, Danai Kitkungvan, Patricia Mendoza, Dejian Lai, Ruosha Li, Stefano Sdringola, David Mcpherson, Jagat Narula

Faculty, Staff and Student Publications

Background and aims: The randomized CENTURY trial tested the hypothesis that a comprehensive strategy integrating intense lifestyle modification and aggressive medical management to goals with revascularization reserved for severely reduced coronary flow capacity (CFC) by positron emission tomography (PET) would reduce risk factors, subsequent revascularization, death and myocardial infarction (MI) compared with standard of care in chronic stable coronary artery disease (CAD).

Methods: Participants were randomly assigned to standard or comprehensive care groups. Rest-stress PET quantified CFC for physiological CAD severity at baseline, 2, 5, and up to 11 years. The comprehensive care group reviewed PET results with frequent clinic …

Clinical Testing For Covid-19, Influenza, And Rsv In Hospitalized Youths, 2016-2024., Ariana P. Toepfer, Rachel E. Rutkowski, Leila C. Sahni, Geoffrey A. Weinberg, Marian G. Michaels, Rangaraj Selvarangan, Mary Allen Staat, Natasha Halasa, Janet A. Englund, Julie A. Boom, Peter G. Szilagyi, Jennifer E. Schuster, Elizabeth P P. Schlaudecker, Laura S. Stewart, Eileen J. Klein, Samantha M. Olson, Sascha Ellington, Meredith L. Mcmorrow, Heidi L. Moline, Fatimah S. Dawood, New Vaccine Surveillance Network Collaborators

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Studies of COVID-19, influenza, and respiratory syncytial virus (RSV) disease clinical epidemiology, disease burden, and vaccine effectiveness often rely on clinical testing to identify cases, particularly with increasing use of electronic health record data. However, few data are available describing clinical testing practices to inform interpretation of these studies.

OBJECTIVE: To characterize clinical testing frequency for SARS-CoV-2, influenza, and RSV among children and adolescents hospitalized with acute respiratory illness during the 2016 to 2024 respiratory illness seasons by age, intensive care unit admission, and time period (2016-2020 and each season in 2020-2024); estimate the case fraction missed by clinical …

Comparison Of Crotalidae Immune F(Ab')2 (Equine) And Crotalidae Polyvalent Immune Fab (Ovine) At Establishing Control Of Initial Envenomation Symptoms In Louisiana Agkistrodon Envenomations, Taylor Sanders, Christine Murphy, Greggory Davis, Christina Aspinwall, Lauren Theriot, Christopher Mcvicker, Thomas Arnold

School of Medicine Faculty Publications

INTRODUCTION: Copperheads and cottonmouths are responsible for most snake envenomations in Louisiana. While the United States Food and Drug Administration has approved both Crotalidae polyvalent immune Fab (FabAV) and Crotalidae immune F(ab') (Fab2AV) for Agkistrodon envenomations, data is limited comparing their efficacies for this indication. METHODS: This is a retrospective study comparing FabAV to Fab2AV in the treatment of suspected Agkistrodon envenomations in Louisiana between April 2017 and October 2024. Cases identifying rattlesnakes were excluded. The primary outcome was the need for additional antivenom doses to achieve control after the initial antivenom dose. RESULTS: One hundred fifty-eight patients received FabAV …

Commensal Colonization Of Candida Albicans In The Mouse Gastrointestinal Tract Is Mediated Via Expression Of Candidalysin And Adhesins, Kelsey E Mauk, Pedro Miramón, Michael C Lorenz, Léa Lortal, Julian R Naglik, Bernhard Hube, Lynn Bimler, Farrah Kheradmand, David B Corry

Faculty, Staff and Students Publications

The ubiquitous fungal pathogen Candida albicans has the potential to either asymptomatically colonize the gastrointestinal (GI) tract or become an invasive pathogen through mechanisms that remain incompletely understood. Here we explored the fungal, host, and environmental factors that influence the ability of C. albicans to colonize the mouse GI tract using a representative clinical strain, CLCA10. After a single gavage challenge (5 × 106 CFU C. albicans), specific pathogen-free (SPF) mice remained colonized with C. albicans strain CLCA10, but not other Candida species, for at least 58 days with the fungus confined largely to the gut luminal …

