Public Health Commons^™

Clinical Characteristics And Outcomes Of Patients With Idiopathic Intracranial Hypertension In East Africa: A Retrospective Cross-Sectional Study, Zian Muikamba

Master of Internal Medicine

Introduction; Idiopathic intracranial hypertension (IIH) is a neurological condition characterized by elevated intracranial cerebrospinal fluid (CSF) pressure without demonstratable evident causes. The mechanisms leading to a particular predilection for women of childbearing age who are overweight and obese or who have recent rapid weight changes remain imprecisely described. The Modified Dandy criteria is used for diagnosis and includes-clinical symptoms, papilledema, lumbar puncture (LP) opening pressure, and neuroimaging. If undiagnosed, it can progress to disabling irreversible visual loss. Weight loss is useful in addition to medical therapy in treating the condition. Data in Sub-Saharan Africa is scarce.

Methods; This study described …

Knowledge And Perception Of Hand Hygiene And Associated Factors Among Final Year Medical And Nursing Students In Dar Es Salaam Tanzania, Anthony Baltazary Ngowi

Master of Obstetrics and Gynecology

Hand hygiene, when practiced correctly and consistently is a simple and effective

method to prevent healthcare associated infections. These infections are acquired during a patients’ hospital stay and pose a major worldwide public health problem. The knowledge and practices related to hand hygiene among health workers need to be instilled early on during their training to develop a culture of correct and consistent practice. Existing literature has explored hand hygiene among health workers but very few studies have looked at it amongst medical and nursing students, who are the healthcare workers of tomorrow. This study aimed to assess hand hygiene …

Challenges In Post Graduate General Surgery Training In Tanzania: A Trainee’S Perspective, Shabbir Adamjee

Master of Surgery

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General Surgery residency training is a complex vigorous program which includes long working hours and complex surgical cases, in order to develop and attain the knowledge and the skills the trainee needs by the end of the program. Worldwide, general surgery programs have high attrition rates and residents have identified challenges which may be work related, related to social wellbeing and/or the residency program structure. Tanzania has public and private institutions providing general surgery residency training and although most have a quality assessment program the data is not readily available. Each institution has its personalized curriculum with its unique …

Microbial Profile And Antimicrobial Resistance Patterns Of Surgical Intra-Abdominal Infections At A Tertiary Hospital In Tanzania A Retrospective Cross-Sectional Study, Abduel Julius Kitua

Master of Surgery

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Among infections of surgical importance, intra-abdominal infections prevail among the most common in surgical patients with considerable morbidity and mortality. The ever-rising microbial resistance to commonly available antibiotics and geographical variations in microbial profile and resistance patterns poses a challenge to the management of these surgical infections of abdominal origin. The aim of this study was to evaluate microbiological characteristics and antibiotic susceptibility of isolates from intra-abdominal infections at a tertiary hospital in Tanzania and how these influence early treatment outcomes.

Factors Associated With Antiretroviral Drug Resistance Mutations Among Plhiv Failing To Achieve Virological Suppression On Second Line Treatment In Tanzania., Mabula M. Mabelele

Master of Internal Medicine

v> Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major public health problem affecting an estimated 38.4 million people globally, with the (54%) of them being from the Eastern and Southern African regions. Despite progress in the availability of multiple classes of antiretroviral drugs and early initiation of treatment with cART, many patients still fail therapy in the first and second-line regimens due to drug resistance driven by continuous acquisition of drug resistance mutation (DRMs). DRMs are high among adults failing treatment regimens, ranging between 50-97%.

Heartsmart: App-Based Implementation For Women With Cardiovascular Diseases, Briana Alfaro-Funes, Camilo Peña, Chelsea Vasquez, Folasade Jackson, Nicholas Williams

DC Health and Academic Prep Program (DC HAPP)

Cardiovascular disease is the leading cause of death for women in the United States, at a rate of 1 in every 5 female deaths. In the United States about 35% of women have an illness related to CVD like hypertension, lack of physical , and high blood cholesterol level. Since 1984, the number of deaths of women caused by CVD has surpassed the number of deaths in men as women makeup 52.6% of the total number of deaths caused by CVD in the United States (Zhang, 2010). There are many factors like oral contraceptives and menopause that can put women …

