Public Health Commons^™

Singapore : Severe Acute Respiratory Syndrome (Sars), Dexter Lipps

Global Public Health

Singapore ranks as one of the healthiest countries in the world and its healthcare system has been regarded as one of the most efficient. While a minority of the population experience any chronic diseases such as diabetes or asthma, one illness, severe acute respiratory syndrome or SARS has been prevalent in the country since the global outbreak in 2003. SARS is a virus causing disease that is easily transmitted through the air. In 2003, Singapore, along with much of the world, saw a high rate of infection for the disease. An in depth look revealed that three women traveling home …

New Zealand : Mumps Outbreak, Kathryn Evans

Global Public Health

The purpose of this Health Brief is to discuss the outbreak of mumps in New Zealand during the summer of 2017. The year saw more cases than the past sixteen years combined. The reason that New Zealand, a high-income country that generally does not struggle with communicable diseases, may be experiencing this outbreak is low vaccination rates in the 1990’s. It appears that there was a decline in coverage for the MMR immunization at this time due to several factors. These include a transition in the timing of the second dose of MMR, a change from four years to eleven …

Nepal : Healthcare And Sanitation Issues Resulting From Frequent Natural Disasters In Nepal, Jake Lauderdale

Global Public Health

This Public Health Brief calls to attention the issues plaguing Nepal as a result of both frequent natural disasters and poor healthcare infrastructure. The geographic characteristics of Nepal are shown to be a major factor in the damage and aftermath of natural disasters such as earthquakes. Due to its status as a poor and economically weakened country, Nepal must rely heavily on outside aid in order to alleviate the pressure of frequently occurring natural disasters. Despite work being done by several Non-Governmental Organizations, Nepal has a long way to go before they are able to independently manage the outcomes of …

Peru : Zika Virus, Benjamin Martin

Global Public Health

This document covers zika virus as a public health issue in Peru. Peru is a coastal country in South America. It has a population of 31,777,000 and faces many problems in the years to come. Some of those problems are a largely informal economy, the melting of glaciers, and lots of the population are impoverish and under-educated. These challenges the country is facing makes zika virus more dangerous. Zika virus is a disease that is spreading across the world and is most dangerous to pregnant women because it can cause birth defects for the child, such as microcephaly. In this …

Afghanistan : Tuberculosis, Emily Fulk

Global Public Health

Afghanistan, a country in the Middle East, faces the epidemic of an infectious bacterial lung disease called Tuberculosis, or TB. Tuberculosis is fairly easy to spread, as the bacteria that causes it are spread from one person to another through tiny droplets released into the air via coughs and sneezes. Despite the widespread amounts of individuals affected with TB, it is known to be easily curable using a six month treatment. And so public health officials have implemented a program called DOTS, or Directly Observed Treatment Short Course in Kabul City to test the effectiveness of this treatment. The DOTS …

Burundi : Water Scarcity, Isabel Salas

Global Public Health

Burundi is located near the African great lakes region of East Africa. This country is one of the poorest and hungriest countries throughout the world because of this they are facing multiple problems with communicable disease. These families are seeing a reduction in the amount of water available to them and based on this they are receiving water from external sources such as wells and lakes. Most of the water throughout Burundi is contaminated with Phytoplankton which increase cholera outbreaks in this area. It has also been shown that uranium impacts the water throughout the wells and lakes. Both of …

Guam : Mumps, Taylor Covert

Global Public Health

In the years of 2009-2010, Guam experienced an outbreak of mumps that was widespread throughout the country. Mumps is a disease in which the parotid gland located in the face and neck region swells and can cause inflammation in the brain. Though a majority of the citizens were vaccinated for MMR, there was still a problem throughout the nation. The vaccine is provided in a number of doses, three being the optimal amount. It was later revealed that citizens who were vaccinated only received two doses, not fully protecting them from the illness. 505 cases were reported overall for this …

Chad : Hepatitis E, Hanna Pegarsch

Global Public Health

Contaminated drinking water in Chad is the main source for a Hepatitis E outbreak, leading Chad citizens to develop severe illness including jaundice, liver-failure, miscarriage, and death. There are 0.4 physicians for every 10,000 people living in Chad needing healthcare. Of the citizens in Chad, only 42% have access to uncontaminated drinking water. With such a long incubation period for Hepatitis E, the citizens don’t know they are spreading the illness to the rest of their community. Even with the symptoms, the citizens don’t have the access or the capacity for treatment, making Hepatitis E an epidemic in Chad.

Namibia : Hiv As A National Issue, Elisabeth Vlasak

Global Public Health

Namibia is located on the southwestern coast of Africa, bordering Angola, Botswana, Zambia, South Africa, and the Atlantic Ocean. Namibia has a population of 2,265,000, as of 2016. Namibia has many challenges, including food insecurity and malnutrition, access to health services, unequal distribution of wealth, but HIV/AIDS is one of the country’s leading challenges. It is estimated that the overall adult infection rate of HIV/AIDS is 15.4% and it is the leading cause of death in Namibia. Adults ages 18-24 are the most at-risk for the disease. Some of the major risk factors are declining condom use, misinformation, social stigma, …

Zimbabwe : Malaria, Ashton Hutcheson

Global Public Health

Zimbabwe, a developing country in southeastern Africa, has a population of over 15 million people. The large majority of this population is at risk for various prevalent infectious disease including the significant threat that is Malaria. Zimbabwe is a country within what the World Health Organization determines as the “WHO African Region.” This region is where 90% of Malaria deaths occur worldwide. This brief provides reasons why malaria is such a major problem including the country’s general lack of clinics and key risk factors associated with contracting malaria. It was found that those most at-risk for malaria live in houses …

Guatemala : Chagas Disease, Audrey Datzman

Global Public Health

Chagas disease is a parasitic and vector-borne endemic prevalent across Latin American countries, particularly Guatemala. The parasite, Trypanosoma cruzi, is spread through triatomine insect vectors often found in low-income housing. Already claiming twelve-thousand deaths in 2016, Guatemala faces a major challenge in attempting to eliminate the triatomine vectors of Chagas disease. Various interventions have been undertaken in the country, including insecticide-based control and community-based vector surveillance.

Ukraine : Papillary Thyroid Cancer, Elizabeth Paris

Global Public Health

Ukraine is a middle- to low- income country run by a semi-presidential republic, after the banning of the Communist party in the early 1990's. While the nation faces various internal and external challenges, including unemployment rates and war with Russia, Ukraine also continues to face a major public health issue that originated in the 1980's. In 1986, an explosion was triggered at the nuclear power plant in Chernobyl, Ukraine. The explosion released radioactive iodine into the ground, water, and air, and it was discovered soon after that this had a long-lasting effect on health. It has been observed that rates …

Gabon : Hiv/Aids, Amanda Lindau

Global Public Health

Gabon is a country in West Africa that has a population of 1.8 million and is a relatively poor nation. It has had quite a few public health and political problems in the last couple of years. These problems include water and electricity shortages along with HIV/AIDS. HIV seems to be one of the biggest public health problems in Gabon at this moment. There is quite a bit of the population that is living with this virus. However, there are many people that are living with this virus but either do not understand the severity of it or just do …

Hiv-Care Access Among People With Incarceration Experience In St. Petersburg, Russia, Monica S. Ruiz, Robert Heimer, Olga Levina, N. Badosova, V. Rassokhin, A. Belyakov, N. Belyakov

Prevention and Community Health Faculty Publications

Background: Little is known about the clinical care experiences of HIV-infected persons in St. Petersburg who have experience with incarceration. To address this question, we conducted a capture-recapture study to identify individuals who had been diagnosed with HIV infection while incarcerated and who subsequently presented for medical care in St. Petersburg, Russia following release from prison.

Methods: We matched 292 HIV-positive prisoners tested by the prison system in 2010 to the medical records at the St. Petersburg AIDS Center in the following 4 years.

Results: The data analysis shows that as many as half of HIV+ prisoners fail to seek …

Transition Into Adult Care: Factors Associated With Level Of Preparedness Among Adolescents Living With Hiv In Cambodia, Siyan Yi, Chanrith Ngin, Khuondyla Pal, Vohith Khol, Sovannary Tuot, Sokunmealiny Sau, Penhsun Ly

Background: Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia.

