97 results on '"Escamilla, Veronica"'
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2. The Examination of Diffusion Effects on Modern Contraceptive Use in Nigeria
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Guilkey, David K., Escamilla, Veronica, Calhoun, Lisa M., and Speizer, Ilene S.
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- 2020
3. Geospatial patterns of access to self-care resources for obesity among endometrial cancer survivors in a high poverty urban community
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Ross, Jerlinda G.C., Escamilla, Veronica, Lee, Nita Karnik, Diane Yamada, S., and Lindau, Stacy Tessler
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- 2019
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4. Longitudinal examination of changing fertility intentions and behaviors over a four-year period in urban Senegal
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Speizer, Ilene S., Escamilla, Veronica, Lance, Peter M., and Guilkey, David K.
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- 2020
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5. Access to public transportation and health facilities offering long-acting reversible contraceptives among residents of formal and informal settlements in two cities in Kenya
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Escamilla, Veronica, Calhoun, Lisa, Odero, Norbert, and Speizer, Ilene S.
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- 2019
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6. The Role of Distance and Quality on Facility Selection for Maternal and Child Health Services in Urban Kenya
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Escamilla, Veronica, Calhoun, Lisa, Winston, Jennifer, and Speizer, Ilene S.
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- 2018
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7. Influence of Detection Method and Study Area Scale on Syphilis Cluster Identification in North Carolina
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Escamilla, Veronica, Hampton, Kristen H., Gesink, Dionne C., Serre, Marc L., Emch, Michael, Leone, Peter A., Samoff, Erika, and Miller, William C.
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- 2016
8. Geospatial analyses identify regional hot spots of diffuse gastric cancer in rural Central America
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Dominguez, Ricardo L., Cherry, Charlotte B., Estevez-Ordonez, Dago, Mera, Robertino, Escamilla, Veronica, Pawlita, Michael, Waterboer, Tim, Wilson, Keith T., Peek, Richard M., Tavera, Gloria, Williams, Scott M., Gulley, Margaret L., Emch, Michael, and Morgan, Douglas R.
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- 2019
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9. Influence of Latrine Proximity and Type on Tubewell Water Quality and Diarrheal Disease in Bangladesh
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Escamilla, Veronica, Knappett, Peter S. K., Yunus, Mohammad, Streatfield, P. K., and Emch, Michael
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- 2013
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10. Sampling at community level by using satellite imagery and geographical analysis/ Echantillonnage au niveau de la communaute a l'aide de l'imagerie satellite et de l'analyse geographique/El muestreo a nivel comunitario mediante el uso de imagenes de satelite y analisis geografico
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Escamilla, Veronica, Emch, Michael, Dandalo, Leonard, Miller, William C., Martinson, Francis, and Hoffman, Irving
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Garmin Ltd. -- Technology application ,Remote sensing -- Analysis -- Technology application ,Avionics industry -- Analysis -- Technology application ,Surveillance equipment -- Usage -- Analysis -- Technology application ,Malaria -- Analysis -- Technology application ,Plasmodium falciparum -- Analysis -- Technology application ,Technology application ,Health ,Google Earth (Geographic information system) - Abstract
Problem Traditional random sampling at community level requires a list of every individual household that can be randomly selected in the study community. The longitudinal demographic surveillance systems often used as sampling frames are difficult to create in many resource-poor settings. Approach We used Google Earth imagery and geographical analysis software to develop a sampling frame. Every household structure within the catchment area was digitized and assigned coordinates. A random sample was then generated from the list of households. Local setting The sampling took place in Lilongwe, Malawi and formed a part of an investigation of the intensity of Plasmodium falciparum transmission in a multi-site Phase III trial of a candidate malaria vaccine. Relevant changes Creation of a complete list of household coordinates within the catchment area allowed us to generate a random sample representative of the population. Once the coordinates of the households in that sample had been entered into the hand- held receivers of a global positioning system device, the households could be accurately identified on the ground and approached. Lessons learnt In the development of a geographical sampling frame, the use of Google Earth satellite imagery and geographical software appeared to be an efficient alternative to the use of a demographic surveillance system. The use of a complete list of household coordinates reduced the time needed to locate households in the random sample. Our approach to generate a sampling frame is accurate, has utility beyond morbidity studies and appears to be a cost-effective option in resource-poor settings. [TEXT NOT REPRODUCIBLE IN ASCII] [TEXT NOT REPRODUCIBLE IN ASCII] Probleme L'echantillonnage aleatoire traditionnel au niveau de la communaute requiert une liste de tous les menages Individueis qui peuvent etre cholsis aleatoirement dans une etude communautaire. Les systemes de surveillance demographlque longitudlnaux, qui sont souvent utllises comme base d'echantlllonnage, sont diffidles a creer dans de nombreux endroits a falbles ressources. Approche Nous avons utlllse llmagerie de Google Earth et un loglciel d'analyse geographique pour developper une base d'echantillonnage. Chaque structure de menage dans la circonscription a ete numerisee et associee a des coordonnees. Un echantillon aleatoire a ensuite ete genere a partir de la liste des menages. Environnement local L'echantillonnage a ete effectue a Lilongwe, au Malawi, et entrait ans le cadre d'une etude sur l'intenslte de la transmission du Plasmodium falciparum dans un essai clinique multicentrique de phase III d'un vaccin contre le paludisme potentlel. Changements significatifs La creation d'une liste complete des coordonnees des menages dans la circonscription nous a permis de generer un echantillon aleatoire representatif de la population. Une fois que les coordonnees des menages de cet echantillon ont ete entrees dans les recepteurs portables d'un dlspositlf du systeme de positionnement universel, les menages ont pu etre predsement identifies et approches sur le terrain. Lecons tirees Dans le developpement d'une base d'echantillonnage geographique, l'utilisation de llmagerie satellite de Google Earth et d'un logiciel geographique semblait etre une alternative efncace a l'utilisation d'un systeme de surveillance demographique. L'utilisation d'une liste complete de coordonnees des menages a redult le temps necessaire pour localiser les menages dans un echantillon aleatoire. Notre approche de generation d'une base d'echantlllonnage est precise, utile au-dela des etudes de morbidlte et semble etre une option economique dans les endroits a faibles ressources. [TEXT NOT REPRODUCIBLE IN ASCII] Situacion El muestreo aleatorio tradicional a nivel comunitario requiere una lista de todos los hogares Individuales que pueden ser seleccionados al azar en la comunidad de estudio. Los sistemas de vigilancia demografica longitudinales que se utilizan a menudo como marcos de muestreo resultan dificiles de crear en muchos entornos con pocos recursos. Enfoque Empleamos imagenes de Google Earth y un software de analisis geografico para desarrollar un marco de muestreo. Se digitalizo y asignaron coordenadas a cada estructura familiar dentro de la zona de captacion, y luego se genero una muestra al azar a partir de la lista de los hogares. Marco regional El muestreo se llevo a cabo en Lilongwe (Malawi) y formo parte de una investigacion sobre la intensidad de la transmision del Plasmodium falciparum en un ensayo de fase III multicentrico de una posible vacuna contra la malaria. Cambios importantes La creacion de una lista completa de las coordenadas de los hogares dentro del area de influencia nos ha permitido generar una muestra aleatoria representativa de la poblacion. Una vez introducidas las coordenadas de los hogares en la muestra en los receptores portatiles de un dispositivo con un sistema de posicionamiento global, se pudo Identificar con precision a los hogares y aproximarse a estos en el terreno. Lecciones aprendidas En el desarrollo de un marco de muestreo geografico, el uso de imagenes de satelite de Google Earth y un software geografico resulto ser una alternativa eficaz a la utilizacion de un sistema de vigilancia demografica. La utilizacion de una lista completa de las coordenadas de los hogares reduce el tiempo necesario para localizar estos en la muestra aleatoria. Nuestro enfoque para generar un marco de muestreo es exacto, tiene una utilidad mas alla de los estudios de morbilidad y parece ser una opcion rentable en los entornos con recursos escasos., Problem In estimating disease prevalence at community level, a sampling frame is required to ensure that the study sample is representative of the study community. Such a sampling frame typically [...]
