Public Health Commons^™

Midline Report: Accelerating Action To End Child Marriage In Bangladesh, Masuma Billah, Eashita Haque, Surojit Kundu, Md. Saddam Hossain, Momoe Makino, Sajeda Amin

Poverty, Gender, and Youth

This report describes results from the midline survey of Accelerating Action to End Child Marriage in Bangladesh. The objective of the program is to identify effective and scalable approaches to end child marriage by empowering girls and communities. To bring about social norms change, the program experiments with alternative means of community engagement that can be offered in conjunction with skills-development opportunities for adolescent girls. The program is being assessed in a multi-arm cluster randomized trial. This report explores the impact on the prevalence of child marriage in two districts of Bangladesh as well as on a range of other …

Gastrointestinal Symptoms In Patients With Covid-19, Mohammed Abbas, Rafik Elbeblawy, Islam Gadelmoula, Suvarna Rekha, Bettina Sinanova, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: Though coronavirus disease 2019 (COVID-19) is predominantly a respiratory illness, a growing number of studies reported gastrointestinal (GI) symptoms among these patients. We examined the incidence of GI symptoms in patients with COVID-19 and GI symptoms as the initial presentation of the disease.

Methods: We examined peer-reviewed studies in English of patients with COVID-19 that reported GI symptoms. We searched PubMed and Google Scholar for articles published up to June 30, 2020, by using the keywords ``COVID-19,'' ``Coronavirus,'' ``severe acute respiratory syndrome coronavirus 2,'', ``SARS-CoV-2,'' ``gastrointestinal tract,'' ``gastrointestinal diseases,'' and ``gastrointestinal symptoms and signs.'' Studies with fewer than 30 …

“If You Report Your Dad, How Are You Going To Survive”: Health Practitioner Perspectives On Quality Of Care For Survivors Of Sexual Violence And The Challenge Of Family Interference, Leso Munala, Emily Hohenshell, Emily Weile

Public Health Faculty Scholarship

This study examined the experiences and perspectives of health practitioners facing the challenges of providing services to female survivors of sexual violence. Interviews were conducted with 28 health practitioners, from eight post-rape care facilities located in Nairobi, Kenya. Data were analyzed using the Colaizzi’s 1978 analytical model. The analysis of the results was guided by four domains of the ecological framework: individual, interpersonal, community/cultural, and public policy. The study documented a myriad of detail about the challenges faced by women before reporting the crime as well as the actual process of reporting. One key finding from this study was that …

Availability Of Over-The-Counter Antibiotics In Guatemalan Corner Stores, Purificación Moreno, Alejandro Cerón, Karen Sosa, Marinees Morales, Laura M. Grajeda, Maria Renee Lopez, John P. Mccraken, Celia Cordón-Rosales, Guy H. Palmer, Douglas R. Call, Brooke M. Ramay

Anthropology: Faculty Scholarship

Widespread availability of antibiotics without prescription potentially facilitates overuse and contributes to selection pressure for antimicrobial resistant bacteria. Prior to this study, anecdotal observations in Guatemala identified corner stores as primary antibiotic dispensaries, where people purchase antibiotics without prescriptions. We carried out a cross sectional study to document the number and types of antibiotics available in corner stores, in four study areas in Guatemala. A total of 443 corner stores were surveyed, of which 295 (67%) sold antibiotics. The most commonly available antibiotics were amoxicillin, found in 246/295 (83%) stores, and tetracycline, found in 195/295 (66%) stores. Over the counter …

A Review Of Quarantine Period In Relation To Incubation Period Of Sars-Cov-2, Satya Rashmit Durugu, Hammad Tanzeem, Divya Menghani, Zahid Imran, Priya Krishnan

The University of Louisville Journal of Respiratory Infections

Introduction: The period from exposure to a potential pathogen to the manifestation of symptoms, i.e.  the incubation period, is time the virus spends replicating in the host. An estimation of this period and subsequent quarantine of the host can limit potential spread, particularly in asymptomatic carriers. Effective contact tracing, length of self-quarantine, repeat testing, and understanding of disease transmission are all contingent on a true estimation of this incubation period.

Methods: Articles in English published since December 1st, 2019, on Google scholar, PubMed, and Research Gate, along with bulletins from the World Health Organization and the Centers for Disease Control …

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Covid-19 Is Associated With Increased Severity In Pregnant Women, Zahid Imran, Vidyulata Salunkhe, Ahmed A. Eladely, Ahmed Abdelhaleem, Satya Durugu, Daisy Sangroula

The University of Louisville Journal of Respiratory Infections

Introduction: The COVID-19 pandemic originated in China in late 2019; the number of cases is increasing with 2,104,346 cases and 116,140 deaths in the United States as of June 16, 2020. Pregnant women are a vulnerable population in epidemics or pandemics. This review is designed to look in detail at the severity of COVID-19 in pregnant women compared to non-pregnant women of reproductive age.

Methods: Literature searches on PubMed, Google Scholar, the Lancet, and Web of Science were conducted.

Results: We found evidence of increased risk for severe disease and distinctive symptoms among pregnant women diagnosed with COVID-19 compared …

Practice-Based Learning: Medico-Legal Evidence Collection As Part Of Post-Rape Care In Refugee Contexts, Michael Gaitho, Ronald Kotut, Anne Ngunjiri, Jane T. Thiomi, Josephine Ngebeh, Chi-Chi Undie

Reproductive Health

Health care providers collect an array of documentation and specimens to support criminal investigations. Such documentation and specimens are referred to as “medico-legal” or “forensic” evidence, and in the case of rape, include a survivor’s documented injuries and emotional state at the time of examination, as well as samples and specimens from the survivor’s body or clothing. For survivors of rape and defilement who want to obtain legal justice, medico-legal evidence is critical. In African countries, health providers and the police are depended upon to ensure such evidence is collected, but medico-legal evidence collection can present challenges. Evidence-based interventions are …

Practice-Based Learning: Establishing Simple Monitoring Systems To Support Sgbv Programming In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Michael Gaitho, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

Implementers of sexual and gender-based violence programs in refugee settings are typically eager to learn about the extent to which their programs are making a difference in the lives of those they serve. Basic monitoring information can help address this imperative without unduly burdening program implementers with time-consuming evaluations. The Sauti/VOICE project is guiding adaptation and implementation of evidence-based SGBV interventions in refugee contexts. These interventions are implemented by UNHCR partners in eight countries in the East, Horn, and Great Lakes region of Africa. Although Sauti/VOICE is primarily focused on integrating tested SGBV interventions into refugee contexts, monitoring the implementation …

State-Level Income Inequality And The Odds For Meeting Fruit And Vegetable Recommendations Among Us Adults, Masako Horino, Sze Yan Liu, Eun-Young Lee, Ichiro Kawachi, Roman Pabayo

Department of Public Health Scholarship and Creative Works

Background

Previous research indicates that income inequality is associated with risk for mortality, self-rated health status, chronic conditions, and health behavior, such as physical activity. However, little is known about the relationship between income inequality and dietary intake, which is a major risk factor for common chronic diseases including heart disease, stroke, diabetes, and certain types of cancers. The objective of this study is to determine the association between US state income inequality and fruit and vegetable consumption among adults.

Methods

Cross-sectional data on 270,612 U.S. adults from the U.S. 2013 Behavioral Risk Factor Surveillance System was used. Fruit and …

Looking Beyond A Rare Presentation Of Betel Nut Use In A North American Patient- An Opportunity For Lessons And Intervention In Global Health And Gender Equity, Muhammad O. Zaman, Thomas M. Park, Vikas Patel, Riley G. Jones

Journal of Refugee & Global Health

Betel nut is estimated to be the fourth most common psychoactive substance used globally behind caffeine, alcohol, and nicotine with 600 million global users. Betel nut use has a strong association with oral cancer and many other systemic effects including oral submucosal fibrosis. Although North American use is rare, its enduring effects may surface long after use posing a diagnostic challenge to practitioners caring for an increasingly global diaspora. Herein, we present a patient with severe trismus due to advanced oral submucosal fibrosis who was unexpectedly found to be importing and using Betel nut for over thirty years after immigrating. …

Municipios Indígenas De Guatemala: Conocimientos, Actitudes Y Prácticas Frente A La Covid-19 Resultados De La Segunda Ronda De Recopilación De Datos, Population Council

Poverty, Gender, and Youth

No abstract provided.

Guatemala: Conocimientos, Actitudes Y Prácticas Frente A La Covid-19—Perspectivas De 144 Informantes Clave En 10 Municipios Con Mayoría De Población Indígena. Resultados De La Segunda Ronda De Recolección De Datos, 21–26 Julio De 2020, Population Council

Poverty, Gender, and Youth

El Population Council tiene una asociación de larga data con las comunidades indígenas y rurales de Guatemala a través del programa Abriendo Oportunidades. Para mediados de agosto de 2020, las restricciones gubernamentales permitían la movilidad entre departamentos a nivel nacional, las clases siguen suspendidas y se permite a las empresas operar en conformidad con los protocolos de prevención de COVID-19. Para entender mejor los conocimientos perspectivas y la evolución de las necesidades relacionadas con la pandemia por la COVID-19 en Guatemala, realizamos una segunda ronda de encuestas telefónicas con 144 informantes clave en 10 municipios con mayoría de población indígena. …

Guatemala: Covid-19 Knowledge, Attitudes And Practices—Perspectives From 144 Key Informants In 10 Indigenous Municipalities. Results From The Second Round Of Data Collection, July 21–26, 2020, Population Council

Poverty, Gender, and Youth

The Population Council has a longstanding partnership with indigenous communities in rural Guatemala through the Abriendo Oportunidades program. In compliance with COVID-19 prevention protocols, as of mid-August 2020 government restrictions allowed for inter-district mobility at the national level, classes remain suspended, and businesses were allowed to operate. To better understand indigenous knowledge, perspectives, and evolution of needs related to the COVID-19 pandemic in Guatemala, we conducted a second round of phone interviews with 144 key informants in ten municipalities. The second round represents 75% (n = 108) of the cohort interviewed April 14–18, 2020. Thirty-six new informants were recruited to …

Intensive Animal Farming Conditions Are A Major Threat To Global Health, Cynthia Schuck-Paim

Animal Sentience

Wiebers & Feigin accurately propose that reducing the risks posed by infectious disease outbreaks and other global health challenges will depend critically on transitioning away from intensive animal farming practices. Creating the right incentive structure for this transition to happen is one of the great challenges in the years to come, but a much-needed step to ensure the health and well-being of current and future generations.

Gaining A “Foothold” On The Diagnosis Of Leishmaniasis, Brent M. Troy, Rebecca Hart, Navjyot Vidwan, Bethany Hodge

Journal of Refugee & Global Health

Pediatric refugees and immigrants may present with unusual diagnoses due to their extensive migration and potential harsh conditions in travel. Trauma and family separation add to the difficulty of obtaining a history of exposures. We report a case of one of the more commonly neglected tropical diseases, Leishmaniasis. A 15-year-old male refugee patient presented to the hospital with ulcerative lesions to his legs. His migration history was extensive, starting in Central Africa with travel to South America, followed by migration through Central America to Texas. The patient developed ulcerative lesions on his legs, and he was brought to the children’s …

Factors Associated With Binge Drinking During The Transition Into Adulthood: Exploring Associations Within Two Distinct Young Adult Age Ranges, Tamara Leech, Sarah Jacobs, Denis Watson

Department of Public Health Scholarship and Creative Works

Background:

Binge drinking among young adults aged 18-21 years has declined over the past decade, but binge drinking rates among people 22-25 years old have remained largely the same. This steady trend in later years represents a departure from the traditional course of maturing out of risky alcohol use, perhaps because young adults are delaying the transition into adulthood.

Aims:

This paper explores the relationship between binge drinking and aspects of the transition into adulthood that could inform interventions targeting these two distinct groups of young adults.

Methods:

We use survey data on 1,081 young adults aged 18-25 living in …

Asking And Telling: An Assessment Of The Feasibility Of Screening Children For Sexual Violence In Kenyan School And Health Facility Contexts, Chi-Chi Undie, Margaret Mak'anyengo

Reproductive Health

Although sexual violence against children is increasingly prevalent in Kenya, documented and tested interventions for proactively identifying child survivors and providing them with care are currently nonexistent. This study aimed to determine the feasibility of screening children for SV in both school and health facility settings, and of providing child survivors identified through this process with access to care. The four-component intervention, implemented from January through April 2017, involved parent dialogues; student sensitization; provider training to administer a child-friendly screening tool and respond to child survivors; and SV screening, paired with SV service provision. As noted in this report, the …

