Statistics and Probability Commons^™

Information-Motivation-Behavioral Skill In Diabetes Self-Management Using Structural Equation Modeling Analysis, Dien Kurtanty, Adang Bachtiar, Cicilya Candi, Alya Pramesti, Almira Fanny Rahmasari

Kesmas

Diabetes is the “mother” of various diseases increasing the risk of morbidity and mortality. Diabetes self-management, an effort made by patients to control blood sugar levels, is an important part of the management strategy. Therefore, this study analyzed information, motivation, and behavioral skills associated with diabetes self-management. Data were collected in the Special Capital Region of Jakarta, with 277 diabetic patients selected using a questionnaire by a systematic random sampling method. The analyzed variables were information (with indicator variables of information on physical activity, nutritional intake, drug consumption, and blood sugar monitoring); sociodemographic (age, sex, occupation, education level, and duration …

Job Satisfaction Model Of Primary Health Care Midwives Based On Indonesian Workforce Research In The Health Sector, Mieska Despitasari, Adang Bachtiar, Harimat Hendarwan, Besral Besral, Yuyun Yuniar

Kesmas

Promotive, preventive, curative, and rehabilitative efforts that are comprehensive, integrated, and sustainable are employed to enhance the health state of the global population. Within this context, however, the quality of primary health care depends on job satisfaction, which leads to the happiness of human resources in the health sector. Therefore, this study aimed to analyze and formulate a job satisfaction model among primary health care midwives in Indonesia. This study was an advanced secondary data analysis of a cross-sectional study conducted in 2017 by the National Institute of Health Research and Development, Ministry of Health of the Republic of Indonesia. …

The Effect Of Covid-19-Related Occupational Stress And Burnout In Referral Hospital Nurses, Yulastri Arif, Masyithah Fadhani

Kesmas

Nurses' continuous contribution to patient health makes them prone to occupational stress, which has been exacerbated during the COVID-19 pandemic. Occupational stress that lasts for a long time and is not resolved may cause burnout. Burnout experienced by nurses can impact patients, hospital services, and themselves. This study aimed to determine the effect of occupational stress on the incidence of nurse burnout during the COVID-19 pandemic. It used a quantitative approach with a cross-sectional design. The study sample was 235 nurses in six COVID-19 referral hospitals in West Sumatra from a proportional random sampling technique. Data were collected using a …

Developing A New Tool For Early Detection Of The Nutritional And Health Risk Factors Of Urban Workers’ Productivity, Hildagardis Meliyani Erista Nai, Arimbi Karunia Estri, Christina Ririn Widianti

Kesmas

Nutrition and health play vital roles in work productivity. This study aimed to develop a risk self-assessment tool called Early Detection of the Nutritional and Health Risk Factors on the productivity of urban workers. This study was conducted in two stages: 1) the development of the tool to determine the nutritional and health risk factors that affect productivity based on literature reviews and scoring systems and 2) the testing of validity and reliability. Finally, the tool contained 63 items, including 28 items on nutritional risk factors and 35 on health risk factors. The validity of the tool was assessed using …

Obesity And Asthma Risk In Indonesian Adults: Findings From The 2018 Indonesia Basic Health Research, Hoirun Nisa

Kesmas

Obesity and asthma are both global public health challenges. Mounting evidence suggests that obesity may increase asthma risk in adults; however, the association by sex remains uncertain. This study examined the association of obesity with asthma risk in Indonesian adult men and women. Data were obtained from the 2018 Indonesia Basic Health Research. The analysis included 299,837 men and 333,218 women aged ≥18 years. Asthma was identified by the self-report of a doctor’s diagnosis. Obesity was defined as a body mass index ≥30 kg/m2. A logistic regression was used for data analysis. Asthma prevalence was 2.7% (2.5% in men and …

Maternal And Child Health Handbook Utilization, Quantity And Quality Of Antenatal Services, And Maternal Emergency Rates In Padang City In 2022, Rena Afri Ningsih, Yusrawati Yusrawati, Joserizal Serudji

