PLoS Articles
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UNC-authored articles published by the Public Library of Science (PLoS)
Works (2127)
181. Validating indicators for monitoring availability and geographic distribution of emergency obstetric and newborn care (EmoNC) facilities: A study triangulating health system, facility, and geospatial data
- Title Tesim:
- Validating indicators for monitoring availability and geographic distribution of emergency obstetric and newborn care (EmoNC) facilities: A study triangulating health system, facility, and geospatial data
- Creator:
- Dotse-Gborgbortsi W., Nigri C., Langer A., Odikro M.A., Berrueta M., Bandoh D.A.B., Vázquez P., Pingray V., Adanu R., Williams C.R., Ramesh S., Blossom J., Jolivet R.R., Saggurti N., Khan N., Gausman J., Kenu E., and Chakraborty S.
- Date of publication:
- 2023
- Abstract Tesim:
- Availability of emergency obstetric and newborn care (EmONC) is a strong supply side measure of essential health system capacity that is closely and causally linked to maternal mortality reduction and fundamentally to achieving universal health coverage. The World Health Organization’s indicator “Availability of EmONC facilities” was prioritized as a core indicator to prevent maternal death. The indicator focuses on whether there are sufficient emergency care facilities to meet the population need, but not all facilities designated as providing EmONC function as such. This study seeks to validate “Availability of EmONC” by comparing the value of the indicator after accounting for key aspects of facility functionality and an alternative measure of geographic distribution. This study takes place in four subnational geographic areas in Argentina, Ghana, and India using a census of all birthing facilities. Performance of EmONC in the 90 days prior to data collection was assessed by examining facility records. Data were collected on facility operating hours, staffing, and availability of essential medications. Population estimates were generated using ArcGIS software using WorldPop to estimate the total population, and the number of women of reproductive age (WRA), pregnancies and births in the study areas. In addition, we estimated the population within two-hours travel time of an EmONC facility by incorporating data on terrain from Open Street Map. Using these data sources, we calculated and compared the value of the indicator after incorporating data on facility performance and functionality while varying the reference population used. Further, we compared its value to the proportion of the population within two-hours travel time of an EmONC facility. Included in our study were 34 birthing facilities in Argentina, 51 in Ghana, and 282 in India. Facility performance of basic EmONC (BEmONC) and comprehensive EmONC (CEmONC) signal functions varied considerably. One facility (4.8%) in Ghana and no facility in India designated as BEmONC had performed all seven BEmONC signal functions. In Argentina, three (8.8%) CEmONC-designated facilities performed all nine CEmONC signal functions, all located in Buenos Aires Region V. Four CEmONC-designated facilities in Ghana (57.1%) and the three CEmONC-designated facilities in India (23.1%) evidenced full CEmONC performance. No sub-national study area in Argentina or India reached the target of 5 BEmONC-level facilities per 20,000 births after incorporating facility functionality yet 100% did in Argentina and 50% did in India when considering only facility designation. Demographic differences also accounted for important variation in the indicator’s value. In Ghana, the total population in Tolon within 2 hours travel time of a designated EmONC facility was estimated at 99.6%; however, only 91.1% of women of reproductive age were within 2 hours travel time. Comparing the value of the indicator when calculated using different definitions reveals important inconsistencies, resulting in conflicting information about whether the threshold for sufficient coverage is met. This raises important questions related to the indicator’s validity. To provide a valid measure of effective coverage of EmONC, the construct for measurement should extend beyond the most narrow definition of availability and account for functionality and geographic accessibility.
- Resource type:
- Article
- DOI:
- https://doi.org/10.17615/8mjw-nz30
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0287904
- ISSN:
- 1932-6203
- Journal Issue:
- 9
- Journal Title:
- PLoS ONE
- Journal Volume:
- 18
- Keyword:
- human experiment, newborn, validity, article, demography, Argentina, travel, software, Comprehensive Health Care, Female, Pregnancy, adult, human, Censuses, Ghana, Humans, emergency health service, data source, health care, geographic distribution, Infant, Newborn, female, Emergency Treatment, Emergency Medical Services, India, pregnancy, emergency treatment, newborn care, and population research
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- University of Southampton, Instituto de Efectividad Clínica y Sanitaria, Harvard University T.H. Chan, School of Public Health, University of Ghana School of Public Health, Universidad Nacional de La Matanza, , Population Council, New Delhi, and Harvard University, T.H. Chan School of Public Health
- Person:
- Dotse-Gborgbortsi W., Nigri C., Langer A., Odikro M.A., Berrueta M., Bandoh D.A.B., Vázquez P., Pingray V., Adanu R., Williams C.R., Ramesh S., Blossom J., Jolivet R.R., Saggurti N., Khan N., Gausman J., Kenu E., and Chakraborty S.
