Statistics and Probability Commons^™

Adolescent Health Risk Behaviors, Adverse Experiences, And Self-Reported Hunger: Analysis Of 10 States From The 2019 Youth Risk Behavior Surveys, Kathryn L. Krupsky, Sarah Silwa, Hilary Seligman, Andrea D. Brown, Angela D. Liese Ph.D., Zewditu Demissie, Ellen Barnidge

Faculty Publications

We examined associations between adolescent self-reported hunger, health risk behaviors, and adverse experiences during the 2018–2019 school year. Youth Risk Behavior Survey data were pooled from 10 states. Prevalence ratios were calculated, and we assessed effect measure modification by sex. The prevalence of self-reported hunger was 13%. Self-reported hunger was associated with a higher prevalence of every health risk behavior/adverse experience analyzed, even after adjusting for sex, grade, and race/ethnicity. Sex did not modify associations. Findings underscore needs for longitudinal research with more robust measures of adolescent food insecurity to clarify the temporality of relationships.

Factors Associated With Covid-19 Vaccine Intentions Among South Carolina Residents, Mufaro Kanyangarara, Lauren Mcabee, Virginie G. Daguise, Melissa Nolan Ph.D., Mph

Faculty Publications

Despite evidence of vaccine safety and efficacy, vaccine hesitancy remains a major global health threat. The COVID-19 vaccine has presented unique vaccine hesitancy concerns compared to parental vaccine hesitancy towards childhood vaccines. South Carolina (SC) is home to a largely conservative population and historically has some of the lowest vaccination coverage rates in the United States of America. The goal of the current study was to identify factors associated with COVID-19 vaccine intentions among SC residents. From November 2020 to September 2021, 300,000 invitations to participate in community testing and complete an online survey were mailed to randomly selected SC …

A Preliminary Study Of Proinflammatory Cytokines And Depression Following West Nile Virus Infection, Allison Lino, Timothy A. Erickson, Melissa Nolan Ph.D., Mph, Kristy O. Murray, Shannon E. Ronca

Faculty Publications

West Nile virus (WNV) is a neurotropic flavivirus that can cause acute febrile illness leading to neuroinvasive disease. Depression is a well-described outcome following infection, but the underlying pathogenic mechanisms are unknown. Proinflammatory cytokines play important roles in WNV infection, but their role in depression post-WNV remains unstudied. This research aimed to retrospectively evaluate associations between proinflammatory cytokines and new onset depression in a WNV cohort. Participants with asymptomatic WNV infection were significantly less likely to report new onset depression when compared to those with symptomatic disease. Participants with encephalitis and obesity were significantly more likely to report new onset …

Unrestricted Factor Analysis: A Powerful Alternative To Confirmatory Factor Analysis, Jan-Benedict E.M. Steenkamp, Alberto Maydeu-Olivares

Faculty Publications

The gold standard for modeling multiple indicator measurement data is confirmatory factor analysis (CFA), which has many statistical advantages over traditional exploratory factor analysis (EFA). In most CFA applications, items are assumed to be pure indicators of the construct they intend to measure. However, despite our best efforts, this is often not the case. Cross-loadings incorrectly set to zero can only be expressed through the correlations between the factors, leading to biased factor correlations and to biased structural (regression) parameter estimates. This article introduces a third approach, which has emerged in the psychometric literature, viz., unrestricted factor analysis (UFA). UFA …

Are Pregnant Women With Disability Prescribed Opioids More And At Higher Dosages Than Those Without Disability?: A Retrospective Cohort Study Of South Carolina Medicaid Beneficiaries, Chelsea L. Richard Phd, Msph, Bryan L. Love Pharm.D., Nansi Boghossian, James Hardin Ph.D., Suzanne Mcdermott

Faculty Publications

Background: Nationally, individuals with disability have higher rates of opioid use and misuse and are prescribed higher doses than those without disability. Opioid prescriptions during pregnancy are associated with adverse birth outcomes. Objective: To understand the difference in opioid prescribing during pregnancy over time by disability status among Medicaid beneficiaries who gave birth from 2008 to 2017 in South Carolina. Methods: Data from hospital discharges, vital records, and pharmacy were linked to determine the mother's disability status, opioid prescriptions filled during pregnancy, and other maternal characteristics. Disability status was characterized into physical disability, inflammatory conditions, intellectual and developmental disabilities (IDD), …

Food Insecurity And Suicidal Behaviors Among Us High School Students*, Andrea D. Brown, Hilary Seligman, Sarah Silwa, Ellen Barnidge, Kathryn L. Krupsky, Zewiditu Demissie, Angela D. Liese

Faculty Publications

BACKGROUND: Food insecurity (FI) rates in the United States are particularly high among households with children. This research set aims to analyze if high school students experiencing FI had higher risk for mental health and suicidal behaviors.

METHODS: Using combined data from 11 states that conducted the 2017 Youth Risk Behavior Survey, a total of 26,962 and24,051 high school students were used to estimate race/ethnicity and sex-stratified prevalence ratios (PRs) from Poissonregression models. A single-question was used to measure the exposure of FI and outcomes of mental health and suicidalbehaviors.

RESULTS: Overall, 10.8% of students reported FI. Students experiencing FI …

Needs Assessment Of Southeastern United States Vector Control Agencies: Capacity Improvement Is Greatly Needed To Prevent The Next Vector-Borne Disease Outbreak, Kyndall C. Dye-Braumuller, Jennifer R. Gordon, Danielle John, Josie Morrissey, Kaci Mccoy, Rhoel R. Dinglasan, Melissa Nolan Ph.D., Mph

Faculty Publications

A national 2017 vector control capacity survey was conducted to assess the United States’ (U.S.’s) ability to prevent emerging vector-borne disease. Since that survey, the southeastern U.S. has experienced continued autochthonous exotic vector-borne disease transmission and establishment of invasive vector species. To understand the current gaps in control programs and establish a baseline to evaluate future vector control efforts for this vulnerable region, a focused needs assessment survey was conducted in early 2020. The southeastern U.S. region was targeted, as this region has a high probability of novel vector-borne disease introduction. Paper copies delivered in handwritten envelopes and electronic copies …

Shining A Light On Marginal Food Insecurity In An Understudied Population Comment, Angela D. Liese

Faculty Publications

No abstract provided.

The Critical Value Of Maternal And Child Health (Mch) To Graduate Training In Public Health: A Framework To Guide Education, Research And Practice Comment, Julianna Deardorff, Michelle Menser Tissue, Patricia Elliott, Arden Handler, Cheryl Vamos, Zobeida Bonilla, Renee Turchi, Cecilia Sem Obeng, Jihong Liu, Holly Grason

Faculty Publications

Introduction

In light of persistent health inequities, this commentary describes the critical role of maternal and child health (MCH) graduate training in schools and programs of public health (SPPH) and illustrates linkages between key components of MCH pedagogy and practice to 2021 CEPH competencies.

Methods

In 2018, a small working group of faculty from the HRSA/MCHB-funded Centers of Excellence (COEs) was convened to define the unique contributions of MCH to SPPH and to develop a framework using an iterative and consensus-driven process. The working group met 5 times and feedback was integrated from the broader faculty across the 13 COEs. …

Dietary Score Associations With Markers Of Chronic Low-Grade Inflammation: A Cross-Sectional Comparative Analysis Of A Middle- To Older-Aged Population, Seán R. Miller, Pilar Navarro, Janas M. Harrington, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Ivan J. Perry, Catherine M. Phillips

Faculty Publications

Purpose

To assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Mediterranean Diet (MD), Dietary Inflammatory Index (DII^®) and Energy-adjusted DII (E-DII™) scores and pro-inflammatory cytokines, adipocytokines, acute-phase response proteins, coagulation factors and white blood cells.

Methods

This was a cross-sectional study of 1862 men and women aged 46–73 years, randomly selected from a large primary care centre in Ireland. DASH, MD, DII and E-DII scores were derived from validated food frequency questionnaires. Correlation and multivariate-adjusted linear regression analyses with correction for multiple testing were performed to examine dietary score relationships with biomarker concentrations.

Results

In fully …

Pro-Inflammatory Diet Pictured In Children With Atopic Dermatitis Or Food Allergy: Nutritional Data Of The Lina Cohort, Olivia Schütte, Larissa Bachmann, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Janine F. Felix, Stefan Röder, Ulrich Sack, Michaek Borte, Wieland Kiess, Ana C. Zenclussen, Gabriele I. Stangl

Faculty Publications

Background: Lifestyle and environmental factors are known to contribute to allergic disease development, especially very early in life. However, the link between diet composition and allergic outcomes remains unclear. Methods: In the present population-based cohort study we evaluated the dietary intake of 10-year-old children and analyses were performed with particular focus on atopic dermatitis or food allergy, allergic diseases known to be affected by dietary allergens. Dietary intake was assessed via semi-quantitative food frequency questionnaires. Based on these data, individual nutrient intake as well as children’s Dietary Inflammatory Index (C-DII™) scores were calculated. Information about atopic manifestations during the first …

Dietetic Intervention In Psoriatic Arthritis: The Dieta Trial, Beatriz F. Leite, Melissa A. Morimoto, Carina M. F. Gomes, Barbara N.C. Klemz, Patrícia S. Genaro, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Nágila R.T. Damasceno, Marcelo M. Pinheiro

Faculty Publications

Aim To evaluate whether dietary pattern changes, antioxidant supplementation or 5-10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA). Methods A total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) …

Associations Among Plant-Based Dietary Indexes, The Dietary Inflammatory Index, And Inflammatory Potential In Female College Students In Saudi Arabia: A Cross-Sectional Study, Ghadeer S. Aljuraiban, Rachel Gibson, Leenah Al-Freeh, Sara Al-Musharaf, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert, Linda M. Oude, Queenie Chan

Faculty Publications

Background Saudi Arabian diets are transitioning to more Western dietary patterns that have been associated with higher levels of inflammation. Emerging evidence suggests plant-based diets are related to lower levels of inflammation; however, the definition of plant-based diets varies. Objective The purpose of this study was to identify the extent to which an overall Plant-Based Diet Index (PDI), Healthy-PDI (hPDI), and Unhealthy-PDI (uPDI) vs Energy-Adjusted Dietary Inflammatory Index correlate with high-sensitivity C-reactive protein (hs-CRP) level. Design This was a cross-sectional study carried out at King Saud University. Data on dietary intake, anthropometrics, and hs-CRP were collected. Participants/setting Female students aged …

Bright Light Treatment Of Combat-Related Ptsd: A Randomized Controlled Trial, Shawn D. Youngstedt, Christopher E. Kline, Alexandria Reynolds, Shannon K. Crowley, James B. Burch Ph.D., Nidha Khan, Seungyong Han

Faculty Publications

Introduction

Post-traumatic stress disorder (PTSD) is a prevalent consequence of combat with significant associated morbidity. Available treatments for PTSD have had limitations, suggesting a need to explore alternative or adjuvant treatments. Numerous rationales for bright light treatment of PTSD include its benefits for common PTSD comorbidities of depression, anxiety, and circadian misalignment and its relative ease of use with few side effects. The primary aims of this research were to examine the effects of bright light treatment for combat-related PTSD and associated morbidity. Materials and Methods

A randomized controlled trial was performed in N = 69 veterans with PTSD attributable …

Predicting Lower Body Soft Tissue Injuries In American Football With Gps Data, Nicholas Tice

Theses and Dissertations

It is of utmost importance to sports organizations that they keep their players as healthy as possible and contributing to the success of the team. Advancements in technology and investments by sports clubs have allowed researchers to better understand the role of load management in high-level athletes to mitigate injury risk. Through GPS tracking data provided by a collaborating Division I American college football team, we seek to predict lower body soft tissue injuries in future training sessions and reduce the number of potentially avoidable injuries within the organization. The difficulty of analyzing the injury data set is that the …

A Comparison Of Inference Methods In High-Dimensional Linear Regression, Imtiaz Ebna Mannan

Theses and Dissertations

Building confidence/credible intervals for the high-dimensional (p >> n) linear models have been the subject of exploration for many years. In this paper, we explore three specific setups. First, we look at the Bayesian paradigm for the LASSO model. A double-exponential prior has been applied to the regression coefficient and from that, a posterior distribution is derived to get the necessary quantiles to calculate the credible intervals for the regression coefficients. Second, we explore the de-sparsified LASSO estimates, and using its asymptotic normality, we calculate the confidence intervals for the model coefficients. Finally, we incorporate an adaptive LASSO model. To …

Simplified Ranking Model For The College Football Playoff Through Weighted Ranking, Edward Buckhouse

Senior Theses

This research project looks to create a better system to rank college football teams in playoff contention. It uses surveys of coaches to create a weighted guideline to evaluate wins and losses for each team. This constructs a value for adjusted wins that is based on coaches’ data but strays away from the inherent bias that any single coach would have when ranking teams. The resulting Top 25 were then compared to the College Football Playoff final regular season rankings to gauge the success of the new system. The Adjusted Wins system that was established properly picked 13 out of …

Television Viewing Time And All-Cause Mortality: Interactions With Bmi, Physical Activity, Smoking, And Dietary Factors, Christopher T. Swain, Julie K. Bassett, Allison M. Hodge, David W. Dunstan, Neville Owen, Yi Yang, Harindra Jayasekara, James R. Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Robert J. Macinnis, Roger L. Milne, Dallas R. English, Brigid M. Lynch

Faculty Publications

Background Higher levels of time spent sitting (sedentary behavior) contribute to adverse health outcomes, including earlier death. This effect may be modified by other lifestyle factors. We examined the association of television viewing (TV), a common leisure-time sedentary behavior, with all-cause mortality, and whether this is modified by body mass index (BMI), physical activity, smoking, alcohol intake, soft drink consumption, or diet-associated inflammation. Methods Using data from participants in the Melbourne Collaborative Cohort Study, flexible parametric survival models assessed the time-dependent association of self-reported TV time (three categories: < 2 h/day, 2-3 h/day, > 3 h/day) with all-cause mortality. Interaction terms were fitted to test whether …

Determinants Of Covid-19 Vaccinations Among A State-Wide Year-Long Surveillance Initiative In A Conservative Southern State, Lídia Gual-Gonzalez, Maggie S.J. Mccarter, Kyndall Dye-Braumuller, Stella Self, Connor H. Ross, Chloe Rodriguez-Ramos, Virginie G. Daguise, Melissa Nolan Ph.D., Mph

Faculty Publications

By the end of 2021, the COVID-19 pandemic resulted in over 54 million cases and more than 800,000 deaths in the United States, and over 350 million cases and more than 5 million deaths worldwide. The uniqueness and gravity of this pandemic have been reflected in the public health guidelines poorly received by a growing subset of the United States population. These poorly received guidelines, including vaccine receipt, are a highly complex psychosocial issue, and have impacted the successful prevention of disease spread. Given the intricate nature of this important barrier, any single statistical analysis methodologically fails to address all …

Riding The Wave: Reactive Vector-Borne Disease Policy Renders The United States Vulnerable To Outbreaks And Insecticide Resistance, Kyndall C. Dye-Braumuller, Jennifer R. Gordon, Kaci Mccoy, Danielle Johnson, Rhoel Dinglasan, Melissa Nolan Ph.D., Mph

Faculty Publications

Funding for vector-borne disease surveillance, management, and research is cyclical and reactive in the United States. The subsequent effects have yielded gross inequities nationally that unintentionally support recurrent outbreaks. This policy forum is comprised of four primary subsections that collectively identify specific areas for improvement and offer innovative solutions to address national inadequacies in vector borne disease policy and infrastructure.

Neighborhood Deprivation And Risk Of Mortality Among Men With Prostate Cancer: Findings From A Long-Term Follow-Up Study, Madhav K.C., Ariane L. Rung, Edward J. Trapido, Laura S. Rozek, Elizabeth T.H. Fontham, Jeannette T. Bensen, Laura Farnan, Susan E. Steck Phd, Mph, Rd, Lixin Song, James L. Mohler, Edward S. Peters

Faculty Publications

Background The overall survival rate of prostate cancer (PCa) has improved over the past decades. However, huge socioeconomic and racial disparities in overall and prostate cancer-specific mortality exist. The neighborhood-level factors including socioeconomic disadvantage and lack of access to care may contribute to disparities in cancer mortality. This study examines the impact of neighborhood deprivation on mortality among PCa survivors. Methods North Carolina–Louisiana Prostate Cancer Project (PCaP) data were used. A total of 2113 men, 1046 AA and 1067 EA, with PCa were included in the analysis. Neighborhood deprivation was measured by the Area Deprivation Index (ADI) at the census …

Diet Quality Scores And Cardiometabolic Risk Factors In Mexican Children And Adolescents: A Longitudinal Analysis, Abeer Ali Aljahdali, Karen E. Peterson, Alejandra Cantoral, Edward Ruiz-Narvaez, Martha M. Tellez-Rojo, Hyungjin Myra Kim, James R. Hébert Scd, Michael David Wirth Msph, Phd, Face, Libni A. Torres-Olascoaga, Nitin Shivappa Mbbs, Mph, Ph.D., Ana Baylin

Faculty Publications

There is limited evidence for the effects of diet on cardiometabolic profiles during the pubertal transition. We collected repeated measures of diet quality and cardiometabolic risk factors among Mexican youth. This analysis included 574 offspring of the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) birth cohort followed up to three time points. Dietary Approaches to Stop Hypertension (DASH), alternate Mediterranean Diet (aMedDiet), and Children’s Dietary Inflammatory Index (C-DII^TM) scores were computed from food frequency questionnaires. Higher DASH and aMedDiet scores reflect a higher diet quality, and lower C-DII scores reflect an anti-inflammatory diet. Cardiometabolic risk factors …

Patients With Obesity And A History Of Metformin Treatment Have Lower Influenza Mortality: A Retrospective Cohort Study, Tammy H. Cummings, Joseph Magagnoli Ph.D., Ms, James W. Hardin, S. Scott Sutton

Faculty Publications

Background: Obesity is a risk factor for the development of influenza by leading to a chronic inflammatory state and T-cell dysfunction. Based upon preclinical research, metformin has influenza activity by restoring T-cell function and improving the immune response. Objective: We aimed to evaluate the potential drug repurposing of metformin for the management of influenza among patients with obesity utilizing national claims data in an electronic health record database. Methods: The VA Informatics and Computing Infrastructure (VINCI) was utilized to obtain individual-level information on demographics, administrative claims, and pharmacy dispensation. A cohort was created among individuals with laboratory confirmed diagnosis of …

Diet Quality And Dietary Inflammatory Index Score Among Women’S Cancer Survivors, Sibylle Kranz, Faten Hasan, Erin Kennedy, Jamie Zoellner, Kristin A. Guertin, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert, Roger Anderson, Wendy Cohn

Faculty Publications

The purpose of this study was to investigate Healthy Eating Index 2015 (HEI-2015) and Energy-Adjusted Dietary Inflammatory Index (E-DIITM) scores in women's cancer survivors and to examine socio-economic (SES) characteristics associated with these two diet indices. In this cross-sectional study, survivors of women's cancers completed a demographic questionnaire and up to three 24-h dietary recalls. HEI-2015 and E-DII scores were calculated from average intakes. One-way ANOVA was used to examine the association of various demographic factors on HEI-2015 and E-DII scores. Pearson Correlation was used to calculate the correlation between the two scores. The average HEI-2015 score was 55.0 +/- …

Transmodel: An R Package For Linear Transformation Model With Censored Data, Jie Zhou, Jiajia Zhang Ph.D.

Faculty Publications

Linear transformation models, including the proportional hazards model and proportional odds model, under right censoring were discussed by Chen, Jin, and Ying (2002). The asymptotic variance of the estimator they proposed has a closed form and can be obtained easily by plug-in rules, which improves the computational efficiency. We develop an R package TransModel based on Chen's approach. The detailed usage of the package is discussed, and the function is applied to the Veterans' Administration lung cancer data.

Comparison Of Human Urinary Exosomes Isolated Via Ultracentrifugation Alone Versus Ultracentrifugation Followed By Sec Column-Purification, Kun Huang, Sudha Garimella, Alyssa Clay-Gilmour, Lucia Vojtech, Bridget Armstrong, Madison Bessonny, Alexis Stamatikos

Faculty Publications

Chronic kidney disease is a progressive, incurable condition that involves a gradual loss of kidney function. While there are no non-invasive biomarkers available to determine whether individuals are susceptible to developing chronic kidney disease, small RNAs within urinary exosomes have recently emerged as a potential candidate to use for assessing renal function. Ultracentrifugation is the gold standard for urinary exosome isolation. However, extravesicular small RNA contamination can occur when isolating exosomes from biological fluids using ultracentrifugation, which may lead to misidentifying the presence of certain small RNA species in human urinary exosomes. Therefore, we characterized human urinary exosomal preparations isolated …

Scanner: A Web Platform For Annotation, Visualization And Sharing Of Single Cell Rna-Seq Data, Guoshuai Cai, Xuanxuan Yu, Choonhan Youn, Jun Zhou, Feifei Xiao

Faculty Publications

In recent years, efficient scRNA-seq methods have been developed, enabling the transcriptome profiling of single cells massively in parallel. Meanwhile, its high dimensionality and complexity bring challenges to the data analysis and require extensive collaborations between biologists and bioinformaticians and/or biostatisticians. The communication between these two units demands a platform for easy data sharing and exploration. Here we developed Single-Cell Transcriptomics Annotated Viewer (SCANNER), as a public web resource for the scientific community, for sharing and analyzing scRNA-seq data in a collaborative manner. It is easy-to-use without requiring special software or extensive coding skills. Moreover, it equipped a real-time database …

The Isocaloric Substitution Of Plant-Based And Animal-Based Protein In Relation To Aging-Related Health Outcomes: A Systematic Review, Jiali Zheng, Tianren Zhu, Guanghuan Yang, Longgang Zhao, Fangyu Li, Yong-Moon Park, Fred K. Tabung, Susan E. Steck Phd, Mph, Rd, Xiaoguang Li, Hui Wang

Faculty Publications

Plant-based and animal-based protein intake have differential effects on various aging-related health outcomes, but less is known about the health effect of isocaloric substitution of plant-based and animal-based protein. This systematic review summarized current evidence of the isocaloric substitutional effect of plant-based and animal-based protein on aging-related health outcomes. PubMed and Embase databases were searched for epidemiologic observational studies published in English up to 15 March 2021. Studies that included adults ≥18 years old; use of a nutritional substitution model to define isocaloric substitution of plant protein and animal protein; health outcomes covering mortality, aging-related diseases or indices; and reported …

Acute Pediatric Chagas Disease In Antioquia, Colombia: A Geographic Location Of Suspected Oral Transmission, Lídia Gual-Gonzalez, Catalina Aango-Ferreira, Laura Camila Lopera-Restrepo, Omar Cantillo-Barraza, Daniela Velásquez Marín, Natalia Restrepo Bustamante, Omar Triana-Chavez, Melissa Nolan Ph.D., Mph

Faculty Publications

Chagas disease, Trypanosoma cruzi infection, is an insidious cause of heart failure in Latin America. Early diagnosis and treatment are critical to prevent irreversible myocardial damage that progressively accumulates over decades. Several structural barriers account for the less than 1% of cases in Colombia being treated, including poor physician knowledge, especially considering that some regions are considered non-endemic. The two cases reported here represent an emerging epidemiologic scenario associated with pediatric Chagas disease. Both cases are suspected oral transmitted parasitic infection in a geographic region of Colombia (Andean region of Antioquia) where no previous oral transmission of Chagas disease had …

Basis For Changes In The Disease Burden Estimates Related To Vitamin A And Zinc Deficiencies In The 2017 And 2019 Global Burden Of Disease Studies, Sonja Y. Hess, Alexander C. Mclain, Haley Lescinsky, Kenneth H. Brown, Ashkan Afshin, Reed Atkin, Saskia Jm Osendarp

Faculty Publications

Background:

The Global Burden of Disease (GBD) Study provides estimates of death and disability from eighty-seven risk factors, including some micronutrient deficiencies. Objectives:

To review methodological changes that led to large differences in the disease burden estimates for vitamin A and Zn deficiencies between the GBD 2017 and 2019 Studies. Methods:

GBD publications were reviewed; additional information was provided by GBD researchers. Results:

Vitamin A deficiency prevalence is based on plasma retinol concentration, whereas the estimate for Zn deficiency prevalence uses dietary adequacy as a proxy. The estimated global prevalence of vitamin A deficiency for children aged 1–4 years in …