A5059095380- HIV/AIDS Research and Interventions
- Global Maternal and Child Health
- Adolescent Sexual and Reproductive Health
- HIV-related health complications and treatments
- Hemoglobinopathies and Related Disorders
- Iron Metabolism and Disorders
- Emergency and Acute Care Studies
- Maternal Mental Health During Pregnancy and Postpartum
- Healthcare Policy and Management
- Pancreatic function and diabetes
- Water Systems and Optimization
- Folate and B Vitamins Research
- HIV/AIDS Impact and Responses
- Cardiovascular Disease and Adiposity
- Global Health and Epidemiology
- Pneumocystis jirovecii pneumonia detection and treatment
- Neurological and metabolic disorders
- Innovations in Medical Education
- Diabetes Management and Research
- Chronic Disease Management Strategies
- Water Treatment and Disinfection
- Groundwater flow and contamination studies
- Ureteral procedures and complications
- Sexual Assault and Victimization Studies
- Nutrition and Health in Aging
University of California, San Francisco
2023-2025
Bugando Medical Centre
2023-2025
Center for Global Health
2019-2024
Catholic University of Health and Allied Sciences
2024
Cornell University
2024
Massachusetts General Hospital
2019-2023
Mwanza Intervention Trials Unit
2023
National Institute for Medical Research
2023
Johns Hopkins University
2014-2020
Johns Hopkins Medicine
2014-2020
Hospitalized people living with HIV (PLWH) experienced extremely high mortality rates in the first year after an index hospitalization pre-Dolutegravir (DTG) era. We conducted a multi-center study Mwanza, Tanzania to (1) describe causes of for PLWH on DTG; (2) determine in-hospital and 3-month post-hospital mortality; (3) examine factors associated overall (4) changes trends predictors pre- post-DTG Between August 2020 February 2021, hospitalized dolutegravir-based antiretroviral therapy...
Cardiovascular disease (CVD) is a growing cause of morbidity and mortality in people with HIV (PWH). Arterial stiffness may be an intermediary between HIV-infection CVD, necessitating holistic assessment arterial correlation cardiac outcomes. We conducted cross-sectional study PWH HIV-uninfected community controls using multimodal echocardiographic performed ankle-brachial index (ABI) pulse-wave velocity (PWV) to characterize cohort Tanzania. Regression analysis was used determine...
HIV-infected pregnant women face complex decisions about whether and how to disclose their serostatus. Previous studies have shown that HIV disclosure is associated with better care engagement, emotional adjustment the disease, reduced risk of transmission, but both real perceived barriers disclosure. We examined patterns predictors in a cohort 200 diagnosed or confirmed during antenatal Kilimanjaro region Tanzania followed participants three months postpartum. Twenty also completed...
Prevention of mother-to-child transmission HIV (PMTCT) is a foundational component comprehensive treatment program. In addition to preventing vertical children, PMTCT an important catch-point for universal test-and-treat strategies that can reduce community viral load and slow the epidemic. However, systematic reviews suggest care engagement in programs sub-optimal. This study enrolled cohort 200 women initiating Kilimanjaro, Tanzania, followed them assess associated factors. Six months...
We sought to assess mental health at the time of antiretroviral therapy (ART) initiation and subsequent retention in care over a six-month follow-up period. A total 136 people living with HIV South Africa were administered surveys measuring demographic information indicators ART initiation. Follow-up was completed via chart abstraction for outcomes viral suppression. At enrollment, 45/136 (33%), 67/136 (49%), (33%) participants screened positive depression, anxiety, alcohol use disorder,...
Despite its rarity in the United States, sickle cell disease accounts for a disproportionate amount of healthcare utilization and costs. The majority this is due to acute care painful crises. A small subpopulation patients most these costs frequent visits emergency departments facilities. Previous investigations have found that high utilizing are distinguished by both more severe course certain non‐hematologic characteristics, which may include higher socioeconomic status some psychiatric...
If a contamination event occurs in water distribution system, sensors the network may observe quality changes. The data from these can be used to identify source of contamination. binary that record presence or absence contamination, fuzzy measure concentration within set range, perfect exact bounds measurement uncertainty. This work presents an adjoint-based probabilistic approach for identifying node, release time, and strength instantaneous based on sensor observations known system...