- Publisher:
- Public Library of Science
- Source:
- 90452897-ae78-4030-bbe1-6a5455f26f9e
182. Rush hour-and-a-half: Traffic is spreading out post-lockdown
- Title Tesim:
- Rush hour-and-a-half: Traffic is spreading out post-lockdown
- Creator:
- Zhang S. and Bhagat-Conway M.W.
- Date of publication:
- 2023
- Abstract Tesim:
- Traffic congestion is ubiquitous in major cities around the world. Congestion is associated with a slew of negative effects, including delays and local air pollution. Because of the negative effects of congestion, governments invest billions of dollars into the highway system to try to reduce congestion and accommodate peak-hour automobile travel demand. The COVID-19 pandemic presented a significant disruption to transportation systems globally. One impact was a drastic reduction in travel, leading to free-flowing traffic conditions in many previously-congested cities. As lockdowns eased, traffic volumes returned to near-normal levels. However, the temporal pattern of demand may differ, due to increased remote work or other factors. In this article, we examine the temporal distribution of highway demand in California, using data from over 3,500 traffic sensors. We find that peak-hour automobile travel is spreading in the post-lockdown period. In addition to decreased traffic congestion, this finding also has implications for infrastructure investment. Roadways are generally sized based on peak-hour demand. As the peaks spread, some highway construction project may prove unnecessary. It may be possible to reallocate road space to other uses with fewer tradeoffs in terms of traffic congestion.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of City and Regional Planning
- DOI:
- https://doi.org/10.17615/reqv-fs96
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0290534
- ISSN:
- 1932-6203
- Journal Issue:
- 9-Sep
- Journal Title:
- PLoS ONE
- Journal Volume:
- 18
- Keyword:
- travel, telecommuting, entropy, highway, Air Pollution, pandemic, air pollution, communicable disease control, car, human, COVID-19, Communicable Disease Control, Pandemics, systematic review, lockdown, city, coronavirus disease 2019, Automobiles, Article, Humans, traffic, and investment
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- University of Colorado and
- Person:
- Zhang S. and Bhagat-Conway M.W.
- Publisher:
- Public Library of Science
- Source:
- 5366270b-95b2-447e-8601-1feca856b862
183. Pay-it-forward influenza vaccination among older adults and children: A cost-effectiveness analysis in China
- Title Tesim:
- Pay-it-forward influenza vaccination among older adults and children: A cost-effectiveness analysis in China
- Creator:
- Ong, Jason J., Kosana, Priya, Wu, Dan, Tucker, Joseph D., Terris-Prestholt, Fern, Jit, Mark, and Tang, Fanny Fong-Yi
- Date of publication:
- 2023
- Abstract Tesim:
- A quasi-experimental study was conducted to evaluate the effectiveness of a pay-it-forward strategy for increasing influenza vaccination among children and older adults compared to a self-paid vaccination strategy in China. Pay-it-forward is an innovative community-engaged intervention in which participants receive a free influenza vaccination and are then asked if they would like to donate or create a message to support subsequent vaccinations. This economic evaluation used a decision-tree model to compare pay-it-forward to a standard of care arm in which patients had to pay for their own influenza vaccine. The analysis was performed from the healthcare provider perspective and costs were calculated with 2020 United States dollars. The time horizon was one year. In the base case analysis, pay-it-forward was more effective (111 vs 55 people vaccinated) but more costly than standard-of-care ($4477 vs $2725). Pay-it-forward spurred 96.4% (107/111) of individuals to voluntarily donate to support influenza vaccination for high-risk groups in China. Further costing and implementation research is needed to inform scale up.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Medicine
- DOI:
- https://doi.org/10.17615/48s8-0c93
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pgph.0001590
- ISSN:
- 2767-3375
- Journal Issue:
- 8
- Journal Title:
- PLOS Global Public Health
- Journal Volume:
- 3
- Keyword:
- Social welfare, Vaccination and immunization, Finance, Vaccines, Influenza, Research design, Vaccine development, and Communications
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- London School of Hygiene and Tropical Medicine, Yale University, , UNAIDS, and University of Hong Kong
- Page Start:
- e0001590
- Person:
- Ong, Jason J., Kosana, Priya, Wu, Dan, Tucker, Joseph D., Terris-Prestholt, Fern, Jit, Mark, and Tang, Fanny Fong-Yi
- Publisher:
- Public Library of Science
- Source:
- 880607d7-8d42-4a87-812a-b66c852f4f90
184. Impact of taxes and warning labels on red meat purchases among US consumers: A randomized controlled trial
- Title Tesim:
- Impact of taxes and warning labels on red meat purchases among US consumers: A randomized controlled trial
- Creator:
- Prestemon C.E., Hall M.G., Taillie L.S., Jaacks L.M., Bercholz M., Higgins I.C.A., and Grummon A.H.
