Epidemiology Commons^™

Investing In The Development Of The Next Generation Of Mch Leaders, Karen A. Mcdonnell, Jamal Percy, Lisa Anders, Monique J. Brown Ph.D., Mph, Alice R. Richman, Julianna Deardorff, Monica S. Ruiz, Jihong Liu Sc.D., Kelli Russell, Audrey Snyder, Cassondra Marshall

Faculty Publications

The public health landscape is constantly evolving to address the strengths and needs of the community. Training for the public health workforce is leading the way, establishing an ecosystem approach that integrates individuals within social, political, and environmental contexts to promote health equity within a framework of social justice. One area of public health that is innovatively preparing the next generation of leaders is maternal and child health (MCH). In the United States, key indicators of health disparities within MCH remain stagnant, highlighting the need for training programs that develop future MCH professionals from diverse backgrounds. These professionals will deliver …

Healthcare Providers’ Perspective On Hiv Testing And Hypothetical Mhealth-Connected Linkage To Care Among Men Who Have Sex With Men (Msm) In South Carolina, Tony Brown, Prince Nii Ossah Addo, Monique J. Brown Ph.D., Mph, Xiaoming Li, Oluwafemi Adeagbo

Faculty Publications

Background: HIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers’ willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers’ perceptions of HIV testing and treatment uptake among MSM, and providers’ willingness to use mHealth technology to address barriers to HIV testing and treatment in SC. Methods: Between August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on …

Sars-Cov-2 Detection And Persistence In A Remote Amazonian Settlement, Glauco M. Silva, Roberto C. Ilacqua, Franciely G. Gonçalves, Carla M. Santana, Felipe T. Jordão, Paula R. Prist, Melissa S. Nolan Ph.D., Mph, Andreia F. Brilhante, Marcia A. Sperança, Gabriel Z. Laporta

Faculty Publications

Background: COVID-19 continues to pose a major global health challenge. Despite its geographic distance from Brazil’s major urban centers, Acre state has experienced notable outbreaks. This study assessed the detection and persistence of SARS-CoV-2 in the rural settlement of Santa Luzia, located in the remote municipality of Cruzeiro do Sul, Acre state, Brazil. Methods: In July 2022, a cross-sectional survey was conducted at 40 sites from an ongoing environmental study, selected by deforestation patterns and proximity to health posts. Saliva samples were collected from residents aged 5–90 years, followed by nucleic acid extraction and multiplex RT-qPCR for SARS-CoV-2 detection. Results: …

Expertise Or Experience: Comparing Discussion Of Drought Between Audiences And Agencies In Nebraska, Kansas, Iowa, And Missouri, Cory L. Armstrong, Sharon E. Baldinelli, Kelly Helm Smith, Sharon J. Medcalf

Journal Articles: Epidemiology

Significant portions of the states in FEMA region 7 (Kansas, Nebraska, Missouri, and Iowa) were in drought in 2022–23. Culling data gathered from a prominent social media platform and from focus group discussions, this research examines how drought information was communicated between the public officials and the general public. Through the lens of the two-step flow of communication theory, the central research question explored the differences between public conversations about drought among individuals experiencing it and the viewpoints of experts who work on drought-related issues. Results from social media conversations were examined, along with insights from focus group discussions involving …

Cellular And Molecular Mechanisms Of Lung Regeneration, Repair, And Fibrosis, Volume Ii, Yong Qiu, Xiao Xiao Tang, Shigeyuki Shichino, Prem Prakash Kushwaha, Yan Y. Sanders, Remo Castro Russo, Chunheng Mo

Department of Biomedical and Translational Sciences Faculty Publications

[Introduction] Organ fibrosis represents a substantial a major contributor to global disease burden, implicated in over 30% of cases leading to disability-associated and fatal conditions. Among these conditions, idiopathic pulmonary fibrosis (IPF) stands as a progressive and frequently fatal interstitial lung disease characterized by aberrant extracellular matrix deposition and parenchymal scarring. The prognosis for IPF patients is poor, with a median survival time of just 3–5 years (Bhattacharya and Ramachandran, 2023; Lederer and Martinez, 2018, Ma et al., 2024, Wei et al., 2024). Current FDA-approved therapeutics, Pirfenidone and Nintedanib, demonstrate capacity to attenuate functional decline in pulmonary fibrosis but remain …

Frailty And Sleep In Adult Survivors Of Childhood Cancer: A Childhood Cancer Survivor Study Report, Lauren C. Daniel, Margaret M. Lubas, Huiqi Wang, Mariana Szklo-Coxe, Kirsten K. Ness, Annalynn M. Williams, Daniel A. Mulrooney, Rebecca Howell, Wendy Leisenring, Yutaka Yasui, Leslie L. Robinson, Gregory T. Armstrong, Eric J. Chow, Kevin R. Krull, Tara M. Brinkman

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Young adult survivors of childhood cancer exhibit rates of frailty similar to adults several decades older without a cancer history. Frailty has been associated with sleep disturbances in non-cancer populations, but the relationship has not been examined in childhood cancer survivors who are known to exhibit elevated rates of sleep problems.