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- 2014
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11. Sex Differences in Interpersonal Violence in Malawi: Analysis of a Hospital-Based Trauma Registry
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Kiser, Michelle, Escamilla, Veronica, Samuel, Jonathan, Eichelberger, Kacey, Mkwaila, Judith, Cairns, Bruce, and Charles, Anthony
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- 2013
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12. Food deserts, endometrial cancer survivors, and healthy food access: Is it equitable in rural America? – A geospatial analysis (2127)
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Patel, Khilen, Escamilla, Veronica, Wolfe, Lauren, Morris, Tinea, Kinsinger, Oliva, Blalock, Elizabeth, Pradhan, Ipsita, Creasman, William, and Ross, Jerlinda
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- 2023
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13. Provider and patient barriers to mental health care in a predominant gynecologic cancer survivor population in the deep south (1146)
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Patel, Khilen, Escamilla, Veronica, Pradhan, Ipsita, Morris, Tinea, Wolfe, Lauren, Creasman, William, and Ross, Jerlinda
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- 2023
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14. The Role of Distance and Quality on Facility Selection for Maternal and Child Health Services in Urban Kenya
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Escamilla, Veronica, Calhoun, Lisa, Winston, Jennifer, and Speizer, Ilene S.
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Adult ,Adolescent ,Geography ,Child Health Services ,Middle Aged ,Kenya ,Article ,Urban reproductive health ,Health Services Accessibility ,Young Adult ,Pregnancy ,Surveys and Questionnaires ,Health service access ,Urban Health Services ,Humans ,Female ,Maternal Health Services ,Child - Abstract
Universal access to health care requires service availability and accessibility for those most in need of maternal and child health services. Women often bypass facilities closest to home due to poor quality. Few studies have directly linked individuals to facilities where they sought maternal and child health services and examined the role of distance and quality on this facility choice. Using endline data from a longitudinal survey from a sample of women in five cities in Kenya, we examine the role of distance and quality on facility selection for women using delivery, facility-based contraceptives, and child health services. A survey of public and private facilities offering reproductive health services was also conducted. Distances were measured between household cluster location and both the nearest facility and facility where women sought care. A quality index score representing facility infrastructure, staff, and supply characteristics was assigned to each facility. We use descriptive statistics to compare distance and quality between the nearest available facility and visited facility among women who bypassed the nearest facility. Facility distance and quality comparisons were also stratified by poverty status. Logistic regression models were used to measure associations between the quality and distance to the nearest facility and bypassing for each outcome. The majority of women bypassed the nearest facility regardless of service sought. Women bypassing for delivery traveled the furthest and had the fewest facility options near their residential cluster. Poor women bypassing for delivery traveled 4.5 km further than non-poor women. Among women who bypassed, two thirds seeking delivery and approximately 46% seeking facility-based contraception or child health services bypassed to a public hospital. Both poor and non-poor women bypassed to higher quality facilities. Our findings suggest that women in five cities in Kenya prefer public hospitals and are willing to travel further to obtain services at public hospitals, possibly related to free service availability. Over time, it will be important to examine service quality and availability in public sector facilities with reduced or eliminated user fees, and whether it lends itself to a continuum of care where women can visit one facility for multiple services reducing travel burden. Electronic supplementary material The online version of this article (10.1007/s11524-017-0212-8) contains supplementary material, which is available to authorized users.
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- 2017
15. Protective Benefits of Deep Tube Wells Against Childhood Diarrhea in Matlab, Bangladesh
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Winston, Jennifer Jane, Escamilla, Veronica, Perez-Heydrich, Carolina, Carrel, Margaret, Yunus, Mohammad, Streatfield, Peter Kim, and Emch, Michael
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- 2013
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16. Impact of tubewell access and tubewell depth on childhood diarrhea in Matlab, Bangladesh
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Wu Jianyong, Yunus Mohammad, Streatfield Peter, van Geen Alexander, Escamilla Veronica, Akita Yasuyuki, Serre Marc, and Emch Michael
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Diarrheal disease ,tubewell ,groundwater ,arsenic ,Industrial medicine. Industrial hygiene ,RC963-969 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background During the past three decades in Bangladesh, millions of tubewells have been installed to reduce the prevalence of diarrheal disease. This study evaluates the impacts of tubewell access and tubewell depth on childhood diarrhea in rural Bangladesh. Methods A total of 59,796 cases of diarrhea in children under 5 were recorded in 142 villages of Matlab, Bangladesh during monthly community health surveys between 2000 and 2006. The location and depth of 12,018 tubewells were surveyed in 2002-04 and integrated with diarrhea and other data in a geographic information system. A proxy for tubewell access was developed by calculating the local density of tubewells around households. Logistic regression models were built to examine the relationship between childhood diarrhea, tubewell density and tubewell depth. Wealth, adult female education, flood control, population density and the child's age were considered as potential confounders. Results Baris (patrilineally-related clusters of households) with greater tubewell density were associated with significantly less diarrhea (OR (odds ratio) = 0.87, 95% confidence interval (CI): 0.85-0.89). Tubewell density had a greater influence on childhood diarrhea in areas that were not protected from flooding. Baris using intermediate depth tubewells (140-300 feet) were associated with more childhood diarrhea (OR = 1.24, 95% CI: 1.19-1.29) than those using shallow wells (10-140 feet). Baris using deep wells (300-990 feet) had less diarrheal disease than those using shallow wells, however, the difference was significant only when population density was low (< 1000 person/km2) or children were at the age of 13-24 months. Conclusions Increased access to tubewells is associated with a lower risk of childhood diarrhea. Intermediate- depth wells are associated with more childhood diarrhea compared to shallower or deeper wells. These findings may have implications for on-going efforts to reduce exposure to elevated levels of arsenic contained in groundwater that is pumped in this study area primarily from shallow tubewells.
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- 2011
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17. Diarrheal disease risk in rural Bangladesh decreases as tubewell density increases: a zero-inflated and geographically weighted analysis
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Yunus Mohammad, Winston Jennifer, Giebultowicz Sophia, Messina Jane, Escamilla Veronica, Carrel Margaret, Streatfield P Kim, and Emch Michael
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Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background This study investigates the impact of tubewell user density on cholera and shigellosis events in Matlab, Bangladesh between 2002 and 2004. Household-level demographic, health, and water infrastructure data were incorporated into a local geographic information systems (GIS) database. Geographically-weighted regression (GWR) models were constructed to identify spatial variation of relationships across the study area. Zero-inflated negative binomial regression models were run to simultaneously measure the likelihood of increased magnitude of disease events and the likelihood of zero cholera or shigellosis events. The aim of this study was to examine the effect of tubewell density on both the occurrence of diarrheal disease and the magnitude of diarrheal disease incidence. Results In Matlab, households with greater tubewell density were more likely to report zero cholera or shigellosis events. Results for both cholera and shigellosis GWR models suggest that tubewell density effects are spatially stationary and the use of non-spatial statistical methods is appropriate. Conclusions Increasing the amount of drinking water available to households through increased density of tubewells contributed to lower reports of cholera and shigellosis events in rural Bangladesh. Our findings demonstrate the importance of tubewell installation and access to groundwater in reducing diarrheal disease events in the developing world.
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- 2011
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18. Local population and regional environmental drivers of cholera in Bangladesh
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Escamilla Veronica, Yunus Mohammad, Emch Michael, Feldacker Caryl, and Ali Mohammad
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Industrial medicine. Industrial hygiene ,RC963-969 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Regional environmental factors have been shown to be related to cholera. Previous work in Bangladesh found that temporal patterns of cholera are positively related to satellite-derived environmental variables including ocean chlorophyll concentration (OCC). Methods This paper investigates whether local socio-economic status (SES) modifies the effect of regional environmental forces. The study area is Matlab, Bangladesh, an area of approximately 200,000 people with an active health and demographic surveillance system. Study data include (1) spatially-referenced demographic and socio-economic characteristics of the population; (2) satellite-derived variables for sea surface temperature (SST), sea surface height (SSH), and OCC; and (3) laboratory confirmed cholera case data for the entire population. Relationships between cholera, the environmental variables, and SES are measured using generalized estimating equations with a logit link function. Additionally two separate seasonal models are built because there are two annual cholera epidemics, one pre-monsoon, and one post-monsoon. Results SES has a significant impact on cholera occurrence: the higher the SES score, the lower the occurrence of cholera. There is a significant negative association between cholera incidence and SSH during the pre-monsoon period but not for the post-monsoon period. OCC is positively associated with cholera during the pre-monsoon period but not for the post-monsoon period. SST is not related to cholera incidence. Conclusions Overall, it appears cholera is influenced by regional environmental variables during the pre-monsoon period and by local-level variables (e.g., water and sanitation) during the post-monsoon period. In both pre- and post-monsoon seasons, SES significantly influences these patterns, likely because it is a proxy for poor water quality and sanitation in poorer households.
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- 2010
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19. Distance to testing sites and its association with timing of HIV diagnosis *
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Escamilla, Veronica, Serre, Marc L., Miller, William C., Cope, Anna B., Mobley, Victoria L., Powers, Kimberly A., Leone, Peter A., and Emch, Michael E.