Background Additional approaches are needed to identify and provide targeted interventions populations at continued risk for HIV-associated mortality. We sought describe care utilization mortality following an index hospitalization people with HIV in South Africa. Methods conducted a prospective cohort study among hospitalized patients admitted medicine wards single hospital serving large catchment area. Participants were followed 6 months post-discharge. Hospital records used overall...
Neurocognitive dysfunction is an important complication of sickle cell disease (SCD), but little published on the utility screening tests for cognitive impairment in people with disease. The purpose this study was to evaluate Montreal Cognitive Assessment (MoCA) as a tool and identify predictors MoCA performance adults disease.We conducted retrospective, cross-sectional first 100 adult patients SCD who completed part routine clinical care at Johns Hopkins Sickle Cell Center Adults. We...
The purpose of this prospective cohort study is to characterize the event acute hospitalization for people living with and without HIV describe its impact on care continuum. This describes care-seeking behavior prior an index hospitalization, inpatient testing diagnosis, discharge instructions, follow-up patients being discharged from a single hospital in South Africa.A convenience sample adult was recruited medical wards tertiary facility. Baseline information at time admission, subsequent...
People living with HIV (PLWH) have a higher prevalence of diastolic dysfunction and left ventricular hypertrophy (LVH) in cross-sectional studies. Longitudinal data are lacking, especially from Africa. The aim was to examine: 1) the incidence PLWH compared community controls Tanzania; 2) progression function LVH after antiretroviral therapy initiation; 3) traditional, endemic, HIV-specific risk factors for LVH. This prospective longitudinal cohort HIV-uninfected who had an echocardiogram at...
Background In 2013, the WHO released new prevention of mother-to-child transmission (PMTCT) HIV guidelines, known as Option B+, to promote lifelong access antiretroviral therapy (ART) for all pregnant and breastfeeding women living with (WLHIV) [1]. As 2017, countries in sub-Saharan Africa (SSA) have adopted B+ guidelines into their PMTCT programs, drastically expanding ART. Since 2011, number WLHIV covered by ART SSA has risen from 3.7 million (29.2% eligible women) 8.7 (61.7% 2016 [2]....
The importance of emphasizing empathy, reflection, and professionalism during anatomy dissection has been well established. This small-group curriculum was developed to fulfill a need for structured reflection at the end anatomy.In this 45-minute session, each team first-year medical students in is led by one or two peer facilitators recruited from second-year student class. session designed include time sharing personal reflections, clinical observation activity about cadaver's cause death,...
It has been reported that, in at least nine countries, forced anal examinations are used to investigate or punish alleged same-sex behavior between consenting men transgender women.• In these settings, usually performed by healthcare providers the request of law enforcement officials, and procedures entirely distinct from those legitimately clinical care.• Forced intended cause physical and/or emotional pain offer no potential benefits targeted individual, violating key principles medical...
Background: In 2014, Tanzania adopted the Option B+ policy for prevention of mother-to-child transmission HIV (PMTCT), which stipulates lifelong antiretroviral therapy (ART) HIV-infected pregnant, postpartum and breastfeeding women, irrespective CD4 count or WHO clinical staging. Loss to follow-up (LTFU) during pregnancy period may undermine effectiveness B+. Factors associated with no (NFU) care, differ from those LTFU at later time points. This study aimed identify factors NFU among...
In 2014, Tanzania adopted the Option B+ policy for prevention of mother-to-child transmission HIV (PMTCT), which stipulates lifelong antiretroviral therapy (ART) HIV-infected pregnant, postpartum and breastfeeding women, irrespective CD4 count or WHO clinical staging. Loss to follow-up (LTFU) during pregnancy period may undermine effectiveness B+. Factors associated with no (NFU) care, differ from those LTFU at later time points. This study aimed identify factors NFU among women who initiate...
Abstract Background Chronic obstructive pulmonary disease (COPD) is a leading cause of global mortality. In high-income settings, the presence cardiovascular among people with COPD increases mortality and complicates longitudinal management. An estimated 26 million are living in sub-Saharan Africa, where risk factors for co-occurring may differ from settings but remain uncharacterized. As non-communicable diseases have become death defining multimorbidity this setting critical to inform...