International Public Health Commons^™

Scales To Measure Motivation Among Community Health Workers, And Trust And Empowerment Among Their Clients: A Guide, Frontline Health Project

Reproductive Health

This How-To Guide presents five multi-item scales to measure motivation among community health workers (CHWs), as well as clients' trust in CHWs, and empowerment within community health systems. The scales presented are intended for use in community health programs and in combination with other indicators in the CHW Performance Measurement Framework (published by the Frontline Health project in 2019) for routine data monitoring to improve quality and accountability in community health.

Age, Comorbidities, And Mortality Correlation In Covid-19 Patients: A Review, Vidyulata Salunkhe, Amr Aboelnasr, Parul Pahal, Nida Qadir, Simra Kiran, Balaji Sekaran, Omar Fahmy, Farah Daas, Syed Shah

The University of Louisville Journal of Respiratory Infections

Background: The risk of death due to COVID-19 among hospitalized patients is known to be higher in older adults and those with underlying health conditions. Understanding the proportion of patients who are at increased risk of death due to COVID-19 and how this varies between age groups will inform the healthcare community as to how to evaluate the risk of COVID-19 and better design healthcare and economic policies.

Methods: We conducted a literature search for studies published between December 2019 and May 16, 2020 in PubMed, Embase, and Cochrane (CENTRAL). Descriptive statistics were performed.

Results: We reviewed 14 studies, of …

Experiences Among Adults And Adolescents During The Covid-19 Pandemic From Four Locations Across Kenya—Study Description, Timothy Abuya, Karen Austrian, Adan Isaac, Beth Kangwana, Faith Mbushi, Eva Muluve, Daniel Mwanga, Thoai Ngo, Mercy Nzioki, Rhoune Ochako, Jessie Pinchoff, Ben Tidwell, John Wanyungu, Corinne White

Poverty, Gender, and Youth

To control the spread of coronavirus, the COVID-19 National Emergency Response Committee (NERC) in Kenya, chaired by the Ministry of Health (MOH), has implemented prevention and mitigation measures. To inform the Government of Kenya’s shorter- and longer-term response strategies, the Population Council COVID-19 study team utilizes rapid phone-based surveys to collect information on knowledge, attitudes, practices and needs among a longitudinal cohort of heads of household sampled from existing prospective cohort studies. The first was carried out across five Nairobi urban informal settlements; the baseline survey (n=2,009) was conducted March 30–31 with subsequent follow-up surveys conducted April 13–14 (n=1,764), May …

Pulmonary Embolism Related To Covid-19 Quarantine, Eduardo J. Quinteros Md, Juan Bisonni Md

The University of Louisville Journal of Respiratory Infections

The mandatory quarantine imposed in response to the COVID-19 pandemic has been related to an increase in cases of thromboembolism in non-COVID-19 patients. Particularly in countries such as Argentina, where strict quarantine was mandated, individuals were far less likely to risk being outside or observe healthy practices that would avoid the exacerbation of diseases such as thromboembolism. We report the case of a patient with pulmonary thromboembolism without usual triggering causes during the quarantine period, related to a previously undiagnosed hypercoagulable condition.

Congregate Care In The Time Of Covid-19: Proposed Best Practices From The Inside, Linda Bergthold, Margan Zajdowicz, Thaddeus R. Zajdowicz, Elli Hall, Kimberley A. Buckner, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Impact Of Mass Distribution Of Long-Lasting Insecticidal Nets (Llins) In Mozambique, 2011 To 2025: Retrospective And Prospective Modelling Of Child Mortality And Lives Saved, Erica Wetzler, Jorge A. H. Arroz, Chulwoo Park, Marta Chande, Figueiredo Mussambala

Faculty Publications

No abstract provided.

