Community Health and Preventive Medicine Commons^™

Prevalence, Age Profile, And Associated Risk Factors For Hymenolepis Nana Infection In A Large Population-Based Study In Northern Peru, Percy M. Vilchez Barreto, Ricardo Gamboa, Saul Santivañez, Seth E. O'Neal, Claudio Muro, Andrés G. Lescano, Luz M. Moyano, Guillermo Gonzálvez, Hector H. García

OHSU-PSU School of Public Health Faculty Publications and Presentations

Hymenolepis nana, the dwarf tapeworm, is a common intestinal infection of children worldwide. We evaluated infection and risk factor data that were previously collected from 14,761 children aged 2-15 years during a large-scale program in northern Peru. We found that 1,124 of 14,761 children (7.61%) had H. nana infection, a likely underestimate given that only a single stool sample was examined by microscopy for diagnosis. The strongest association with infection was lack of adequate water (adjusted prevalence ratio [aPR] 2.22, 95% confidence interval [CI] 1.82-2.48) and sanitation infrastructure in the house (aPR 1.94, 95% CI 1.64-2.29). One quarter of …

Brief Report: Medication Sharing Is Rare Among African Hiv-1 Serodiscordant Couples Enrolled In An Efficacy Trial Of Oral Pre-Exposure Prophylaxis (Prep) For Hiv-1 Prevention, Kerry A. Thomson, Jessica Haberer, Mark A. Marzinke, Andrew Mujugira, Craig Hendrix, Connie Celum, Patrick Ndase, Alan Ronald, David Bangsberg, Jared Baeten

OHSU-PSU School of Public Health Faculty Publications and Presentations

Sharing of pre-exposure prophylaxis (PrEP) medications is a concern for PrEP implementation. For HIV-1 serodiscordant couples, sharing may undermine the HIV-1 prevention benefit and also cause antiretroviral resistance if taken by HIV-1 infected partners. Within a PrEP efficacy trial among HIV-1 serodiscordant couples, we assessed the occurrence of PrEP sharing by self-report and plasma tenofovir concentrations in HIV-1 infected partners. PrEP sharing was self-reported at < 0.01% of visits, and 0% -1.6% of randomly selected and 0% of purposively selected specimens from HIV-1 infected participants had detectable tenofovir concentrations (median: 66.5 ng/mL, range: 1.3-292 ng/mL). PrEP sharing within HIV-1 serodiscordant couples was extremely rare.

Association Of Depressive Symptomology And Psychological Trauma With Diabetes Control Among Older American Indian Women: Does Social Support Matter?, R. Turner Goins, Carolyn Noonan, Kelly Gonzales, Blythe Winchester, Vickie L. Bradley

OHSU-PSU School of Public Health Faculty Publications and Presentations

Aims—Among older American Indian women with type 2 diabetes (T2DM), we examined the association between mental health and T2DM control and if social support modifies the association.

Methods—Survey data were linked to T2DM medical record information. Mental health measures were the Center for Epidemiologic Studies – Depression Scale and the National Anxiety Disorders Screening Day instrument. T2DM control was all HbA1c values taken post mental health measures.

Results—There was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support. There was a significant association …

Civic Engagement Among Orphans And Non-Orphans In Five Low- And Middle-Income Countries, Christine L. Gray, Brian W. Pence, Lynne C. Messer, Jan Ostermann, Rachel A. Whetten, Nathan M. Thielman, Karen O'Donnell, Kathryn Whetten

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Communities and nations seeking to foster social responsibility in their youth are interested in understanding factors that predict and promote youth involvement in public activities. Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in resource-poor settings. Understanding whether and how OSC are engaged in civic activities is important for community and world leaders who need to provide care for OSC and ensure their involvement in sustainable development.

Methods: The Positive Outcomes for Orphans study (POFO) is a multi-country, longitudinal cohort study of OSC randomly sampled from institution-based care and from family-based care, and …

Elimination Of Taenia Solium Transmission In Northern Peru, Hector H. Garcia, Armando E. Gonzalez, Victor C.W. Tsang, Seth E. O'Neal, Fernando Llanos‑Zavalaga, Guillermo Gonzalvez, Jaime Romero, Silvia Rodriguez, Luz M. Moyano, Viterbo Ayvar, Andre Diaz, Allen Hightower, Philip S. Craig, Marshall W. Lightowlers, Charles G. Gauci, Elli Leontsini, Robert H. Gilman

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Taeniasis and cysticercosis are major causes of seizures and epilepsy. Infection by the causative parasite Taenia solium requires transmission between humans and pigs. The disease is considered to be eradicable, but data on attempts at regional elimination are lacking. We conducted a three-phase control program in Tumbes, Peru, to determine whether regional elimination would be feasible.

Methods: We systematically tested and compared elimination strategies to show the feasibility of interrupting the transmission of T. solium infection in a region of highly endemic disease in Peru. In phase 1, we assessed the effectiveness and feasibility of six intervention …

Reasons For Missing Antiretroviral Therapy: Results From A Multi-Country Study In Tanzania, Uganda, And Zambia, Olivier Koole, Julie A. Denison, Joris Menten, Sharon Tsui, Fred Wabwire-Mangen, Gideon Kwesigabo, Modest Mulenga, Andrew F. Auld, Simon G. Agolory, Ya Diul Mukadi, Eric Van Praag, Kwasi Torpey, Seymour Williams, Jonathan Kaplan, Aaron Zee, David Bangsberg, Robert Colebunders

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives To identify the reasons patients miss taking their antiretroviral therapy (ART) and the proportion who miss their ART because of symptoms; and to explore the association between symptoms and incomplete adherence.

Methods Secondary analysis of data collected during a cross-sectional study that examined ART adherence among adults from 18 purposefully selected sites in Tanzania, Uganda, and Zambia. We interviewed 250 systematically selected patients per facility (≥18 years) on reasons for missing ART and symptoms they had experienced (using the HIV Symptom Index). We abstracted clinical data from the patients’ medical, pharmacy, and laboratory records. Incomplete adherence was defined as …

Sociocultural And Structural Factors Contributing To Delays In Treatment For Children With Severe Malaria: A Qualitative Study In Southwestern Uganda, Radhika Sundararajan, Juliet Mwanga-Amumpaire, Harriet Adrama, Jackline Tumuhairwe, Sheilla Mbabazi, Kenneth Mworozi, Ryan W. Carroll, David Bangsberg, Yap Boum Ii, Norma C. Ware

OHSU-PSU School of Public Health Faculty Publications and Presentations

Malaria is a leading cause of pediatric mortality, and Uganda has among the highest incidences in the world. Increased morbidity and mortality are associated with delays to care. This qualitative study sought to characterize barriers to prompt allopathic care for children hospitalized with severe malaria in the endemic region of southwestern Uganda. Minimally structured, qualitative interviews were conducted with guardians of children admitted to a regional hospital with severe malaria. Using an inductive and content analytic approach, transcripts were analyzed to identify and define categories that explain delayed care. These categories represented two broad themes: sociocultural and structural factors. Sociocultural …