Kesmas

This study analyzed the relationship between the utilization of the Indonesian Ministry of Health’s Maternal and Child Health Handbook and the quantity and quality of antenatal care to maternal emergency levels. This study applied mixed methods with a consecutive sampling technique and included 108 mothers undergoing maternal emergencies at a central general hospital (quantitative) and eight mothers, seven midwives, and five cadres at primary health cares (qualitative) as informants. The result showed a relationship between the utilization of the Maternal and Child Health Care Handbook (p-value = 0.043), the quantity of antenatal care (p-value

The Determinants Of Stunting In The Under-Five In Three Municipalities In The Special Capital Region Of Jakarta, Tria Astika Endah Permatasari, Chairunnisa Chairunnisa, Hernani Djarir, Lily Herlina, Munaya Fauziah, Andriyani Andriyani, Yudi Chadirin

Kesmas

The COVID-19 pandemic has impacted the global decline in public health status. This study aimed to analyze the determinants of stunting in the under-five in three municipalities in the Special Capital Region of Jakarta, Indonesia. A cross-sectional study was conducted in August-December 2020 with 460 pairs of mothers and children selected by simple random sampling. Stunting was measured using a conventional anthropometric index (length/height-for-age), and anthropometric failure was measured using the Composite Index of Anthropometric Failure. The prevalence of stunting, underweight, and wasting was 41.5%,35%, and 19.8%, respectively, and 62% of the under-five experienced anthropometric failure. The dominant factor associated …

The Current State Of Underrepresented Osteopathic Minorities In Competitive Specialties, Emmanuel Oyalabu, Steve Guzman, Dashon Eure, Ezenna Obilor

Annual Research Symposium

It is well documented that barriers exist for underrepresented minorities to enter the field of medicine and even more competitive residencies. As defined by the NRMP, competitive specialties include but are not limited to Interventional Radiology, Orthopedic Surgery, Plastic Surgery, Radiation Oncology, Vascular Surgery, Neurosurgery, Dermatology, and Otornylogy (NRMP-AMA). A large number of osteopathic medical school graduates have a history of going into primary care specialties because many osteopathic medical schools have a primary care focus (Primary Care- Osteopathic Medicine). The emphasis on primary care, whether intentional or not, can foster a less-than-advantageous environment for underrepresented minority students (URM), pursuing …

Massachusetts Prevalence Of Opioid Use Disorder Estimation Revisited: Comparing A Bayesian Approach To Standard Capture-Recapture Methods, Jianing Wang, Nathan Doogan, Katherine L. Thompson, Dana Bernson, Daniel Feaster, Jennifer Villani, Redonna Chandler, Laura F. White, David Kline, Joshua A. Barocas

Statistics Faculty Publications

Background: The National Survey on Drug Use and Health (NSDUH) estimated the prevalence of opioid use disorder (OUD) among the civilian, noninstitutionalized people aged 12 years or older in Massachusetts as 1.2% between 2015 and 2017. Accurate estimation of the prevalence of OUD is critical to the success of treatment and resource planning. Various indirect estimation approaches have been used but are subject to data availability and infrastructure-related issues.

Methods: We used 2015 data from the Massachusetts Public Health Data Warehouse (PHD) to compare the results of two approaches to estimating OUD prevalence in the Massachusetts population. First, we used …

Turnover, Covid-19, And Reasons For Leaving And Staying Within Governmental Public Health, Jonathan P. Leider, Gulzar H. Shah, Valerie A. Yeager, Jingjing Yin, Kusuma Madamala

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Background and Objectives:

Public health workforce recruitment and retention continue to challenge public health agencies. This study aims to describe the trends in intention to leave and retire and analyze factors associated with intentions to leave and intentions to stay.

Design:

Using national-level data from the 2017 and 2021 Public Health Workforce Interests and Needs Surveys, bivariate analyses of intent to leave were conducted using a Rao-Scott adjusted chi-square and multivariate analysis using logistic regression models.