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human activities - Abstract
Early HIV diagnosis enables prompt treatment initiation, thereby contributing to decreased morbidity, mortality, and transmission. We aimed to describe the association between distance from residence to testing sites and HIV disease stage at diagnosis. Using HIV surveillance data, we identified all new HIV diagnoses made at publicly-funded testing sites in central North Carolina during 2005-2013. Early-stage HIV was defined as acute HIV (antibody-negative test with a positive HIV RNA) or recent HIV (normalized optical density
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- 2016
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20. Distance from household to clinic and its association with the uptake of prevention of mother-to-child HIV transmission regimens in rural Zambia
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Escamilla, Veronica, Chibwesha, Carla J., Gartland, Matthew, Chintu, Namwinga, Mubiana-Mbewe, Mwangelwa, Musokotwane, Kebby, Musonda, Patrick, Miller, William C., Stringer, Jeffrey S. A., and Chi, Benjamin H.
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Adult ,Rural Population ,Adolescent ,Anti-HIV Agents ,Maternal-Child Health Centers ,Infant, Newborn ,Zambia ,HIV Infections ,Pilot Projects ,Prenatal Care ,Transportation ,Article ,Infectious Disease Transmission, Vertical ,Young Adult ,Cross-Sectional Studies ,Pregnancy ,Risk Factors ,Odds Ratio ,Humans ,Female ,Pregnancy Complications, Infectious - Abstract
In rural settings, HIV-infected pregnant women often live significant distances from facilities that provide prevention of mother-to-child transmission (PMTCT) services.We offered universal maternal combination antiretroviral regimens in 4 pilot sites in rural Zambia. To evaluate the impact of services, we conducted a household survey in communities surrounding each facility. We collected information about HIV status and antenatal service utilization from women who delivered in the past 2 years. Using household Global Positioning System coordinates collected in the survey, we measured Euclidean (i.e., straight line) distance between individual households and clinics. Multivariable logistic regression and predicted probabilities were used to determine associations between distance and uptake of PMTCT regimens.From March to December 2011, 390 HIV-infected mothers were surveyed across four communities. Of these, 254 (65%) had household geographical coordinates documented. One hundred sixty-eight women reported use of a PMTCT regimen during pregnancy including 102 who initiated a combination antiretroviral regimen. The probability of PMTCT regimen initiation was the highest within 1.9 km of the facility and gradually declined. Overall, 103 of 145 (71%) who lived within 1.9 km of the facility initiated PMTCT versus 65 of 109 (60%) who lived farther away. For every kilometer increase, the association with PMTCT regimen uptake (adjusted odds ratio: 0.90, 95% confidence interval: 0.82 to 0.99) and combination antiretroviral regimen uptake (adjusted odds ratio: 0.88, 95% confidence interval: 0.80 to 0.97) decreased.In this rural African setting, uptake of PMTCT regimens was influenced by distance to health facility. Program models that further decentralize care into remote communities are urgently needed.
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- 2015
21. Implementation and Operational Research: Distance From Household to Clinic and Its Association With the Uptake of Prevention of Mother-to-Child HIV Transmission Regimens in Rural Zambia
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Mubiana-Mbewe, Mwangelwa, Miller, William C., Chi, Benjamin H., Musokotwane, Kebby, Stringer, Jeffrey S. A., Chibwesha, Carla J., Musonda, Patrick, Chintu, Namwinga, Escamilla, Veronica, and Gartland, Matthew
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virus diseases ,reproductive and urinary physiology - Abstract
In rural settings, HIV-infected pregnant women often live significant distances from facilities that provide prevention of mother-to-child transmission (PMTCT) services.
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- 2015
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22. On the sustainability of a family planning program in Nigeria when funding ends.
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Speizer, Ilene S., Guilkey, David K., Escamilla, Veronica, Lance, Peter M., Calhoun, Lisa M., Ojogun, Osifo T., and Fasiku, David
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FAMILY planning services ,FAMILY planning ,SUSTAINABILITY ,URBAN health ,REPRODUCTIVE health ,DEMOGRAPHIC surveys - Abstract
Few studies have examined the sustainability of family planning program outcomes in the post-program period. This article presents the results of a natural experiment where the Nigerian Urban Reproductive Health Initiative Phase I programming ended in early 2015 and Phase II activities continued in a subset of cities. Using data collected in 2015 and 2017, we compare contraceptive ideation and modern family planning use in two cities: Ilorin where program activities concluded in 2015 and Kaduna where program activities continued. The results demonstrate that exposure to program activities decreased in Ilorin but for those individuals reporting continuing exposure, the effect size of exposure on modern family planning use remained the same and was not significantly different from Kaduna. Modern family planning use continued to increase in both cites but at a lower rate than during Phase I. The results are useful for designing family planning programs that sustain beyond the life of the program. [ABSTRACT FROM AUTHOR]
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- 2019
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23. Exploring the spatial relationship between primary road distance to antenatal clinics and HIV prevalence in pregnant females of Lilongwe, Malawi.
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Amuquandoh, Amy, Escamilla, Veronica, Mofolo, Innocent, and Rosenberg, Nora E
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- 2019
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24. The Geography of Groundwater Quality and Childhood Diarrheal Disease in Bangladesh
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Escamilla, Veronica
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Childhood diarrhea persists in Bangladesh despite efforts to shift from surface water to groundwater for drinking. It is unknown whether shallow aquifer groundwater extracted through tubewells is a significant source of disease or if other sources such as surface water and local sanitation are driving transmission. Using the disease ecology framework, this study explores the influence of poor sanitation on diarrheal disease transmission. Specific questions addressed in this study include: 1) Does poor sanitation influence shallow tubewell water quality? 2) Does fecal contamination of tubewells influence diarrheal disease? 3) Does the neighborhood water and sanitation infrastructure affect childhood diarrheal disease incidence above and beyond household factors? 4) Does poor sanitation influence diarrheal disease via bathing ponds? 5) Does obtaining drinking water from deep tubewells have a protective effect against childhood diarrhea incidence? This study integrates groundwater microbial data, health and demographic surveillance data, and detailed spatial data of the water and sanitation infrastructure in six villages in Matlab, Bangladesh. The relationship between groundwater quality and poor sanitation is measured at multiple scales using geographic analysis tools. Direct and indirect sanitation influences on childhood diarrheal disease (2002-2006) are explored using neighborhood latrine metrics, and bathing pond latrine metrics. A deep tubewell arsenic mitigation intervention is also examined to determine whether children drinking from deep tubewells experience less diarrhea than children drinking from shallow wells. Results suggest that poor sanitation is predictive of both groundwater contamination and diarrheal disease. Children living in neighborhoods with insufficient access to septic latrines experience higher diarrhea incidence. Additionally, children living near bathing ponds surrounded by latrines leaking effluent also have a higher incidence. While deep tubewells were installed for arsenic mitigation, they are also protective against diarrheal disease. These results shed light on the importance of integrating population and environment data to identify particular circumstances in which groundwater is compromised and children are at risk of contracting diarrheal diseases. These results suggest that poor sanitation diminishes the effect of improved drinking water sources and improvements to the built sanitation infrastructure are needed to reduce diarrheal disease incidence.
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- 2011
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25. Diarrheal disease risk in rural Bangladesh decreases as tubewell density increases: a zero-inflated and geographically weighted analysis
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Escamilla, Veronica, Messina, Jane P, Giebultowicz, Sophia, Winston, Jennifer, and Emch, Michael
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Background This study investigates the impact of tubewell user density on cholera and shigellosis events in Matlab, Bangladesh between 2002 and 2004. Household-level demographic, health, and water infrastructure data were incorporated into a local geographic information systems (GIS) database. Geographically-weighted regression (GWR) models were constructed to identify spatial variation of relationships across the study area. Zero-inflated negative binomial regression models were run to simultaneously measure the likelihood of increased magnitude of disease events and the likelihood of zero cholera or shigellosis events. The aim of this study was to examine the effect of tubewell density on both the occurrence of diarrheal disease and the magnitude of diarrheal disease incidence. Results In Matlab, households with greater tubewell density were more likely to report zero cholera or shigellosis events. Results for both cholera and shigellosis GWR models suggest that tubewell density effects are spatially stationary and the use of non-spatial statistical methods is appropriate. Conclusions Increasing the amount of drinking water available to households through increased density of tubewells contributed to lower reports of cholera and shigellosis events in rural Bangladesh. Our findings demonstrate the importance of tubewell installation and access to groundwater in reducing diarrheal disease events in the developing world.
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- 2011
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26. 125 - Geospatial Analyses Identify a Clustering of Diffuse Gastric Cancers and Related Risk Exposures in Central America
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Cherry, Charlotte Buehler, Escamilla, Veronica, Dominguez, Ricardo L., Schneider, Barbara G., Gulley, Margaret L., Tavera, Gloria, Williams, Scott, Israel, Dawn, Piazuelo, M. Blanca, Wilson, Keith T., Peek, Richard M., Emch, Michael, and Morgan, Douglas
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- 2017
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27. Effects of community-level bed net coverage on malaria morbidity in Lilongwe, Malawi.
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Escamilla, Veronica, Alker, Alisa, Dandalo, Leonard, Juliano, Jonathan J., Miller, William C., Kamthuza, Portia, Tembo, Tapiwa, Tegha, Gerald, Martinson, Francis, Emch, Michael, and Hoffman, Irving F.
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- *
MALARIA prevention , *PUBLIC health , *MOSQUITO nets , *INSECTICIDE application ,MALARIA transmission - Abstract
Background: The protective effect of insecticide-treated bed nets against individual-level malaria transmission is well known, however community-level effects are less understood. Protective effects from community-level bed net use against malaria transmission have been observed in clinical trials, however, the relationship is less clear outside of a controlled research setting. The objective of this research was to investigate the effect of community-level bed net use against malaria transmission outside of a bed net clinical trial setting in Lilongwe, Malawi following national efforts to scale-up ownership of long-lasting, insecticide-treated bed nets. Methods: An annual, cross-sectional, household-randomized, malaria transmission intensity survey was conducted in Lilongwe, Malawi (2011-2013). Health, demographic, and geographic-location data were collected. Participant blood samples were tested for Plasmodium falciparum presence. The percentage of people sleeping under a bed net within 400-m and 1-km radii of all participants was measured. Mixed effects logistic regression models were used to measure the relationship between malaria prevalence and surrounding bed net coverage. Each year, 800 people were enrolled (400 <5 years; 200 5-19 years; 200 ≥20 years; total n = 2400). Results: From 2011 to 2013, malaria prevalence declined from 12.9 to 5.6%, while bed net use increased from 53.8 to 78.6%. For every 1% increase in community bed net coverage, malaria prevalence decreased among children under 5 years old [adjusted odds ratio: 0.98 (0.96, 1.00)]. Similar effects were observed in participants 5-19 years [unadjusted odds ratio: 0.98 (0.97, 1.00)]; the effect was attenuated after adjusting for individual-level bed net use. Community coverage was not associated with malaria prevalence among adults ≥20 years. Supplemental analyses identified more pronounced indirect protective effects from community-level bed net use against malaria transmission among children under 5 years who were sleeping under a bed net [adjusted odds ratio: 0.97 (0.94, 0.99)], compared to children who were not sleeping under a bed net [adjusted odds ratio: 0.99 (0.97, 1.01)]. Conclusions: Malawi's efforts to scale up ownership of long-lasting, insecticide-treated bed nets are effective in increasing reported use. Increased community-level bed net coverage appears to provide additional protection against malaria transmission beyond individual use in a real-world context. [ABSTRACT FROM AUTHOR]
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- 2017
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28. Distance to testing sites and its association with timing of HIV diagnosis.
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Cope, Anna B., Powers, Kimberly A., Serre, Marc L., Escamilla, Veronica, Emch, Michael E., Leone, Peter A., Mobley, Victoria L., and Miller, William C.
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DIAGNOSIS of HIV infections ,BLACK people ,CONFIDENCE intervals ,GAY men ,HEALTH services accessibility ,MEDICAL screening ,RACE ,RESEARCH funding ,SEX distribution ,TIME ,TRAVEL ,DISEASE prevalence ,EARLY diagnosis ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Early HIV diagnosis enables prompt treatment initiation, thereby contributing to decreased morbidity, mortality, and transmission. We aimed to describe the association between distance from residence to testing sites and HIV disease stage at diagnosis. Using HIV surveillance data, we identified all new HIV diagnoses made at publicly funded testing sites in central North Carolina during 2005–2013. Early-stage HIV was defined as acute HIV (antibody-negative test with a positive HIV RNA) or recent HIV (normalized optical density <0.8 on the BED assay for non-AIDS cases); remaining diagnoses were considered post-early-stage HIV. Street distance between residence at diagnosis and (1) the closest testing site and (2) the diagnosis site was dichotomized at 5 miles. We fit log-binomial models using generalized estimating equations to estimate prevalence ratios (PR) and robust 95% confidence intervals (CI) for post-early-stage diagnoses by distance. Models were adjusted for race/ethnicity and testing period. Most of the 3028 new diagnoses were black (N = 2144; 70.8%), men who have sex with men (N = 1685; 55.7%), and post-early-stage HIV diagnoses (N = 2010; 66.4%). Overall, 1145 (37.8%) cases traveled <5 miles for a diagnosis. Among cases traveling ≥5 miles for a diagnosis, 1273 (67.6%) lived <5 miles from a different site. Residing ≥5 miles from a testing site was not associated with post-early-stage HIV (adjusted PR, 95% CI: 0.98, 0.92–1.04), but traveling ≥5 miles for a diagnosis was associated with higher post-early HIV prevalence (1.07, 1.02–1.13). Most of the elevated prevalence observed in cases traveling ≥5 miles for a diagnosis occurred among those living <5 miles from a different site (1.09, 1.03–1.16). Modest increases in post-early-stage HIV diagnosis were apparent among persons living near a site, but choosing to travel longer distances to test. Understanding reasons for increased travel distances could improve accessibility and acceptability of HIV services and increase early diagnosis rates. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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29. Health-Specific Information and Communication Technology Use and Its Relationship to Obesity in High-Poverty, Urban Communities: Analysis of a Population-Based Biosocial Survey.
- Author
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Gopalan, Anjali, Makelarski, Jennifer A, Garibay, Lori B, Escamilla, Veronica, Merchant, Raina M, Wolfe, Marcus B Sr, Holbrook, Rebecca, and Lindau, Stacy Tessler
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STATISTICS on Black people ,HYPERTENSION epidemiology ,STATISTICS on Hispanic Americans ,COMMUNICATION ,DIABETES ,MEDICAL care use ,MEDICAL informatics ,OBESITY ,POVERTY ,RESEARCH funding ,CITY dwellers ,COMORBIDITY ,RESIDENTIAL patterns ,DISEASE prevalence - Abstract
Background: More than 35% of American adults are obese. For African American and Hispanic adults, as well as individuals residing in poorer or more racially segregated urban neighborhoods, the likelihood of obesity is even higher. Information and communication technologies (ICTs) may substitute for or complement community-based resources for weight management. However, little is currently known about health-specific ICT use among urban-dwelling people with obesity.Objective: We describe health-specific ICT use and its relationship to measured obesity among adults in high-poverty urban communities.Methods: Using data collected between November 2012 and July 2013 from a population-based probability sample of urban-dwelling African American and Hispanic adults residing on the South Side of Chicago, we described patterns of ICT use in relation to measured obesity defined by a body mass index (BMI) of ≥30 kg/m(2). Among those with BMI≥30 kg/m(2), we also assessed the association between health-specific ICT use and diagnosed versus undiagnosed obesity as well as differences in health-specific ICT use by self-reported comorbidities, including diabetes and hypertension.Results: The survey response rate was 44.6% (267 completed surveys/598.4 eligible or likely eligible individuals); 53.2% were African American and 34.6% were Hispanic. More than 35% of the population reported an annual income of less than US $25,000. The population prevalence of measured obesity was 50.2%. People with measured obesity (BMI≥30 kg/m(2)) were more likely to report both general (81.5% vs 67.0%, P=.04) and health-specific (61.1% vs 41.2%, P=.01) ICT use. In contrast, among those with measured obesity, being told of this diagnosis by a physician was not associated with increased health-specific ICT use. People with measured obesity alone had higher rates of health-specific use than those with comorbid hypertension and/or diabetes diagnoses (77.1% vs 60.7% vs 47.4%, P=.04).Conclusions: In conclusion, ICT-based health resources may be particularly useful for people in high-poverty urban communities with isolated measured obesity, a population that is at high risk for poor health outcomes. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
30. Protective Benefits of Deep Tube Wells Against Childhood Diarrhea in Matlab, Bangladesh.
- Author
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Jane Winston, Jennifer, Escamilla, Veronica, Perez-Heydrich, Carolina, Carrel, Margaret, Yunus, Mohammad, Streatfield, Peter Kim, and Emch, Michael
- Abstract
Objectives. We investigated whether deep tube wells installed to provide arsenic-free groundwater in rural Bangladesh have the added benefit of reducing childhood diarrheal disease incidence. Methods. We recorded cases of diarrhea in children younger than 5 years in 142 villages of Matlab, Bangladesh, during monthly community health surveys in 2005 and 2006. We surveyed the location and depth of 12 018 tube wells and integrated these data with diarrhea data and other data in a geographic information system. We fit a longitudinal logistic regression model to measure the relationship between childhood diarrhea and deep tube well use. We controlled for maternal education, family wealth, year, and distance to a deep tube well. Results. Household clusters assumed to be using deep tube wells were 48.7% (95% confidence interval = 27.8%, 63.5%) less likely to have a case of childhood diarrhea than were other household clusters. Conclusions. Increased access to deep tube wells may provide dual benefits to vulnerable populations in Matlab, Bangladesh, by reducing the risk of childhood diarrheal disease and decreasing exposure to naturally occurring arsenic in groundwater. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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31. Comparative population structure of Plasmodium falciparum circumsporozoite protein NANP repeat lengths in Lilongwe, Malawi.
