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3. The impact of a community health worker intervention on uptake of antenatal care: a cluster-randomized pragmatic trial in Dar es Salaam

Author

Regan, Mathilda, primary, Cheng, Chao, additional, Mboggo, Eric, additional, Larson, Elysia, additional, Lema, Irene Andrew, additional, Magesa, Lucy, additional, Machumi, Lameck, additional, Ulenga, Nzovu, additional, Sando, David, additional, Mwanyika-Sando, Mary, additional, Barnhart, Dale A, additional, Hong, Biling, additional, Mungure, Ester, additional, Li, Nan, additional, Siril, Hellen, additional, Mujinja, Phares, additional, Naburi, Helga, additional, Kilewo, Charles, additional, Ekström, Anna Mia, additional, Geldsetzer, Pascal, additional, Fawzi, Wafaie, additional, Bärnighausen, Till, additional, Sudfeld, Christopher R, additional, and Spiegelman, Donna, additional

Published
2022
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4. The impact of a community health worker intervention on uptake of antenatal care: a cluster-randomized pragmatic trial in Dar es Salaam.

Author

Regan, Mathilda, Cheng, Chao, Mboggo, Eric, Larson, Elysia, Lema, Irene Andrew, Magesa, Lucy, Machumi, Lameck, Ulenga, Nzovu, Sando, David, Mwanyika-Sando, Mary, Barnhart, Dale A, Hong, Biling, Mungure, Ester, Li, Nan, Siril, Hellen, Mujinja, Phares, Naburi, Helga, Kilewo, Charles, Ekström, Anna Mia, and Geldsetzer, Pascal

Subjects
COMMUNITY health workers, PRENATAL care, GENERALIZED estimating equations, PUBLIC sector, MATERNAL mortality
Abstract

The provision of high-quality antenatal care (ANC) is important for preventing maternal and newborn mortality and morbidity, but only around half of pregnant women in Tanzania attended four or more ANC visits in 2019. Although there is emerging evidence on the benefit of community health worker (CHW) interventions on ANC uptake, few large-scale pragmatic trials have been conducted. This pragmatic cluster-randomized trial, implemented directly through the public sector health system, assessed the impact of an intervention that trained public sector CHWs to promote uptake of ANC. We randomized 60 administrative wards in Dar es Salaam to either a targeted CHW intervention or standard of care. The impact of the intervention was assessed using generalized estimating equations (GEE) with an independent working correlation matrix to account for clustering within wards. A total of 243,908 women were included in the analysis of our primary outcome of four or more ANC visits. The intervention significantly increased the likelihood of attending four or more ANC visits (RR 1.42; 95% CI: 1.05, 1.92), and had a modest beneficial effect on the total number of ANC visits (percent change: 7.7%; 95% CI: 0.2%, 15.5%). While slightly more women in the intervention arm attended ANC in their first trimester compared to the standard-of-care arm (19% vs 18.7%) the difference was not significant (RR:1.02; 95% CI: 0.84, 1.22). Our findings suggest that trained CHWs can increase attendance of ANC visits in Dar es Salaam and similar settings. However, additional interventions appear necessary to promote early initiation of ANC. This study demonstrates that routine health systems data can be leveraged for outcome assessment in trials and program evaluation, and that the results are likely superior, both in terms of bias and precision, to data that is collected specifically for science. [ABSTRACT FROM AUTHOR]

Published
2023
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8. The University of Michigan Dioxin Exposure Study: Predictors of Human Serum Dioxin Concentrations in Midland and Saginaw, Michigan

Author

Garabrant, David H., Franzblau, Alfred, Lepkowski, James, Gillespie, Brenda W., Adriaens, Peter, Demond, Avery, Hedgeman, Elizabeth, Knutson, Kristine, Zwica, Lynn, Olson, Kristen, Towey, Timothy, Chen, Qixuan, Hong, Biling, Chang, Chiung-Wen, Lee, Shih-Yuan, Ward, Barbara, LaDronka, Kathy, Luksemburg, William, and Maier, Martha