Methods: In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15–17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a …

Using Risk-Tracing Snowball Approach To Increase Hiv Case Detection Among High-Risk Populations In Cambodia: An Intervention Study, Srean Chhim, John Macom, Chettana Pav, Nirada Nim, Phearun Yun, Sopheap Seng, Siyan Yi

Background: Early HIV diagnosis and initiation onto antiretroviral therapy may prevent ongoing spread of HIV. Risk Tracing Snowball Approach (RTSA) has been shown to be effective in detecting new HIV cases in other settings. The main objective of this study is to evaluate the effectiveness of RTSA in increasing the rate of newly identified HIV cases among high-risk populations. Our second objective was to evaluate the effectiveness of RTSA, as compared to the walk-in group, in increasing the number of HIV tests and early case detection.

Methods: This study was conducted from April 1 to September 30, 2016 at two …

Changing Hearts And Minds: Results From A Multi-Country Gender And Sexual Diversity Training, Tonia Poteat, Chulwoo Park, Diego Solares, John K. Williams, R. Cameron Wolf, Noah Metheny, Andrea Vazzano, Juan Dent, Ashley Gibbs, Bareng Aletta Sanny Nonyane, Nora Toiv

Faculty Publications

Engaging key populations, including gender and sexual minorities, is essential to meeting global targets for reducing new HIV infections and improving the HIV continuum of care. Negative attitudes toward gender and sexual minorities serve as a barrier to political will and effective programming for HIV health services. The President’s Emergency Plan for AIDS Relief (PEPFAR), established in 2003, provided Gender and Sexual Diversity Trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. The outcomes of these one-day trainings were evaluated among a subset of participants using a mixed methods pre- …

High Prevalence Of Non-Communicable Diseases And Associated Risk Factors Amongst Adults Living With Hiv In Cambodia, Pheak Chhoun, Sovannary Tuot, Anthony D. Harries, Nang Thu Thu Kyaw, Khuondyla Pal, Carinne M. Brody, Siyan Yi

BACKGROUND:

With rapid expansion of antiretroviral therapy for HIV, there are rising life expectancies among people living with HIV. As a result, co-morbidity from non-communicable diseases in those living and aging with HIV is increasingly being reported. Published data on this issue have been limited in Cambodia. The aim of this study was to determine the prevalence of diabetes mellitus, hypertension and hypercholesterolemia and associated risk factors in adults living with HIV in Cambodia.

METHODS:

This cross-sectional study was conducted in five provinces of Cambodia from May-June 2015. Information was obtained on socio-demographic and clinical characteristics through face-to-face interviews using …

Sudan : Malaria, Olivia Jilek

Global Public Health

Sudan faces a great number of public health issues, however one of the most prevalent diseases within the country is Malaria. An estimated nine million cases were reported in 2002, with the total number of deaths at 44,000, in a country that has a population of 37,345,935. The research done on Malaria in Sudan looks at the basic epidemiology of the region, how to identify the disease, and major risks factors present. Other major challenges that Sudan faces are included, as well as suggestions for preventing further illness from the disease.

Israel : Translocation Of Rabies, Sarah Baker

Global Public Health

Israel is now faced with a steady growing public health threat as canine rabies has reemerged in the northern region of Israel. While the steady increase in cases is of notable alarm, moreover the close contact most often shared between dog and human populations is of much more concern from a public health prospective. Rabies is a vaccine-preventable disease. Vaccinating dogs has proven to be the most cost-effective strategy for preventing rabies in people. Additionally, education on bite prevention and rabid animal behaviors for both children and adults is an essential extension of the long term rabies vaccination program that …

Madagascar : Plague In Madagascar, Matthew Donald Hesch

Global Public Health

This public health brief calls attention to a disease issue in the country Madagascar. We show reasons as to why Madagascar has such a problem with the plague and what they should do to solve the issue. Madagascar has many areas that are high poverty because of a political crisis and this results in the easy spread of the plague. We show that Madagascar needs an increase in funds so that they can get out of the political crisis and begin fixing the plague issue. I offer ideas on how Madagascar could use the extra funds to overcome the plague …

Anti-Müllerian Hormone And Its Relationships With Subclinical Cardiovascular Disease And Renal Disease In A Longitudinal Cohort Study Of Women With Type 1 Diabetes, Catherine Kim, Yuanyuan Pan, Barbara Braffett, Valerie Arends, Michael Steffes, Hunter Wessells, Aruna V. Sarma

GW Biostatistics Center

Background

Reproductive age may be a risk factor for vascular disease. Anti-Müllerian hormone (AMH) is produced by viable ovarian follicles and reflects reproductive age. We examined whether AMH concentrations were associated with markers of subclinical cardiovascular disease (CVD) and kidney disease among women with type 1 diabetes.