Results:

In 2021, 20% of employees planned to retire and 30% were considering leaving. In contrast, 23% of employees planned to retire and 28% …

Striving For Appropriate Antibiotic Use: A Biomarker Initiative, And Outcomes Associated With Azithromycin Exposure, Amanda Gusovsky

Theses and Dissertations--Pharmacy

The introduction of antibiotics into clinical practice is considered the greatest medical breakthrough of the 20^thcentury. However, the use of antibiotics can contribute to the development of resistance. In the United States (U.S.), approximately 2.8 million people are infected with antibiotic-resistant bacteria each year, and more than 35,000 people die as a result. Moreover, some antibiotics are known to cause cardiac side effects including QT prolongation, hypotension, and ventricular arrythmias. The U.S. Centers for Disease Control and Prevention (CDC) defines appropriate antibiotic use as the effort to use “the right antibiotic, at the right dose, for the right …

Laboratory Practices And Antimicrobial Resistance In A Florida Hospital, Crispina Marie Sy-Trias

Walden Dissertations and Doctoral Studies

Antibiotic resistance is a health threat affecting millions of Americans. Microorganisms develop resistance to antibiotics, rendering them useless for treating infections. The purpose of this quantitative study was to assess the associations between sample processing time and antibiotic resistance and is based on the health belief model. A retrospective specimen tracking activity of data from November 2019 to November 2020 was obtained by random sampling of 246 bacterial cultures. One hundred ninety-six (80%) samples were processed on time, and 50 (20%) were delayed; 167 (68%) samples were determined to have the presence of antimicrobial resistance (AMR), and 79 (32%) with …

On Kernel-Based Estimator Of Odds Ratio Using Different Stratified Sampling Schemes, Abbas Eftekharian, Hani Samawi, Haresh Rochani

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

The kernel-based estimator of Cochran Mantel-Haenszel odds ratio based on stratified simple and ranked set sampling is proposed. The expectation and variance of the estimator are analytically obtained. Using a simulation study, the estimator based on stratified ranked set sampling is more efficient than its counterpart based on stratified simple random sampling. Finally, the estimator's performance is investigated by using base deficit data.

Association Of Chlorhexidine Use And Scaling And Root Planing With Birth Outcomes In Pregnant Individuals With Periodontitis: A Systematic Review And Meta-Analysis, Maxwell Akonde, Rajat Das Gupta, Maxwell Akonde, Mark Reynolds, Stephanie Smith-Warner, Jihong Liu Sc.D., Fouzia Tarannum, James Beck, Donald Mattison

Faculty Publications

Importance Chlorhexidine mouthwash enhances treatment effects of conventional periodontal treatment, but data on chlorhexidine as a source of heterogeneity in meta-analyses assessing the treatment of maternal periodontitis in association with birth outcomes are lacking.

Objective To assess possible heterogeneity by chlorhexidine use in randomized clinical trials (RCTs) evaluating the effect of periodontal treatment (ie, scaling and root planing [SRP]) vs no treatment on birth outcomes.

Data Sources Cochrane Oral Health’s Trials Register, Cochrane Pregnancy and Childbirth’s Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science …

Association Of Chlorhexidine Use And Scaling And Root Planing With Birth Outcomes In Pregnant Individuals With Periodontitis: A Systematic Review And Meta-Analysis, Anwar T. Nerchant, Rajat Das Gupta, Maxwell Akonde, Mark Reynolds, Stephanie Smith-Warner, Jihong Liu, Fouzia Tarannum, James Beck, Donald Mattison

Faculty Publications

Importance Chlorhexidine mouthwash enhances treatment effects of conventional periodontal treatment, but data on chlorhexidine as a source of heterogeneity in meta-analyses assessing the treatment of maternal periodontitis in association with birth outcomes are lacking.

Objective To assess possible heterogeneity by chlorhexidine use in randomized clinical trials (RCTs) evaluating the effect of periodontal treatment (ie, scaling and root planing [SRP]) vs no treatment on birth outcomes.

Data Sources Cochrane Oral Health’s Trials Register, Cochrane Pregnancy and Childbirth’s Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science …

A Bayesian Susceptible-Infectious-Hospitalized-Ventilated-Recovered Model To Predict Demand For Covid-19 Inpatient Care In A Large Healthcare System, Stella Coker Watson Self Ph.D., Ms, Rongjie Huang, Shrujan Amin, Joseph Ewing, Carolina Rudisill, Alexander C. Mclain Ph.D.