Aims

Examine associations between frailty and poor sleep quality in long-term survivors of childhood cancer.

Methods

This study utilized data from 9044 participants (> 5 years from diagnosis, M(age) = 40.8 years [SD = 9.5]) in the Childhood Cancer Survivor Study. Survivors' frailty status, chronic health conditions (CHC), …

Analyzing The Centers For Disease Control And Prevention Mortality Data Using Weekly Exceedance In Mortality Count And Weekly Change In Mortality Indicator: A Time Series Study, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Aims

Cause-specific mortality (CSM) count prediction plays a vital role in the context of public health policy. In this study, we introduce a new analytical approach, which is divided into three phases to answer specific questions regarding CSM due to 14 specific causes by computing different simple, compound, and conditional probabilities.

Methods

A multivariate time series forecasting model was developed using the CDC weekly mortality count data. A binary data matrix was constructed for 14 causes of death (COD) as a function of weeks by combining the observed and forecasted mortalities. We introduced two new concepts: Weekly Exceedance …

Pediatric Cancer Incidence, Temporal Trends, And Mortality In The United States By Health Disparities Indicators, Seer (1973-2014), Prachi P. Chavan, Laurens Holmes Jr.

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pediatric cancer incidence has been increasing in the United States, despite improvement in pediatric cancer survival. This steady increase in incidence trends is not completely understood but maybe associated with social and environmental factors. In this study we aimed to assess the cumulative incidence, temporal trends, and mortality rates in pediatric cancer. Additionally, we examined sub-group variability in both incidence and mortality rates. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) −18 from 1973–2014 were used for the purpose of analysis in this study. Age-adjusted incidence rates were used to assess temporal trends in cancer among children aged < 1–19 years. Univariable and multivariable binomial regression models were used to examine the association between race and cancer mortality while adjusting for potential confounders. Results: There were 92,594 cancer diagnoses during this period. White children comprised 74,758, (80.7%), black children 10,030, (10.8%), and other races 6648, (7.2%). Overall the age-adjusted cumulative incidence was slightly higher among white children (16.4%) than black children (12.4%) and other (13.0%). Children aged 15–19 years and those in metropolitan regions were more likely to be diagnosed with pediatric cancer. Relative to females, males were 16% more likely to die from the disease [adjusted Risk Ratio (aRR): 1.16, 95% Confidence Interval (CI): 1.09–1.22]. Additionally, compared to white children, black children had higher mortality rates [(aRR): 1.37, 99% CI: 1.23–1.52]. Conclusions: There is an increasing trend in pediatric cancer incidence; while white children have the highest incidence, black children and males indicated a survival disadvantage, indicative of racial and sex variability in overall pediatric cancer in the United States.

Tobacco And Trouble: Exploring The Health Consequences Of Electronic Cigarette Use In Adolescents, Noor Ibrahim Abdulhay

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Tobacco use remains one of the leading causes of preventable disease and death in the United States (U.S.). Although conventional cigarette use among youth has declined, the use of electronic cigarettes (e-cigarettes) has become highly prevalent and poses emerging public health concerns. Adolescence represents a critical developmental period for both oral and mental health, making it essential to understand the consequences of tobacco and nicotine exposure during this stage. The goal of this dissertation is to examine the health impacts of tobacco use in adolescents across multiple domains. Specifically, this research (1) synthesizes existing evidence on the relationship between …

Risk Of Post-Acute Symptoms Among Adults: A Comparison Study Of Severe Covid-19, Pneumonia, And Influenza, Caroline M Schaefer, Trudy Millard Krause, George L Delclos, Raymond S Greenberg

Faculty, Staff and Student Publications

Background: A retrospective cohort study was undertaken to assess the relationship between initial disease severity of COVID-19 and the risk of post-acute symptoms. The COVID-19 cohort was compared against influenza and pneumonia cohorts to assess whether risk of post-acute symptoms differed.

Methods: Administrative health claims data were obtained for commercially insured and Medicare Advantage covered adults (≥ 18 years) with symptomatic laboratory-confirmed COVID-19 diagnosed in 2020 (n=121,205), and similar cohorts of influenza (n=20,844) and pneumonia (n=29,052) patients diagnosed prior to the pandemic. Post-acute symptoms were assessed at four weeks, three and six months following initial diagnosis.

