Epidemiology Commons^™

The Barriers And Facilitators Of Maternal Influenza Vaccination, Rashida Karida Jones

USF Tampa Graduate Theses and Dissertations

Influenza remains a leading cause of morbidity and mortality in the United States, with Black individuals disproportionately affected. Pregnant women are particularly vulnerable due to their modulated immune state, placing them at increased risk of complications, hospitalization, and intensive care admission. Despite strong evidence supporting the safety and efficacy of maternal seasonal influenza vaccination (SIV), uptake remains suboptimal. This study employed a multi-method design to identify barriers and facilitators of maternal SIV uptake, with a particular focus on racial disparities.

Quantitative analyses utilized the Florida Pregnancy Risk Assessment Monitoring System (FL PRAMS) dataset from the years 2018–2022. In the fully …

Google Search Trends And Their Correlation With Covid-19 Cases And Vaccination Rates In Austria, Stefanie Wendell

Walden Dissertations and Doctoral Studies

Timely digital surveillance is essential because clinical reporting often lags. This quantitative, longitudinal correlational study tested whether weekly Google searches in Austria signal changes in COVID-19 cases and vaccination uptake, and short-term case-vaccination dynamics, guided by Rogers’ Diffusion of Innovations Theory. Weekly Google Trends indices (0-100) and nationally reported surveillance totals (weekly counts of new cases and vaccine doses) were aggregated; cases: N = 175 weeks (Feb 2020–Jun 2023); vaccinations: N = 132 weeks (Dec 2020–Jun 2023). Time series correlations and lagged growth models showed that symptom-related searches consistently rose 1 week before reported cases (Δlog cases_t on Δlog searches_{t−1}: …

Elucidating The Relationship Between Water Quality And Antibiotic Resistance Of Rainwater Microbes Across Western Humboldt County, Theo P. Murphy, Eve Wendley, Justice Laskowski, Tyler Paredes

Humboldt Journal of Microbiology

Limited studies have been conducted regarding the fecal contamination and microbial dispersal through rainwater, with no known studies investigating the potential connection between antibiotic resistant microbes and water quality in rainwater. This study seeks to identify the presence of a correlation between water quality and incidence of antibiotic resistance in rainwater microbes. We hypothesize that there will be a correlation between these two variables. We additionally anticipate a high incidence of fecal contamination across rural and urban collection sites alike, with fecal contamination being more prevalent in rural areas than urban locals. To determine water quality, we measured the concentration …

Implementation And Evaluation Of Infection Prevention And Control Training In Sub-Saharan Africa, David Odada, James Ndai, Ruth Thuku, Philip Adebayo

Internal Medicine, East Africa

No abstract provided.

Examining Gender And Ethnic Disparities In Scientific Authorship To Promote A Culture Of Equity, Diversity And Inclusion At A University School Of Public Health, Paula Christen, Julia Michalow, Tristan Naidoo, Hillary Topazian, Sabine An Elsland, Abeer Arif, Marc Baguelin, Gemma Clunie, Sarah Essilfie-Quaye, Chinedu Momoh

Brain and Mind Institute

In public health research, diverse perspectives are vital to identify biases that homogenous teams might miss. Since publication metrics influence career progression, we investigated publication rate disparities within a School of Public Health. We analysed 18 322 peer-reviewed publications by 513 affiliated researchers between 2014 and 2023 using multivariable regression models and network analysis to assess the impact of gender, ethnicity, job level and centrality in the School’s research network on publication rates. We found a persistent gender gap in publication rates across job levels and ethnicities, with men publishing more than women (incidence rate ratio 1.30, 95% confidence interval …

Acceptability, Feasibility And Preliminary Evaluation Of The Who Caregiver Skills Training For Children With Developmental Disabilities In Rural And Urban Kenya, Amina Abubakar, Eva Mwangome, Paul Mwangi, Vibian Angweny, Martha Kombe, Rachel Mapenzi, Patricia Kipkemoi, Patricia Kipkemoi, Beatrice Mkubwa, Silas Onyango