Availability And Affordability Of Medicines And Cardiovascular Outcomes In 21 High-Income, Middle-Income And Low-Income Countries, Clara Kayei Chow, Tu Ngoc Nguyen, Simone Marschner, Rafael Diaz, Omar Rahman, Alvaro Avezum, Scott A. Lear, Koon Teo, Karen E. Yeates, Khawar Kazmi

Section of Cardiology

Objectives: We aimed to examine the relationship between access to medicine for cardiovascular disease (CVD) and major adverse cardiovascular events (MACEs) among people at high risk of CVD in high-income countries (HICs), upper and lower middle-income countries (UMICs, LMICs) and low-income countries (LICs) participating in the Prospective Urban Rural Epidemiology (PURE) study.
Methods: We defined high CVD risk as the presence of any of the following: hypertension, coronary artery disease, stroke, smoker, diabetes or age >55 years. Availability and affordability of blood pressure lowering drugs, antiplatelets and statins were obtained from pharmacies. Participants were categorised: group 1-all three drug types …

Gender And Racial Disparity For Hospital Emergency Service Usage In Usa: A Quantitative Analysis For Various Age Groups During 2010–2017., Subhendra N. Sarkar, Anthony F. Devito, Evans Lespinasse, Faisal Khosa

Publications and Research

Background: Annually emergency department (ED) services are utilized by more than 100 million Americans making ED usage trends important determinants of healthcare quality, outcomes and cost. Previous workers have demonstrated the existence of disparity in various healthcare services in USA although a comprehensive analysis has not been undertaken. Dahlgren and Whitehead rainbow model has offered insights for multiple factors of influence on an individual’s health and focuses on the relationships among these factors. The Commission on Social Determinants of Health (CSDH; WHO initiatives) suggests that the social and environmental factors are at the root of most of the inequalities responsible …

Frontline Health: Harmonizing Metrics, Advancing Evidence, Accelerating Policy—Project Overview Brief, Frontline Health Project

Reproductive Health

Despite decades of technological and medical progress globally, half the world’s population still lacks access to essential health care due to insufficient numbers and types of health workers, especially in remote settings. There is growing recognition that well-supported community health workers (CHWs) are essential for effective delivery of primary health care (PHC). Despite broad consensus on the importance of CHWs, few countries have successfully integrated them as part of PHC at scale, and many lack official statistics on the performance of CHW programs. USAID, UNICEF, and the Bill & Melinda Gates Foundation developed a Memorandum of Understanding to collaborate on …

Covid-19 Contact Tracing Apps: How They Notify Users Of Potential Exposure, William A. Mattingly

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Considerations For A Covid-19 Research Data Warehouse In The Time Of Covid, William A. Mattingly

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Population Council-Led Partnership Influences National And Global Efforts To End Female Genital Mutilation/Cutting, Population Council

Research Utilization and Impact Briefs

The Evidence to End FGM/C program has filled critical data gaps, bolstered local capacity, and strengthened stakeholder relationships over the past five years. Through a collaborative, African-led approach, the program informed high-level national policy dialogue in several countries, including Kenya and Nigeria, and contributed to UNFPA’s new global estimates of girls at risk for FGM/C.

Project Soar Research Informs National Policy Change In Tanzania Expanding Access To Hiv Services For Marginalized Populations, Population Council

Research Utilization and Impact Briefs

A recent Project SOAR study evaluated community-based delivery of antiretroviral treatment to female sex workers (FSWs) in Tanzania, demonstrating the value of this approach to improve HIV care. Informed by these findings, the Government of Tanzania changed national guidance to allow for community-based HIV treatment to better meet the needs of marginalized populations, including FSWs.

Chronic Inflammation Was A Major Predictor And Determinant Factor Of Anemia In Lactating Women In Sidama Zone Southern Ethiopia: A Cross-Sectional Study, Tafere Gebreegziabher Belay, Taylor Roice, Barbara J. Stoecker

All Faculty Scholarship for the College of the Sciences

Anemia in women of reproductive age is highly prevalent globally and remains a public health problem. In Ethiopia, despite efforts to minimize the burden of anemia, it is still a moderate public health problem. Anemia has various etiologies including nutritional deficiency, parasitic infection, and inflammation. The aim of this study was to examine contributing factors to anemia in lactating women. Following ethical approval, and six months after delivery, all lactating women (n = 150) were recruited to participate in this study from eight randomly selected rural villages. Anthropometric and socio-economic factors were assessed. From each, a blood sample was collected …

