Matching Items (13)
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- All Subjects: public health
- All Subjects: Mosquito
- Creators: Jehn, Megan
- Status: Published
Description
This study examines associations between clean water, sanitation, mosquito net usage, and immune biomarkers among the Tsimane, a remote subsistence population of forager-horticulturalists with a high pathogen load. Interviews with heads of household (n=710, aged 18-92, median age 40 years) were conducted to ascertain household water sources, ownership and usage of mosquito nets, and latrine use. In this sample, 21% of households used latrines, 20% always boiled their water, and 85% used mosquito nets. Regression models estimate their associations biomarkers of pathogen exposure, including white blood cell count (WBC), hemoglobin (Hb), eosinophils, and sedimentation rate (ESR). Controlling for age, sex, and distance from the closest market town, latrine use (Std. β = -0.11, p= 0.017) and boiling water (Std. β = -0.08, p= 0.059) are associated with lower WBCs. Latrine use is marginally associated with higher hemoglobin (Std. β = 0.09, p= 0.048), but not boiling water (p= 0.447). ESR trends toward lower levels for households that always boil water (Std. β= -0.09, p= 0.131), but is not associated with latrine use (p=0.803). Latrine use was significantly associated with lower eosinophil counts (Std. β= -0.14, p=0.013), but not boiling water (p=0.240). Mosquito nets are not associated with any of these biomarkers. Both boiling water and latrine use are associated with better health outcomes in this sample. These results suggest that scarce public health resources in rural subsistence populations without malarial risk may wish to prioritize boiling water and latrine use to improve health outcomes.
ContributorsDinkel, Katelyn Aubree (Author) / Trumble, Benjamin (Thesis director) / Costa, Megan (Committee member) / Jehn, Megan (Committee member) / School of Mathematical and Statistical Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
Background: This study examines how pro-vaccine flu messages, guided by the Extended Parallel Process Model (EPPM), affect parents’ intentions to vaccinate their children.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
ContributorsHall, Sarah (Author) / Jehn, Megan (Thesis advisor) / Mongeau, Paul (Committee member) / Hruschka, Daniel (Committee member) / Margolis, Eric (Committee member) / Arizona State University (Publisher)
Created2015
Description
Hundreds of thousands of people die annually from malaria; a protozoan of the genus Plasmodium is responsible for this mortality. The Plasmodium parasite undergoes several life stages within the mosquito vector, the transition between which require passage across the lumen of the mosquito midgut. It has been observed that in about 15% of parasites that develop ookinetes in the mosquito abdomen, sporozoites never develop in the salivary glands, indicating that passage across the midgut lumen is a significant barrier in parasite development (Gamage-Mendis et al., 1993). We aim to investigate a possible correlation between passage through the midgut lumen and drug-resistance trends in Plasmodium falciparum parasites. This study contains a total of 1024 Anopheles mosquitoes: 187 Anopheles gambiae and 837 Anopheles funestus samples collected in high malaria transmission areas of Mozambique between March and June of 2016. Sanger sequencing will be used to determine the prevalence of known resistance alleles for anti-malarial drugs: chloroquine resistance transporter (pfcrt), multidrug resistance (pfmdr1) gene, dihydropteroate synthase (pfdhps) and dihydrofolate reductase (pfdhfr). We compare prevalence of resistance between abdomen and head/thorax in order to determine whether drug resistant parasites are disproportionately hindered during their passage through the midgut lumen. A statistically significant difference between resistance alleles in the two studied body sections supports the efficacy of new anti-malarial gene surveillance strategies in areas of high malaria transmission.
ContributorsPhillips, Keeley Isabella (Author) / Huijben, Silvie (Thesis director) / Gile, Gillian (Committee member) / Young, Steven (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
Short-term medical missions (STMMs) are groups of volunteer medical providers who travel to provide health care, including basic services and surgeries, to global low-income populations. STMM organizations present their work as contrary to both public and private systems within Guatemala that do not adequately serve the patient population, though they operate within the same framework as other providers and mirror the same neoliberal ideology in their planning, organization and strategy, and execution. STMMs strive to offer free, high-quality access to surgeries and basic health care services via volunteer medical providers willing to dedicate their time and skill to low-income patients. The patient population of STMMs in Guatemala, who are often rural, indigenous, and low-income, already experience diminishing access to health care due to neoliberal health policies and discrimination within the existing health care landscape, going to great lengths to access quality health care services. This research investigates the planning, organization and strategy, and execution of STMMs through the lens of the enduring influence of neoliberal health ideologies on volunteer medical providers and existing health resources in Guatemala. Organizational strategies that prioritize the ease of travel for volunteer medical providers mirror the geographical lack of health care access, neglect of indigenous language services in the health care context, and urban focus already existing in the country’s public health care system. The patient population experiences heightened vulnerability exacerbated by STMMs when seeking care because of their low adherence to Guatemalan law surrounding registration requirements for foreign medical providers and poor institutional accountability, burdening patients, who lack legal literacy and financial resources, with denouncing malpractice or post-operative problems. Finally, STMM providers expect patients to both demonstrate passivity, humility, and material deficiency and show that they can be ‘good’ patients—able to understand and abide by the authority of the medical providers, know what information to provide, and communicate effectively—essentially, to be good health consumers. Ultimately, this research demonstrates how neoliberal health ideologies remain deeply engrained in the psyche of STMM organizations, despite their targeted approach to deliver health care to patients struggling to access services in Guatemala’s chaotic health care landscape.
