Public Health Commons^™

An Assessment Of Occupational Heat Stress In A Central Utility Plant, Abdoulaye Abdoulaziz

Capstone Experience: Master of Public Health

Global climate change has been declared a threat to human health, which includes occupational safety issues. As temperatures continue to increase, heat stress and heat-related illness are occupational safety issues that need to be better understood. Assessments of workplace heat exposures are key to implement appropriate health and safety interventions. This study attempted to assess whether workers’ perception of work environment temperature in a Central Utility Plant was associated with heat-stress prevention behaviors. Therefore, we used a questionnaire to collect Central Utility Plant employees’ demographic characteristics, data regarding their perceived work environment temperatures, and their behaviors related to preventing heat-related …

Planning A Culturally And Linguistically Appropriate Obesity Intervention For Hispanic/Latino Children Living In Rural Nebraska, Ada V. Luna

Capstone Experience: Master of Public Health

Childhood obesity is a public health concern in the U.S; however, for the Hispanic/Latino community these concerns have grown to epic proportions. In Nebraska, the rate of childhood obesity is 25.1%; among Hispanic / Latinos students, the obesity rate is 30.9%. Unfortunately, specific Nebraska obesity rates by race and ethnicity are limited among rural communities, and programs that can effectively address this problem in the Hispanic / Latino community are limited or non-existent. Consequently, disparities between urban and rural communities exist. The purpose of this capstone project is to design a culturally and linguistically oriented intervention to address childhood obesity …

Prevalence Of Intimate Partner Violence Among The Maternal-Fetal Medicine Population, Sarah K. Larsen

Capstone Experience: Master of Public Health

Intimate partner violence (IPV) is increasingly understood as an important public health issue. It is well understood that intimate partner violence has many negative effects on its survivors ranging from physical to mental health conditions. The population of people who experience intimate partner violence and population of pregnant women are both vulnerable populations. Examining the two populations together demands a trauma-informed approach and an understanding of the intricacies of both pregnancy and intimate partner violence. While IPV has been studied among the pregnant population, intimate partner violence as it relates to the maternal fetal medicine (MFM) or high-risk pregnancy population …

The Wellbeing Partners’ Use Of The School Health Index To Identify Needs In Omaha Public Schools: A Process Evaluation, Sophia A. Quintero

Capstone Experience: Master of Public Health

The School Health Index tool from the Center for Disease Control and Prevention has been a useful tool to identify needs and areas of improvement for schools. This tool is most effective when used in collaboration with school staff and assistance from an outside facilitator. The purpose of this evaluation was to determine the administration efficiency of the School Health Index in select schools throughout the Omaha Public School (OPS) district by The Wellbeing Partners. A process evaluation was conducted to: 1) assess the relationship between the schools’ wellness champions at five Omaha Public School (OPS) elementary schools and The …

Closing The Loop: Pilot Evaluation Of Referral Navigator At Oneworld Community Health Centers, Oliver Ramirez-Gutierrez

Capstone Experience: Master of Public Health

Background. Low-income persons are subject to barriers to accessing health care and the additional complexity of the referral process, specifically for those receiving assistance from indigent care programs, contributes to those barriers. The requirements for patients receiving social assistance from indigent care programs leads to increased waiting time to be seen by specialists and contributes to health disparities.

Aim. Through a partnership with OneWorld Community Health Centers this project seeks to understand the efficacy of the implementation of a “referral navigator” at OneWorld and make recommendations to enhance the process. The proposed navigator is aimed to decrease the waiting time …

The Effect Of Childhood Farm Exposure On Adult Respiratory Symptoms And Proinflammatory Cytokine Responsiveness In Agricultural Workers, Jacob C. Grothe

Capstone Experience: Master of Public Health

Introduction: Studies have shown that the farm exposes workers and family members to countless microorganisms such as, gram-negative bacteria that possess endotoxins, which have been demonstrated to contribute to lung disease, such as asthma, in exposed workers. Results of studies of children show conflicting results regarding the development of asthma or asthma-like symptoms in response to farm exposures. European children show a “protective effect” against atopy and asthma during adolescence, while North American children show a higher prevalence of asthma or asthma-like symptoms. Also, whether this protective effect carries into adulthood is unclear. Some studies show a low prevalence of …

Effect Of Cigarette Smoking On Cd4 Count And Viral Load Among Hiv Patients Attending Treatment At Nebraska Medicine, Chacha Josiah Mwita

Capstone Experience: Master of Public Health

Background

Smoking is known to have a negative impact on both morbidity and mortality in people living with HIV (PLHIV). However, there is inconsistent information about the role of smoking on markers of HIV disease progression (CD4 count and HIV viral load). This study examined the effects of cigarette smoking on markers of HIV disease progression among PLHIV at Nebraska Medicine.