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Bowman, Natalie M., Congdon, Seth, Mvalo, Tisungane, Patel, Jaymin C., Escamilla, Veronica, Emch, Michael, Martinson, Francis, Hoffman, Irving, Meshnick, Steven R., and Juliano, Jonathan J.
- Subjects
PLASMODIUM falciparum ,MALARIA ,CIRCUMSPOROZOITE protein ,IMMUNITY ,GEL electrophoresis - Abstract
Humoral immunity to Plasmodium falciparum circumsporozoite protein is partly mediated by a polymorphic NANP tetra-amino acid repeat. Antibody response to these repeats is the best correlate of protective immunity to the RTS,S malaria vaccine, but few descriptions of the natural variation of these repeats exist. Using capillary electrophoresis to determine the distribution of NANP repeat size polymorphisms among 98 isolates from Lilongwe, Malawi, we characterised the diversity of P. falciparum infection by several ecological indices. Infection by multiple distinct variants was common, and 20 distinct repeat sizes were identified. Diversity of P. falciparum appeared greater in children (18 variants) than adults (12 variants). There was evidence of genetic distance between different geographic regions by Nei's Standard Genetic Distance, suggesting parasite populations vary locally. We show that P. falciparum is very diverse with respect to NANP repeat length even on a local level and that diversity appears higher in children. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
32. Implications of Fecal Bacteria Input from Latrine-Polluted Ponds for Wells in Sandy Aquifers.
- Author
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Knappett, Peter S. K., McKay, Larry D., Layton, Alice, Williams, Daniel E., Alam, Md. J., Huq, Md. R., Mey, Jacob, Feighery, John E., Culligan, Patricia J., Mailloux, Brian J., Zhuang, Jie, Escamilla, Veronica, Emch, Michael, Perfect, Edmund, ayler, Gary S. S, Ahmed, Kazi M., and van Geen, Alexander
- Published
- 2012
- Full Text
- View/download PDF
33. Increase in Diarrheal Disease Associated with Arsenic Mitigation in Bangladesh.
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Jianyong Wu, van Geen, Alexander, Ahmed, Kazi Matin, Alam, Yasuyuki Akita Jahangir, Culligan, Patricia J., Escamilla, Veronica, Feighery, John, Ferguson, Andrew S., Knappett, Peter, Mailloux, Brian J., McKay, Larry D., Serre, Marc L., Streatfield, P. Kim, Yunus, Mohammad, and Emch, Michael
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DIARRHEA ,PHYSIOLOGICAL effects of arsenic ,PEDIATRIC gastroenterology ,ESCHERICHIA coli ,PUBLIC health - Abstract
Background Millions of households throughout Bangladesh have been exposed to high levels of arsenic (As) causing various deadly diseases by drinking groundwater from shallow tubewells for the past 30 years. Well testing has been the most effective form of mitigation because it has induced massive switching from tubewells that are high (>50 μg/L) in As to neighboring wells that are low in As. A recent study has shown, however, that shallow low-As wells are more likely to be contaminated with the fecal indicator E. coli than shallow high-As wells, suggesting that well switching might lead to an increase in diarrheal disease. Methods Approximately 60,000 episodes of childhood diarrhea were collected monthly by community health workers between 2000 and 2006 in 142 villages of Matlab, Bangladesh. In this cross-sectional study, associations between childhood diarrhea and As levels in tubewell water were evaluated using logistic regression models. Results Adjusting for wealth, population density, and flood control by multivariate logistic regression, the model indicates an 11% (95% confidence intervals (CIs) of 4-19%) increase in the likelihood of diarrhea in children drinking from shallow wells with 10-50 μg/L As compared to shallow wells with >50 μg/L As. The same model indicates a 26% (95%CI: 9-42%) increase in diarrhea for children drinking from shallow wells with ≤10 μg/L As compared to shallow wells with >50 μg/L As. Conclusion Children drinking water from shallow low As wells had a higher prevalence of diarrhea than children drinking water from high As wells. This suggests that the health benefits of reducing As exposure may to some extent be countered by an increase in childhood diarrhea. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
34. Impact of population and latrines on fecal contamination of ponds in rural Bangladesh
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Knappett, Peter S.K., Escamilla, Veronica, Layton, Alice, McKay, Larry D., Emch, Michael, Williams, Daniel E., Huq, R., Alam, J., Farhana, Labony, Mailloux, Brian J., Ferguson, Andy, Sayler, Gary S., Ahmed, Kazi M., and van Geen, Alexander
- Subjects
- *
FECAL contamination , *WATER pollution , *PONDS , *POPULATION , *TOILETS , *DIARRHEA , *ADENOVIRUS diseases , *POLYMERASE chain reaction - Abstract
Abstract: A majority of households in Bangladesh rely on pond water for hygiene. Exposure to pond water fecal contamination could therefore still contribute to diarrheal disease despite the installation of numerous tubewells for drinking. The objectives of this study are to determine the predominant sources (human or livestock) of fecal pollution in ponds and examine the association between local population, latrine density, latrine quality and concentrations of fecal bacteria and pathogens in pond water. Forty-three ponds were analyzed for E. coli using culture-based methods and E. coli, Bacteroidales and adenovirus using quantitative PCR. Population and sanitation spatial data were collected and measured against pond fecal contamination. Humans were the dominant source of fecal contamination in 79% of the ponds according to Bacteroidales measurements. Ponds directly receiving latrine effluent had the highest concentrations of fecal indicator bacteria (up to 106 Most Probable Number (MPN) of culturable E. coli per 100mL). Concentrations of fecal indicator bacteria correlated with population surveyed within a distance of 30–70m (p<0.05) and total latrines surveyed within 50–70m (p<0.05). Unsanitary latrines (visible effluent or open pits) within the pond drainage basin were also significantly correlated to fecal indicator concentrations (p<0.05). Water in the vast majority of the surveyed ponds contained unsafe levels of fecal contamination attributable primarily to unsanitary latrines, and to lesser extent, to sanitary latrines and cattle. Since the majority of fecal pollution is derived from human waste, continued use of pond water could help explain the persistence of diarrheal disease in rural South Asia. [Copyright &y& Elsevier]
- Published
- 2011
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- View/download PDF
35. Fecal Contamination of Shallow Tubewells in Bangladesh Inversely Related to Arsenic.
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van Geen, Alexander, Ahmed, Kazi Matin, Akita, Yasuyuki, Alam, Md. Jahangir, Culligan, Patricia J., Emch, Michael, Escamilla, Veronica, Feighery, John, Ferguson, Andrew S., Knappett, Peter, Layton, Alice C., Mailloux, Brian J., McKay, Larry D., Mey, Jacob L., Serre, Marc L., Streatfield, P. Kim, Jianyong Wu, and Yunus, Mohammad
- Published
- 2011
- Full Text
- View/download PDF
36. Diarrheal disease risk in rural Bangladesh decreases as tubewell density increases: a zeroinflated and geographically weighted analysis.
