Epidemiology Commons^™

Analysis Of Malaria-Induced Anemia And Gender Differences Among Children In Nigeria, Temitope Bamgbose

Walden Dissertations and Doctoral Studies

Malaria is one of the leading causes of death among children under 5 years old in sub-Saharan Africa (SSA). Also, public health efforts on malaria prevention have been successful in many regions but remains an issue in SSA. Malaria-induced anemia (MA) is associated with health complications among children. The impact of several sociodemographic factors (age, gender, residential type, and parent’s educational level) and malaria preventive/intervention measures such as mosquito net use and malaria medication use among children under 5 years old in Nigeria were assessed to inform malaria best practices and strategies, prioritize resource allocation, and support existing literature on …

Social Determinants Of Maternal And Neonatal Birth Outcomes Among Syrian Refugees In Lebanon, Mona Charbel Kiwan

Walden Dissertations and Doctoral Studies

Neonatal and maternal health indicators have been impacted due to Syrian refugees’ displacement in Lebanon and an increase in child marriage rates from 13% in pre-conflict Syria to 41%. Using the causal continuum framework, the retrospective cross-sectional study’s purpose was to examine whether there is a statistically significant association between adverse maternal and birth health outcomes among Syrian refugees in Lebanon and social determinants of health. The sample size drawn from UNHCR database included 48,083 maternal and 4,288 neonatal refugees admitted to the secondary health care in 2018. Pearson chi-square and binomial logistic regression results showed that employed, newcomers mothers …

Marital Status And Human Immunodeficiency Virus Mortality In A Southern County, Javis Nkwanwoh

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) remains a substantial cause of mortality, particularly among U.S. segments of the population. Marriage is protective of HIV/AIDS mortality due to monogamy; however, the increased risk of HIV/AIDS mortality among other marital subgroups is understudied. The purpose of this study was to examine the association between marital status and HIV/AIDS mortality among a cohort of HIV infected individuals in a southern county. Mills' behavior theory guided this research as it posits that all behaviors are acquired through conditioning, which occurs through the interaction with the environment. The study had a quantitative research design …

Assessing The Risk Of Developing Liver Cancer Among Adults In The United States, Magbor Oben

Walden Dissertations and Doctoral Studies

The risk of developing liver cancer among adults in the United States remains asignificant threat due to an increasing prevalence of the disease. Despite the identification of some biological, environmental, and socioeconomic risk factors, uncertainty exists as to the role of sociodemographic factors. In this study, participants (N=27,804), age 18 and over, were assessed for liver cancer outcome specific to three factors liver disease, insurance coverage, and access to healthcare. With the person-centered care model as the framework, data from the 2016 National Health and Interview Surveys were subjected to the selection criteria and quantitatively analyzed using binary logistic regression. …

Domestic Abuse Against Men In Kenya, Catherine W. Kigaya

Walden Dissertations and Doctoral Studies

Domestic violence, also known as intimate partner violence (IPV), is prevalent globally and causes severe physical, psychological, and social harm to victims. The purpose of this quantitative cross-sectional study was to highlight the predictors of physical and sexual IPV among men in Kenya and examine the influence of media in seeking help. These factors were explored through the lens of the socio-ecological model and the social learning theory. The 2014 Demographic Health Survey archival data obtained through in-depth interviews were used to answer the research questions. Dependent variables were physical abuse, sexual abuse, and seeking help while independent variables were …

Receiving Positive Hiv Test Results From Home Testing And Suicidality, Nekeisha A. Hewitt

Walden Dissertations and Doctoral Studies

Limited studies have been conducted on whether receiving a positive result from at-home HIV testing correlates with suicidality (suicidal attempt or ideation). Based on the Ajzen theory of planned behavior, this cross-sectional study comprises a surveyed convenience sample of (N = 213) HIV -positive or negative adults who either tested for HIV at home or in-clinic. The purpose of this study was to explore any association between testing positive for HIV using the HIV at-home test kit and (a) suicidal attempt and (b) suicidal ideation; also, to discover any association between (c) HIV-negative and suicidality and (d) all HIV-positives …

Predictors Of Depression Screening Among Cancer Patients In U.S. Ambulatory Settings, Joseph Oluyinka Fawole

Walden Dissertations and Doctoral Studies

Depression is a common mental health comorbidity in cancer diagnoses, affecting 8-24% of cancer patients. Despite the high prevalence of depression among cancer patients, it is often unrecognized and untreated, thereby representing an enormous psychological distress source among the cancer patient population. The purpose of this study was to explore and establish the factors that predict depression screening among cancer patients in the ambulatory care setting in the United States. The health belief model guided the study. Secondary data from the National Ambulatory Medical Care Survey were analyzed to evaluate the predictors of depression screening in patients diagnosed with cancer. …

Leadership, Quality Improvement, Team Functionality, And Hiv Viral Load Suppression In Uganda, Esther Karungi Karamagi Nkolo

Walden Dissertations and Doctoral Studies

Low viral load suppression rate is a significant public health issue in Uganda and similar countries. A nationwide quality improvement (QI) initiative was implemented from January 2019 to improve viral load suppression. Although QI team characteristics have been shown to influence the success of such QI initiatives, no studies have been found to understand how they influence the success of QI efforts to improve HIV viral load suppression in Uganda. The purpose of this cross-sectional, quantitative study was to determine whether there is a significant association between HIV clinic leader involvement in QI teams, QI team functionality, QI team diversity, …

Drug-Resistant Neisseria Gonorrhoeae; Identification Of At-Risk Groups In Florida By Regional Variation, Scott August Herber

Walden Dissertations and Doctoral Studies

Neisseria gonorrhoeae has been on the rise in the State of Florida since 2013. Florida currently follows the Centers for Disease Control and Prevention guidelines for identifying those at-risk for gonorrhea and drug resistant gonorrhea infections. These groups are narrowly defined and do not consider the different population dynamics throughout the State. This study examined the question of who is at-risk for contracting drug resistant strains of gonorrhea in the eight different regions of Florida based on the prescribed use of last-line-of-antibiotic-defense. Florida’s Surveillance Tools and Reporting System provided 12 years of secondary data from 2007 to 2018. The data …

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …

Effects Of Hepatitis On Human Immunodeficiency Virus Viral Suppression, Andrenita Checoby West

Walden Dissertations and Doctoral Studies

Coinfection with human immunodeficiency virus (HIV) and viral hepatitis leads to unfavorable health outcomes, making treatment of HIV difficult and increasing the odds of HIV transmission. The purpose of this study is to assess whether viral hepatitis (B and C) hinders HIV viral suppression and impacts the white blood cell count (CD4) when a person is concurrently infected with both viruses. The syndemics theory guided this study. Two research questions tested whether there was an association between coinfection with viral hepatitis and HIV viral load suppression. The research design was quantitative case-control with secondary data from 65,626 reports of HIV, …

Demographic Characteristics And Response Preparedness Of Employed Adults To Ebola Virus Disease In Monrovia, Liberia, Beth Ann Sexton

Walden Dissertations and Doctoral Studies

AbstractEbola virus disease (EVD) is a deadly disease with no known cure and it caused an outbreak from 2014-2016 in Western Africa. Liberia had the highest morbidity and mortality; its capital city, Monrovia, was the focus of this study. The purpose of this research was to explore the association between sociodemographic and socioeconomic factors (gender, religion, age, occupation, education, and ward) and the use of preventative hygiene measures and understanding of EVD among working Monrovian adults. This population was chosen because 97% of the Monrovian population is employed, and thus serves as a good source for future public health campaigns. …

Predictors Of Hiv Testing Amongst Women Of Childbearing Age In Nigeria, Hassana Bashir Yakasai

Walden Dissertations and Doctoral Studies

HIV infection is still a public health issue in Nigeria. One of the sustainable development goal targets is to eliminate new HIV infections by the year 2030. Women of childbearing age are a vital group to focus on in eliminating new infections because HIV infection can be transmitted from women to their partners and their children. Nigeria accounts for about one-third of the cases of mother-to-child infections in the world. The purpose of this three manuscript dissertation was to investigate socioecological factors, demographic factors and knowledge of mother-to-child transmission of HIV infection (MTCT) as they relate to HIV testing in …

