Clinical Epidemiology Commons^™

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305) had …

Geodemographic Features Of Human Blastomycosis In Eastern Wisconsin, Megan E. Huber, Dennis J. Baumgardner, Jessica J. F. Kram, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Blastomycosis is an endemic fungal infection. In rural northern Wisconsin, blastomycosis cases are associated with certain environmental features including close proximity to waterways. Other studies have associated blastomycosis with particular soil chemicals. However, blastomycosis also occurs in urban and suburban regions. We explored the geodemographic associations of blastomycosis cases in the more urban/suburban landscape of eastern Wisconsin.

Methods

We conducted a retrospective study of 193 laboratory-identified blastomycosis cases in a single eastern Wisconsin health system, 2007–2015. Controls were 250 randomly selected cases of community-diagnosed pneumonia from a similar time period. Geographic features of home addresses were explored using Google …

Expression Of Complement And Toll-Like Receptor Pathway Genes Is Associated With Malaria Severity In Mali: A Pilot Case Control Study, Rafal S. Sobota, Antoine Dara, Jessica E. Manning, Amadou Niangaly

Dartmouth Scholarship

Background: The host response to infection by Plasmodium falciparum, the parasite most often responsible for severe malaria, ranges from asymptomatic parasitaemia to death. The clinical trajectory of malaria is influenced by host genetics and parasite load, but the factors determining why some infections produce uncomplicated malaria and some proceed to severe disease remain incompletely understood.

Methods: To identify molecular markers of severe falciparum malaria, human gene expression patterns were compared between children aged 6 months to 5 years with severe and uncomplicated malaria who were enrolled in a case–control study in Bandiagara, Mali. Microarrays were used to obtain expression …

A Model For Hiv Disclosure Of A Parent's And/Or A Child's Illness, Gary J. Burkholder Jr, Grace Gachanja

Walden Faculty and Staff Publications

HIV prevalence in Kenya remains steady at 5.6% for adults 15 years and older, and 0.9% among children aged below 14 years. Parents and children are known to practice unprotected sex, which has implications for continued HIV spread within the country. Additionally, due to increased accessibility of antiretroviral therapy, more HIV-positive persons are living longer. Therefore, the need for HIV disclosure of a parent's and/or a child's HIV status within the country will continue for years to come. We conducted a qualitative phenomenological study to understand the entire process of disclosure from the time of initial HIV diagnosis of an …

Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal

Journal of Patient-Centered Research and Reviews

Purpose

Kidney transplantation remains the best treatment option for end-stage renal disease. However, despite overall improvements in patient and graft survival rates after kidney transplantation, differences in outcomes still exist among different racial and ethnic groups, with African-Americans having lower graft survival. Gaps continue to exist in the understanding of how demographic factors contribute to the varying outcomes among racial/ethnic groups.

Methods

We retrospectively evaluated kidney transplant outcomes in four racial/ethnic groups over a 12-year period at a large tertiary care center. Primary and secondary study outcomes were patient and graft survival across groups. To determine factors that might predict …

Models For Hsv Shedding Must Account For Two Levels Of Overdispersion, Amalia Magaret

UW Biostatistics Working Paper Series

We have frequently implemented crossover studies to evaluate new therapeutic interventions for genital herpes simplex virus infection. The outcome measured to assess the efficacy of interventions on herpes disease severity is the viral shedding rate, defined as the frequency of detection of HSV on the genital skin and mucosa. We performed a simulation study to ascertain whether our standard model, which we have used previously, was appropriately considering all the necessary features of the shedding data to provide correct inference. We simulated shedding data under our standard, validated assumptions and assessed the ability of 5 different models to reproduce the …

A Combination Sms And Transportation Reimbursement Intervention To Improve Hiv Care Following Abnormal Cd4 Test Results In Rural Uganda: A Prospective Observational Cohort Study, Mark J. Siedner, Data Santorino, Alexander J. Lankowski, Michael Kanyesigye, Mwebesa B. Bwana, Jessica E. Haberer, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Up to 50 % of HIV-infected persons in sub-Saharan Africa are lost from care between HIV diagnosis and antiretroviral therapy (ART) initiation. Structural barriers, including cost of transportation to clinic and poor communication systems, are major contributors.

