Global Health

The analysis of population health in a global context in order to understand and reduce disparities and protect against global threats such as infectious diseases

Health Screening for Emerging and Non-Communicable Disease Burdens Among the Global Poor

Research Brief
Jan. 26, 2021

Among adults in rural Malawi, population health screening for high blood pressure (BP) led to a 22-percentage point drop in the likelihood of being hypertensive four years later. Individuals with elevated BP received a referral letter upon initial screening; at follow-up, they had lower BP and higher self-reported mental health than individuals with similar BP who were just below the threshold for referral. Population health screenings can reduce the burden of non-communicable diseases in low-income countries.

Financial Incentives and Real-Time Adherence Monitoring To Promote Daily Adherence to HIV Treatment and Viral Suppression Among People Living With HIV: A Pilot Study

Harsha Thirumurthy
Jan. 15, 2021

Cedric H. Bien-Gund, Joshua I. Ho, Elizabeth F. Bair, Noora Marcus, Rebekah Ji Choi, Zsofia Szep, Amy Althoff, Florence M. MomplaisirHarsha Thirumurthy

Abstract [from journal]

Background: Interventions to promote medication adherence and viral suppression are needed among HIV-positive individuals. We aimed to determine the feasibility, acceptability, and preliminary impact of daily financial incentives linked to real-time adherence monitoring among treatment-experienced individuals.

Methods: At an HIV clinic in Philadelphia, we conducted a pilot randomized trial among treatment-experienced HIV-positive adults with unsuppressed viral loads (>400 copies/ml).

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The Data Used to Build the Models: Pertussis Morbidity and Mortality Burden Considering Various Brazilian Data Sources

Jan. 3, 2021

Angela M. Bagattini, Gabriela Policena, Ruth Minamisava, Ana Lucia S. Andrade, Sérgio de A. Nishioka, Anushua Sinha, Louise B. Russell, Cristiana M. Toscano 

Abstract [from journal]

Background: Pertussis is associated with significant disease burden in children worldwide. In addition to its cyclical nature, resurgences of pertussis cases, hospitalizations and deaths have been reported by many countries. We describe the dynamics of pertussis in Brazil, a middle-income country that has experienced a resurgence and that provides good quality data to allow building a dynamic transmission disease model.

Methods: We conducted a descriptive analysis

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Cost-Effectiveness of Maternal Pertussis Immunization: Implications of a Dynamic Transmission Model for Low- and Middle-Income Countries

Jan. 3, 2021

Sun-Young Kim, Kyung-Duk Min, Sung-mok Jung, Louise B. Russell, Cristiana Toscano, Ruth Minamisava, Ana Lucia S. Andrade, Colin Sanderson, Anushua Sinha

Abstract [from journal]

Objective: This study evaluates the cost-effectiveness of maternal acellular pertussis (aP) immunization in low- and middle-income countries using a dynamic transmission model.

Methods: We developed a dynamic transmission model to simulate the impact of infant vaccination with whole-cell pertussis (wP) vaccine with and without maternal aP immunization. The model was calibrated to Brazilian surveillance data and then used to project health outcomes and costs under

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Modeling the Cost-Effectiveness of Maternal Acellular Pertussis Immunization (aP) in Different Socioeconomic Settings: A Dynamic Transmission Model of Pertussis in Three Brazilian States

Jan. 3, 2021

Paula M. Luz, Claudio J. Struchiner, Sun-Young Kim, Ruth Minamisava, Ana Luci S. Andrade, Colin Sanderson, Louise B. Russell, Cristiana M. Toscano

Abstract [from journal]

Objectives: Using dynamic transmission models we evaluated the health and cost outcomes of adding acellular pertussis (aP) vaccination of pregnant women to infant vaccination in three Brazilian states that represent different socioeconomic conditions. The primary objective was to determine whether the same model structure could be used to represent pertussis disease dynamics in differing socioeconomic conditions.

Methods: We tested three model structures (SIR, SIRS

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Comparison of Static and Dynamic Models of Maternal Immunization to Prevent Infant Pertussis in Brazil

Jan. 3, 2021

Louise B. Russell, Sun-Young Kim, Cristiana Toscano, Ben Cosgriff, Ruth Minamisava, Ana Lucia Andrade, Colin Sanderson, Anushua Sinha

Abstract [from journal] 

Background: This paper compares cost-effectiveness results from two models of maternal immunization to prevent pertussis in infants in Brazil, one static, one dynamic, to explore when static models are adequate for public health decisions and when the extra effort required by dynamic models is worthwhile.