Faculty Publications

The COVID-19 pandemic has strained healthcare systems in many parts of the United States. During the early months of the pandemic, there was substantial uncertainty about whether the large number of COVID-19 patients requiring hospitalization would exceed healthcare system capacity. This uncertainty created an urgent need to accurately predict the number of COVID-19 patients that would require inpatient and ventilator care at the local level. As the pandemic progressed, many healthcare systems relied on such predictions to prepare for COVID-19 surges and to make decisions regarding staffing, the discontinuation of elective procedures, and the amount of personal protective equipment (PPE) …

A Bayesian Susceptible-Infectious-Hospitalized-Ventilated-Recovered Model To Predict Demand For Covid-19 Inpatient Care In A Large Healthcare System, Stella Coker Watson Self Ph.D., Ms, Rongjie Huang, Shrujan Amin, Joseph Ewing, Caroline Rudisill, Alexander C. Mclain

Faculty Publications

The COVID-19 pandemic has strained healthcare systems in many parts of the United States. During the early months of the pandemic, there was substantial uncertainty about whether the large number of COVID-19 patients requiring hospitalization would exceed healthcare system capacity. This uncertainty created an urgent need to accurately predict the number of COVID-19 patients that would require inpatient and ventilator care at the local level. As the pandemic progressed, many healthcare systems relied on such predictions to prepare for COVID-19 surges and to make decisions regarding staffing, the discontinuation of elective procedures, and the amount of personal protective equipment (PPE) …

Survival Of Epithelial Ovarian Cancer In Black Women: A Society To Cell Approach In The African American Cancer Epidemiology Study (Aaces), Joellen M. Schildkraut, Courtney Johnson, Lauren F. Dempsey, Bo Qin, Paul Terry, Maxwell Akonde, Edward S. Peters, Hannah Mandle, Michele L. Cote, Lauren Peres, Patricia Moorman, Ann G. Schwartz, Micheal Epstein, Jeffrey Marks, Melissa Bondy, Andrew B. Lawson, Anthony Alberg, Elisa V. Bandera

Faculty Publications

Purpose

The causes for the survival disparity among Black women with epithelial ovarian cancer (EOC) are likely multi-factorial. Here we describe the African American Cancer Epidemiology Study (AACES), the largest cohort of Black women with EOC.

Methods

AACES phase 2 (enrolled 2020 onward) is a multi-site, population-based study focused on overall survival (OS) of EOC. Rapid case ascertainment is used in ongoing patient recruitment in eight U.S. states, both northern and southern. Data collection is composed of a survey, biospecimens, and medical record abstraction. Results characterizing the survival experience of the phase 1 study population (enrolled 2010–2015) are presented.

Results …

Effects Of A Behavioral Intervention On Physical Activity, Diet, And Health-Related Quality Of Life In Pregnant Women With Elevated Weight: Results Of The Hipp Randomized Controlled Trial, Sarah Wilcox Phd, Jihong Liu, Gabrielle Turner-Mcgrievy Ph.D., Rd, Alycia K. Boutte, Ellen Wingard Msph, Rd, Ld

Faculty Publications

Background

Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight.

Methods

Health In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based …

Metabolic Alterations And Cardiovascular Risk After Hepatitis C Cure In Subjects With Or At Risk For Hiv, Christophe Maxime Fokoua Dongmo

Legacy Theses & Dissertations (2009 - 2024)

Background. Hepatitis C virus (HCV) infection engenders substantial metabolic changes. These changes are altered when the virus is cleared after successful treatment. We measured these metabolic alterations that occur after HCV cure; further, we assessed whether these alterations differed in subgroups defined by patients’ characteristics.

