Author Interviews, Dermatology, Global Health, Infections, PLoS / 28.12.2018

MedicalResearch.com Interview with: Michael Marks MRCP DTM&H PhD Clinical Research Department, Faculty of Infectious & Tropical Diseases London School of Hygiene and Tropical Medicine Hospital for Tropical Diseases London, United Kingdom Twitter @dr_michaelmarks Daniel Engelman MBBS; BMedSci; MPHTM; FRACP; PhD Centre for International Child Health, University of Melbourne, Tropical Diseases Research Group Murdoch Children’s Research Institute Melbourne, Australia Twitter @Dan_Engelman                   MedicalResearch.com: What is the background for this study? MM: Scabies is extremely common. Globally in the region of 100-200 million people are believed to be affected by scabies annually. Recently the WHO has recognised Scabies as a ‘Neglected Tropical Disease’ in response to this burden of disease. There has been increasing interest in using Mass Drug Administration (treating whole communities) as a strategy to control scabies in communities. In order to make this practical countries need an easy mechanism for establishing if scabies is a significant problem in their communities. In general when treating an individual, clinicians would conduct a full body examination to diagnose scabies – however this may not be practical or necessary when making decisions about whether to treat whole communities. DE: Despite the fact that Scabies is a very common condition that causes a great deal of health problems, it has been largely neglected by health, research and funding agencies – but pleasingly, the WHO has now started to take action on scabies control, starting with the recognition of scabies as a "Neglected Tropical Disease" (more…)
Author Interviews, Global Health, Stroke / 26.12.2018

MedicalResearch.com Interview with: Gregory A. Roth MD MPH Assistant Professor, Medicine - Cardiology Adjunct Assistant Professor, Global Health Adjunct Assistant Professor, Health Metrics Sciences School of Public Health University of Washington Seattle, WA MedicalResearch.com: What is the background for this study? What are the main findings?   Response:  We found that globally, one in four people over age 25 is at risk for stroke during their lifetime. But we also found large geographic variation, including a nearly five-fold difference in lifetime stroke risk worldwide, with the highest risk in East Asia (38.8%), Central Europe (31.7%), and Eastern Europe (31.6%), and the lowest risk in eastern sub-Saharan Africa (11.8%). Chinese men and Latvian women had the world’s highest estimated lifetime stroke risk in 2016. The lifetime stroke risk on average for 25-year-olds in 2016 ranges from 8% to 39%, depending on the country in which they live. This is the first time a study has produced estimates of lifetime stroke risk starting at age 25, whereas previous studies begin at age 45. These findings suggest that adults need to think about their long-term health risks, including stroke, at a much younger age. Additionally, one’s risk of stroke over the course of your lifetime depends on where you live. Given the burden of stroke among adults is dependent on modifiable risk factors and the characteristics of health systems, our findings may be useful for long-term planning, especially in terms of prevention and public education.  (more…)
Author Interviews, Global Health, Heart Disease, JAMA, Pediatrics, Surgical Research / 17.11.2018

MedicalResearch.com Interview with: Marcelo G. Cardarelli, MD Inova Children’s Hospita Fairfax, Falls Church, Virginia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Global Humanitarian Medical efforts consume a large amount of resources (nearly $38B in 2016) and donors (Countries, International organizations, WHO, Individuals) make the decisions as to where their funds should be allocated based on cost-effectiveness studies. Most resources go to prevent/treat infectious diseases, sanitation efforts and maternal/child care issues. An insignificant amount of resources is directed to satisfy the surgical needs of the populations in low and middle income countries (LMICs). The idea behind our project was to find out if it was cost-effective to perform a tertiary surgical specialty (pediatric cardiac surgery) in this context and the answer (at $171 per DALY averted) was an overwhelming yes! But most importantly, we believe, as many others do, that judging the cost/effectiveness of an intervention in order to decide resources allocation is valid for diseases that can be prevented, but not relevant when it comes to surgical problems that are not preventable. Instead, we propose the use of another measure of effectiveness, what we call "The Humanitarian Footprint". The Humanitarian Footprint represents the long term benefits, as measured by changes in the life expectancy, extra years of schooling and potential lifetime earnings of patients treated surgically during humanitarian interventions. To our surprise and based on the results, the effects on society of at least this particular surgical intervention were greater than we expected. We suspect this measure can be used in many other surgical humanitarian interventions as well.  (more…)
Author Interviews, BMJ, Global Health, Pediatrics / 07.11.2018

