Public Health Commons^™

Ascertainment Of The Estimated Excess Mortality From Hurricane Maria In Puerto Rico, Carlos Santos-Burgoa, Ann Goldman, Elizabeth Andrade, Nicole Barrett, Uriyoan Colon-Ramos, Mark Edberg, Alejandra Garcia-Meza, Lynn Goldman, Amira Roess, John Sandberg, Scott Zeger

Global Health Faculty Publications

No abstract provided.

High-Risk Advanced Maternal Age And High Parity Pregnancy: Tackling A Neglected Need Through Formative Research And Action., Khadidiatou Ndiaye, Erin Portillo, Dieneba Ouedraogo, Allison Mobley, Stella Babalola

Global Health Faculty Publications

Pregnancy among women of advanced maternal age (those 35 years or older) or among women of high parity (those having had 5 or more births) is linked to maternal and infant mortality. Yet little is known about the drivers of these pregnancies as they are often neglected in existing family planning and reproductive health programs. To better understand the context in which advanced maternal age and high parity pregnancies occur and the acceptability of discussing associated pregnancy risks, the Health Communication Capacity Collaborative (HC3) conducted formative qualitative research between January and March 2015 on the perception and determinants of such …

A Qualitative Study Examining The Benefits And Challenges Of Incorporating Patient-Reported Outcome Substance Use And Mental Health Questionnaires Into Clinical Practice To Improve Outcomes On The Hiv Care Continuum., Anne K Monroe, Sarah M Jabour, Sebastian Peña, Jeanne C Keruly, Richard D Moore, Geetanjali Chander, Kristin A Riekert

Epidemiology Faculty Publications

BACKGROUND: Inadequate identification and treatment of substance use (SU) and mental health (MH) disorders hinders retention in HIV care. The objective of this study was to elicit stakeholder input on integration of SU/MH screening using computer-assisted patient-reported outcomes (PROs) into clinical practice.

METHODS: We conducted semi-structured interviews with HIV-positive patients who self-reported SU/MH symptoms on a computer-assisted PROs (n = 19) and HIV primary care providers (n = 11) recruited from an urban academic HIV clinic. Interviews were audio-recorded and transcribed. We iteratively developed codes and organized key themes using editing style analysis.

RESULTS: Two themes emerged: (1) Honest Disclosure: …

Prevention Paradox: Medical Students Are Less Inclined To Prescribe Hiv Pre-Exposure Prophylaxis For Patients In Highest Need., Sarah K Calabrese, Valerie A Earnshaw, Kristen Underhill, Douglas S Krakower, Manya Magnus, Nathan B Hansen, Kenneth H Mayer, Joseph R Betancourt, Trace S Kershaw, John F Dovidio

Epidemiology Faculty Publications

INTRODUCTION: Despite healthcare providers' growing awareness of pre-exposure prophylaxis (PrEP), prescription rates remain low. PrEP is an efficacious HIV prevention strategy recommended for use with condoms but still protective in their absence. Concern about the impact of PrEP on condom use and other risk behaviour is, nonetheless, among the barriers to prescription commonly reported. To understand the implications of this concern for PrEP access, we examined how medical students' willingness to prescribe PrEP varied by patients' condom use and partnering practices. We also assessed the perceived acceptability of various reasons for condom discontinuation with PrEP.

METHODS: An online survey was …

The Ramazzini Institute 13-Week Study On Glyphosate-Based Herbicides At Human-Equivalent Dose In Sprague Dawley Rats: Study Design And First In-Life Endpoints Evaluation., Simona Panzacchi, Daniele Mandrioli, Fabiana Manservisi, Luciano Bua, Laura Falcioni, Melissa J Perry, +Several Additional Authors

Environmental and Occupational Health Faculty Publications

BACKGROUND: Glyphosate-based herbicides (GBHs) are the most widely used pesticides worldwide, and glyphosate is the active ingredient of such herbicides, including the formulation known as Roundup. The massive and increasing use of GBHs results in not only the global burden of occupational exposures, but also increased exposure to the general population. The current pilot study represents the first phase of a long-term investigation of GBHs that we are conducting over the next 5 years. In this paper, we present the study design, the first evaluation of in vivo parameters and the determination of glyphosate and its major metabolite aminomethylphosphonic acid …

