Research Interests: Obstetrics, Medical Microbiology, Malaria, Research, Medicine, and 12 moreEmerging Infectious Diseases, Multivariate Analysis, Pregnancy, Humans, Female, Risk factors, Clinical Sciences, Newborn Infant, Public health systems and services research, Risk Factors, Inflammatory Bowel Diseases, and HIV infections
Research Interests:
Research Interests:
Research Interests:
Research Interests: Immunology, Cytokines, DNA, Pregnancy, Humans, and 14 moreInfectious Disease, Female, Blood sampling, Polymerase Chain Reaction, Perfusion, Phenotype, Human immunodeficiency virus, Optometry and Ophthalmology, Red blood cell, DNA typing, Monoclonal Antibody, Enzyme Linked Immunosorbent Assay, Fetal Hemoglobin, and Phosphate Buffer Saline
Research Interests: Research Methodology, Poverty, Family, Pakistan, Health Education, and 27 moreDeveloping Countries, Survey Methodology, Population Dynamics, Health, Public Health, Community, Adolescent, Prevention, Population, Humans, Child, Surveys, Female, Male, Infant, Risk factors, Hygiene, Risk Factor, SOAP, Adult, Interventions, Risk Factors, JAMA, Population distribution, Nino, Child preschool, and soaps
A large-scale longitudinal cohort project was initiated in western Kenya in June 1992. The primary purpose of the project was to study Plasmodium falciparum malaria in a highly endemic area using a comprehensive and multidisciplinary... more
A large-scale longitudinal cohort project was initiated in western Kenya in June 1992. The primary purpose of the project was to study Plasmodium falciparum malaria in a highly endemic area using a comprehensive and multidisciplinary approach, which included epidemiology, entomology, and immunology. Between June 1992 and July 1994, pregnant women living in 15 rural villages were identified during a monthly census and 1,164 were enrolled. The women were followed-up throughout their pregnancy and they, along with their newborn infants and direct siblings of the infants' less than 15 years of age, were monitored over time. As of May 1995, 1,017 infants had been born to these women. This paper presents the design and general methodology used in this study and describes the initial experience with intense monitoring of a large population over a prolonged period.
Research Interests: Genetics, Education, Housing, Kenya, Adolescent, and 27 morePregnancy, Humans, Child, Female, Animals, Male, Cohort Study, Infant, Anemia, Rain, Mosquito Control, Newborn Infant, Prevalence, Spectrum, Longitudinal Studies, Plasmodium falciparum, Pregnant Women, Seasons, Boolean Satisfiability, Large Scale, Multidisciplinary Approach, Cerebral Malaria, Pregnancy Outcome, Cohort Studies, The American, Socioeconomic Factors, and Child preschool
Research Interests:
Research Interests:
Washing hands with soap prevents diarrhea, but children at the highest risk of death from diarrhea are younger than 1 year, too young to wash their own hands. Previous studies lacked sufficient power to assess the impact of household... more
Washing hands with soap prevents diarrhea, but children at the highest risk of death from diarrhea are younger than 1 year, too young to wash their own hands. Previous studies lacked sufficient power to assess the impact of household handwashing on diarrhea in infants. To evaluate the effect of promoting household handwashing with soap among children at the highest risk of death from diarrhea. A cluster randomized controlled trial of 36 low-income neighborhoods in urban squatter settlements in Karachi, Pakistan. Field workers visited participating households at least weekly from April 15, 2002, to April 5, 2003. Eligible households located in the study area had at least 2 children younger than 15 years, at least 1 of whom was younger than 5 years. Weekly visits in 25 neighborhoods to promote handwashing with soap after defecation and before preparing food, eating, and feeding a child. Within intervention neighborhoods, 300 households (1523 children) received a regular supply of antibacterial soap and 300 households (1640 children) received plain soap. Eleven neighborhoods (306 households and 1528 children) comprised the control group. Incidence density of diarrhea among children, defined as the number of diarrheal episodes per 100 person-weeks of observation. Children younger than 15 years living in households that received handwashing promotion and plain soap had a 53% lower incidence of diarrhea (95% confidence interval [CI], -65% to -41%) compared with children living in control neighborhoods. Infants living in households that received handwashing promotion and plain soap had 39% fewer days with diarrhea (95% CI, -61% to -16%) vs infants living in control neighborhoods. Severely malnourished children (weight for age z score, <-3.0) younger than 5 years living in households that received handwashing promotion and plain soap had 42% fewer days with diarrhea (95% CI, -69% to -16%) vs severely malnourished children in the control group. Similar reductions in diarrhea were observed among children living in households receiving antibacterial soap. In a setting in which diarrhea is a leading cause of child death, improvement in handwashing in the household reduced the incidence of diarrhea among children at high risk of death from diarrhea.
Research Interests: Poverty, Family, Pakistan, Adolescent, Humans, and 9 moreChild, Female, Male, Infant, Risk factors, Hygiene, Adult, Risk Factors, and JAMA
Research Interests:
To assess unfiltered drinking water as a source of cryptosporidium infection in patients with the acquired immunodeficiency syndrome (AIDS) the prevalence of cryptosporidiosis among persons with AIDS in Los Angeles County was assessed by... more
To assess unfiltered drinking water as a source of cryptosporidium infection in patients with the acquired immunodeficiency syndrome (AIDS) the prevalence of cryptosporidiosis among persons with AIDS in Los Angeles County was assessed by water service area. One water distributor, serving approximately 60% of the county's residents (area B), has consistently employed filtration. The other company, which serves the remainder of the county (area A), did not institute filtration until mid-December 1986. This difference provided a 'natural experiment' in which to assess the effect of municipal water filtration on the level of cryptosporidiosis among persons with AIDS. The prevalence of cryptosporidiosis among AIDS patients was compared for the two water service areas for the time period (1983-6) preceding the implementation of filtration in area A. From 1983 to 1986 the age-standardized prevalence of cryptosporidiosis among AIDS patients was 32% lower in area A (4.2%), which received unfiltered water, than in area B (6.2%). Following addition of filtration in area A, the prevalence of cryptosporidiosis among AIDS patients decreased by 20%; however, a decline, of 47%, was also observed in area B. The similar baseline levels of cryptosporidiosis and the corresponding post-filtration decline in both areas suggest that filtration had no effect on levels of cryptosporidiosis among persons with AIDS. Thus it does not appear that municipal drinking water is an important risk factor for cryptosporidiosis in AIDS patients residing in Los Angeles County.