Methods

A retrospective cohort study was conducted utilizing electronic health information of 604 PLHIV who attended treatment at Nebraska Medicine between 2012 and 2020. Multiple linear regression was used to model the effects of smoking on the mean change …

The Association Of Demographic And Clinical Characteristics And Self-Reported Sleep Duration Among Patients With Prediabetes, Priyanka Chaudhary

Capstone Experience: Master of Public Health

Background: Sleep has been recognized as a critical component of healthy development and overall health. However, sleep duration has emerged as an important lifestyle factor that influences endocrine function and glucose metabolism. There remains a dearth of research to assess sleep duration among patients with prediabetes.

Objective: To evaluate the association between socio-demographic and clinical characteristics and self-reported sleep duration among patients with prediabetes.

Methods: Baseline data (n=599) was used from a diabetes prevention trial. A chi-square test was used to assess the differences between the groups of sleep duration for the categorical, whereas the t-test was used for the …

A Review Of The Characteristics Of Super-Utilizers And Evidence-Based Approaches To Reduce Healthcare Utilization, Suswara Mandala Rayabandla

Capstone Experience: Master of Public Health

A significant fraction of health care resources in the United States of America is utilized by a comparatively small number of people. An examination of the attributes and patterns and associated evidence-based interventions for such high-utilizing patients might aid clinicians to improve interventions to address the distinctive needs of these patients, decrease their risks for numerous hospitalizations, and contribute to reducing the costs. This study aims at exploring the existing literature on the characteristics of super-utilizers and interventions to reduce avoidable use of health care among this population. The method used for this research is a comprehensive literature review. Search …

Sé Un Héroe Tú También, Samantha S. Rohe, Sophie Cemaj

Books: Pediatrics

This children's book explains COVID-19 and how to decrease the incidence of transmissions.

Hepatitis B Seroprevalence In The U.S. Military And Its Impact On Potential Screening Strategies, Paul T. Scott, Robert L. Cohen, David Brett-Major, Shilpa Hakre, Jennifer A. Malia, Jason F. Okulicz, Charmagne G. Beckett, Jason M. Blaylock, Michael A. Forgione, Stephen A. Harrison, Clinton K. Murray, Francisco J. Rentas, Roland L. Fahie, Adam W. Armstrong, Aatif M. Hayat, Laura A. Pacha, Peter Dawson, Beth Blackwell, Angelia A. Eick-Cost, Hala H. Maktabi, Nelson L. Michael, Linda L. Jagodzinski, Steven B. Cersovsky, Sheila A. Peel

Journal Articles: Epidemiology

INTRODUCTION: Knowledge of the contemporary epidemiology of hepatitis B virus (HBV) infection among military personnel can inform potential Department of Defense (DoD) screening policy and infection and disease control strategies.

MATERIALS AND METHODS: HBV infection status at accession and following deployment was determined by evaluating reposed serum from 10,000 service members recently deployed to combat operations in Iraq and Afghanistan in the period from 2007 to 2010. A cost model was developed from the perspective of the Department of Defense for a program to integrate HBV infection screening of applicants for military service into the existing screening program of screening …

Evaluation Of The Therapeutic Efficacy Of Praziquantel Against Schistosomes In Seven Countries With Ongoing Large-Scale Deworming Programs, B. Levecke, J. Vlaminck, L. Andriamaro, S. Ame, V. Belizario, Abraham Degarege, D. Engels, B. Erko, A. D. Garba, G. M. Kaatano, Z. Mekonnen, A. Montresor, P. Olliaro, O. S. Pieri, M. Sacko, S. O. Sam-Wobo, L. A. Tchuem Tchuenté, J. P. Webster, J. Vercruysse

Journal Articles: Epidemiology

The World Health Organization (WHO) recommends periodic assessment of the therapeutic efficacy of praziquantel (PZQ) to detect reduced efficacy that may arise from drug resistance in schistosomes. In this multi-country study (2014), we assessed the therapeutic efficacy of a single oral dose of PZQ (40 mg/kg) against Schistosoma mansoni (Brazil, Cameroon, Ethiopia, Mali, Madagascar and Tanzania), S. haematobium (Cameroon, Ethiopia, Mali, Tanzania and Zanzibar) and S. japonicum (the Philippines) infections in school-aged children, across a total of 12 different trials. Each trial was performed according to the standardized methodology for evaluating PZQ efficacy as described by the WHO. Overall, therapeutic …

Dual Substance Use Of Electronic Cigarettes And Alcohol, Tanner J. Wetzel, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

Electronic cigarettes (ECs) are a modern nicotine delivery system that rapidly grew in widespread use, particularly in younger populations. Given the long history of the comorbidity of alcohol and nicotine use, the rising prevalence of ECs raises the question as to their role in the consumption of alcohol. Of the numerous models of ECs available, JUUL is the most popular. This narrative review aims to determine current trends in literature regarding the relationship between EC and alcohol dual use, as well as hypothesize potential pathogenic tissue damage and summarize areas for future study, including second-hand vapor exposure and calling for …

Thirty-Day Unplanned Readmission And Its Effect On 90-Day Mortality In Hepatocellular Carcinoma Patients Undergoing Partial Hepatectomy, Yongyue Qi, Tricia Levan, Gleb Haynatzki, Chandrakanth Are, Evi A. Farazi

Journal Articles: Epidemiology

Background: Despite advances of surgical techniques, hepatectomy continues to be potentially dangerous and is associated with postoperative mortality, morbidity and readmission. The objective of this study was to determine the effect of 30-day unplanned readmission on ‘conditional’ 90-day mortality among hepatocellular carcinoma (HCC) patients who underwent partial hepatectomy.

Methods: National Cancer Database (NCDB) was queried from 2004 to 2012 for patients with hepatocellular carcinoma (HCC) who underwent partial hepatectomy. Thirty-day unplanned readmission rate, and associated risk factors, was determined for 7,696 patients. The association between 30-day unplanned readmission and conditional 90-day mortality was further addressed.

Results: The 30-day unplanned readmission …

Structural Equation Modeling To Detect Correlates Of Childhood Vaccination: A Moderated Mediation Analysis, Abraham Degarege, Karl Krupp, Vijaya Srinivas, Boubakari Ibrahimou, Purnima Madhivanan

Journal Articles: Epidemiology

OBJECTIVES: This study used a health belief theory derived framework and structural equation model to examine moderators, mediators, and direct and indirect predictors of childhood vaccination.

METHODS: A secondary analysis was conducted using data collected from a cross-sectional survey of a random sample of 1599 parents living in urban and rural areas of Mysore district, India. Applying two-stage probability proportionate-to-size sampling, adolescent girls attending 7th through 10th grades in 23 schools were selected to take home a questionnaire to be answered by their parents to primarily assess HPV vaccine intentions. Parents were also asked whether their children had received one …

Parasitic Infections Represent A Significant Health Threat Among Recent Immigrants In Chicago, Jesica A. Herrick, Monica Nordstrom, Patrick M. Maloney, Miguel Rodriguez, Kevin Naceanceno, Gloria Gallo, Rojelio Mejia, Ron Hershow

Journal Articles: Epidemiology

Parasitic infections are likely under-recognized among immigrant populations in the USA. We conducted a cross-sectional study to evaluate if such infections have health impacts among recent immigrants in Chicago and to identify predictive factors for parasitic infections. A total of 133 recent immigrants were enrolled, filling out a standardized medical questionnaire and providing blood and stool samples. Appriximately 12% of subjects (15/125) who provided a blood or stool sample for testing were found to have evidence of current or prior infection with a pathogenic parasite, of which Toxocara spp. (8 subjects, 6.4%) and Strongyloides stercoralis (5 subjects, 4%) were most …

Aerosol And Surface Contamination Of Sars-Cov-2 Observed In Quarantine And Isolation Care, Joshua L. Santarpia, Danielle N. Rivera, Vicki L. Herrera, M. Jane Morwitzer, Hannah M. Creager, George W. Santarpia, Kevin K. Crown, David Brett-Major, Elizabeth R. Schnaubelt, M. Jana Broadhurst, James V. Lawler, St. Patrick Reid, John Lowe