- Date of publication:
- 2023
- Abstract Tesim:
- Background AU Policies: Pleaseconfirmthatallheadinglevelsarerepresentedcorrectly to reduce red meat intake are important for mitigating : climate change and improving public health. We tested the impact of taxes and warning labels on red meat purchases in the United States. The main study question was, will taxes and warning labels reduce red meat purchases? Methods and findings We recruited 3,518 US adults to participate in a shopping task in a naturalistic online grocery store from October 18, 2021 to October 28, 2021. Participants were randomized to one of 4 conditions: control (no tax or warning labels, n = 887), warning labels (health and environmental warning labels appeared next to products containing red meat, n = 891), tax (products containing red meat were subject to a 30% price increase, n = 874), or combined warning labels + tax (n = 866). We used fractional probit and Poisson regression models to assess the co-primary outcomes, percent, and count of red meat purchases, and linear regression to assess the secondary outcomes of nutrients purchased. Most participants identified as women, consumed red meat 2 or more times per week, and reported doing all of their household's grocery shopping. The warning, tax, and combined conditions led to lower percent of red meat-containing items purchased, with 39% (95% confidence interval (CI) [38%, 40%]) of control participants' purchases containing red meat, compared to 36% (95% CI [35%, 37%], p = 0.001) of warning participants, 34% (95% CI [33%, 35%], p < 0.001) of tax participants, and 31% (95% CI [30%, 32%], p < 0.001) of combined participants. A similar pattern was observed for count of red meat items. Compared to the control, the combined condition reduced calories purchased (−312.0 kcals, 95% CI [−590.3 kcals, −33.6 kcals], p = 0.027), while the tax (−10.4 g, 95% CI [−18.2 g, −2.5 g], p = 0.01) and combined (−12.8 g, 95% CI [−20.7 g, −4.9 g], p = 0.001) conditions reduced saturated fat purchases; no condition affected sodium purchases. Warning labels decreased the perceived healthfulness and environmental sustainability of red meat, while taxes increased perceived cost. The main limitations were that the study differed in sociodemographic characteristics from the US population, and only about 30% to 40% of the US population shops for groceries online. Conclusions Warning labels and taxes reduced red meat purchases in a naturalistic online grocery store. Trial Registration: http://www.clinicaltrials.gov/NCT04716010.
- Resource type:
- Article
- Affiliation Label Tesim:
- Carolina Population Center, Department of Health Behavior, and Department of Nutrition
- DOI:
- https://doi.org/10.17615/gmg8-4t07
- Edition:
- Postprint
- Identifier:
- https://dx.doi.org/10.1371/journal.pmed.1004284
- ISSN:
- 1549-1277
- Journal Issue:
- 9
- Journal Title:
- PLoS Medicine
- Journal Volume:
- 20
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- , University of Edinburgh, and Stanford University School of Medicine
- Person:
- Prestemon C.E., Hall M.G., Taillie L.S., Jaacks L.M., Bercholz M., Higgins I.C.A., and Grummon A.H.
- Publisher:
- Public Library of Science
- Source:
- 8030312d-bc48-4678-b530-a48d5e81059b
185. How race, sex and age interact in association with COVID-19 outcomes over time: An analysis of Michigan data
- Title Tesim:
- How race, sex and age interact in association with COVID-19 outcomes over time: An analysis of Michigan data
- Creator:
- Browne A. and Tiako M.J.N.