Published
2009
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10. Case Report: Human Exposure to Dioxins from Clay

Author

Franzblau, Alfred, Hedgeman, Elizabeth, Chen, Qixuan, Lee, Shih-Yuan, Adriaens, Peter, Demond, Avery, Garabrant, David, Gillespie, Brenda, Hong, Biling, Jolliet, Olivier, Lepkowski, James, Luksemburg, William, Maier, Martha, and Wenger, Yvan

Published
2008
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11. Efficacy of vitamin D

Author

Sudfeld, Christopher R., Mugusi, Ferdinand, Muhihi, Alfa, Aboud, Said, Nagu, Tumaini J., Ulenga, Nzovu, Hong, Biling, Wang, Molin, and Fawzi, Wafaie W.

Subjects
Adult, Male, Incidence, HIV Infections, Kaplan-Meier Estimate, Tanzania, Article, Intention to Treat Analysis, Placebos, Treatment Outcome, Double-Blind Method, Dietary Supplements, Tuberculosis, Humans, Female, Vitamin D, Tuberculosis, Pulmonary, Cholecalciferol
Abstract

BACKGROUND: Observational data suggests that low vitamin D status is associated with an increased incidence of pulmonary tuberculosis (TB) and mortality among people living with HIV. The primary aims of this study were to assess the effect of vitamin D(3) supplementation on the risk of mortality and incidence of pulmonary TB among adults initiating antiretroviral therapy (ART). METHODS: We conducted a randomized, double-blind, placebo-controlled trial of vitamin D(3) supplementation among adults living with HIV who initiated ART with low serum 25-hydroxyvitamin D (25(OH)D) levels at four large HIV care and treatment centers in Dar es Salaam, Tanzania. The vitamin D group received weekly 50,000 IU vitamin D(3) supplements for the first month of ART followed by daily 2,000 IU vitamin D(3) supplements. The placebo arm received a matching weekly and daily placebo regimen. The trial follow-up duration was one year and the primary efficacy outcomes were death and incident pulmonary TB. An intent-to-treat analysis was followed. This study is registered with ClinicalTrials.gov, NCT01798680, and is completed. FINDINGS: Between 24 February 2014 and 7 March 2018, 4,000 adults initiating ART were enrolled in the trial and followed-up for one year. A total of 415 deaths were recorded; 211 in the vitamin D(3) group and 204 in the placebo group. Among all randomized participants, there was no overall effect of vitamin D(3) supplementation on the risk of mortality (hazard ratio (HR): 1·04; 95% CI: 0·85–1·25; P=0·73). There was also no difference in the overall incidence of pulmonary TB between the vitamin D(3) (50 events) and placebo groups (67 events) (HR: 0·78; 95% CI: 0·54–1·13; P=0·19). In terms of adverse events, the vitamin D(3) regimen did not increase the risk of hypercalcemia (3 events vitamin D(3) group, 2 events placebo group, relative risk: 1.25; 95% CI: 0.43–3.66; Fisher’s exact P =1·00). There were 101 hospitalizations reported in the vitamin D(3) group and 94 in the placebo group (incidence rate ratio: 1.06; 95% CI: 0.80–1.41; P=0·66). INTERPRETATION: Additional research is needed before vitamin D(3) supplementation should be considered for implementation in HIV care and treatment programs for the prevention of pulmonary TB or mortality.