Methods

We performed a cross-sectional analysis of the Epidemiology of Diabetes Interventions and Complications Study. Participants included women with type 1 diabetes and ≥1 AMH measurement (n = 390). In multivariable regression models which adjusted for repeated measures, we examined the associations between AMH with CVD risk factors, estimated glomerular filtration rate, …

Perspectives On Model Forecasts Of The 2014–2015 Ebola Epidemic In West Africa: Lessons And The Way Forward, Gerardo Chowell, Cecile Viboud, Lone Simonsen, Stefano Merler, Alessandro Vespignani

Global Health Faculty Publications

The unprecedented impact and modeling efforts associated with the 2014–2015 Ebola epidemic in West Africa provides a unique opportunity to document the performances and caveats of forecasting approaches used in near-real time for generating evidence and to guide policy. A number of international academic groups have developed and parameterized mathematical models of disease spread to forecast the trajectory of the outbreak. These modeling efforts often relied on limited epidemiological data to derive key transmission and severity parameters, which are needed to calibrate mechanistic models. Here, we provide a perspective on some of the challenges and lessons drawn from these efforts, …

Hiv Prevalence, Risky Behaviors, And Discrimination Experiences Among Transgender Women In Cambodia: Descriptive Findings From A National Integrated Biological And Behavioral Survey, Siyan Yi, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Srean Chhim, Khuondyla Pal, Gitau Mburu

Background: Transgender people are disproportionately affected by HIV. Despite their high vulnerability to HIV, lack of adequate epidemiological and surveillance data related to this population in many countries prevents provision of appropriate services. This paper summarizes descriptive findings from a national integrated biological and behavioral survey and discusses policy implications of the findings on HIV prevention among transgender women in Cambodia.

Methods: This cross-sectional study was conducted between December 2015 and February 2016. Participants were recruited from 20 sites in the capital city and 12 provinces of Cambodia using Respondent Driven Sampling (RDS) method. Behavioral data were collected …

Non-Communicable Diseases And Related Risk Behaviors Among Men And Women Living With Hiv In Cambodia: Findings From A Cross-Sectional Study, Pheak Chhoun, Chanrith Ngin, Martin Steel, Jennifer Dionisio, Hattie Pearson, Carinne M. Brody, Siyan Yi

Background: There is a growing concern for an increasing burden of non-communicable diseases (NCDs) in people living with HIV. This concern is evident especially in developing countries where dietary and lifestyle risk factors associated with NCDs are becoming more prominent. This study explored the prevalence of diabetes mellitus, hypertension, and hyperlipidemia and related risk factors in men and women living with HIV in Cambodia.

Methods: This cross-sectional study was conducted among 510 adult people living with HIV randomly selected from one city and four provinces in Cambodia. A structured questionnaire was used to collect data on socio-demographic characteristics, …

Awareness And Willingness To Use Hiv Pre-Exposure Prophylaxis Among Men Who Have Sex With Men In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis, Siyan Yi, Sovannary Tuot, Grace W. Mwai, Chanrith Ngin, Kolab Chhim, Khuondyla Pal, Gitau Mburu

Introduction: To facilitate provision of pre-exposure prophylaxis (PrEP) in low- and middle-income countries (LMIC), a better understanding of potential demand and user preferences is required. This review assessed awareness and willingness to use oral PrEP among men who have sex with men (MSM) in LMIC.