The Power Of Exogenous Variables In Predicting West Nile Virus In South Carolina, Christopher Lee Glaze

Walden Dissertations and Doctoral Studies

Despite the availability of medical data, environmental surveillance tools, and heightened public awareness, West Nile Virus (WNv) remains a global health hazard. Reliable methods for predicting WNv outbreaks remain elusive, and environmental health managers must take preventive actions without the benefit of simple predictive tools. The purpose of this ex post facto research was to examine the accuracy and timeliness of exogenous data in predicting outbreaks of WNv in South Carolina. Decision theory, the CYNEFIN construct, and systems theory provided the theoretical framework for this study, allowing the researcher to broaden traditional decision theory concepts with powerful system-level precepts. Using …

Diabetes Management And Self-Perception Of Health Among Adults In The United States, Moses Ajoku

Walden Dissertations and Doctoral Studies

The burden and complications of diabetes have been a public health concern and societal challenge for decades, and the rate of prevalence is projected to increase in the future. The study aims to examine the association between blood glucose monitoring, glycated hemoglobin test, and self-perceived health status among diabetic adults in the United States. Guided by the chronic care model, the study used data from the 2019 Behavioral Risk Factor Surveillance System to investigate diabetes management practices among diabetic adults in the United States. Quantitative and cross-sectional methods were used to assess the associations between diabetes management practices and self-perceived …

Predictors Of Cancer Information Seeking Among Adults With A Family History Of Cancer, Oluwakemi Akindeju Fawole

Walden Dissertations and Doctoral Studies

Cancer is a significant cause of illness and mortality in the United States. A family history of cancer is a valuable factor for assessing disease risk and increasing cancer information-seeking behaviors for prevention. Guided by the health belief model, this quantitative study addressed the predictors of cancer information seeking behavior among adults with a family history of cancer. In this study, data from 8,473 participants in the 2017–2019 Health Information Trends Analysis Survey were analyzed using multivariate logistic regression. This analysis addressed whether there was a statistically significant difference in sociodemographic factors, measures of health status, and health care engagement …

Hospital Emergency Room Visits For Heavy Menstrual Bleeding, Henry John Mead

Walden Dissertations and Doctoral Studies

Heavy menstrual bleeding (HMB) is a well-recognized health issue among women of reproductive age. The characteristics and demographics of women in the community with HMB who present at the emergency department (ED) are not well described. This research aimed to describe the cohort of women who seek treatment at the ED. The Healthcare Cost and Utilization Project 2016 National Emergency Department Sample was examined. The theory of reasoned action predicts that women who present at the ED are exhibiting health seeking behavior. From 32 million records, the inception cohort identified N = 111,555 cases. Using national estimation weights, this translates …

How Cyber Activity Influences Depression And Anxiety In Teenagers, Mary Fridah Gatwiri Muiruri

Walden Dissertations and Doctoral Studies

Both depression and anxiety have been a focus of scholars since their rates have recently skyrocketed from 5.4 % in 2003 to 20 % currently among teenagers in the United States. Although numerous studies have assessed the association between playing video games and depression, few studies have examined how cyberbullying and screen time contribute to depressive symptoms in teenagers. The purpose of this study was to analyze cyberbullying and screen time on depression in teens. . The exploration of associations between the dependent variable, depression, and the independent variables, screen time, video gaming, and cyberbullying, were guided by Bandura’s social …

Exploring The Relationship Between Antenatal Care And Postnatal Care To Newborn Outcomes In Borno State, Northeastern Nigeria, Adebe Gabriel

Walden Dissertations and Doctoral Studies

Newborn outcomes (morbidity or mortality) have been on the increase in Borno State. This study explores the relationship between antenatal care (ANC) and postnatal care (PNC) and newborn outcomes among women in Mafa local government area, Borno State. Also examined were the relationships between transportation and newborn outcomes, women’s knowledge of illness during pregnancy and ANC attendance, availability of staff/health workers, availability of supplies/equipment relations with ANC and PNC attendance. The three delays model was used as theoretical framework. The research will be useful for government and program-implementing partners to guide quality reproductive maternal newborn child adolescent health and nutrition …