ContributorsDriese, Mary Catherine (Author) / Maupin, Jonathan N (Thesis advisor) / Hall-Clifford, Rachel (Committee member) / Jehn, Megan (Committee member) / Arizona State University (Publisher)
Created2022
Description
The COVID-19 pandemic has renewed interest in the importance of indoor air quality for health. The spread of respiratory aerosols is the primary mechanism for COVID-19 transmission, making it crucial to understand the role of effective ventilation in managing the risk of disease transmission. The concentration of exhaled carbon dioxide (CO2) in indoor spaces can be used as a proxy measure of ventilation efficiency. Poor indoor air quality has been associated with a range of acute and chronic health problems, including respiratory issues, cardiovascular disease, and cancer. Poor air quality may also impair cognitive performance and productivity. Social and economic inequalities exacerbate the impact of indoor air quality issues, making it crucial to address these problems in an equitable manner. Public libraries have been identified as an effective intermediary for providing education and free air quality monitoring technology to communities, with the ultimate goal of promoting awareness and increasing access to tools to promote accountability for maintaining high indoor air quality standards. The primary objectives of this initiative are to: 1) develop a citizen science toolkit for assessing indoor air quality in public spaces and deploy the toolkit to public libraries in Arizona; and 2) to conduct a program evaluation to determine whether this kit can be effectively deployed through public libraries to promote citizen science efforts and engage community members in promoting healthier indoor air quality, identify areas where improvements can be made, and prepare the program to be scaled to a larger audience.
ContributorsYoung, Parker (Author) / Jehn, Megan (Thesis director) / Cavalier, Darlene (Committee member) / Barrett, The Honors College (Contributor) / School of Molecular Sciences (Contributor) / School of International Letters and Cultures (Contributor)
Created2023-05
Description
Latest estimates show that roughly 188 individuals in the United States die everyday due to an opioid-related overdose. This dissertation explores three avenues for
mitigating opioid use disorder (OUD) and the opioid epidemic in the United States (1.)
How can researchers and public health professionals identify areas most in need of
treatment for OUD in an easy-to-use and publicly accessible interface?; (2.) What do
practitioners see as opportunities for reducing barriers to treatment?; and (3.) Why do
differences in opioid mortality exist between demographic groups? To address question
one, I developed an interactive web-based to assist in identifying those counties with the
greatest unmet need of medically assisted treatment (MAT). To answer question two, I
conducted a study of stakeholders (medical providers, peer support specialists, public
health practitioners, etc.) in four New Mexico counties with high unmet need of MAT. to
identify cultural and structural barriers to MAT provision in underserved areas as well as
opportunities for improving access. To answer the third question. I conducted a
systematic review of peer-reviewed literature and government reports to identify how
previous research accounts for race/ethnic and sex disparities in opioid-related
mortality. While many opioid mortality studies show demographic differences, little is
known about why they exist. According to the findings of this systematic review, research
needs to go beyond identifying demographic differences in opioid-related mortality to
understand the reasons for those differences to reduce these inequities.
ContributorsDrake, Alexandria (Author) / Hruschka, Daniel (Thesis advisor) / Jehn, Megan (Committee member) / Scott, Mary Alice (Committee member) / Arizona State University (Publisher)
Created2023
The Association Between School COVID-19 Mitigation Policies and School-Associated COVID-19 Outbreaks
Description
SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is an enveloped single-stranded positive-sense RNA virus that originated in China and has rapidly spread worldwide. With the Delta variant arriving before many K-12 schools in Arizona resumed in-person learning for the 2021-2022 academic year, a plethora of mitigation measures were utilized by schools. Public schools in both Maricopa and Pima county without mask mandates were found to be 3.5 times more likely to have COVID-19 outbreaks in comparison to those with mask requirements at the start of the school year. In addition, when analyzing the presence of three other mitigation measures (cohorting, random testing, and use of improved air filtration), only 5.42% were found to use all four mitigation measures.
ContributorsGue, Matthew (Author) / Jehn, Megan (Thesis director) / Ross, Heather (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2022-05
Description
Vector control plays an important role in the prevention and control of mosquito-borne diseases (MBDs). As there are no (prophylactic) drugs and/or vaccines available for many arboviral diseases (such as zika, chikungunya, Saint Louis encephalitis, Ross River virus), the frontline approach to prevent or reduce disease morbidity and mortality is through the reduction of the mosquito vector population size and/or reducing vector-human contact using insecticides. Frontline tools in malaria (an MBD caused by a parasite) control and elimination have been drugs (targeting the malaria parasite) and insecticides (targeting the vectors) through indoor residual spraying (IRS) (spraying the internal walls and sometimes the roofs of dwellings with residual insecticides to kill adult mosquito vectors), and long-lasting insecticidal nets (LLINs), while arboviral vectors are frequently targeted using outdoor fogging and space spraying (indoor or outdoor spraying of insecticides to kill adult mosquito vectors). Integrative and novel vector control efforts are urgently needed since the aforementioned tools may not be as effective against those mosquito species that are resistant to insecticides and/or have a different (or changed) behavior allowing them to avoid existing tools. In Chapters 2 and 3, I investigate mosquito vector surveillance in Arizona by (i) discussing the species composition and public health implications of the State’s mosquito fauna, and (ii) comparing the effectiveness of 4 different carbon dioxide (CO2) sources in attracting different mosquito species on the Arizona State University Tempe Campus. In Chapters 4 and 5, I investigate a novel vector control tool by (i) completing a literature review on using electric fields (EFs) to control insects, and (ii) presenting novel data on using Insulated Conductor Wires (ICWs) to generate EFs that prevent host-seeking female Aedes aegypti from entering spaces. In Chapter 6, I discuss the non-target effects of chemical malaria control on other arthropods, including other biological and mechanical infectious disease vectors. Overall, this dissertation highlights the important role that the development of novel surveillance and vector control tools could play in improved mosquito control, which ultimately will reduce disease morbidity and mortality.
ContributorsJobe, Ndey Bassin (Author) / Paaijmans, Krijn (Thesis advisor) / Cease, Arianne (Committee member) / Hall, Sharon (Committee member) / Huijben, Silvie (Committee member) / Arizona State University (Publisher)
Created2024
Description
Background. Street food stands (SFS) are common ways in which people in Mexico access food, having been a part of the environment and culture of Mexican food for generations. However, no studies have used a validated assessment tool to reliably measure food and beverage availability at a variety of SFS. Nor have the availability, density, variety, and distribution of SFS and street foods and beverages been assessed across neighborhood income levels.Objective: This dissertation’s goal was to decrease gaps in knowledge about the role SFS may play in food availability in the Mexican food environment.
Methods: Survey design and ethnographic field methods were used to develop, test, and validate the Street Food Stand Assessment Tool (SFSAT). Geographic information system and ground-truthing methods were used to identify a sample of street segments across 20 neighborhoods representing low-, middle- and high-income neighborhoods in Mexico City on which to assess the availability, density, variety, and distribution of SFS and the foods and beverages sold at these food venues using the SFSAT.
Results: A sample of 391 SFS were assessed across 791 street segments. Results showed that SFS were found in all neighborhoods. Contrary to the initial hypothesis, most SFS were found in middle-income neighborhoods. While the availability of street foods and beverages was higher in middle-income neighborhoods, the variety was less consistent: fruit/vegetable variety was high in high-income neighborhoods whereas processed snack variety was higher in low-income neighborhoods. SFS were most often distributed near homes, transportation centers, and worksites across the three neighborhood income levels.
Conclusion: This study bridged the gap in knowledge about the availability, density, variety, and distribution of SFS and products sold at these sources of food by using an assessment tool that was developed, tested, and validated specifically for SFS. The findings showed that SFS were found across all neighborhoods. Furthermore, results also suggested that SFS can be a source of healthy food items. Additional studies are needed to understand the relationship between SFS availability, food consumption, and health outcomes in the Mexican population.
Methods: Survey design and ethnographic field methods were used to develop, test, and validate the Street Food Stand Assessment Tool (SFSAT). Geographic information system and ground-truthing methods were used to identify a sample of street segments across 20 neighborhoods representing low-, middle- and high-income neighborhoods in Mexico City on which to assess the availability, density, variety, and distribution of SFS and the foods and beverages sold at these food venues using the SFSAT.