- Date of publication:
- 2023
- Abstract Tesim:
- Background COVID-19 has had a disproportionate impact on racial and ethnic minorities compared to White people. Studies have not sufficiently examined how sex and age interact with race/ ethnicity, and potentially shape COVID-19 outcomes. We sought to examine disparities in COVID-19 outcomes by race, sex and age over time, leveraging data from Michigan, the only state whose Department of Health and Human Services (DHSS) publishes cross-sectional race, sex and age data on COVID-19. Methods This is an observational study using publicly available COVID-19 data (weekly cases, deaths, and vaccinations) from August 31 2020 to June 9 2021. Outcomes for descriptive analysis were age-standardized COVID-19 incidence and mortality rates, case-fatality rates by race, sex, and age, and within-gender and within-race incidence rate ratios and mortality rate ratios. We used descriptive statistics and linear regressions with age, race, and sex as independent variables. Results The within-sex Black-White racial gap in COVID-19 incidence and mortality decreased at a similar rate among men and women but the remained wider among men. As of June 2021, compared to White people, incidence was lower among Asian American and Pacific Islander people by 2644 cases per 100,000 people and higher among Black people by 1464 cases per 100,000 people. Mortality was higher among those aged 60 or greater by 743.6 deaths per 100,000 people vs those 0-39. The interaction between race and age was significant between Black race and age 60 or greater, with an additional 708.5 deaths per 100,000 people vs White people aged 60 or greater. Black people had a higher case fatality rate than White people. Conclusion COVID-19 incidence, mortality and vaccination patterns varied over time by race, age and sex. Black-White disparities decreased over time, with a larger effect on Black men, and Older Black people were particularly more vulnerable to COVID-19 in terms of mortality. Considering different individual characteristics such as age may further help elucidate the mechanisms behind racial and gender health disparities.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Sociology
- DOI:
- https://doi.org/10.17615/c6hz-cb11
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0288383
- ISSN:
- 1932-6203
- Journal Issue:
- 8
- Journal Title:
- PLoS ONE
- Journal Volume:
- 18
- Keyword:
- female, sex, vaccination coverage, descriptive research, Cross-Sectional Studies, infant, Black person, health disparity, coronavirus disease 2019, Asian, race, Asian American, case fatality rate, clinical outcome, age, retrospective study, child, cumulative incidence, Humans, cross-sectional study, Pacific Islander, human, Black People, incidence, adolescent, mortality rate, adult, vaccination, United States, Male, Michigan, observational study, newborn, Caucasian, COVID-19, Article, male, and Female
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- and Harvard Medical School
- Person:
- Browne A. and Tiako M.J.N.
- Publisher:
- Public Library of Science
- Source:
- acba12a2-253c-462e-b8da-47bd3eb2d94e
186. Household water insecurity experiences and their perceived determinants in a low-income community of Cartagena, Colombia, during a water service expansion project
- Title Tesim:
- Household water insecurity experiences and their perceived determinants in a low-income community of Cartagena, Colombia, during a water service expansion project
- Creator:
- Stoler, Justin, Miller, Joshua D., and Lemaitre, Andrea K.
- Date of publication:
- 2023
- Abstract Tesim:
- Traditional water indicators primarily focus on water quantity and quality, but emergent research demonstrates that measurement of lived experiences with water availability, accessibility, and use is important for understanding how household water insecurity impacts health and well-being. Few empirical studies have explored which household water insecurity experiences are most salient, or their potential causes, in Latin American cities. We analyzed data from 266 households in a low-income settlement of Cartagena, Colombia, to identify correlates and perceived determinants of water insecurity. The most prevalent household water insecurity experiences were water supply interruptions (96%), water worry (94%), and anger about the water situation (90%). Unexpected water interruptions and use of non-piped primary drinking water sources were associated with greater household water insecurity scores, water worry subscores, and hygiene subscores. Respondents perceived water issues in their community to be caused by deficiencies in gray infrastructure (49%), which included deficiencies in water distribution, treatment, or storage technologies. Social infrastructure (36%), including issues with political, economic, or administrative systems, was also cited as a barrier to water security. We did not detect significant relationships between water insecurity scores and the attribution of these problems to gray or social infrastructure, but there may be relationships between these factors and duration of residency and using a non-piped water source. These findings underscore the importance of socio-political factors and community engagement for improving urban water insecurity through slum-upgrade projects.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Nutrition
- DOI:
- https://doi.org/10.17615/ew1d-bv78
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pwat.0000154
- ISSN:
- 2767-3219
- Journal Issue:
- 9
- Journal Title:
- PLOS Water
- Journal Volume:
- 2
- Keyword:
- Mental health and psychiatry, Water resources, Sanitation, Hygiene, Vendors, Water quality, Urban infrastructure, and Water management
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- University of Miami and
- Page Start:
- e0000154
- Person:
- Stoler, Justin, Miller, Joshua D., and Lemaitre, Andrea K.