The Role Of Rapid Diagnostic Point Of Care Igg/Igm Antibody Tests In The Diagnosis Of Sars-Cov-2 Infection, Nishita Tripathi, Daniya Sheikh, Dawn Balcom

The University of Louisville Journal of Respiratory Infections

Background: Current testing of symptomatic patients for SARS-CoV-2 involves the use of nucleic acid amplification tests, also known as genetic, RNA, or polymerase chain reaction (PCR), to detect viral RNA. The initial use of point of care (POC) antibody tests, also known as serological tests, in the management of SARS-CoV-2 infection was limited. In this review, we determine the significance of POC antibody serological tests and explore their possible role in the diagnosis and management of patients infected with the SARS-CoV-2 virus.

Methods: A literature search was conducted in Google Scholar, PubMed, and Embase, supplemented by searching the Centers for …

Changes In Preventive Care Utilisation And Its Influencing Factors Among Chinese Adults Before And After The Healthcare Reform: Cross-Sectional Evidence From The China Health And Nutrition Survey In 2004-2015, Tingting Wu, Wei Wei Liu, Mao Zou, Xun Lei, Qiang Yang, Manoj Sharma, Yong Zhao, Zu Min Shi

Environmental & Global Health Faculty Research

Objective China launched its health reform in 2009. This study aimed to assess changes in preventive care utilisation (PCU) and its relationship with the healthcare reform. Design A cross-sectional study using demographic characteristics, socioeconomic status, environmental factors, and lifestyle and health status data of adults from five waves (2004–2015) of the China Health and Nutrition Survey (CHNS) was conducted. Multilevel mixed-effects logistic regression models were used. Setting Data were derived from urban and rural communities of nine provinces in China. Participants Data were obtained from five waves of the CHNS, with 9960 participants in 2004, 9888 in 2006, 10 286 …

The Role Of Paraprofessionals In The Mental Health Structure Of India, Amy Abraham

Senior Theses

The mental health treatment gap in India is part of a growing public health crisis, with over 95% of those in need of services never receiving them. Over 197 million Indians suffer from at least one diagnosable mental health disorder, and this number continues to grow given the treatment gap. The treatment gap is a result of four major factors: lack of government support, stigma, limited treatment facilities, and the dearth of professionals able to provide treatment. The current study aimed to analyze several factors of paraprofessional led mental health interventions including setting, treatments delivered, treatment models, and client outcomes. …

Gastrointestinal Symptoms In Patients With Covid-19, Mohammed Abbas, Rafik Elbeblawy, Islam Gadelmoula, Suvarna Rekha, Bettina Sinanova, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: Though coronavirus disease 2019 (COVID-19) is predominantly a respiratory illness, a growing number of studies reported gastrointestinal (GI) symptoms among these patients. We examined the incidence of GI symptoms in patients with COVID-19 and GI symptoms as the initial presentation of the disease.

Methods: We examined peer-reviewed studies in English of patients with COVID-19 that reported GI symptoms. We searched PubMed and Google Scholar for articles published up to June 30, 2020, by using the keywords ``COVID-19,'' ``Coronavirus,'' ``severe acute respiratory syndrome coronavirus 2,'', ``SARS-CoV-2,'' ``gastrointestinal tract,'' ``gastrointestinal diseases,'' and ``gastrointestinal symptoms and signs.'' Studies with fewer than 30 …

Midline Report: Accelerating Action To End Child Marriage In Bangladesh, Masuma Billah, Eashita Haque, Surojit Kundu, Md. Saddam Hossain, Momoe Makino, Sajeda Amin

