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- All Subjects: public health
- Creators: Hruschka, Daniel
Description
Food system and health characteristics were evaluated across the last Waorani hunter-gatherer group in Amazonian Ecuador and a remote neighboring Kichwa indigenous subsistence agriculture community. Hunter-gatherer food systems like the Waorani foragers may not only be nutritionally, but also pharmaceutically beneficial because of high dietary intake of varied plant phytochemical compounds. A modern diet that reduces these dietary plant defense phytochemicals below levels typical in human evolutionary history may leave humans vulnerable to diseases that were controlled through a foraging diet. Few studies consider the health impact of the recent drastic reduction of plant phytochemical content in the modern global food system, which has eliminated essential components of food because they are not considered "nutrients". The antimicrobial and anti-inflammatory nature of the food system may not only regulate infectious pathogens and inflammatory disease, but also support beneficial microbes in human hosts, reducing vulnerability to chronic diseases. Waorani foragers seem immune to certain infections with very low rates of chronic disease. Does returning to certain characteristics of a foraging food system begin to restore the human body microbe balance and inflammatory response to evolutionary norms, and if so, what implication does this have for the treatment of disease? Several years of data on dietary and health differences across the foragers and the farmers was gathered. There were major differences in health outcomes across the board. In the Waorani forager group there were no signs of infection in serious wounds such as 3rd degree burns and spear wounds. The foragers had one-degree lower body temperature than the farmers. The Waorani had an absence of signs of chronic diseases including vision and blood pressure that did not change markedly with age while Kichwa farmers suffered from both chronic diseases and physiological indicators of aging. In the Waorani forager population, there was an absence of many common regional infectious diseases, from helminthes to staphylococcus. Study design helped control for confounders (exercise, environment, genetic factors, non-phytochemical dietary intake). This study provides evidence of the major role total phytochemical dietary intake plays in human health, often not considered by policymakers and nutritional and agricultural scientists.
ContributorsLondon, Douglas (Author) / Tsuda, Takeyuki (Thesis advisor) / Beezhold, Bonnie L (Committee member) / Hruschka, Daniel (Committee member) / Eder, James (Committee member) / Arizona State University (Publisher)
Created2012
Description
Contact tracing was deployed widely during the COVID-19 pandemic to attempt to stop the spread of SARS Co-V-2. This dissertation investigates the research on contact tracing from a scientometric perspective and looks qualitatively at how case investigators and contact tracers conducted public health practice during the pandemic. Through approaching the public health practice of contact tracing from both a broad, top-down angle, and an on the ground experiential approach, this dissertation provides insight into the issues facing contact tracing as a public health tool.
ContributorsWhite, Alexandra C. (Author) / Jehn, Megan (Thesis advisor) / Hruschka, Daniel (Committee member) / Gaughan, Monica (Committee member) / Arizona State University (Publisher)
Created2022
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
Description
Significant health inequalities exist between different castes and ethnic communities in India, and identifying the roots of these inequalities is of interest to public health research and policy. Research on caste-based health inequalities in India has historically focused on general, government-defined categories, such as “Scheduled Castes,” “Scheduled Tribes,” and “Other Backward Classes.” This method obscures the diversity of experiences, indicators of well-being, and health outcomes between castes, tribes, and other communities in the “scheduled” category. This study analyzes data on 699,686 women from 4,260 castes, tribes and communities in the 2015-2016 Demographic and Health Survey of India to: (1) examine the diversity within and overlap between general, government-defined community categories in both wealth, infant mortality, and education, and (2) analyze how infant mortality is related to community category membership and socioeconomic status (measured using highest level of education and household wealth). While there are significant differences between general, government-defined community categories (e.g., scheduled caste, backward class) in both wealth and infant mortality, the vast majority of variation between communities occurs within these categories. Moreover, when other socioeconomic factors like wealth and education are taken into account, the difference between general, government-defined categories reduces or disappears. These findings suggest that focusing on measures of education and wealth at the household level, rather than general caste categories, may more accurately target those individuals and households most at risk for poor health outcomes. Further research is needed to explain the mechanisms by which discrimination affects health in these populations, and to identify sources of resilience, which may inform more effective policies.
ContributorsClauss, Colleen (Author) / Hruschka, Daniel (Thesis director) / Davis, Mary (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution & Social Change (Contributor) / Department of Psychology (Contributor)
Created2022-05
Description
Understanding the consequences of changes in social networks is an important an-
thropological research goal. This dissertation looks at the role of data-driven social
networks on infectious disease transmission and evolution. The dissertation has two
projects. The first project is an examination of the effects of the superspreading
phenomenon, wherein a relatively few individuals are responsible for a dispropor-
tionate number of secondary cases, on the patterns of an infectious disease. The
second project examines the timing of the initial introduction of tuberculosis (TB) to
the human population. The results suggest that TB has a long evolutionary history
with hunter-gatherers. Both of these projects demonstrate the consequences of social
networks for infectious disease transmission and evolution.
The introductory chapter provides a review of social network-based studies in an-
thropology and epidemiology. Particular emphasis is paid to the concept and models
of superspreading and why to consider it, as this is central to the discussion in chapter
2. The introductory chapter also reviews relevant epidemic mathematical modeling
studies.
In chapter 2, social networks are connected with superspreading events, followed
by an investigation of how social networks can provide greater understanding of in-
fectious disease transmission through mathematical models. Using the example of
SARS, the research shows how heterogeneity in transmission rate impacts super-
spreading which, in turn, can change epidemiological inference on model parameters
for an epidemic.
Chapter 3 uses a different mathematical model to investigate the evolution of TB
in hunter-gatherers. The underlying question is the timing of the introduction of TB
to the human population. Chapter 3 finds that TB’s long latent period is consistent
with the evolutionary pressure which would be exerted by transmission on a hunter-
igatherer social network. Evidence of a long coevolution with humans indicates an
early introduction of TB to the human population.
Both of the projects in this dissertation are demonstrations of the impact of var-
ious characteristics and types of social networks on infectious disease transmission
dynamics. The projects together force epidemiologists to think about networks and
their context in nontraditional ways.
thropological research goal. This dissertation looks at the role of data-driven social
networks on infectious disease transmission and evolution. The dissertation has two
projects. The first project is an examination of the effects of the superspreading
phenomenon, wherein a relatively few individuals are responsible for a dispropor-
tionate number of secondary cases, on the patterns of an infectious disease. The
second project examines the timing of the initial introduction of tuberculosis (TB) to
the human population. The results suggest that TB has a long evolutionary history
with hunter-gatherers. Both of these projects demonstrate the consequences of social
networks for infectious disease transmission and evolution.
The introductory chapter provides a review of social network-based studies in an-
thropology and epidemiology. Particular emphasis is paid to the concept and models
of superspreading and why to consider it, as this is central to the discussion in chapter
2. The introductory chapter also reviews relevant epidemic mathematical modeling
studies.
In chapter 2, social networks are connected with superspreading events, followed
by an investigation of how social networks can provide greater understanding of in-
fectious disease transmission through mathematical models. Using the example of
SARS, the research shows how heterogeneity in transmission rate impacts super-
spreading which, in turn, can change epidemiological inference on model parameters
for an epidemic.
Chapter 3 uses a different mathematical model to investigate the evolution of TB
in hunter-gatherers. The underlying question is the timing of the introduction of TB
to the human population. Chapter 3 finds that TB’s long latent period is consistent
with the evolutionary pressure which would be exerted by transmission on a hunter-
igatherer social network. Evidence of a long coevolution with humans indicates an
early introduction of TB to the human population.
Both of the projects in this dissertation are demonstrations of the impact of var-
ious characteristics and types of social networks on infectious disease transmission
dynamics. The projects together force epidemiologists to think about networks and
their context in nontraditional ways.
ContributorsNesse, Hans P (Author) / Hurtado, Ana Magdalena (Thesis advisor) / Castillo-Chavez, Carlos (Committee member) / Mubayi, Anuj (Committee member) / Arizona State University (Publisher)
Created2019
Description
Statistical Methods have been widely used in understanding factors for clinical and public health data. Statistical hypotheses are procedures for testing pre-stated hypotheses. The development and properties of these procedures as well as their performance are based upon certain assumptions. Desirable properties of statistical tests are to maintain validity and to perform well even if these assumptions are not met. A statistical test that maintains such desirable properties is called robust. Mathematical models are typically mechanistic framework, used to study dynamic interactions between components (mechanisms) of a system, and how these interactions give rise to the changes in behavior (patterns) of the system as a whole over time.
In this thesis, I have developed a study that uses novel techniques to link robust statistical tests and mathematical modeling methods guided by limited data from developed and developing regions in order to address pressing clinical and epidemiological questions of interest. The procedure in this study consists of three primary steps, namely, data collection, uncertainty quantification in data, and linking dynamic model to collected data.
The first part of the study focuses on designing, collecting, and summarizing empirical data from the only national survey of hospitals ever conducted regarding patient controlled analgesia (PCA) practices among 168 hospitals across 40 states, in order to assess risks before putting patients on PCA. I used statistical relational models and exploratory data analysis to address the question. Risk factors assessed indicate a great concern for the safety of patients from one healthcare institution to other.
In the second part, I quantify uncertainty associated with data obtained from James A Lovell Federal Healthcare Center to primarily study the effect of Benign Prostatic Hypertrophy (BPH) on sleep architecture in patients with Obstructive Sleep Apnea (OSA). Patients with OSA and BPH demonstrated significant difference in their sleep architecture in comparison to patients without BPH. One of the ways to validate these differences in sleep architecture between the two groups may be to carry out a similar study that evaluates the effect of some other chronic disease on sleep architecture in patients with OSA.
Additionally, I also address theoretical statistical questions such as (1) how to estimate the distribution of a variable in order to retest null hypothesis when the sample size is limited, and (2) how changes on assumptions (like monotonicity and nonlinearity) translate into the effect of the independent variable on the outcome variable. To address these questions we use multiple techniques such as Partial Rank Correlation Coefficients (PRCC) based sensitivity analysis, Fractional Polynomials, and statistical relational models.
In the third part, my goal was to identify socio-economic-environment-related risk factors for Visceral Leishmaniasis (VL) and use the identified critical factors to develop a mathematical model to understand VL transmission dynamics when data is highly underreported. I primarily studied the role of age-specific- susceptibility and epidemiological quantities on the dynamics of VL in the Indian state of Bihar. Statistical results provided ideas on the choice of the modeling framework and estimates of model parameters.
In the conclusion, this study addressed three primary theoretical modeling-related questions (1) how to analyze collected data when sample size limited, and how modeling assumptions varies results of data analysis? (2) Is it possible to identify hidden associations and nonlinearity of these associations using such underpowered data and (3) how statistical models provide more reasonable structure to mathematical modeling framework that can be used in turn to understand dynamics of the system.
In this thesis, I have developed a study that uses novel techniques to link robust statistical tests and mathematical modeling methods guided by limited data from developed and developing regions in order to address pressing clinical and epidemiological questions of interest. The procedure in this study consists of three primary steps, namely, data collection, uncertainty quantification in data, and linking dynamic model to collected data.
The first part of the study focuses on designing, collecting, and summarizing empirical data from the only national survey of hospitals ever conducted regarding patient controlled analgesia (PCA) practices among 168 hospitals across 40 states, in order to assess risks before putting patients on PCA. I used statistical relational models and exploratory data analysis to address the question. Risk factors assessed indicate a great concern for the safety of patients from one healthcare institution to other.