Oxidative Stress And Cardiovascular Risk In Type 1 Diabetes Mellitus: Insights From The Dcct/Edic Study, W. Wilson Tang, P. Mcgee, John M. Lachin, D. Li, B. Hoogwerf, S. Hazen, +Several Additional Authors

Epidemiology Faculty Publications

Background--Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus. Methods and Results--A random subcohort of 349 participants was selected from the DCCT/EDIC (Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from DCCT baseline, year 1, and closeout of DCCT, and 1 to 2 years post-DCCT (EDIC years 1 and …

A Global Health Research Checklist For Clinicians., Rasha D Sawaya, Kristen A Breslin, Eiman Abdulrahman, Jennifer I Chapman, Dafina M Good, Lili Moran, Paul C Mullan, Oluwakemi Badaki-Makun

Pediatrics Faculty Publications

Global health research has become a priority in most international medical projects. However, it is a difficult endeavor, especially for a busy clinician. Navigating the ethics, methods, and local partnerships is essential yet daunting.To date, there are no guidelines published to help clinicians initiate and complete successful global health research projects. This Global Health Research Checklist was developed to be used by clinicians or other health professionals for developing, implementing, and completing a successful research project in an international and often low-resource setting. It consists of five sections: Objective, Methodology, Institutional Review Board and Ethics, Culture and partnerships, and Logistics. …

Perceptions, Careseeking, And Experiences Pertaining To Non-Cephalic Births In Rural Sarlahi District, Nepal: A Qualitative Study., Naoko Kozuki, Luke C Mullany, Subarna K Khatry, James M Tielsch, Steven C Leclerq, Caitlin E Kennedy, Joanne Katz

Global Health Faculty Publications

BACKGROUND: In low-resource settings, a significant proportion of fetal, neonatal, and maternal deaths can be attributed to intrapartum-related complications. Certain risk factors, such as non-cephalic presentation, have a particularly high risk of complications. This qualitative study describes experiences around non-cephalic births and highlights existing perceptions and care-seeking behavior specific to non-cephalic presentation in rural Sarlahi District, Nepal.

METHODS: We conducted in-depth interviews with 34 individuals, including women who recently gave birth to a non-cephalic infant and female decision-makers in their households. We also conducted two focus groups with mothers (have two or more children, with at least one child under …

An Exploration Of Global Women’S Health: Findings From A Pilot Online Course Elective For Health Sciences Studies At Gw, Marisa Cordon, Maranda Ward, Leslie Davidson

GW Research Days 2016 - 2020

In 1995, 189 countries endorsed the Platform for Action, designed to address issues of gender equality, including health. Despite this 23 year old initiative, women’s health issues continue to be a global crisis (WHO, 2015). The SMHS piloted an 8-week online 1-credit course in Fall 2017 to educate GW students on the top ten issues for women’s health delineated by the World Health Organization (WHO). Each of the eight weeks covered a core women’s health WHO issue while tying in a global human rights perspective. Issues included but were not limited to reproductive health, STIs, violence against women, to name …

Piloting Carestart™ Rapid Diagnostic Test (Rdt) To Promote Glucose-6-Phosphate Dehydrogenase (G6pd) Screening In Malaria Endemic Community In Cambodia, Bertha Nyagaya-Wojnarski, +Several Additional Authors

GW Research Days 2016 - 2020

Background: Primaquine (PQ) is the only FDA-approved drug for radical cure of Plasmodium vivax (P.v) malaria, but treatment can result in life-threatening hemolysis if given to a glucose-6-phosphate dehydrogenase deficient (G6PDd) patient. Therefore, the G6PD status of the patient with P.v must be known prior to prescribing PQ. However, a patient’s G6PD status in rural malaria endemic settings is generally unknown, illuminating the need for reliable point of care G6PD diagnostic tests as a prerequisite to safely administer PQ. To increase community PQ access in Cambodia, performance of CareStart™ G6PD rapid diagnostic tests (RDTs) needs to …

(Video) Dirty Cotton: Occupational Pesticide Exposure And Elevated Suicide Risk Among Male Cotton Farmers In India, Bethany Natalia Kondavaty

GW Research Days 2016 - 2020

Purpose: The aim of this critical analysis was to examine the association (or lack thereof) of occupational pesticide exposure and elevated suicide risk among male cotton farmers in India.