Poverty, Gender, and Youth

This report describes results from the midline survey of Accelerating Action to End Child Marriage in Bangladesh. The objective of the program is to identify effective and scalable approaches to end child marriage by empowering girls and communities. To bring about social norms change, the program experiments with alternative means of community engagement that can be offered in conjunction with skills-development opportunities for adolescent girls. The program is being assessed in a multi-arm cluster randomized trial. This report explores the impact on the prevalence of child marriage in two districts of Bangladesh as well as on a range of other …

Availability Of Over-The-Counter Antibiotics In Guatemalan Corner Stores, Purificación Moreno, Alejandro Cerón, Karen Sosa, Marinees Morales, Laura M. Grajeda, Maria Renee Lopez, John P. Mccraken, Celia Cordón-Rosales, Guy H. Palmer, Douglas R. Call, Brooke M. Ramay

Anthropology: Faculty Scholarship

Widespread availability of antibiotics without prescription potentially facilitates overuse and contributes to selection pressure for antimicrobial resistant bacteria. Prior to this study, anecdotal observations in Guatemala identified corner stores as primary antibiotic dispensaries, where people purchase antibiotics without prescriptions. We carried out a cross sectional study to document the number and types of antibiotics available in corner stores, in four study areas in Guatemala. A total of 443 corner stores were surveyed, of which 295 (67%) sold antibiotics. The most commonly available antibiotics were amoxicillin, found in 246/295 (83%) stores, and tetracycline, found in 195/295 (66%) stores. Over the counter …

A Review Of Quarantine Period In Relation To Incubation Period Of Sars-Cov-2, Satya Rashmit Durugu, Hammad Tanzeem, Divya Menghani, Zahid Imran, Priya Krishnan

The University of Louisville Journal of Respiratory Infections

Introduction: The period from exposure to a potential pathogen to the manifestation of symptoms, i.e.  the incubation period, is time the virus spends replicating in the host. An estimation of this period and subsequent quarantine of the host can limit potential spread, particularly in asymptomatic carriers. Effective contact tracing, length of self-quarantine, repeat testing, and understanding of disease transmission are all contingent on a true estimation of this incubation period.

Methods: Articles in English published since December 1st, 2019, on Google scholar, PubMed, and Research Gate, along with bulletins from the World Health Organization and the Centers for Disease Control …

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Covid-19 Is Associated With Increased Severity In Pregnant Women, Zahid Imran, Vidyulata Salunkhe, Ahmed A. Eladely, Ahmed Abdelhaleem, Satya Durugu, Daisy Sangroula

The University of Louisville Journal of Respiratory Infections

Introduction: The COVID-19 pandemic originated in China in late 2019; the number of cases is increasing with 2,104,346 cases and 116,140 deaths in the United States as of June 16, 2020. Pregnant women are a vulnerable population in epidemics or pandemics. This review is designed to look in detail at the severity of COVID-19 in pregnant women compared to non-pregnant women of reproductive age.

Methods: Literature searches on PubMed, Google Scholar, the Lancet, and Web of Science were conducted.

Results: We found evidence of increased risk for severe disease and distinctive symptoms among pregnant women diagnosed with COVID-19 compared …

Practice-Based Learning: Establishing Simple Monitoring Systems To Support Sgbv Programming In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Michael Gaitho, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

Implementers of sexual and gender-based violence programs in refugee settings are typically eager to learn about the extent to which their programs are making a difference in the lives of those they serve. Basic monitoring information can help address this imperative without unduly burdening program implementers with time-consuming evaluations. The Sauti/VOICE project is guiding adaptation and implementation of evidence-based SGBV interventions in refugee contexts. These interventions are implemented by UNHCR partners in eight countries in the East, Horn, and Great Lakes region of Africa. Although Sauti/VOICE is primarily focused on integrating tested SGBV interventions into refugee contexts, monitoring the implementation …

Practice-Based Learning: Medico-Legal Evidence Collection As Part Of Post-Rape Care In Refugee Contexts, Michael Gaitho, Ronald Kotut, Anne Ngunjiri, Jane T. Thiomi, Josephine Ngebeh, Chi-Chi Undie