Published
2019

13. Particulate matter air pollution exposure, distance to road, and incident lung cancer in the nurses' health study cohort

Author

Puett, Robin C., Hart, Jaime E., Yanosky, Jeff D., Spiegelman, Donna, Wang, Molin, Fisher, Jared A., Hong, Biling, and Laden, Francine

Subjects
Oncology, Experimental -- Analysis -- Health aspects, Nursing -- Research, Transportation, Automotive -- Health aspects, Lung cancer -- Environmental aspects, Cancer -- Research, Air pollution -- Analysis -- Health aspects, Environmental issues, Health
Abstract

BACKGROUND: A body of literature has suggested an elevated risk of lung cancer associated with particulate matter and traffic-related pollutants. OBJECTIVE: We examined the relation of lung cancer incidence with long-term residential exposures to ambient particulate matter and residential distance to roadway, as a proxy for traffic-related exposures. METHODS: For participants in the Nurses' Health Study, a nationwide prospective cohort of women, we estimated 72-month average exposures to [PM.sub.2.5], [PM.sub.2.5]_io, and [PM.sub.10] and residential distance to road. Follow-up for incident cases of lung cancer occurred from 1994 through 2010. Cox proportional hazards models were adjusted for potential confounders. Effect modification by smoking status was examined. RESULTS: During 1,510,027 person-years, 2,155 incident cases of lung cancer were observed among 103,650 participants. In fully adjusted models, a 10-[micro]g/[m.sup.3] increase in 72-month average [PM.sub.10] [hazard ratio (HR) = 1.04; 95% CI: 0.95, 1.14], [PM.sub.2.5] (HR = 1.06; 95% CI: 0.91, 1.25), or [PM.sub.2.5-10] (HR = 1.05; 95% CI: 0.92, 1.20) was positively associated with lung cancer. When the cohort was restricted to never-smokers and to former smokers who had quit at least 10 years before, the associations appeared to increase and were strongest for [PM.sub.2.5] ([PM.sub.10]: HR = 1.15; 95% CI: 1.00, 1.32; [PM.sub.2.5]: HR = 1.37; 95% CI: 1.06, 1.77; [PM.sub.2.5-10]: HR = 1.11; 95% CI: 0.90, 1.37). Results were most elevated when restricted to the most prevalent subtype, adenocarcinomas. Risks with roadway proximity were less consistent. CONCLUSIONS: Our findings support those from other studies indicating increased risk of incident lung cancer associated with ambient PM exposures, especially among never- and long-term former smokers. http://dx.doi.org/10.1289/ehp.1307490, Introduction A number of general population studies around the world have demonstrated adverse associations of chronic exposures to ambient particulate matter (PM) and/or traffic-related pollutants with lung cancer (Beelen et [...]

Published
2014
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15. The association of long-term exposure to PM2.5 on all-cause mortality in the Nurses’ Health Study and the impact of measurement-error correction

Author

Hart, Jaime E, Hart, Jaime E, Liao, Xiaomei, Hong, Biling, Puett, Robin C, Yanosky, Jeff D, Suh, Helen, Kioumourtzoglou, Marianthi-Anna, Spiegelman, Donna, Laden, Francine, Hart, Jaime E, Hart, Jaime E, Liao, Xiaomei, Hong, Biling, Puett, Robin C, Yanosky, Jeff D, Suh, Helen, Kioumourtzoglou, Marianthi-Anna, Spiegelman, Donna, and Laden, Francine

Abstract

Long-term exposure to particulate matter less than 2.5 μm in diameter (PM2.5) has been consistently associated with risk of all-cause mortality. The methods used to assess exposure, such as area averages, nearest monitor values, land use regressions, and spatio-temporal models in these studies are subject to measurement error. However, to date, no study has attempted to incorporate adjustment for measurement error into a long-term study of the effects of air pollution on mortality. We followed 108,767 members of the Nurses’ Health Study (NHS) 2000–2006 and identified all deaths. Biennial mailed questionnaires provided a detailed residential address history and updated information on potential confounders. Time-varying average PM2.5 in the previous 12-months was assigned based on residential address and was predicted from either spatio-temporal prediction models or as concentrations measured at the nearest USEPA monitor. Information on the relationships of personal exposure to PM2.5 of ambient origin with spatio-temporal predicted and nearest monitor PM2.5 was available from five previous validation studies. Time-varying Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 percent confidence intervals (95%CI) for each 10 μg/m3 increase in PM2.5. Risk-set regression calibration was used to adjust estimates for measurement error. Increasing exposure to PM2.5 was associated with an increased risk of mortality, and results were similar regardless of the method chosen for exposure assessment. Specifically, the multivariable adjusted HRs for each 10 μg/m3 increase in 12-month average PM2.5 from spatio-temporal prediction models were 1.13 (95%CI:1.05, 1.22) and 1.12 (95%CI:1.05, 1.21) for concentrations at the nearest EPA monitoring location. Adjustment for measurement error increased the magnitude of the HRs 4-10% and led to wider CIs (HR = 1.18; 95%CI: 1.02, 1.36 for each 10 μg/m3 increase in PM2.5 from the spatio-temporal models and HR = 1.22