- Publisher:
- Public Library of Science
- Source:
- 94fa9cd1-30f6-4980-ab86-1d9cd5088333
187. Hepatitis B care cascade among people with HIV/HBV coinfection in the North American AIDS Cohort Collaboration on Research and Design, 2012-2016
- Title Tesim:
- Hepatitis B care cascade among people with HIV/HBV coinfection in the North American AIDS Cohort Collaboration on Research and Design, 2012-2016
- Creator:
- Napravnik S., Torgersen J., Moore R.D., Lim J.K., Horberg M.A., Kim J., Lang R., Klein M.B., McGinnis K.A., Sterling T.R., Kirk G.D., Newcomb C.W., Silverberg M.J., Chew K., Reddy K.R., Gill M.J., Carbonari D.M., Lo Re V., 3rd, Gebo K.A., Hull M., Coburn S.B., Mayor A.M., Cachay E.R., Althoff K.N., Seaberg E.C., Kim H.N., and Kitahata M.M.
- Date of publication:
- 2023
- Abstract Tesim:
- A care cascade is a critical tool for evaluating delivery of care for chronic infections across sequential stages, starting with diagnosis and ending with viral suppression. However, there have been few data describing the hepatitis B virus (HBV) care cascade among people living with HIV infection who have HBV coinfection. We conducted a cross-sectional study among people living with HIV and HBV coinfection receiving care between January 1, 2012 and December 31, 2016 within 13 United States and Canadian clinical cohorts contributing data to the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). We evaluated each of the steps in this cascade, including: 1) laboratory-confirmed HBV infection, 2) tenofovir-based or entecavir-based HBV therapy prescribed, 3) HBV DNA measured during treatment, and 4) viral suppression achieved via undetectable HBV DNA. Among 3,953 persons with laboratory-confirmed HBV (median age, 50 years; 6.5% female; 43.8% were Black; 7.1% were Hispanic), 3,592 (90.9%; 95% confidence interval, 90.0-91.8%) were prescribed tenofovir-based antiretroviral therapy or entecavir along with their antiretroviral therapy regimen, 2,281 (57.7%; 95% confidence interval, 56.2-59.2%) had HBV DNA measured while on therapy, and 1,624 (41.1%; 95% confidence interval, 39.5-42.6) achieved an undetectable HBV DNA during HBV treatment. Our study identified significant gaps in measurement of HBV DNA and suppression of HBV viremia among people living with HIV and HBV coinfection in the United States and Canada. Periodic evaluation of the HBV care cascade among persons with HIV/HBV will be critical to monitoring success in completion of each step.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Medicine
- DOI:
- https://doi.org/10.17615/r8xd-kb29
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pone.0290889
- ISSN:
- 1932-6203
- Journal Issue:
- 9
- Journal Title:
- PloS one
- Journal Volume:
- 18
- Keyword:
- Hepatitis B virus, Coinfection, coinfection, hepatitis B, Canada, Humans, tenofovir, Female, Human immunodeficiency virus infection, Cross-Sectional Studies, human, Tenofovir, virus DNA, complication, Acquired Immunodeficiency Syndrome, female, male, cross-sectional study, HIV Infections, Male, Middle Aged, middle aged, DNA, Viral, Hepatitis B, and acquired immune deficiency syndrome
- Language Label:
- English
- License Label:
- CC0 1.0 Universal
- ORCID:
- Other Affiliation:
- , University of Pennsylvania, Johns Hopkins University, VA Connecticut Healthcare System, Mid-Atlantic Permanente Research Institute, Drexel University College of Medicine, University of Calgary, McGill University Health Centre, Vanderbilt University Medical Center, Kaiser Permanente Northern California, University of California Los Angeles, University of British Columbia, Universidad Central del Caribe, University of California San Diego, and University of Washington
- Page Start:
- e0290889
- Person:
- Napravnik S., Torgersen J., Moore R.D., Lim J.K., Horberg M.A., Kim J., Lang R., Klein M.B., McGinnis K.A., Sterling T.R., Kirk G.D., Newcomb C.W., Silverberg M.J., Chew K., Reddy K.R., Gill M.J., Carbonari D.M., Lo Re V., 3rd, Gebo K.A., Hull M., Coburn S.B., Mayor A.M., Cachay E.R., Althoff K.N., Seaberg E.C., Kim H.N., and Kitahata M.M.
