Epidemiology Commons^™

Europe–Africa Collaboration: Working Together To Strengthen Health Research, Implementation, And Equitable Systems, Lara Pandya, Irene Norstedt, Martin Seychell, Emer Cooke, Isabel De La Mata Barranco, Niklas Blomberg, Marleen Temmerman, Michael Makanga

Centre of Excellence in Women and Child Health

In September 2024, key representatives from European Union (EU) directorates and agencies convened to enhance collaboration with Africa in strengthening health research, innovation, and implementation. The meeting focused on bolstering joint efforts to improve health outcomes and support wellbeing across all ages in Africa. Despite progress in addressing infectious diseases, the continent faces a dual burden with the rise of non-communicable diseases and emerging threats such as antimicrobial resistance, climate change, falsified medicines, and pandemic risks. These challenges are exacerbated by fragile health systems, rapid population growth, urbanisation, and limited access to affordable medical interventions.

To address these issues, the …

Fine-Scale Population Structure Of Japanese Helicobacter Pylori Provides New Anthropological And Epidemiological Insights, Kohei Tomonari, Batsaikhan Saruuljavkhlan, Ricky Indra Alfaray, Kartika Afrida Fauzia, Osamu Matsunari, Daisuke Chinda, Tadashi Shimoyama, Phawinee Subsomwong, Nagisa Kinjo, Tetsu Kinjo, Yasuo Hanamure, Masato Shinzato, Rumiko Suzuki, Fukunori Kinjo, Shigeru Takigami, Toshio Fujioka, Takeshi Matsuhisa, Junko Akada, Takashi Matsumoto, Yoshio Yamaoka

Faculty, Staff and Students Publications

Helicobacter pylori is considered to contribute to gastric cancer and is also used as a marker to trace human migration due to its co-evolution with humans. To understand the recently proposed tripartite model suggesting three ancestral origins for the Japanese population and address the enigma of the high incidence of gastric cancer in Northeast Hondo (Hondo is mainland Japan), we conducted a fine-scale population structure analysis using a large Japanese H. pylori dataset, including 438 strains from 9 regions based on whole-genome sequences. As a result of fineSTRUCTURE analysis, it was found that H. pylori in Northeast Hondo is genetically …

Intersectoral Interventions: Integration For Impact On Preterm Birth, Etienne V. Langlois, Maria El Bizri, Kelly Thompson, Amy Reid, Merette Khalil, Giulia Gasparri, Joy E. Lawn, Teesta Dey, Judith Robb-Mccord, Marleen Temmerman

Centre of Excellence in Women and Child Health

Progress: The last two decades have seen a growing focus on intersectoral interventions to improve maternal and newborn health and well-being outcomes, as refected in eforts to achieve the Millennium Development Goals (MDGs) and advance the Sustainable Development Goals (SDGs). Preterm births are linked to cross-sectoral determi‑ nants that afect health outcomes and human capital across the life-course, necessitating an intersectoral approach that addresses these multifaceted challenges.

Programmatic priorities: Recognizing that social, biological and economic determinants signifcantly infuence health outcomes, it is critical that robust health systems are reinforced by a comprehensive intersectoral approach. Evidence suggests that the factors infuencing …

Investigating The Associations Of Cognitive Health, Health Behaviors, And Personality In Older Community-Dwelling Adults, Yan-Jhu Su

Graduate Doctoral Dissertations

Cognitive decline poses a significant public health challenge, with profound implications for aging populations. This dissertation investigates the associations between health behaviors, leisure activities, personality traits, and cognitive function in older U.S. adults, using data from the Health and Retirement Study (HRS) and the Consumption and Activities Mail Survey (CAMS). This work comprises three studies that explore both cross-sectional and longitudinal perspectives on cognitive aging.

Study 1 examines the complex interactions between personality traits, education, health behaviors, and cognitive function. The study is divided into two parts: Study 1a explores the role of health behaviors—smoking, alcohol use, and physical activity—as …

Risk Factors Associated With Long Covid Among Hospitalized Adults In Several Hospitals In Palembang City, Indonesia, Hotma Martogi Lorensi Hutapea, Mondastri Korib Sudaryo, Arli Aditya Parikesit, Tri Yunis Miko Wahyono, Nelda Aprilia Salim

Kesmas

Long COVID is characterized by one or more symptoms experienced by individuals prior to a COVID-19 infection that last for ≥2 months, and its risk factors remain unclear. This study aimed to identify risk factors associated with long COVID among patients admitted between June 1, 2020, and October 31, 2023, at three referral COVID-19 hospitals in Palembang City, Indonesia. This cohort study included adults who were admitted for ≥5 days. The participant’s medical records were reviewed for admission and discharge dates, sociodemographic and clinical characteristics, and vaccination and therapy status. A standardized and validated instrument was used to assess fatigue …

Machine Learning For Preeclampsia Prediction: Enhancing Screening In Primary Health Care, Dwirani Amelia, Asri Adisasmita, Kemal N. Siregar, Detty Siti Nurdiati

Kesmas

Preeclampsia is a leading cause of maternal morbidity and mortality worldwide, with early detection being critical for reducing adverse outcomes. This study aimed to develop a machine learning model for predicting the risk of preeclampsia using readily available maternal characteristics such as body mass index, mean arterial pressure, and clinical history of hypertension or diabetes mellitus. Secondary data from 2,250 pregnancies were analyzed, addressing challenges such as missing data and class imbalance through preprocessing. Various algorithms, including support vector machines, random forest, and logistic regression, were evaluated. Herein, a support vector machines model with threshold adjustment showed the best performance, …

Understanding Vaccine Hesitancy And Barriers To Access In Hispanic Individuals Of Metro Detroit​, Rafael Ramos, John Gallegher, Nevil Khurana, Ingrid Rocha, Rene Andino-Galva, Izabel Thomas, Deni Peterson, Alexander Eskandarian, Eliezer Arody Gomez, Md

Medical Student Research Symposium

Background:

Detroit’s Hispanic community is still disproportionally uninsured at about 2x the rate of non-Hispanic white and 3x the rate of non-Hispanic Black residents. In the post-COVID era, vaccine hesitancy and barriers to access have been well-documented. Studies suggest that minority populations, including the Hispanic population, may experience unique social determinants of health which affect their vaccination rates and outcomes. Additionally, research shows that knowledge of vaccines may correlate with levels of trust.

Methods:

We sought to describe the knowledge, barriers to access, and levels of trust regarding the influenza (flu) vaccine in Hispanic individuals of Metro Detroit. We used …

Socioeconomic Disparities In Breast Cancer Survival: Examining Potential Mediator Role Of Oncotype Dx(Odx) Test And Stage At Diagnosis Among Hr+/Her2- Breast Cancer Women, Pratibha Shrestha, Qingzhao Yu, Edward S. Peters, Edward Trapido, Mei Chin Hsieh, Tekeda Ferguson, Quyen D. Chu, Xiao Cheng Wu

School of Public Health Faculty Publications

Background: Women with a lower socioeconomic status (SES) have an increased risk of dying from breast cancer (BC) than those with a higher SES. The association of SES with BC survival may be partially mediated by factors such as Oncotype DX (ODX) testing and stage at diagnosis. This study aims to examine SES disparities in survival among HR+/HER2- BC women and to quantify the mediating effects of the ODX test and stage. Methods: We used data from the Louisiana Tumor Registry to identify women aged 20–90 years diagnosed with stage I–II in 2011–2014 and stage I–III in 2015–2017 HR+/HER2- BC …

Intersectional Analysis Of Vaccination Inequity Among Individuals With Disabilities In The United States During The Covid-19 Pandemic, Philip Ndoki, Heba M. Athar, David O. Anderson

Journal of Social, Behavioral, and Health Sciences

We investigated how disability status, types, sociodemographic indicators, and reasons for not receiving vaccinations influenced COVID-19 vaccination rates among individuals with disabilities in the United States. Despite efforts, vaccination disparities persisted, necessitating a nuanced understanding of the barriers to vaccination. Using intersectionality theory and the social determinants of health framework, we examined the impact of marginalized identities and structural inequalities. Key questions included the association between disability status and vaccination uptake, differences among disability types moderated by sociodemographic factors, and the interaction between disability status and reasons for not vaccinating. We used Household Pulse Survey data from the U.S. Census …

Exposure To Second-Hand Smoke In Homes And Respiratory Symptoms Among Non-Smoking Adults In Depok, Indonesia 2025, Faraz Ali, Budi Hartono

Journal of Indonesian Health Policy and Administration

Second-hand smoke (SHS) exposure in the home environment has become a public health emergency, especially in countries with very high smoking rates, such as Indonesia. SHS exposure has already presented evidence of symptoms of the respiratory category, like a cough and shortness of breath. This study aimed to assess the association between exposure to SHS at home and the presence of respiratory symptoms among non-smoking adults in Depok, Indonesia. Convenience sampling was adopted for enrolling 108 non-smoking adults aged 18-30 who were jointly exposed to SHS in their homes for a cross-sectional study. Data aggregations of gatherings were performed using …

Dietary Intake Of Protein By Food Source And Incident Hypertension Among Diverse Us Adults: The Mesa Study, Ji Yun Tark, Ruosha Li, Bing Yu, Alexis C Wood, Nikhil S Padhye, Marcia C De Oliveira Otto

Faculty, Staff and Student Publications

Background: Dietary guidelines recommend adequate protein intake from diverse sources for optimal blood pressure; however, its role in hypertension risk remains unclear. We examined prospective associations of protein intake and diversity, overall and by source, with hypertension risk in the MESA (Multi-Ethnic Study of Atherosclerosis) study.

Methods and results: Among 2294 participants aged 45 to 84 years without hypertension at baseline, total, animal, and plant protein intake was assessed using a 120-item food frequency questionnaire. Protein diversity was evaluated using count and the dissimilarity index. Over a 9-year median follow-up, 1356 hypertension cases were identified through blood pressure measurements and …

Science Tikkun: A Bioscience Pandemic Framework In A Hebrew Tradition Of Global Repair, Peter Hotez

Center for Medical Ethics and Health Policy Staff Publications

Over the past decade we have seen a steady increase in dangerous pandemic threats. They include two major Ebola epidemics and cholera in Africa; dengue, Zika, yellow fever in the Americas; a COVID-19 pandemic; and H5N1 in Texas. This is happening because of a confluence of modern forces including urbanization, deforestation, and climate change. Yet as pandemics emerge on a crowded and warming planet, anti-science disinformation and antisemitism impede our response. Science tikkun is an overarching framework for repair and redress. It honors the legacy of Maimonides, Teilhard de Chardin, and others who have sought reconciliation between science and religion.

Quantiferon Tb Gold Test Utilization During Inpatient And Emergency Department Encounters At A Multi-Site, Single Academic Institution, Laxman Singanamala, Bs, Laura Walters, Do, Devin M. Weber, Md, Courtney E. Comar, Phd

Health Equity and Quality Improvement (HEQI) Summit

Background

• The QuantiFERON-TB Gold Plus test (QG) is an in vitro Interferon Gamma Release Assay that can be used to assess for prior exposure to Mycobacterium tuberculosis (MTB). The optimal use is in screening for latent disease.
• The United States is a low endemic country for MTB infection with 2.5 cases/100,000-persons in 2022 (CDC). Yet, we noted high utilization of the QG in our institution.
• Our goal was to understand our patient population and the clinical rationale for testing to create an electronic medical record (EMR) order set to optimize appropriate test use, decreasing unnecessary testing for patients and healthcare …

A Retrospective Study Of Pulmonary Function Tests In Bronchiectasis: An Infectious Disease Of The Respiratory System, Vinod Mutkule, Mahesh Shinde, Vidya Bapmare, Sangramsingh Dixit, Atharva Sharma, Kshitij Sarwey, Yogeshwari Patil, Sanket Jethlia, Aayushi Dwivedi, Disha Pardeshi, Anmol Rai, Kunal Shah, Vidhi Kalwar

The University of Louisville Journal of Respiratory Infections

Introduction: Bronchiectasis, currently being recognized worldwide, is an abnormal dilatation of the bronchi and bronchioles brought on by recurrent cycles of inflammation and airway infection. Impaired pulmonary function has a predictive significance in bronchiectasis. When treating patients with suspected or confirmed respiratory diseases, pulmonary function tests (PFT) are useful examinations. Very few studies have been done on PFTs in bronchiectasis. The main aim of this study is to study PFTs in bronchiectasis.

Method: This is a retrospective observational study done on 50 patients over two years at the tertiary care center. The previous records of patients were collected from the …

“Do You Even Lift, Bro?”: Correlates Of Muscle Dysmorphia Symptomatology In Filipino Male University Students, Pamela Paula C. Pioquinto

UNLV Theses, Dissertations, Professional Papers, and Capstones

Muscle Dysmorphia (MD) is a subtype of Body Dysmorphic Disorder (BDD) and is marked by the desire to increase muscularity and reduce body fat. MD is typically more prevalent among younger male populations, and it often drives comorbid disorders, including substance abuse, eating disorders, and social anxiety. Despite the growing literature on MD, it remains understudied in certain racial/ethnic populations, such as Filipinos. Acculturation, defined as the process in which an individual adopts, acquires, and adapts to a new cultural environment as a result of immigration, influences body image by reshaping an individual’s perceptions of beauty and muscularity standards. Guided …

From Vector To Consequence: Integrating Vector Surveillance, Environmental Drivers, And Public Health Impact Into Lyme Disease Risk Management, Kathleen E. Angell

Theses & Dissertations

Lyme disease is the most common vector-borne disease in North America. This dissertation examines (1) how crowd-sourced compares to active vector surveillance and whether they are associated with Lyme disease, (2) how ecological factors relate to tick abundance and whether they can predict high disease years, and (3) estimated health and economic burden of Lyme disease and savings when interventions are applied. Tick abundance data from active and passive surveillance were compared and tested for association with Lyme disease in the first aim. We found differences in tick life-stage, species, and seasonality. Tick observations were positively correlated with Lyme disease. …

Schistosoma Haematobium Infection In Ethiopian Children: Evaluating Praziquantel Efficacy, Nutritional Effects, And Diagnosis Using Flukecatcher, Louis Fok

Theses & Dissertations

Urogenital schistosomiasis continues to impact the wellbeing of hundreds of millions of people worldwide and remains a significant public health challenge across Ethiopia. Despite existing knowledge on the disease, there remain significant unanswered questions with regard to its treatment and diagnosis. This dissertation evaluated the efficacy of praziquantel at treating urogenital schistosomiasis, improving nutritional parameters among children and the performance of FlukeCatcher at detecting and determining the intensity of infection. In effecting this, a total of 977 children aged 5 through 15 from the Afar and Gambella regions of Ethiopia were screened for S. haematobium infection using urine filtration microscopy …

Demographic And Clinical Factors Associated With Mechanisms Of Open Globe Injury In The United States: A Multi-Center Study, Shruti Anant, Alicia Casella, Jason A. Greenfield, Sarah C. Miller, Kristine Y. Wang, Bita Momenaei, Karen Lee, Hana A. Mansour, Grant A. Justin, Kevin G. Makhoul, Racquel A. Bitar, Alice Lorch, Grayson W. Armstrong, Taku Wakabayashi, Yoshihiro Yonekawa, Kara M. Cavuoto, Fasika Woreta

Wills Eye Hospital Papers

PURPOSE: We sought to examine the demographic and clinical risk factors associated with specific mechanisms of open globe injuries (OGIs) and identify predictors of Zone III injuries across multiple tertiary eye care centers.

PATIENTS AND METHODS: 1570 patients with OGIs presenting to the Wilmer Eye Institute, the Bascom Palmer Eye Institute, Massachusetts Eye and Ear, and Wills Eye Hospital between 2018-2021 were retrospectively reviewed. Multinomial and binomial logistic regression models were used to evaluate associations between demographic and clinical risk factors with injury mechanisms and Zone III injuries.

RESULTS: Among the study population (74.2% male, mean age 48.2 years), falls …

Enhancing Healthcare-Associated Infection Prevention: The Role Of Hand Hygiene, Ppe, Isolation, And Vaccination Education, Kaitlyn N. Rollo

Aurora

Healthcare-associated infections (HAIs) represent a significant threat to patient safety in hospital environments. These infections are often linked to lapses in infection prevention protocols, including inadequate hand hygiene, improper use of personal protective equipment (PPE), and insufficient isolation procedures. This project aimed to evaluate compliance with infection control policies and identify areas for improvement at Lima Memorial Hospital. By focusing on auditing, education, and data analysis, the goal was to reduce HAI rates and strengthen overall infection prevention practices.

Methods included a comprehensive review of existing hospital infection prevention policies, followed by hand hygiene and PPE audits across the hospital’s …

Optimising Non-Cycloplegic Screening Strategies For Early Detection Of Pre-Myopia And Myopia In Young Children, Síofra Harrington, Michael Moore, James Loughman, Ian Flitcroft, Veronica O'Dwyer

Articles

Purpose: Early detection of myopia is essential to delay its onset and progression. Pre-myopia, defined by an inadequate hyperopic reserve, increases myopia risk in childhood. However, effective screening methods remain limited. This study aimed to develop practical non-cycloplegic screening methods for pre-myopia and myopia in 6- to 7-year-olds to support earlier interventions.

Methods: This cross-sectional study of 621 Irish schoolchildren (mean age: 7.12 ± 0.45 years; 51.8% boys) assessed uncorrected distance visual acuity (UDVA). Cycloplegic spherical equivalent refraction (SER) classified refractive status (myopia: SER ≤ −0.50D; pre-myopia: SER > −0.50 ≤ 0.75D). Pre- and post-cycloplegic SER were measured using the Welch …