International Public Health Commons^™

Progress Toward Eliminating Mother To Child Transmission Of Hiv In Kenya: Review Of Treatment Guideline Uptake And Pediatric Transmission At Four Government Hospitals Between 2010 And 2012., Sarah Finocchario-Kessler, Kristine F. Clark, Samoel Khamadi, Brad J. Gautney, Vincent Okoth, Kathy Goggin, Hitsystem Study Team

Manuscripts, Articles, Book Chapters and Other Papers

We analyzed prevention of mother-to-child transmission (PMTCT) data from a retrospective cohort of n = 1365 HIV+ mothers who enrolled their HIV-exposed infants in early infant diagnosis services in four Kenyan government hospitals from 2010 to 2012. Less than 15 and 20 % of mother-infant pairs were provided with regimens that met WHO Option A and B/B+ guidelines, respectively. Annually, the gestational age at treatment initiation decreased, while uptake of Option B/B+ increased (all p's < 0.001). Pediatric HIV infection was halved (8.6-4.3 %), yet varied significantly by hospital. In multivariable analyses, HIV-exposed infants who received no PMTCT (AOR 4.6 [2.49, 8.62], p < 0.001), mixed foods (AOR 5.0 [2.77, 9.02], p < 0.001), and care at one of the four hospitals (AOR 3.0 [1.51, 5.92], p = 0.002) were more likely to be HIV-infected. While the administration and uptake of WHO PMTCT guidelines is improving, an expanded focus on retention and medication adherence will further reduce pediatric HIV transmission.

Implementation Of Universal Hplc Analysis For Counterfeit Medication: A Partnership Of Purdue University And The Kilimanjaro School Of Pharmacy, Jordyn Mccord, Michael Mavity, David Wintczak

Purdue Journal of Service-Learning and International Engagement

Jordyn McCord and Michael Mavity are 2016 graduates of both biological engineering and pharmaceutical sciences. David Wintczak is a third-year pharmacy doctoral candidate. Here, in their second article published in PJSL, they describe a weeklong study abroad course at the Kilimanjaro School of Pharmacy in Tanzania, designed to engage students in the implementation of methods for detecting counterfeit medications.

Testing Modeling Assumptions In The West Africa Ebola Outbreak, Matthew C. Ingram, Keith Burghardt, Christopher Verzijl, Junming Huang, Binyang Song, Marie-Pierre Hasne

Political Science Faculty Scholarship

The Ebola virus in West Africa has infected almost 30,000 and killed over 11,000 people. Recent models of Ebola Virus Disease (EVD) have often made assumptions about how the disease spreads, such as uniform transmissibility and homogeneous mixing within a population. In this paper, we test whether these assumptions are necessarily correct, and offer simple solutions that may improve disease model accuracy. First, we use data and models of West African migration to show that EVD does not homogeneously mix, but spreads in a predictable manner. Next, we estimate the initial growth rate of EVD within country administrative divisions and …

Global, Regional, And National Incidence, Prevalence, And Years Lived With Disability For 310 Diseases And Injuries, 1990-2015: A Systematic Analysis For The Global Burden Of Disease Study 2015, T Vos, C Allen, M Arora, R Barber, Z Bhutta, A Brown, A Carter, D Casey, Sahil Khera, M Tavakkoli, Gbd 2015 Disease And Injury Incidence And Prevalence Collaborators

NYMC Faculty Publications

Background Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015. Methods We estimated incidence and prevalence by age, sex, cause, year, and geography with …

Breast Is Best: Determinants Of Breastfeeding In Bali, Leah Hardenbergh

Independent Study Project (ISP) Collection

Breastfeeding greatly benefits the health of newborns, providing them with needed antibodies and protection from numerous diseases, including some of the leading causes of infant mortality. This paper explores breastfeeding practices in Bali, and the wide array of factors that have led to these practices. After discussing how breastfeeding fits into the larger context of maternal and newborn health, I explain factors in Bali that affect a woman’s decision to breastfeed and experience while breastfeeding. Determinants include those related to health, financial position, and social status. I explore the history of formula companies and formula as an alternative to breastmilk, …

Characterizing The Reproduction Number Of Epidemics With Early Subexponential Growth Dynamics., Gerardo Chowell, Cécile Viboud, Lone Simonsen, Seyed M Moghadas

Global Health Faculty Publications

Early estimates of the transmission potential of emerging and re-emerging infections are increasingly used to inform public health authorities on the level of risk posed by outbreaks. Existing methods to estimate the reproduction number generally assume exponential growth in case incidence in the first few disease generations, before susceptible depletion sets in. In reality, outbreaks can display subexponential (i.e. polynomial) growth in the first few disease generations, owing to clustering in contact patterns, spatial effects, inhomogeneous mixing, reactive behaviour changes or other mechanisms. Here, we introduce the generalized growth model to characterize the early growth profile of outbreaks and estimate …

The Road Into The Future Of Health Care: The Importance Of Addressing Access To Health Facilities In Transportation Infrastructure Investment Decisions, Nicola (Nikki) Van Den Heever

Independent Study Project (ISP) Collection

Background: One school of thought argues that transportation infrastructure is not an ultimate end goal of development and therefore shouldn’t be addressed within development funding decisions while the other argues that transportation infrastructure is the crucial foundation from which all development efforts are based and therefore needs to be addressed within development funding decisions. Within this framework, there is a lack of academic and other research addressing how physical access to health care for pregnant women can better be addressed when making decisions regarding funding of transportation infrastructure projects.

Purpose: To demonstrate the importance of considering access to health care …

Self-Perceptions Of Disability And Impairment In An Indian Prosthetic Population Using Jaipur Foot Technology, Litany Esguerra

Independent Study Project (ISP) Collection

Twenty-nine first time and repeat prosthetic users were interviewed over a period of three weeks to determine how they perceived their own disability at Bhagwan Mahaveer Viklang Sahayata Samiti, or Jaipur Foot, located in Jaipur, India. The questions delineated different aspects of people’s disabilities and impairment, and asked a multitude of questions regarding social, economic, political, and other contexts, influenced by the conceptual framework of the International Classification of Functioning (ICF). The study analyzed all of the factors as specified by the questionnaire and found that many varying trends over all types of prosthetic users. The study also used the …

Zika Virus And Global Health Security, Lawrence O. Gostin, James G. Hodge Jr.

Georgetown Law Faculty Publications and Other Works

Americans are largely apathetic about the risks of Zika virus and Congress cannot agree on preparedness funding. Strategies to counter the spread of Zika by the World Health Organisation (WHO) grossly underestimate the disease’s impact. WHO and member countries lack sufficient resources to respond. Consequences of fiscal apathy can be measured in lives lost and long-term disabilities. Zika prevention is a matter of global health security.

The epidemiologic brunt of Zika in South America falls largely on vulnerable women at heightened risk of exposure through mosquitoes and sexual transmission. Resulting transmission to fetuses and infants will have generational impacts in …

Sustainable Global Medical Mission Work: The Csb/Sju Global Medical Brigade, Tyler J. Bruinsma

Forum Lectures

International medical mission work, especially programs that include undergraduate students are under increasing fire as an unsustainable method for providing care to marginalized populations in developing countries. Medical mission work is often short-sighted and neglects to address the underlying causes of diseases. Annually, the CSB/SJU Global Health Affairs Club plans and executes a "Global Medical Brigade" to Honduras in conjunction with Global Brigades, a 501(c)3 non-profit organization. Global Brigades is different than most medical mission organizations in that it follows a holistic model to address health concerns. Through seven separate "brigades," Global Brigades addresses both immediate health concerns and their …

Exploring Determinants Of Handwashing With Soap In Indonesia: A Quantitative Analysis, Mitsuaki Hirai, Jay P. Graham, Kay Mattson, Andrea Kelsey, Supriya Mukherji, Aidan Cronin

Environmental and Occupational Health Faculty Publications

Handwashing with soap is recognized as a cost-effective intervention to reduce morbidity and mortality associated with enteric and respiratory infections. This study analyzes rural Indonesian households’ hygiene behaviors and attitudes to examine how motivations for handwashing, locations of handwashing space in the household, and handwashing moments are associated with handwashing with soap as potential determinants of the behavior. The analysis was conducted using results from a UNICEF cross-sectional study of 1700 households in six districts across three provinces of Indonesia. A composite measure of handwashing with soap was developed that included self-reported handwashing, a handwashing demonstration, and observed handwashing materials …

Predictors Of Infant Age At Enrollment In Early Infant Diagnosis Services In Kenya., Kathy Goggin, Catherine Wexler, Niaman Nazir, Vincent S. Staggs, Brad Gautney, Vincent Okoth, Samoel A Khamadi, Andrea Ruff, Michael Sweat, An-Lin Cheng, Sarah Finocchario-Kessler

Manuscripts, Articles, Book Chapters and Other Papers

Despite the importance of early detection to signal lifesaving treatment initiation for HIV+ infants, early infant diagnosis (EID) services have received considerably less attention than other aspects of prevention of mother to child transmission care. This study draws on baseline data from an on-going cluster randomized study of an intervention to improve EID services at six government hospitals across Kenya. Two logistic regressions examined potential predictors of "on time" (infant ≤6 weeks of age) vs. "late" (≥7 weeks) and "on time" versus "very late" (≥12 weeks) EID engagement among 756 mother-infant pairs. A quarter of the infants failed to get …

