Epidemiology Commons^™

Challenges Created By The Covid-19 Pandemic: Pediatric Emergency Medicine And Disaster Management Perspectives, Thomas E Tanner, Nichole R Davis, Brent D Kaziny, Erin E Endom, Esther M Sampayo

Faculty, Staff and Students Publications

OBJECTIVE: The coronavirus disease (COVID-19) pandemic has presented unique challenges to pediatric emergency medicine (PEM) departments. The purpose of this study was to identify these challenges and ascertain how centers overcame barriers in creating solutions to continue to provide high-quality care and keep their workforce safe during the early pandemic.

METHODS: This is a qualitative study based on semi-structured interviews with physicians in leadership positions who have disaster or emergency management experience. Participants were identified through purposive sampling. Interviews were recorded and transcribed electronically. Themes and codes were extracted from the transcripts by 2 independent coders. Constant comparison analysis was …

Longitudinal Analysis Of The Impact Of Oral Contraceptive Use On The Gut Microbiome, Xinwei Hua, Yueming Cao, David M Morgan, Kaia Miller, Samantha M Chin, Danielle Bellavance, Hamed Khalili

Department of Medicine Faculty Papers

Introduction. Evidence has linked exogenous and endogenous sex hormones with the human microbiome.Hypothesis/Gap statement. The longitudinal effects of oral contraceptives (OC) on the human gut microbiome have not previously been studied.Aim. We sought to examine the longitudinal impact of OC use on the taxonomic composition and metabolic functions of the gut microbiota and endogenous sex steroid hormones after initiation of OC use.Methodology. We recruited ten healthy women who provided blood and stool samples prior to OC use, 1 month and 6 months after starting OC. We measured serum levels of sex hormones, including estradiol, progesterone, sex hormone-binding …

Sars-Cov-2 Infection Increases Risk Of Acute Kidney Injury In A Bimodal Age Distribution, Erica C Bjornstad, Gary Cutter, Pramod Guru, Shina Menon, Isabella Aldana, Scott House, Nancy M Tofil, Catherine A St Hill, Yasir Tarabichi, Valerie M Banner-Goodspeed, Amy B Christie, Surapaneni Krishna Mohan, Devang Sanghavi, Jarrod M Mosier, Girish Vadgaonkar, Allan J Walkey, Rahul Kashyap, Vishakha K Kumar, Vikas Bansal, Karen Boman, Mayank Sharma, Marija Bogojevic, Neha Deo, Lynn Retford, Ognjen Gajic, Katja M Gist, Sccm Discovery Virus Investigators Group

Faculty, Staff and Students Publications

BACKGROUND: Hospitalized patients with SARS-CoV2 develop acute kidney injury (AKI) frequently, yet gaps remain in understanding why adults seem to have higher rates compared to children. Our objectives were to evaluate the epidemiology of SARS-CoV2-related AKI across the age spectrum and determine if known risk factors such as illness severity contribute to its pattern.

METHODS: Secondary analysis of ongoing prospective international cohort registry. AKI was defined by KDIGO-creatinine only criteria. Log-linear, logistic and generalized estimating equations assessed odds ratios (OR), risk differences (RD), and 95% confidence intervals (CIs) for AKI and mortality adjusting for sex, pre-existing comorbidities, race/ethnicity, illness severity, …

Operational Effect Of Covid-19 On Surgical Care At A Tertiary Pediatric Hospital, Andrew M Ferry, Rami P Dibbs, Amanda Ward, Veronica Velez, Sarah L Ringold, Nakeisha M Archer, Janet M Winebar, Dean B Andropoulos, Larry H Hollier

Faculty, Staff and Students Publications

The detrimental effects of the coronavirus disease 2019 (COVID-19) pandemic have profoundly disrupted surgical care at health care facilities worldwide. At our tertiary pediatric hospital, we made substantial adjustments to surgical suite utilization and staff member scheduling to account for reductions in surgical volume, increased demand for staff members in other sectors of the hospital, and the highly infectious properties of the virus. Perioperative leaders took advantage of the pandemic's disruption to clinical activities to design and implement a new procedure-scheduling process to rectify the inefficiencies that had accumulated as the previous system evolved. The implementation of said directives was …

Mothers' Perceptions Of Their Children's Weight: Opportunity For Health Promotion In Kuwait, Abdullah Al-Taiar, Nawal Alqaoud, Reem Sharaf-Alddin, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Background: Mothers’ perceptions of their children’s weight remain mostly unknown in oil-rich countries of the Middle East.