Published
2015

20. Effect of Brown Rice, White Rice, and Brown Rice with Legumes on Blood Glucose and Insulin Responses in Overweight Asian Indians: A Randomized Controlled Trial

Author

Mohan, Viswanathan, primary, Spiegelman, Donna, additional, Sudha, Vasudevan, additional, Gayathri, Rajagopal, additional, Hong, Biling, additional, Praseena, Kallingal, additional, Anjana, Ranjit Mohan, additional, Wedick, Nicole M., additional, Arumugam, Kokila, additional, Malik, Vasanti, additional, Ramachandran, Sabitha, additional, Bai, Mookambika Ramya, additional, Henry, Jeya Kumar, additional, Hu, Frank B., additional, Willett, Walter, additional, and Krishnaswamy, Kamala, additional

Published
2014
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22. Relationship between polychlorinated dibenzo- p -dioxin, polychlorinated dibenzofuran, and dioxin-like polychlorinated biphenyl concentrations in vegetation and soil on residential properties

Author

Department of Civil and Environmental Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan 48109, USA ; Department of Civil and Environmental Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan 48109, USA., Department of Civil and Environmental Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan 48109, USA, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA, Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA, LimnoTech, Ann Arbor, Michigan, USA, Vista Analytical Laboratory, El Dorado Hills, California, USA, Demond, Avery, Towey, Timothy, Adriaens, Peter, Zhong, Xiaobo, Knutson, Kristine, Chen, Qixuan, Hong, Biling, Gillespie, Brenda, Franzblau, Alfred, Garabrant, David, Lepkowski, James, Luksemburg, William, Maier, Martha, Department of Civil and Environmental Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan 48109, USA ; Department of Civil and Environmental Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan 48109, USA., Department of Civil and Environmental Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan 48109, USA, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA, Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA, LimnoTech, Ann Arbor, Michigan, USA, Vista Analytical Laboratory, El Dorado Hills, California, USA, Demond, Avery, Towey, Timothy, Adriaens, Peter, Zhong, Xiaobo, Knutson, Kristine, Chen, Qixuan, Hong, Biling, Gillespie, Brenda, Franzblau, Alfred, Garabrant, David, Lepkowski, James, Luksemburg, William, and Maier, Martha

Abstract

The University of Michigan Dioxin Exposure Study was undertaken to address concerns that the industrial discharge of dioxin-like compounds in the Midland, Michigan, USA area had resulted in the contamination of soil and vegetation in the Tittabawassee River floodplain and downwind of the incinerator in the City of Midland. The study included the analysis of 597 vegetation samples, predominantly grass and weeds, from residential properties selected through a multistage probabilistic sample design in the Midland area, and in Jackson and Calhoun Counties (Michigan), as a background comparison, for 29 polychlorinated dibenzo- p -dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and polychlorinated biphenyls (PCBs). The mean toxic equivalent (TEQ) of the house perimeter vegetation samples ranged from 4.2 to 377???pg/g. The ratio of TEQs (vegetation to soil) was about 0.3, with a maximum of 3.5. Based on a calculation of the similarity of the congener patterns between the soil and the vegetation, it appeared that the source of the contamination on the vegetation was the surrounding soil. This conclusion was supported by linear regression analysis, which showed that the largest contributor to the R 2 for the outcome variable of log 10 of the vegetation concentration was log 10 of the surrounding soil concentration. Models of vegetation contamination usually focus on atmospheric deposition and partitioning. The results obtained here suggest that the deposition of soil particles onto vegetation is a significant route of contamination for residential herbage. Thus, the inclusion of deposition of soil particles onto vegetation is critical to the accurate modeling of contamination residential herbage in communities impacted by historic industrial discharges of persistent organic compounds. Environ. Toxicol. Chem. 2010;29:2660???2668. ?? 2010 SETAC