- Publisher:
- Public Library of Science
- Source:
- 76d210b6-4758-4cfd-9267-84080ee5bc8a
188. Global implementation research capacity building to address cardiovascular disease: An assessment of efforts in eight countries
- Title Tesim:
- Global implementation research capacity building to address cardiovascular disease: An assessment of efforts in eight countries
- Creator:
- Price, LeShawndra N., Ramirez-Zea, Manuel, Weber, Mary Beth, Andesia, Josephine, Apusiga, Kingsley, Rakhra, Ashlin, Fitzpatrick, Annette L., Muula, Adamson S., Nguyen, Hoa L., Ha, Duc A., Fort, Meredith P., Hosseinipour, Mina C., Akwanalo, Constantine, Adjei, Kezia Gladys Amaning, and Baumann, Ana A.
- Date of publication:
- 2023
- Abstract Tesim:
- Cardiovascular diseases are the leading causes of morbidity and mortality worldwide, but implementation of evidence-based interventions for risk factors such as hypertension is lacking, particularly in low and middle income countries (LMICs). Building implementation research capacity in LMICs is required to overcome this gap. Members of the Global Research on Implementation and Translation Science (GRIT) Consortium have been collaborating in recent years to establish a research and training infrastructure in dissemination and implementation to improve hypertension care. GRIT includes projects in Ghana, Guatemala, India, Kenya, Malawi, Nepal, Rwanda, and Vietnam. We collected data from each site on capacity building activities using the Potter and Brough (2004) model, mapping formal and informal activities to develop (a) structures, systems and roles, (b) staff and infrastructure, (c) skills, and (d) tools. We captured information about sites’ needs assessments and metrics plus program adaptations due to the COVID-19 pandemic. All sites reported capacity building activities in each layer of the Capacity Pyramid, with the largest number of activities in the Skills and Tools categories, the more technical and easier to implement categories. All sites included formal and informal training to build Skills. All sites included a baseline needs assessment to guide capacity building activities or assess context and inform intervention design. Sites implementing evidence-based hypertension interventions used common implementation science frameworks to evaluate implementation outcomes. Although the COVID-19 pandemic affected timelines and in-person events, all projects were able to pivot and carry out planned activities. Although variability in the activities and methods used existed, GRIT programs used needs assessments to guide locally appropriate design and implementation of capacity building activities. COVID-19 related changes were necessary, but strong collaborations and relationships with health ministries were maintained. The GRIT Consortium is a model for planning capacity building in LMICs.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Medicine
- DOI:
- https://doi.org/10.17615/3k0n-3449
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pgph.0002237
- ISSN:
- 2767-3375
- Journal Issue:
- 9
- Journal Title:
- PLOS Global Public Health
- Journal Volume:
- 3
- Keyword:
- Pandemics, COVID 19, Guatemala, Health care policy, Low and middle income countries, Hypertension, Health systems strengthening, and Consortia
- Language Label:
- English
- License Label:
- CC0 1.0 Universal
- ORCID:
- Other Affiliation:
- National Institutes of Health, Institute of Nutrition of Central America and Panama, Emory University, Academic Model Providing Access to Healthcare, Kwame Nkrumah University of Science & Technology, NYU Grossman School of Medicine, University of Washington, University of Malawi and the Kamuzu University of Health Sciences, University of Massachusetts Chan Medical School, Vietnam Ministry of Health, University of Colorado – Anschutz Medical Campus, , Moi Teaching and Referral Hospital, and Washington University in St. Louis
- Page Start:
- e0002237
- Person:
- Price, LeShawndra N., Ramirez-Zea, Manuel, Weber, Mary Beth, Andesia, Josephine, Apusiga, Kingsley, Rakhra, Ashlin, Fitzpatrick, Annette L., Muula, Adamson S., Nguyen, Hoa L., Ha, Duc A., Fort, Meredith P., Hosseinipour, Mina C., Akwanalo, Constantine, Adjei, Kezia Gladys Amaning, and Baumann, Ana A.