Methods: We conducted a prospective, pragmatic, before-and-after clinical trial to evaluate a combination mobile health and transportation reimbursement intervention to improve care at a publicly operated HIV clinic in Uganda. Patients undergoing CD4 count testing were enrolled, and clinicians selected a result threshold that would prompt early return for ART initiation or further care. Participants enrolled in the pre-intervention period (January – …

Know Your Status: Alleviating Stigma From The Hiv Positive Community Of San Luis Obispo California, Mario Alberto Viveros Espinoza

Ethnic Studies

The purpose of this project is to alleviate stigma from the HIV community in San Luis Obispo, CA by creating an outreach program, “Know Your Status,” that raises awareness of HIV education and prevention. Research on HIV stigma and on ideologies for program development and implementation shows that HIV positive individuals face both internalized and externalized stigma. Program development and implementation can be effective by assessing and addressing the specific needs of those living within the community. This project includes the data needed for program development and implementation, collected through anonymous surveys from HIV positive community members, interviews with professionals …

Ebola Scare And Measles Resurgence: Mandatory Isolation/Quarantine And Vaccination, Mark C. Aita Md, Takeem T. Ragland Ma

Journal of Health Ethics

Public outcry for radical isolation and quarantine policies followed the first Ebola diagnosis in the United States when Eric Duncan, upon his return home Oct 2014 from West Africa, then in the midst of a catastrophic Ebola epidemic, tested positive for Ebola. Likewise, the Dec 2014 Disneyland measles outbreak unleashed an angry backlash against parents who refused to have their children vaccinated; and there was public momentum to repeal all legal exemptions to mandatory vaccination of school children. This paper presents an ethical and legal analysis to adjudicate the issue which is at stake in both controversies; namely the inherent …

Genetic Predictors Of Metabolic Side Effects Of Diuretic Therapy, Jorge L. Del Aguila

Dissertations and Theses (Open Access)

Thiazide diuretics are a recommended first-line monotherapy for hypertension (i.e.SBP>140 mmHg or DBP>90 mmHg). Even so, diuretics are associated with adverse metabolic side effects, such as hyperlipidemia, hyperglycemia and hypokalemia which increase the risk of developing type II diabetes. This thesis used three analytical strategies to identify and quantify genetic factors that contribute to the development of adverse metabolic effects due to thiazide diuretic treatment. I performed a genome-wide association study (GWAS) and meta-analysis of the change in fasting plasma glucose and triglycerides in response to HCTZ from two different clinical trials: the Pharmacogenomic Evaluation of Antihypertensive Responses …

Investigating The Viability Of Two Stenotrophomonas Maltophilia Isolates After Air-Drying, Samantha Lane, Joanna Brooke

DePaul Discoveries

Abstract

Stenotrophomonas maltophilia is a water-borne infectious bacterium that is found in both clinical (hospitals) and non-clinical environments. This human pathogen is commonly recovered from respiratory tract infections. A recent study at a hospital in Taiwan suggested that dry patient charts can serve as a vehicle of transmission of this bacterium⁷. As S. maltophilia is not commonly isolated from dry surfaces, this current study tested the hypothesis that this pathogen can remain viable for some time on a dry surface. This study was designed to determine how long S. maltophilia could remain viable after air-drying by observing …

Computational Model For Survey And Trend Analysis Of Patients With Endometriosis : A Decision Aid Tool For Ebm, Salvo Reina, Vito Reina, Franco Ameglio, Mauro Costa, Alessandro Fasciani