Results: A sample of 391 SFS were assessed across 791 street segments. Results showed that SFS were found in all neighborhoods. Contrary to the initial hypothesis, most SFS were found in middle-income neighborhoods. While the availability of street foods and beverages was higher in middle-income neighborhoods, the variety was less consistent: fruit/vegetable variety was high in high-income neighborhoods whereas processed snack variety was higher in low-income neighborhoods. SFS were most often distributed near homes, transportation centers, and worksites across the three neighborhood income levels.
Conclusion: This study bridged the gap in knowledge about the availability, density, variety, and distribution of SFS and products sold at these sources of food by using an assessment tool that was developed, tested, and validated specifically for SFS. The findings showed that SFS were found across all neighborhoods. Furthermore, results also suggested that SFS can be a source of healthy food items. Additional studies are needed to understand the relationship between SFS availability, food consumption, and health outcomes in the Mexican population.
ContributorsRosales Chavez, Jose Benito (Author) / Jehn, Megan (Thesis advisor) / Bruening, Meg (Thesis advisor) / Lee, Rebecca E (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2020
Description
Neglected tropical diseases (NTDs) comprise of diverse communicable diseases that affect mostly the developing economies of the world, the “neglected” populations. The NTDs Visceral Leishmaniasis (VL) and Soil-transmitted Helminthiasis (STH) are among the top contributors of global mortality and/or morbidity. They affect resource-limited regions (poor health-care literacy, infrastructure, etc.) and patients’ treatment behavior is irregular due to the social constraints. Through two case studies, VL in India and STH in Ghana, this work aims to: (i) identify the additional and potential hidden high-risk population and its behaviors critical for improving interventions and surveillance; (ii) develop models with those behaviors to study the role of improved control programs on diseases’ dynamics; (iii) optimize resources for treatment-related interventions.
Treatment non-adherence is a less focused (so far) but crucial factor for the hindrance in WHO’s past VL elimination goals. Moreover, treatment non-adherers, hidden from surveillance, lead to high case-underreporting. Dynamical models are developed capturing the role of treatment-related human behaviors (patients’ infectivity, treatment access and non-adherence) on VL dynamics. The results suggest that the average duration of treatment adherence must be increased from currently 10 days to 17 days for a 28-day Miltefosine treatment to eliminate VL.
For STH, children are considered as a high-risk group due to their hygiene behaviors leading to higher exposure to contamination. Hence, Ghana, a resource-limited country, currently implements a school-based Mass Drug Administration (sMDA) program only among children. School staff (adults), equally exposed to this high environmental contamination of STH, are largely ignored under the current MDA program. Cost-effective MDA policies were modeled and compared using alternative definitions of “high-risk population”. This work optimized and evaluated how MDA along with the treatment for high-risk adults makes a significant improvement in STH control under the same budget. The criticality of risk-structured modeling depends on the infectivity coefficient being substantially different for the two adult risk groups.
This dissertation pioneers in highlighting the cruciality of treatment-related risk groups for NTD-control. It provides novel approaches to quantify relevant metrics and impact of population factors. Compliance with the principles and strategies from this study would require a change in political thinking in the neglected regions in order to achieve persistent NTD-control.
Treatment non-adherence is a less focused (so far) but crucial factor for the hindrance in WHO’s past VL elimination goals. Moreover, treatment non-adherers, hidden from surveillance, lead to high case-underreporting. Dynamical models are developed capturing the role of treatment-related human behaviors (patients’ infectivity, treatment access and non-adherence) on VL dynamics. The results suggest that the average duration of treatment adherence must be increased from currently 10 days to 17 days for a 28-day Miltefosine treatment to eliminate VL.
For STH, children are considered as a high-risk group due to their hygiene behaviors leading to higher exposure to contamination. Hence, Ghana, a resource-limited country, currently implements a school-based Mass Drug Administration (sMDA) program only among children. School staff (adults), equally exposed to this high environmental contamination of STH, are largely ignored under the current MDA program. Cost-effective MDA policies were modeled and compared using alternative definitions of “high-risk population”. This work optimized and evaluated how MDA along with the treatment for high-risk adults makes a significant improvement in STH control under the same budget. The criticality of risk-structured modeling depends on the infectivity coefficient being substantially different for the two adult risk groups.
This dissertation pioneers in highlighting the cruciality of treatment-related risk groups for NTD-control. It provides novel approaches to quantify relevant metrics and impact of population factors. Compliance with the principles and strategies from this study would require a change in political thinking in the neglected regions in order to achieve persistent NTD-control.
ContributorsThakur, Mugdha (Author) / Mubayi, Anuj (Thesis advisor) / Hurtado, Ana M (Committee member) / Paaijmans, Krijn (Committee member) / Michael, Edwin (Committee member) / Arizona State University (Publisher)
Created2020