Published
2010

23. Estimation of age- and sex-specific background human serum concentrations of PCDDs, PCDFs, and PCBs in the UMDES and NHANES populations

Author

Chen, Qixuan, primary, Jiang, Xiaohui, additional, Hedgeman, Elizabeth, additional, Knutson, Kristine, additional, Gillespie, Brenda, additional, Hong, Biling, additional, Lepkowski, James M., additional, Franzblau, Alfred, additional, Jolliet, Olivier, additional, Adriaens, Peter, additional, Demond, Avery H., additional, and Garabrant, David H., additional

Published
2013
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24. Consumer Acceptance and Preference Study (CAPS) on Brown and Undermilled Indian Rice Varieties in Chennai, India

Author

Sudha, Vasudevan, primary, Spiegelman, Donna, additional, Hong, Biling, additional, Malik, Vasanti, additional, Jones, Clara, additional, Wedick, Nicole M., additional, Hu, Frank B., additional, Willett, Walter, additional, Bai, Mookambika Ramya, additional, Ponnalagu, Muthu Mariyammal, additional, Arumugam, Kokila, additional, and Mohan, Viswanathan, additional

Published
2013
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27. Substituting White Rice with Brown Rice for 16 Weeks Does Not Substantially Affect Metabolic Risk Factors in Middle-Aged Chinese Men and Women with Diabetes or a High Risk for Diabetes

Author

Zhang, Geng, primary, Pan, An, additional, Zong, Geng, additional, Yu, Zhijie, additional, Wu, Hongyu, additional, Chen, Xiafei, additional, Tang, Lixin, additional, Feng, Ying, additional, Zhou, Hong, additional, Chen, Xiaolei, additional, Li, Huaixing, additional, Hong, Biling, additional, Malik, Vasanti S., additional, Willett, Walter C., additional, Spiegelman, Donna, additional, Hu, Frank B., additional, and Lin, Xu, additional

Published
2011
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28. Relationship between polychlorinated dibenzo-p-dioxin, polychlorinated dibenzofuran, and dioxin-like polychlorinated biphenyl concentrations in vegetation and soil on residential properties

Author

Demond, Avery, primary, Towey, Timothy, additional, Adriaens, Peter, additional, Zhong, Xiaobo, additional, Knutson, Kristine, additional, Chen, Qixuan, additional, Hong, Biling, additional, Gillespie, Brenda, additional, Franzblau, Alfred, additional, Garabrant, David, additional, Lepkowski, James, additional, Luksemburg, William, additional, and Maier, Martha, additional

Published
2010
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29. Impact of WHO 2005 revised toxic equivalency factors for dioxins on the TEQs in serum, household dust and soil

Author

Hong, Biling, primary, Garabrant, David, additional, Hedgeman, Elizabeth, additional, Demond, Avery, additional, Gillespie, Brenda, additional, Chen, Qixuan, additional, Chang, Chiung-Wen, additional, Towey, Timothy, additional, Knutson, Kristine, additional, Franzblau, Alfred, additional, Lepkowski, James, additional, and Adriaens, Peter, additional

Published
2009
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30. An Investigation of Homes with High Concentrations of PCDDs, PCDFs, and/or Dioxin-Like PCBs in House Dust

Author

Franzblau, Alfred, primary, Zwica, Lynn, additional, Knutson, Kristine, additional, Chen, Qixuan, additional, Lee, Shih-Yuan, additional, Hong, Biling, additional, Adriaems, Peter, additional, Demond, Avery, additional, Garabrant, David, additional, Gillespie, Brenda, additional, Lepkowski, James, additional, Luksemburg, William, additional, Maier, Martha, additional, and Towey, Tim, additional