Encapsulation Of Disease-Causing And Commensal Mitis Group Non-Pneumococcal Streptococci, Daniel M Musher, Mathias Müsken, M John Hicks, Lesley Mcgee, Bernard Beall

Faculty, Staff and Students Publications

Background: Mitis group non-pneumococcal streptococci (MGNPS), specifically Streptococcus mitis, Streptococcus infantis and Streptococcus oralis, have recently been shown to cause pneumonia and/or bacteremia. These organisms often have capsular (cps) operons resembling those in pneumococci, and some express cps-generated polysaccharides that antigenically cross-react with pneumococcal capsular serotypes. But, to date, a series of MGNPS isolates has not been studied by electron microscopy (EM) for the presence of a capsule.

Methods: We studied 21 MGNPS; 11 were isolated from sputum and determined to have caused pneumonia, 3 were isolated from blood, and 7 were commensal isolates cultured …

Secondhand Smoke Exposure Among United States Children With Functional Disabilities: National Health And Nutrition Examination Survey, 2021–2023, Raed A. Bahelah

Population Health Science Publications

Objective

Methods

Results

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Knowledge, Attitude, And Practice Towards Cervical Cancer Screening Among Women Aged 20 Years And Above In Mysuru, India, Sneha Manosh Kumar, Rashmi S, Amogha Shree

Digital Journal of Clinical Medicine

Background: Cervical cancer remains the fourth most common cancer among women globally and a leading cause of cancer-related mortality in India. Despite being largely preventable through screening, uptake remains suboptimal due to socio-cultural and systemic barriers.

Methods: A community-based cross-sectional study was conducted among 300 women aged ≥20 years residing in urban and rural areas of Mysuru. Data were collected using a pre-tested, semi-structured questionnaire and analyzed with SPSS version 30.

Results: Awareness of cervical cancer was reported by 90% of participants and of screening methods by 80%. However, only 21% had ever undergone screening and 17% within the preceding …

Towards Accessibility In Healthcare For Individuals With And Without Hearing Loss: Evaluation Of Usability, Fit, And Communicative Effectiveness Of A Transparent N95 Mask Prototype, Samuel R. Atcherson, Brooklyn Schultes, Jeanne Hahne, Barbara Debaun, Chris Showell

JADARA

The COVID-19 pandemic has underscored the necessity of effective face masks in both public and healthcare settings for mitigating the spread of disease. However, traditional face masks impede communication, posing significant challenges for approximately 13% of the general population and 10% of healthcare and social assistance workers who have hearing loss and who rely on lipreading and other non-verbal cues. Traditional surgical masks and N95 respirator masks serve important roles in healthcare, but they differ in levels of protection. Currently, a transparent surgical mask is available, but not an N95 version. Thus, this study aimed to evaluate the usability, fit, …

Assessing The Impact Of Tungiasis On Children’S Quality Of Life In Kenya, Lynne Elson, Berrick Otieno, Abneel Matharu, Naomi Riithi, Esther Chongwo, Francis Mutebi, Hermann Feldmeier, Jürgen Krücken, Ulrike Fillinger, Amina Abubakar

Institute for Human Development, East Africa

Tungiasis is a neglected tropical skin disease caused by the sand flea, Tunga penetrans which penetrates the skin causing considerable pain and itching. In this cross-sectional study we aimed to assess its impact on the quality of life of school children in Kenya. School pupils (198) aged 8–14 years with tungiasis were randomly selected and interviewed using a tungiasis-specific quality of life instrument (TLQI). The caregivers of each infected pupil and 199 randomly selected caregivers of uninfected pupils were interviewed using the proxy KIDscreen52 to assess their child’s general health-related quality of life (HR-QoL). Generalized linear models were used to …

Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Health workers in the frontline are the major drivers of health systems in low- and middle-income countries. However, these health workers face both chronic and acute shocks and stressors that expose them to mental health problems which are often overlooked. We examined the prevalence of mental health problems, correlates of psychological functioning, and resilience of frontline health workers in Uganda.