Medications For Opioid Use Disorder & Implications For Mobile Methadone Units, Sarah Boeke, Samantha Singer, Stella Resko

Substance Use Research Team

Research has shown the urgent need for updates to guidelines regulating opioid treatment programs (OTPs), especially as the COVID-19 pandemic exacerbated overdose rates and the drug supply became increasingly contaminated with fentanyl, synthetic opioids, and xylazine (Moghtaderi et al., 2023)(DEA, 2022). Part 8 of Title 42 of the Code of Federal Regulations (CFR), originally enacted in 2001, includes regulations that guide OTPs. The 42 CFR Part 8 final rule, issued by SAMHSA, updates these federal regulations. It is the first major revision since 2001, aimed at expanding access to care, improving patient outcomes, and integrating lessons learned from the COVID-19 …

A Case Study In Program Evaluation, Alyssa Osborne

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

As a result of a Methicillin-Resistant Staphylococcus Aureus (MRSA) outbreak at a local high school, the Lexington Fayette County Health Department (LFCHD) has been tasked with developing a program to ensure timely reporting of actions taken in the event of a MRSA outbreak or disease outbreak of similar nature (1). This program evaluation is guided by the CDC’s 6-step program evaluation framework (2), which was used to inform this assessment.

Evaluation Of Public Radon Messaging In Kentucky As Compared To Three Other States, Abigail Knapp

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Radon poses a large health risk to those exposed to it, as it is an invisible, odorless, carcinogenic gas. Kentucky has high ambient levels of radon, but public awareness remains low as tobacco has been publicized as the main cause of lung cancer. As Kentucky has the highest incidence of lung and bronchial cancers in the United States, we aimed to examine the state’s health department radon page to see if it has sufficient information to warn residents about radon and provide resources. We reviewed the current Kentucky public messaging, radon rates, testing rates, and legislation compared to Ohio, Washington, …

Managing Stress: A Study Of Stress Response Mechanisms In Mycobacteria, Augusto C. Hunt Serracin

Biology Dissertations - Archive

Mycobacteria encompass many pathogenic species known to cause severe disease in humans. A well-known example is Mycobacterium tuberculosis (Mtb), the causative agent of the lung disease tuberculosis, which kills millions of humans worldwide yearly. Pathogenic mycobacteria like Mtb are challenging to treat because of their innate ability to adapt to environmental stress. Their unique cell physiology and conserved stress responses allow them to combat biological insults, regulate growth, and regulate genes involved in stress; all these responses increase tolerance to antibiotics. The current therapies to treat mycobacterial infections are lengthy and, at times, unsuccessful, partly due to antibiotic tolerance. A …

Acceptability And Feasibility Of Screening With A Pediatric Care Provider-Led Social Determinants Of Health Identification Tool, Alison Eyre, Janice Cohen, Sarah Funnell, Lynsey James, Sheena Guglani, Hounaida Abi Haidar, Lindy Samson, Michelle Ward, Radha Jetty, Megan Harrison, John Lyons Dr., Leigh Fraser-Roberts, Susan Bennet, Douglas Archibald, Soha Khorsand, Tobey Audcent

Health Management and Policy Faculty Publications

Background Complex social determinants of health may not be easily recognized by health care providers and pose a unique challenge in the vulnerable pediatric population where patients may not be able to advocate for themselves. The goal of this study was to examine the acceptability and feasibility of health care providers using an integrated brief pediatric screening tool in primary care and hospital settings.

Methods The framework of the Child and Adolescent Needs and Strengths (CANS) and Pediatric Intermed tools was used to inform the selection of items for the 9-item Child and Adolescent Needs and Strengths-Pediatric Complexity Indicator (CANS-PCI). …

Leveraging Local Knowledge To Contextualize The Opioid Epidemic Within Healing Communities Study Communities: A Photovoice Protocol, Peter Balvanz, Ramona G. Olvera, Margaret Louise Mcgladrey, Marisa Booty, Dacia Beard, Sylvia Ellison, Craig Mcclay, Monica Nouvong, Carrie B. Oser, Owusua Yamoah, Linda Sprague Martinez