Evaluating The Health Impacts Of Fruit And Vegetable Intake At The Individual Level And Food Pantry Level Among Food Pantry Users, Jiacheng Chen

Legacy Theses & Dissertations (2009 - 2024)

Background: Chronic diseases impose heavy burdens on individuals and the healthcare system in the US. Many factors were found to be associated with chronic diseases, including demographics, family history, social environmental factors, and individual behavioral factors such as diet and physical activity. Among those factors, fruit and vegetable intake can have substantial health impacts via a variety of causal pathways. Fruit and vegetable (F&V) consumption is generally lower among individuals living in households experiencing food insecurity and rely on food assistance programs. Decreased F&V intake among food pantry users may negatively impact health. However, conducting quantitative analysis on this population …

Estimating The Distribution Of Ratio Of Paired Event Times In Phase Ii Oncology Trials, Li Chen, Mark Burkard, Jianrong Wu, Jill M. Kolesar, Chi Wang

Markey Cancer Center Faculty Publications

With the rapid development of new anti-cancer agents which are cytostatic, new endpoints are needed to better measure treatment efficacy in phase II trials. For this purpose, Von Hoff (1998) proposed the growth modulation index (GMI), that is, the ratio between times to progression or progression-free survival times in two successive treatment lines. An essential task in studies using GMI as an endpoint is to estimate the distribution of GMI. Traditional methods for survival data have been used for estimating the GMI distribution because censoring is common for GMI data. However, we point out that the independent censoring assumption required …

Infrastructure Development For Personalized Risk Prediction To Reduce Cardiovascular Disease In Childhood Cancer Survivors, Suman Shrestha

Dissertations and Theses (Open Access)

Although childhood cancer survivors have lengthy life expectancies, they run the risk of experiencing long-term health issues as a result of their treatment. The most frequent non-cancerous cause of morbidity and mortality for these survivors is cardiac disease. Radiation therapy (RT) has been linked in numerous cohort studies to a higher chance of developing a late cardiac disease in these survivors, and this risk rises with higher mean heart doses and increased RT exposure to larger cardiac volumes. Since, the heart is a heterogeneous organ made up of several distinct substructures, RT dose received by the entire heart does not …

Use Of Healthcare Utilization Records For Analyzing Trends In Clinical Toxoplasmosis: A Comparison Of Nevada And The United States, Elijah Kreutzer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Toxoplasmosis, a zoonotic disease caused by the parasitic protist Toxoplasma gondii, is a ubiquitous, global public health concern with a wide variety of clinical manifestations. Surveillance for the disease is lacking even in developed countries, and what surveillance is present most often focuses on pregnant women. This research investigated trends in clinical toxoplasmosis in Nevada and nationally to address the lack of knowledge concerning how Nevada discharges compare to national discharges in cases of toxoplasmosis. Specifically, this research sought to determine what characterizes toxoplasmosis in Nevada across inpatient, outpatient, and emergency department settings, as well as how these cases differ …

A Bootstrap Method For A Multiple-Imputation Variance Estimator In Survey Sampling, Lili Yu, Yichuan Zhao

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Rubin’s variance estimator of the multiple imputation estimator for a domain mean is not asymptotically unbiased. Kim et al. derived the closed-form bias for Rubin’s variance estimator. In addition, they proposed an asymptotically unbiased variance estimator for the multiple imputation estimator when the imputed values can be written as a linear function of the observed values. However, this needs the assumption that the covariance of the imputed values in the same imputed dataset is twice that in the different imputed datasets. In this study, we proposed a bootstrap variance estimator that does not need this assumption. Both theoretical argument and …

Pandemic Fatigue Impedes Mitigation Of Covid-19 In Hong Kong, Zhanwei Du, Lin Wang, Songwei Shan, Dickson Lam, Tim K. Tsang, Jingyi Xiao, Huizhi Gao, Bingyi Yang, Sheikh Taslim Ali, Sen Pei, Isaac Chun-Hai Fung, Eric H. Y. Lau, Qiuyan Liao, Peng Wu, Lauren Ancel Meyers, Gabriel M. Leung, Benjamin Cowling

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Hong Kong has implemented stringent public health and social measures (PHSMs) to curb each of the four COVID-19 epidemic waves since January 2020. The third wave between July and September 2020 was brought under control within 2 m, while the fourth wave starting from the end of October 2020 has taken longer to bring under control and lasted at least 5 mo. Here, we report the pandemic fatigue as one of the potential reasons for the reduced impact of PHSMs on transmission in the fourth wave. We contacted either 500 or 1,000 local residents through weekly random-digit dialing of landlines …