Association Between Food Insecurity And Influenza Outcome In The United States., Sabrina Fiona Pink

Walden Dissertations and Doctoral Studies

AbstractThe influenza virus is one of the most commonly occurring respiratory viral infections in the world. The outer capsule of the virus contains 18H proteins and 11N proteins, which allows the virus to reform in over 100 different strands and outperform the vaccine. Despite efforts to improve access to care and reduce vaccine inequities; the Center for Disease Control and Prevention estimates 9-45 million documented influenza-related illnesses, 140,000 to 810,000 hospitalization, and 64,000 deaths yearly. The purpose of this study is to investigate whether food insecurity, access to care and other social determinants of health such as age, race, and …

Isocitrate Dehydrogenase-1 Mutation As A Prognostic Factor In Recurrent Glioblastoma, Haroon R. Hashmi

Walden Dissertations and Doctoral Studies

Glioblastoma (GBM) is an aggressive form of brain cancer that has a high recurrence rate and very poor prognosis. The prognostic value of various molecular markers (e.g., IDH 1 mutation, MGMT promoter methylation, etc.) and clinical factors (e.g., age, KPS, surgery and chemotherapy) has been studied in GBM after initial diagnosis but not as extensively in the recurrent GBM. Utilizing a retrospective cohort design, based on quantitative data collected through medical chart reviews, and the conceptual framework of outcomes research in oncology, this study evaluated the prognostic value of IDH-1 mutation in recurrent GBM in the context of key predictor …

Risk Factors For Foodborne Illness Outbreaks In Retail Food Establishments, Brendalee Viveiros

Walden Dissertations and Doctoral Studies

Despite policies and interventions over the last two decades, foodborne illness remains a significant public health concern. According to the CDC’s Foodborne Disease Outbreak Surveillance System, 60% of reported foodborne illness outbreaks involved food that was prepared at a restaurant. Reducing foodborne illness outbreaks that occur at restaurants would have a significant impact on the overall number of foodborne illnesses that occur each year. The purpose of this study was to quantitatively analyze the differences in risk factors in food establishments that have had a foodborne illness outbreak compared to food establishments that have not. This study used Reckwitz’s theory …

The Perception Of Men's Preferred Female Body Size And Weight Control Behaviors Of Afro-Caribbean Women In The United States Virgin Islands, Alice Victoria Henry

Walden Dissertations and Doctoral Studies

The prevalence of obesity among Afro-Caribbean women living in the United States Virgin Islands (USVI) is a health care issue that can have detrimental effects on society. To reverse the spread of this disease, factors contributing to its prevalence must be understood so that they can be addressed. The purpose of this cross-sectional study was to examine Afro-Caribbean women's perception of the female body size preferred by Afro-Caribbean men and the influence of that perception on the women's weight control behaviors of diet and physical activity. The reasoned action approach was the basis for the theoretical foundation. The research problem …

Reducing Morbidity: Establishing A Relationship Between Perioperative Normothermia And Colon Surgical Site Infections, Nychie Dotson

Walden Dissertations and Doctoral Studies

Healthcare-associated infections (HAIs) are an emerging public health threat. Every day in the United States, HAIs impact 1 in 31 hospitalized patients. Surgical site infections (SSIs) account for over 40% of all reported HAIs and have an increased risk for morbidity and mortality. Surgery associated with colon procedures present an increased risk for infection, morbidity, and mortality. There has been vast work to prevent colon SSIs; however, there remain areas for improvement and exploration. The main research question evaluated the relationship between maintaining perioperative normothermia and colon SSIs. Secondary research questions explored additional risk factors to include age, gender, obesity, …

Health Behaviors Of Fruit And Vegetable Consumption, Physical Activity, And Breast Cancer Among African American Women, Nicole Ekoue

