A5068013234- HIV/AIDS Research and Interventions
- Global Maternal and Child Health
- Child Nutrition and Water Access
- Food Security and Health in Diverse Populations
- Mobile Health and mHealth Applications
- ICT in Developing Communities
- Adolescent and Pediatric Healthcare
- HIV, Drug Use, Sexual Risk
- Religion, Spirituality, and Psychology
- HIV Research and Treatment
- Poverty, Education, and Child Welfare
- T-cell and B-cell Immunology
- Systemic Lupus Erythematosus Research
- Mental Health Treatment and Access
- Climate Change and Health Impacts
- Statistical Methods in Epidemiology
- Pharmaceutical studies and practices
- Emergency and Acute Care Studies
- HIV/AIDS Impact and Responses
- Antibiotic Use and Resistance
- Health Policy Implementation Science
- Adolescent Sexual and Reproductive Health
- Immune Cell Function and Interaction
- Global Public Health Policies and Epidemiology
- Cytokine Signaling Pathways and Interactions
University of Washington
2019-2025
Washington University in St. Louis
2024-2025
Seattle University
2023
University of Chicago
2012-2013
BackgroundMortality among children with acute illness in low-income and middle-income settings remains unacceptably high the importance of post-discharge mortality is increasingly recognised. We aimed to explore epidemiology deaths young across sub-Saharan Africa south Asia inform development interventions improved guidelines.MethodsIn this prospective cohort study, we enrolled aged 2–23 months illness, stratified by nutritional status defined anthropometry (ie, no wasting, moderate or...
Structural, psychological, and clinical barriers to HIV care engagement among adolescents young adults living with (AYAH) persist globally despite gains in epidemic control. Phone-based peer navigation may provide critical support, increase delivery flexibility, require fewer resources. Prior studies show that phone-based automated text messaging interventions improve engagement, adherence, retention AYAH. However, little is known about AYAH experiences utilizing electronic (E-NAV). We...
Systemic lupus erythematosus (SLE) disease manifestations are highly variable among patients, and the prevalence of individual clinical features differs significantly by ancestry. Serum tumor necrosis factor α (TNFα) levels elevated in some SLE patients may play a role pathogenesis. The aim this study was to look for associations between serum TNFα levels, SLE, autoantibodies, interferon-α (IFNα) large multiancestral cohort.We studied 653 (214 African Americans, 298 European 141 Hispanic...
Introduction Accelerating progress in reducing child deaths is needed order to achieve the Sustainable Development Goal mortality target. This will require a focus on vulnerable children–including young children, those who are undernourished or with acute illnesses requiring hospitalization. Improving adherence inpatient guidelines may be an important strategy reduce mortality, including among most vulnerable. The aim of our assessment nine sub-Saharan African and South Asian hospitals was...
BackgroundGrowth faltering is well-recognized during acute childhood illness and growth acceleration convalescence, with or without nutritional therapy, may occur. However, there are limited recent data on after hospitalization in low- middle-income countries.MethodsWe evaluated following among children aged 2–23 months sub-Saharan Africa South Asia. Between November 2016 January 2019, were recruited at hospital admission classified as: not-wasted (NW), moderately-wasted (MW),...
Children in low and middle-income countries remain vulnerable following hospital-discharge. We estimated the incidence correlates of hospital readmission among young children admitted to nine hospitals sub-Saharan Africa South Asia.
The Data-informed Stepped Care (DiSC) study is a cluster-randomized trial implemented in 24 HIV care clinics Kenya, aimed at improving retention for adolescents and youth living with (AYLHIV). DiSC multi-component intervention that assigns AYLHIV to different intensity (steps) of services according risk. We used the Framework Reporting Adaptations Modifications-Expanded (FRAME) characterize provider-identified adaptations implementation optimize uptake delivery, determine influence on outcomes.
Gaps in HIV RNA monitoring persist globally impeding the ability to determine clinical progress and outcomes. This study systematically evaluated provider (e.g., guideline non-adherence), system laboratory error) participant-level refusal) drivers of missed viral load (VL) measurements among people with Kenya. Adults aged 18–65 years were followed across five health facilities Kenya as part a trial (NCT#02338739) where was done routinely. Instances VL despite being indicated per Kenyan...
e16090 Background: Esophageal cancer (EC) is among the top five prevalent cancers in Africa, including at Jaramogi Oginga Odinga Training and Referral Hospital (JOOTRH). EC associated with poor prognosis data to inform improvements are limited. Furthermore, characteristics impact of high HIV prevalence region has not been studied. This study explores evaluates influence status on survival mortality risk. Methods: retrospective included all patients diagnosed receiving care JOOTRH Kisumu,...