Health Management and Policy Faculty Publications

Since its inception 30 years ago, Photovoice has gained increasing popularity as a research method and more recently has been incorporated within randomized controlled trial (RCT) designs. Photovoice is a participatory action research method that pairs photography with focus group discussions to record community strengths and concerns, build critical consciousness, and reach policymakers. Adherence of Photovoice implementation to these original tenets of Photovoice varies. This article provides the Photovoice protocol developed by the authors to improve the methodological rigor of Photovoice integration into RCTs and help contextualize the landscape for the HEALing Communities Study (HCS: NCT04111939), a greater than $350 …

Gestational Weight Gain And Epilepsy In The Offspring: A Population-Based Retrospective Cohort Study, Jiawen Chen

Public Health Theses

AbstractBackground and aims: Epilepsy is one of the most common neurologic disorders in childhood, but the etiology for the majority of the cases remains unknown. As a modifiable trait in pregnancy, gestational weight gain (GWG) has been shown to be a risk factor for multiple adverse birth outcomes. This study aims to investigate whether non-optimal GWG is associated with the risk of epilepsy in the offspring using a linked database in California. Methods: A population-based cohort study was conducted using the linked database from the Birth Certificate Record in California (2007-2015) for GWG, and the diagnostic records of epilepsy from …

Climate Change And Its Hidden Victims: A Review Of The Link Between Climate Change Impacts And Sexual And Gender-Based Violence In East Africa, Ezinwa Osuoha

Public Health Theses

Introduction: Climate change is having profound and disproportionate impacts on East Africa. Rising temperatures, unpredictable rainfall patterns, and prolonged droughts have become prevalent, leading to profound humanitarian challenges. The effects of climate change in East Africa span beyond those related to agriculture, food insecurity, and economic well-being. Sexual and gender-based violence (SGBV) is only proliferated in the climate change context. In the event of natural disasters, sexual and gender-based violence increases in tandem with the increase in vulnerability and instability in affected communities. Due to its myriad health consequences, SGBV requires the attention of public health professionals, policymakers, and those …

Ai-Aki: Ai-Consulted Inpatient Care For Acute Kidney Injury, William Jingyi Zhang

Public Health Theses

Acute kidney injury (AKI) increases the risk of death in hospitalized adults, and early medical chart review and involvement by a nephrologist may lead to improved patient outcomes. A Kidney Action Team—comprised of a pharmacist and a board-certified nephrologist or nephrology fellow—can serve as a remote consultation service to deliver recommendations for AKI patient diagnosis, initial work up, and care. We aimed to evaluate whether an AI-automated clinical decision support system for AKI could demonstrate predictive power comparable to that of human specialists, with regards to AKI evaluation and treatment. This study uses data from KAT-AKI (NCT04040296), a triple-masked, randomized …

Opportunities For Prep In High Risk Hiv Negative Patients, Steven Veselsky, Erin Smith, Amethyst Wilder, Misty Burkes, Nnamdi Ilouga, Jean B. Wiggins, Erik Shaw, William Hannah

South Atlantic Division GME Research Day 2024

No abstract provided.

Project Hydration: A Clean Drinking Water Solution For Washington, D.C., Djenaba Diallo, Matthew Liu, Miqueas Ramirez De La Rosa, Syieda Tomlinson, Zaniya Willson

DC Health and Academic Prep Program (DC HAPP)

Water pollution is a global issue that has been ongoing since 1800 (NOAA,2024). Water pollution occurs when harmful substances, mostly chemicals or microorganisms, contaminate a stream, river, lake, ocean, aquifer, or other body of water, creating harmful water quality and rendering it toxic to humans and the environment. D.C. has faced ongoing challenges with lead contamination in its drinking water. As of 2024, D.C. Water still has tens of thousands of lead service lines (D.C. Water, 2024). Lead is a poisonous metal in small amounts in the earth's crust. On May 8, 2024, D.C. issued a boil water advisory due …

Feasibility Assessment Of A Novel Isolation Care Tent In Uganda During The 2022, M. Jana Broadhurst, Rodgers R. Ayebare, David Brett-Major, Sean M. Carroll, Jacob Lacore, Alexander D. Laskey, James V. Lawler, Patricia Lord, Ruben M. Vazquez, Peter Waitt, Mohammed Lamorde

