A5009043437- Health Promotion and Cardiovascular Prevention
- Blood Pressure and Hypertension Studies
- Acute Myocardial Infarction Research
- HIV-related health complications and treatments
- Global Public Health Policies and Epidemiology
- Emergency and Acute Care Studies
- Cardiac Arrest and Resuscitation
- Cardiac Health and Mental Health
- Chronic Disease Management Strategies
- Climate Change and Health Impacts
- Global Health and Epidemiology
- Cardiovascular Syncope and Autonomic Disorders
- Cardiovascular Effects of Exercise
- Heart Failure Treatment and Management
- Antibiotic Resistance in Bacteria
- Substance Abuse Treatment and Outcomes
- Smoking Behavior and Cessation
- Pneumonia and Respiratory Infections
- Pericarditis and Cardiac Tamponade
- Health Policy Implementation Science
- Thermal Regulation in Medicine
- Malaria Research and Control
- Lipoproteins and Cardiovascular Health
- Pathogenesis and Treatment of Hiccups
- Diabetes, Cardiovascular Risks, and Lipoproteins
Duke University
2017-2024
Duke Institute for Health Innovation
2017-2024
Duke Medical Center
2018-2022
University of Arizona
2015
Icahn School of Medicine at Mount Sinai
2012
Introduction Sub-Saharan Africa is particularly vulnerable to the growing global burden of hypertension, but epidemiological studies are limited and barriers optimal management poorly understood. Therefore, we undertook a community-based mixed-methods study in Tanzania investigate epidemiology hypertension care. Methods In Northern Tanzania, between December 2013 June 2015, conducted study, including cross-sectional household survey qualitative sessions focus groups in-depth interviews. For...
Little is known about community knowledge of myocardial infarction symptoms and perceptions self-risk in sub-Saharan Africa.A survey was conducted northern Tanzania, where the prevalence cardiovascular risk factors high. Households were selected randomly a population-weighted fashion surveys administered to self-identified household healthcare decision-makers. Respondents asked list all heart attack whether they thought had chance suffering attack. Associations between participant...
The prevalence of cardiovascular disease in sub-Saharan Africa is substantial and growing. Much remains to be learned about the relative burden acute coronary syndrome (ACS), heart failure, stroke on emergency departments hospital admissions. A retrospective chart review admissions from September 2017 through March 2018 was conducted at department a tertiary care center northern Tanzania. Stroke admission volume compared previously published data same adjusted for population growth. Of 2418...
Introduction: Little is known about the burden of hypertension and diabetes on emergency department (ED) utilization hospitalizations in sub-Saharan Africa.Methods: A retrospective review adult ED patients northern Tanzania was performed from September 2017 through March 2018. Hypertension defined as documented diagnosis or blood pressure ≥ 140/90 mm Hg. Diabetes mellitus random glucose 200 mg/dL.Results: Of 3961 patients, 1359 (34.3%) had hypertension, 518 (13.1%) diabetes, 273 (6.9%) both....
Background Rigorous incidence data for acute myocardial infarction (AMI) in sub‐Saharan Africa are lacking. Consequently, modeling studies based on limited have suggested that the burden of AMI and AMI‐associated mortality is lower than other world regions. Methods Results We estimated northern Tanzania 2019 by integrating from a prospective surveillance study (681 participants) community survey healthcare‐seeking behavior (718 participants). In study, adults presenting to an emergency...
Background Little is known about community perceptions of chest pain and healthcare seeking behavior for in sub-Saharan Africa. Methods A two-stage randomized population-based cluster survey with selection proportional to population size was performed northern Tanzania. Self-identified household decision-makers from randomly selected households were asked list all possible causes an adult where they would go if member had pain. Results Of 718 respondents, 485 (67.5%) females. The most...
<strong>Introduction:</strong> HIV confers increased risk of myocardial infarction (MI), but there has been little study ischemic electrocardiogram (ECG) findings among people with in sub-Saharan Africa. <strong>Objectives:</strong> To compare the prevalence ECG Tanzanians and without to identify correlates changes HIV. <strong>Methods:</strong> Consecutive adults presenting for routine care at a Tanzanian clinic were enrolled. Age- sex-matched HIV-uninfected controls enrolled from nearby...