MedicalResearch.com Interview with: Professor Ngianga-Bakwin Kandala Professor of Biostatistics Department: Mathematics, Physics and Electrical Engineering Northumbria University, UKProfessor Ngianga-Bakwin Kandala Professor of Biostatistics Department: Mathematics, Physics and Electrical Engineering Northumbria University, UK  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The background “UNICEF (2014) estimates that worldwide more than two hundred million women have undergone some form of FGM/C, and approximately 3.3 million girls are cut each year. Recent estimates show that if FGM/C practices continue at current, 68 million girls will be cut between 2015 and 2030 in 25 countries where FGM is routinely practiced and more recent data are available (UNJP, 2018).” Main findings: The prevalence of FGM/C among children varied greatly between countries and regions and also within countries over the survey periods. We found evidence of significant decline in the prevalence of FGM/C in the last three decades among children aged 0–14 years in most of the countries and regions, particularly in East, North and West Africa. We show that the picture looks different in Western Asia, where the practice remains and affects the same age group. (more…)
Author Interviews, Global Health, Hospital Acquired, Infections, Lancet / 07.11.2018

MedicalResearch.com Interview with: "Antibiotics" by Michael Mortensen is licensed under CC BY-SA 2.0Dr Alessandro Cassini MD Epidemiologist, European Centre for Disease Prevention and Control Solna, Sweden MedicalResearch.com: What is the background for this study? Response: We published an ECDC study estimating attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the European Union and the European Economic Area (EU/EEA). This study is based on 2015 data from the European Antimicrobial Resistance Surveillance Network (EARS-Net). The study was developed by experts at ECDC and the Burden of AMR Collaborative Group, and published in The Lancet Infectious Diseases. (more…)
Author Interviews, CMAJ, Geriatrics, Global Health / 05.11.2018

MedicalResearch.com Interview with: "Drapeau au Parlement du Canada" by abdallahh is licensed under CC BY 2.0Dr. Justin Lang, PhD Research Analyst, Public Health Agency of Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is based on the Global Burden of Disease Study, which is led by the Institute of Health Metrics at the University of Washington. In this study, we present estimates from the Global Burden of Disease Study to describe the major causes of health loss among Canadians, and how these have changed from 1990 to 2016. In 2016, cancers, cardiovascular diseases, musculoskeletal disorders, and mental and substance use disorders, combined, resulted in over half of the total health loss among Canadians as measured by disability adjusted life years. Disability-adjusted life years is a measure that combines both mortality, through years of life lost, and morbidity, through years lived with disability, into a single measure that allows us to compare health loss from different causes using the same metric. The all-cause age-standardized years of life lost rate declined 12% between 2006 and 2016, while the all-cause age-standardized years lived with disability rate remained stable (+1%) and the all-cause age-standardized disability-adjusted life year rate declined by 5%. Finally, between 1990 and 2016, there has been a shift in what contributes to health loss in Canada from premature mortality to disability. In 1990, 45% of total all-cause disability-adjusted life years were due to years lived with disability. By 2016, this proportion grew to 52%.  (more…)
Author Interviews, Cost of Health Care, Global Health, Infections, Vaccine Studies / 13.09.2018

MedicalResearch.com Interview with: Veronica Toffolutti PhD Research Fellow in Health Economics Bocconi University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Austerity has been linked to several health damaging effects such as suicides, increase in unmet needs, disease outbreaks that affect vulnerable peoples such as malaria in Greece, HIV in Greece and Romania during the current economic crises or in the earlier economic crisis cuts in public health expenditure have been linked with diphtheria and TB. Europe is experiencing declining vaccination rates and resurgences in measles incidence rates. Italy appears to be particularly affected reporting the second largest number, second to Romania, of infection in Europe in 2017. Starting from the point that the primary reason for the outbreak in the decline in the measles vaccination we test the hypothesis that large budget reductions in public health spending were also a contributing factor. Using data on 20 Italian regions for the period 2000-2014 we found that each 1% reduction in the real per capita public health expenditure was associated with a decrease of 0.5 percentage points (95% CI: 0.36-0.65 percentage points) in MMR coverage, after adjusting for time and regional-specific time-trends.  (more…)
Author Interviews, Global Health, JAMA, Pediatrics / 13.08.2018