Journal Articles: Epidemiology

This case study describes a feasibility assessment of a novel isolation care tent used in health facilities in Uganda during the 2022 Sudan ebolavirus outbreak. The Isolation System for Treatment and Agile Response to High-Risk Infections Model 1B (ISTARI 1B) is a single-occupancy, portable, negative-pressure isolation tent designed for the safe delivery of standard care to patients with a communicable disease, including Ebola disease (Sudan). At the request of the Uganda Ministry of Health, the Makerere University Infectious Diseases Institute and University of Nebraska Medical Center partnered to evaluate 7 health facilities across 4 districts in Uganda for infrastructure, case …

Redesigning Surveillance Through The Global Emerging Infections Surveillance Program, David Brett-Major

Journal Articles: Epidemiology

No abstract provided.

N.U.R.T.U.R.E: Neutralizing Unsafe Risks Through Unique Responsive Environmental Care, Clara Durante, Easton Duppins, Feven Eskinder, Hiba Mohammed, Faith Niranoluwa

DC Health and Academic Prep Program (DC HAPP)

Environmental factors can be distinguished by physical, chemical, biological, behavioral, and socioeconomic categories. Each category has its own individual effect on human health. These environmental factors play a critical role in determining the health outcomes of pregnancies, influencing both maternal and fetal well-being. This project aims to empower pregnant women by providing comprehensive support and education on mitigating environmental risks. Environmental factors have a significant impact on pregnancy outcomes, specifically among women from lower socioeconomic status (SES) background. Low SES is linked with increased exposure to harmful environmental toxins, high stress levels, limited access to healthcare, which contribute to pregnancy …

Infographic: Equity Opportunities: Income: Need For Dental Care Among Third Grade Students In North Dakota, Shawnda Schroeder

Indigenous Health Faculty Publications

We have third grade students in North Dakota whose dental care needs are not being met. Programs, providers, and initiatives need to focus on providing equal access to preventive dental care supplies and educational resources to support good dental hygiene. Children attending schools where more than 50% of the students are eligible for the national school lunch program (NSLP) have a significantly higher need for early or urgent dental care and a higher rate of rampant decay compared to those attending schools with less than 50% of students eligible for the NSLP

Emergency Department And Dental Clinic Perceptions Of Appropriate, And Preventable, Use Of The Ed For Non-Traumatic Dental Conditions In Hot-Spot Counties: A Mixed Methods Study, Shawnda Schroeder, Judy Beck, Nick Medalen, Anastasia Stepanov

Indigenous Health Faculty Publications

Objectives:Frequency of emergency department (ED) use for nontraumatic dental conditions (NTDC) is a well-researched community health concern. However, research predominately relies on ambulatory ED discharge records. This explanatory sequential mixed methods study reviewed NTDC ED use in hot-spot counties and assessed perceptions around preventable and appropriate use among EDs and dental clinics.

Methods:Tooth pain data (2015-2021) were drawn from State Medicaid, and the Early Notification of Community-Based Epidemics (ESSENCE). NTDC data were compiled using International Classification of Disease, Ninth and Tenth Revisions. Employing extreme case sampling, providers in counties with the highest per-capita NTDC ED use were interviewed.

Results:North Dakota …

Infographic: Oral Health Of North Dakota’S Third Grade Students: Comparing To National Trends, Shawnda Schroeder

Indigenous Health Faculty Publications

No abstract provided.

Too Hot To Thrive: A Qualitative Inquiry Of Community Perspectives On The Effect Of High Ambient Temperature On Postpartum Women And Neonates In Kilifi, Kenya., Adelaide Lusambili, Sari Kovats, Britt Nakstad, Veronique Filippi, Peter Khaemba, Nathalie Roos, Cherie Part, Stanley Luchters, Matthew Chersich, Jeremy Hess

Institute for Human Development, East Africa

Objectives; To understand community perspectives on the effects of high ambient temperature on the health and wellbeing of neonates, and impacts on post-partum women and infant care in Kilifi.

Design; Qualitative study using key informant interviews, in-depth interviews and focus group discussions with pregnant and postpartum women (n = 22), mothers-in-law (n = 19), male spouses (n = 20), community health volunteers (CHVs) (n = 22) and stakeholders from health and government ministries (n = 16).

Settings; We conducted our research in Kilifi County in Kenya’s Coast Province. The area is largely rural and during …

Exploring The Willingness Toward Hiv Immediate Test And Treat Among Msm In Nairobi And Its Environs: A Cross-Sectional Study., Kingori Ndungu, Peter Gichanga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model.

Methods: This cross-sectional exploratory study targeted MSM (aged 18–60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was …

Caregiver Burden And Resilience In Family Members Of Alcohol Dependent Patients: Observations From Eastern India, Shatavisa Mukherjee, Nikhil Era, Siddhartha Roy

Digital Journal of Clinical Medicine

Background: Caregiver burden for alcohol dependent patients refers to the physical, emotional, financial, and social challenges faced by individuals who provide care and support to someone struggling with alcohol dependence. Caregivers often experience high levels of stress, anxiety, and emotional distress when dealing with a loved one's alcohol dependence. The present study tried to analyse the caregiver burden and resilience among family members of alcohol dependent individuals in eastern India.

Methods: A cross-sectional observational study patients attending general outpatient clinics who had positive alcohol consumption history and were being accompanied by their caregivers to the facility. Patient and caregiver’s demographics …

Evaluation Of The Role Of Prolactin To Prevent Diabetic Retinopathy, Suliman A. Suliman

Digital Journal of Clinical Medicine

Abstract:

Introduction: Diabetic retinopathy (DR) is a one of the long-term complications of DM and constitutes the leading cause of blindness in working-age individuals and affects a majority of diabetic patients by 20 years after disease onset.

Objective: The aim of this study it investigation of the potential role of prolactin in the prevention of Diabetic retinopathy.

Methods: The study was conducted on 90 diabetic patients who were divided into a group that included 37 patients without retinopathy and a group that included 27 patients with non-proliferative retinopathy and 26 patients with proliferative retinopathy who attended the Endocrinology clinic and …

The Crucial Role Of Community Medicine In Improving Public Health, Malik Maaz Ahmad, Imran Ahmed Khan, Neha Priyanka

Digital Journal of Clinical Medicine

Community medicine, also known as Social and Preventive Medicine, is a specialized field of medicine that focuses on promoting and protecting the health and well-being of communities and populations. Unlike other medical specialties that primarily focus on individual patients, community medicine takes a broader approach, addressing the health needs of entire populations. The specialty of community medicine plays a vital role in clinical practice and public health. Its focus on prevention, population health, and evidence-based medicine makes it an essential discipline in improving the health and well-being of communities. Community-based medical education is of vital relevance in the modern change …

Umbrella Review As A Data Collection Tool: Towards Observation, Analysis, And Empirical Transformation Of Qualitative Drivers Describing Healthcare Workforce Shortage Factors Into Quantitative Data To Support Medical Education Interventions In A Global Challenge., Fabio Galli, Marco Grech

Digital Journal of Clinical Medicine

A healthcare workforce shortage of 18 million is expected by 2030, against a global demand of 80 million, and it is difficult to analyse and monitor the real drivers driving this personnel shortage on a global level. The transformation of qualitative data into quantitative data can be a strategy in this global challenge, that can implement the medical education intervention strategies.

Atypical Immune Response: Acquired Hemolytic Anemia In A Non-Hodgkin Lymphoma Patient With Unusual Findings, Mannan Mangal

Digital Journal of Clinical Medicine

Acquired hemolytic anemia, caused by external factors like autoimmune disorders or infections, includes rare cases of Cold Agglutinin Syndrome (CAS), a cold-antibody-mediated condition affecting 1 in 1 million annually. This report highlights a unique case of CAS in a patient with Non-Hodgkin lymphoma and polyclonal gammopathy, contrasting with the typical presentation of warm-reactive autoantibodies and monoclonal antibodies. The patient presented with weakness, breathlessness, and splenomegaly, with laboratory findings showing a hemoglobin level of 5.8 g/dL and elevated ferritin. Imaging revealed mesenteric lymphadenopathy and thickening of the cecum, suggesting possible lymphomatous involvement. Non-Hodgkin lymphoma was confirmed via lymph node biopsy. This …