Aims: To compare maternal perceptions of their children’s weight with actual body weight.

Methods: We used the Kuwait nutritional surveillance data for 5 consecutive years (2015-2019) (N = 5119), which were collected through face-to-face interviews with mothers of children aged 2-5 years attending vaccination centres.

Results: Of the 5119 mothers in the study, 163 (3.18%) and 332 (6.48%) had obese or overweight children, respectively. Among 4624 mothers who had normal weight children, 1350 (29.20%) perceived their children’s weight as …

Creation Of A Global Vaccine Risk Index, Tasmiah Nuzhath, Peter J Hotez, Ashish Damania, P Shuling Liu, Brian Colwell

Center for Medical Ethics and Health Policy Staff Publications

The World Health Organization has identified vaccine hesitancy as one of its top ten global health threats for 2019. Efforts are underway to define the factors responsible for reductions in vaccine confidence. However, as global measles cases accelerated beginning in 2018, it became evident that additional factors were promoting measles re-emergence, including war, political and socio-economic collapse, shifting poverty, and vulnerability to weather events and climate change. Accordingly, we propose a Global Vaccine Risk Index (VRI) to consider these variables as a more comprehensive means to identify vulnerable nations where we might expect measles and other vaccine-preventable diseases to emerge …

Crisis Preparedness In Acute And Intensive Treatment Settings: Lessons Learned From A Year Of Covid-19, Jarrod M Leffler, Cassandra L Esposito, Elisabeth A Frazier, Michelle A Patriquin, Meredith K Reiman, Alysha D Thompson, Carl Waitz

Staff and Researcher Publications

The impact of COVID-19 changed the use and delivery of health care services, requiring an abrupt shift in treatment and staffing models 1,2. This is particularly salient in youth acute and intensive treatment services (AITS), including inpatient psychiatric hospitals (IPH), intensive outpatient programs (IOP), and partial hospitalization programs (PHP), because of challenging issues of maintaining high-quality care and a safe therapeutic milieu during increased demand for acute services,3 all while limiting transmission of COVID-19 on locked units, in close quarters, and for youths traveling back and forth to day-programs. Over the past year, AITS adapted and evolved without the ability …

Challenges In Feeding Children Posed By The Covid-19 Pandemic: A Systematic Review Of Changes In Dietary Intake Combined With A Dietitian's Perspective, Heather Campbell, Alexis C Wood

Children’s Nutrition Research Center Staff Publications

Purpose of review: To examine the evidence that the dietary quality of children changed between the period preceding the COVID-19 pandemic and the first year during the pandemic.

Recent findings: A systematic review of the evidence for dietary changes occurring as a result of the pandemic-related restrictions, in Part I of this article, yielded 38 original research articles. These articles had conflicting results, some describing improvements in overall quality and some describing deteriorations. As a whole the studies were characterized by a low study quality, and children were poorly represented. Taken together, these studies do not provide enough evidence to …

A Review Of The Cardiac And Cardiovascular Effects Of Covid-19 In Adults And Children, Bibhuti B Das, S Kristen Sexon Tejtel, Shriprasad Deshpande, Lara S Shekerdemian

The Texas Heart Institute Journal

Symptomatic coronavirus disease 2019 (COVID-19) typically affects the respiratory system but can involve the cardiovascular system. Cardiac complications of COVID-19 can result directly from myocarditis or indirectly from numerous other mechanisms. Differentiating between primary and secondary cardiovascular involvement-our focus in this review-may help to identify the long-term effects of COVID-19 on the heart in adults and children.

Timing Of Surgery Following Sars-Cov-2 Infection: An International Prospective Cohort Study, Covidsurg Collaborative, Globalsurg Collaborative

Faculty, Staff and Student Publications

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 …

A Cross-Sectional Study On Bullying And Psychological Disturbances Among Malaysian School Children, Muhammad Lokman Md Isa, Nurfatin Aina Mocktar, Wisam Nabeel Ibrahim, Mohd Said Nurumal, Muhammad Kamil Che Hasan

Makara Journal of Health Research

Background: Bullying is a common violence in school and has become a major public health and global concern. Bullying influences mental health and is identified as a leading factor of depression. Therefore, this study aimed to identify bullying prevalence and its association toward psychological disturbances (stress, anxiety, and depression).

Methods: This cross-sectional study was conducted in three secondary schools in Kuantan. After obtaining consent from parents/guardians, participants were asked to answer a self-administered questionnaire, including School Climate Bullying Survey, Depression Anxiety Stress Questionnaire-21, Patient Depression Questionnaire, and Generalized Anxiety Disorder. Demographic data were self-reported. Data were analyzed using …

Mothers’ Nutritional Knowledge, Self-Efficacy, And Practice Of Meal Preparation For School-Age Children In Yangon, Myanmar, Wut Yee Phyo, Ohn Khin Khin, Min Htike Aung

Makara Journal of Health Research

Background: Childhood malnutrition is a global public health concern. For Myanmar, mothers play a prominent role in improving the nutritional status of children as they prepare meals for children.

Methods: This community-based cross-sectional analytical study was conducted on 367 mother-child pairs (6–10 years). Significantly, systematic random sampling and structured questionnaires were utilized in this study.

Results: The mean age of mothers was 35.73 ± 6.9 years, and a majority had fair nutritional knowledge (52.3%), good self-efficacy (79.8%), and good practice of meal preparation (59.4%). The prevalence of childhood malnutrition was categorized as stunting (18.2%), underweight (18.8%), wasting …

Molecular Characterization Of Cryptosporidium Spp. From Humans In Ethiopia, Ambachew W. Hailu, Abraham Degarege, Haileeyesus Adamu, Damien Costa, Venceslas Villier, Abdelmounaim Mouhajir, Loic Favennec, Romy Razakandrainibe, Beyene Petros

Journal Articles: Epidemiology

Data on the distribution and genotype of Cryptosporidium species is limited in Ethiopia. This study examined the presence and genetic diversity of Cryptosporidium species circulating in Ethiopian human population. Stool samples collected from patients who visited rural (n = 94) and urban (n = 93) health centers in Wurgissa and Hawassa district, respectively, were examined for the presence of Cryptosporidium spp. using microscopy, nested PCR and real-time PCR. To detect infection with PCR, analysis of 18S ribosomal RNA was performed. Subtyping was performed by sequencing a fragment of GP60 gene. The overall prevalence of infection was 46% (n = 86) …

Lying In Wait: The Resurgence Of Dengue Virus After The Zika Epidemic In Brazil, Anderson Fernandes Brito, Lais Ceschini Machado, Rachel J. Oidtman, Márcio Junio Lima Siconelli, Quan Minh Tran, Joseph R. Fauver, Rodrigo Dias De Oliveira Carvalho, Filipe Zimmer Dezordi, Mylena Ribeiro Pereira, Luiza Antunes De Castro-Jorge, Elaine Cristina Manini Minto, Luzia Márcia Romanholi Passos, Chaney C. Kalinich, Mary E. Petrone, Emma Allen, Guido Camargo España, Angkana T. Huang, Derek A. T. Cummings, Guy Baele, Rafael Freitas Oliveira Franca, Benedito Antônio Lopes Da Fonseca, T. Alex Perkins, Gabriel Luz Wallau, Nathan D. Grubaugh

Journal Articles: Epidemiology

After the Zika virus (ZIKV) epidemic in the Americas in 2016, both Zika and dengue incidence declined to record lows in many countries in 2017-2018, but in 2019 dengue resurged in Brazil, causing ~2.1 million cases. In this study we use epidemiological, climatological and genomic data to investigate dengue dynamics in recent years in Brazil. First, we estimate dengue virus force of infection (FOI) and model mosquito-borne transmission suitability since the early 2000s. Our estimates reveal that DENV transmission was low in 2017-2018, despite conditions being suitable for viral spread. Our study also shows a marked decline in dengue susceptibility …

Utility Of Repeat Testing For Covid-19: Laboratory Stewardship When The Stakes Are High, Lindsey M. Rearigh, Angela L. Hewlett, Paul D. Fey, M. Jana Broadhurst, David Brett-Major, Mark Rupp, Trevor Van Schooneveld

Journal Articles: Epidemiology

As the coronavirus disease 2019 (COVID-19) continues to circulate, testing strategies are of the utmost importance. Given national shortages of testing supplies, personal protective equipment, and other hospital resources, diagnostic stewardship is necessary to aid in resource management. We report the low utility of serial testing in a low-prevalence setting.

Effect Of The Sims Program On Oral Hygiene Levels Of 5–6-Year-Old Children In The Kampar District, Malaysia: A Cluster-Randomized Controlled Trial, Nurul Hayati Anwar, Nor Azlida Mohd Nor, Zamros Yuzadi Mohd Yusof

Makara Journal of Health Research

Background: This study evaluated the effect of the “Senyuman Indah Milik Semua” program (SIMSP) versus the existing preschool oral healthcare program (POHP) on children’s oral health and parents’ oral health literacy (OHL) in Kampar district, Malaysia.

Methods: This was a cluster-randomized, matched pair, examiner-blind, controlled trial. Using computer-generated random tables, 14 preschools were allocated to the SIMSP intervention over 6 months and another 14 were allocated to the POHP, which was concealed at the cluster level. Healthy 5–6-year-old children and parents who understood the Malay language were recruited. The SIMSP was comprised of preschool visits by dental …

Age At Migration And The Risk Of Psychotic Disorders: A Systematic Review And Meta-Analysis., Kelly K. Anderson, Jordan Edwards

Epidemiology and Biostatistics Publications

OBJECTIVE: To conduct a systematic review and meta-analysis of the existing evidence on the association between age at migration and the risk of psychotic disorders.

METHODS: Observational studies were eligible for inclusion if they presented data on the association between age at migration and the risk of psychotic disorders among first-generation migrant groups. We used two random effects meta-analyses to pool effect estimates for each stratum of age at migration relative to (i) a native-born reference category and (ii) the youngest age stratum (0 to 2 years).

RESULTS: Ten studies met inclusion criteria, and five were included in the meta-analysis. …

Obesity Is Associated With Depression In Malaysian Schoolchildren: A Cross-Sectional Study, Mohd Said Nurumal, Rohulizzat Zainal Abidin, Wisam Nabeel Ibrahim, Muhammad Lokman Md Isa, Muhammad Kamil Che Hasan

Makara Journal of Health Research

Background: Overweight and obesity, which may lead to depression, have become prevalent among children worldwide. Hence, this study aimed to measure obesity and depression among schoolchildren in Kuantan.

Methods: This cross-sectional study was conducted in three different primary schools in Kuantan by purposive sampling. With consent from their parents/guardians, participants were given a self-administered questionnaire. Demographics and anthropometric measurement data were self-reported on the basis of the school records. Furthermore, body mass index was calculated. Data were analyzed using SPSS version 20.0, and chi-square and correlation tests were conducted for the variables.

Results: Among the 300 schoolchildren …

Evaluation Of The Therapeutic Efficacy Of Praziquantel Against Schistosomes In Seven Countries With Ongoing Large-Scale Deworming Programs, B. Levecke, J. Vlaminck, L. Andriamaro, S. Ame, V. Belizario, Abraham Degarege, D. Engels, B. Erko, A. D. Garba, G. M. Kaatano, Z. Mekonnen, A. Montresor, P. Olliaro, O. S. Pieri, M. Sacko, S. O. Sam-Wobo, L. A. Tchuem Tchuenté, J. P. Webster, J. Vercruysse

Journal Articles: Epidemiology

The World Health Organization (WHO) recommends periodic assessment of the therapeutic efficacy of praziquantel (PZQ) to detect reduced efficacy that may arise from drug resistance in schistosomes. In this multi-country study (2014), we assessed the therapeutic efficacy of a single oral dose of PZQ (40 mg/kg) against Schistosoma mansoni (Brazil, Cameroon, Ethiopia, Mali, Madagascar and Tanzania), S. haematobium (Cameroon, Ethiopia, Mali, Tanzania and Zanzibar) and S. japonicum (the Philippines) infections in school-aged children, across a total of 12 different trials. Each trial was performed according to the standardized methodology for evaluating PZQ efficacy as described by the WHO. Overall, therapeutic …

Structural Equation Modeling To Detect Correlates Of Childhood Vaccination: A Moderated Mediation Analysis, Abraham Degarege, Karl Krupp, Vijaya Srinivas, Boubakari Ibrahimou, Purnima Madhivanan

Journal Articles: Epidemiology

OBJECTIVES: This study used a health belief theory derived framework and structural equation model to examine moderators, mediators, and direct and indirect predictors of childhood vaccination.

METHODS: A secondary analysis was conducted using data collected from a cross-sectional survey of a random sample of 1599 parents living in urban and rural areas of Mysore district, India. Applying two-stage probability proportionate-to-size sampling, adolescent girls attending 7th through 10th grades in 23 schools were selected to take home a questionnaire to be answered by their parents to primarily assess HPV vaccine intentions. Parents were also asked whether their children had received one …

Association Between Breastfeeding And Child Stunting In Mexico, Ana Paola Campos, Mireya Vilar-Compte, Summer Sherburne Hawkins

Department of Public Health Scholarship and Creative Works

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

The Impact Of Body Mass Index And Sociodemographic Factors On Moderate-To-Vigorous Physical Activity And Sedentary Behaviors Of Women With Young Children: A Cross-Sectional Examination, Danae M. Dinkel, Nicholas Hein, Kailey Snyder, Mohammad Siahpush, Shannon I. Maloney, Lynette M. Smith, Evi A. Farazi, Corrine K. Hanson

Journal Articles: Epidemiology

OBJECTIVES: Moderate-to-vigorous physical activity provides multiple benefits to women after childbirth. To achieve these benefits, the recommendation that adults obtain, 150 min of moderate-to-vigorous physical activity per week and reduce sedentary behaviors, also applies to women in the post-partum phase of the life span. However, research examining the moderate-to-vigorous physical activity and sedentary behaviors of women with young children (0-2 years) is limited. A greater understanding of these behaviors from a nationally representative sample is needed. Therefore, the primary objective of this study was to determine the levels of moderate-to-vigorous physical activity and sedentary behaviors of a nationally representative sample …

Dimensions Of Stress In Parents Of Children With Autistic Spectrum Disorder, Amirah Hazwani Binti Bakri, Noor Aishah Binti Rosli, Zarinah Binti Mohd Kasirun, Mohd Hairul Nizam Bin Md Nasir, Fazidah Binti Othman, Tengku Sarina Aini Binti Tengku Kasim

Makara Journal of Health Research

Background: Parents of children with Autistic Spectrum Disorder (ASD) are at an increased risk for stress and other mental health problems. While treatment is mainly focused on the child, somehow parents’ stress is exacerbated. Accordingly, the purpose of this study was to identify the sources of stress in the parents of children with ASD. Methods: The 52 parents of children with ASD who participated in the study completed the child domain (CD) and parent domain (PD) subscales of the Parenting Stress Index Fourth Edition (PSI-4). Subsequently, the scores of the PSI-4 subscales were analyzed and compared. Results: …

Mapping Of Lymphatic Filariasis In Loiasis Areas: A New Strategy Shows No Evidence For Wuchereria Bancrofti Endemicity In Cameroon, Samuel Wanji, Mathias Eyong Esum, Abdel Jelil Njouendou, Amuam Andrew Mbeng, Patrick W Chounna Ndongmo, Raphael Awah Abong, Jerome Fru, Fanny F. Fombad, Gordon Takop Nchanji, Glory Ngongeh, Narcisse V. Ngandjui, Peter Ivo Enyong, Helen Storey, Kurt C. Curtis, Kerstin Fischer, Joseph R. Fauver, Daphne Lew, Charles W. Goss, Peter U. Fischer

Journal Articles: Epidemiology

BACKGROUND: Mapping of lymphatic filariasis (LF) caused by Wuchereria bancrofti largely relies on the detection of circulating antigen using ICT cards. Several studies have recently shown that this test can be cross-reactive with sera of subjects heavily infected with Loa loa and thus mapping results in loiasis endemic areas may be inaccurate.

METHODOLOGY/PRINCIPAL FINDINGS: In order to develop an LF mapping strategy for areas with high loiasis prevalence, we collected day blood samples from 5,001 subjects residing in 50 villages that make up 6 health districts throughout Cameroon. Antigen testing using Filarial Test Strip (FTS, a novel platform that uses …

Temporal And Geospatial Trends Of Pediatric Cancer Incidence In Nebraska Over A 24-Year Period, Evi A. Farazi, Shinobu Watanabe-Galloway, L. Westman, B. Rettig, P. Hunt, R. Cammack, John W. Sparks, Don W. Coulter

Journal Articles: Epidemiology

BACKGROUND: Data from the Surveillance, Epidemiology, and End Results (SEER) revealed that the incidence of pediatric cancer in Nebraska exceeded the national average during 2009-2013. Further investigation could help understand these patterns.

