Serogroup B meningococcal disease (MenB) causes almost 60% of meningitis cases among adolescents ... more Serogroup B meningococcal disease (MenB) causes almost 60% of meningitis cases among adolescents and young adults. Yet, MenB vaccine coverage among adolescents remains below 10%. Since parents are the primary medical decision makers for adolescents, we examined MenB vaccination rates and parent attitudes about meningitis and the MenB vaccine. In 2018, in conjunction with a county-wide, school-based immunization campaign, we conducted a mixed methods study among parents of 16- to 17-year-olds. We facilitated focus groups asking parents about their knowledge of meningitis and reactions to educational materials and sent behavioral surveys based on Health Belief Model constructs to parents through the county high school system. Parents in three focus groups (n = 8; participation rate = 13%) expressed confusion about their child’s need to receive the MenB vaccine in addition to the meningococcal conjugate vaccine (MenACWY), but conveyed strong trust in their physicians’ recommendation. A...
Abstract: The objective of this study was to examine child, mother, and environmental factors ass... more Abstract: The objective of this study was to examine child, mother, and environmental factors associated with undernutrition in children less than five years old in a Maya community in Yucatan, Mexico. This investigation was designed as a case-control study. All cases (n=42) of undernutrition were included, and a sample of 52 controls was randomly selected from the study population. The frequency of investigated exposure factors was compared between cases and controls by using logistic regression. Undernutrition was associated with child’s age (> 36 months old; OR = 3.53; 95 % CI = 1.04, 18.40) and mother’s marital status (married; OR = 0.29; 95 % CI = 0.09, 0.90). The odds of undernutrition were 2.81 times higher in children infected with Giardia spp, but this association was not significant (P = 0.18) after controlling for child’s age and mother’s marital status. In conclusion, child’s age and mother’s marital status were associated with child undernutrition in study subjects. ...
Poverty alleviation and health promotion programs have become part and parcel of life in rural Za... more Poverty alleviation and health promotion programs have become part and parcel of life in rural Zambia. It is critical to track the performance of these programs to assess the impact they have on the people involved. The purpose of this study is to ascertain barriers, specifically related to market access and crop yields, faced by smallholder groundnut farmers in Eastern Zambia following implementation of the PROFIT+ program. Focus group discussion and informants were selected based on participation in the PROFIT+. Interview data were then qualitatively analyzed to determine consistent themes among farmers. Farmers highlight three general barriers/risks that impacted both their economic well-being and health. In some cases, these barriers may act as feedback loops, health affecting economic productivity and vice versa. These include (a) a lack of adequate storage facilities (b) exposure to aflatoxins produced by the Aspergillus fungus (c) and exposure to pesticides due to a lack of p...
The overutilization of antibiotics during pregnancy and early life are associated with adverse he... more The overutilization of antibiotics during pregnancy and early life are associated with adverse health outcomes for mothers and infants. In this study, we explored pregnant women’s opinions and concerns of antibiotics and how perceptions may affect their health-related decision-making. We conducted 18 in-depth, semi-structured interviews with pregnant women and used the Health Belief Model (HBM) as a framework to analyze the data. We found that mothers generally understood the benefits of antibiotics and were aware that antibiotics are clinically effective for treating bacterial infections. Importantly, perceived barriers related to antibiotic use included concerns regarding the impact of antibiotics on breastfeeding efficacy, microbial health, and societal factors such as antimicrobial resistance. The prescription of antibiotics by a healthcare provider was a cue to action for women, as they trusted providers to recommend medications that were safe for them and their infants. Overal...
In recent years, the Far North Region of Cameroon has experienced serious and recurrent cholera o... more In recent years, the Far North Region of Cameroon has experienced serious and recurrent cholera outbreaks. Yet, understanding of cultural influences on outbreaks and spread remain poorly understood. This qualitative study explored cultural influences on cholera exposure in this region. Interviews and group discussions were conducted in two phases. Phase I involved key informants and phase II included focus group and household discussions. Thematic techniques including word repetition, key-indigenous-terms, and key-words-in-context were used for qualitative data analysis. Key informants attributed cholera etiology to dirt and spread through water () and food (group eating or ) while group discussions attributed it to a reprimand from and transmission through the air. Participants suggested that funerals, weddings, open defecation, and mountaintop burial might influence cholera exposure and facilitate its spread. Hospital avoidance and non-adherence with cholera treatment regimens wer...
Http Dx Doi Org 10 1080 03670244 2012 696013, Aug 10, 2012
Food preferences during pregnancy result from a complex set of biocultural interactions with impo... more Food preferences during pregnancy result from a complex set of biocultural interactions with important implications for maternal and child health. This article explores the social context of maternal food choice in marginal environments of East Africa. Biocultural data collected among Turkana and Datoga women living in Kenya and Tanzania indicate there is a significant social context to food choice that influences the types of food that women report craving and the food that is consumed. Our framework argues for a deeper understanding of how culture shapes food preferences and how marginalization can constrain access to favored and healthy foods.
Risk, Reproduction and Narratives of Experience, Apr 15, 2012
The strategies that mothers use to prevent and negotiate infant illness are a useful interface fo... more The strategies that mothers use to prevent and negotiate infant illness are a useful interface for understanding the complex relationship between risk and reproduction on both an individual and a societal level. This chapter gives a brief background to the construction of risk and harm reduction among Datoga women and uses research on diarrheal illness in north-central Tanzania as a case study to illustrate the complexities of trying to disentangle the interrelationship between risk, responsibility, and the practice of child care and ...