COBRA Preprint Series

Endometriosis is increasingly collecting worldwide attention due to its medical complexity and social impact. The European community has identified this as a “social disease”. A large amount of information comes from scientists, yet several aspects of this pathology and staging criteria need to be clearly defined on a suitable number of individuals. In fact, available studies on endometriosis are not easily comparable due to a lack of standardized criteria to collect patients’ informations and scarce definitions of symptoms. Currently, only retrospective surgical stadiation is used to measure pathology intensity, while the Evidence Based Medicine (EBM) requires shareable methods and correct …

Using Quantitative Disease Dynamics As A Tool For Guiding Response To Avian Influenza In Poultry In The United States Of America, K. M. Pepin, E. Spackman, J. D. Brown, K. L. Pabilonia, Lindsey P. Garber, J. Todd Weaver, D. A. Kennedy, Kelly A. Patyk, K. P. Huyvaert, Ryan S. Miller, Alan B. Franklin, Kerri Pedersen, T. L. Bogich, P. Rohani, Susan A. Shriner, Colleen T. Webb, S. Riley

United States Department of Agriculture Wildlife Services: Staff Publications

Wild birds are the primary source of genetic diversity for influenza A viruses that eventually emerge in poultry and humans. Much progress has been made in the descriptive ecology of avian influenza viruses (AIVs), but contributions are less evident from quantitative studies (e.g., those including disease dynamic models). Transmission between host species, individuals and flocks has not been measured with sufficient accuracy to allow robust quantitative evaluation of alternate control protocols. We focused on the United States of America (USA) as a case study for determining the state of our quantitative knowledge of potential AIV emergence processes from wild hosts …

Associations Between Alcohol Consumption And Fasting Blood Glucose In Young Adults, Julie Ann Lucca

Master's Theses

Current research shows moderate alcohol consumption is associated with decreased risk of diabetes and excessive consumption or binge drinking can cause insulin resistance and diabetes. In 2010, diabetes was the seventh leading cause of death in the United Statesand was responsible for significant health complications: blindness, kidney failure, and limb amputations, and is a large national economic burden. Fasting blood glucose (FBG) is a tool used to help diagnose diabetes. Abnormally high FBG, ≥100 mg/dl, is indicative of diabetes and pre-diabetes. Few studies have observed diabetic prevalence among young adults or college students. Studying young adults can help provide added …

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

Comparing Risk Factors Of Hiv Among Hijra Sex Workers In Larkana And Other Cities Of Pakistan: An Analytical Cross Sectional Study, Arshad Altaf, Aysha Zahidie, Ajmal Agha

Community Health Sciences

Background

In 2005, Pakistan was first labeled as a country with concentrated epidemic of Human Immunodeficiency Virus (HIV). This was revealed through second generation surveillance conducted by HIV/AIDS Surveillance Project (HASP). While injection drug users (IDUs) were driving the epidemic, subsequent surveys showed that Hijra (transgender) sex workers (HSWs) were emerging as the second most vulnerable group with an average national prevalence of 6.4%. An exceptionally high prevalence (27.6%) was found in Larkana, which is a small town on the right bank of river Indus near the ruins of Mohenjo-Daro in the province of Sindh. This paper presents the risk …

Race And Hepatitis C Management Within The Veterans Administration, Joahd Toure, Joshua Metlay, Sandford Schwartz, Knashawn Morales, David Kaplan, Peter Groeneveld

Journal of Health Disparities Research and Practice

Objective: To examine black-white differences in hepatitis C treatment within the Veterans Administration (VA) and determine whether racial variation in specialty consultation explains differences in hepatitis C treatment between blacks and whites.