Published
2009
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31. Residences with anomalous soil concentrations of dioxin-like compounds in two communities in Michigan, USA: A case study

Author

Franzblau, Alfred, primary, Demond, Avery, additional, Towey, Timothy, additional, Adriaens, Peter, additional, Chang, Shu-Chi, additional, Luksemburg, William, additional, Maier, Martha, additional, Garabrant, David, additional, Gillespie, Brenda, additional, Lepkowski, James, additional, Chang, Chiung-Wen, additional, Chen, Qixuan, additional, and Hong, Biling, additional

Published
2009
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32. Geostatistical Modeling of the Spatial Distribution of Soil Dioxin in the Vicinity of an Incinerator. 2. Verification and Calibration Study

Author

Goovaerts, Pierre, primary, Trinh, Hoa T., additional, Demond, Avery H., additional, Towey, Timothy, additional, Chang, Shu-Chi, additional, Gwinn, Danielle, additional, Hong, Biling, additional, Franzblau, Alfred, additional, Garabrant, David, additional, Gillespie, Brenda W., additional, Lepkowski, James, additional, and Adriaens, Peter, additional

Published
2008
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33. The association of long-term exposure to PM2.5 on all-cause mortality in the Nurses' Health Study and the impact of measurement-error correction.

Author

Hart, Jaime E., Xiaomei Liao, Hong, Biling, Puett, Robin C., Yanosky, Jeff D., Suh, Helen, Kioumourtzoglou, Marianthi-Anna, Spiegelman, Donna, and Laden, Francine

Subjects
MORTALITY risk factors, AIR pollution measurement, PHYSIOLOGICAL effects of air pollution, PHYSIOLOGICAL effects of chemicals, CHEMOGENOMICS
Abstract

Background: Long-term exposure to particulate matter less than 2.5 μm in diameter (PM2.5) has been consistently associated with risk of all-cause mortality. The methods used to assess exposure, such as area averages, nearest monitor values, land use regressions, and spatio-temporal models in these studies are subject to measurement error. However, to date, no study has attempted to incorporate adjustment for measurement error into a long-term study of the effects of air pollution on mortality. Methods: We followed 108,767 members of the Nurses' Health Study (NHS) 2000-2006 and identified all deaths. Biennial mailed questionnaires provided a detailed residential address history and updated information on potential confounders. Time-varying average PM2.5 in the previous 12-months was assigned based on residential address and was predicted from either spatio-temporal prediction models or as concentrations measured at the nearest USEPA monitor. Information on the relationships of personal exposure to PM2.5 of ambient origin with spatio-temporal predicted and nearest monitor PM2.5 was available from five previous validation studies. Time-varying Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 percent confidence intervals (95%CI) for each 10 μg/m3 increase in PM2.5. Risk-set regression calibration was used to adjust estimates for measurement error. Results: Increasing exposure to PM2.5 was associated with an increased risk of mortality, and results were similar regardless of the method chosen for exposure assessment. Specifically, the multivariable adjusted HRs for each 10 μg/m3 increase in 12-month average PM2.5 from spatio-temporal prediction models were 1.13 (95%CI:1.05, 1.22) and 1.12 (95%CI:1.05, 1.21) for concentrations at the nearest EPA monitoring location. Adjustment for measurement error increased the magnitude of the HRs 4-10% and led to wider CIs (HR = 1.18; 95%CI: 1.02, 1.36 for each 10 μg/m3 increase in PM2.5 from the spatio-temporal models and HR = 1.22; 95%CI: 1.02, 1.45 from the nearest monitor estimates). Conclusions: These findings support the large body of literature on the adverse effects of PM2.5, and suggest that adjustment for measurement error be considered in future studies where possible. [ABSTRACT FROM AUTHOR]

Published
2015
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