Walden Dissertations and Doctoral Studies

Breast cancer incidence is suddenly increasing among African American women. Recent studies indicate that health behaviors are thought to confer important health benefits and have the potential to lowering breast cancer incidence. Guided by the social ecological model, the purpose of this quantitative, cross-sectional study was to investigate the association between health behaviors of fruit consumption, vegetable consumption, and physical activity and breast cancer after adjusting for age, body mass index, and smoker status. Social support and income level were assessed as modifiers. Using the 2012 to 2017 Health Information and National Trends Survey data, this study was conducted with …

Factors Contributing To Community-Associated Carbapenem Resistant Enterobacteriaceae Infections In The United States, Zabrina Lockett

Walden Dissertations and Doctoral Studies

Carbapenem-resistant Enterobacteriaceae (CRE) health care acquired infections are a serious public health threat due to a high mortality rate, economic burden, and depletion of last resort CRE antimicrobials. CRE infections have emerged as community-associated type infections in the United States. For CRE to now have that type of potential is cause for immediate and extensive action. The prevalence of CRE infection cases that were reported as community-associated CRE and health care acquired CRE by examining specific clinical characteristics between 4 selected states that were reported to respective state health departments and the Centers for Disease Control were explored in this …

Microcystins And Liver Disease Mortality, Insights From An Ecological Study, Rajesh Tirpaul Melaram

Walden Dissertations and Doctoral Studies

Microcystins (MCs) are toxic secondary metabolites produced by freshwater cyanobacteria. Algal bloom subsidence can stimulate MC release, which can impair liver function if orally exposed to in large doses. The purpose of this retrospective, U.S. ecological study was to determine if MC exposure represented an environmental risk factor for liver disease mortality using a socioecological approach. A longitudinal ecological substudy investigated the association between average total MCs in Lake Washington and Lake Manatee and age-adjusted chronic liver disease (CLD)/cirrhosis death rates in Brevard County and Manatee County, Florida (FL). A prediction model of total MCs was deduced by quantifying levels …

Childhood Blood Lead Levels And Adolescent Crime Rates In The United States, Jude Juiye Soweh

Walden Dissertations and Doctoral Studies

Juvenile violent crime rates in the United States have been on a continuous decline since 1996. Despite this decrease, youth violence as well as racial differences in crime rates continues to be a public health issue in the United States. Researchers have linked externalization behavior in children to factors including genetics, parental upbringing, abuse, school environment, and media exposure but have not fully considered the relationship between early childhood lead contamination and youth violence. This was an ecologic study of the relationship between early childhood blood lead levels (BLLs; ≥ 10µg/dL before 2012 or ≥ 5µg/dL after 2012) and crime …

Population Density And Spatial Distribution Of Neglected Tropical Diseases In Sierra Leone, Abou B. Funna

Walden Dissertations and Doctoral Studies

Neglected tropical diseases (NTDs) are the most common health conditions affecting the poorest residents of sub-Saharan Africa (SSA). These infections affect an estimated 2 billion people worldwide, including 500 million people living in SSA. About 85% of NTD infections are a result of helminth infections; hookworm is also a common occurrence among SSA’s poorest people, especially children. Schistosomiasis is the 2nd most prevalent NTD after hookworm. This quantitative correlational study investigated population distribution and the spread of NTDs in Sierra Leone. The focus was on 5 major NTDs: ascariasis, hookworm, schistosomiasis, soil-transmitted helminthiasis, and trichuris. Data were obtained from the …

Health Literacy And Diabetes Among Refugee Women Residing In Arizona, Aline Nina Indatwa

Walden Dissertations and Doctoral Studies

There is limited research available linking health literacy and diabetes knowledge to poor health outcomes among refugees. The aim of this study was to determine the levels of health literacy and diabetes knowledge and examine whether different factors (age, education, employment status, number of years lived with diabetes and length of stay since resettlement) are associated with health literacy and diabetes knowledge. A cross-sectional study was performed among 82 refugee women with a known diagnosis of diabetes and residing in Maricopa County, Arizona. A modified two part questionnaire (self-reported health literacy extracted from the European Health Literacy Questionnaire [HLS-EU-Q16] and …