A Livelihood Intervention To Improve Economic And Psychosocial Well-Being In Rural Uganda: Longitudinal Pilot Study, Bernard Kakuhikire, Diego Suquillo, Elly Atuhumuza, Rumbidzai Mushavi, Jessica M. Perkins, Atheendar S. Venkataramani, Sheri D. Weiser, David Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV and poverty are inextricably intertwined in sub-Saharan Africa. Economic and livelihood intervention strategies have been suggested to help mitigate the adverse economic effects of HIV, but few intervention studies have focused specifically on HIV positive persons. We conducted three pilot studies to assess a livelihood intervention consisting of an initial orientation and loan package of chickens and associated implements to create poultry microenterprises. We enrolled 15 HIV-positive and 22 HIV-negative participants and followed them for up to 18 months. Over the course of follow-up, participants achieved high chicken survival and loan repayment rates. Median monthly income increased, and severe …

Improving Data Collection To Reduce Maternal And Infant Mortality And Morbidity In Malawi: Evaluating Chimwemwe Mu'bereki, A Community Based Intervention, Alexandra E. H. Jones

Master's Projects and Capstones

Maternal and infant death rates in Malawi are among the highest in the world. Over 17 million people live in this small country in sub-Saharan Africa, where the country’s life expectancy is just 60.6 years (World Bank, 2015). These deaths can be attributed to many complex factors, including cultural practices, lack of adequate medical equipment, long travel distances to health facilities, low staffing at hospitals and clinics, extreme poverty, and malnutrition. Without government support and intervention, community groups must fill in the gaps to make needed improvements to maternal and infant health outcomes. African Mothers Health Initiative (AMHI) enrolls high …

Unicef Kid Power: Empowering Kids To Get Active And Save Lives, Emily L. Gudaitis

Master's Projects and Capstones

UNICEF Kid Power is a program aimed at increasing U.S. children’s activity levels by tapping into children’s intrinsic desire to do good. Through their activity levels, kids earn points, which unlocks funding from partners that will support treatment for a malnourished child. This one-of-a-kind program was implemented in the Bay Area in Spring 2016 with 7,800 youth participants. The attached paper is a summary of a 300-hour fieldwork experience at the U.S. Fund for UNICEF assisting with the UNICEF Kid Power implementation in the Bay Area. The fieldwork included program implementation and evaluation, presentations at participating schools in the area, …

The Complexity Of Non-Profit Administration In Global Development: A Case-Study On Neonatal Mortality, Paul D. Glantz

Master's Projects and Capstones

In 2015, 5.9 million children died with 44% of those deaths occurring in the most vulnerable period of life: the neonatal period (first 28 days of life). Because this is such a pervasive problem, in order to meet the United Nation’s third Sustainable Development Goal of reducing the global neonatal mortality rate down from 27 to 12 deaths per 1,000 live births, there needs to be more evidence-based, effective interventions. Thrive Networks addresses newborn mortality by improving facility-based care in low-resource settings via intensive training and lifesaving medical equipment built to operate in these conditions. Despite all of the evidence …

Partnerships For Change: A Collaboration For Global Wellbeing, Ravneet Gill

Master's Projects and Capstones

Partnerships For change (PFC) consists of a team of social impact strategists and practitioners. The organization is dedicated to promote sustainable development through direct humanitarian action and transforming social and economic conditions of underserved communities around the globe. With the commitment to elevate and empower individuals to reach their ultimate potential, PFC partnered with Jaipur foot, world's largest organization for prosthetic devices, to network Jaipur Foot to innovators and funders. They have also started the building of a health clinic in Johnsonville, Liberia due to inadequate medical support for individuals living in the community. There are several steps in building …

Planetary Health: Report On The 7th Annual Global Health Conference, Lucille B. Pilling Edd,Mph,Rn

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Stigmatization Fo Hiv/Aids: A Cross-Cultural Analysis, Jamie Doctrow

Mahurin Honors College Capstone Experience/Thesis Projects

The Human Immunodeficiency Virus (HIV) is the cause of a public health epidemic that has impacted millions of individuals worldwide. Though medical advances have decreased the number of AIDS related deaths by 42% since the peak year of 2004 (UNAIDS, 2015), many individuals with HIV/AIDS are unaware of their status and are not currently receiving antiretroviral treatment. Many experts have suggested that a significant barrier to HIV/AIDS prevention and treatment is the social stigma that has become attached to the disease. No single cause of this stigmatization has been identified, but a variety of influences may play a role. To …

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …