Biostatistics Commons^™

Data Management And Data Quality In Perch, A Large International Case-Control Study Of Severe Childhood Pneumonia., Nora L Watson, Christine Prosperi, Amanda J Driscoll, Melissa M Higdon, Daniel E Park, Megan Sanza, Andrea N Deluca, Juliet O Awori, Doli Goswami, Emily Hammond, Lokman Hossain, Catherine Johnson, Alice Kamau, Locadiah Kuwanda, David P Moore, Omid Neyzari, Uma Onwuchekwa, David Parker, Patranuch Sapchookul

Epidemiology Faculty Publications

The Pneumonia Etiology Research for Child Health (PERCH) study is the largest multicountry etiology study of pediatric pneumonia undertaken in the past 3 decades. The study enrolled 4232 hospitalized cases and 5325 controls over 2 years across 9 research sites in 7 countries in Africa and Asia. The volume and complexity of data collection in PERCH presented considerable logistical and technical challenges. The project chose an internet-based data entry system to allow real-time access to the data, enabling the project to monitor and clean incoming data and perform preliminary analyses throughout the study. To ensure high-quality data, the project developed …

Colonization Density Of The Upper Respiratory Tract As A Predictor Of Pneumonia-Haemophilus Influenzae, Moraxella Catarrhalis, Staphylococcus Aureus, And Pneumocystis Jirovecii., Daniel E Park, Henry C Baggett, Stephen R C Howie, Qiyuan Shi, Nora L Watson, W Abdullah Brooks, Perch Study Group

Epidemiology Faculty Publications

Background.

There is limited information on the association between colonization density of upper respiratory tract colonizers and pathogen-specific pneumonia. We assessed this association for Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pneumocystis jirovecii. Methods.

In 7 low- and middle-income countries, nasopharyngeal/oropharyngeal swabs from children with severe pneumonia and age-frequency matched community controls were tested using quantitative polymerase chain reaction (PCR). Differences in median colonization density were evaluated using the Wilcoxon rank-sum test. Density cutoffs were determined using receiver operating characteristic curves. Cases with a pathogen identified from lung aspirate culture or PCR, pleural fluid culture or …

Microscopic Analysis And Quality Assessment Of Induced Sputum From Children With Pneumonia In The Perch Study., David R Murdoch, Susan C Morpeth, Laura L Hammitt, Amanda J Driscoll, Daniel E Park, +Several Additional Authors

Epidemiology Faculty Publications

Background.

It is standard practice for laboratories to assess the cellular quality of expectorated sputum specimens to check that they originated from the lower respiratory tract. The presence of low numbers of squamous epithelial cells (SECs) and high numbers of polymorphonuclear (PMN) cells are regarded as indicative of a lower respiratory tract specimen. However, these quality ratings have never been evaluated for induced sputum specimens from children with suspected pneumonia. Methods.

We evaluated induced sputum Gram stain smears and cultures from hospitalized children aged 1–59 months enrolled in a large study of community-acquired pneumonia. We hypothesized that a specimen representative …

Is Higher Viral Load In The Upper Respiratory Tract Associated With Severe Pneumonia? Findings From The Perch Study., Daniel R Feikin, Wei Fu, Daniel E Park, Qiyuan Shi, Melissa M Higdon, Henry C Baggett, +Several Additional Authors

Epidemiology Faculty Publications

Background.

The etiologic inference of identifying a pathogen in the upper respiratory tract (URT) of children with pneumonia is unclear. To determine if viral load could provide evidence of causality of pneumonia, we compared viral load in the URT of children with World Health Organization–defined severe and very severe pneumonia and age-matched community controls.

Methods.

In the 9 developing country sites, nasopharyngeal/oropharyngeal swabs from children with and without pneumonia were tested using quantitative real-time polymerase chain reaction for 17 viruses. The association of viral load with case status was evaluated using logistic regression. Receiver operating characteristic (ROC) curves were constructed …

Association Of C-Reactive Protein With Bacterial And Respiratory Syncytial Virus-Associated Pneumonia Among Children Aged <5 Years In The Perch Study., Melissa M Higdon, Tham Le, Katherine L O'Brien, David R Murdoch, Christine Prosperi, Henry C Baggett, Daniel E Park, +Several Additional Authors

Epidemiology Faculty Publications

Background.

Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for identifying bacterial vs respiratory syncytial virus (RSV) pneumonia in the Pneumonia Etiology Research for Child Health (PERCH) multicenter case-control study. Methods.

We measured serum CRP levels in cases with World Health Organization–defined severe or very severe pneumonia and a subset of community controls. We evaluated the sensitivity and specificity of elevated CRP for “confirmed” bacterial pneumonia (positive blood culture or positive lung aspirate or pleural fluid …

Standardization Of Clinical Assessment And Sample Collection Across All Perch Study Sites., Jane Crawley, Christine Prosperi, Henry C Baggett, W Abdullah Brooks, Maria Deloria Knoll, Daniel E Park, +Several Additional Authors

Epidemiology Faculty Publications

Background.: Variable adherence to standardized case definitions, clinical procedures, specimen collection techniques, and laboratory methods has complicated the interpretation of previous multicenter pneumonia etiology studies. To circumvent these problems, a program of clinical standardization was embedded in the Pneumonia Etiology Research for Child Health (PERCH) study.

Methods.: Between March 2011 and August 2013, standardized training on the PERCH case definition, clinical procedures, and collection of laboratory specimens was delivered to 331 clinical staff at 9 study sites in 7 countries (The Gambia, Kenya, Mali, South Africa, Zambia, Thailand, and Bangladesh), through 32 on-site courses and a training website. Staff competency …

The Diagnostic Utility Of Induced Sputum Microscopy And Culture In Childhood Pneumonia., David R Murdoch, Susan C Morpeth, Laura L Hammitt, Amanda J Driscoll, Nora L Watson, Daniel E Park, +Several Additional Authors

Epidemiology Faculty Publications

Background.

Sputum microscopy and culture are commonly used for diagnosing the cause of pneumonia in adults but are rarely performed in children due to difficulties in obtaining specimens. Induced sputum is occasionally used to investigate lower respiratory infections in children but has not been widely used in pneumonia etiology studies. Methods.

We evaluated the diagnostic utility of induced sputum microscopy and culture in patients enrolled in the Pneumonia Etiology Research for Child Health (PERCH) study, a large study of community-acquired pneumonia in children aged 1–59 months. Comparisons were made between induced sputum samples from hospitalized children with radiographically confirmed pneumonia …

Optimal, Two Stage, Adaptive Enrichment Designs For Randomized Trials Using Sparse Linear Programming, Michael Rosenblum, Xingyuan Fang, Han Liu

Johns Hopkins University, Dept. of Biostatistics Working Papers

Adaptive enrichment designs involve preplanned rules for modifying enrollment criteria based on accruing data in a randomized trial. We focus on designs where the overall population is partitioned into two predefined subpopulations, e.g., based on a biomarker or risk score measured at baseline. The goal is to learn which populations benefit from an experimental treatment. Two critical components of adaptive enrichment designs are the decision rule for modifying enrollment, and the multiple testing procedure. We provide a general method for simultaneously optimizing these components for two stage, adaptive enrichment designs. We minimize the expected sample size under constraints on power …

Impact Of Serum Sp-A And Sp-D Levels On Comparison And Prognosis Of Idiopathic Pulmonary Fibrosis: A Systematic Review And Meta-Analysis., Kai Wang, Qing Ju, Jing Cao, Wenze Tang, Jian Zhang

Epidemiology Faculty Publications

Background and objective:

Idiopathic pulmonary fibrosis (IPF) has a poor prognosis in general; however, it is heterogeneous to detect relative biomarkers for predicting the disease progression. Serum biomarkers can be conveniently collected to detect and help to differentially diagnose IPF and predict IPF prognosis. This meta-analysis aimed to evaluate the use of serum surfactant proteins A and D (SP-A and SP-D) for differential diagnosis and prognosis of IPF.

Methods:

Relevant articles were searched in PubMed, Embase, and Chinese National Knowledge Infrastructuredatabases and reviewed by 2 independent readers. Standard mean difference (SMD) and 95% confidence interval (CI) were …

Risk Of Incident Clinical Diagnosis Of Alzheimer's Disease-Type Dementia Attributable To Pathology-Confirmed Vascular Disease, Hiroko H. Dodge, Jian Zhu, Randy Woltjer, Peter T. Nelson, David A. Bennett, Nigel J. Cairns, David W. Fardo, Jeffrey A. Kaye, Deniz-Erten Lyons, Nora Mattek, Julie A. Schneider, Lisa C. Silbert, Chengjie Xiong, Lei Yu, Frederick A. Schmitt, Richard J. Kryscio, Erin L. Abner, Smart Data Consortium

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: The presence of cerebrovascular pathology may increase the risk of clinical diagnosis of Alzheimer's disease (AD).

METHODS: We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modeling of Aging and Risk of Transition study, a consortium of longitudinal cohort studies with more than 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate, or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with …

Estimated Probability Of Becoming A Case Of Drug Dependence In Relation To Duration Of Drug-Taking Experience: A Functional Analysis Approach, Olga A. Vsevolozhskaya, James C. Anthony

Biostatistics Faculty Publications

Measured as elapsed time from first use to dependence syndrome onset, the estimated "induction interval" for cocaine is thought to be short relative to the cannabis interval, but little is known about risk of becoming dependent during first months after onset of use. Virtually all published estimates for this facet of drug dependence epidemiology are from life histories elicited years after first use. To improve estimation, we turn to new month-wise data from nationally representative samples of newly incident drug users identified via probability sampling and confidential computer-assisted self-interviews for the United States National Surveys on Drug Use and Health, …

The Use Of “Kakayu Dental Flipbook” In Oral Health Knowledge Improvement For Elementary School Students In Depok, Rikawarastuti Rikawarastuti, Eka Anggreni, Rahaju Budiarti, Nurlaila Ramadhan Suid

Kesmas

Perlu adanya edukasi untuk meningkatkan pengetahuan anak Indonesia tentang pentingnya memelihara kesehatan gigi dan mulut. Penelitian ini bertujuan untuk menjelaskan hubungan antara faktor siswa sekolah dasar seperti kelas, usia, jenis kelamin dengan jumlah anak dalam keluarga atau faktor ekonomi seorang ibu rumah tangga atau berpenghasilan tetap, yang dipengaruhi oleh peningkatan pengetahuan dari edukasi kesehatan gigi dan mulut. Disain penelitian quasi experiment pre-test dan post-test tanpa desain grup kontrol melibatkan 141 siswa yang dipilih melalui purposive sampling. Sampel tersebar pada siswa kelas IV, V, dan VI sekolah dasar swasta di Depok, Jawa Barat, Indonesia pada April-Oktober 2016. Data penelitian diperoleh dari …

Extrovert Personality Type And Prolonged Second Stage Of Labor, Yuni Kusmiyati, Chandra Tyas Nurfitria, Suherni Suherni, Heni Puji Wahyuningsih

Kesmas

Kepribadian dapat memengaruhi respons individu yang dapat berdampak pada proses persalinan lama. Penelitian sebelumnya menunjukkan adanya hubungan kepribadian dengan waktu persalinan. Tipe kepribadian ekstrover (tipe A) cenderung lebih rentan terhadap stres dibandingkan orang dengan tipe kepribadian introvert (tipe B). Penelitian ini bertujuan untuk mengetahui hubungan tipe kepribadian ekstrover dan variabel luar (pendidikan, ekonomi, usia ibu dan paritas) dengan persalinan kala II lama. Studi kasus kontrol dilakukan pada 156 ibu bersalin yang memenuhi kriteria inklusi pada tahun 2015 di Yogyakarta. Sampel kasus adalah 52 ibu dengan persalinan kala II lama dan kontrol adalah 104 ibu dengan persalinan kala II normal. Penelitian …