1622 Background: Breast cancer and HIV/AIDS pose significant public health challenges. Women living with HIV face higher mortality rates when diagnosed breast than HIV-negative women. Although advancements in treatment have improved survival outcomes, limited evidence exists on the impact of outcomes low-resource settings. This study examines disparities between patients without HIV. Methods: We conducted a retrospective cohort at JOOTRH January 2013 September 2024. Data from paper-based...
e17539 Background: Cervical cancer is the leading cause of cancer-related deaths among Kenyan women, with 3,211 reported in 2023. Women HIV have a 4- to 5-fold higher risk cervical due compromised immunity. However, studies on survival outcomes patients by status remain limited Kenya. This study examines and associated factors at JOOTRH, comparing HIV-positive HIV-negative individuals. Methods: retrospective analyzed paper-based records women diagnosed JOOTRH (January 2013–December 2024)....
e22529 Background: Virus-associated cancers cause significant mortality in Africa. Understanding risk factors for is crucial effective prevention and treatment. We analyzed demographic clinical characteristics of people with virus-associated Kisumu County, western Kenya – a region high HIV prevalence 14.5% evaluated associated mortality. Methods: conducted retrospective cohort study adult patients who presented cancer care at Jaramogi Oginga Odinga Teaching Referral Hospital (JOOTRH) between...
Although health, development, and environment challenges are interconnected, evidence remains fractured across sectors due to methodological conceptual differences in research practice. Aligned methods needed support Sustainable Development Goal advances similar agendas. The Bridge Collaborative, an emergent research-practice collaboration, presents principles recommendations that help harmonize for generation use. Recommendations were generated the context of designing evaluating impact...
The COVID-19 pandemic resulted in disruptions to routine HIV services for youth living with (YLH), provoking rapid adaptation mitigate interruptions care. Adolescent Transition Adult Care HIV-infected adolescents (ATTACH) study (NCT03574129) was a hybrid I cluster randomized trial testing the effectiveness of healthcare worker (HCW)-delivered disclosure and transition intervention - Package (ATP). During pandemic, HCWs leveraged phone delivery ATP were supported make adaptations. We...
Systemic lupus erythematosus (SLE) patients frequently have high circulating tumor necrosis factor alpha (TNF- α ) levels. We explored TNF- levels in SLE families to determine whether of were clustered a heritable pattern. measured 242 patients, 361 unaffected family members, 23 spouses and 62 unrelated healthy controls. Familial correlations relative recurrence risk rates for the trait assessed. SLE-affected individuals had highest levels, was significantly higher first degree relatives...
Abstract Stigma about mental illness is a known barrier to engagement in health services. We conducted an online cross-sectional study, aiming estimate the associations between religiosity and stigma among Black adults ( n = 269, ages 18–65 years) United States. After adjusting for demographic factors (age, education, ethnicity), respondents with higher attendance at religious services or greater activities e.g. , prayer, meditation, Bible study) reported proximity people living problems...
Abstract Objectives Mortality during acute illness among children in low- and middle-income settings remain unacceptably high there is increasing recognition of the importance post-discharge mortality. A comprehensive understanding pathways underlying mortality acutely ill needed to develop interventions improve guidelines. We aimed determine incidence, timing contributions proximal exposures for young from admission hospital until 6 months after discharge sub-Saharan Africa South Asia...
Introduction: Gaps in HIV RNA monitoring persist globally impeding the ability to determine clinical progress and outcomes. This study systematically evaluated provider (e.g., guideline non-adherence), system laboratory error) patient-based refusal) drivers of missed viral load (VL) measurements among adults living with Kenya. Methods: Adults aged 18-65 years were followed across five health facilities Kenya as part a trial ((NCT#02338739) ) where was done routinely. Instances VL despite...
Abstract Background: The COVID-19 pandemic resulted in disruptions to routine HIV services for youth living with (YLH), provoking rapid adaptation mitigate interruptions care. Adolescent Transition Adult Care HIV-infected Adolescents (ATTACH) study (NCT03574129) was a hybrid I cluster randomized trial testing the effectiveness of healthcare worker-delivered disclosure and transition intervention – Package (ATP). During pandemic, HCWs leveraged phone delivery ATP were supported make...