MedicalResearch.com Interview with: Chunling Lu, PhD Director, Program in Global Health Economics and Social Change Assistant Professor in Global Health and Social Medicine Division of Global Health Equity, Brigham and Women's Hospital Department of Global Health and Social Medicine, Harvard Medical School Harvard Center for Population and Development Studies Institute for Quantitative Social Science, Harvard University Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Today, we have the largest generation of youth (10-24 years) in human history (1·8 billion) and about 90% of them live in low- and middle-income countries.  Healthy growth and learning during the adolescent years underpins future population health and productivity. The importance of adolescent health has now been recognized with the inclusion of adolescents in the 2015 Every Woman, Every Child agenda through the Global Strategy for Women’s Children’s and Adolescents’ Health. A capacity to finance health care has underpinned progress in most areas of health. In poorer countries much of that financing comes from global donors. As little is known about donors’ contribution to adolescent health, our study fills in that knowledge gap by assessing how much development assistance has been disbursed to projects for adolescent health in 132 developing countries between 2003 and 2015. We found that donors’ contribution to the projects targeting adolescent health cumulatively accounted for only 1.6% of development assistance for health. Among the top 10 leading causes of disability adjusted life years (DALYs) in adolescents, sexual, reproductive health and HIV/AIDS received the largest donors’ contribution (approximately 68% during the study period), followed by interpersonal violence, tuberculosis, and diarrheal diseases. Other major causes of disease burden, including anemia, road injuries, and depressive disorders, have been largely overlooked by donors.  (more…)
Author Interviews, Global Health, HIV / 25.07.2018

MedicalResearch.com Interview with: Professor Donna Spiegelman ScD Susan Dwight Bliss Professor of Biostatistics Director, Center for Methods in Implementation and Prevention Science (CMIPS)­­­­­­, Yale School of Public Health Professor, Department of Statistics and Data Science, Yale University Director, Interdisciplinary Methods Core, Center for Interdisciplinary Research on AIDS Yale School of Medicine MedicalResearch.com: What is the background for this study? Response: HIV infections can be transmitted from mothers to their infants during pregnancy, childbirth, and  breastfeeding.  Without access to a package of health services that includes antiretroviral medicines and counseling on best breastfeeding practices, it is estimated that 25% of children born to HIV-positive mothers become infected with HIV.In low-resource settings, 50% of these children die before their second birthday. A 32% increase in under-five mortality between 1988 and 2003 prompted the Kenyan government to establish Prevention of Mother to Child Transmission of HIV (PMTCT) programs in over 10,000 health facilities. This achievement was supported by U.S.President’s Emergency Fund for AIDS Relief (PEPFAR), the which contributed over $248 million to PMTCT programs in Kenya between 2004 and 2014. Although this investments in PMTCT coincided with a remarkable halving of Kenya’s under-five mortality rate, it is unknown whether this improvement can be causally attributed to PEPFAR funding for PMTCT. During the 2000s, child mortality decreased across most of sub-Saharan African countries.  These regional trends, rather than PEPFAR funding, may explain all or part of Kenya’s reduction in over 10,000 in child mortality. To help identify whether PEPFAR’s investments in PMTCT made a causal contribution to this reduction in child mortality, we used statistical methods to assess whether the amount or “dose” of PEPFAR funding provided to different provinces in Kenya was associated with increased HIV testing among pregnant women, which is a critical first step in identifying which women need PMTCT, and reduced infant mortality in Kenya. (more…)
Author Interviews, Global Health, Infections / 12.06.2018

MedicalResearch.com Interview with: “Cholera Hospital 3” by Mark Knobil is licensed under CC BY 2.0Dr. Daihai He Assistant Professor Department of Applied Mathematics Hong Kong Polytechnic University   MedicalResearch.com: What is the background for this study? What are the main findings? Response: A large-scale cholera outbreak hit Yemen in 2017-2018 and caused an estimated 1,100,720 suspected cases and 2291 associated deaths between 27 April 2017 and 20 May 2018, thus a case fatality ratio 0.21%. (more…)
Author Interviews, Global Health, JAMA, Leukemia / 21.05.2018