Reproductive Health

Health care providers collect an array of documentation and specimens to support criminal investigations. Such documentation and specimens are referred to as “medico-legal” or “forensic” evidence, and in the case of rape, include a survivor’s documented injuries and emotional state at the time of examination, as well as samples and specimens from the survivor’s body or clothing. For survivors of rape and defilement who want to obtain legal justice, medico-legal evidence is critical. In African countries, health providers and the police are depended upon to ensure such evidence is collected, but medico-legal evidence collection can present challenges. Evidence-based interventions are …

Looking Beyond A Rare Presentation Of Betel Nut Use In A North American Patient- An Opportunity For Lessons And Intervention In Global Health And Gender Equity, Muhammad O. Zaman, Thomas M. Park, Vikas Patel, Riley G. Jones

Journal of Refugee & Global Health

Betel nut is estimated to be the fourth most common psychoactive substance used globally behind caffeine, alcohol, and nicotine with 600 million global users. Betel nut use has a strong association with oral cancer and many other systemic effects including oral submucosal fibrosis. Although North American use is rare, its enduring effects may surface long after use posing a diagnostic challenge to practitioners caring for an increasingly global diaspora. Herein, we present a patient with severe trismus due to advanced oral submucosal fibrosis who was unexpectedly found to be importing and using Betel nut for over thirty years after immigrating. …

Guatemala: Conocimientos, Actitudes Y Prácticas Frente A La Covid-19—Perspectivas De 144 Informantes Clave En 10 Municipios Con Mayoría De Población Indígena. Resultados De La Segunda Ronda De Recolección De Datos, 21–26 Julio De 2020, Population Council

Poverty, Gender, and Youth

El Population Council tiene una asociación de larga data con las comunidades indígenas y rurales de Guatemala a través del programa Abriendo Oportunidades. Para mediados de agosto de 2020, las restricciones gubernamentales permitían la movilidad entre departamentos a nivel nacional, las clases siguen suspendidas y se permite a las empresas operar en conformidad con los protocolos de prevención de COVID-19. Para entender mejor los conocimientos perspectivas y la evolución de las necesidades relacionadas con la pandemia por la COVID-19 en Guatemala, realizamos una segunda ronda de encuestas telefónicas con 144 informantes clave en 10 municipios con mayoría de población indígena. …

Guatemala: Covid-19 Knowledge, Attitudes And Practices—Perspectives From 144 Key Informants In 10 Indigenous Municipalities. Results From The Second Round Of Data Collection, July 21–26, 2020, Population Council

Poverty, Gender, and Youth

The Population Council has a longstanding partnership with indigenous communities in rural Guatemala through the Abriendo Oportunidades program. In compliance with COVID-19 prevention protocols, as of mid-August 2020 government restrictions allowed for inter-district mobility at the national level, classes remain suspended, and businesses were allowed to operate. To better understand indigenous knowledge, perspectives, and evolution of needs related to the COVID-19 pandemic in Guatemala, we conducted a second round of phone interviews with 144 key informants in ten municipalities. The second round represents 75% (n = 108) of the cohort interviewed April 14–18, 2020. Thirty-six new informants were recruited to …

Municipios Indígenas De Guatemala: Conocimientos, Actitudes Y Prácticas Frente A La Covid-19 Resultados De La Segunda Ronda De Recopilación De Datos, Population Council

Poverty, Gender, and Youth

No abstract provided.

Gaining A “Foothold” On The Diagnosis Of Leishmaniasis, Brent M. Troy, Rebecca Hart, Navjyot Vidwan, Bethany Hodge

Journal of Refugee & Global Health

Pediatric refugees and immigrants may present with unusual diagnoses due to their extensive migration and potential harsh conditions in travel. Trauma and family separation add to the difficulty of obtaining a history of exposures. We report a case of one of the more commonly neglected tropical diseases, Leishmaniasis. A 15-year-old male refugee patient presented to the hospital with ulcerative lesions to his legs. His migration history was extensive, starting in Central Africa with travel to South America, followed by migration through Central America to Texas. The patient developed ulcerative lesions on his legs, and he was brought to the children’s …