PhD
November 24, 2020
Environmental Enteropathy and Fibroblast Growth Factor 21 are associated with early childhood growth in Bangladesh
Chronic undernutrition, marked by stunting (low height for age), is associated with increased child morbidity and mortality worldwide. Current intervention strategies are often ineffective at preventing or reversing stunting; while some children grow in response to nutrition programs, many do not. This dissertation aims to improve understanding of two major challenges in the prevention and…
Changing etiologies of childhood acute febrile illness: implications for management in an era of declining malaria
Background: Acute febrile illness (AFI) is a common syndrome among children presenting to a healthcare facility in resource-limited settings and a substantial contributor to childhood mortality. In sub-Saharan Africa, malaria has historically been a leading cause of childhood AFI but malaria incidence and mortality have declined dramatically over the past decade. At the same time,…
Gender Based Violence and HIV Risk: Mediating Pathways and Strategies for Prevention
The studies within this dissertation address gender-based violence (GBV) and its relationship with risk factors for HIV acquisition in African women. Women exposed to GBV have a higher risk of HIV infection, but the mechanisms for this association are not well understood, and the mechanisms may differ according to the patterns of violence experienced. Therefore,…
Using HIV Surveillance Data for Public Health Evaluations and Interventions: Common Challenges & Proposed Methodological Solutions
In the United States (U.S.), the purpose of HIV surveillance and related data systems is changing. Evolving programmatic priorities and complicated care needs of an aging population has led to greater demand for timely, accurate, and detailed data. My dissertation evaluates three prominent data systems: (1) National HIV Surveillance System (NHSS), (2) Medical Monitoring Project…
Lipopolysaccharide-binding protein, associated factors, and colorectal cancer
BACKGROUND – Recent research has pointed to a possible key role of gut microbial communities (GMC) in understanding the link between obesity, chronic inflammation, and the development of colorectal cancer (CRC) [1]. While some studies have demonstrated a strong association between obesity and circulating levels of lipopolysaccharide (LPS) [2-5], an endotoxin which is found on…
Evaluating the efficiency of community-based HIV testing and counseling strategies to decrease HIV burden in sub-Saharan Africa
Knowledge of one’s HIV status is vital to accessing treatment and prevention yet only a fraction of individuals in sub-Saharan Africa are regularly tested for HIV. Community-based HIV testing and counseling (HTC), defined as HTC conducted outside of a healthcare facility, has the potential to achieve high population testing coverage and linkage to care. The…
Implementation science to expand an mHealth intervention for improving retention in care for women living with HIV and their children
Introduction: The multi-step cascade of care for prevention of mother-to-child HIV transmission (PMTCT) paves the way to potentially eliminating mother-to-child HIV transmission; yet, it also lays the foundation for attrition and disengagement from care, increasing the risk of morbidity and mortality for both mother and child. We recently concluded a randomized controlled trial (RCT) in…
Antiretroviral Treatment as Prevention in African HIV-1 Serodiscordant Couples: Understanding the Challenges and Opportunities
The studies described in this dissertation examine the relationship between use of antiretroviral therapy (ART) and biologic and behavioral factors related to HIV-1 transmission risk in stable heterosexual HIV-1 serodiscordant African couples. ART is recommended for all HIV-1 infected persons, regardless of CD4 count, to reduce HIV-1 related morbidity, mortality and risk of transmission to…
Assessing the association between receipt of antimalarial drugs and adverse pregnancy outcomes using pooled data
Malaria is a major cause of maternal morbidity and mortality and neonatal death in areas of malaria transmission. Worldwide, it is responsible for up to 100,000 neonatal deaths and 10,000 maternal deaths annually. There is a need for better information on the safety of antimalarial drugs for women and their fetuses. Artemisinin-based combination therapies (ACT)…
Air Pollution and High Density Lipoprotein Structure and Function
BACKGROUND: A growing body of evidence suggests that air pollution is an important contributor to risk of cardiovascular disease. Federal regulatory agencies require evidence of the biological mechanisms explaining the relationship between air pollution and cardiovascular disease in order to inform regulatory policy. High density lipoproteins (HDL) are an important cardiovascular risk factor, and air…
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