Methods: We conducted a cross-sectional study comprising 1800 frontline health workers across all regions of Uganda from August through October 2023. We used tools such as the PC-PTSD-5, PHQ9, PSS, GAD-7, Oldenburg Burnout Inventory, and CD-RISC-10 to assess PTSD, …

Prevalence And Factors Associated With Depression, Anxiety And Post-Traumatic Stress Disorder Among Healthcare Workers From Sub-Saharan Africa: Systematic Review, Ezra Too, Peninah Wachira, Solomon Njenga, Sabina Odero, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Depression, anxiety and post-traumatic stress disorder (PTSD) are prevalent among healthcare workers (HCWs), including those from sub-Saharan Africa (SSA). However, there are limited summary data on the burden and factors associated with these disorders in this region. We conducted this systematic review (registration no. CRD42022349136) to fill this gap.

Aims: The aim of this review was to systematically summarise the available evidence on the prevalence and factors associated with depression, anxiety and PTSD, or their symptoms, among HCWs from SSA.

Method: We searched African Index Medicus, African Journals Online, CINAHL, PsycINFO and PubMed for articles published, from database inception …

Monitoring Nutrition Security: Perspectives From A Workshop On Nutrition Security Measurement, Ximena Perez-Velazco, Edward A. Frongillo Jr. Ph.D., Joanne F. Guthrie, Alisha Coleman-Jensen, Mariah D. Ehmke, Christian Gregory, Hilary K. Seligman

Faculty Publications

Nutrition security, an emerging concept distinct from and complementary to food security, has gained increasing interest as a focus of efforts to reduce hunger, improve nutrition, and prevent diet-related health conditions. Yet, unlike food security, which has well-established measures, nutrition security lacks standardized measures for assessment. This gap hinders the ability to evaluate progress in improving nutrition security both in the United States and globally. In September 2024, a workshop to explore how to measure nutrition security was hosted by the United States Department of Agriculture Economic Research Service, in collaboration with the Southern University Agricultural Science Center of Excellence …

Bridging Gaps In Breast Cancer Care: A Breast Cancer Care Quality Index To Improve Outcomes Worldwide, Eduardo Cazap, Benjamin Anderson, Giuseppe Curigliano, Sandeep Sehdev, Fatima Cardoso, Ana Gonzalez, Emad Shash, Cheng-Har Yip, André Mattar, Miriam Mutebi

General Surgery, East Africa

Background: Breast cancer (BC) care faces challenges in early detection, timely diagnosis and comprehensive management. Disparities persist, with underserved populations facing the greatest barriers. Addressing these requires policies that support consistent, evidence-based practices and enhance healthcare capacity and technology advancements. This document presents the development of the Breast Cancer Care Quality Index (BCCQI), supported by evidence to promote equitable care and improve BC outcomes globally, and discusses its adoption as a strategic tool within National Cancer Control Plans.

Methods: A two-part methodology identified challenges in BC care and defined dimensions, targets and indicators for the BCCQI, aligned with …

Old Frames On New Media: Health Misinformation In Black Digital Communities, Merriah Croston

Brown School Graduate Student Theses and Dissertations

Growing evidence suggests that health misinformation has the potential to proliferate on social media. However, our understanding of the problem’s magnitude continues to evolve. Despite several studies on health misinformation and Black communities in the United States (U.S.), few of these studies characterize misinformation within digital settings. This dissertation seeks to address this gap by: 1) synthesizing the literature on health misinformation and Black communities to identify prevalent misinformation topics and claims, characteristics of exposure to and belief in these topics and claims, and successful intervention strategies; 2) quantifying and characterizing the volume of COVID-19 misinformation on Black Twitter during …

Outcomes Of Bio-Psycho-Social-Spiritual Communitybased Drug Rehabilitation Program For Voluntary Vs. Court-Mandated Clients In The Philippines, Maria Regina M. Hechanova, Trixie Anne Co, Fessa R. Egusquiza

Psychology Department Faculty Publications

This study sought to evaluate the outcomes of a community- based rehabilitation program for voluntary and court-mandated drug users in the Philippines. Participants went through a bio-psycho-social-spiritual group-based program that aimed to develop their recovery skills and life skills. The program also included family modules to enhance their knowledge of drug use, its effects, and the role of family in recovery. A cohort design was used with pre- and posttest surveys administered before and immediately after the program. The sample consisted of 105 voluntary clients and 118 court-mandated clients who underwent screening or drug dependency evaluation and were recommended for …

Low Prevalence Of Helminth Infection In Ugandan Children Hospitalized With Severe Malaria, Drew Capone, Nuzrath Jahan, Ruth Namazzi, Robert Opoka, Chandy John

Paediatrics and Child Health, East Africa

Co-infection by intestinal helminths and Plasmodium spp. may be common in endemic communities. In 2003, Uganda instituted a national deworming program, with anti-helminth medication provided twice annually to children 6 months to 5 years of age, but few follow-up studies have been conducted. Several studies have identified a relationship between helminth infection, Plasmodium spp. infection and malaria severity. However, the relationship is not well defined, and results are inconclusive. We analyzed 177 stool samples from a cohort of children with severe malaria enrolled in two hospitals in Uganda from 2014–2017. All children were 6 months to 48 months of age …

First-Time Mothers' Experiences Of Breastfeeding During The Early Postpartum Period In Nairobi, Kenya: A Qualitative Study, Viola Siongei, Rose Maina, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background/Aims The rate of exclusive breastfeeding in the first 6 months is still low, despite global active promotion of the practice. The exclusive breastfeeding rate among first-time mothers is much lower than among multiparous women, which has been attributed to difficulties assuming the new role and a lack of breastfeeding skills. This study aimed to gain an in-depth understanding of first-time mothers' breastfeeding experiences and the factors that influence these experiences during the early postpartum period in Nairobi, Kenya.

Methods This qualitative explorative, descriptive study involved 17 purposively sampled first-time mothers at 4–6 weeks postpartum. In-depth, face-to-face semi-structured interviews were …

Platelet Transfusion Practices In The Icu: A Prospective Multicenter Cohort Study, Van Stefan, Raasveld Jorinde, Andrew Flint, Jimmy Schenk, Claudia Van Den Oord, Merijn Reuland, Sanne De Bruin, Jan Bakker, Maurizio Cecconi,, Marcus Lance

Anaesthesiology, East Africa

Objective: There is a lack of comprehensive international data regarding platelet transfusion practices in the ICU. This study aimed to evaluate the current occurrence rate of platelet transfusion in the ICU and provide an overview of platelet transfusion practices including indications for a platelet transfusion, thresholds, (non-)adherence and geo-economic region variations.

Design: International prospective cohort study.

Setting: Two hundred thirty-three centers in 30 countries worldwide.

Patients: All patients 18 years old and older, admitted to the ICU during a single study week, selected by each site from one of the 16 predefined weeks (March 2019 to …

The Relationships Between Sporadic And Repetitive Non-Suicidal Self-Injury And Mental Disorders Among First-Year College Students: Results From The World Mental Health International College Student Initiative, Penelope Hasking, Glenn Kiekens, Maria Petukhova, Yesica Albor, Ahmad Al-Hadi, Jordi Alonso, Nouf Al-Saud, Yasmin Altwaijri, Claes Andersson, Lukoye Atwoli

Brain and Mind Institute

Background: Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time–order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults.

Methods: We used survey data from n = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time–order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1–5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in …

Tissue-Specific Distribution Of Microplastics In Human Blood And Carotid Plaques: A Paired Sample Analysis, Cancan Cui, Zheng Guo, Yanxi Liu, Ning Han, Jiayin Song, Yuanmei Chen, Yulu Zheng, Chen Sheng, Lois Balmer, Haibin Li, Rui Liu, Lin Liu, Jianshi Du, Zhiyuan Wu

Research outputs 2022 to 2026

Backgrounds: Microplastics (MPs) have been increasingly detected in human tissues, raising concerns about their role in cardiovascular disease. However, their distribution in matched blood and vascular tissues, such as atherosclerotic plaques, remains poorly understood. Methods: Paired blood and carotid plaque samples were analyzed for 12 polymer types of MPs using pyrolysis–gas chromatography–mass spectrometry among twenty patients undergoing carotid endarterectomy. Results: The mean concentration of total MPs was 75.2 μg/g in blood and 432.9 μg/g in plaque. Polyethylene (PE) dominated blood samples (46.5 %), followed by polyvinyl chloride (PVC, 16.8 %) and styrene-butadiene rubber (SBR, 16.3 %). In plaques, MPs were …