Methods: We performed a retrospective cohort study of 1040 veterans meeting VA eligibility criteria for hepatitis C treatment. We used multiple imputation to handle missing race data. Specialty consultation was determined from the VA outpatient medical dataset and hepatitis C treatment was determined from the VA decision support system. Conditional logistic regression was used to examine the association between race and hepatitis C treatment as well as race …

Prevention Of Mother-To-Child Transmission (Pmtct) Of Hiv In The Sub-Saharan Africa Region With A Focus On Uganda, Emily K. Franks

Senior Honors Theses

With the rise of the HIV/AIDS epidemic in the past thirty years, people of all ages, infants to elderly alike, all over the world, suffer from its adverse effects. Even an unborn baby in-utero can contract this virulent infection by means of mother-to-child transmission (MTCT) (Sweeney, 2005). Infants and children diseased in this way comprise 90% of the estimated 800,000 new cases of HIV in children seen each year, but the region hit hardest, however, is Sub-Saharan Africa, with the country of Uganda historically having the highest incident rate for a time (Stringer, E.M., et al. 2008). Therefore, the purpose …

Health Communication Theories: Implications For Hiv Reporting In Asia And The Pacific, Trevor Cullen

Research outputs pre 2011

This paper focuses on the expanding HIV (Human Immunodeficiency Virus) epidemic in parts of Asia and the Pacific region and recommends the adoption of insights from particular health communication theories. The author argues that these paradigms can assist in broadening the current scope and content of HIV reporting. One theory in particular - Social Change Communication (SCC) - challenges the media to extend the framing of HIV from primarily a health story to one that is linked to more macro socio-economic, cultural and political factors. Asian and Pacific countries that have an emerging or expanding HIV epidemic need to realise …

Calibrating Parametric Subject-Specific Risk Estimation, Tianxi Cai, Lu Tian, Hajime Uno, Scott D. Solomon, L. J. Wei

Harvard University Biostatistics Working Paper Series

No abstract provided.

Evaluating Subject-Level Incremental Values Of New Markers For Risk Classification Rule, Tianxi Cai, Lu Tian, Donald M. Lloyd-Jones, L. J. Wei

Harvard University Biostatistics Working Paper Series

No abstract provided.

Is The Number Of Sick Persons In A Cohort Constant Over Time?, Paula Diehr, Ann Derleth, Anne Newman, Liming Cai

UW Biostatistics Working Paper Series

Objectives: To estimate the number of persons in a cohort who are sick, over time.

Methods: We calculated the number of sick persons in the Cardiovascular Health Study (CHS), a cohort study of older adults followed up to 14 years, using eight definitions of “healthy” and “sick”. We projected the number in each health state over time for a birth cohort.

Results: The number of sick persons in CHS was approximately constant for 14 years, for all definitions of “sick”. The estimated number of sick persons in the birth cohort was approximately constant from ages 55-75, after which it decreased. …

Ukimwi : Hiv/Aids In Kenya, Virginia Wangui Gathua

Graduate Research Papers

This manuscript points out the deficiencies school counseling programs in Kenya for children/adolescents affected/infected by HIV/AIDS. In addition, the paper is intended to inform, guide, and encourage policy makers, program developers, and school counselors as they develop school counseling interventions for the disease. The focus of the paper is limited to children/adolescents because they bear the greatest burden of HIV/ AIDS infections. The paper also provides evidence for planning and implementation of culturally and developmentally relevant, school-based counseling interventions. The paper explores the impact of HIV/AIDS on Kenyan children/adolescents infected/affected by HIV/AIDS and points out the factors that hinder prevention …

Trends. Controlling Aids Through Control, Ibpp Editor

International Bulletin of Political Psychology

This article discusses the concept of political control and public health in the context of the HIV/AIDS epidemic.

The Association Of Fluid Intake With Total Natural-Cause Mortality, Coronary Heart Disease And Fatal Stroke, Jacqueline Chung Lun Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Hypohydration may be more widespread than realized since it does not always arouse a sense of thirst. When thirst is felt, it is often ignored, or satisfied before euhydration is achieved. There is growing evidence indicating that hypohydration contributes to acute and chronic illnesses, and to rheological factors associated with coronary heart disease (CHD) and stroke. Therefore the relationship of fluid intake with risk of total natural-cause mortality, CHD and stroke death was examined using data on 34,192 white, non-Hispanic participants in the Adventist Health Study.

Among the 27,342 reporting no CHD, stroke or diabetes at baseline, during six years …