MedicalResearch.com Interview with: Andrew J. Cowan, MD Seattle Cancer Care Alliance Division of Medical Oncology University of Washington, Seattle MedicalResearch.com: What is the background for this study? What are the main findings?   Response: Multiple myeloma (MM) is a plasma cell neoplasm with substantial morbidity and mortality. A comprehensive description of the global burden of multiple myeloma is needed to help direct health policy, resource allocation, research, and patient care. Myeloma cases and deaths increased from 1990 to 2016, with middle-income countries contributing the most to this increase. Treatment availability is very limited in countries with low socioeconomic development. (more…)
Author Interviews, Global Health, JAMA, Pulmonary Disease, Technology / 15.05.2018

MedicalResearch.com Interview with: Michael Hawkes MD PhD Adjunct Professor Assistant Professor Pediatrics, Faculty of Medicine School of Public Health University of Alberta MedicalResearch.com: What is the background for this study? What are the main findings?
  • Pneumonia is the leading cause of mortality in children globally.
  • Oxygen is an essential therapy for children with hypoxemic pneumonia, but is not available in many resource-limited and rural areas.
  • Our innovation, solar powered oxygen delivery, harnesses freely available sun and air to delivery oxygen to patients independent of grid electricity.
  • We performed a randomized controlled trial of solar powered oxygen delivery, compared to standard oxygen delivery using compressed oxygen cylinders in children with hypoxemia hospitalized at two centres in Uganda.
  • Solar powered oxygen was non-inferior to cylinder oxygen with respect to clinical outcomes, and offers advantages in terms of reliability, simplicity, and cost.
(more…)
Author Interviews, BMJ, Global Health, Pediatrics, Vitamin D, Weight Research / 04.05.2018

MedicalResearch.com Interview with: Dr Javeria Saleem PhD Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry Queen Mary University of London London, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: Severe acute malnutrition is the most extreme and visible form of undernutrition. Affected children have very low weight for their height and severe muscle wasting; they may also have swollen feet, face and limbs. Around 20 million children suffer from severe acute malnutrition worldwide of whom an estimated 1.4 million live in Pakistan. The condition is a major cause of death in children under 5 in Asia and Africa. The standard treatment is to give a high-energy, micronutrient enhanced paste called ready-to-use therapeutic food (RUTF). Vitamin D deficiency has been reported to be a risk factor for severe wasting in children with severe acute malnutrition Ready-to-use therapeutic food contains relatively modest amounts of vitamin D. However, the effects of adding high-dose vitamin D to this standard treatment have not previously been evaluated. We therefore did a clinical trial to assess whether high-dose vitamin D hastened recovery in 185 children aged 6-58 months who were receiving standard treatment for severe acute malnutrition in Southern Punjab, Pakistan. The 93 children in the active arm of the study received two doses of 5 mg vitamin D by mouth, while the 92 children in the control arm received placebo (a dummy medicine containing no vitamin D). Our findings were very striking: after 2 months of treatment, the children who received high-dose vitamin D in addition to standard therapy had significantly better weight gain, and significantly better motor and language development, than those who received standard treatment alone. (more…)
Author Interviews, Global Health, Infections, Pediatrics / 10.04.2018

MedicalResearch.com Interview with: Georgies Mgode PhD Sokoine University of Agriculture Pest Management Centre African Centre of Excellence for Innovative Rodent Pest Management and Biosensor Technology Development Morogoro, Tanzania MedicalResearch.com: What is the background for this study? Response: The background of this study is the APOPO and Sokoine University of Agriculture together with NIMR and NTLP interest to explore a cheap, reliable and sustainable means of addressing TB problem in high-burden countries with limited access to advanced sensitive tests. This refers to countries where to-date TB diagnosis is mainly by microscopy that is less sensitive leaving majority of patients undetected. We were driven to explore how these rats can contribute to diagnosis of TB in children that is known to be difficult and rats are known to have a better and advanced sense of smell. According to WHO " an estimated 1 million children became ill with TB and 250 000 children died of TB in 2016 and the actual burden of TB in children is likely higher given the challenge in diagnosing childhood TB.  (more…)
Author Interviews, Global Health, Weight Research / 27.03.2018

MedicalResearch.com Interview with:

Pepita Barlow, MSc, Department of Sociology University of Oxford, Manor Road Building, Manor Road, Oxford, United Kingdom 

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: The escalating global prevalence of overweight and obesity, or “globesity,” is often described as a pandemic. Globalization via free trade agreements (FTAs) with the US has been implicated in this pandemic because of its role in spreading high-calorie diets rich in salt, sugar, and fat through the reduction of trade barriers like tariffs in the food and beverage sector.  