Institute for Human Development, East Africa

Background Interventions to improve the developmental outcomes of children with developmental disabilities (DDs) in low-resourced settings such as Kenya are limited. The WHO caregiver skills training (CST) was developed to address social and communication needs of children with DDs through caregiver-mediated engagement strategies. This study investigated CST’s acceptability, feasibility and evaluated its effect on behavioural, communication and quality of life outcomes for children with DDs and their caregivers in Kenya.

Methods The settings were rural Kilifi and Korogocho informal settlement in Nairobi, Kenya. A sequential mixed-methods design consisting of three phases. First, CST materials translation to Swahili, stakeholder consultations and …

Age-Specific Distribution Of Cervical Precancer And Cancer Among Women Living With Hiv Across Seven Countries: A Systematic Review And An Individual Patient Data Meta-Analysis, Shona Dalal, Karin Sundström, Ronaldo Silva, Katayoun Taghavi, Helen Cejtin, Michael Chung, Sharon Greene, Smita Joshi, Helen Kelly, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Background Women living with HIV have an elevated risk for cervical cancer, present earlier, and have more recurrent human papillomavirus (HPV) infections compared with women without HIV. To update WHO recommendations on screening and treatment to prevent cervical cancer, we aimed to identify whether women living with HIV should be screened for cervical cancer at a specific age, the optimal screening interval following a negative cervical screen, and the screening interval following treatment.

Methods We conducted a systematic literature review on cervical cancer and HIV by searching MEDLINE, Embase, CENTRAL, the Cochrane Library, and clinical trial registries covering Jan 1, …

Food Insecurity Is Associated With Depressive And Anxiety Symptoms Among Caregivers Of Young Children In Arid And Semi-Arid Regions Of Kenya: A Cross-Sectional Study, Esther Chongwo, Daisy Chelangat, Eunice Njoroge, Barack Aoko, Martha Kaniala, Moses Wesala, Phillis Magoma, Joyce Marangu, Margaret Kabue, Daniel Rabok

Institute for Human Development, East Africa

Introduction: This study fills a critical gap by assessing the prevalence and association between food insecurity and depressive and anxiety symptoms among caregivers of young children in Kenya's arid and semi-arid lands (ASALs).

Methods: A cross-sectional design was used to collect data from caregivers of children aged 0–3 years from Lamu, Isiolo and Turkana Counties (N = 446). Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales were used to assess depressive and anxiety symptoms, respectively. We also administered the Household Food Insecurity Access Scale, alongside sociodemographic and health-related questionnaires.

Results: The mean caregiver age was 29.37 years …

Evaluating The Impact Of Alcohol On Dementia: Evidence From 13 Developing Countries, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission on Dementia Prevention identified alcoholconsumption as a risk factor contributing to a global increase in dementia cases by onepercent.

Method: We used a panel VAR model to analyze the impact of alcohol consumption ondementia prevalence in 13 developing countries with different alcohol tax systems.

Result: In countries with progressive alcohol tax systems, an increase in taxes onbeer and spirits leads to a 10 percent reduction in per capita alcohol consumption.This decline corresponds to a 4 percent reduction in dementia prevalence within fouryears. In countries with hybrid alcohol tax systems, a combination of alcohol bansand tax …

Cardiac Arrest Events On Australian Beaches, David Reid, Kye Bostwick, Jasmin C. Lawes, Ogilvie Thom, Ned Douglas

Research outputs 2022 to 2026

Background: Surf Life Saving Australia (SLSA) members respond to cardiac arrests near their patrolling location and have successfully resuscitated many community members over the years. In addition, members often act as first responders to cardiac arrest events in community settings, workplaces or through applications such as GoodSAM®. The outcomes achieved are not known after an update to resuscitation guidelines. Objective: We aimed to analyse Surf Life Saving Australia data on cardiopulmonary resuscitation (CPR) and describe the epidemiology and outcomes of cardiac arrest on Australian beaches and factors associated with survival after CPR. Methods: Using SLSA's national Incident Reporting Database held …

Real-World Effectiveness And Safety Of Upadacitinib In Crohn's Disease: A Multicenter Study, Jalpa Devi, Anthony Xu, Molly Stone, Anish Patel, Abdul Khan, Nikhil Reddy, Jeremy Klein, Navreet Chowla, Caroline Benson, Bryan Christopher Luu, Katherine Huang, Fnu Jaiprada, Marc Fenster, Ryan Ungaro, Joel Pekow, Amanda M Johnson, Andres J Yarur, Richa Shukla, Julia Huecker, Shrinivas Bishu, Reboot Ibd Consortium, Parakkal Deepak

Faculty, Staff and Students Publications

Background & aims: We aimed to describe the real-world effectiveness and safety of upadacitinib (UPA), an oral Janus kinase 1 inhibitor, in patients with Crohn's disease (CD).

Methods: A retrospective analysis was conducted across 9 centers in the United States, focusing on adults with CD treated with UPA, 45 mg, as induction therapy for active luminal disease. The coprimary end points were clinical remission at 12 weeks (Harvey Bradshaw Index ≤4 or absence of symptoms on physician's global assessment) and endoscopic remission at 6 months (Simplified Endoscopic Mucosal Assessment for Crohn's Disease score of 0-1 or absence of ulcers). Secondary …

Factors Associated With Cervical Cancer Screening Among Women Attending Maternal Child Health Clinics In Kenya, Loise Nthambi, Marleen Temmerman, William Macharia, Joshua Nyagol, Sophia Mogere, Jillian Neary, Edward Nyabs, Janet Itindi, Agnes Langat, Evelyn Wangari

Centre of Excellence in Women and Child Health

Background Cervical cancer is the second leading malignancy in incidence among women in sub-Saharan Africa. Early detection through screening and treatment of pre-cancerous cervical lesions is paramount in preventing cervical cancer. We sought to examine factors associated with ever being screened for cervical cancer among women attending infant immunization clinics in Kenya.

Methods We conducted secondary data analysis from a cross-sectional survey that enrolled mother-infant pairs attending 55 infant immunization clinics in Kenya between 2018 and 2019. Clinics were selected from high and medium/low HIV-burden counties using probability-proportionate-to-size sampling. The primary outcome was self-reported cervical cancer screening. To align with …

A Literature Review Of The United States Of America’S Reliance On Imported Covid Personal Protective Equipment During The Pandemic, Pradip K. Shukla, Izzet Kosar, Hedieh Setayesh

Business Faculty Articles and Research

This paper provides a literature review of United States of America’s reliance on imported Covid Personal Protective Equipment (PPEs) during the Covid pandemic. The abstracted and cited articles show that the United States was too reliant on imported PPEs, primarily imported from Asia which led to shortages as the cases of Covid surged at various points during the waves of Covid cases. This supply and demand imbalance was not just an inconvenience such as the toilet paper shortage and other supply chain disruptions of basic commodities; this supply and demand imbalance had life and death impacts for many first responders, …

Racial Disparities In Clonal Hematopoiesis And Their Impact On Hematologic Malignancies, Zijian Zhang, Chao Cheng

Faculty, Staff and Students Publications

Clonal hematopoiesis of indeterminate potential (CHIP) is a known risk factor for hematologic malignancies (HM), but its distribution and clinical implications across diverse ancestries remain poorly characterized. In this study, we investigated CHIP and its progression to HM in a large, racially diverse cohort from the All of Us Research Program, comprising 245,388 participants. We identified 10,446 CHIP driver mutations in 9,476 individuals. Our analysis revealed clear racial disparities in CHIP prevalence and mutational profiles: African American (AA) individuals had higher odds of CHIP and exhibited distinct mutation patterns compared to White American (WA) individuals. Consistent with prior studies, CHIP …