Serogroup B meningococcal disease (MenB) causes almost 60% of meningitis cases among adolescents ... more Serogroup B meningococcal disease (MenB) causes almost 60% of meningitis cases among adolescents and young adults. Yet, MenB vaccine coverage among adolescents remains below 10%. Since parents are the primary medical decision makers for adolescents, we examined MenB vaccination rates and parent attitudes about meningitis and the MenB vaccine. In 2018, in conjunction with a county-wide, school-based immunization campaign, we conducted a mixed methods study among parents of 16- to 17-year-olds. We facilitated focus groups asking parents about their knowledge of meningitis and reactions to educational materials and sent behavioral surveys based on Health Belief Model constructs to parents through the county high school system. Parents in three focus groups (n = 8; participation rate = 13%) expressed confusion about their child’s need to receive the MenB vaccine in addition to the meningococcal conjugate vaccine (MenACWY), but conveyed strong trust in their physicians’ recommendation. A...
Abstract: The objective of this study was to examine child, mother, and environmental factors ass... more Abstract: The objective of this study was to examine child, mother, and environmental factors associated with undernutrition in children less than five years old in a Maya community in Yucatan, Mexico. This investigation was designed as a case-control study. All cases (n=42) of undernutrition were included, and a sample of 52 controls was randomly selected from the study population. The frequency of investigated exposure factors was compared between cases and controls by using logistic regression. Undernutrition was associated with child’s age (> 36 months old; OR = 3.53; 95 % CI = 1.04, 18.40) and mother’s marital status (married; OR = 0.29; 95 % CI = 0.09, 0.90). The odds of undernutrition were 2.81 times higher in children infected with Giardia spp, but this association was not significant (P = 0.18) after controlling for child’s age and mother’s marital status. In conclusion, child’s age and mother’s marital status were associated with child undernutrition in study subjects. ...
Poverty alleviation and health promotion programs have become part and parcel of life in rural Za... more Poverty alleviation and health promotion programs have become part and parcel of life in rural Zambia. It is critical to track the performance of these programs to assess the impact they have on the people involved. The purpose of this study is to ascertain barriers, specifically related to market access and crop yields, faced by smallholder groundnut farmers in Eastern Zambia following implementation of the PROFIT+ program. Focus group discussion and informants were selected based on participation in the PROFIT+. Interview data were then qualitatively analyzed to determine consistent themes among farmers. Farmers highlight three general barriers/risks that impacted both their economic well-being and health. In some cases, these barriers may act as feedback loops, health affecting economic productivity and vice versa. These include (a) a lack of adequate storage facilities (b) exposure to aflatoxins produced by the Aspergillus fungus (c) and exposure to pesticides due to a lack of p...
The overutilization of antibiotics during pregnancy and early life are associated with adverse he... more The overutilization of antibiotics during pregnancy and early life are associated with adverse health outcomes for mothers and infants. In this study, we explored pregnant women’s opinions and concerns of antibiotics and how perceptions may affect their health-related decision-making. We conducted 18 in-depth, semi-structured interviews with pregnant women and used the Health Belief Model (HBM) as a framework to analyze the data. We found that mothers generally understood the benefits of antibiotics and were aware that antibiotics are clinically effective for treating bacterial infections. Importantly, perceived barriers related to antibiotic use included concerns regarding the impact of antibiotics on breastfeeding efficacy, microbial health, and societal factors such as antimicrobial resistance. The prescription of antibiotics by a healthcare provider was a cue to action for women, as they trusted providers to recommend medications that were safe for them and their infants. Overal...
In recent years, the Far North Region of Cameroon has experienced serious and recurrent cholera o... more In recent years, the Far North Region of Cameroon has experienced serious and recurrent cholera outbreaks. Yet, understanding of cultural influences on outbreaks and spread remain poorly understood. This qualitative study explored cultural influences on cholera exposure in this region. Interviews and group discussions were conducted in two phases. Phase I involved key informants and phase II included focus group and household discussions. Thematic techniques including word repetition, key-indigenous-terms, and key-words-in-context were used for qualitative data analysis. Key informants attributed cholera etiology to dirt and spread through water () and food (group eating or ) while group discussions attributed it to a reprimand from and transmission through the air. Participants suggested that funerals, weddings, open defecation, and mountaintop burial might influence cholera exposure and facilitate its spread. Hospital avoidance and non-adherence with cholera treatment regimens wer...
Http Dx Doi Org 10 1080 03670244 2012 696013, Aug 10, 2012
Food preferences during pregnancy result from a complex set of biocultural interactions with impo... more Food preferences during pregnancy result from a complex set of biocultural interactions with important implications for maternal and child health. This article explores the social context of maternal food choice in marginal environments of East Africa. Biocultural data collected among Turkana and Datoga women living in Kenya and Tanzania indicate there is a significant social context to food choice that influences the types of food that women report craving and the food that is consumed. Our framework argues for a deeper understanding of how culture shapes food preferences and how marginalization can constrain access to favored and healthy foods.
Risk, Reproduction and Narratives of Experience, Apr 15, 2012
The strategies that mothers use to prevent and negotiate infant illness are a useful interface fo... more The strategies that mothers use to prevent and negotiate infant illness are a useful interface for understanding the complex relationship between risk and reproduction on both an individual and a societal level. This chapter gives a brief background to the construction of risk and harm reduction among Datoga women and uses research on diarrheal illness in north-central Tanzania as a case study to illustrate the complexities of trying to disentangle the interrelationship between risk, responsibility, and the practice of child care and ...
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