Methods: A literature review was performed using Scopus, PubMed, and Google Scholar databases. The review included documents published before and after year 2002. Children were excluded from the search as well as women, with exception to research on gender differences in suicide.

Results: Studies outside India show a positive correlation between work-related pesticide exposure and suicide. Animal studies have shown that pesticides, as organophosphates, are toxic, …

Shigellosis And Giardiasis Among People Living With Hiv In Washington, Dc, 2012-2016, Kimesha Linton, Kerri Dorsey, Sasha Mcgee, Preetha Iyengar, Garret Lum, Rupali Doshi

GW Research Days 2016 - 2020

Background: Shigellosis and giardiasis are transmitted via food, water, and fecal-oral contact. CDC has recently reported increased shigellosis among men who have sex with men (MSM) and among people living with HIV (PLWH), particularly stage 3. Our goal was to characterize the incidence and risk factors associated with shigellosis and giardiasis among PLWH in Washington, DC, in an era of robust availability of antiretroviral treatment.

Methods: We conducted a retrospective analysis of HIV, shigellosis and giardiasis cases reported to the District of Columbia Department of Health from 2012 to 2016. We used LinkPlus to probabilistically match individuals with reported …

Breastfeeding As A Predictor Of Serum Concentrations Of Per- And Polyfluorinated Alkyl Substances In Reproductive-Aged Women And Children: A Rapid Systematic Review, Brianna N. Vannoy, Juleen Lam, Ami R. Zota

GW Research Days 2016 - 2020

Purpose of Review: Per- and polyfluorinated alkyl substances (PFASs) are synthetic chemicals widely detected in human serum, and at low levels in breast milk. We conducted a rapid systematic review on breastfeeding practices and serum concentrations of PFASs – specifically PFOS and PFOA - among reproductive-aged women and young children using the Navigation Guide systematic review methodology.

Recent Findings: We included 14 studies examining associations between breastfeeding and PFASs in infants/toddlers or pregnant/postnatal women. Breastfeeding was significantly associated with lower PFASs exposure among women and higher PFASs exposure among children. Summary: We concluded there was “sufficient” evidence supporting an association …

How Climate Effects The Tick Vector Of Lyme Disease: A Critical And Systematic Review Of The Literature, Anita Desikan, Matias Attene Ramos

GW Research Days 2016 - 2020

Background

Lyme disease (LD) is a common vector-borne disease in North America. Understanding the causes behind inter-annual fluctuations of LD incidence can help warn healthcare providers of upcoming outbreaks.

Objective

Identifying what specific climate variables affects the vector, Ixodes scapularis ticks, and ultimately LD incidence.

Methods

A systematic review was carried out to understand how climate variables affect the tick population variables that are related to LD.

Results

Twenty-one studies met the inclusion criteria. Risk of bias was generally rated “low” or “probably low” and quality of evidence was rated “moderate”. Strength of evidence was assessed for tick abundance, a …

Occupational Exposure To Solvents And Associated Neurotoxicity In Construction Painters: A Systematic Review, Allison Cailliau

GW Research Days 2016 - 2020

Background

Existing evidence suggests that occupational exposure to solvents can have devastating and adverse effects on cognitive function. Individuals in the construction industry, specifically construction painters, often come in contact with these harmful chemicals on a regular basis. A solvent is a liquid that can dissolve, suspend, or extract other materials without chemical change to the solvent itself. They are present in a wide range of industries and can be used for extraction of fats and oils, degreasing, or manufacturing of paints and plastics. Their main routes of exposure are through inhalation and skin absorption, and they have a tendency …