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Carrel, Margaret, Escamilla, Veronica, Messina, Jane, Giebultowicz, Sophia, Winston, Jennifer, Yunus, Mohammad, Streatfield, P Kim, and Emch, Michael
- Subjects
- *
CHOLERA , *SHIGELLOSIS , *GROUNDWATER ,MATLAB (Bangladesh) - Abstract
Background: This study investigates the impact of tubewell user density on cholera and shigellosis events in Matlab, Bangladesh between 2002 and 2004. Household-level demographic, health, and water infrastructure data were incorporated into a local geographic information systems (GIS) database. Geographically-weighted regression (GWR) models were constructed to identify spatial variation of relationships across the study area. Zero-inflated negative binomial regression models were run to simultaneously measure the likelihood of increased magnitude of disease events and the likelihood of zero cholera or shigellosis events. The aim of this study was to examine the effect of tubewell density on both the occurrence of diarrheal disease and the magnitude of diarrheal disease incidence. Results: In Matlab, households with greater tubewell density were more likely to report zero cholera or shigellosis events. Results for both cholera and shigellosis GWR models suggest that tubewell density effects are spatially stationary and the use of non-spatial statistical methods is appropriate. Conclusions: Increasing the amount of drinking water available to households through increased density of tubewells contributed to lower reports of cholera and shigellosis events in rural Bangladesh. Our findings demonstrate the importance of tubewell installation and access to groundwater in reducing diarrheal disease events in the developing world. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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- View/download PDF
37. Local population and regional environmental drivers of cholera in Bangladesh.
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Emch, Michael, Yunus, Mohammad, Escamilla, Veronica, Feldacker, Caryl, and Ali, Mohammad
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CHOLERA diagnosis ,EPIDEMICS ,MONSOONS ,DEMOGRAPHIC characteristics ,SOCIAL status ,ECONOMIC status - Abstract
Background: Regional environmental factors have been shown to be related to cholera. Previous work in Bangladesh found that temporal patterns of cholera are positively related to satellite-derived environmental variables including ocean chlorophyll concentration (OCC). Methods: This paper investigates whether local socio-economic status (SES) modifies the effect of regional environmental forces. The study area is Matlab, Bangladesh, an area of approximately 200,000 people with an active health and demographic surveillance system. Study data include (1) spatially-referenced demographic and socio-economic characteristics of the population; (2) satellite-derived variables for sea surface temperature (SST), sea surface height (SSH), and OCC; and (3) laboratory confirmed cholera case data for the entire population. Relationships between cholera, the environmental variables, and SES are measured using generalized estimating equations with a logit link function. Additionally two separate seasonal models are built because there are two annual cholera epidemics, one pre-monsoon, and one post-monsoon. Results: SES has a significant impact on cholera occurrence: the higher the SES score, the lower the occurrence of cholera. There is a significant negative association between cholera incidence and SSH during the pre-monsoon period but not for the post-monsoon period. OCC is positively associated with cholera during the pre-monsoon period but not for the post-monsoon period. SST is not related to cholera incidence. Conclusions: Overall, it appears cholera is influenced by regional environmental variables during the pre-monsoon period and by local-level variables (e.g., water and sanitation) during the post-monsoon period. In both pre- and post-monsoon seasons, SES significantly influences these patterns, likely because it is a proxy for poor water quality and sanitation in poorer households. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
38. Late-Stage Breast Cancer Diagnosis and Health Care Access in Illinois.
- Author
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Wang, Fahui, McLafferty, Sara, Escamilla, Veronica, and Luo, Lan
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BREAST cancer ,MAMMOGRAMS ,CANCER treatment ,CARING ,MEDICAL care ,RISK management in business ,CANCER in women ,MORTALITY ,SPATIAL systems ,HEALTH services accessibility - Abstract
Copyright of Professional Geographer is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2008
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39. The Right Prescription for Family Bliss: A Cross-Sectional Study on Community Satisfaction in Indonesian Family Planning Programs.
- Author
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Amini, Nyigit Wudi, Suaedi, Falih, and Setijaningrum, Erna
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COMMUNITY involvement ,FAMILY planning services ,SATISFACTION ,COMMUNITY-based programs ,CROSS-sectional method ,MEDICAL personnel - Abstract
Although significant progress has been achieved over many decades, sustaining the success of family planning programs in Indonesia requires a deep understanding of the factors that influence community satisfaction among those involved. This study surveyed 503 Family Planning Field Workers (PKBs) across Indonesia's regions to identify the main factors encouraging satisfaction among communities participating in these programs. A structured online questionnaire was distributed to collect data on the sociodemographic factors influencing satisfaction, which were then analyzed using multiple linear regression. The results showed that effective follow-up on community feedback (β = 0.233, p < 0.001), implementing a rights-based approach (β = 0.207, p < 0.001), enabling community participation (β = 0.147, p < 0.001), collaborating with healthcare providers and facilities (β = 0.159, p < 0.001), and monitoring and evaluating programs (β = 0.155, p < 0.001) were significant positive predictors. More notable, the regression model accounted for a considerable 74.7% of the variation in community satisfaction, pointing to how significant the explanatory power of the identified factors was in predicting the level of satisfaction among communities participating in family planning programs. Actions must be developed to enhance reproductive health and manage population growth by focusing on key factors such as responsive communication, rights, integrated services, community involvement, and evaluations, which are what matters most for family planning programs. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
40. Sampling at community level by using satellite imagery and geographical analysis
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Dandalo, Leonard, Escamilla, Veronica, Miller, William C., Hofman, Irving, Emch, Michael, and Martinson, Francis
- Subjects
3. Good health - Abstract
ProblemTraditional random sampling at community level requires a list of every individual household that can be randomly selected in the study community. The longitudinal demographic surveillance systems often used as sampling frames are difficult to create in many resource-poor settings.ApproachWe used Google Earth imagery and geographical analysis software to develop a sampling frame. Every household structure within the catchment area was digitized and assigned coordinates. A random sample was then generated from the list of households.Local settingThe sampling took place in Lilongwe, Malawi and formed a part of an investigation of the intensity of Plasmodium falciparum transmission in a multi-site Phase III trial of a candidate malaria vaccine.Relevant changesCreation of a complete list of household coordinates within the catchment area allowed us to generate a random sample representative of the population. Once the coordinates of the households in that sample had been entered into the hand-held receivers of a global positioning system device, the households could be accurately identified on the ground and approached.Lessons learntIn the development of a geographical sampling frame, the use of Google Earth satellite imagery and geographical software appeared to be an efficient alternative to the use of a demographic surveillance system. The use of a complete list of household coordinates reduced the time needed to locate households in the random sample. Our approach to generate a sampling frame is accurate, has utility beyond morbidity studies and appears to be a cost-effective option in resource-poor settings.
41. Impact of tubewell access and tubewell depth on childhood diarrhea in Matlab, Bangladesh
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van Geen, Alexander, Streatfield, Peter Kim, Akita, Yasuyuki, Escamilla, Veronica, Wu, Jianyong, Yunus, Mohammad, Emch, Michael, and Serre, Marc
- Subjects
2. Zero hunger - Abstract
BackgroundDuring the past three decades in Bangladesh, millions of tubewells have been installed to reduce the prevalence of diarrheal disease. This study evaluates the impacts of tubewell access and tubewell depth on childhood diarrhea in rural Bangladesh.MethodsA total of 59,796 cases of diarrhea in children under 5 were recorded in 142 villages of Matlab, Bangladesh during monthly community health surveys between 2000 and 2006. The location and depth of 12,018 tubewells were surveyed in 2002-04 and integrated with diarrhea and other data in a geographic information system. A proxy for tubewell access was developed by calculating the local density of tubewells around households. Logistic regression models were built to examine the relationship between childhood diarrhea, tubewell density and tubewell depth. Wealth, adult female education, flood control, population density and the child's age were considered as potential confounders.ResultsBaris (patrilineally-related clusters of households) with greater tubewell density were associated with significantly less diarrhea (OR (odds ratio) = 0.87, 95% confidence interval (CI): 0.85-0.89). Tubewell density had a greater influence on childhood diarrhea in areas that were not protected from flooding. Baris using intermediate depth tubewells (140-300 feet) were associated with more childhood diarrhea (OR = 1.24, 95% CI: 1.19-1.29) than those using shallow wells (10-140 feet). Baris using deep wells (300-990 feet) had less diarrheal disease than those using shallow wells, however, the difference was significant only when population density was low (< 1000 person/km2) or children were at the age of 13-24 months.ConclusionsIncreased access to tubewells is associated with a lower risk of childhood diarrhea. Intermediate- depth wells are associated with more childhood diarrhea compared to shallower or deeper wells. These findings may have implications for on-going efforts to reduce exposure to elevated levels of arsenic contained in groundwater that is pumped in this study area primarily from shallow tubewells.
42. Comparative population structure of Plasmodium falciparum circumsporozoite protein NANP repeat lengths in Lilongwe, Malawi
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Mvalo, Tisungane, Emch, Michael, Escamilla, Veronica, Hoffman, Irving, Congdon, Seth, Juliano, Jonathan J., Bowman, Natalie M., Meshnick, Steven R., Martinson, Francis, and Patel, Jaymin C.