Effects Of Multilevel Intervention In Workplace Health Promotion On Workers’ Metabolic Syndrome Components, Zahtamal Zahtamal, Wasilah Rochmah, Yayi Suryo Prabandari

Kesmas

Sekitar 10-30% orang Asia dewasa mengalami sindrom metabolik. Penelitian ini bertujuan untuk mengungkap efek Promosi Kesehatan di Tempat Kerja PKDTK dengan intervensi multilevel pada komponen/penanda pekerja yang menderita sindrom metabolik. Penelitian ini dilakukan pada tahun 2014-2015 dengan menggunakan desain quasi experimental dengan intervensi subjek secara multilevel di Indonesia. Program PKDTK untuk kelompok intervensi multilevel berupa kombinasi latihan fisik, diet, pendidikan kesehatan, dukungan sosial, dan advokasi salama 12 minggu. Program PKDTK untuk kelompok kontrol hanya pendidikan kesehatan. Instrumen penelitian seperti IPAQ, table food recall 24 jam, alat pengukuran fisik, dan laboratorium klinis. Analisis data menggunakan Marginal Homogeneity, paired sample t, Mc …

Counterfeit Medicines In Socioeconomic Perspective, Desy Nuryunarsih Nuryunarsih

Kesmas

Obat-obatan palsu berpotensi mencapai 70% dari pasaran obat internasional dengan proporsi terbanyak ditemukan di negara berkembang. Meningkatkan kesadaran masyarakat akan adanya obat-obatan palsu akan secara langsung memengaruhi permintaan produk obat palsu yang akhirnya akan mengurangi kegiatan pemalsuan obat. Akan tetapi, meningkatkan pengetahuan masyarakat akan bahaya obat-obatan palsu tidaklah mudah sebab profesi kesehatan masyarakat harus juga mempertimbangkan keberagaman faktor-faktor sosial, ekonomi dan pendidikan. Laporan ini menelaah artikel jurnal yang ditelaah oleh kelompok seminat, laporan media, laporan resmi pemerintah dan non-pemerintah. Sebanyak 179 artikel (dari 1990 sampai 2014) ditelaah untuk mengetahui hubungan antara indeks pembangunan manusia (IPM) dari USA, Jepang, Brasil, Iran, …

Rebon Shrimp Powder Addition Influence To Nutritional Values, Organoleptic Properties And Acceptance Of Supplementary Food By Children Aged 4-5 Years Old, Priyo Sulistiyono, Dewi Marhaeni Diah Herawati, Insi Farisa Desy Arya

Kesmas

Prevalensi gizi kurang dan stunting pada anak bawah lima tahun (balita) di Kota Cirebon masih cukup tinggi yaitu mencapai 13,9% dan 15,7%. Udang rebon (Acetes erythraeus) memiliki kandungan protein dan kalsium yang tinggi. Pengaruh penambahan udang rebon dalam makanan tambahan (bubur lemu dan bolu kukus) terhadap kualitas gizi diteliti. Penelitian ini bertujuan untuk mengetahui pengaruh bubuk udang rebon terhadap nilai gizi, sifat organoleptik dan daya terima. Uji laboratorium dan perangkat lunak Nutriservey digunakan untuk analisis nilai gizi bubuk udang rebon dan gizi makanan tambahan. Uji organoleptik menggunakan rancangan acak lengkap dengan empat perlakuan (bubuk udang rebon 0%, 5%, 10%, 15%) …

Controlling Factors That Potentially Against Transmission Of Dengue Hemorrhagic Fever At State Elementary Schools In Yogyakarta, Tri Baskoro Tunggul Satoto, Nur Alvira, Tri Wibawa, Ajib Diptyanusa

Kesmas

Sekolah dasar merupakan tempat yang dapat mengakibatkan peningkatan penyakit dengue pada anak karena faktor lingkungan, adanya potensi penularan, belum adanya system manajemen lingkungan yang baik dan beberapa upaya pengendalian yang tidak lagi efektif. Penelitian ini bertujuan untuk mengetahui faktor yang berpotensi terhadap penularan demam berdarah dengue bagi anak, sehingga sistem kewaspadaan dini dapat ditegakkan. Jenis penelitian ini adalah analitik dengan rancangan potong lintang. Penelitian dilaksanakan pada 91 sekolah dasar negeri di Kota Yogyakarta. Variabel yang diobservasi adalah serotype virus DEN, resistensi insektisida, kepadatan vektor,dan kondisi fisik sekolah. Analisis data menggunakan analisis deskriptif dan korelasi-regresi (a = 0.05). Hasil menunjukkan bahwa …

Impact Of Women’S Empowerment On Infant Mortality In Indonesia, Hanik Stiyaningsih, Febri Wicaksono

Kesmas

Secara umum, otonomi dan pemberdayaan perempuan menjadi salah satu faktor penting dalam pembangunan. Kurangnya otonomi dan pemberdayaan perempuan dapat menyebabkan hasil negatif pada kesehatan dan kematian anak. Belum terdapat penelitian terkini yang menganalisis hubungan antara pemberdayaan perempuan dan kematian bayi di Indonesia. Penelitian ini berusaha mengisi kekosongan tersebut dengan menelusuri pengaruh pemberdayaan perempuan terhadap kematian bayi di Indonesia. Sampel berjumlah 9.754 perempuan berusia 15-49 tahun yang terakhir melahirkan pada periode tahun 2007-2012 diambil dari Survei Demografi dan Kesehatan Indonesia 2012. Pemberdayaan perempuan diukur dengan menggunakan indeks komposit yang dibangun dari delapan indikator dari tiga dimensi pemberdayaan perempuan, yaitu partisipasi dalam …

Risk Factors Of Acute Respiratory Infections In Practice Area For Community Of Medical Students In Semarang, Siti Thomas Zulaikhah, Purwito Soegeng, Titiek Sumarawati

Kesmas

Infeki saluran pernapasan akut (ISPA) menempati urutan pertama dari 10 besar penyakit di Puskesmas Bangetayu dengan persentase terbanyak di Kelurahan Penggaron Lor. Keterampilan untuk mempelajari distribusi dan frekuensi penyakit serta faktor determinan yang memengaruhi manusia sangat diperlukan untuk menetapkan intervensi yang paling efektif untuk meningkatkan derajat kesehatan masyarakat. Perlu dilakukan penelitian untuk mengetahui faktor risiko yang paling dominan berhubungan dengan kejadian ISPA di lokasi praktik komunitas mahasiswa Fakultas Kedokteran Universitas Islam Sultan Agung Semarang. Penelitian ini menggunakan desain potong lintang dengan jumlah responden 100 orang dan sampel dikumpulkan dengan menggunakan stratified random sampling. Sepuluh variabel yang diteliti adalah faktor risiko …

Midlife And Late-Life Vascular Risk Factors And White Matter Microstructural Integrity: The Atherosclerosis Risk In Communities Neurocognitive Study., Melinda C Power, Jonathan V Tingle, Robert I Reid, Juebin Huang, A Richey Sharrett, Josef Coresh, Michael Griswold, Kejal Kantarci, Clifford R Jack, David Knopman, Rebecca F Gottesman, Thomas H Mosley

Epidemiology Faculty Publications

BACKGROUND: Diffusion tensor imaging measures of white matter (WM) microstructural integrity appear to provide earlier indication of WM injury than WM hyperintensities; however, risk factors for poor WM microstructural integrity have not been established. Our study quantifies the association between vascular risk factors in midlife and late life with measures of late-life WM microstructural integrity.

METHODS AND RESULTS: We used data from 1851 participants in ARIC (Atherosclerosis Risk in Communities Study) who completed 3-T magnetic resonance imaging, including diffusion tensor imaging, as part of the ARIC Neurocognitive Study (ARIC-NCS). We quantified the association among lipids, glucose, and blood pressure from …