Epidemiology Commons^™

Surveillance And Comparative Genomics Of Bacteria From Hospital And Human Reservoirs, Emily E. Benedict

WUSM Theses and Dissertations – All Programs

Bacteria are diverse and adaptable and, consequently, present in a wide variety of environments. They are capable of growing under intense pressures, including those brought on by the human immune system and disinfection strategies. To survive these pressures, bacteria develop resistances. Antimicrobial resistance, which occurs when a microbe is no longer responsive to the antibiotic intended to control it, is one such adaptation that presents an especially serious threat, as it limits treatment options for infections caused by antimicrobial resistant microbes. Similarly, the ability of bacteria to survive in environments subjected to heavy disinfection efforts, such as intensive care units …

Knowledge, Attitudes, And Practices (Kap) Of Parents Regarding The Prevention And Control Of Childhood Iron Deficiency Anemia In Egypt: A Cross-Sectional Study, Omnia Soliman

Theses and Dissertations

Childhood Iron Deficiency Anemia (IDA) remains a major public health challenge in Egypt, where its persistently high and rising prevalence carries substantial consequences for child growth, cognitive development, immunity, and long-term health outcomes. Globally, approximately 40% of children aged 6–59 months are affected by anemia (World Health Organization, 2025), and Egypt mirrors this burden, with national data showing a worsening trend in recent years. In Egypt, national strategies have traditionally focused on biomedical interventions such as iron supplementation and food fortification, while less attention has been directed toward behavioral and household-level determinants, particularly parental knowledge, attitudes, and practices (KAP) related …

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …

Progression Of Non-Radiographic To Radiographic Axial Spondyloarthritis: A Risk Model Based On A Chinese Cohort Study, Rui Ying Deng, Xiaojia Xu, Jian Hua Peng, Feng Cai Shen, Yao Gong, Dan Min Wang, Hong Jin Liang, Shu Xin Huang, Zhao Peng Chen, Wen Long Wu, Ze Xin Zheng, Ling Lin, Zhi Duo Hou

Research outputs 2022 to 2026

Objectives: To evaluate the progression from non-radiographic axial spondyloarthritis (nr-axSpA) to radiographic axial spondyloarthritis (r-axSpA) in a Chinese cohort, identify associated risk factors in both clinical and imaging arms, and enable risk stratification based on these factors. Methods: Overall, 572 patients with nr-axSpA were enrolled with a median follow-up of 5 years. Cox proportional hazard regression analyses were conducted to identify potential risk factors associated with the progression from nr-axSpA to r-axSpA in both clinical and imaging arms. A risk-scoring system was then developed by assigning each independent predictor a weight based on its regression coefficient. Patients were subsequently categorized …

Women’S Empowerment And Child Stunting In Peru: A Nationally Representative Analysis, Marisella Chumán-Sánchez, Brando Ortiz-Saavedra, Leonardo J. Uribe-Cavero, Anita P. Llamo-Vilcherrez, Joshua W. Moxey, Carlos J. Toro-Huamanchumo

Research outputs 2022 to 2026

Background: Child stunting remains a persistent public health challenge in Peru. Although women’s empowerment has been linked to improved child health, evidence on its domain-specific relationship with stunting remains limited. The objective of this study was to assess the association between women’s empowerment, across attitudes towards violence, social independence, and decision-making, and child stunting in Peru.

Methods: We conducted an analytical cross-sectional study using nationally representative data from the 2021 Demographic and Family Health Survey (ENDES), including 16,650 mother-child pairs. Analyses of women’s empowerment were conducted in a sub-sample with complete SWPER data (n = 12,696). Stunting was defined as …

Pooled Proportion And Associated Factors Of Postoperative Pain During The Recovery Time Among Adult Surgical Patients In An Ethiopian Setting With Limited Resources: A Systematic Review And Meta-Analysis, Sintayehu Samuel Lorato, Mitiku Desalegn, Kelemu Abebe Gelaw, Yohannes Godie Ashebir, Olyad Kuma Getahun, Gebeyehu Lakew, Mathewos Mekonnen Gemmechu, Tiruye Menshaw Tiruneh, Yibeltal Assefa Atalay, Amlaku Nigusie Yirsaw, Eyob Ketema Bogale, Natnael Atnafu Gebeyehu, Tewodros Shitemaw Tekoye, Genanew Kassie Getahun, Kedir Seid, Abel Tibebu Goshu

Research outputs 2022 to 2026

No abstract provided.

A Spatiotemporal Study Of Environmentally Associated Pulmonary Diseases In Georgia, Jason Raymond Baum

Walden Dissertations and Doctoral Studies

Exposures to particulate dust matter (PM10 and smaller) from aggregate comminution facilities (ACF) can lead to the onset of environmentally associated pulmonary diseases (EAPDs); acute and chronic asthma (Type I allergic hypersensitivity reaction), chronic pulmonary disease, interstitial lung disease (ILD), and lung cancer. In this environmental epidemiological research study, three primary spatial and spatiotemporal research questions related to nonoccupational exposures from 118 facilities across Georgia were evaluated. Secondary data analysis was conducted from the Centers for Disease Control and Prevention’s (CDC) 2018–2023 Behavioral Risk Factor Surveillance System (BRFSS) and the Metropolitan Statistical Areas, Micropolitan Statistical Areas, and Metropolitan Divisions to …

Plasmodium Falciparum Parasite Density And Its Association With Malaria Rapid Diagnostic Test Positivity Among School-Aged Children Across Diverse Malaria Transmission Settings In Mainland Tanzania, Felista Mwingira

Tanzania Journal of Science

Malaria rapid diagnostic tests (mRDTs) are widely used for malaria diagnosis and surveillance; however, their performance is influenced by parasite density. This study assessed the relationship between parasite density and mRDT positivity among school-aged children (SAC) across diverse malaria transmission settings in mainland Tanzania. Data were obtained from 17,131 school-aged children participating in a nationwide malaria survey. Malaria infection was assessed using mRDT and quantitative polymerase chain reaction (qPCR) targeting the Plasmodium falciparum lactate dehydrogenase (PfLDH) gene. Parasite density distributions were examined across demographic, environmental, and epidemiological characteristics. Malaria prevalence was 19.5% by malaria rapid diagnostic test (mRDT) and 19.2% …

Burden And Prioritization Of Airborne Diseases In Bogor City, 2024: A Situational Analysis, Tuti Alawiyah, Helda Helda, Menikha Maulida

Jurnal Epidemiologi Kesehatan Indonesia

Indonesia, particularly urban agglomeration areas such as Bogor, continues to face major challenges related to air quality, resulting in an increased risk of airborne disease transmission. This study aimed to assess the burden of airborne diseases and determine health problem priorities in Bogor City using surveillance data from 2022 to October 2024. A descriptive epidemiological study was conducted in Bogor City using surveillance data from 2022 to 2024. Health problem prioritization was performed using the Pan American Health Organization (PAHO)-adapted Hanlon method through structured questionnaires administered to an expert panel consisting of health office officials and heads of primary healthcare …

Covid-19 Vaccination Coverage And Associated Factors In Conflict-Affected Provinces Of The Democratic Republic Of The Congo: A Cross-Sectional Study, Anthony E. Mwakapugi

Jurnal Epidemiologi Kesehatan Indonesia

Background: This study analysed the coverage and determinant factors for COVID-19 vaccination in Ituri, North Kivu, and South Kivu provinces in the Democratic Republic of the Congo (D.R.C). These are war-affected provinces that have experienced prolonged armed conflict, potentially limiting vaccine access.

Methods: A cross-sectional analysis of 9,795 people aged at least 15 years old and older fromyears from the 2023–2024 D.R.C Demographic and Health III Survey was conducted. Weighted descriptive statistics, design-adjusted chi-square tests, and multivariable logistic regression identified determinants of vaccination uptake.

Results: Overall vaccination coverage was 14.1% (95% CI: 11.3% - 17.4%)16.6% (95% CI= 14.2–19.3), with marked …

Situational Analysis Of Maternal And Child Health Problems In Dki Jakarta Province In 2024, Jennifer Irene Amorita Hadiono, Helda Helda, Tri Yunis Miko Wahyono, Inggariwati Inggariwati

Jurnal Epidemiologi Kesehatan Indonesia

Maternal and child health (MCH) is a critical indicator of national health development aligned with SDGs targets. DKI Jakarta, as a densely populated capital city, faces unique challenges in providing equitable MCH services. This study aims to analyze the situational status of MCH problems in DKI Jakarta Province in 2024 and to determine health priorities using the PAHO-adopted Hanlon method. A descriptive study using quantitative and qualitative approaches was conducted at the DKI Jakarta Provincial Health Office from October 2024 to January 2025. Primary data were collected through structured interviews, while secondary data were sourced from reports of the Nutrition …

Factors Associated With Hiv Infection Among People Who Inject Drugs In Jakarta, Igo Cahya Negara, Mondastri Korib Sudaryo, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

HIV infection among people who inject drugs (PWID) remains a substantial public health burden, with Jakarta consistently reporting among the highest PWID-associated HIV prevalence in Indonesia. This study aimed to identify factors associated with HIV infection among PWID in Jakarta, utilizing secondary data from the 2023 Integrated Biological and Behavioral Survey (IBBS 2023). A cross-sectional study design was employed using secondary data from 261 PWID recruited in Jakarta. Bivariate associations were examined using Chi-square tests, and multivariate analysis was performed using modified Cox regression with a constant time parameter to estimate adjusted prevalence ratios (aPR) with 95% confidence intervals. The …

Determinants Of Antiretroviral Therapy Status Among Men Who Have Sex With Men (Msm) Living With Hiv In Greater Jakarta, Leonita Agustine, Mondastri Korib Sudaryo, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

Men who have sex with men (MSM) are a key population contributing to the largest proportion of new HIV infections among the adult population in Indonesia, accounting for 44% of new infections in 2024. However, antiretroviral therapy (ART), as a key intervention in HIV control, remains suboptimal among this group, with previous studies showing that only around 57% of MSM living with HIV in Indonesia were receiving ART. In urban settings such as Greater Jakarta, these gaps may be more pronounced due to complex social and structural barriers to care. This study used a cross-sectional design based on data from …

Faktor-Faktor Yang Berhubungan Dengan Kepatuhan Minum Obat Anti Tuberkulosis (Oat) Di Kota Samarinda, Fahmi Nur Indah Sari, Irfansyah Baharuddin Pakki, Nur Rohmah, Siswanto Siswanto, Muhamad Z. Saefurrohim

Jurnal Epidemiologi Kesehatan Indonesia

Latar Belakang: Tuberkulosis (TB) merupakan penyakit menular yang masih menjadi masalah kesehatan masyarakat utama di Indonesia. Keberhasilan pengobatan sangat bergantung pada kepatuhan pasien dalam mengonsumsi Obat Antituberkulosis (OAT) .

Tujuan . Untuk mengetahui hubungan antara persepsi kerentanan, keparahan, manfaat, hambatan (stigma), isyarat untuk bertindak (peran tenaga kesehatan), dan efikasi diri dengan kepatuhan minum OAT pada pasien TB di Kota Samarinda.

Metode . Penelitian ini menggunakan desain potong lintang dengan pendekatan kuantitatif yang melibatkan 121 pasien TB dari empat Puskesmas di Samarinda. Sampel dipilih menggunakan teknik multistage sampling. Data dikumpulkan melalui wawancara terstruktur menggunakan kuesioner dan dianalisis menggunakan uji Chi-Square.

Hasil …

Descriptive Epidemiology Of Tuberculosis Case With Diabetes Mellitus Identified Through Screening Activities In Indonesia, 2024, Chrisshanti Putri Pasaribu

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) remains a major public health problem, particularly among individuals with diabetes mellitus (DM), who are at an increased risk of developing TB disease. Screening activities conducted through health facility-based screening and active case finding (ACF) provide opportunities to identify TB cases with DM comorbidity. This study aimed to describe the epidemiological characteristics of TB-DM cases identified through screening activities in Indonesia in 2024. This descriptive study used routine secondary program data obtained from the Tuberculosis Information System (SITB). The source population consisted of 615,357 individuals screened for TB in 2024, among whom 14,727 TB cases were identified. Of …

Psychosocial And Demographic Determinants Of Work Stress Among Lecturers At University X, Natasha Putri Ayu Kayla, Fajaria Nurcandra, Dr. Dyah Utari, Nayla K. Fithri, Siti Norashikin Mohamad Shaifuddin

Jurnal Epidemiologi Kesehatan Indonesia

Occupational stress is a psychological pressure related to work conditions. Psychosocial and demographic determinants may be the influence. Lecturers are white collar workers who have the opportunity to experience occupational stress. The aim of this study is to determine the factors that influence occupational stress among lecturers in X University. This research is a quantitative study with a cross-sectional study design. The sampling technique used is Accidental Sampling. The number of samples used was 132 respondents. The study was conducted in April-June 2024. The Cox Regression Model was used to analyze. The instruments used were The Workplace Stress Scale, Multidimensional …

From Advisory To Action: The Case For Preserving Paccarb In The Fight Against Antimicrobial Resistance, Leila S. Hojat, Muhammad Dhanani, Amy Y. Kang, Salome O. Chitavi, Robert A. Weinstein, Edward Stenehjem

Pharmacy Faculty Articles and Research

The Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) was established to advise the government on strategies to mitigate antimicrobial resistance (AMR) and its increasing threat to public health and national security. Its members included experts from diverse disciplines such as healthcare, veterinary medicine, industry, public health, and agriculture who were positioned to interface with key stakeholders and the public in an aspirational multidisciplinary approach to combating AMR. The council was successful in elevating AMR as a national priority and played a crucial role in watershed events for antimicrobial stewardship (AS) such as the development of the second National Action …

Degree Assortativity And Estimation Of Degree Distribution In A Contact Network Of People Who Inject Drugs, Peter Geissert

Dissertations and Theses

This dissertation analyzes data from a respondent driven sampling (RDS) study of people who inject drugs in Portland, OR.  The objective was to assess assumptions for the use of weighted estimators to estimate a population physical contact (syringe sharing) network degree distribution.

Visualization of degree distribution for social and physical networks, Kolmogorov-Smirnov tests of difference, and kernel tests of equivalence were used for comparison of distributions. Spearman's rho and GAM non-parametric regression models were used to test for association and assess non-monotonic relationship. The validity of Markov chain assumptions for RDS was assessed using a transition matrix, Markov chain graphs, …

Pola Rujukan Penyakit Saluran Pernapasan Di Fasilitas Kesehatan Tingkat Pertama: Tantangan Gatekeeper Program Jaminan Kesehatan Nasional Di Jakarta, Syarif Rahman Hasibuan, Melrose Holy Natasha, Fatih Jihadi Ramadan

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Program Jaminan Kesehatan Nasional yang diselenggarakan oleh Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan mewajibkan Fasilitas Kesehatan Tingkat Pertama (FKTP) untuk menyeleksi kasus yang memerlukan rujukan. Penyakit saluran pernapasan yang menjadi penyebab utama kunjungan ke FKTP memiliki pola rujukan yang masih belum banyak diteliti. Oleh karena itu, dilakukan penelitian untuk melihat pola rujukan penyakit saluran pernapasan di FKTP dan mengetahui faktor yang berasosiasi dengan keputusan rujukan. Penelitian potong lintang ini dilakukan terhadap 89.225 klaim FKTP di Jakarta pada periode 2017-2023, dengan kriteria inklusi semua kunjungan dengan diagnosis ICD-10 diseases of the respiratory system. Uji regresi logistik dilakukan untuk mengidentifikasi faktor …

Precision Approaches Improve Community Health, Roger A. Rennekamp, David Buys

Journal of Extension

Recent advances in data science provide Extension practitioners with access to data sorted by zip code, census tract, or neighborhood. Such hyper-local data now allows Extension personnel to assess community needs and assets at a more granular level and focus their work on the people and communities of greatest need. In this article, we introduce an approach we refer to as precision public health. Using such a precision approach to community assessment and, ultimately, programming can save money, increase the likelihood of producing measurable results, and create more manageable workloads for county-based Extension personnel.