We used a “natural experiment” design (that mimics a randomized controlled trial as closely as possible) and data from the United Nations Food and Agricultural Office to evaluate the impact of the 1989 Canada-US Free Trade Agreement on caloric availability in Canada (CUSFTA).  

We found that CUSFTA was associated with an increase in caloric availability and likely intake of approximately 170 kilocalories per person per day in Canada. Additional models showed that this rise in caloric intake can contribute to weight gain of between 1.8-9.3 kg for men and 2.0-12.2 kg for women aged 40, depending on their physical activity levels and the extent to which availability affects caloric intake.  (more…)

Author Interviews, Global Health, JAMA, Pediatrics / 26.03.2018

MedicalResearch.com Interview with: Professor Jeffrey Braithwaite, PhD Dr. Braithwaite is founding director of the Australian Institute of Health Innovation at Macquarie University and Chief Investigator of the just-published CareTrack Kids Study the largest study of the quality of care to children ever undertaken. MedicalResearch.com: What is the background for this study?   Response: While seeking to improve health outcomes for patients, there has been substantial investment in developing clinical practice guidelines, to support the delivery of evidence-based healthcare. Prior to the CareTrack Kids study, little was known about the level of adherence to clinical practice guidelines for the care of Australian children. Our study examined care provided to children under 16 years of age treated for 17 important clinical conditions, such as asthma or fever, to assess adherence to these guidelines. We surveyed over 6500 medical records in four clinical settings (general practices; paediatricians offices; hospital emergency departments; and hospital inpatient wards) in South Australia, New South Wales and Queensland, and assessed visits during 2012 and 2013.  (more…)
Author Interviews, Dermatology, Global Health, NEJM, Zika / 15.03.2018

MedicalResearch.com Interview with: Professor Bruno Hoen, M.D., Ph.D Dept of Infectious Diseases, Dermatology, and Internal Medicine University Medical Center of Guadeloupe  MedicalResearch.com: What is the background for this study? Response: Zika virus (ZIKV) infection during pregnancy has been identified only recently to cause severe birth defects, including microcephaly, other brain defects, and the congenital Zika syndrome. However, the magnitude of this risk was not clearly defined, with discrepancies between observational data from Brazil and the U.S. Zika Pregnancy Registry. We implemented a cohort study of pregnant women who have been exposed to ZIKV throughout the outbreak that hit the Caribbean in 2016. (more…)
Aging, Author Interviews, BMJ, Cost of Health Care, Global Health / 11.02.2018

MedicalResearch.com Interview with: Dr Grace Sum Chi-En National University of Singapore MedicalResearch.com: What is the background for this study? Response: Chronic diseases are conditions that are not infectious and are usually long-term, such as diabetes, hypertension, cancer, chronic lung disease, asthma, arthritis, stroke, obesity, and depression. They are also known as non-communicable diseases (NCDs). Multimorbidity, is a term we use in our field, to mean the presence of two or more NCDs. Multimorbidity is a costly and complex challenge for health systems globally. With the ageing population, more people in the world will suffer from multiple chronic diseases. Patients with multimorbidity tend to need many medicines, and this incurs high levels of out-of-pocket expenditures, simply known as cost not covered by insurance. Even the United Nations and World Health organisation are recognising NCDs as being an important issue. Governments will meet in New York for the United Nations 3rd high-level meeting on chronic diseases in 2018. Global leaders need to work towards reducing the burden of having multiple chronic conditions and providing financial protection to those suffering multimorbidity. Our research aimed to conduct a high-quality systematic review on multimorbidity and out-of-pocket expenditure on medicines.  (more…)
Author Interviews, Environmental Risks, Global Health / 06.11.2017

MedicalResearch.com Interview with: “air pollution, beijing” by 大杨 is licensed under CC BY 2.0Longjian Liu, M.D., Ph.D. MSc (LSHTM), FAHA Associate Professor Department of Epidemiology and Biostatistics Dornsife School of Public Health, and Adjunct Associate Professor, College of Medicine Drexel University Nesbitt Hall-RM515, 3215 Market ST Philadelphia PA, 19104  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is an international collaborative project, supported by Drexel Office of International Programs, and Chinese Academy of Sciences. The main findings are air pollution has posted a serious public health issue in China, specifically in urban cities. MedicalResearch.com: What should clinicians and patients take away from your report? Response: Air pollution is an international issue, we must take action, specifically in developing counties with rapid urbanization, like China.   (more…)
Author Interviews, Environmental Risks, Global Health / 20.10.2017