Journal Articles: Epidemiology

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in Wuhan, China in late 2019, and its resulting coronavirus disease, COVID-19, was declared a pandemic by the World Health Organization on March 11, 2020. The rapid global spread of COVID-19 represents perhaps the most significant public health emergency in a century. As the pandemic progressed, a continued paucity of evidence on routes of SARS-CoV-2 transmission has resulted in shifting infection prevention and control guidelines between classically-defined airborne and droplet precautions. During the initial isolation of 13 individuals with COVID-19 at the University of Nebraska Medical Center, we collected air …

Real-Time Public Health Communication Of Local Sars-Cov-2 Genomic Epidemiology, Chaney C. Kalinich, Cole G. Jensen, Peter Neugebauer, Mary E. Petrone, Mario Peña-Hernández, Isabel M. Ott, Anne L. Wyllie, Tara Alpert, Chantal B. F. Vogels, Joseph R. Fauver, Nathan D. Grubaugh, Anderson F. Brito

Journal Articles: Epidemiology

Genomic epidemiology can provide a unique, real-time understanding of SARS-CoV-2 transmission patterns. Yet the potential for genomic analyses to guide local policy and community-based behavioral decisions is limited because they are often oriented towards specially trained scientists and conducted on a national or global scale. Here, we propose a new paradigm: Phylogenetic analyses performed on a local level (municipal, county, or state), with results communicated in a clear, timely, and actionable manner to strengthen public health responses. We believe that presenting results rapidly, and tailored to a non-expert audience, can serve as a template for effective public health response to …

Acute Encephalopathy With Elevated Csf Inflammatory Markers As The Initial Presentation Of Covid-19, Shelli Farhadian, Laura R. Glick, Chantal B. F. Vogels, Jared Thomas, Jennifer Chiarella, Arnau Casanovas-Massana, Jing Zhou, Camila Odio, Pavithra Vijayakumar, Bertie Geng, John Fournier, Santos Bermejo, Joseph R. Fauver, Tara Alpert, Anne L. Wyllie, Cynthia Turcotte, Matthew Steinle, Patrick Paczkowski, Charles Dela Cruz, Craig Wilen, Albert I. Ko, Sean Mackay, Nathan D. Grubaugh, Serena Spudich, Lydia Aoun Barakat

Journal Articles: Epidemiology

BACKGROUND: COVID-19 is caused by the severe acute respiratory syndrome virus SARS-CoV-2. It is widely recognized as a respiratory pathogen, but neurologic complications can be the presenting manifestation in a subset of infected patients.

CASE PRESENTATION: We describe a 78-year old immunocompromised woman who presented with altered mental status after witnessed seizure-like activity at home. She was found to have SARS-CoV-2 infection and associated neuroinflammation. In this case, we undertake the first detailed analysis of cerebrospinal fluid (CSF) cytokines during COVID-19 infection and find a unique pattern of inflammation in CSF, but no evidence of viral neuroinvasion.

CONCLUSION: Our findings …

Motor Vehicle Fatalities During Memorial Day Weekends, 1981-2016, Yuni Tang, Kendra Ratnapradipa, Henry Xiang, Motao Zhu

Journal Articles: Epidemiology

OBJECTIVE: Motor vehicle crashes are a leading cause of injury death in the United States, and Memorial Day weekend is one of six holiday periods with an increased number of motor vehicle fatalities in the United States. However, few motor vehicle fatality comparisons were made between Memorial Day weekend and non-holiday periods. Our aims were to determine which day(s) during the holiday had highest motor vehicle fatality risk compared to non-holiday travel and to identify potential risk factors.

RESULTS: Of 43,457 traffic fatalities studied, 15,292 (35%) occurred during the holiday, with Saturday being deadliest but Monday having highest odds of …

Increased Motor Vehicle Fatalities Tuesday Through Thursday During The Us Thanksgiving Holiday (1980-2018), Kendra Ratnapradipa, Motao Zhu

Journal Articles: Epidemiology

Traffic crashes remain a leading cause of death in the United States; holidays are known to have increased travel and traffic fatalities. Our purpose was to determine which days during Thanksgiving had the highest crash fatality risk compared to non-holiday periods. Using time series and binomial approximations, we analyzed Fatality Analysis Reporting System data (1980-2018) with a Monday-Sunday holiday and matching comparisons the weeks before and after. Fatalities included 31,263 during the holiday, 30,361 the previous week, and 29,399 the following week. Deadliest days during the holiday were Saturday (16.7% of fatalities) and Wednesday (16.0%), but odds of a traffic …