Results: Among the patients …

Polygenic Risk Scores Of Grip Strength In Men And Women With Or At Risk For Hiv, Sreevidya Sadananda Sadasiva Rao

Electronic Theses & Dissertations (2024 - present)

Background: Adequate hand function among older adults is necessary for the successful completion of activities of daily living and can affect whether an older adult is able to live independently. Current research highlights grip strength, the strength people have in their hands, as a robust predictor of morbidity and mortality, and explores the decline in grip strength over time. A person’s family history and genes (DNA) affect how much grip strength they have. Previous studies have identified genes that affect grip strength, mainly in European ancestry populations. In this study, we examined whether these genetic elements predict grip strength in …

Epidemiologi Kejadian Luar Biasa Malaria Bulan September-November 2024: Studi Serial Kasus Di Kabupaten Indragiri Hilir, Provinsi Riau, Rajunitrigo Rajunitrigo, Irwan Muryanto, Renti Mahkota, Fadhil Armen, Yusni Nuryanti, Fahrul Rizal, Rabiatul Adwiyah

Jurnal Epidemiologi Kesehatan Indonesia

Abstract

Malaria remains a public health issue in Indragiri Hilir Regency, Riau, despite its elimination certification 2018. In 2024, a malaria outbreak occurred, and an epidemiological investigation was then carried out. This study aims to describe the epidemiological characteristics of the malaria outbreak based on person, time, and place. This study used a serial case design, analyzing all confirmed malaria cases reported in the e-SISMAL system of Indragiri Hilir Regency from September 1^st to November 30^th, 2024. Data on Anopheles Sundaicus habitats were obtained from epidemiological investigation reports. Univariate and bivariate analyses were conducted using the chi-square …

Analisis Situasi Masalah Penyakit Infeksi Menular Seksual Di Kota Bogor Tahun 2024, Wardiman Wardiman, Ratna Djuwita, Bai Kusnadi

Jurnal Epidemiologi Kesehatan Indonesia

Abstrak

Infeksi menular seksual (IMS) masih menjadi tantangan kesehatan global, termasuk di Indonesia, terutama pada kelompok usia produktif 15-49 tahun. Di Kota Bogor, angka kasus IMS mengalami peningkatan, namum belum sepenuhnya menggambarkan kondisi yang sebenarnya. Penelitian ini bertujuan untuk menganalisis situasi IMS secara mendalam dan menetapkan prioritas masalah kesehatan menggunakan metode PAHO-adapted Hanlon, yang mengacu pada pembobotan Basic Priority Rating (BPR) berdasarkan lima kriteria utama, yaitu, A=Masalah utama; B=Keseriusan masalah; C=Efektivitas intervensi; E=Ketidakadilan; F=Kapasitas institusi dalam mengatasi masalah. Penelitian ini dilaksanakan di Dinas kesehatan Kota Bogor pada Oktober 2024 hingga Januari 2025, dengan pendekatan kualitatif dan kuantitatif, serta disajikan secara …

Determinan Faktor Dengan Ketidakpatuhan Dalam Mengonsumsi Obat Antiretroviral Pada Orang Dengan Hiv(Odhiv) Di Rumah Sakit Umum Daerah Kabupaten Tangerang Tahun 2023, Dessi Marantika Nilam Sari, Mondastri Korib Sudaryo, Syahrizal Syarif, Helwiah Umniyati, Suyono .

Jurnal Epidemiologi Kesehatan Indonesia

Ketidakpatuhan alasan utama Pasien HIV tidak menerima pengobatan ARV sehingga harus selalu dipantau dan dinilai secara teratur serta didorong pada setiap kunjungan. Penelitian ini bertujuan untuk mengamati determinan faktor terjadinya ketidakpatuhan dalam mengonsumsi obat ARV pada ODHIV yang mendapatkan terapi ARV di Rumah Sakit Umum Daerah Kabupaten Tangerang. Jenis penelitian ini menggunakan penelitian observasional dengan rancangan cross sectional. Penelitian dilakukan di poli HIV RSUD Kabupaten pada bulan November 2023 menggunakan data laporan HIV pada SIHA. Populasi penelitian berjumlah 1.337 ODHIV aktif menjalani pengobatan antiretroviral di RSUD Kabupaten Tangerang dengan menggunakan total sampling sesuai dengan kriteria inklusi dan ekslusi sehingga sampel …

Effect Of Pre-Treatment Lab-Based Comorbidities On Treatment Related Outcomes Among Patients With Cancer, Jeffrey Alan Franks

All ETDs from UAB

Cancer is one of the leading causes of mortality and morbidity in the United States. In addition to their cancer, nearly 50% of individuals have a comorbid condition. This adds complexity to the treatment of these patients as it may delay cancer diagnosis or treatment or prevent treatment all together. Lab-values are an important tool to measure comorbidities and end-organ damage as they are routinely captured as part of standard of care and the basis of clinician decision making. However, despite the widespread multimorbidity and how crucial they are to decision making, few studies assess the association of lab abnormalities …

The Impact Of Transportation Insecurity On No-Show Appointments And Acute Care Utilization In Pediatric Sickle Cell Patients, Seabrook Hannah Jeffcoat

All ETDs from UAB

Sickle cell disease (SCD) patients experience high levels of transportation insecurity. Missed or delayed medical care due to transportation barriers can result in worsened clinical outcomes and increased hospital admissions and emergency department (ED) visits. We hypothesized that the relationship between transportation insecurity and acute care utilization is partially mediated by no-show appointments. This retrospective cohort study included 101 SCD patients aged ≤ 21 treated through the Pediatric Sickle Cell Clinic at Children’s of Alabama (COA) hospital from 2023 to 2024 and completed a social determinants of health (SDoH) questionnaire. Negative binomial or Poisson regression was used to model ED …

"The Association Between Serious Psychological Distress And Life Satisfaction Among U.S Adults With Hypertension", Kellen Michael Lenz

All ETDs from UAB

Purpose: Given the observed link between psychosocial and physical health outcomes, this study investigates the association between serious psychological distress and life satisfaction among U.S adults with hypertension. Methods: A cross-sectional study using 2021 National Health Interview Survey data among U.S adults was conducted to investigate the association between serious psychological distress and hypertension and assess the role of life satisfaction in modifying this relationship. Hypertension (diagnosed, undiagnosed), serious psychological distress (≥ 13 on the Kessler 6 nonspecific distress scale), and life satisfaction (Very satisfied, Satisfied, Dissatisfied, Very dissatisfied) were self-reported by participants. Ordinal logistic regression was used to investigate …

Exploring The Impact Of Returning To Office Work Post-Pandemic On The Mental Health Of Workers: A Cross-Sectional Analysis, Jasmine M. Nelson

All ETDs from UAB

This study examines the association between work settings and mental health outcomes among Black working-aged women, with a focus on racial disparities and the role of self-care. Using data from the U.S. Census Bureau's 2024 Household Pulse Survey, this cross-sectional analysis includes responses from 196,293 employed women aged 18–65. Mental health outcomes, including anxiety, worry, lack of interest, and depressive symptoms—were assessed through self-reported measures. Work settings were categorized as telework (hybrid/remote) or in-office, and logistic regression models were used to assess associations between work setting and mental health outcomes, adjusting for demographic and socioeconomic factors. Findings indicate that Black …

Impact Of Volume-Based Procurement Policy On Coronary Stent Use In Tianjin: Interrupted Time Series Analysis, Zhao Yang, Liangyu Ni, Wei Zhao, Yuxi Li, Yongyi Wu, Qiyun Zhu, Linlin Da, Weijia Liu, Qi Zhang, Jianping Li, Bin Jiang

Health Behavior, Policy & Management Faculty Publications

Objectives

This study aimed to analyze the impact of China’s centralized volume-based procurement policy on the procurement and utilization of coronary stents in Tianjin from 2019 to 2021.

Methods

An interrupted time-series design was used to assess monthly procurement data of coronary stents and balloons in Tianjin from January 2019 to December 2021.

Results

The volume-based procurement policy significantly reduced coronary stents prices, with an average price reduction of 92.67% for ten selected stents, and the lowest price dropped to 469 CNY. Following policy implementation, annual procurement in Tianjin increased by 59.55%, and tertiary hospitals demonstrated a significant monthly level …

Association Between Hypertension And Dementia Risk In Low- And Middle-Income Countries: A Systematic Review, Josephine E. Lindhout, Marieke P. Hoevenaar-Blom, Jan Willem Van Dalen, Manshu Song, Dong Lin, Wei Wang, Edo Richard, Eric P. Moll Van Charante, Tessa Van Middelaar

Research outputs 2022 to 2026

Background: Dementia prevalence is rising most rapidly in low- and middle-income countries (LMICs), yet most evidence on risk factors such as hypertension stems from high-income settings. In LMICs, hypertension may have a greater impact due to its high prevalence and poor control. We systematically reviewed evidence on the association between blood pressure and dementia and cognition in LMICs, and compared findings across regions. Methods: We searched PubMed, Embase, PsycINFO, and Global Index Medicus and reviewed reference lists for relevant studies. We included longitudinal studies (follow-up ≥6 months) from LMICs on the association between systolic blood pressure or hypertension and incident …