DGHI Research News

When DGHI faculty are not in the classroom, they are collaborating with their colleagues across Duke and around the world.

Published January 28, 2014 under Research News


Access to clean water and economic benefit in less developed countries

In a new PLoS One publication, DGHI faculty member Marc Jeuland and colleagues outline country-level trends and projections for access to clean water, sanitation and hygiene, and associated mortality rates in less-developed nations as they experience economic growth. The analysis shows steady and substantial improvements in water, sanitation and hygiene, and economic benefits from lower mortality rates across many developing regions in East Asia and the Pacific, Latin America and the Caribbean, Eastern Europe and the Middle East. A high number of deaths related to poor water and sanitation continue across parts of South Asia and much of sub-Saharan Africa, and if those trends continue, researchers say it will be several decades before economic development and investments in improved water and sanitation will result in economic benefit.

What Indian rural villagers think of cook stoves

DGHI faculty members Subhrendu Pattanayak and Jeuland say people living in rural India are cautious, but generally interested in, new improved cook stove technologies. In a study published in the International Journal of Environmental Research and Public Health, researchers sought  to understand how people in Uttar Pradesh and Uttarakhand perceive these technologies and whether they would opt for using them in the future.  The study found that people generally believed that improved cook stoves are linked with health and time savings.  Factors that shaped their perceptions were education level, gender, prior experience with clean stoves and social norms. The team suggests that efforts to increase the use of clean stoves should involve a combination of supply-chain improvements, carefully designed social marketing and promotion campaigns and possible incentives.

Gender influences HIV medication adherence

Psychological distress and drug use can interfere with a patient’s ability to take HIV medication regularly. New research in AIDS Care by DGHI Doctoral Scholar Sarah Wilson and DGHI faculty member Kathleen Sikkema shows that gender could also influence medication adherence.  The study included more than 200 adults living with HIV/AIDS who have a history of childhood sexual abuse.  Researchers found that women, in particular, who used drugs to cope with their distress did not take their HIV medication as regularly. For men, distress and drug use did not significantly impact adherence. Researchers highlight the importance of addressing emotional distress and drug use within the context of HIV disease management, especially among women with abuse histories.

Race and ethnicity play role in physical disability

Nursing and DGHI faculty member Bei Wu published new research in the Journal of the American Geriatrics Society showing that overweight and obese Hispanics and blacks were much more likely to develop physical disability than whites in the same BMI categories. These physical impairments included having trouble with everyday activities like dressing, showering, eating and getting in and out of bed.  Wu and colleagues argue for more programs that promote weight control, prevention and exercise to reduce functional impairment, especially for blacks and Hispanics.

Mental health good predictor for high rates of unprotected sex

A new study in PLoS One involving several researchers at DGHI and the Center for Health Policy and Inequalities Research emphasizes the importance of mental health screening for managing HIV risk behaviors. Researchers Kathryn Whetten, Kristen Shirey, Nathan Thielman and Rachel Whetten found that changes in post-traumatic stress among Tanzanian adults with HIV were linked with changes in sexual transmission risk behaviors, like having more unprotected sex. The research team recommends more investment in mental health screening and intervention services for HIV patients, both to improve their mental health and support larger prevention efforts.

Malaria screening unsuccessful in some schools

New research by DGHI faculty member Liz Turner and colleagues at the London School of Hygiene and Tropical Medicine found that a school-based malaria screening and treatment program in rural coastal Kenya had no benefit on the health and education of school children.  Of the more than 5,000 children screened, 17 percent tested positive for malaria and receive antimalarial drugs. Over a two-year period, the team found no difference in anemia cases or the proportion of malaria diagnoses when comparing schools that had the program against other schools without it.

Forecasting future disease burden

Turner also published a new study in Statistics in Medicine that presents a new way to estimate the burden of a curable, non-recurring disease. The research focused on blindness due to eye cataracts, a leading cause of blindness globally but can be easily treated with surgery. The research team used data from a nationally representative sample of 10,000 people in Nigeria to test and evaluate a new statistical method for determining both the current diseases burden and also reliable estimates on future burden when there is limited historical data.

Eat now or later

A new study in Obesity by DGHI and Duke-NUS faculty member Eric Finkelstein is among the first to show the balance between the motivation to eat and ability to delay gratification as predictors of body mass index, or BMI. Women with lower BMIs found healthier, low-energy-density foods more gratifying and were able to wait for those. Higher BMIs were linked with high food reinforcement, or how hard someone will work for food, and a lack of strong alternatives. The research team suggests that reducing delay discounting, which is choosing the smaller immediate reward over the larger reward later, can help prevent obesity and improve the treatment of obesity.  An alternative approach is putting more emphasis on the future to influence how individuals make choices about food.