Epidemiology Commons^™

Determinants Of Uncontrolled Hypertension In Rural Communities In South Asia-Bangladesh, Pakistan, And Sri Lanka, Tazeen Jafar, Mihir Gandhi, Imtiaz Jehan, Aliya Naheed, H Asita De Silva, Hunaina Shahab, Dewan Alam, Nathasha Luke, Ching Wee Lim Wee Lim, Cobra-Bps Study Group

Community Health Sciences

Background: Uncontrolled blood pressure (BP) is a leading risk factor for death and disability in South Asia. We aimed to determine the cross-country variation, and the factors associated with uncontrolled BP among adults treated for hypertension in rural South Asia.
Methods: We enrolled 1718 individuals aged ≥40 years treated for hypertension in a cross-sectional study from rural communities in Bangladesh, Pakistan, and Sri Lanka. Multivariable logistic regression model was used to determine the factors associated with uncontrolledBP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg).
Results: Among hypertensive individuals, 58.0% (95% confidence interval 55.7, 60.4) had uncontrolled BP: 52.8% …

Hypermethylation Of Mir21 In Cd4+ T Cells From Patients With Relapsing-Remitting Multiple Sclerosis Associates With Lower Mirna-21 Levels And Concomitant Up-Regulation Of Its Target Genes, Sabrina Ruhrmann, Ewoud Ewing, Eliane Piket, Lara Kular, Julio Cesar Cetrulo Lorenzi, Sunjay Jude Fernandes, Hiromasa Morikawa, Shahin Aeinehband, Sergi Sayols-Baixeras, Stella Aslibekyan, Devin M. Absher, Donna K. Arnett, Jesper Tegner, David Gomez-Cabrero, Fredrik Piehl, Maja Jagodic

Epidemiology and Environmental Health Faculty Publications

Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system caused by genetic and environmental factors. DNA methylation, an epigenetic mechanism that controls genome activity, may provide a link between genetic and environmental risk factors.

Objective: We sought to identify DNA methylation changes in CD4+ T cells in patients with relapsing-remitting (RR-MS) and secondary-progressive (SP-MS) disease and healthy controls (HC).

Methods: We performed DNA methylation analysis in CD4+ T cells from RR-MS, SP-MS, and HC and associated identified changes with the nearby risk allele, smoking, age, and gene expression.

Results: We observed significant methylation differences in …

Improving Pregnancy Outcomes In Low- And Middle-Income Countries, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem

Community Health Sciences

This paper reviews the very large discrepancies in pregnancy outcomes between high, low and middle-income countries and then presents the medical causes of maternal mortality, stillbirth and neonatal mortality in low-and middle-income countries. Next, we explore the medical interventions that were associated with the very rapid and very large declines in maternal, fetal and neonatal mortality rates in the last eight decades in high-income countries. The medical interventions likely to achieve similar declines in pregnancy-related mortality in low-income countries are considered. Finally, the quality of providers and the data to be collected necessary to achieve these reductions are discussed. It …

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 …

Physical Activity Across The Lifespan And Liver Cancer Incidence In The Nih-Aarp Diet And Health Study Cohort., Hannah Arem, Erikka Loftfield, Pedro F Saint-Maurice, Neal D Freedman, Charles E Matthews

Epidemiology Faculty Publications

While liver cancer rates in the United States are increasing, 5-year survival is only 17.6%, underscoring the importance of prevention. Physical activity has been associated with lower risk of developing liver cancer, but most studies assess physical activity only at a single point in time, often in midlife. We utilized physical activity data from 296,661 men and women in the NIH-AARP Diet and Health Study cohort to test whether physical activity patterns over the life course could elucidate the importance of timing of physical activity on liver cancer risk. We used group modeling of longitudinal data to create physical activity …

Rural And Urban Injection Drug Use In Puerto Rico: Network Implications For Human Immunodeficiency Virus And Hepatitis C Virus Infection, Courtney Thrash, Melissa L. Welch-Lazoritz, G. Robin Gauthier, Bilal Khan, Roberto Abadie, Kirk Dombrowski, Sandra Miranda De Leon, Yadira Rolon Colon

Department of Sociology: Faculty Publications

Understanding the short- and long-term transmission dynamics of blood-borne illnesses in network contexts represents an important public health priority for people who inject drugs and the general population that surrounds them. The purpose of this article is to compare the risk networks of urban and rural people who inject drugs in Puerto Rico. In the current study, network characteristics are drawn from the sampling “trees” used to recruit participants to the study. We found that injection frequency is the only factor significantly related to clustering behavior among both urban and rural people who inject drugs.

Inequalities In The Use Of Secondary Prevention Of Cardiovascular Disease By Socioeconomic Status: Evidence From The Pure Observational Study, Adrianna Murphy, Benjamin Palafox, Owen O'Donnell, David Stuckler, Pablo Perel, Khalid F. Alhabib, Alvaro Avezum, Xiulin Bai, Jephat Chifamba, Romaina Iqbal

Community Health Sciences

Background: There is little evidence on the use of secondary prevention medicines for cardiovascular disease by socioeconomic groups in countries at different levels of economic development.
Methods: We assessed use of antiplatelet, cholesterol, and blood-pressure-lowering drugs in 8492 individuals with self-reported cardiovascular disease from 21 countries enrolled in the Prospective Urban Rural Epidemiology (PURE) study. Defining one or more drugs as a minimal level of secondary prevention, wealth-related inequality was measured using the Wagstaff concentration index, scaled from -1 (pro-poor) to 1 (pro-rich), standardised by age and sex. Correlations between inequalities and national health-related indicators were estimated.
Findings: The …

Assessment Of Temperature And Ultraviolet Radiation Effects On Sunburn At An Inland U.S. Beach: A Cohort Study, Jason W. Marion, Jiyoung Lee, James Rosenblum, Timothy J. Buckley

EKU Faculty and Staff Scholarship

Background

Increases in outdoor temperature may lead to increases in sunburn, outdoor exposure, and skin cancer in human populations.

Objective

This study aimed to quantify sunburn incidence and risk for Ohio beachgoers exposed to varying outdoor conditions.

Methods

Sunburn incidence data were obtained through a prospective cohort study at East Fork Lake (Cincinnati, Ohio, USA). Recruitment occurred over 26 weekend days. Beach interviews and follow-up telephone interviews obtained exposure and health information. New sunburns were self-reported 8–9 days post-enrollment. Survey data were paired with ultraviolet radiation (UVR) index and temperature data for statistical analysis.

Results

Among 947 beachgoers, new sunburns …

“When One Shingle Sends Up Smoke”: The Summit Beacon Advises Akron About The Epidemic Cholera, 1849, Elizabeth Hall

Nineteenth-Century Ohio Literature

Elizabeth Hall explains the American cholera epidemic of 1849, with special attention to how cholera afflicted Akron, a booming canal town in Northeast Ohio. The article presents the full text of 1849 Akron newspaper articles on cholera and explains how their mix of good and bad information was published right before scientific breakthroughs in cholera research.

Sexually Transmitted Infections Among Hiv-Infected Individuals In The District Of Columbia And Estimated Hiv Transmission Risk: Data From The Dc Cohort, Jose Lucar, Rachel Hart, Nabil Rayeed, Arpi Terzian, Amy Weintrob, Amanda D. Castel, Debra A. Benator, Dc Cohort Executive Committee

Epidemiology Faculty Publications

Background

Washington, DC, has one of the highest rates of HIV infection in the United States. Sexual intercourse is the leading mode of HIV transmission, and sexually transmitted infections (STIs) are a risk factor for HIV acquisition and transmission.

Methods

We evaluated the incidence and demographic factors associated with chlamydia, gonorrhea, and syphilis among HIV-infected persons enrolled at 13 DC Cohort sites from 2011 to 2015. Using Poisson regression, we assessed covariates of risk for incident STIs. We also examined HIV viral loads (VLs) at the time of STI diagnosis as a proxy for HIV transmission risk.

Results

Six point …

Pre- And Post-Diagnosis Physical Activity, Television Viewing, And Mortality Among Hematologic Cancer Survivors., Daniela Schmid, Gundula Behrens, Hannah Arem, Christina Hart, Wolfgang Herr, Carmen Jochem, Charles E Matthews, Michael F Leitzmann

Epidemiology Faculty Publications

PURPOSE: The associations of physical activity and television (TV) viewing with mortality risk among individuals with hematologic malignancies remain unclear.

METHODS: We examined the relations of physical activity and TV viewing time before and after diagnosis with mortality among 5182 U.S. adults aged 50-71 years from the NIH-AARP Diet and Health Study cohort who survived a first primary hematologic cancer between 1995-1996 and 2011.

RESULTS: For the pre- and post-diagnosis analyses, we confirmed 2606 and 613 deaths respectively. In multivariable-adjusted Cox proportional hazard regression models, comparing high (≥4 hrs/wk) versus low (/wk) activity levels, pre-diagnosis physical activity was associated with …

Incidence Of Second Malignancy In Patients With Papillary Thyroid Cancer From Surveillance, Epidemiology, And End Results 13 Dataset, Mayumi Endo, Jessica Liu, Marcelle Dougan, Jennifer Lee

Faculty Publications

Increased risk of second primary malignancy (SPM) in papillary thyroid cancer (PTC) has been reported. Here, we present the most updated incidence rates of second primary malignancy from original diagnosis of PTC by using the data from the Surveillance, Epidemiology, and End Results. In this cohort, 3,200 patients developed SPM, a substantially higher number than in the reference population of 2,749 with observed to expected ratio (O/E) of 1.16 (95% CI; 1.12–1.21). Bone and joint cancer had the highest O/E ratio of 4.26 (95% confidence interval [CI] 2.33–7.15) followed by salivary gland (O/E 4.15; 95% CI 2.76–6.0) and acute lymphocytic …

Impact Of Chronic Sexual Abuse And Depression On Inflammation And Wound Healing In The Female Reproductive Tract Of Hiv-Uninfected And Hiv-Infected Women., Mimi Ghosh, Jason Daniels, Maria Pyra, Monika Juzumaite, Mariel Jais, Kerry Murphy, Tonya N Taylor, Seble Kassaye, Lorie Benning, Mardge Cohen, Kathleen Weber

Epidemiology Faculty Publications

Sexual violence is associated with increased risk of HIV acquisition/transmission in women. Forced sex can result in physical trauma to the reproductive tract as well as severe psychological distress. However, immuno-biological mechanisms linking sexual violence and HIV susceptibility are incompletely understood. Using the Women's Interagency HIV Study repository, a total of 77 women were selected to form 4 groups, stratified by HIV serostatus, in the following categories: 1) no sexual abuse history and low depressive symptom score (below clinically significant cut-off, scores

Lebanon: Cholera Outbreak, Muhammad Naqvi

Global Public Health

Lebanon is a country that has always been tangled with the ever looming threat of a growing health crisis. With a failing government and massive influx of refugees, mostly the victim of their war torn economy, it seemed inevitable that sanitation procedures would run short. Now the Lebanese people and government face the challenge of the spread of Cholera, a water-borne disease, within the countries vicinity as a result of mass pollution from the formation of informal settlements as well as the country being a hotbed for political instability. These have resulted in limited success in controlling the outbreak engulfing …

Democratic Republic Of The Congo: Hiv/Aids, John Tworek

Global Public Health

The Democratic Republic of the Congo faces a great number of health issues, however, one of the most prevalent diseases within the country is HIV/AIDS. An estimated 122,168 thousand cases were reported in 2015, with the total number of deaths at 19,000, in a country that has a population of 82,804,942. The research done on HIV/AIDS in The Democratic Republic of the Congo looks at the basic epidemiology of the region, how to identify the disease, and major risk factors present. Other major challenges The Democratic Republic of the Congo faces are included, as well as suggestions for preventing further …

Bahrain: Cardiovascular Disease, Sandra Morales

Global Public Health

A beautiful island in the Arabian Gulf (Persian Gulf), east of Saudi Arabia, north of Qatar, Bahrain is home to over 1.5 million people. The diverse population consists of Muslims, Hindus, Christians, Asians, Africans, and so much more. Bahrain is a constitutional monarchy. The current commander of the Bahrain defense force is Khalifa bin Salman Al Khalifa. For the most part, Bahrainis have political freedoms. However, one major problem Bahrainis face, in particular men, is cardiovascular disease. Cardiovascular disease accounted for 34% of deaths in 2002. It is a major cause of morbidity and mortality in Bahrain. Obesity and inactivity …

Somalia: Rift Valley Fever, Alyson Meeks

Global Public Health

This walks readers through the basic demographics of Somalia, a country located in the horn of Africa. After learning about the government in Somalia and the problems that the people of the country face, this focuses on the problem of Rift Valley Fever. Rift Valley Fever is a virus that year after year strikes Somalia and surrounding countries. Weather patterns seem to help predict when Rift Valley Fever will be at the highest risk for an outbreak. This outlines the steps the current government and people are trying to take to help prevent outbreaks of RVF. But the solutions currently …

Uganda: Malaria, Sui Hnem

Global Public Health

Malaria is an infectious disease caused by mosquito bite. It is a major health problem in Uganda and is a major cause of mortality and morbidity. Pregnant women and children are the most infected groups in the country. The Ugandan government did their best to keep children and women healthy by providing clinics near the villages and advocating home treatment for malaria. Although, the government is very supportive in preventing and promoting the malaria, people did not seek healthcare as much as they should. The reason for not seeking healthcare was because they feel healthy, or the clinic had long …

Rwanda: Hiv/Aids, Alissa Anderson

Global Public Health

Rwanda is a small country in Africa. Rwanda has had many conflicts within its borders with wars, genocide, and disease. One of Rwanda’s current threats is HIV/AIDS. This disease is spreading through its population, and making it easier for other diseases; such as hepatitis and tuberculosis, to spread as well. Rwanda is a country that is putting into effect many efforts to decrease its HIV/AIDS population by means of education, campaigns, and treatments regarding the disease. In this article, I use peer reviewed and reliable articles to show the past and current issues that Rwanda has to face with the …

Hiv/Aids: Nigeria, Lauren Tropinski

Global Issues in Public Health

Nigeria has one of the largest prevalence rates of HIV infections in Africa. HIV is a communicable disease that is transmitted by bodily fluids through unprotected sex, using contaminated needles, or mother to child. The most affected populations include heterosexuals who have unprotected sex, followed by sex workers, and men who have sex with men. People will experience three stages of HIV before the last stage referred to as AIDS. Rapid diagnostic tests are used to diagnose the disease. There is no cure for HIV/AIDS. However, people with HIV are given antiretrovirals to keep HIV at a low level throughout …

Microcephaly, Christianne E. Albers

Global Issues in Public Health

Microcephaly is a noncommunicable condition causing the head of an infant to be smaller than what is typical. Microcephaly can cause delays in developmental milestones and/or can cause other conditions such as epilepsy, cerebral palsy, learning disabilities, hearing loss and vision problems. Microcephaly is found more frequently in certain populations of the world than others, specifically those with an increased number of cases with Zika virus. Women need to take preventative measures to ensure their unborn child is safe from the Zika virus. The Zika virus is not the only way microcephaly can occur. Many other causes like exposure to …

Type 1 Diabetes, Dan Bornstein

Global Issues in Public Health

The aim of this research was to increase the awareness of this disease and show the range of which it travels. Type 1 Diabetes, although not as common as Type 2 Diabetes, is a very serious disease present well around the world. Between the two forms, there are nearly 1.5 million people diagnosed with diabetes each year (American Diabetes Association, 2015). Northern European countries tend to have the highest prevalence of Type 1 diabetes. Younger children on average ages of 0-14 years, are most frequently struck with this disease (American Diabetes Association, 2015). With the given amount of symptoms that …

Type 2 Diabetes, Aj Mimlitz

Global Issues in Public Health

The purpose of this two page educational document is to inform not only educators, but also students about the description of type two diabetes and what populations are affected, the epidemiology of type 2 diabetes, including how get diagnosed and how that diagnosis will affect specific outcomes, and the solutions to how we can prevent or begin to cure type 2 diabetes. This brief project shows plenty of statistics revolving around these main points. Research shows that “type 2 diabetes already causes 5 million deaths per year, expecting to become the 7th cause of death globally by 2030” (Alidrisi & …

Health Systems Readiness For Adopting Mhealth Interventions For Addressing Non-Communicable Diseases In Low- And Middle-Income Countries: A Current Debate, Anam Shahil Feroz, Muhammad Masood Kadir, Sarah Saleem

Community Health Sciences

In low-and-middle-income countries, epidemiologic transition is taking place very rapidly from communicable diseases to non-communicable diseases. NCDs mortality rates are increasing faster and nearly 80% of NCDs deaths occur in LMICs. Existing weak health systems of LMICs are undergoing a devastating human and economic toll as a result of increasing treatment costs and losses to productivity from NCDs. At the same time, the increasing penetration of mobile phone technology and the spread of cellular network and infrastructure have led to the introduction of the mHealth field. While mHealth field offers a great promise to prevent and control non-communicable diseases in …