Association Between The Health Belief Model, Exercise, And Nutrition Behaviors During The Covid-19 Pandemic, Keagan Kiely, Bill Mase, Andrew R. Hansen, Jessica S. Schwind

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Introduction: The COVID-19 pandemic has affected our nation’s health further than the infection it causes. Physical activity levels and dietary intake have suffered while individuals grapple with the changes in behavior to reduce viral transmission. With unique nuances regarding the access to physical activity and nutrition during the pandemic, the constructs of Health Belief Model (HBM) may present themselves differently in nutrition and exercise behaviors compared to precautions implemented to reduce viral transmission studied in previous research. The purpose of this study was to investigate the extent of exercise and nutritional behavior change during the COVID-19 pandemic and explain the …

Laboratory Evaluation And Field Feasibility Of Micro-Encapsulated Insecticide Effect On Rhodnius Prolixus And Triatoma Dimidiata Mortality In Rural Households In Boyaca, Colombia, Lidia Gual-Gonzalez, Manuel Medina, Cesar Valverde-Castro, Virgilio Beltran, Rodrigo Caro, Omar Triana-Chavez, Melissa Nolan Ph.D., Mph, Omar Cantillo-Barraza

Faculty Publications

Chagas disease is a neglected vector-borne zoonosis caused by the parasite Trypanosoma cruzi that is primarily transmitted by insects of the subfamily Triatominae. Although control efforts targeting domestic infestations of Rhodnius prolixus have been largely successful, with several regions in Boyacá department certified free of T. cruzi transmission by intradomicile R. prolixus, novel native species are emerging, increasing the risk of disease. Triatoma dimidiata is the second most important species in Colombia, and conventional control methods seem to be less effective. In this study we evaluated the efficacy and usefulness of micro-encapsulated insecticide paints in laboratory conditions and its …

The Dietary Inflammatory Index Is Associated With Subclinical Mastitis In Lactating European Women, Myriam C. Afeiche, Alison Iroz, Frank Thielecke, Antoino C. De Castro, Gregory Lefebvre, Colleen F. Draper, Cecilia Martiínez-Costa, Maria Jose Costeira, Mireille Vanpee, Claude Billeaud, Jean-Charles Picaud, Daryl Lim Kah Hian, Guimei Liu, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Tinu M. Samuel

Faculty Publications

Subclinical mastitis (SCM) is an inflammatory state of the lactating mammary gland, which is asymptomatic and may have negative consequences for child growth. The objectives of this study were to: (1) test the association between the dietary inflammatory index (DII®) and SCM and (2) assess the differences in nutrient intakes between women without SCM and those with SCM. One hundred and seventy-seven women with available data on human milk (HM) sodium potassium ratio (Na:K) and dietary intake data were included for analysis. Multivariable logistic regression was used to examine the association between nutrient intake and the DII score in relation …

Antibody Prevalence And Risk Factors Associated With Rickettsia Spp. In A Pediatric Cohort: Sfgr Remains Underdiagnosed And Underreported In El Salvador, Kyndall C. Dye-Braumuller, Marvin Stanley Rodríguez Aquino, Kia Zellars, Hanna Waltz, Madeleine Meyer, Lídua Gual-Gonzalez, Stella C.W. Self, Mufaro Kanyangarara, Melissa Nolan Ph.D., Mph

Faculty Publications

Spotted fever group rickettsioses (SFGR) are caused by a group of tick-borne pathogens that are increasing in incidence globally. These diseases are typically underreported and undiagnosed in low- and middle-income countries, and thus, have been classified as neglected bacterial pathogens. Countries with high poverty, low human development index score, and limited health infrastructure—like El Salvador in Central America—lack necessary surveillance for SFGR and other tick-borne pathogens. This paucity of baseline SFGR infection prevalence leaves vulnerable populations at risk of misdiagnosis. Further, tick-borne disease burdens in El Salvador are severely limited. To lay the foundation for tick-borne disease epidemiology in El …