PhD
November 24, 2020
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…
Escherichia coli O157:H7 Phylogenetics: Implications for Virulence and Disease Distribution
This dissertation uses phylogenetic classifications to investigate heterogeneity in the epidemiology of Shiga toxin-producing Escherichia coli (STEC) O157:H7, one of the top causes of foodborne illness and hospitalization. Isolates of a given phylogenetic lineage may express similar traits. Understanding differences between lineages may increase our understanding of STEC O157:H7 incidence and its progression to hemolytic…
Overcoming Barriers to HIV/STD Partner Services in Kenya and the United States
Increasing the proportion of people living with HIV and sexually transmitted diseases (STDs) who know their status is critical to curbing the HIV and STD epidemics. Partner services (PS) are a core public health strategy that test and treat or link to care the partners of individuals newly diagnosed with HIV or an STD (“index…
Non-Steroidal Anti-Inflammatory Drugs, Chronic Inflammation and Colorectal Cancer Risk
Substantial experimental and epidemiological evidence shows that long-term use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are protective against colorectal cancer (CRC). However, the underlying chemopreventive mechanisms of NSAIDs are not fully understood, and whether there are specific subgroups of the population for whom the benefits of NSAIDs clearly outweigh the risk remains unknown….
November 23, 2020
Severe Infection and Mortality in Kenyan Newborns
This dissertation addresses severe neonatal infection and neonatal mortality in high-burden settings. Worldwide, almost half of all deaths in children under 5 years of age occur in the neonatal period (days 0-27 of life). Complications of prematurity, intrapartum events and severe infections cause the majority of these deaths, despite known effective interventions. The risk of…
Pre-Diagnostic Genome-Wide DNA Methylation in Blood and Risk of Bladder Cancer
BACKGROUND Differential DNA methylation as measured in blood is a promising marker of bladder cancer susceptibility. In fact, established bladder cancer risk factors such as smoking and various germline genetic variants may promote carcinogenesis in bladder tissue through processes that are detectable as differential DNA methylation in blood. METHODS Genome-wide methylation was measured in pre-diagnostic…
November 19, 2020
Air Pollution, Change in Retinal Vascular Caliber, and Cellular Adhesion in the Multi-ethnic Study of Atherosclerosis (MESA)
Research strongly suggests an association between acute air pollution exposure and cardiovascular events, and there is growing evidence that long-term exposure to air pollution may be associated with cardiovascular disease development. Further research on possible biologic pathways relating air pollution and cardiovascular pathology is needed to support a causal relationship and provide evidence for stricter…
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