Advanced Preparation Makes Research In Emergencies And Isolation Care Possible: The Case Of Novel Coronavirus Disease (Covid-19), David Brett-Major, Elizabeth R. Schnaubelt, Hannah M. Creager, Abigail Lowe, Theodore J. Cieslak, Jacob M. Dahlke, Daniel W. Johnson, Paul D. Fey, Keith F. Hansen, Angela L. Hewlett, Bruce G. Gordon, Andre C. Kalil, Ali S. Khan, Mark G. Kortepeter, Christopher J. Kratochvil, Luann Larson, Deborah A. Levy, James Linder, Sharon J. Medcalf, Mark E. Rupp, Michelle M. Schwedhelm, James N. Sullivan Md, Angela M. Vasa, Michael C. Wadman, Rachel E. Lookadoo, John-Martin J. Lowe, James V. Lawler, M. Jana Broadhurst

Journal Articles: Epidemiology

The optimal time to initiate research on emergencies is before they occur. However, timely initiation of high-quality research may launch during an emergency under the right conditions. These include an appropriate context, clarity in scientific aims, preexisting resources, strong operational and research structures that are facile, and good governance. Here, Nebraskan rapid research efforts early during the 2020 coronavirus disease pandemic, while participating in the first use of U.S. federal quarantine in 50 years, are described from these aspects, as the global experience with this severe emerging infection grew apace. The experience has lessons in purpose, structure, function, and performance …

Diagnostic Accuracy Of Chest Computed Tomography Scans For Suspected Patients With Covid-19: Receiver Operating Characteristic Curve Analysis, Lianpin Wu, Qike Jin, Jie Chen, Jiawei He, David Brett-Major, Jianghu James Dong

Journal Articles: Epidemiology

BACKGROUND: Computed tomography (CT) scans are increasingly available in clinical care globally. They enable a rapid and detailed assessment of tissue and organ involvement in disease processes that are relevant to diagnosis and management, particularly in the context of the COVID-19 pandemic.

OBJECTIVE: The aim of this paper is to identify differences in the CT scan findings of patients who were COVID-19 positive (confirmed via nucleic acid testing) to patients who were confirmed COVID-19 negative.

METHODS: A retrospective cohort study was proposed to compare patient clinical characteristics and CT scan findings in suspected COVID-19 cases. A multivariable logistic model with …

The Impact Of Body Mass Index And Sociodemographic Factors On Moderate-To-Vigorous Physical Activity And Sedentary Behaviors Of Women With Young Children: A Cross-Sectional Examination, Danae M. Dinkel, Nicholas Hein, Kailey Snyder, Mohammad Siahpush, Shannon I. Maloney, Lynette M. Smith, Evi A. Farazi, Corrine K. Hanson

Journal Articles: Epidemiology

OBJECTIVES: Moderate-to-vigorous physical activity provides multiple benefits to women after childbirth. To achieve these benefits, the recommendation that adults obtain, 150 min of moderate-to-vigorous physical activity per week and reduce sedentary behaviors, also applies to women in the post-partum phase of the life span. However, research examining the moderate-to-vigorous physical activity and sedentary behaviors of women with young children (0-2 years) is limited. A greater understanding of these behaviors from a nationally representative sample is needed. Therefore, the primary objective of this study was to determine the levels of moderate-to-vigorous physical activity and sedentary behaviors of a nationally representative sample …

The Covid-19 Response In Nebraska: How Students Answered The Call, Sabrine Chengane, Anlan Cheney, Sierra Garth, Sharon J. Medcalf

Journal Articles: Epidemiology

The Student Response Team at the University of Nebraska Medical Center answered the statewide call to assist local health departments during the coronavirus disease 2019 (COVID-19) pandemic. As a voluntary student-led effort, the SRT assisted health departments to conduct contact tracing, monitor social media, and educate the public. Their experience demonstrates how students can increase the public health surge capacity of local health departments while gaining applied experience during public health emergencies. This call-to-action commentary proposes that SRTs should be formed, trained, and deployed through academic institutions across the nation and the globe, during and beyond the current pandemic.

Colorectal Cancer Screening Uptake: Differences Between Rural And Urban Privately-Insured Population, Mesnad Alyabsi, Jane L. Meza, K. M. Monirul Islam, Amr Soliman, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

Earlier studies investigated rural-urban colorectal cancer (CRC) screening disparities among older adults or used surveys. The objective was to compare screening uptake between rural and urban individuals 50-64 years of age using private health insurance. Data were analyzed from 58,774 Blue Cross Blue Shield of Nebraska beneficiaries. Logistic regression was used to assess the association between rural-urban and CRC screening use. Results indicate that rural individuals were 56% more likely to use the Fecal Occult Blood Test (FOBT) compared with urban residents, but rural females were 68% less likely to use FOBT. Individuals with few Primary Care Physician (PCP) visits …

Identification And Evaluation Of Epidemic Prediction And Forecasting Reporting Guidelines: A Systematic Review And A Call For Action, Simon Pollett, Michael Johansson, Matthew Biggerstaff, Lindsay C. Morton, Sara L. Bazaco, David Brett-Major, Anna M. Stewart-Ibarra, Julie A. Pavlin, Suzanne Mate, Rachel Sippy, Laurie J. Hartman, Nicholas G. Reich, Irina Maljkovic Berry, Jean-Paul Chretien, Benjamin M. Althouse, Diane Myer, Cecile Viboud, Caitlin Rivers

Journal Articles: Epidemiology

INTRODUCTION: High quality epidemic forecasting and prediction are critical to support response to local, regional and global infectious disease threats. Other fields of biomedical research use consensus reporting guidelines to ensure standardization and quality of research practice among researchers, and to provide a framework for end-users to interpret the validity of study results. The purpose of this study was to determine whether guidelines exist specifically for epidemic forecast and prediction publications.

METHODS: We undertook a formal systematic review to identify and evaluate any published infectious disease epidemic forecasting and prediction reporting guidelines. This review leveraged a team of 18 investigators …

Reduction Of Polyunsaturated Fatty Acids With Tumor Progression In A Lean Non-Alcoholic Steatohepatitis-Associated Hepatocellular Carcinoma Mouse Model, Elizabeth M. Vlock, Shilpa Karanjit, G. Talmon, Evi A. Farazi

Journal Articles: Epidemiology

Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries. While obesity and diabetes are the hallmarks of NAFLD, it also develops in lean individuals in the absence of metabolic syndrome, with a prevalence of 7 percent in the U.S. and 25-30 percent in some Asian countries. NAFLD represents the spectrum of liver disease, starting with excess liver fat accumulation (NAFL) that can progress to nonalcoholic steatohepatitis (NASH), cirrhosis and ultimately hepatocellular carcinoma (HCC). To date, the pathogenesis of lean NASH-HCC is poorly understood and a mouse model is lacking. We aimed …

Mitigating A Covid-19 Outbreak Among Major League Baseball Players - United States, 2020, Meghan T. Murray, Margaret A. Riggs, David M. Engelthaler, Caroline Johnson, Sharon Watkins, Allison Longenberger, David Brett-Major, John Lowe, M. Jana Broadhurst, Chandresh N. Ladva, Julie M. Villanueva, Adam Macneil, Shoukat Qari, Hannah L. Kirking, Michael Cherry, Ali S. Khan

Journal Articles: Epidemiology

Mass gatherings have been implicated in higher rates of transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), and many sporting events have been restricted or canceled to limit disease spread (1). Based on current CDC COVID-19 mitigation recommendations related to events and gatherings (2), Major League Baseball (MLB) developed new health and safety protocols before the July 24 start of the 2020 season. In addition, MLB made the decision that games would be played without spectators. Before a three-game series between teams A and B, the Philadelphia Department of Public Health was notified of a team A …

Deployment And Travel Medicine Knowledge, Attitudes, Practices, And Outcomes Study (Kapos): Malaria Chemoprophylaxis Prescription Patterns In The Military Health System, Patrick W. Hickey, Indrani Mitra, Jamie Fraser, David Brett-Major, Mark S. Riddle, David R. Tribble

Journal Articles: Epidemiology

The Deployment and Travel Medicine Knowledge, Attitudes, Practices, and Outcomes Study (KAPOS) examines the integrated relationship between provider and patient inputs and health outcomes associated with travel and deployments. This study describes malaria chemoprophylaxis prescribing patterns by medical providers within the U.S. Department of Defense's Military Health System and its network of civilian healthcare providers during a 5-year period. Chemoprophylaxis varied by practice setting, beneficiary status, and providers' travel medicine expertise. Whereas both civilian and military facilities prescribe an increasing proportion of atovaquone-proguanil, doxycycline remains the most prevalent antimalarial at military facility based practices. Civilian providers dispense higher rates of …