- Subjects
parasitic diseases ,3. Good health - Abstract
Humoral immunity to Plasmodium falciparum circumsporozoite protein is partly mediated by a polymorphic NANP tetra-amino acid repeat. Antibody response to these repeats is the best correlate of protective immunity to the RTS,S malaria vaccine, but few descriptions of the natural variation of these repeats exist. Using capillary electrophoresis to determine the distribution of NANP repeat size polymorphisms among 98 isolates from Lilongwe, Malawi, we characterised the diversity of P. falciparum infection by several ecological indices. Infection by multiple distinct variants was common, and 20 distinct repeat sizes were identified. Diversity of P. falciparum appeared greater in children (18 variants) than adults (12 variants). There was evidence of genetic distance between different geographic regions by Nei's Standard Genetic Distance, suggesting parasite populations vary locally. We show that P. falciparum is very diverse with respect to NANP repeat length even on a local level and that diversity appears higher in children.
43. Fecal Contamination of Shallow Tubewells in Bangladesh Inversely Related to Arsenic
- Author
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Streatfield, P. Kim, Layton, Alice C., Mey, Jacob L., Ferguson, Andrew S., Culligan, Patricia J., Akita, Yasuyuki, Wu, Jianyong, Yunus, Mohammad, Feighery, John, McKay, Larry D., Serre, Marc L., Knappett, Peter, Mailloux, Brian J., Alam, Md. Jahangir, Emch, Michael, Escamilla, Veronica, Ahmed, Kazi Matin, and van Geen, Alexander
- Subjects
6. Clean water ,3. Good health - Abstract
The health risks of As exposure due to the installation of millions of shallow tubewells in the Bengal Basin are known, but fecal contamination of shallow aquifers has not systematically been examined. This could be a source of concern in densely populated areas with poor sanitation because the hydraulic travel time from surface water bodies to shallow wells that are low in As was previously shown to be considerably shorter than for shallow wells that are high in As. In this study, 125 tubewells 6−36 m deep were sampled in duplicate for 18 months to quantify the presence of the fecal indicator Escherichia coli. On any given month, E. coli was detected at levels exceeding 1 most probable number per 100 mL in 19−64% of all shallow tubewells, with a higher proportion typically following periods of heavy rainfall. The frequency of E. coli detection averaged over a year was found to increase with population surrounding a well and decrease with the As content of a well, most likely because of downward transport of E. coli associated with local recharge. The health implications of higher fecal contamination of shallow tubewells, to which millions of households in Bangladesh have switched in order to reduce their exposure to As, need to be evaluated.Shallow tubewells in Bangladesh that are low in As are more susceptible to fecal contamination than shallow wells that are high in As.
44. Increase in Diarrheal Disease Associated with Arsenic Mitigation in Bangladesh
- Author
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Serre, Marc L., Alam, Yasuyuki Akita Jahangir, Emch, Michael, Ahmed, Kazi Matin, Culligan, Patricia J., Mailloux, Brian J., Knappett, Peter, van Geen, Alexander, Streatfield, P. Kim, Feighery, John, Yunus, Mohammad, Ferguson, Andrew S., Escamilla, Veronica, McKay, Larry D., and Wu, Jianyong
- Subjects
6. Clean water ,3. Good health - Abstract
BackgroundMillions of households throughout Bangladesh have been exposed to high levels of arsenic (As) causing various deadly diseases by drinking groundwater from shallow tubewells for the past 30 years. Well testing has been the most effective form of mitigation because it has induced massive switching from tubewells that are high (>50 µg/L) in As to neighboring wells that are low in As. A recent study has shown, however, that shallow low-As wells are more likely to be contaminated with the fecal indicator E. coli than shallow high-As wells, suggesting that well switching might lead to an increase in diarrheal disease.MethodsApproximately 60,000 episodes of childhood diarrhea were collected monthly by community health workers between 2000 and 2006 in 142 villages of Matlab, Bangladesh. In this cross-sectional study, associations between childhood diarrhea and As levels in tubewell water were evaluated using logistic regression models.ResultsAdjusting for wealth, population density, and flood control by multivariate logistic regression, the model indicates an 11% (95% confidence intervals (CIs) of 4–19%) increase in the likelihood of diarrhea in children drinking from shallow wells with 10–50 µg/L As compared to shallow wells with >50 µg/L As. The same model indicates a 26% (95%CI: 9–42%) increase in diarrhea for children drinking from shallow wells with ≤10 µg/L As compared to shallow wells with >50 µg/L As.ConclusionChildren drinking water from shallow low As wells had a higher prevalence of diarrhea than children drinking water from high As wells. This suggests that the health benefits of reducing As exposure may to some extent be countered by an increase in childhood diarrhea.
45. Longitudinal estimation of Plasmodium falciparum prevalence in relation to malaria prevention measures in six sub-Saharan African countries
- Author
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Otieno, Walter, Mahende, Coline, Asante, Kwaku P, Greenwood, Brian, Pirçon, Jean-Yves, Escamilla, Veronica, Bawa, John T, Kaslow, David C, Martinson, Francis, Leboulleux, Didier, Otieno, Solomon, Mihayo, Michael G, Lell, Bertrand, Owusu-Agyei, Seth, Ansong, Daniel, Dandalo, Léonard, Gesase, Samwel, Diallo, Salou, Boateng, Harry O, Adjei, George, Tahita, Marc C, Agyekum, Alex, Bahmanyar, Edith R, Agnandji, Selidji T, Maenje, Peter, Mewono, Ludovic, Fernandes, José F, Oyieko, Janet, Dery, Dominic B, Carter, Terrell, Agbenyega, Tsiri, Lompo, Palpouguini, Abdulla, Salim, Segeja, Method, Bache, Bache E, Otieno, Lucas, Lusingu, John, Atibilla, Dorcas, Ogutu, Bernhards, Adjei, Samuel, Tinto, Halidou, Hoffman, Irving, Tanner, Marcel, Kremsner, Peter, Mongi, Robert, Adeniji, Elisha, Usuf, Effua, D’Alessandro, Umberto, Juma, Omar, and Drakeley, Chris
- Subjects
parasitic diseases ,3. Good health - Abstract
Background Plasmodium falciparum prevalence (PfPR) is a widely used metric for assessing malaria transmission intensity. This study was carried out concurrently with the RTS,S/AS01 candidate malaria vaccine Phase III trial and estimated PfPR over ≤ 4 standardized cross-sectional surveys. Methods This epidemiology study (NCT01190202) was conducted in 8 sites from 6 countries (Burkina Faso, Gabon, Ghana, Kenya, Malawi, and Tanzania), between March 2011 and December 2013. Participants were enrolled in a 2:1:1 ratio according to age category: 6 months–4 years, 5–19 years, and ≥ 20 years, respectively, per year and per centre. All sites carried out surveys 1–3 while survey 4 was conducted only in 3 sites. Surveys were usually performed during the peak malaria parasite transmission season, in one home visit, when medical history and malaria risk factors/prevention measures were collected, and a blood sample taken for rapid diagnostic test, microscopy, and haemoglobin measurement. PfPR was estimated by site and age category. Results Overall, 6401 (survey 1), 6411 (survey 2), 6400 (survey 3), and 2399 (survey 4) individuals were included in the analyses. In the 6 months–4 years age group, the lowest prevalence (assessed using microscopy) was observed in 2 Tanzanian centres (4.6% for Korogwe and 9.95% for Bagamoyo) and Lambaréné, Gabon (6.0%), while the highest PfPR was recorded for Nanoro, Burkina Faso (52.5%). PfPR significantly decreased over the 3 years in Agogo (Ghana), Kombewa (Kenya), Lilongwe (Malawi), and Bagamoyo (Tanzania), and a trend for increased PfPR was observed over the 4 surveys for Kintampo, Ghana. Over the 4 surveys, for all sites, PfPR was predominantly higher in the 5–19 years group than in the other age categories. Occurrence of fever and anaemia was associated with high P. falciparum parasitaemia. Univariate analyses showed a significant association of anti-malarial treatment in 4 surveys (odds ratios [ORs]: 0.52, 0.52, 0.68, 0.41) and bed net use in 2 surveys (ORs: 0.63, 0.68, 1.03, 1.78) with lower risk of malaria infection. Conclusion Local PfPR differed substantially between sites and age groups. In children 6 months–4 years old, a significant decrease in prevalence over the 3 years was observed in 4 out of the 8 study sites. Trial registration Clinical Trials.gov identifier: NCT01190202:NCT. GSK Study ID numbers: 114001