Racial Moderation Of Infant Mortality Risk And Protective Factors In The United States, Temitope Oluwaseun Akinsola

Walden Dissertations and Doctoral Studies

The rate of infant mortality is a pressing health issue in the United States, as ethnic minorities are disproportionately affected. This study addressed how race controls the predictive power of demographic, socioeconomic, and geographic factors on infant mortality. Using a quantitative correlational design, secondary data from 181 individuals listed in the CDC-National Vital Statistics System database were used, which contains nationally aggregated data related to infant mortality rates. Bronfenbrenner’s social ecological model guided the study, and multiple regression and moderation models were used to examine socioeconomic status and access to healthcare on infant mortality outcomes. Results indicated that race significantly …

Sleep Quality, Emotional Moods, And Cognitive Outcomes Among People Living With Hiv: An Ecological Momentary Assessment Study, Shan Qiao Ph.D., Abhishek Aggarwal, Camryn Garrett, Arielle N’Diaye, Atena Pasha, Irene Esu, Chih Hsiang Yang Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Introduction Although studies have explored the relationship between sleep quality, mood, and cognitive outcomes among people living with HIV (PLWH), few use ecological momentary assessment (EMA) techniques to evaluate within-person associations between sleep quality and emotional/cognitive outcomes among PLWH at the day level. This study investigated the association between previous night’s sleep quality and momentary psychological outcomes in participants’ natural setting. Methods Study participants were PLWH in South Carolina who were at least 18 years old, diagnosed with HIV for at least 2 years, and able to operate a cellphone. Participants were sampled using posters posted in AIDS Service organizations, …

Replication Of Blood Dna Methylomic Signatures Associated With Cerebrospinal Fluid Levels Of Ykl-40 And Nfl Biomarkers, Timo Kaleck, Rafael Campos-Martin, Amanda Cano, Maria Victoria Fernández, Pamela Martino-Adami, Luca Kleineidam, Victor M Andrade Fuentes, Kumar P Tripathi, Kayenat Parveen, Raquel Puerta, Itziar De Rojas, Kishore A Ravichandran, Oliver Peters, Julian Hellmann-Regen, Josef Priller, Maria Gemenetzi, Anja Schneider, Jens Wiltfang, Emrah Düzel, Katharina Buerger, Robert Perneczky, Stefan Teipel, Christoph Laske, Frederic Brosseron, Marta Marquié, Daniel La Van Den Hove, Mercè Boada, Michael T Heneka, Michael Wagner, Natalie Marchant, Jean-Charles Lambert, Ruth Frikke-Schmidt, Frank Jessen, Agustín Ruiz, Alfredo Ramirez

Faculty, Staff and Student Publications

No abstract provided.

Drivers Of Frequent Emergency Department Use In Socioeconomically Disadvantaged Older Adults: A Qualitative Study, Anita Chary, Annika Bhananker, Michelle Suh, David Leavitt, Elise Brickhouse, Shreya Tamma, Jose Ramirez, Mariana Rios, Aanand D Naik, Margaret Samuels-Kalow, Naomi George

Faculty, Staff and Student Publications

Background: The emergency department (ED) is the safety net for and a common point of healthcare access for socioeconomically disadvantaged older adults. Little is known about socioeconomically disadvantaged older ED patients' perspectives on their health, healthcare access, and ED use. Such insights could guide tailored interventions to address unmet clinical and health-related social needs (HRSN).

Methods: We performed a qualitative study with older adults in a single public safety net hospital ED. We interviewed patients age 60+ who had ≥ 4 ED 4 visits in the past year. Semi-structured interviews explored perceived health needs and motivations underlying ED visits. We …

Identifying Geographic Cold Spots Of Pcos Diagnosis In Texas: A Spatial Analysis Of Underdiagnosis And Rural Disparities, Ryan Ramphul, Geethika Yalavarthy, Jooyeon Lee

Faculty, Staff and Student Publications

Context: Polycystic ovary syndrome (PCOS) is a common yet underdiagnosed endocrine disorder with substantial reproductive and metabolic consequences. Although disparities in PCOS care have been documented, few studies have employed spatial methods to identify areas of potential underdiagnosis.

Objective: This study uses geospatial analysis to detect cold spots of PCOS clinical encounters across Texas and investigates neighborhood characteristics associated with these areas.

Methods: We analyzed inpatient and outpatient encounter data from the Texas Public Use Data File (PUDF) between 2018 and 2024 to identify PCOS-related visits (International Classification of Diseases, revision 10: E28.2). ZIP code tabulation area (ZCTA)-level PCOS encounter …

Do Medicaid Data Accurately Reflect The Expenditures And Outcomes For Extremely Premature Infants?, Elenir B C Avritscher, Jon E Tyson, Therese A Stukel, Youngran Kim, Cecilia Ganduglia Cazaban, Kanekal S Gautham, David Lynch, David C Goodman

Faculty, Staff and Student Publications

The accurate and meaningful assessment of Medicaid expenditures relative to survival rates among Medicaid-eligible extremely premature infants has received little scrutiny, despite its importance for improving outcomes. We have identified key problems that hindered such assessments using Texas Medicaid data, which may also be relevant to other states.

Maternal Sleep Disorders And Maternal And Birth Outcomes: A Retrospective Us Claims-Based Study, Anayeli Herrera Morales, Audrey C Choh, Cici X Bauer, Stefan A Czerwinski, Miryoung Lee

Faculty, Staff and Student Publications

Introduction: Sleep disturbances are commonly reported during pregnancy and have been associated with adverse maternal, fetal, and neonatal outcomes. However, self-reported sleep disturbances may not be accurately reflected in the prevalence of clinically diagnosed sleep disorders.

Methods: Using Optum's de-identified Clinformatics Data Mart Database, we conducted a cross-sectional study of 93,767 American women who were pregnant with singletons between January 1, 2015 and June 30, 2021, to (1) determine the prevalence of clinically diagnosed sleep disorders and breathing abnormalities; (2) examine their associations with maternal health outcomes; and (3) examine their associations with birth outcomes. Sleep disorders and breathing abnormalities …

The Psychosocial Impact Of Covid-19 Mitigation Measures On Frontline Staff Providing Sexual Health And Family Planning Services In Kenya: A Mixed-Methods Study, Ferdinand Okwaro, Abdu Mohiddin, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background The recognition of the unintended impact of COVID-19 mitigation measures to the availability of sexual and reproductive health (SRH) services led to the initiation of mitigation and health systems support mechanisms within public health facilities by the Ministry of Health (MoH) in Kenya to maintain pre-Covid-19 levels of SRH service provision. These recovery mechanisms however concentrated on policy and infrastructural elements of service provision with limited attention given to the psychosocial impacts of COVID-19 on health care workers (HCWs). This paper examines the psychosocial impact of COVID-19 on front line family planning (FP) and sexually transmitted infections (STI) management …

Routine Antenatal Ultrasound By Nurse-Midwives In Rural Kenya: A Pragmatic Trial Assessing Feasibility And Effects Of The Mimba Yangu (My Pregnancy) Project, Claudia Hanson, Lucy Nyaga, Nidhi Leekha, Michaela Mantel, Sarah Kedenge, Caroline Gitonga, Violet Naanyu, Jasmit Shah, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction: Task-sharing of obstetric ultrasound between nurse-midwives and doctors has the potential to operationalize the World Health Organization’s recommendation of at least one ultrasound before 24 weeks of gestational age for every pregnant woman. Here, we report on the feasibility, acceptability, and effects of the Mimba Yangu (My Pregnancy) task-sharing approach in rural Kenya.

Methods: We conducted a pragmatic trial including 28 primary care facilities between April 2021 and March 2022, selected based on feasibility criteria. Fourteen facilities received the ultrasound intervention composed of (i) task-sharing with nurse-midwives, (ii) the use of portable ultrasound devices (Lumify™) connected to a tablet, …