Methods: We defined two scenarios to explore key differences between static and dynamic models, herd immunity and time horizon. Scenario 1 evaluates the

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Behavioral Insights Into Micronutrient Powder Use for Childhood Anemia in Arequipa, Peru

Dec. 23, 2020

Jessica D. Brewer, Julianna Shinnick, Karina Román, Maria P. Santos, Valerie A. Paz-Soldan, Alison M. Buttenheim

Abstract [from journal]

Childhood anemia remains a significant driver of morbidity in low- and middle-income countries, including Peru. To identify behavioral challenges to using micronutrient powder (MNP) that is given to supplement children's diets and prevent anemia, we applied a behavioral design approach to interviews and focus groups with 129 caregivers in Arequipa, Peru. We examined 3 key points in the decision-making process: accessing MNP through the health system; forming intentions to use MNP; and MNP use at the time of child feeding. Using the

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Prescription Requirements and Patient Autonomy: Considering an Over-the-Counter Default

Holly Fernandez Lynch 160
Dec. 14, 2020

Madison KilbrideSteven JoffeHolly Fernandez Lynch

Abstract [from journal]

When new drugs are approved by the Food and Drug Administration, the default assumption is that they will be available by prescription only, safe for use exclusively under clinical supervision. The paternalism underlying this default must be interrogated in order to ensure appropriate respect for patient autonomy. Upon closer inspection, prescription requirements are justified when nonprescription status would risk harm to third parties and when a large segment of the population would struggle to exercise their autonomy in using a

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Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer

Dec. 1, 2020

Leilei Xia, Ruchika Talwar, Raju R. Chelluri, Thomas J. Guzzo, Daniel J. Lee

Abstract [from journal]

Importance: There is a lack of data evaluating the association of surgical delay time (SDT) with outcomes in patients with localized, high-risk prostate cancer.

Objective: To investigate the association of SDT of radical prostatectomy and final pathological and survival outcomes.

Design, setting, and participants: This cohort study used data from the US National Cancer Database (NCDB) and identified all patients with clinically localized (cT1-2cN0cM0) high-risk prostate

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What Can COVID-19 Teach Us About Using AI in Pandemics?

Dec. 1, 2020

Krzysztof LaudanskiGregory Shea, Matthew DiMeglio, Mariana Rastrepo, Cassie Solomon

Abstract [from journal]

The COVID-19 pandemic put significant strain on societies and their resources, with the healthcare system and workers being particularly affected. Artificial Intelligence (AI) offers the unique possibility of improving the response to a pandemic as it emerges and evolves. Here, we utilize the WHO framework of a pandemic evolution to analyze the various AI applications. Specifically, we analyzed AI from the perspective of all five domains of the WHO pandemic response. To effectively review the current scattered literature, we

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Health Screening for Emerging Non-Communicable Disease Burdens Among the Global Poor: Evidence From Sub-Saharan Africa

Nov. 9, 2020

Alberto Ciancio, Fabrice Kämpfen, Hans-Peter KohlerIliana V. Kohler

Abstract [from journal]

Evidence for the effectiveness of population health screenings to reduce the burden of non-communicable diseases in low-income countries remains very limited. We investigate the sustained effects of a health screening in Malawi where individuals received a referral letter if they had elevated blood pressure. Using a regression discontinuity design and a matching estimator, we find that receiving a referral letter reduced blood pressure and the probability of being hypertensive by about 22 percentage points four years later. These

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Planning Prompts To Promote Uptake of HIV Services Among Men: A Randomised Trial in Rural Uganda

Nov. 5, 2020

Nolan M. Kavanagh, Elisabeth M. Schaffer, Alex Ndyabakira, Kara Marson, Diane V. Havlir, Moses R. Kamya, Dalsone Kwarisiima, Gabriel Chamie, Harsha Thirumurthy

Abstract [from journal]

Introduction: Interventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men.

Methods: We randomised adult men in rural Ugandan parishes to receive a calendar planning prompt that gave them the opportunity to

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Surface Mining And Low Birth Weight In Central Appalachia

Dylan S. Small, PhD
Oct. 21, 2020

Dylan S. Small, Daniel W. Firth, Luke J. Keele, Matthew Huber, Molly Passarella, Scott A. Lorch, Heather H. Burris

Abstract [from journal]

Background: Surface mining has become a significant method of coal mining in the Central Appalachian region of the eastern United States alongside the traditional underground mining. Concerns have been raised about the health effects of this surface mining, particularly mountaintop removal mining where coal is mined upon steep mountaintops by removing the mountaintop through clearcutting forests and explosives.

Methods: We used a control group design with a pretest and a posttest to assess the

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