METHODS: This retrospective cohort study investigated pediatric cancer (0-19 years old) age adjusted incidence rates (AAR) in Nebraska using the Nebraska Cancer Registry. SEER AARs were also calculated as a proxy for pediatric cancer incidence in the United States (1990-2013) and compared to the Nebraska data. Geographic Information System (GIS) mapping was also used to display the spatial distribution of cancer in Nebraska at the county level. Finally, …

Common Diagnoses Among Refugee Populations: Linked Results With Statewide Hospital Discharge Database, Kerui Xu, Shinobu Watanabe-Galloway, Ming Qu, Brandon Grimm, Jungyoon Kim

Journal Articles: Epidemiology

BACKGROUND: According to the U.S. State Department's Refugee Processing Center and the U.S. Census Bureau, in the fiscal year 2016, among all states in the United States, Nebraska resettled the highest number of refugees per capita.

OBJECTIVES: The objectives of this study were to determine the most common reasons for refugees utilizing hospital services in Nebraska between January 2011 and September 2015, and to examine whether refugee patients had increased risks for adverse health conditions compared to non-refugee patients.

METHODS: Statewide linkage was performed between Nebraska Medicaid Program's immigration data, and 2011-2015 Nebraska hospital discharge data inpatient and outpatient files. …

Clinical Features Of Guillain-Barré Syndrome With Vs Without Zika Virus Infection, Puerto Rico, 2016, Emilio Dirlikov, Chelsea G. Major, Nicole A. Medina, Roberta Lugo-Robles, Desiree Matos, Jorge L. Muñoz-Jordan, Candimar Colon-Sanchez, Myriam Garcia, Marangely Olivero-Segarra, Graciela Malave, Gloria M. Rodríguez-Vega, Dana L. Thomas, Stephen H. Waterman, James J. Sejvar, Carlos A. Luciano, Tyler M. Sharp, Brenda Rivera-García

Journal Articles: Epidemiology

Importance: The pathophysiologic mechanisms of Guillain-Barré syndrome (GBS) associated with Zika virus (ZIKV) infection may be indicated by differences in clinical features.

Objective: To identify specific clinical features of GBS associated with ZIKV infection.

Design, Setting, and Participants: During the ZIKV epidemic in Puerto Rico, prospective and retrospective strategies were used to identify patients with GBS who had neurologic illness onset in 2016 and were hospitalized at all 57 nonspecialized hospitals and 2 rehabilitation centers in Puerto Rico. Guillain-Barré syndrome diagnosis was confirmed via medical record review using the Brighton Collaboration criteria. Specimens (serum, urine, cerebrospinal fluid, and saliva) from …

Schistosoma Mansoni And Other Intestinal Parasitic Infections In Schoolchildren And Vervet Monkeys In Lake Ziway Area, Ethiopia, Dejene Teklemariam, Mengistu Legesse, Abraham Degarege, Song Liang, Berhanu Erko

Journal Articles: Epidemiology

OBJECTIVE: To assess Schistosoma mansoni and other intestinal parasitic infections in schoolchildren and vervet monkeys (Chlorocebus aethiops) in Bochessa Village, Ziway, Ethiopia.

RESULTS: Fecal specimens from selected schoolchildren and droppings of the vervet monkeys were collected and microscopically examined for intestinal parasites using the Kato-Katz thick smear and formol-ether concentration techniques. The prevalences of S. mansoni, Trichuris trichiura, Ascaris lumbricoides, Enterobius vermicularis, hookworms, Hymenolepis nana and Taenia species among the children were 35.7, 26.9, 24.1, 2.1, 2.1, 1.07 and 2.1%, respectively (by Kato-Katz) and 39.3, 36.1, 35.6, 2.9, 10.0, 4.3, and 2.9%, respectively (by formol-ether concentration). Prevalence of S. mansoni …

An Investigation Of The Relationship Between Child, Family, And Community Factors And Early Childhood Oral Health And The Utilization Of Dental Health Services, Nicole Holt

Electronic Theses and Dissertations

Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health. Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community …

Infant Sleep Problems And Childhood Overweight: Effects Of Three Definitions Of Sleep Problems, Arsham Alamian, Liang Wang, Amber M. Hall, Melanie Pitts, Joseph Ikekwere

ETSU Faculty Works

Sleep problems have been defined using a variety of definitions. No study has assessed the longitudinal association between infant sleep problems and childhood overweight or obesity using existing definitions of sleep problems. This study used longitudinal data (n=895) from the multi-site Study of Early Child Care and Youth Development (SECCYD) to investigate the effects of infant sleep problems on childhood weight status in Grade 6. Infants with sleep problems in Phase I (1991) and with complete data through Phase III (2004) of SECCYD were included. Sleep problems were assessed using maternal reports of night wakings and duration of a waking …