A5082140454- Viral Infections and Outbreaks Research
- Global Maternal and Child Health
- Disaster Response and Management
- Child Nutrition and Water Access
- Maternal and Neonatal Healthcare
- Global Public Health Policies and Epidemiology
- Health disparities and outcomes
- Food Security and Health in Diverse Populations
- Data-Driven Disease Surveillance
- Climate Change and Health Impacts
- Global Security and Public Health
- COVID-19 Digital Contact Tracing
- Global Health Care Issues
- Insurance, Mortality, Demography, Risk Management
- Birth, Development, and Health
- Healthcare Policy and Management
- Neonatal Respiratory Health Research
- Smoking Behavior and Cessation
- Viral Infections and Vectors
- Ethics and Legal Issues in Pediatric Healthcare
- Blood Pressure and Hypertension Studies
- ICT in Developing Communities
- Public Health Policies and Education
- Pregnancy and preeclampsia studies
- Child and Adolescent Health
Harvard University
2008-2023
London School of Hygiene & Tropical Medicine
2014-2022
University of London
2014-2019
Johns Hopkins University
2019
Children's Hospital
2018
Response Biomedical (Canada)
2018
MRC Clinical Trials Unit at UCL
2018
University College London
2018
University of Sierra Leone
2018
Great Ormond Street Hospital
2018
BackgroundDespite remarkable progress in the improvement of child survival between 1990 and 2015, Millennium Development Goal (MDG) 4 target a two-thirds reduction under-5 mortality rate (U5MR) was not achieved globally. In this paper, we updated our annual estimates by cause to 2000–15 reflect on toward MDG consider implications for Sustainable Goals (SDG) survival.MethodsWe increased estimation input data causes deaths 43% among neonates 23% 1–59-month-olds, respectively. We used adequate...
Objective To estimate cause-of-death distributions in the early (0-6 days of age) and late (7-27 neonatal periods, for 194 countries between 2000 2013.Methods For 65 with high-quality vital registration, we used each country's observed proportional cause distributions.For remaining 129 countries, multinomial logistic models to these low child mortality registration data as inputs high distribution from studies similar settings.We applied cause-specific proportions death estimates United...
There has been substantial research on psychosocial and health care determinants of disparities in the United States (US) but less role modifiable risk factors. We estimated effects smoking, high blood pressure, elevated glucose, adiposity national life expectancy disease-specific mortality among eight subgroups US population (the "Eight Americas") defined basis race location socioeconomic characteristics county residence, 2005.
Blood pressure is an important risk factor for cardiovascular disease and mortality has lifestyle healthcare determinants that vary across states. Only self-reported hypertension status measured at the state level in United States. Our aim was to estimate levels trends state-level mean systolic blood (SBP), prevalence of uncontrolled hypertension, attributable all higher-than-optimal SBP.We estimated relationship between actual SBP/uncontrolled use medication, a set health system...
The days immediately after birth are the most risky for human survival, yet neonatal mortality risks generally not reported by day. Early deaths sometimes under-reported or might be misclassified day of death as stillbirths. We modelled daily risk and estimated proportion on in week 1 186 countries 2013.We reviewed data from vital registration (VR) demographic health surveys information timing deaths. For with high-quality VR we used reported. without data, applied an exponential model to...
Although self-rated health is proposed for use in public monitoring, previous reports on US levels and trends have shown ambiguous results. This study presents a comprehensive comparative analysis of responses to common question 4 national surveys from 1971 2007: the National Health Nutrition Examination Survey, Behavioral Risk Factor Surveillance System, Interview Current Population Survey. In addition variation across surveys, striking discrepancies time were observed. Whereas data System...
Current US surveillance data provide estimates of diabetes using laboratory tests at the national level as well self-reported state level. Self-reported prevalence may be biased because respondents not aware their risk status. Our objective was to estimate diagnosed and undiagnosed by state.We estimated a function set health system sociodemographic variables logistic regression in National Health Nutrition Examination Survey (2003-2006). We applied this relationship identical from Behavioral...
India had the largest number of under-5 deaths all countries in 2015, with substantial subnational disparities. We estimated national and all-cause cause-specific mortality among children younger than 5 years annually 2000-15 to understand progress made consider implications for achieving Sustainable Development Goal (SDG) child survival targets.We used a multicause model estimate proportions neonates aged 1-59 months at state level, causes death grouped into pneumonia, diarrhoea,...
Goals (MDGs) were established in 2000 a declaration adopted unanimously by the member countries of United Nations to focus resources and efforts toward critical global poverty, health, sustainability problems (http: //millenniumindicators.un.org/unsd/mdg /Default.aspx).The MDGs set numerical targets be achieved 2015 use socioeconomic, environmental, nutritional, health indicators monitor progress these targets.There are concerns that some health-related has been slow many countries, making...
The operational cleavage between the US public health and medical care systems contributed to country's difficulty in containing community spread of COVID-19 pandemic's first months. We provide an overview independent evolution these two systems, drawing on case examples publicly available outcome data, demonstrate how three fundamental elements epidemic response-case finding, mitigating transmission, treatment-were undermined by lack coordination gaps disparities. propose policy initiatives...
Stringent infection control requirements at Ebola treatment centers (ETCs), which are specialized facilities for isolating and treating patients, create substantial challenges recording reviewing patient information. During the 2014-2016 West African epidemic, paper-based data collection systems ETCs compromised quality, quantity, confidentiality of data. Electronic health record (EHR) have potential to address such problems, with benefits care, surveillance, research. However, no suitable...
To assess the frequency of fatal recrudescence from Ebola virus disease after discharge treatment centres, and explore influence infecting dose on case fatality rates. Retrospective cohort study. Western Area, Sierra Leone. 151 survivors treated for at Kerry Town centre discharged. Survivors were followed up a vital status check four to nine months discharge, again six 13 discharge. Verbal autopsies conducted who had died since (that is, late deaths). still living in Area interviewed...
Little is known about potentially modifiable factors in Ebola virus disease children. We undertook a retrospective cohort study of children <13 years old admitted to 11 holding units the Western Area, Sierra Leone, during 2014-2015 identify affecting outcome. Primary outcome was death or discharge after transfer treatment centers. All 309 virus-positive 2 days-12 were included; outcomes available for 282 (91%). Case-fatality 57%, and 55% deaths occurred units. Blood test results showed...
Abstract Background Healthcare associated infections (HAI) are estimated to affect up 15% of hospital inpatients in low-income countries (LICs). A critical but often neglected aspect HAI prevention is basic environmental hygiene, particularly surface cleaning and linen management. TEACH CLEAN an educational intervention aimed at improving hygiene. We evaluated the effectiveness this a pilot study three high-volume maternity newborn units Dar es Salaam, Tanzania. Methods This design...
The 2014–2016 West Africa Ebola epidemic highlighted the difficulty of collecting patient information during emergencies, especially in highly infectious environments. Health systems (HISs) appropriate for such settings were lacking prior to this outbreak. Here we describe our development and implementation paper electronic HISs at Sierra Leone Kerry Town treatment centre (ETC) from 2014 2015. We share approach, experiences, recommendations future health emergencies. developed eight...
Background While a number of predictors for Ebola mortality have been identified, less is known about post-viral symptoms. The identification acute-illness symptoms could allow the selection patients more active follow up in future, and those whom early interventions may be beneficial long term. Studying both within single cohort also further our understanding pathophysiology survivor sequelae. Methods/Principal findings We performed historical study using data collected as part routine...
Rapidly identifying likely Ebola patients is difficult because of a broad case definition, overlap symptoms with common illnesses, and lack rapid diagnostics. However, identification critical for care containment contagion. We analyzed retrospective data from 252 Ebola-positive 172 Ebola-negative at Sierra Leone treatment center to develop easy-to-use risk scores, based on laboratory tests (if available), stratify triaged by their likelihood having infection. Headache, diarrhea, difficulty...
Throughout the COVID-19 pandemic, US has struggled with many aspects of public health response, from determining where transmission is occurring to building trust communities and implementing interventions. Three factors have contributed these challenges: insufficient local capacity, siloed interventions, underuse a cluster-based approach outbreak response. In this article we introduce Community-based Outbreak Investigation Response (COIR), strategy developed during pandemic that addresses...
We compared children who were positive for Ebola virus disease (EVD) with those negative to derive a pediatric EVD predictor (PEP) score. collected data on all <13 years of age admitted 11 holding units in Sierra Leone during August 2014-March 2015 and performed multivariable logistic regression. Among 1,054 children, 309 (29%) 697 (66%) negative, 48 (5%) missing. Contact history, conjunctivitis, the strongest predictors EVD. The PEP score had an area under receiver operating characteristics...