In the second part, I quantify uncertainty associated with data obtained from James A Lovell Federal Healthcare Center to primarily study the effect of Benign Prostatic Hypertrophy (BPH) on sleep architecture in patients with Obstructive Sleep Apnea (OSA). Patients with OSA and BPH demonstrated significant difference in their sleep architecture in comparison to patients without BPH. One of the ways to validate these differences in sleep architecture between the two groups may be to carry out a similar study that evaluates the effect of some other chronic disease on sleep architecture in patients with OSA.
Additionally, I also address theoretical statistical questions such as (1) how to estimate the distribution of a variable in order to retest null hypothesis when the sample size is limited, and (2) how changes on assumptions (like monotonicity and nonlinearity) translate into the effect of the independent variable on the outcome variable. To address these questions we use multiple techniques such as Partial Rank Correlation Coefficients (PRCC) based sensitivity analysis, Fractional Polynomials, and statistical relational models.
In the third part, my goal was to identify socio-economic-environment-related risk factors for Visceral Leishmaniasis (VL) and use the identified critical factors to develop a mathematical model to understand VL transmission dynamics when data is highly underreported. I primarily studied the role of age-specific- susceptibility and epidemiological quantities on the dynamics of VL in the Indian state of Bihar. Statistical results provided ideas on the choice of the modeling framework and estimates of model parameters.
In the conclusion, this study addressed three primary theoretical modeling-related questions (1) how to analyze collected data when sample size limited, and how modeling assumptions varies results of data analysis? (2) Is it possible to identify hidden associations and nonlinearity of these associations using such underpowered data and (3) how statistical models provide more reasonable structure to mathematical modeling framework that can be used in turn to understand dynamics of the system.
ContributorsGonzalez, Beverly, 1980- (Author) / Castillo-Chavez, Carlos (Thesis advisor) / Mubayi, Anuj (Thesis advisor) / Nuno, Miriam (Committee member) / Arizona State University (Publisher)
Created2015
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
The health situation of indigenous peoples is comparable to that of the world's poorest populations, but with the additional burdens of social and cultural marginalization, geographic and cultural barriers to accessing health services, and, in some areas, appropriation of land and natural resources. Cultural transmission (the transfer of beliefs, ideas, and behaviors from one culture to another) from outsider health institutions should presumably aid in closing this health gap by transferring knowledge, practices, and infrastructure to prevent and treat disease. This study examines the biosocial construction of the disease ecology of tuberculosis (TB) in indigenous communities of the Paraguayan Chaco with varying degrees of cultural transmission from outside institutions (government, religious, and NGOs), to determine the influence of cultural transmission on local disease ecologies. Using a biocultural epidemiological framework for the analysis of human infectious disease ecology, this study employed an interdisciplinary, mixed methods approach to examine the interactions of host, pathogen, and the environment in the Paraguayan Chaco. Three case studies examining aspects of TB disease ecology in indigenous communities are presented: (1) The effective cultural transmission of biomedical knowledge to isolated communities, (2) Public health infrastructure, hygiene, and the prevalence of intestinal parasites: co-morbidities that promote the progression to active TB disease, and (3) Community-level risk factors for TB and indigenous TB burden. Findings from the case studies suggest that greater influence from outside institutions was not associated with greater adoption of biomedical knowledge of TB. The prevalence of helminthiasis was unexpectedly low, but infection with giardia was common, even in a community with cleaner water sources. Communities with a health post were more likely to report active adult TB, while communities with more education were less likely to report active pediatric TB, suggesting that healthcare access is the major determinant of TB detection. More research is needed on the role of non-indigenous community residents and other measures of acculturation or integration in TB outcomes, especially at the household level. Indigenous TB burden in the Chaco is disproportionately high, and better understanding of the mechanisms that produce higher incidence and prevalence of the disease is needed.
ContributorsVansteelandt, Amanda (Author) / