International Public Health Commons^™

Malaria In Southern Venezuela: The Hottest Hotspot In Latin America, Maria Eugenia Grillet, Jorge E. Moreno, Juan V. Hernández-Villena, Maria F. Vincenti-González, Oscar Noya, Adriana Tami, Alberto Paniz-Mondolfi, Martin Llewellyn, Rachel Lowe, Ananias A. Escalante, Jan E. Conn

Harold W. Manter Laboratory of Parasitology: Library Materials

Malaria elimination in Latin America is becoming an elusive goal. Malaria cases reached a historical ~1 million in 2017 and 2018, with Venezuela contributing 53% and 51% of those cases, respectively. Historically, malaria incidence in southern Venezuela has accounted for most of the country’s total number of cases. The efficient deployment of disease prevention measures and prediction of disease spread to new regions requires an in-depth understanding of spatial heterogeneity on malaria transmission dynamics. Herein, we characterized the spatial epidemiology of malaria in southern Venezuela from 2007 through 2017 and described the extent to which malaria distribution has changed country-wide …

Community As Medicine: A Trauma-Informed Yoga Program For Multi-Cultural Female Immigrants Identified In The Primary Care Setting, Katherine Rizzolo, Sean Lena, Maha Jaber, Jessica Schaumburg, Kiana Vakil-Gilani, Nicole Rebusi, Dianna Stade, Adriana Nadeau, Nicoleta Toma, Brian King, Lesley Gordon

Journal of Maine Medical Center

Introduction: The immigrant population in Maine represents a unique group of patients with complicated health care needs due to cultural, linguistic, and systemic barriers. We sought to bridge gaps in health access for immigrant women by expanding and integrating community resources through the development and evaluation of a trauma-informed yoga class.

Methods: A needs assessment via a focus group with immigrant women revealed barriers to care and community health needs. Health partners of the immigrant community were identified via word of mouth and a Google search. Yoga participants were recruited in the primary care clinic and by community outreach. Participants …

Antibiotics And Antimicrobial Resistance In The Covid-19 Era: Perspective From Resource-Limited Settings, Mentor Ali Ber Lucien, Michael F. Canarie, Paul E. Kilgore, Gladzin Jean-Denis, Natael Fénélon, Manise Pierre, Mauricio Cerpa, Gerard A. Joseph, Gina Maki, Marcus J. Zervos, Patrick Dely, Jacques Boncy, Hatim Sati, Ana Del Rio, Pilar Ramon-Pardo

Department of Pharmacy Practice

The dissemination of COVID-19 around the globe has been followed by an increased consumption of antibiotics. This is related to the concern for bacterial superinfection in COVID-19 patients. The identification of bacterial pathogens is challenging in low and middle income countries (LMIC), as there are no readily-available and cost-effective clinical or biological markers that can effectively discriminate between bacterial and viral infections. Fortunately, faced with the threat of COVID-19 spread, there has been a growing awareness of the importance of antimicrobial stewardship programs, as well as infection prevention and control measures that could help reduce the microbial load and hence …

Impact Of Heavy Metals In Ambient Air In Insulin Resistance Of Shipyard Welders In Northern Taiwan, Ting-Yao Su, Hueiwang Anna Jeng, Yuan-Ting Hsu, Ching-Huang Lai, Chih-Hong Pan

Community & Environmental Health Faculty Publications

Exposure to metals poses potential health risks, including insulin resistance (IR), to those exposed to them in excess. Limited studies have examined such risks in occupational workers, including welders, and these have yielded inconsistent results. Thus, we examined the associations between exposure to welding metals and IR in welders. We recruited 78 welders and 75 administrative staff from a shipyard located in northern Taiwan. Personal exposure to heavy metals, including chromium (Cr), manganese (Mn), iron (Fe), nickel (Ni), copper (Cu), zinc (Zn), and cadmium (Cd), was monitored through particulate matter with an aerodynamic diameter of less than 2.5 μm (PM …

Corruption: An Impediment To Delivering Pathology And Laboratory Services In Resource-Limited Settings, Emily H. Glynn Md, Timothy Amukele, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

OBJECTIVES

Corruption is a widely acknowledged problem in the health sector of low- and middle-income countries (LMICs). Yet, little is known about the types of corruption that affect the delivery of pathology and laboratory medicine (PALM) services. This review is a first step at examine PALM corruption risks.

METHODS

We performed a critical review of medical literature focused on health sector corruption in LMICs. To provide context, we categorized cases of lab-related fraud and abuse in the U.S.

RESULTS

Forms of corruption in LMICs that may impact the provision of PALM services include informal payments, absenteeism, theft and diversion, kickbacks, …

Impact Of Covid-19 On The Italian And American Healthcare Systems : A Comparative Assessment, Bita Pejam, Jennifer Lam

All Reports

This report aims to examine and assess the impact of the COVID-19 global pandemic on the healthcare systems of the United States of America and Italy; two of the most heavily affected nations. Using data from December 2019 to January 2021, several consultations, and policy reviews, we identify risks and notable areas of issue in each nations’ approach to combating the virus. We focus our report particularly on the health policies and the governmental structures in place that contributed to each nations’ initial method of alleviating the impact of COVID-19. Our report compares the two healthcare systems and proposes a …

Implementación De Políticas De Prevención Y Control De La Obesidad Infantil En Estados Unidos Y Latinoamérica: Lecciones Para La Investigación Y La Práctica Transfronterizas, Mireya Vilar-Compte, Rafael Perez-Escamilla, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Aunque se han hecho avances en el desarrollo y aplicación a gran escala de inter-venciones eficaces contra la obesidad infantil, los retos siguen siendo importantes. Nuestro objetivo era comprender las causas del éxito de Estados Unidos y los países latinoamericanos en la implementación de políticas y programas (PYP) contra la obe-sidad e identificar oportunidades de mejora aplicando los principios de la ciencia de la implementación. Seleccionamos tres estudios de comparación de casos: (1) el etique-tado frontal en los envases de alimentos (México y Chile), (2) los programas de calles abiertas y calles para el juego (Colombia y Estados Unidos) y …

Time Trends Of Overweight And Obesity Among Schoolchildren In Kuwait Over A 13-Year Period (2007-2019): Repeated Cross-Sectional Study, Abdullah Al-Taiar, Nawal Alqaoud, Ali H. Ziyab, Faheema Alanezi, Monica Subhakaran, Reem Sharaf Alddin, Hueiwang Anna Jeng, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Objectives: This study aimed to examine age-specific trends in the prevalence of overweight and obesity in schoolchildren in Kuwait over a 13-year period (2007 to 2019) using the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC) and the International Obesity Taskforce (IOTF) definitions.

Design: Using cross-sectional approach, Kuwait Nutrition Surveillance System (KNSS) objectively measured weight and height of schoolchildren over a 13-year period. Log-binomial regression models were used to examine age-specific trends of obesity and overweight over the study period.

Setting: Public primary, middle, and high schools in all provinces of Kuwait.

Participants: Schoolchildren aged 5-19 …

Evaluating The Incidence Of Melanoma And Lung Cancer Of Current And Former Active-Duty U.S. Military Who Were Deployed In Support Of Operation Enduring Freedom And Operation Iraqi Freedom, Brian Kovacic

Theses and Dissertations--Epidemiology and Biostatistics

The incidence of melanoma and lung cancer has been gradually increasing in the United States over the past three decades with the reputed causes due to etiological and environmental exposures, and tobacco usage. There has been concern that melanoma and lung cancer incidence among military personnel may be associated with deployment to environments with intense sun exposure and increased smoking rates due to post-traumatic stress disorder. The aim of this study was to examine associations between deployment in support of Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF), from 2001 through 2015, with subsequent melanoma and lung cancer incidence. …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

English Summary:
The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls. The toolkit contains all the materials needed to help make a preliminary assessment of the assets a girl should acquire and the age by which she should acquire them. This document contains the Building Assets Toolkit’s List of …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

[In Arabic] The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls.

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The …

Income-Related Health Inequality Among Chinese Adults During The Covid-19 Pandemic: Evidence Based On An Online Survey, Peng Nie, Lanlin Ding, Zhou Chen, Shiyong Liu, Qi Zhang, Zumin Shi, Lu Wang, Hong Xue, Gordon G. Liu, Youfa Wang

Community & Environmental Health Faculty Publications

BACKGROUND: Partial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic.

METHODS: The 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID-19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for …

African Environmental Ethics: Keys To Sustainable Development Through Agroecological Villages, Charles Verharen, Flordeliz Bugarin, John Tharakan, Enrico Wensing, Bekele Gutema, Joseph Fortunak, George Middendorf

Center for Global Health Publications

This essay proposes African-based ethical solutions to profound human problems and a working African model to address those problems. The model promotes sustainability through advanced agroecological and information communication technologies. The essay's first section reviews the ethical ground of that model in the work of the Senegalese scholar, Cheikh Anta Diop. The essay's second section examines an applied African model for translating African ethical speculation into practice. Deeply immersed in European and African ethics, Godfrey Nzamujo developed the Songhaï Centers to solve the problem of rural poverty in seventeen African countries. Harnessing advanced technologies within a holistic agroecological ecosystem, Nzamujo's …

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

Is There A Cure For Vaccine Nationalism?, Ana Santos Rutschman

All Faculty Scholarship

“[V]accine nationalism . . . should serve as a reality check for the status of global health cooperation in the twenty-first century.”

Cost-Effectiveness Of Alternative Hiv Testing Strategies Among Hard-To-Reach Populations In East And Southern Africa., Deo Mujwara, Deo Mujwara

Graduate Research Posters

No abstract provided.

Mortalidad Por Diabetes En Guatemala 2018: Patrones E Inequidades, Alejandro Cerón, Gila Goldstein

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por diabetes en Guatemala con el propósito de identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir de diabetes en Guatemala muestra marcadas desigualdades por departamento, las que son aún más marcadas al comparar por municipio. El riesgo de morir es también más alto en mujeres, en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Deberían implementarse medidas de salud pública orientadas a los municipios y grupos en mayor riesgo de morir de diabetes. Este estudio …

How Did We Learn About Sex? —— Sex Education And Sexual Health In Chinese Youth, Yujuan Liu

Theses and Dissertations (Comprehensive)

Attitudes toward sexuality among Chinese youth have become more liberal in recent generations, but sex education remains controversial and limited. Due to the lack of awareness of sexual risks, many Chinese youth engage in unprotected sexual activities resulting in unintended pregnancy, abortions, and STIs. Therefore, understanding successful pathways and unique challenges are crucial to develop adequate sex education for youth’s sexual health in China. The current study used semi-structured in-depth interviews and investigated 28 Chinese youths’ experiences of sex education and sexual health. The results mapped out youth’s sex education experiences by age and sources and demonstrated the impacts of …

The Risks For Eating Disorders/Disordered Eating In Refugee & Immigrant Experiences And The Imperative Of Culturally Alert Screening, Chantal A. Bushelle

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Eating Disorders (ED)/Disordered Eating (DE) largely remain outside of global mental health agendas. There are limited data on the epidemiology EDs/DE in refugee and immigrant populations, and there is a paucity of research on refugee and immigrant experiences of EDs/DE. Study of acculturation issues in refugee and immigrant populations have historically missed investigating what role and impact experiences of stress and trauma (e.g., historical, chronic) along with cultural change and transition may have on their food attitudes and eating behaviors. While there has been some study of eating habits within refugee and immigrant populations, the focus is typically on food …

Decomposing Differences In Coronavirus Disease 2019-Related Case-Fatality Rates Across Seventeen Nations, Ashley Wendell Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

As of 1 November 2020, estimated case-fatality rates associated with coronavirus disease 2019 are not uniformly patterned across the world and differ substantially in magnitude. Given the global spatial heterogeneity in case-fatality rates, we applied the Blinder-Oaxaca regression decomposition technique to identify how putative sociodemographic, structural, and environmental sources influence variation in case-fatality rates. We show that compositional and associational differences in country-level risk factors explain a substantial proportion of the coronavirus disease 2019-related case-fatality rate gap across nations. Asian countries fair better vis-à-vis case-fatality rate differences mainly due to variation in returns to sociodemographic, structural, and environmental sources among …

Right To Health In Gats: Can The Public Health Exception Pave The Way For Complementarity?, Swati Gola

Pace International Law Review

This paper demonstrates how a right to health approach in the interpretation of the public health exception outlined in GATS Article XIV(b) can bring about a harmonious application of international human rights and international trade law regimes. Focusing on the interpretive value of the right to health for the public health exception in GATS, it examines whether a WTO Member, who has committed itself under GATS to fully liberalize all service sectors that have implications for health (e.g., hospital and other healthcare services), still retains the regulatory space to undertake measures to fulfill their right to health obligations and can …

Healthcare Workers Hospitalized With Covid-19: Outcomes From The Burden Of Covid-19 Study At The University Of Louisville Center Of Excellence For Research In Infectious Diseases [Cerid], Ruth Carrico, T'Shura S. Ali, Maria Hill, Lucia B. Puga Sanchez, Catherine M. Bryan, Dawn Balcom, Stephen P. Furmanek, Amr Aboelnasr, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Introduction: On March 6, 2020, the current ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, reached the commonwealth of Kentucky. Within days, the first cases of infection and hospitalization were identified among healthcare workers (HCW) in Kentucky, other states in the U.S., and around the world. There is little information available regarding the impact of COVID-19 on the HCW population within this area. The objective of this study was to describe the baseline characteristics of hospitalized HCWs infected with COVID-19.

Methods: Data collection was performed as part of a retrospective study of patients hospitalized …

Covid-19 & Pregnancy Complication During Early Pandemic: A Narrative Review, Ahmed A. Eladely, Maria Hill, Ahmed Abdelhaleem, Zahid Imran, Ahsan M. Khan, Daisy Sangroula

The University of Louisville Journal of Respiratory Infections

Background: Coronaviruses have caused three outbreaks in the past two decades. The novel one is SARS-COV-2, which causes COVID-19. Pregnant women have a somewhat altered immune state, which may make them more vulnerable to COVID-19 and its complications. Extensive research is needed to better understand the clinical course of COVID-19 in this population. This review article discusses the comparison of SARS-CoV-2 with previous coronavirus outbreaks, clinical presentations, and complications in pregnant women and newborns.

Methods: We conducted a literature search for case series and case reports about pregnancy outcomes in pregnant women with COVID-19 during the early phase of pandemic. …

The Case Of A Pregnant Woman With Ards Due To Covid-19 Treated With Hydroxychloroquine, Azithromycin, And Remdesivir And Delivery Of A Healthy Baby During Mechanical Ventilation Through Cesarean Section, Adria Madera-Acosta, Martin Gnoni, Bassman Tappuni, Monika Sadlak, Ravleen Grewal, Angel Mena, Yousef Ali-Ahwel

The University of Louisville Journal of Respiratory Infections

We are in the midst of a pandemic due to SARS-CoV-2. Pregnancy was identified among the risk factors for worse clinical outcomes in multiple studies. The optimal therapy in this group of patients remains to be defined. Here, we present the case of a 39-year-old Caucasian pregnant female at 31 weeks of gestation, who was treated successfully with hydroxychloroquine, azithromycin, remdesivir, prone therapy, and cesarean delivery of a healthy baby while on mechanical ventilation. She remained SARS-CoV-2-positive until the 39th day of hospitalization. We discuss the pathophysiology of the increased risk of infections during pregnancy and particularly the high risk …

Individual- And Country-Level Correlates Of Female Permanent Contraception Use In Sub-Saharan Africa, Babayemi O. Olakunde, Jennifer R. Pharr, Lung-Chang Chien, Rebecca D. Benfield, Francisco S. Sy

Environmental & Global Health Faculty Research

Background: Female permanent contraception is a cost-effective contraceptive method that can help clients with the desire to limit childbearing achieve their reproductive intention. However, despite its benefits, the use of FPC remains low in sub-Saharan Africa (SSA), and limited studies have examined the correlates of its uptake. In this study, we assessed the individual- and country-level factors associated with the use of FPC among married or in-union women using modern contraceptive methods to limit childbearing in SSA. Methods: This study was a secondary data analysis of individual- and country-level data obtained from the Demographic and Health Surveys (DHS) Program and …

Characteristics And Outcomes Of Adults Hospitalized With Sars-Cov-2 Community-Acquired Pneumonia In Louisville, Kentucky, Julio A. Ramirez, Jose Bordon, Rodrigo Cavallazzi, Stephen P. Furmanek, Amr Aboelnasr, Mahder A. Tella, William A. Mattingly, Ashley M. Wilde, Daisy Sangroula, Demetra Antimisiaris, Donghoon Chung, Guillermo Cabral, Gabino R Fernandez-Botran, Jiapeng Huang, Martin Gnoni, Ozan Akca, Paul Schulz, Phillip F. Bressoud, Priya Krishnan, Sally Suliman, Sathya Krishnasamy, Stephen S. Hanson, William P. Mckinney, Harpal Sandhu, Leslie A Wolf, Mark Burns, Ruth Carrico, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Background: Patients infected with the novel coronavirus SARS-CoV-2 are frequently hospitalized with community-acquired pneumonia (CAP). The objective of this study was to define the clinical characteristics and outcomes of hospitalized patients with SARS-CoV-2 CAP in the city of Louisville, KY.

Methods: This was a retrospective observational study of 700 patients with SARS-CoV-2 infection hospitalized at eight of the adult hospitals in the city of Louisville. Patients with 1) a positive RT-PCR for SARS-CoV-2, 2) fever, cough, or shortness of breath, and 3) an infiltrate on chest imaging were defined as having SARS-CoV-2 CAP. Demographic characteristics of the study population were …

Implementation Of The University Of Louisville Covid-19 Biorepository: Experiences From The Center Of Excellence In Infectious Diseases (Cerid), Dawn Balcom, Leslie A Wolf, Subathra Marimuthu, William Johnson, Danial Malik, Chet Dhakal, Pavani Nathala, Mohammed Abbas, Sahaj Hardeep Singh, Basel Haddad, Rafik Elbeblawy, Fnu Deepti, Ahmed Ali, Evelyn Exposito Gonzalez, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

The limited availability of biological samples from patients testing positive for SARS-CoV-2 for future research was quickly identified at the onset of the COVID-19 pandemic. In response to this need, a COVID-19 biobank was initiated by the University of Louisville Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID). The COVID-19 biobank contains waste samples obtained from patients hospitalized with COVID-19 in any of the nine Louisville, Kentucky, area hospitals during the timeframe of April 13 to September 20, 2020. The COVID-19 biobank stores approximately 1,623 waste samples with 2,127 aliquots for distribution. All samples are …

Acute Ischemic Stroke As The Presenting Feature Of Covid-19 In The Young And Pregnant, Nermila A. Ballmick, Jiri F. Kubac, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction: Coronavirus disease (COVID-19) is an emerging and rapidly evolving public health issue that has become globally widespread and an overwhelming pandemic. Clinical manifestations of the disease include asymptomatic carrier states, acute respiratory distress syndrome, and even multiorgan dysfunction. Here, we present a unique and rare case of an acute ischemic stroke (AIS) in an asymptomatic pregnant woman with no predisposing medical illnesses.

Discussion: An 18-year-old G2P1 African American woman at 7 weeks gestational age with no significant medical or family history presenting to the Emergency Department during the initial phases of the pandemic with complaints of new onset left …

Bangladesh: Covid-19 Knowledge, Attitudes, Practices & Needs—Responses From Three Rounds Of Data Collection Among Adolescent Girls In Districts With High Rates Of Child Marriage, Sajeda Amin, Ubaidur Rob, Sigma Ainul, Md. Irfan Hossain, Forhana Rahman Noor, Iqbal Ehsan, Mehnaz Manzur

Poverty, Gender, and Youth

From April 20–30, 2020, during a nationwide lockdown, the Population Council Bangladesh conducted the first round of a rapid phone-based survey on COVID-19 knowledge, attitudes, and practices. The survey randomly selected girls who had provided phone numbers during enrollment in a skills-building program that began before the pandemic. The survey’s objective was to assess the impact of COVID-19 on adolescent lives and to design programs that would contribute to protecting girls and meet social distancing guidelines imposed by the government. Phone interviews were conducted with 479 girls living in the districts of Chapainawabganj, Kushtia, and Sherpur who were participants in …