Background Sub-Saharan Africa has a high prevalence of hypertension with low rate awareness, treatment adherence, and control. The emergency department (ED) may represent unique opportunity to improve screening, linkage care. We conducted qualitative study among hypertensive patients presenting the ED their healthcare providers determine barriers care Methods In northern Tanzania, between November December 2017, we three focus group discussions in-depth interviews physicians. our study, was...
Self-treatment with antimicrobials is common in sub-Saharan Africa. Little known about the prevalence of this practice where malaria transmission intensity low, and little self-treatment other medications such as antihypertensives antihyperglycemics.A two-stage randomized population-based cluster survey selection proportional to population size was performed northern Tanzania. Self-identified healthcare decision-makers from randomly selected households were asked report instances...
Background Chronic myocardial injury is a condition defined by stably elevated cardiac biomarkers without acute ischemia. Although studies from high-income countries have reported that chronic predicts adverse prognosis, there are no published data about the in sub-Saharan Africa. Methods Between November 2020 and January 2023, adult patients with chest pain or shortness of breath were recruited an emergency department Moshi, Tanzania. Medical history point-of-care troponin T (cTnT) assays...
Objectives Globally, hypertension affects one billion people and disproportionately burdens low-and middle-income countries. Despite the high disease burden in sub-Saharan Africa, optimal care models for diagnosing treating have not been established. Emergency departments (EDs) are frequently first biomedical healthcare contact many region. ED encounters may offer a unique opportunity identifying risk patients linking them to care. Methods Between July 2017 March 2018, we conducted...
One in three people with HIV (PWH) has hypertension. However, most hypertensive PWH sub-Saharan Africa are unaware of their hypertension diagnosis and not on treatment. To better understand barriers to care faced by PWH, we interviewed 15 medical providers who for patients northern Tanzania. The data revealed at the patient, provider, system level included: stress, depression, HIV-related stigma; lack knowledge; insufficient training; inefficient prescribing practices; challenges...
<title>Abstract</title> <bold>Background:</bold> In Tanzania, acute myocardial infarction (AMI) is under-diagnosed, and uptake of evidence-based care sub-optimal. Using an implementation science approach, intervention was developed to address local barriers care: the Multicomponent Intervention for Improving Myocardial Infarction Care in Tanzania (MIMIC). <bold>Methods:</bold> This single-arm pre-post trial conducted a northern Tanzanian emergency department (ED). During pre-intervention...
Background People with HIV in sub-Saharan Africa are increasingly developing age-related comorbidities. The purpose of this prospective observational study was to describe 6-month outcomes among Tanzanians and elevated blood pressure or hyperglycemia under current care pathways. Methods Adults presenting for routine were enrolled underwent glucose measurements. Participants abnormal referred further care, as per guidelines. Participants’ point-of-care re-evaluated during their follow-up...
Africa has the second highest rate of alcohol dependence and road traffic fatality despite lowest number vehicles. Sub-Saharan (SSA) is particularly vulnerable to growing global burden alcohol-related injury. Therefore, we aimed describe compare proportion emergency department (ED) patients presenting with RTIs who are breathalyzer (BAC) positive in three African countries determine dose-response. Secondary data analysis on RTI from International Collaborative Alcohol Injury Study EDs used...
The prevalence of cardiovascular disease (CVD) is rising among people with HIV (PWH) in sub-Saharan Africa (SSA). Despite the utility electrocardiogram (ECG) screening for CVD, there limited data regarding longitudinal ECG changes PWH SSA. In this study, we aimed to describe over a 6-month period cohort northern Tanzania. Between September 2020 and March 2021, adult were recruited from Majengo Care Treatment Clinic (MCTC) Moshi, Trained research assistants surveyed participants obtained...
We aimed to prospectively describe incident cardiovascular events among people living with HIV (PLWH) in northern Tanzania. Secondary aims of this study were understand non-communicable disease care-seeking behaviour and patient preferences for care education. A prospective observational study. This was conducted at the Majengo Care Treatment Clinic, an outpatient government-funded clinic Moshi, Tanzania PARTICIPANTS: Adult patients presenting routine enrolled from 1 September 2020 March...