PhD
May 20, 2022
Understanding Enteric Dysfunction as a Determinant of Post-Discharge Pediatric Outcomes in Kenya and Pakistan.
Background: This dissertation aims to establish if enteric dysfunction appears to be an important interventional target for clinical trials hoping to reduce pediatric post-discharge mortality. We also aim to generate new knowledge regarding the pathophysiology of enteric dysfunction among acutely ill children, while validating previous observations from community cohorts. Finally, we will contribute to a…
Cadmium Burden and Blood Pressure
Background Hypertension, or high blood pressure (BP) affects 1 in 3 adults worldwide and is a leading cause of cardiovascular disease. A growing body of literature has implicated toxic heavy metals, such as cadmium (Cd), as contributors to higher BP and hypertensive disorders. Cd is extensively used in production of consumer products such as batteries,…
Structural Barriers to Continuity of HIV Care: Characterizing and Evaluating the Impact of Patient Discontinuation from AIDS Drug Assistance Programs
The Ryan White HIV/AIDS Drug Assistance programs (ADAPs) are the largest source of medical care for people living with HIV (PLWH) in the United States. They pay for insurance and medical care for 20% of people living with HIV in the United States, and people on the program have high rates of viral suppression, the…
Karibu na sirenji (Near the Syringe): Applying mixed methods to characterize the HIV risk environment and gender differences among persons who inject drugs in Nairobi, Kenya
In Kenya, people who inject drugs (PWID) are considered a key population that are disproportionately affected by the HIV and hepatitis C (HCV) epidemics, with prevalence estimates reaching upwards of 19-25% and 11-36%, respectively. Kenya’s national HIV program scale-up for key populations has resulted in significant reductions in HIV incidence among PWID, but service gaps…
Evaluating PrEP use and safety among women of reproductive age in sub-Saharan Africa
In sub-Saharan Africa, oral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) has emerged as an important HIV prevention strategy for women and is being scaled up rapidly in areas with high HIV burden. New, long-acting PrEP methods are also approaching introduction, including the dapivirine vaginal ring, which women can wear continuously and…
Making Sense of Brain Aging: Hearing and Visual Impairments, Ophthalmic Conditions, and Risk of Dementia in Older Adults
Background: Hearing and vision play an important role in physical, mental, and functional health. Less is known about the impact of deficits in hearing and vision, including dual sensory impairment (DSI), and causes of these sensory impairments on cognitive function. Objectives of this study were to examine risk of dementia associated with: (1) hearing and…
Genetics, Mammographic Density and Breast Cancer Risk
Mammographic, or breast density, describing breast tissue composition, is one of the strongest risk factors for breast cancer, the most common cancer type among women in the US. In general, women in the highest breast density quartile are estimated to have a three to five-fold higher risk of developing breast cancer, compared to those in…
May 16, 2022
Livestock and the epidemiology of sleeping sickness: mechanisms and implications
In recent decades, remarkable progress in the control of Human African trypanosomiasis (HAT)—a bloodborne protozoal parasite transmitted by the tsetse fly (Glossina species)— has led the WHO to set targets for elimination as public health problem (EPHP) by 2020, and elimination of transmission (EOT) by 2030. Global EPHP targets were met in 2018, however most…
Cervical cancer prevention in the context of abating HIV prevalence in Kenya
In 2020, the World Health Organization (WHO) launched an initiative to eliminate cervical cancer as a public health problem globally. While high-income countries are expected to achieve this goal in the coming decades, the timeline for elimination will be significantly longer for lower-resourced countries with high HIV burden. In low-and-middle income countries, HIV infection is…
Using Big Data to Improve Bacterial Sepsis Risk Stratification Among Immunocompromised Cancer Patients
Allogeneic hematopoietic stem cell transplant (HCT) recipients are an immunocompromised population that is disproportionately affected by sepsis, a life-threatening dysregulated immunologic response to an infection. While it is well established that early detection and treatment of sepsis with fluids and broad-spectrum antibiotics reduce the risk of mortality, recent data suggests early broad-spectrum antibiotic use in…
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