Faculty Contribute to the Science of Global Health

Global health challenges are complex and it takes sound research to begin to understand the problem from different perspectives, and then develop solutions and innovate. In the latest round-up of research news, DGHI faculty researchers uncover key findings across a variety of topics in global health, including infectious diseases, mental health, aging and violence. Learn more about DGHI’s research.

HIV

HIV testing preferences in Tanzania
In a new study in BMC Public Health, DGHI researchers Jan Ostermann, Nathan Thielman and Elizabeth Reddy found there are a variety of factors that could prevent people from seeking HIV counseling and testing in Tanzania. In earlier studies, they found that voluntary counseling and testing can be an effective prevention strategy and entry point for care. Despite the availability of testing options, these services are under-utilized in Tanzania and may not align well with the preferences of the community. Researchers found that community members are influenced by perceptions about confidentiality of the venue or counselor, accessibility of testing sites and to medicines, quality of tests and counseling, payment, and test accuracy at different venues.

Risk reduction program for newly HIV-diagnosed men who have sex with men
A new study in AIDS and Behavior found that integrating brief risk reduction approaches into HIV care can benefit newly-diagnosed men of who have sex with men. Led by DGHI researchers Kathleen Sikkema, Melissa Watt and Laurie Abler, the intervention recruited men three months after their diagnosis to either receive standard HIV support services through the health center or to take part in a three-session intervention over a nine-month period. Delivered by trained HIV counselors, the intervention focused on promoting a healthy lifestyle and positive attitudes toward risk reduction. Researchers found the men who participated in the intervention had less unprotected sex.

HIV risk reduction and eHealth intervention
A new study in Digital Culture and Education by DGHI faculty member Sara LeGrand found that a mobile app was useful in engaging men who have sex with men and transgender women who have sex with men. The website and cell phone app HealthMpowerment.org was well-received by study participants and shows promise for using behavior change and gaming theories to reduce risky sexual behaviors and build community. Men who have sex with men and transgender women who have sex with men are disproportionately at risk for HIV and other sexually-transmitted diseases.

Mental Health

Why pregnant South African women may drink
Women may drink alcohol as a way to cope with stress and negative emotions associated with pregnancy, according to new research by Melissa Watt and Kathleen Sikkema. The study published in Social Science and Medicine identified five factors that contribute to drinking during pregnancy in South Africa. In addition to coping with stress, researchers also found women drank as a way to maintain social connections, they may lack attachment to their pregnancy and can be driven physiologically by alcohol addiction. Also, social norms tend to support drinking during pregnancy.  Researchers suggest alcohol-serving venues are important sites to identify and target women at risk of drinking during pregnancy.

Links between psychological distress and alcohol use
Published in BMC Psychiatry, a new study by Laurie Abler, Kathleen Sikkema and Melissa Watt finds that addressing post-traumatic stress among South African women who drink may also be a way to reduce alcohol use. In the study of more than 500 women in a Cape Town township who frequented bars, increased alcohol use was linked with post-traumatic stress symptoms. Alcohol use was exacerbated among women experiencing symptoms of both post-traumatic stress and depression.

How generative leisure activities impact cognitive function
A new study published in the Journal of American Geriatrics Society by Joanna (Asia) Maselko, Truls Ostbye and Master of Science in Global Health alumnus Matthew Sebranek found that more frequent generative activities, activities that benefit future generations or society, were linked with higher levels of cognitive function.  These activities can include volunteering, babysitting, civic or political duties, participating in religious organization, or protecting the environment. Researchers suggest that programs involving these types of activities have promise for slowing cognitive decline among older adults. The study included more than 250 adults living in peri-urban or rural settings in southern Sri Lanka.          

Aging

Tooth loss among middle-aged and older Americans
Racial and ethnic disparities exist in trends of tooth loss among middle-aged and older adults, according to a new study published in Community Dentistry and Oral Epidemiology by DGHI faculty member Bei Wu. The research team found the prevalence of edentulism and missing teeth was higher among Blacks, older participants, the less educated and lower income individuals. Wu and colleagues argue for more interventions designed to improve oral health, particularly among those with a low-income.

Malaria

Factors influencing malaria control policy
Donor preferences and agendas are exerting too much influence on malaria policies in Kenya, Uganda and Tanzania, according to new research published in Malaria Journal by DGHI researchers Randall Kramer, Doctoral Scholar Chris Paul and Adriane Lesser. In country-specific questionnaires, it was also commonly reported that engagement of parliament was not given enough consideration in malaria decision-making. The researchers found various factors that influence decisions about specific malaria control strategies:  donor agendas, costs, effectiveness of interventions, health and environmental impacts, compliance and acceptance, financial sustainability, and vector resistance to insecticides. They suggest effective malaria control policy requires further engagement of government legislators and other policymakers.

Understanding malaria resistance in Africa and Asia
A new study in The Journal of Infectious Diseases  by DGHI affiliate Steve Taylor used molecular surveillance to test for artemisinin-resistant parasite populations in sub-Saharan Africa. Plasmodium falciparum is a parasite that causes malaria in humans, with the highest rates of complications and mortality. It’s been detected that these parasites are resistant to artemisinin, a standard treatment for malaria in Southeast Asia. In this study, researchers found various mutations, but not those that have been observed in Southeast Asia.

Child Health

Promoting breastfeeding in child care
Few states have regulations that meet breastfeeding standards, according to new research published in Maternal and Child Health Journal by DGHI faculty member Sara Benjamin Neelon and DGHI biostatistician Alyssa Platt. Researchers found that child care centers and homes in the majority of states across the US had less than one regulation on average that met the Caring for our Children recommendations set forth by The American Academy of Pediatrics. These regulations include general breastfeeding support, designated space for breastfeeding , introduction of solid foods no earlier than four months, and parental permission to feed infants formula. This is the first known study to examine the distribution and clustering of breastfeeding regulations across the US.

Violence

Measuring teenage violence
Former DGHI Visiting Scholar Monica Wijeratne and DGHI faculty Truls Ostbye and Catherine Lynch have developed a culturally-relevant and reliable tool to assess victimization and perpetration of peer violence among teenagers aged 13-15 in Sri Lankan and other South Asian schools.  Because violence is understood differently by different cultures and societies, the study published in BioMed Research International sought to define peer violence and develop an inventory of violence acts based on a literature review, focus groups and more. The Sri Lankan Early Teenagers’ Violence Inventory study was carried out among 1700 teens in the district of Gampaha across 28 schools with varying levels of violence. The tool can be used for early detection of high risk groups and tailored to address priority areas for violence prevention programs in schools.