International Public Health Commons^™

Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. Mcmanus

Apurv Soni

BACKGROUND: Atrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India. Moreover, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF.

OBJECTIVE: The objectives of this study are to evaluate the age- and sex-stratified epidemiology of AF in Anand District, Gujarat India; characterize the profile of individuals who are diagnosed with AF; and determine the performance of two mobile technologies for community-based AF …

News From Cart, Patricia Fanning, Amos Nwosu

Patricia J. Fanning

No abstract provided.

The Spatial Dynamics Of Dengue Virus In Kamphaeng Phet, Thailand, Piraya Bhoomiboonchoo, Robert V. Gibbons, Angkana Huang, In-Kyu Yoon, Darunee Buddhari, Ananda Nisalak, Natkamol Chansatiporn, Mathuros Thipayamongkolgul, Siripen Kalanarooj, Timothy Endy, Alan L. Rothman, Anon Srikiatkhachorn, Sharone Green, Mammen P. Mammen, Derek A. Cummings, Henrik Salje

Sharone Green

BACKGROUND: Dengue is endemic to the rural province of Kamphaeng Phet, Northern Thailand. A decade of prospective cohort studies has provided important insights into the dengue viruses and their generated disease. However, as elsewhere, spatial dynamics of the pathogen remain poorly understood. In particular, the spatial scale of transmission and the scale of clustering are poorly characterized. This information is critical for effective deployment of spatially targeted interventions and for understanding the mechanisms that drive the dispersal of the virus.

METHODOLOGY/PRINCIPAL FINDINGS: We geocoded the home locations of 4,768 confirmed dengue cases admitted to the main hospital in Kamphaeng Phet …

Sequential Dengue Virus Infections Detected In Active And Passive Surveillance Programs In Thailand, 1994-2010, Piraya Bhoomiboonchoo, Ananda Nisalak, Natkamol Chansatiporn, In-Kyu Yoon, Siripen Kalayanarooj, Mathuros Thipayamongkolgul, Timothy Endy, Alan L. Rothman, Sharone Green, Anon Srikiatkhachorn, Darunee Buddhari, Mammen P. Mammen, Robert V. Gibbons

Sharone Green

BACKGROUND: The effect of prior dengue virus (DENV) exposure on subsequent heterologous infection can be beneficial or detrimental depending on many factors including timing of infection. We sought to evaluate this effect by examining a large database of DENV infections captured by both active and passive surveillance encompassing a wide clinical spectrum of disease.

METHODS: We evaluated datasets from 17 years of hospital-based passive surveillance and nine years of cohort studies, including clinical and subclinical DENV infections, to assess the outcomes of sequential heterologous infections. Chi square or Fisher's exact test was used to compare proportions of infection outcomes such …

The Politics Of Transition & The Economics Of Hiv: Aids & Pepfar In South Africa, Matthew M. Kavanagh

Matthew M. Kavanagh

AIDS poses a unique and unprecedented challenge to South Africa. The country has the largest HIV epidemic in the world—with 6.4 million people living with HIV—and one of the largest TB epidemics in the world as well. The country’s recent AIDS response has generated enormous optimism, both in South Africa and internationally. The biggest change, in many ways, has been political—dramatic shifts in ideology and motivation at the highest levels of government have moved the country from denialism and inaction to a bold national mobilization to bring anti-retroviral treatment to scale. Meanwhile, the approach of the U.S. government has evolved …

Why Are There Delays In Seeking Treatment For Childhood Diarrhoea In India?, Nisha Malhotra

Nisha Malhotra

Abstract Aim To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment.

Methods Data from Indian Demographic and Health survey 2005–06 (NFHS-III) was used. Mothers were asked if their children (<5-years) had suffered from diarrhoea during the two weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness, and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the “delay” in seeking advice/treatment.

Results Out of a sample of 41,287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percent of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08 – 2.54), richest (OR 1.76; 95% CI, 1.24 – 2.48) wealth index, mother's lack of knowledge of oral …

Awareness, Acceptability And Uptake Of Human Papilloma Virus Vaccine Among Cameroonian School-Attending Female Adolescents, Claudine Ayissi, Richard Wamai, Geofrey Oduwo, Stacey Perlman, Edith Welty, Simon Manga, Javier Ogembo

Richard G. Wamai

The purpose of this study is to assess awareness, knowledge and beliefs about HPV, cervical cancer HPV vaccine and willingness to vaccinate among adolescent females aged 12-26 years at clinics and schools in the North West Region of Cameroon where the Cameroon Baptist Convention Health Services (CBCHS) conducted a sensitization and education campaign. A questionnaire survey was administered among female adolescents in schools and clinics. Descriptive statistics including frequencies, percentages and proportions were generated for independent variables and bivariate analyses (Chi square test) were used to assess the relationship between independent and outcome variables. Data were analyzed using SAS Version …

Assessing The Effectiveness Of A Community-Based Sensitization Strategy In Creating Awareness About Hpv, Cervical Cancer And Hpv Vaccine Among Parents In North West Cameroon, Richard Wamai, Claudine Ayissi, Geofrey Oduwo, Stacey Perlman, Edith Welty, Simon Manga, Javier Ogembo

Richard G. Wamai

In 2010, the Cameroon Baptist Convention Health Services (CBCHS) received a donation of HPV vaccine (Gardasil(A (R))) to immunize girls of ages 9-13 years in the North West Region of Cameroon. We evaluated the effectiveness of the CBCHS campaign program in sensitizing parents/guardians to encourage HPV vaccine uptake, identified factors that influence parents' decisions to vaccinate girls, and examined the uptake of cervical cancer screening among mothers. We conducted a cross-sectional survey in four healthcare facilities run by CBCHS, churches and other social settings. A total of 350 questionnaires were distributed and 317 were used for the analysis. There were …

Criticisms Of African Trials Fail To Withstand Scrutiny: Male Circumcision Does Prevent Hiv Infection, Richard Wamai, Brian Morris, Jake Waskett, Edward Green, Joya Banerjee, Robert Bailey, Jeffrey Klausner, David Sokal, Catherine Hankins

Richard G. Wamai

A recent article in the JLM (Boyle GJ and Hill G, "Sub-Saharan African Randomised Clinical Trials into Male Circumcision and HIV Transmission: Methodological, Ethical and Legal Concerns" (2011) 19 JLM 316) criticises the large randomised controlled trials (RCTs) that scientists, clinicians and policy-makers worldwide have concluded provide compelling evidence in support of voluntary medical male circumcision (VMMC) as an effective HIV prevention strategy. The present article addresses the claims advanced by Boyle and Hill, demonstrating their reliance on outmoded evidence, outlier studies, and flawed statistical analyses. In the current authors' view, their claims portray misunderstandings of the design, execution and …

Biological Basis For The Protective Effect Conferred By Male Circumcision Against Hiv Infection, Brian Morris, Richard Wamai

Richard G. Wamai

Here we provide an up-to-date review of research that explains why uncircumcised men are at higher risk of HIV infection. The inner foreskin is a mucosal epithelium deficient in protective keratin, yet rich in HIV target cells. Soon after sexual exposure to infected mucosal secretions of a HIV-positive partner, infected T-cells from the latter form viral synapses with keratinocytes and transfer HIV to Langerhans cells via dendrites that extend to just under the surface of the inner foreskin. The Langerhans cells with internalized HIV migrate to the basal epidermis and then pass HIV on to T-cells, thus leading to the …

Kenya Keen On Achieving Targets On Neglected Diseases, Richard Wamai

Richard G. Wamai

No abstract provided.

Review: A Critical Evaluation Of Arguments Opposing Male Circumcision For Hiv Prevention In Developed Countries, Brian Morris, Robert Bailey, Jeffrey Klausner, Arleen Leibowitz, Richard Wamai, Jake Waskett, Joya Banerjee, Daniel Halperin, Laurie Zoloth, Helen Weiss, Catherine Hankins

Richard G. Wamai

A potential impediment to evidence-based policy development on medical male circumcision (MC) for HIV prevention in all countries worldwide is the uncritical acceptance by some of arguments used by opponents of this procedure. Here we evaluate recent opinion-pieces of 13 individuals opposed to MC. We find that these statements misrepresent good studies, selectively cite references, some containing fallacious information, and draw erroneous conclusions. In marked contrast, the scientific evidence shows MC to be a simple, low-risk procedure with very little or no adverse long-term effect on sexual function, sensitivity, sensation during arousal or overall satisfaction. Unscientific arguments have been recently …

Targeting Diseases Beyond Our Borders, Richard Wamai

Richard G. Wamai

No abstract provided.

'How To Contain Generalized Hiv Epidemics' Article Misconstrues The Evidence, Richard Wamai, B. Morris

Richard G. Wamai

No abstract provided.

Circumcision Denialism Unfounded And Unscientific, Joya Banerjee, Jeffrey Klausner, Daniel Halperin, Richard Wamai, Edgar Schoen, Stephen Moses, Brian Morris, Stefan Bailis, Francois Venter, Neil Martinson, Thomas Coates, Glenda Gray, Kasonde Bowa

Richard G. Wamai

No abstract provided.

Health Development Experiences In Haiti: What Can Be Learned From The Past To Find A Way Forward?, Richard Wamai, Colleen Larkin

Richard G. Wamai

Haiti’s history is marred by neo colonialism, structural violence, dictatorial politics, and severe natural disasters. These social political and geo-ecological factors have played a strong role in shaping the country’s past and current experiences in health and development. This paper overviews Haiti’s recent developments in health in light of the country’s tragic and complex history and comments on the health impact of the 2010 earthquake. In light of this information we draw some general conclusions and recommendations for going forward.

Lowering The Risk Of Spreading Hiv Among Heterosexual Men In Africa, Richard Wamai

Richard G. Wamai

No abstract provided.

Battling Hiv/Aids And The Healthcare Crisis In Africa, Richard Wamai

Richard G. Wamai

No abstract provided.

Hiv Prevention Cost-Effectiveness: A Systematic Review, Omar Gálarraga, M. Arantxa Colchero, Richard G. Wamai, Stefano Bertozzi

Richard G. Wamai

Background: After more than 25 years, public health programs have not been able to sufficiently reduce the number of new HIV infections. Over 7,000 people become infected with HIV every day. Lack of convincing evidence of cost-effectiveness (CE) may be one of the reasons why implementation of effective programs is not occurring at sufficient scale. This paper identifies, summarizes and critiques the CE literature related to HIV-prevention interventions in low- and middle-income countries during 2005-2008. Methods: Systematic identification of publications was conducted through several methods: electronic databases, internet search of international organizations and major funding/implementing agencies, and journal browsing. Inclusion …

A Conversation On African Diaspora, Richard Wamai

Richard G. Wamai

No abstract provided.

Response: Hiv Testing For Whole Populations, Daniel Halperin, Malcolm Potts, Doug Kirby, Jeff Klausner, Richard Wamai, Ann Swidler, Elliot Marseille, Norman Hearst

Richard G. Wamai

No abstract provided.

Reassessing Hiv Prevention, Malcolm Potts, Daniel Halperin, Douglas Kirby, Ann Swidler, Elliot Marseille, Jeffrey Klausner, Norman Hearst, Richard Wamai, James Kahn, Julia Walsh

Richard G. Wamai

No abstract provided.

Experts Call For Rethinking Aids Money, Richard Wamai

Richard G. Wamai

No abstract provided.

Is Male Circumcision As Good As The Hiv Vaccine We’Ve Been Waiting For?, Jeffrey Klausner, Richard Wamai, Kasonde Bowa, Kawango Agot, Jesse Kagimba, Daniel Halperin

Richard G. Wamai

No abstract provided.

Male Circumcision Is An Efficacious, Lasting And Cost-Effective Strategy For Combating Hiv In High-Prevalence Aids Epidemics: Time To Move Beyond Debating The Science, Richard Wamai

Richard G. Wamai

Letter to the editor, from R.G. Wamai + 43 co-authors

Conservation And Development Interventions At The Wildlife-Livestock Interface, Steven A. Osofsky, Sarah Cleaveland, William B. Karesh, Michael D. Kock, Philip J. Nyhus, Lisa Starr, Angela Yang

Philip J. Nyhus

No abstract provided.