Methods: Electronic literature search of Cochrane library, Embase, PubMed, PsychINFO, CINHAL, Web of Science, and Google Scholar was conducted between July and September 2016. Reference lists of relevant studies were searched, and three authors contacted for additional data. Non-peer reviewed publications were excluded. Studies were screened for inclusion, and relevant data abstracted, assessed …

Clinical And Mucosal Immune Correlates Of Hiv-1 Semen Levels In Antiretroviral-Naive Men., Brendan J W Osborne, Angie K Marsh, Sanja Huibner, Kamnoosh Shahabi, Cindy Liu, Tania Contente, Nico J D Nagelkerke, Colin Kovacs, Erika Benko, Lance Price, Kelly S Macdonald, Rupert Kaul

Environmental and Occupational Health Faculty Publications

Background.

This study was done to characterize parameters associated with semen human immunodeficiency virus (HIV)-1 ribonucleic acid (RNA) viral load (VL) variability in HIV-infected, therapy-naive men. Methods.

Paired blood and semen samples were collected from 30 HIV-infected, therapy-naive men who have sex with men, and 13 participants were observed longitudinally for up to 1 year. Human immunodeficiency virus RNA, bacterial load by 16S RNA, herpesvirus (Epstein-Barr virus and cytomegalovirus [CMV]) shedding, and semen cytokines/chemokines were quantified, and semen T-cell subsets were assessed by multiparameter flow cytometry. Results.

Semen HIV RNA was detected at 93% of visits, with >50% of men …

From Sea To Shining Sea, And The Great Plains To Patagonia: A Review On Current Knowledge Of Diabetes Mellitus In Hispanics/Latinos In The U.S. And Latin America, Larissa Aviles-Santa, Uriyoán Colon-Ramos, Nangel Lindberg, Joseimer Mattei, Francisco Pasquel, Cynthia Perez

Global Health Faculty Publications

The last two decades have witnessed many advances in the prevention, treatment, and control of diabetes mellitus and its complications. Increased screening has led to a greater recognition of Type 2 diabetes mellitus (Type 2 DM) and prediabetes; however, Hispanics/Latinos, the largest minority group in the U.S., have not fully benefited from these advances. The Hispanic/Latino population is highly diverse in ancestries, birth places, cultures, languages, and socioeconomic backgrounds, and it populates most of the Western Hemisphere. In the U.S., the prevalence of diabetes mellitus varies among Hispanic/Latino heritage groups, being higher among Mexicans, Puerto Ricans, and Dominicans, and lower …

Effects Of Instrument Handle Design On Dental Hygienists' Forearm Muscle Activity During Scaling, Jessica R. Suedbeck, Susan L. Tolle, Gayle Mccombs, Martha L. Walker, Daniel M. Russell

Dental Hygiene Faculty Publications

Purpose: The purpose of this study was to determine the effects of 4 different commercially available instrument handle designs (A. 16 grams and 12.7 mm diameter, B. 23 grams and 11.1 mm diameter, C. 21 grams and 7.9 mm diameter and D. 18 grams and 6.35 mm diameter) on the muscle activity of four forearm muscles during a simulated scaling experience.

Methods: A convenience sample of 27 (n=27) dental hygienists used a Columbia 13/14 curet with four different instrument handles to scale artificial calculus from typodont teeth. Each participant's muscle activity was measured using surface electromyography (sEMG).

Results: Similar muscle …

A Neighborhood-Wide Association Study (Nwas): Example Of Prostate Cancer Aggressiveness, Shannon M. Lynch, Nandita Mitra, Michelle Ross, Craig Newcomb, Karl Dailey, Tara Jackson, Charnita M. Zeigler-Johnson, Harold Riethman

School of Medical Diagnostics & Translational Sciences Publications

Purpose

Cancer results from complex interactions of multiple variables at the biologic, individual, and social levels. Compared to other levels, social effects that occur geospatially in neighborhoods are not as well-studied, and empiric methods to assess these effects are limited. We propose a novel Neighborhood-Wide Association Study(NWAS), analogous to genome-wide association studies(GWAS), that utilizes high-dimensional computing approaches from biology to comprehensively and empirically identify neighborhood factors associated with disease.

Methods

Pennsylvania Cancer Registry data were linked to U.S. Census data. In a successively more stringent multiphase approach, we evaluated the association between neighborhood (n = 14,663 census variables) and prostate …