A5023517286- Child Nutrition and Water Access
- Global Maternal and Child Health
- HIV/AIDS Research and Interventions
- Aquatic Ecosystems and Biodiversity
- Poverty, Education, and Child Welfare
- Adolescent Sexual and Reproductive Health
- HIV, Drug Use, Sexual Risk
- Food Security and Health in Diverse Populations
- Demographic Trends and Gender Preferences
- Migration, Health and Trauma
- Global Health and Surgery
- Complementary and Alternative Medicine Studies
- Obesity, Physical Activity, Diet
- Rangeland Management and Livestock Ecology
- HIV/AIDS Impact and Responses
- Immune responses and vaccinations
- Ethnobotanical and Medicinal Plants Studies
- Global Health and Epidemiology
- Vaccine Coverage and Hesitancy
- Therapeutic Uses of Natural Elements
- Fatty Acid Research and Health
- African Botany and Ecology Studies
- HIV Research and Treatment
University of Minnesota
2015-2024
Twin Cities Orthopedics
2018
North Memorial Health Care
2017
Center for Global Health
2017
Microclinic International
2014-2016
University of California, San Francisco
2011-2015
Global Brain Health Institute
2015
University of Oxford
2011
Antiretroviral hair levels objectively quantify drug exposure over time and predict virologic responses. We assessed the acceptability feasibility of collecting small samples in a rural Kenyan cohort. Ninety-five percentage participants (354/373) donated hair. Although median self-reported adherence was 100% (interquartile range, 96%-100%), wide range concentrations likely indicates overestimation advantages pharmacologic measure. Higher nevirapine observed women older adults require further...
HIV treatment is life-long, yet many patients travel or migrate for their livelihoods, risking interruption. We examine timely reengagement in care among who transferred-out were lost-to-follow-up (LTFU) from a rural facility. conducted cohort study 369 adult on antiretroviral therapy between November 2011 and 2013 Mfangano Island, Kenya. Patients transferred LTFU (i.e., missed scheduled appointment by ≥90 days) traced to determine if they reengaged accessed at another clinic. report...
Despite progress in the global scale-up of antiretroviral therapy, sustained engagement HIV care remains challenging. Social capital is an important factor for engagement, but interventions designed to harness this powerful social force are uncommon.We conducted a quasiexperimental study evaluating impact Microclinic Network intervention on and medication adherence Mfangano Island, Kenya. The was introduced into 1 4 similar communities served by clinic; comparisons were made between using...
The objective of this study was to investigate the relationship among socioeconomic status, social support, and food insecurity in a rural Kenyan island community. A cross-sectional random sample 111 female heads households representing 583 household members were surveyed Mfangano Island, Kenya from August October 2010 using adaptations Household Food Insecurity Access Scale Medical Outcomes Study Social Support Survey. In multiple linear regression models, less instrumental defined as...
Understanding feedbacks between human and environmental health is critical for the millions who cope with recurrent illness rely directly on natural resources sustenance. Although studies have examined how degradation exacerbates infectious disease, effects of our use environment remains unexplored. Human often tacitly assumed to reduce impacts environment. By this logic, ill people time effort that they put into extractive livelihoods and, thereby, their impact resources. We followed 303...
Background: Pica, the craving and purposeful consumption of nonfoods, is poorly understood. We described prevalence pica among women on Mfangano Island, Kenya, examined sociodemographic health correlates. Methods: Our cross-sectional study included 299 pregnant or postpartum in 2012. used a 24-h recall to assess pica, defined as earth (geophagy), charcoal/ash, raw starches (amylophagy) built multivariable logistic regression models examine correlates pica. Results: Eighty-one (27.1%) engaged...
Background Existing social relationships are a potential source of “social capital” that can enhance support for sustained retention in HIV care. A previous pilot study network-based ‘microclinic’ intervention, including group health education and facilitated status disclosure, reduced disengagement from We conducted pragmatic randomized trial to evaluate microclinic effectiveness. Methods In nine rural facilities western Kenya, we HIV-positive adults with recent missed clinic visit either...
As global health researchers, we have long embraced the conviction that answers to complex problems of poverty and disease will reveal themselves if only apply enough scientific rigor. Yet, at community level, our group American Kenyan investigators has begun question whether veneration rigor is itself contributing intractability certain types problems. Here, illustrate examples from experience among remote island communities Lake Victoria, Kenya, join a chorus emerging voices, examine how...
In rural sub-Saharan Africa, preventable delays in accessing emergency care remain a dominant factor maternal and neonatal deaths. The MOMENTUM study is pragmatic cohort investigation designed to measure the "Three Delays", i.e. recognizing need for (Type 1), reaching 2), receiving 3) within remote island health system on Lake Victoria, Kenya. utilizes an adaptive methodology provide actionable data locally-directed "Health Navigation" intervention. We present analysis of 56 cases occurring...
Prior to the COVID-19 pandemic, families in rural sub-Saharan Africa faced numerous well-documented barriers accessing timely care during maternal and neonatal health emergencies. We are now beginning further appreciate complex impacts that global disruptions, like can have on access across vulnerable systems, particularly for mothers seeking remote settings. In 2021, we initiated a qualitative follow-up study MOMENTUM (Monitoring Maternal Emergency Navigation Triage Mfangano) cohort...
Despite worldwide improvements in maternal and infant mortality, mothers babies remote, low-resource communities remain disproportionately vulnerable to adverse health outcomes. In these settings, delays accessing emergency care are a major driver of poor The 'Three Delays' model is now widely utilised conceptualise delays. However, out-of-hospital contexts, operational methodological constraints present obstacles practically quantifying the Delays'. Here, we describe novel protocol for...
In rural sub-Saharan Africa (SSA), the human immunodeficiency virus (HIV)/AIDS pandemic has exerted effects on nearly every aspect of life. Yet despite pandemic's near ubiquitous impacts, major barriers to HIV care, treatment, and support persist. Compounding care is incredible complexity diversity experience across different sociocultural contexts.This exploratory community-based participatory study aimed generate an explanatory model about how geographic socioeconomic marginalization shape...
Household food insecurity around Kenya’s Lake Victoria is widespread. The goal of this study was to examine the associations between insecurity, child anthropometry and development in 300 children 0‐2 years old living a rural lakeside community Kenya. Outcome measures obtained included anthropometric measurements (length weight) Ages Stages Questionnaire [ASQ] (Gross Motor, Personal‐Social, Communication sub‐scales). assessed using Food Insecurity Access Scale [HFIAS], scale household...
For rural populations, natural resources provide for food and livelihoods. An estimated 10‐12% of people work in fisheries; while the majority fishers are men, 90% traders women. To understand how affect security, we study changing fish catch Lake Victoria, Kenya affects security a transactional sexual economy. Where 65% households severely insecure HIV prevalence is 27%, analyze declines' influence on fish‐for‐sex participation power dynamics. Our mixed methods approach includes...
Among the many profound disruptions created by COVID-19 around world, pandemic has greatly tested community-based research endeavours that rely upon international collaboration and face-to-face interactions in rural communities. Our group of Kenyan American investigators based on remote Mfangano Island Lake Victoria experienced numerous challenges due to travel restrictions, safety guidelines, funding interruptions, forcing us rapidly adapt objectives as conditions evolved real time. Here we...
Food‐producing livelihoods have the potential to improve nutrition, through direct consumption or indirectly income. Yet, livelihood interventions rarely show any effects on nutrition indicators. In this study, we explore whether fishing households eat more fish and higher food security than non‐fishing around Lake Victoria, Kenya. 2010, conducted a household survey of 111 randomly sampled in rural community where half all fish. Our results suggest that bivariate analyses (results were...
Long‐chain polyunsaturated fatty acids found in breast milk are critical for optimal infant development and derived from dietary sources. While the availability of these is associated with consumption fish general, little known about relative contribution maternal different species shaping concentrations. Yet composition shifting response to global environmental changes. Understanding how specific contribute acid provides an important link understanding food environment affects nutrition. We...
Marginalization and Community Perception of HIV Care, Treatment, Support on Mfangano Island, Kenya Annie Chang, MD, MS, Kathryn J. Fiorella, PhD, MPH, Matthew D. Hickey, Charles R. Salmen, MPHIL, Elizabeth A. Bukusi, MBChB, M.Med, Craig Cohen, Colette L. Auerswald, MS What Is the Problem? • In rural sub-Saharan Africa, human immunodeficiency virus (HIV)/AIDS epidemic has exerted effects nearly every aspect life. Yet despite pandemic’s near ubiquitous impacts, major barriers to care,...