- Publisher:
- Public Library of Science
- Rights Statement Label:
- In Copyright
- Source:
- 3252079a-5338-4ea4-9da8-495ba21aa377
189. Estimating the proportion of clinically suspected cholera cases that are true Vibrio cholerae infections: A systematic review and meta-analysis
- Title Tesim:
- Estimating the proportion of clinically suspected cholera cases that are true Vibrio cholerae infections: A systematic review and meta-analysis
- Creator:
- Zou K., Wiens K.E., Lessler J., Xu H., Mwaba J., Lee E.C., Malembaka E.B., Qadri F., Azman A.S., Demby M.N., and Bwire G.
- Date of publication:
- 2023
- Abstract Tesim:
- Background Cholera: surveillance relies on clinical diagnosis of acute watery : diarrhea. Suspected cholera case definitions have high sensitivity but low specificity, challenging our ability to characterize cholera burden and epidemiology. Our objective was to estimate the proportion of clinically suspected cholera that are true Vibrio cholerae infections and identify factors that explain variation in positivity. Methods and findings We conducted a systematic review of studies that tested ≥10 suspected cholera cases for V. cholerae O1/O139 using culture, PCR, and/or a rapid diagnostic test. We searched PubMed, Embase, Scopus, and Google Scholar for studies that sampled at least one suspected case between January 1, 2000 and April 19, 2023, to reflect contemporary patterns in V. cholerae positivity. We estimated diagnostic test sensitivity and specificity using a latent class meta-analysis. We estimated V. cholerae positivity using a random-effects meta-analysis, adjusting for test performance. We included 119 studies from 30 countries. V. cholerae positivity was lower in studies with representative sampling and in studies that set minimum ages in suspected case definitions. After adjusting for test performance, on average, 52% (95% credible interval (CrI): 24%, 80%) of suspected cases represented true V. cholerae infections. After adjusting for test performance and study methodology, the odds of a suspected case having a true infection were 5.71 (odds ratio 95% CrI: 1.53, 15.43) times higher when surveillance was initiated in response to an outbreak than in non-outbreak settings. Variation across studies was high, and a limitation of our approach was that we were unable to explain all the heterogeneity with study-level attributes, including diagnostic test used, setting, and case definitions. Conclusions In this study, we found that burden estimates based on suspected cases alone may overestimate the incidence of medically attended cholera by 2-fold. However, accounting for cases missed by traditional clinical surveillance is key to unbiased cholera : burden estimates. Given the substantial variability in positivity between settings, extrapolations from suspected to confirmed cases, which is necessary to estimate cholera incidence rates without exhaustive testing, should be based on local data.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Epidemiology
- DOI:
- https://doi.org/10.17615/54q1-5559
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pmed.1004286
- ISSN:
- 1549-1277
- Journal Issue:
- 9
- Journal Title:
- PLoS Medicine
- Journal Volume:
- 20
- Keyword:
- acute gastroenteritis, sensitivity and specificity, diagnostic test, sensitivity analysis, Vibrio cholerae, meta analysis, task performance, diarrhea, polymerase chain reaction, human, systematic review, controlled study, Article, false positive result, incidence, diagnostic test accuracy study, and cholera
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- Johns Hopkins University, Temple University, , University of Zambia, Université Catholique de Bukavu, International Centre for Diarrhoeal Disease Research Bangladesh, and Ministry of Health
- Person:
- Zou K., Wiens K.E., Lessler J., Xu H., Mwaba J., Lee E.C., Malembaka E.B., Qadri F., Azman A.S., Demby M.N., and Bwire G.