MedicalResearch.com Interview with: Philip J. Landrigan, MD, MSc, FAAP Dean for Global Health Professor of Preventive Medicine and Pediatrics Arnhold Institute for Global Health Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? What are the main findings?
  1.  Pollution is the largest environmental cause of disease and premature death in the world today.  It is responsible for 9 million deaths per year – 16% of all deaths worldwide – three times more deaths than AIDS, malaria and TB combined.  These numbers are growing from year to year as pollution in many parts of the world increase.
  2. Pollution is highly unjust. 92% of all pollution-related deaths occur in low-and middle- income countries, and in the United States and other high-income countries pollution-related disease and death are concentrated among minorities and the poor.  Think Flint.
  3. Pollution is very costly.  Pollution-related diseases cause productivity losses that reduce GDP in low- and middle-income countries by up to 2% per year. Pollution-related disease also results in health-care costs that are responsible for 1.7% of annual health spending in high-income countries like the US and for up to 7% of health spending in heavily polluted and rapidly developing low- and middle-income countries.
  4. Pollution is neglected and its control is seriously underfunded.
  5. The good news is that despite its great magnitude and long-standing neglect, pollution can be controlled, and pollution prevention is highly cost-effective. Pollution is not the inevitable consequence of economic development. High-income and some middle-income countries have enacted legislation and issued regulations mandating clean air and clean water, established chemical safety policies, and curbed their most flagrant forms of pollution. As a result, our air and water are now cleaner, the blood lead concentrations of our children have decreased by more than 90%, our rivers no longer catch fire, our worst hazardous waste sites have been remediated, and many of our cities are less polluted and more livable. Health has improved and people are living longer. High-income countries have achieved this progress while increasing GDP by nearly 250%. The claim that pollution control stifles economic growth, kills jobs and drags down the economy is false and has repeatedly been proven to be untrue. Pollution control is a winnable battle, and the control of pollution will return billions of dollars to the economies of countries around the world as it has already in the United States.
(more…)
Author Interviews, Gastrointestinal Disease, Global Health, Lancet / 18.10.2017

MedicalResearch.com Interview with: Gilaad Kaplan, MD, MPH, FRCPC Associate Professor CIHR New Investigator & AI-HS Population Health Investigator Co-Director, Environmental Health Research Group Snyder Institute for Chronic Diseases & Institute of Public Health Departments of Medicine & Community Health Sciences University of Calgary MedicalResearch.com: What is the background for this study? What are the main findings? Response: The aim of the study was to provide a global perspective on the epidemiology of the inflammatory bowel diseases in the 21st century. During the 20th century IBD was considered a disease of the Western world. At the turn of the 21st century, IBD has become a global disease with accelerating number of cases in the developing world as it transition towards a westernized society. (more…)
Author Interviews, Global Health, Infections, Pediatrics / 19.06.2017

MedicalResearch.com Interview with: Aleksandra Jakubowski, MPH PhD candidate Department of Health Policy and Management Gillings School of Global Public Health University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? Response: The US President’s Malaria Initiative (PMI) provides approximately $600 million annually to fund implementation of key evidence-based malaria prevention and treatment interventions, including insecticide treated nets (ITNs), artemisinin-based combination therapy (ACT), and indoor residual spraying (IRS) to populations in 19 recipient countries in sub-Saharan Africa (SSA). Despite this considerable investment, no study to date has evaluated the impact of PMI on population health outcomes. Previous evaluations have noted improved health outcomes in PMI countries, but comparison groups are needed to establish whether these changes were beyond the declining trends in mortality observed in the rest of the region. Our study sought to generate objective evidence for policy makers about the role this US-funded malaria aid program may have played in curbing child mortality in SSA. We used a quasi-experimental design known as difference-in-differences to compare trends in health outcomes in PMI-recipient vs. PMI non-recipient countries. We analyzed publicly-available data from 32 countries in SSA spanning a period that included about ten years before and after the introduction of the program. (more…)
Author Interviews, Global Health, Heart Disease / 03.05.2017