Designing A Social Norms-Based Intervention To Reduce Anemia In India: A Formative Research Protocol, Aika Aluc, Erica Sedlander, Rajiv N. Rimal, Sameera A. Talegawkar, Hagere Yilma, Wolfgang Munar

GW Research Days 2016 - 2020

Background: Economic and gender inequalities are important determinants of anemia in low and middle income countries. Gender dimensions of food security contribute to the undernutrition among women. More than half of women of reproductive age in India are anemic. Anemia causes increased risk of preterm delivery, higher maternal mortality and contributes to fatigue, which influences women’s work productivity. The World Health Organization (WHO) recommends daily oral iron and folic acid (IFA) supplements during pregnancy and weekly supplements for women of reproductive age. Despite the efforts of government programs and global donors to reduce anemia in India, both initial uptake and …

Impact Of Water, Sanitation, And Hygiene Interventions On Environmental Enteric Dysfunction In Children In Developing Countries: A Systematic Literature Review, Abdoulaye Bangoura, Susan Anenberg

GW Research Days 2016 - 2020

Environmental Enteric Dysfunction (EED) is a global disturbance of intestinal structure and function that has its origin in environmental factors (Owino et al. 2016). As a response to prolonged and persistent inflammation, the intestine morphology is altered. EED is an important contributor to poor child cognitive development, child stunting, poor oral vaccine response, acute infections, and childhood mortality globally (Trehan et al. 2016) in developing countries.

We hypothesized that WASH interventions could reduce the risk of EED, thereby positively impacting children’s overall health. The Navigation Guide review methodology and the Grading of Recommendations Assessment and Evaluation (GRADE) were followed to …

Occupational Exposure To Organophosphate Pesticides And Its Effects On Human Sperm Parameters: A Systematic Review, Roxana E. Amaya-Fuentes, Melissa J. Perry

GW Research Days 2016 - 2020

Background

Previous research has indicated there is a decrease in sperm quality in the last 40 years. There have been a few reports that have associated occupational exposure to Organophosphate pesticides with a decrease in sperm count, abnormalities in the head or tail, and motility leading to infertility over time. Organophosphates are the most common pesticides used in the United States and have been classified as toxic to bees, wildlife, and humans by the EPA even at low exposures. Furthermore, Organophosphates are considered endocrine disrupting chemicals altering the normal function of the endocrine system. This occurs by interfering with the …

Does Occupational Exposure To Swine Increase The Risk Of Influenza? A Systematic Literature Review, Courtney Youngbar, Lance Price

GW Research Days 2016 - 2020

Background Workers who have an occupational exposure to swine may have an increased risk of influenza infection.

Objective We conducted a systematic review regarding occupational exposure to swine and influenza infection in humans.

Methods We searched articles published within the past ten years at the time of writing, and included original studies that quantified exposures to swine and resulting influenza infections in swine farm workers, including veterinarians. We evaluated the risk of bias of individual studies and the overall quality and strength of the evidence according to the Navigation Guide systematic review methodology. Twelve studies met the inclusion criteria. We …

Evaluation Of Pm Emissions Of A Diesel Engine Fueled With Waste Cooking Oil Biodiesel: A Systematic Review, Omobolanle H. Oshinusi, George M. Gray

GW Research Days 2016 - 2020

Background: The Navigation Guide developed by Johnson et al was used to conduct a robust systematic review of six experimental intervention studies looking at particulate matter (PM)emissions from conventional petroleum diesel and a biodiesel alternative utilizing waste cooking oil in heavy-duty petroleum diesel engines. Waste cooking oil biodiesel is thought to be a more sustainably sourced alternative to its fossil fuel counterpart.

Objectives: Application of the Navigation Guide systematic review methodology to answer the question: Does the replacement of petroleum diesel with waste cooking oil biodiesel reduce hazardous PMemissions? Methods: The study question was specified, evidence was selected and the …

(Video) Outreach Services To Treat Women Living With Obstetric Fistula: A Systematic Review, Pauline Pamela Pratt, Rashida Muhammad

GW Research Days 2016 - 2020

Background: Obstetric fistula is a condition experienced by women who because of prolonged labor become incontinent forming one or more holes in between the rectum and the vagina or the vagina and the bladder (Heller, A., 2017). The hole causes uncontrollable stool and urine to leak from the woman. For most women with obstetric fistula, the duration of the labor leading to fistula varied between 5 hours and 9 days, averaging 3.0 days long (Heller, A., 2017). Women who suffer from this from this condition are do not have access to quality medical care. While prevention is the priority and …

Cross-Sectional Comparison Of Behavioral Risk Factors For Hiv/Hcv In People Who Inject Drugs (Pwid) In Egypt, Sarah Martinez, Amira A. Roess, Monica S. Ruiz, Atef Bakhoum, Ehab El Kharrat

GW Research Days 2016 - 2020

Background

Egypt has the greatest HCV prevalence worldwide at 15% and a concentrated HIV epidemic in male people who inject drugs (PWID) at 6.8%, who are at a high risk for HCV infection as well. Injection drug use is criminalized in Egypt, and there is limited availability of harm reduction programs. Drug-use and sexual risk behaviors between PWID and the general population have not been studied there.

Methods

To address this gap, a cross-sectional HIV/HCV epidemiological study of 632 consenting injection drug users in Cairo and Alexandria was conducted. Bivariate logistic regression analysis was done to evaluate the associations between …

How Collective Norms And Media Use Affect Attitudes About Violence Against Women And Contraception Use In Sub-Saharan Africa, Erica Sedlander, Rajiv N. Rimal

GW Research Days 2016 - 2020

Background: Contraceptive use and attitudes about violence against women, though enacted at the individual level, are also driven by factors at the interpersonal and social levels. The role of mass media in promoting social norms surrounding these attitudes and behaviors has not received much scholarly attention but can be helpful to illuminate areas for intervention.

Hypothesis: We proposed and tested the hypothesis that collective norms (defined as a groups aggregate behavior or attitudes) would be associated with individual level attitudes (tolerance towards violence against women) and behaviors (contraception use). This relationship was further hypothesized to vary by media use, such …

Systematic Literature Review Of Indoor School Exposure To Pm2.5 In Children, Brittany Wagner, Ami Zota

GW Research Days 2016 - 2020

Asthma is a chronic respiratory disease that puts a strain on lung function and breathing. It is the leading cause of school absenteeism and hospitalization for American children. Genetics play a major role in allergy related disease development such as asthma, but environmental exposures are proving to be a potential contributor to childhood asthma. Despite the sufficient data regarding air pollution, there is a huge knowledge gap regarding indoor air quality and its relationship with health outcomes such as asthma. Many of the studies available only look at outdoor air pollution levels, while children spend the majority of their time …

Assessing Psychophysiological Effects Of Malodorous Pollutants In Residents Of Leandrinho, Bahia, Brazil: A Pilot Study Using A Whatsapp-Based Questionnaire, Shanell Folger, Courtney Woods, Rita Franco Rego, Carlos Henrique Amaral, Washington Ramos, Amanda Northcross

GW Research Days 2016 - 2020

Background: Leandrinho is located in the region that is home to the largest industrial chemical complex in the southern hemisphere that covers approximately 49 km². Leandrinho residents have reported experiencing adverse health effects that co-occur during periods of malodor emitted by the petrochemical industry. However, there is currently no tool for the residents to systematically record incidents of malodor. This pilot study assessed the feasibility of using a questionnaire designed through Whatsapp, a text-messaging application commonly used among residents.

Method: Leandrinho residents were randomly recruited to complete a daily questionnaire using either paper (n=24) or Whatsapp (n=24) over …

An Assessment Of Cultural Perceptions And Recognition Of Ebola Virus Disease, And Its Correlation With Traditional Burial Practice In Rural Guinea, Chulwoo Park, Amira Roess, Sally Lahm, Mamadou Kally Bah, Mohamed Campel Camara, John Sandberg

GW Research Days 2016 - 2020

Background:

In the midst of the unprecedented Ebola outbreak in West Africa during 2014-2016, the humanitarian response to control the disease was hampered in part because there was a limited understanding of local traditional rituals or indigenous medicine (ethnomedicine) on the part of the responders. The Ebola outbreak claimed 11,310 lives, more than all other outbreaks combined. West African burial funeral ceremonies and surrounding rituals may have hindered interventions that included the forceful removal of the sick or dead from the community.

Objective:

Our objective was to understand transmission associated with traditional burial practices in rural Guinea. Through the lens …

Implications Of Foodborne Bacteria On Human Health: Isolation And Antibiotic Resistance Of Salmonella Enterica And Campylobater Spp. On Retail Chicken Sold In California, Grace Rahman, Lance Price, Hanna-Grace Rabanes

GW Research Days 2016 - 2020

Overuse of antibiotics contributes to antimicrobial resistance (AMR), which continues to be a growing threat to human health. In the United States, industrial food animal production (IFAP) is a formidable driver for antibiotic use. Prior work has focused on the link between antimicrobial use in poultry and human AMR infections. Common foodborne pathogens such as Salmonella enterica (S. enterica) along with Campylobacter coli (C. coli) and Campylobacter jejuni (C. jejuni) are commonly associated with human gastroenteritis. However, it has been shown that these pathogens are capable of causing disease outside of the gastrointestinal tract, specifically urinary tract infections (UTIs). …

Toolkits To Help Women Who Have Experienced Or Are At Risk Of Female Genital Cutting: A Review, Hina Shaikh, Karen Mcdonnell, Nadia Kalley, Christine Hedstrom, Ghada Khan

GW Research Days 2016 - 2020

In recent years, written guidance and other tools to assist professionals in multiple sectors has been issued to increase their awareness about female genital mutilation/cutting (FGM/C), knowledge of how to respond appropriately, and means of delivering optimal care to women who have undergone FGM/C. A long-standing human rights-framed issue, FGM/C is a global health concern and is most often carried out on young girls. Apart from practicing origin countries, increased international migration has given rise to FGM/C in countries in the Americas, Europe, and Oceania, and compelled domestic legislation to outlaw FGM/C. This prohibition makes FGM/C an area in which …

(Video) Characterizing The Exposome: Critical Analysis Of Exposome-Wide Association Studies, Marlee Nelson, Matias Attene Ramos

GW Research Days 2016 - 2020

Purpose: The exposome is a conceptual framework of all exposures encountered by an individual in his or her lifetime. Studying the exposome is thereby a monumental feat that may require extensive research, conceptualization, and proof-of-concept analyses. Researchers have begun studying the exposome by developing exposome- and environment-wide association studies (EWAS). Since EWAS is such a novel technique, this critical analysis of existing EWAS in the literature sought to determine whether the studies utilized common research methods, how the data were analyzed, and whether the analyses were similar. The analysis also sought to explore ways in which these studies could inform …

Etiology And Management Of Hospitalized And Outpatient Diarrhea Among Children Less Than 5 Years Of Age In Lambaréné, Gabon, Christina Pugliese, Natalie Byrne, Frederique Nguema, Kafui Vodounou, Mirabeau Mbong Ngwese, Gedeon Manouana, Jean Edoa, Bayode Adegbite, Jeannot Zinsou, Ayola Adegnika, Martin Grobusch, David Diemert

GW Research Days 2016 - 2020

Objectives: Diarrhea remains a significant cause of global under-5 mortality, particularly in SubSaharan Africa (SSA). To reduce morbidity and mortality, the World Health Organization (WHO) recommends oral rehydration salts (ORS), zinc supplementation, and continued feeding or breastfeeding for all children with diarrhea to prevent dehydration and malnutrition; antibiotics only for bloody diarrhea (i.e. probable shigellosis), suspected cholera, or severe non-intestinal infections (e.g. pneumonia or sepsis); and avoidance of antidiarrheals and antiemetics owing to lack of benefit and potential for harm in young children. Gabon is an upper-middle income country in SSA for which there is a lack of recent, high …