- Publisher:
- Public Library of Science
- Source:
- b4e81a45-752a-4e44-9789-f45fa7cf015f
190. Estimating the effect of a rifampicin resistant tuberculosis diagnosis by the Xpert MTB/RIF assay on two-year mortality
- Title Tesim:
- Estimating the effect of a rifampicin resistant tuberculosis diagnosis by the Xpert MTB/RIF assay on two-year mortality
- Creator:
- Van Rie, Annelies, De Vos, Elise, Stevens, Wendy, Scott, Lesley, da Silva, Pedro, Hayes, Cindy, de Lima, Yara Voss, and Westreich, Daniel
- Date of publication:
- 2023
- Abstract Tesim:
- Studies assessing patient-centred outcomes of novel rifampicin resistant tuberculosis (RR-TB) diagnostics are rare and mostly apply conventional methods which may not adequately address biases. Even though the Xpert MTB/RIF molecular assay was endorsed a decade ago for simultaneous diagnosis of tuberculosis and RR-TB, the impact of the assay on mortality among people with RR-TB has not yet been assessed. We analysed data of an observational prospective cohort study (EXIT-RIF) performed in South Africa. We applied a causal inference approach using inverse odds of sampling weights to rectify survivor bias and selection bias caused by differing screening guidelines. We also adjusted for confounding using a marginal structural model with inverse probability of treatment weights. We estimated the total effect of an RR-TB diagnosis made by the Xpert assay versus the pre-Xpert diagnostic algorithm (entailing a targeted Line Probe Assay (LPA) among TB-confirmed patients) on two-year mortality and we assessed mediation by RR-treatment initiation. Of the 749 patients diagnosed with RR-TB [247 (33%) by the pre-Xpert diagnostic algorithm and 502 (67%) by the Xpert assay], 42.7% died. Of these, 364 (48.6%) patients died in the pre-Xpert group and 200 (39.8%) in the Xpert group. People diagnosed with RR-TB by the Xpert assay had a higher odds of RR-TB treatment initiation compared to those diagnosed by the targeted LPA-based diagnostic process (OR 2.79; 95%CI 2.19–3.56). Receiving an RR-TB diagnosis by Xpert resulted in a 28% reduction in the odds of mortality within 2 years after presentation to the clinic (ORCI 0.72; 95%CI 0.53–0.99). Causal mediation analysis suggests that the higher rate of RR-TB treatment initiation in people diagnosed by the Xpert assay explains the effect of Xpert on 2-year mortality [natural indirect effect odds ratio 0.90 (95%CI 0.85–0.96). By using causal inference methods in combination with high quality observational data, we could demonstrate that the introduction of the Xpert assay caused a 28% reduction in 2-year odds of mortality of RR-TB. This finding highlights the need for advocacy for a worldwide roll-out of rapid molecular tests. Because the effect is mainly caused by increased RR-TB treatment initiation, health care systems should also ensure timely initiation of effective treatment upon an RR-TB diagnosis.
- Resource type:
- Article
- Affiliation Label Tesim:
- University of North Carolina at Chapel Hill
- DOI:
- https://doi.org/10.17615/c34x-tk65
- Edition:
- Publisher
- Identifier:
- https://dx.doi.org/10.1371/journal.pgph.0001989
- ISSN:
- 2767-3375
- Journal Issue:
- 9
- Journal Title:
- PLOS Global Public Health
- Journal Volume:
- 3
- Keyword:
- Tuberculosis, Diagnostic medicine, Tuberculosis diagnosis and management, HIV diagnosis and management, Death rates, Tuberculosis drug discovery, Directed acyclic graphs, and Body weight
- Language Label:
- English
- License Label:
- Attribution 4.0 International
- ORCID:
- Other Affiliation:
- University of Antwerp, University of the Witwatersrand, National Health Laboratory Service, National Health Laboratory Services, Instituto Nacional de Saude, and
- Page Start:
- e0001989
- Person:
- Van Rie, Annelies, De Vos, Elise, Stevens, Wendy, Scott, Lesley, da Silva, Pedro, Hayes, Cindy, de Lima, Yara Voss, and Westreich, Daniel
- Publisher:
- Public Library of Science
- Source:
- 0e7645c3-d69a-4279-b297-a06d5a357770
Collection Details
- Total items
-
2127
- Size
-
unknown
- Date created
-
February 2, 2022