Mold Exposure And Cognitive Health During Menopausal Transitions: A Quantitative Analysis Using Secondary Data, Holly Jeannette Burns

Walden Dissertations and Doctoral Studies

Mold exposure and menopausal transition have been independently linked to cognitive decline, yet their interaction among socioeconomically disadvantaged populations has not been well examined. This quantitative study is an exploration of how menopausal transition influences the relationship between mold exposure and cognitive health outcomes among women aged 40 to 60 living in low-income housing in the United States. Bronfenbrenner’s ecological systems theory was used to guide the cross-sectional design using secondary data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES; N = 149). Weighted logistic regression and Hayes’ PROCESS (Models 2 and 4) were used to test associations …

Adverse Childhood Experiences, Positive Childhood Experiences, And Digital Media Use Among Children And Adolescents In The United States, Elizabeth L. Crouch, Emma Boswell, Monique J. Brown Ph.D., Kevin J. Bennett

Publications

No abstract provided.

Econometric Analyses Across The Continuum Of Care For Individuals With Hearing Loss, Teresa I. Anthony

USF Tampa Graduate Theses and Dissertations

Hearing loss affects individuals across the age span and, if left untreated, can lead to developmental delays and health and well-being concerns. This dissertation applies econometric analyses to investigate factors influencing diagnostic outcomes in the neonatal intensive care unit (NICU), intervention enrollment rates among babies with permanent childhood hearing loss (PCHL), and utilization and hospitalization outcomes among adults with sensory impairment (SI). The first study evaluates the cost-effectiveness of automated auditory brainstem response (aABR) versus transient evoked otoacoustic emissions (TEOAE) for newborn hearing screenings in a Thailand hospital NICU. Decision tree modeling and economic evaluation suggested that although aABR is …

Association Between Diabetes Mellitus, Hypertension, Obesity, And Diagnosis Of Covid-19 In Puerto Rico, Julian Rene Rivera Rodriguez

Walden Dissertations and Doctoral Studies

The population of Puerto Rico has been heavily affected by chronic diseases; however, data remains limited on the influence of diabetes mellitus (DM), hypertension, and obesity on the probability of COVID-19 diagnosis. The purpose of this quantitative study was to evaluate the association between non-communicable diseases that included DM, obesity, hypertension, and COVID-19 diagnosis, controlling for age and sex and person exposure in Puerto Rico. The sample consisted of 1,463 participants who underwent a polymerase chain reaction (PCR) test for COVID-19 from April 1, 2020, to March 31, 2021. Results from adjusted multivariable logistic regression analyses established that obesity OR …

Learning From Covid-19: Clinical Trials, Health Information Technology, And Patient Mortality, Christos Nicolaides, Avinash Collis, Seth Benzell, Indranil Bardhan

Economics Faculty Articles and Research

During the COVID-19 pandemic, deaths per case in the United States decreased from 7.46% in April 2020 to 1.76% in April 2021. One mechanism that could explain this decline is a learning effect associated with testing of new treatments by hospitals. Hospitals that participated in clinical trials developed better organizational capabilities to diagnose and treat COVID-19 patients. Simultaneously, hospitals used health information technologies (IT) that integrated health information across healthcare providers to facilitate greater learning and sharing of best practices. Using US county-level data on clinical trial participation, use of health IT, and COVID-19 cases and deaths, we show that …

A Quantitative Analysis Of Postmarketing Safety Events Of Breakthrough Medicines, Richard Judson Davis

Walden Dissertations and Doctoral Studies

Adverse events to medicines pose a risk to the public health of patients. Breakthrough therapy medicines are designed to address unmet medical needs and are often approved on an expedited timeline; however they are also criticized for lacking an adequate understanding of their risk profile at the time of approval. This study examined the relationship between the number of concomitant medicines, as well as the approved therapeutic indication, and the outcomes of reported adverse events associated with medicines approved under the breakthrough therapy designation. The conceptual framework applied in this retrospective, cross-sectional, quantitative study is the process of pharmacovigilance, which …

Higher Mortality Following Sars-Cov-2 Infection In Rural Versus Urban Dwellers Persists For Two Years Post-Infection, A. Jerrod Anzalone, Michael T. Vest, Makayla E. Schissel, Bradley Price, William B. Hillegass, Ronald Horswell, San Chu, Clifford J. Rosen, Lucio Miele, Susan L. Santangelo, Gordon S. Smith, Sally L. Hodder, Christopher G. Chute

School of Medicine Faculty Publications

Previous studies demonstrated higher short-term mortality among rural compared with urban residents infected with SARS-CoV-2. However, whether this difference persists remains uncertain. This retrospective cohort study analyzed two-year post-COVID-19 mortality by rurality using the National Clinical Cohort Collaborative COVID-19 Enclave, a United States-based longitudinal electronic health record repository. We analyzed mortality among patients infected with SARS-CoV-2 between April 2020 and December 2022, with follow-up until December 2024. Patients were categorized into urban, urban-adjacent rural (UAR), and nonurban-adjacent rural (NAR) groups based on residential ZIP Code. Mortality differences were assessed using Kaplan-Meier analysis and weighted multivariable Cox regression, with weights derived …

Impact Of Covid-19 Pandemic On Quality Of Life, Anxiety, Connections To Friends, And Access To Resources Among People With Hiv: Using The Social Ecological Model, Carol Dawson-Rose, Christine Davey, Emily Huang, Laura Cox, Phillips Craig, Motshedisi Sabone, Lufuno Makhado, Emilia Iwu, Kathleen Fitch, Sheila Shaibu

School of Nursing & Midwifery, East Africa

The purpose of this study was to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic and mitigation efforts on health and social outcomes for people with HIV at the individual, social, and structural levels of the Social Ecological Model. The International Nursing Network for HIV collected data for a cross-sectional survey of people with HIV in Botswana, Canada, Colombia, Hong Kong, Kenya, Nigeria, South Africa, Thailand, and the United States from August 2021 through June 2023. Among 1,400 participants, 47.5% experienced decreased quality of life, 40.9% experienced increased anxiety, 33.0% had reduced connection with friends, and 38.8% had …

Broadening Dementia Risk Models: Building On The 2024 Lancet Commission Report For A More Inclusive Global Framework, Cyprian Mostert, Chinedu Momoh, Andrea Winkler, Connor Mclaughlin, Harris Eyre, Mohamed Salama, Levi Muyela, Karen Blackmon, Zul Merali, Kirti Ranchod

Brain and Mind Institute

No abstract provided.

Weight Loss Remains A Challenge For Idiopathic Intracranial Hypertension Patients: A Retrospective Case Series From Kenya, Zian Muikamba, Jaskirat Sokhi, Jasmit Shah, Sheila Marco, Juzar Hooker, Dilraj Sokhi

Internal Medicine, East Africa

Background Idiopathic intracranial hypertension (IIH) is a neurological condition characterized by elevated intracranial 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. If undiagnosed, it can progress to disabling irreversible visual loss. Weight loss is useful in addition to medical therapy in treating the condition. There is a rise of obesity in sub-Saharan Africa (SSA) but there is little published on IIH.

Methods We conducted a retrospective cross-sectional study at our tertiary regional referral neurology centre …

Unnoticed Early Pregnancy During Myomectomy With Favorable Outcome: Case Report, Ronak Mulji, Lusajo Mwagobele, Farhat Seif, Zainab Fidaali, Munawar Kaguta

Obstetrics and Gynaecology, East Africa

Introduction

Uterine fibroids are a common cause of infertility, and myomectomy remains a key surgical intervention to improve reproductive outcomes. However, the occurrence of an undetected pregnancy during myomectomy is rare and poses significant clinical risks.

Case Presentation

We report a 34-year-old woman, nulliparous with a history of secondary infertility and three first-trimester miscarriages. She had multiple fibroids and was managed for polycystic ovarian syndrome and hyperprolactinemia. Scheduled for abdominal myomectomy, the surgery proceeded uneventfully, with six fibroids removed and no breach of the endometrial cavity. Five weeks postoperatively, she presented with symptoms suggestive of early pregnancy. Ultrasound confirmed a …

Cervical Hpv 18 Detection Is Associated With High-Grade Cervical Dysplasia In Kenyan And Ugandan Women Living With Hiv, Miriam Nakalembe, Collins Mpamani, Jane Namugga, Carolyn Nakisige, Grace Banturaki, Phillip Tonui, Peter Itsura, Omenge Orango, Kapten Muthoka, Anthony Ngeresa

Obstetrics and Gynaecology, East Africa

Objectives Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).

Methods Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical …

Cervical Hpv 18 Detection Is Associated With High-Grade Cervical Dysplasia In Kenyan And Ugandan Women Living With Hiv, Miriam Nakalembe, Collins Mpamani, Jane Namugga, Carolyn Nakisige, Grace Banturaki, Phillip Tonui, Peter Itsura, Elkanah Orang'o, Kapten Muthoka, Anthony Ngeresa

Obstetrics and Gynaecology, East Africa

Objectives Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).

Methods Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical …

Growth Measurements In Ugandan Children With Sickle Cell Anaemia From A Hydroxyurea (Hydroxycarbamide) Treatment Trial Relative To Unaffected Sibling Controls, Dennis Kalibbala, Vincent Mboizi, Grace Nambatya, Susan Murungi, Joan Ashaba, Catherine Nabaggala, Lynnth Turyagyenda, Deogratias Munube, Phillip Kasirye, Robert Opoka

Paediatrics and Child Health, East Africa

No abstract provided.

Prevalence And Risk Factors Of Hypertension Among Clients Seeking Care At Selected Healthcare Facilities In Kenya, Jasmit Shah, Soraiya Manji, Jamila Nambafu, Cynthia Smith, Anthony Ochola, Linda Barasa, Faraj Amir, Husni Abdalla, Rajiv Patel, Sayed Karar

Internal Medicine, East Africa

Background Hypertension remains one of the primary risk factors for cardiovascular disease and the leading cause of mortality worldwide. According to the World Health Organization (WHO), as estimated 1.28 billion adults suffer from hypertension worldwide and approximately half are unaware of the problem. This study aimed to explore the prevalence of hypertension, and the association of sociodemographic, behavioral, and physiological factors related to hypertension in patients seeking care at the different healthcare facilities in Kenya.

Methodology We carried out a cross-sectional survey study between April 2023 and July 2023. The general adult public visiting the outpatient clinics were recruited from …

Influence Of Institutional Support And Organisational Culture On Hiv And Ncd Integration, David Njuguna, Caroline Kyalo, Eunice Muthoni, Daniel Mwai, Elvis Kirui, Wesley Rotich, Joy Mugambi, James Waweru, Nelson Muriu, Easter Olwanda

Population Health, East Africa

Background: The integration of services for human immunodeficiency virus (HIV) and noncommunicable diseases (NCDs) has gained increasing attention in recent years because of the overlapping prevalence and shared risk factors between these health conditions. However, successful integration requires more than just the alignment of clinical practices. The role of institutional support and organisational culture in promoting effective integration remains an underexplored area.

Aim: This study aims to fill this gap by examining how institutional structures and organisational values influence the integration of HIV and NCD care.

Setting: The study setting was Nakuru County in Kenya.

Methods: …