MedicalResearch.com Interview with: Hisham Dokainish, M.D., FRCPC, FASE, FACC Associate Professor of Medicine, McMaster University Principal Investigator, Population Health Research Insitute Director of Heart Failure Services, Director of Medical Diagnostic Units & Echocardiography, Hamilton Health Sciences Hamilton, ON, Canada MedicalResearch.com: What is the background for this study? Response: Most data on mortality and prognostic factors in patients with heart failure come from North America and Europe, with little information from other regions of the world, particularly from low and middle income countries. MedicalResearch.com: What are the main findings? Response: We enrolled 5823 patients within 1 year (with 98% follow-up). Overall mortality was 16·5%: highest in Africa (34%) and India (23%), intermediate in southeast Asia (15%), and lowest in China (7%), South America (9%), and the Middle East (9%). These large regional differences in mortality persisted after multivariable adjustment for demographic, clinical, medication and socioeconomic variables. About half of the mortality risk was explained by multivariable modeling with these variables; however, the remainder was unexplained. (more…)
Author Interviews, CDC, Global Health, Vaccine Studies / 10.04.2017

MedicalResearch.com Interview with: Deborah Lee, MPH Division of Global Migration and Quarantine Centers for Disease Control and Prevention, Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to assess whether documentation for vaccines provided to refugees overseas was received by clinicians in the US and if doses of measles-mumps-rubella (MMR) vaccine were integrated into the vaccine schedule as recommended for adults and children by the US Advisory Committee on Immunization Practices. CDC recommends that US-bound refugees receive vaccinations prior to arrival in the United States. Vaccinations are documented on the Vaccination Documentation Worksheet (DS-3025), which refugees bring with them to the United States, and made available to state and local refugee health programs through CDC’s Electronic Disease Notification (EDN) system. Thirty to 90 days after arrival, most refugees have a post-arrival health assessment performed by clinicians affiliated with the state and local refugee health programs. Our assessment indicated that most refugees had overseas vaccination documentation available at the post-arrival health assessments (87%), and that MMR vaccine was given when needed (83%). Furthermore, many refugees (90%) in our assessment did not require an additional MMR dose because they had received vaccination before entering the United States. (more…)
Author Interviews, Global Health, JAMA, Pediatrics / 06.04.2017

MedicalResearch.com Interview with: Dr. Nicholas Kassebaum, MD Assistant Professor Institute for Health Metrics and Evaluation University of Washington MedicalResearch.com: What is the background for this study? Response: Reducing deaths of young children has been an international priority over the past few decades, and much progress has been made in this regard. Comprehensive and timely measurement of death and disease burden among children and adolescents is essential for improving the health of young people. Analyzing the latest estimates from the Global Burden of Disease (GBD), the current study quantifies and describes levels and trends of mortality and disease burden among children and adolescents under the age of 19 from 1990 to 2015. (more…)
Author Interviews, Global Health, Infections / 02.04.2017

MedicalResearch.com Interview with: Dr Mihály Sulyok MD Eberhard Karls University Institute of Tropical Medicine, Tübingen, Germany MedicalResearch.com: What is the background for this study? What are the main findings? Response: New antimalarials are desperately needed, not just for treatment, but also for prophylaxis. DSM265, a novel antimalarial compound that selectively inhibits the plasmodial dihydroorotate dehydrogenase has a promising pharmacokinetic profile characterized by a long elimination half-life. We performed a study at the Institute of Tropical Medicine, Eberhard Karls University (Tübingen, Germany) to investigate safety, tolerability and efficacy of DSM265 using controlled human malaria infection. In the first cohort, 400mg of DSM265 was administered orally to five healthy, malaria naive individuals one day before direct venous inoculation of an established infective dose of P. falciparum sporozoites (PfSPZ Challenge). Placebo was administered to two volunteers. The study was randomized and double blinded. In this cohort all placebo participants developed malaria, whereas all DSM265 participants were protected. In a second cohort, 400mg DSM265 was administered 7 days before the sporozoite inoculation for six participants, two participants recieved placebo. In this cohort, the two placebo and three of six DSM265 volunteers developed thick blood smear positive malaria. The remaining three DSM265 volunteers developed transient submicroscopic parasitemia without symptoms or thick blood smear positivity. The only possible DSM265-related adverse event was a slight transient elevation in serum bilirubin in one volunteer. The study was funded by the Global Health Innovative Technology Fund, Wellcome Trust, Bill & Melinda Gates Foundation through Medicines for Malaria Venture, and the German Center for Infection Research. (more…)
Author Interviews, Columbia, Global Health, Schizophrenia / 16.03.2017

MedicalResearch.com Interview with: L. H. Lumey, MD, PhD Professor of Epidemiology Mailman School of Public Health Columbia University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Chinese Great Leap Forward Famine in 1959-1961 is the largest famine in human history. Earlier studies have reported that overweight, type 2 diabetes, hyperglycemia, the metabolic syndrome and schizophrenia were more common among adults who were exposed to the famine. Our re-analysis of all previous studies shows no increases in diabetes, high blood pressure and other chronic conditions among famine births except for schizophrenia. (more…)
Author Interviews, Dermatology, Global Health, JAMA / 07.03.2017

MedicalResearch.com Interview with: Chante Karimkhani, MD University Hospitals Case Western Medical Center, Cleveland, Ohio now with Department of Dermatology University of Colorado, Denver MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ranging from benign inflammatory to infectious, autoimmune, and malignant conditions, skin diseases cause significant disfigurement, pain, and psychological morbidity. The Global Burden of Disease (GBD) Study 2013 is a large-scale epidemiological assessment of burden from 306 diseases in 195 countries, both sexes, and 14 age groups. Disease burden is measured by combining morbidity and mortality into a single metric of disability-adjusted life years (DALYs), where one DALY is equivalent to one year of healthy life lost. Skin diseases contributed 1.79% of the total global burden from all diseases. The skin diseases arranged in order of decreasing global DALYs are: dermatitis (atopic, contact, seborrheic), acne vulgaris, urticaria, psoriasis, viral skin diseases, fungal skin diseases, fungal skin diseases, scabies, melanoma, pyoderma, cellulitis, keratinocyte carcinoma (basal and squamous cell carcinomas), decubitus ulcer, and alopecia areata. Younger populations had the greatest burden from infectious skin conditions, while acne caused the greatest burden in the second and third decades of life. Elderly populations had the greatest DALY rates from melanoma and keratinocyte carcinoma. Skin conditions also exhibit distinct geographical patterns of disease burden. (more…)
Author Interviews, Environmental Risks, Global Health / 01.03.2017

MedicalResearch.com Interview with: Dr. Meiyun Lin PhD Research  Scholar NOAA and Princeton University’s Cooperative Institute for Climate Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ground-level ozone, also known as smog, has climbed in the rural West over the past 25 years, even in such seemingly pristine places as Yellowstone National Park. We have found out why – and why cutting our own output of smog-forming chemicals such as nitrogen oxides by 50% hasn’t helped. This study found that increased pollution from Asia, which has tripled its nitrogen oxide emissions since 1990, contribute to the persistence of smog in the West. While ozone in the eastern U.S. has decreased overall, the levels can spike during heat waves, characterized by large-scale air stagnation, warm temperatures, and plentiful radiation needed for ozone formation locally. As heat waves appears to be on the rise due to global climate change, progress in reducing smog in the eastern US is likely to be slower in the coming decades. (more…)
Author Interviews, Global Health, HIV, Lancet / 19.02.2017

MedicalResearch.com Interview with: Jennifer A. Downs, M.D., Ph.D. Assistant Professor of Medicine and Microbiology & Immunology Department of Medicine Weill Cornell Medicine Center for Global Health New York, NY 10065 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Between 2002 and 2006, three large randomized controlled trials in sub-Saharan Africa demonstrated that male circumcision reduces new HIV infections in men by approximately 60%. Based on these findings, the World Health Organization recommended male circumcision as an HIV prevention strategy in countries with high levels of HIV and a low prevalence of male circumcision. This led to prioritization of 14 countries in Eastern and Southern Africa for massive scale-up of male circumcision beginning in 2011. In many of these countries, the uptake of male circumcision was lower than expected. In northwest Tanzania, where we work, there are a number of barriers to male circumcision. Some of these barriers are cultural, tribal, economic, and religious. We conducted focus group interviews in 2012 that showed that many Christian church leaders and church attenders in our region in Tanzania had major concerns about whether male circumcision was compatible with their religious beliefs. This led us to hypothesize that the uptake of male circumcision could be increased when religious leaders were taught about male circumcision, with the goal that they would then be equipped to discuss this issue with their congregations. (more…)