The Incidence Of Common Respiratory Viruses During The Covid-19 Pandemic: Results From The Louisville Covid-19 Epidemiology Study, Brian C. Bohn Pharmd, Bcidp, Ashley M. Wilde Pharmd, Bcps-Aq Id, Sarah E. Moore Pharmd, Matthew Song Pharmd, Bcidp, Clayton J. Patross Pharmd, Bcps, Alan D. Junkins Phd, D(Abmm), Paul Schulz Md, Julio A. Ramirez Md Facp

The University of Louisville Journal of Respiratory Infections

Introduction: Social distancing has been utilized during the COVID-19 pandemic to reduce the spread of SARS-CoV-2; it is also expected to reduce the spread of common respiratory viruses.

Methods: This retrospective, descriptive study assessed the rate of positivity of common respiratory viruses from a commercially available respiratory pathogen panel across a five-hospital health system during four-week periods within March to April of 2019 and 2020.

Results: During the four-week period in 2019, the percent positivity of common respiratory viruses from week 1 to week 4 decreased from 6 to 32% among the four included viruses. In the comparator period in …

Impact Of 2012 Spanish Health Care Reform On Hiv-Positive Immigrants: A Mixed Methods Approach, Megi Gogishvili

Dissertations and Theses

Background: The financial crisis of 2008 hit Spain hard. As a consequence, the government took multiple austerity measures, including reforms in the healthcare system in 2012. Specifically, the government reduced the budget for health and social services by 13.7% in 2012.The reduction was further followed with structural changes via the 2012 Royal Decree Law (RDL) and Royal Decree (RD).The 2012 RDL and RD entailed broad areas of action,but most importantly the Spanish National Health System (SNS) no longer covered undocumented immigrants. The 2012 RDL and RD excluded approximately 500,000 undocumented immigrants from SNS.

The number of immigrants in Spain has …

Impact And Mortality Of Covid-19 On People Living With Dementia: Cross-Country Report, Aida Suárez-González, Gill Livingston, Lee Fay Low, Suzanne Cahill, Niamh Hennelly, Walter D. Dawson, Wendy Weidner, Martina Bocchetta, Cleusa P. Ferri, Jordi A. Matias-Guiu, Multiple Additional Authors

Institute on Aging Publications

This report brings together international evidence on the impact of the COVID-19 pandemic on people living with dementia and an overview of international policy and practice measures to mitigate the impact of COVID-19 among people living with dementia.

Key Findings

• We have collected data on impact and mortality of COVID-19 in people living with dementia in 9 countries: The United Kingdom (UK), Spain, Ireland, Italy, Australia, the United States (US), India, Kenya and Brazil.
• The share of people whose deaths were linked to COVID-19 in care homes who had dementia ranges from 29% to 75% across those countries. Within countries, …

Housing Stability And Diabetes Among People Living In New York City Public Housing, Sungwoo Lim, Sze Yan Liu, Melanie H. Jacobson, Eugenie Poirot, Aldo Crossa, Sean Locke, Jennifer Brite, Elizabeth Hamby, Zinzi Bailey, Stephanie Farquhar

Department of Public Health Scholarship and Creative Works

Public housing provides affordable housing and, potentially, housing stability for low-income families. Housing stability may be associated with lower incidence or prevalence and better management of a range of health conditions through many mechanisms. We aimed to test the hypotheses that public housing residency is associated with both housing stability and reduced risk of diabetes incidence, and the relationship between public housing and diabetes risk varies by levels of housing stability. Using 2004-16 World Trade Center Health Registry data, we compared outcomes (housing stability measured by sequence analysis of addresses, self-reported diabetes diagnoses) between 730 New York City public housing …

Reproductive Health In The Philippines: Poverty, Religiosity, And Navigating Reproductive Choices, Allison Goncena

International Studies (MA) Theses

This dissertation centers the Philippines as a case study in which quantitative and qualitative data from empirical studies, science journal articles, social science texts, and interviews are cross-examined to ascertain two main areas of interest. The first incentive is to identify and analyze the Catholic Church’s resources in perpetuating moral male-dominant rhetoric that have delayed efforts supporting reproductive health intended to aid low-income women concerning their sexual and reproductive health. The second incentive is to detect how low-income women’s thoughts and behaviors in making reproductive decisions are resonant or not of the Church’s moral rectitude over SRH through their demonstrations …

Support Clubs For Children And Youth In Haiti Living With Hiv: A Case Study, Susan Settergren, Robert Philippe, Joanne St. Louis, Nathaniel Segaren, Sylvie Boisson, Tessa Lewis, Olbeg Désinor, Kesner François

HIV and AIDS

In Haiti, where an estimated 3,000 children and youth are receiving antiretroviral therapy (ART), Caris Foundation, with funding from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID), provides hospital-linked psychosocial support groups, known as Kids Clubs, for young people ages nine and older. The clubs are intended to help ensure that HIV-positive children and adolescents stay in contact with health services, and serve as a conduit for delivery of other services, including health messages and health products. In 2019, Project SOAR conducted a study to describe the Kids Club …

Mexico: Covid-19 Knowledge, Attitudes And Practices, Population Council

Poverty, Gender, and Youth

This brief presents responses from the first round of data collection among adults, adolescents, and community leaders in indigenous municipalities of Chiapas and Yucatan, Mexico, June 1–30, 2020. In total, 295 people from 17 municipalities were surveyed in Yucatan, and 83 people from 15 municipalities were surveyed in Chiapas. Adults and adolescents in both states identified the groups most at risk of suffering complications. Food insecurity may be a consequence of the pandemic. Regarding livelihoods, 51% of women and 63% of men in Yucatan have lost their work and/or their primary source of income since the start of the pandemic, …

Anesthesia Services In The Time Of Covid, James Chen, Daisy Sangroula, Katelyn Williams, Sydney Pham, Ozan Akca, Jiapeng Huang, Sean Clifford

The University of Louisville Journal of Respiratory Infections

Our hospital is a 400-bed, Level-1 trauma center with 78 intensive care unit (ICU) beds serving the greater Louisville metropolitan area. The COVID-19 pandemic forced our hospital to re-evaluate our core business operations and to develop a coherent response to a fluid situation. Between March 15 and May 15, 2020, the University of Louisville Hospital admitted more than 100 COVID-19 inpatients; approximately 30 were admitted to the ICU, and most required endotracheal intubation. The following review describes our Department of Anesthesiology \& Perioperative Medicine foci, actions, and rationale during the COVID-19 pandemic. While we hope not to experience another pandemic …

México: Conocimientos, Actitudes Y Prácticas Relacionadas Con Covid-19, Population Council

Poverty, Gender, and Youth

Este informe presenta las respuestas de la primera ronda de recolección de información con personas adultas, adolescentes y autoridades comunitarios en las comunidades indígenas de Chiapas y Yucatán, México, del 1 al 30 de junio de 2020. En total, 295 personas originarias de 17 municipios fueron encuestados en Yucatán, y se encuestó a 83 personas de 15 municipios de Chiapas. Los adultos y adolescentes de ambos estados identificaron a los grupos en mayor riesgo de sufrir complicaciones. La inseguridad alimentaria puede ser una consecuencia de la pandemia Covid-19. En cuanto a los medios de vida, el 51% de las mujeres …

Is Sars-Cov-2 A Neurotropic Virus And A Potential Facilitator Of Cns Infection For Other Pathogens?, Jose Bordon

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Severe Covid-19, Arpan H. Chawala, Shivam Gulati, Bettina Sinanova, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: There is substantial variation in the clinical characteristics and outcomes of severe coronavirus disease (COVID-19), making it difficult to do an optimal assessment of this condition. We reviewed the current English literature to identify the findings concerning the baseline characteristics and health outcomes of patients with severe COVID-19, primarily those with acute respiratory distress syndrome (ARDS).

Methods: We examined only studies that assessed patients with confirmed COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) with at least one of the following severity criteria: treated in the intensive care unit (ICU), ARDS, and/or invasive …

The Importance Of Cycle Threshold Values In The Evaluation Of Patients With Persistent Positive Pcr For Sars-Cov-2: Case Study And Brief Review, Jose Bordon, Donghoon Chung, Priya Krishnan, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Some patients recover from COVID-19, but their reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 remains persistently positive. In the evaluation of these patients, it is important to define the cycle threshold (Ct) value of the RT-PCR test. This article will present a case study, address relevant findings and interpretation of the RT-PCR test, and explain the use of Ct values in defining when a healthcare worker may return to work. Our current approach is to allow health care workers with persistently positive RT-PCR to return to work if the Ct value is greater than 35.