46. G3 and G9 Rotavirus genotypes in waste water circulation from two major metropolitan cities of Pakistan.
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Naqvi, Syeda Sumera, Javed, Sundus, Naseem, Saadia, Sadiq, Asma, Khan, Netasha, Sattar, Sadia, Shah, Naseer Ali, and Bostan, Nazish
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ROTAVIRUSES ,BODIES of water ,WATER supply ,POLYMERASE chain reaction - Abstract
Rotavirus A (RVA) is a diarrheal pathogen affecting children under age five, particularly in developing and underdeveloped regions of the world due to malnutrition, poor healthcare and hygienic conditions. Water and food contamination are found to be major sources of diarrheal outbreaks. Pakistan is one of the countries with high RVA related diarrhea burden but with insufficient surveillance system. The aim of this study was to gauge the RVA contamination of major open sewerage collecting streams and household water supplies in two major metropolitan cities of Pakistan. Three concentration methods were compared using RNA purity and concentration as parameters, and detection efficiency of the selected method was estimated. Water samples were collected from 21 sites in Islamabad and Rawalpindi in two phases during the year 2014–2015. Meteorological conditions were recorded for each sampling day and site from Pakistan Meteorological Department (PMD). Nested PCR was used to detect the presence of RVA in samples targeting the VP7 gene. Logistic regression was applied to assess the association of weather conditions with RVA persistence in water bodies. Statistical analysis hinted at a temporal and seasonal pattern of RVA detection in water. Phylogenetic analysis of selected isolates showed a close association of environmental strains with clinical RVA isolates from hospitalized children with acute diarrhea during the same period. This is the first scientific report cataloging the circulating RVA strains in environmental samples from the region. The study highlights the hazards of releasing untreated sewerage containing potentially infectious viral particles into collecting streams, which could become a reservoir of multiple pathogens and a risk to exposed communities. Moreover, routine testing of these water bodies can present an effective surveillance system of circulating viral strains in the population. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
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47. Impact of a Low-Intensity Resource Referral Intervention on Patients' Knowledge, Beliefs, and Use of Community Resources: Results from the CommunityRx Trial.
- Author
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Tung, Elizabeth L., Abramsohn, Emily M., Boyd, Kelly, Makelarski, Jennifer A., Beiser, David G., Chou, Chiahung, Huang, Elbert S., Ozik, Jonathan, Kaligotla, Chaitanya, and Lindau, Stacy Tessler
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COMMUNITY life ,MEDICAL centers ,INFORMATION-seeking behavior ,POPULATION health management ,COUNSELING ,BEHAVIOR ,MEDICAL referrals ,RESEARCH ,SMOKING cessation ,CLINICAL trials ,RESEARCH methodology ,MEDICAL cooperation ,EVALUATION research ,COMPARATIVE studies ,RESEARCH funding - Abstract
Background: Connecting patients to community-based resources is now a cornerstone of modern healthcare that supports self-management of health. The mechanisms that link resource information to behavior change, however, remain poorly understood.Objective: To evaluate the impact of CommunityRx, an automated, low-intensity resource referral intervention, on patients' knowledge, beliefs, and use of community resources.Design: Real-world controlled clinical trial at an urban academic medical center in 2015-2016; participants were assigned by alternating week to receive the CommunityRx intervention or usual care. Surveys were administered at baseline, 1 week, 1 month, and 3 months.Participants: Publicly insured adults, ages 45-74 years.Intervention: CommunityRx generated an automated, personalized list of resources, known as HealtheRx, near each participant's home using condition-specific, evidence-based algorithms. Algorithms used patient demographic and health characteristics documented in the electronic health record to identify relevant resources from a comprehensive, regularly updated database of health-related resources in the study area.Main Measures: Using intent-to-treat analysis, we examined the impact of HealtheRx referrals on (1) knowledge of the most commonly referred resource types, including healthy eating classes, individual counseling, mortgage assistance, smoking cessation, stress management, and weight loss classes or groups, and (2) beliefs about having resources in the community to manage health.Key Results: In a real-world controlled trial of 374 adults, intervention recipients improved knowledge (AOR = 2.15; 95% CI, 1.29-3.58) and beliefs (AOR = 1.68; 95% CI, 1.07-2.64) about common resources in the community to manage health, specifically gaining knowledge about smoking cessation (AOR = 2.76; 95% CI, 1.07-7.12) and weight loss resources (AOR = 2.26; 95% CI 1.05-4.84). Positive changes in both knowledge and beliefs about community resources were associated with higher resource use (P = 0.02).Conclusions: In a middle-age and older population with high morbidity, a low-intensity health IT intervention to deliver resource referrals promoted behavior change by increasing knowledge and positive beliefs about community resources for self-management of health.Nih Trial Registry: NCT02435511. [ABSTRACT FROM AUTHOR]- Published
- 2020
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48. Geographical Studies of Sub-Saharan Africa: A Bibliography.
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Rumney, Thomas
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LIBRARIANS ,GEOGRAPHIC boundaries ,WORLD War II ,INFORMATION resources ,ECONOMIC conditions in Africa - Published
- 2018
49. Influences of heatwave, rainfall, and tree cover on cholera in Bangladesh.
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Wu, Jianyong, Yunus, Mohammad, Ali, Mohammad, Escamilla, Veronica, and Emch, Michael
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CHOLERA , *COMMUNICABLE diseases , *HEAT waves (Meteorology) , *RAINFALL , *CLIMATE change , *PUBLIC health - Abstract
Abstract Cholera is a severe diarrheal disease and remains a global threat to public health. Climate change and variability have the potential to increase the distribution and magnitude of cholera outbreaks. However, the effect of heatwave on the occurrence of cholera at individual level is still unclear. It is also unknown whether the local vegetation could potentially mitigate the effects of extreme heat on cholera outbreaks. In this study, we designed a case-crossover study to examine the association between the risk of cholera and heatwaves as well as the modification effects of rainfall and tree cover. The study was conducted in Matlab, a cholera endemic area of rural Bangladesh, where cholera case data were collected between January 1983 and April 2009. The association between the risk of cholera and heatwaves was examined using conditional logistic regression models. The results showed that there was a higher risk of cholera two days after heatwaves (OR = 1.53, 95% CI: 1.07–2.19) during wet days (rainfall > 0 mm). For households with less medium-dense tree cover, the heatwave after a 2-day lag was positively associated (OR = 1.80, 95% CI: 1.01–3.22) with the risk of cholera during wet days. However, for households with more medium-dense tree cover, the association between the risk of cholera and heatwave in 2-day lag was not significant. These findings suggest that heatwaves might promote the occurrence of cholera, while this relationship was modified by rainfall and tree cover. Further investigations are needed to explore major mechanisms underlying the association between heatwaves and cholera as well as the beneficial effects of tree cover. Highlights • Relationship between heatwave and cholera was examined at the individual level. • Heatwave after a 2-day lag was positively associated with cholera risk in wet days. • Tree cover could mitigate the adverse effect of heatwave on cholera. • Further studies are needed to explore mechanisms of the effect of heatwaves. [ABSTRACT FROM AUTHOR]
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- 2018
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50. CommunityRx: A Population Health Improvement Innovation That Connects Clinics To Communities.
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Lindau, Stacy T., Makelarski, Jennifer, Abramsohn, Emily, Beiser, David G., Escamilla, Veronica, Jerome, Jessica, Johnson, Daniel, Kho, Abel N., Lee, Karen K., Long, Timothy, and Miller, Doriane C.
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ASIANS , *BLACK people , *COMMUNITY health services , *HEALTH promotion , *HISPANIC Americans , *NATIVE Americans , *INFORMATION storage & retrieval systems , *MEDICAL databases , *MEDICAL records , *METROPOLITAN areas , *SOCIAL problems , *WHITE people , *COMMUNITY-based social services , *INFORMATION needs , *DATA analysis software - Abstract
The CommunityRx system, a population health innovation, combined an e-prescribing model and community engagement to strengthen links between clinics and community resources for basic, wellness, and disease self-management needs in Chicago. The components of CommunityRx were a youth workforce, whose members identified 19,589 public-serving entities in the 106-square-mile implementation region between 2012 and 2014; community health information specialists, who used the workforce's findings to generate an inventory of 14,914 health-promoting resources; and a health information technology (IT) platform that was integrated with three electronic health record systems at thirty-three clinical sites. By mapping thirty-seven prevalent social and medical conditions to community resources, CommunityRx generated 253,479 personalized HealtheRx prescriptions for more than 113,000 participants. Eighty-three percent of the recipients found the HealtheRx very useful, and 19 percent went to a place they learned about from the HealtheRx. All but one organization continued using the CommunityRx system after the study period ended. This study demonstrates the feasibility of using health IT and workforce innovation to bridge the gap between clinical and other health-promoting sectors. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
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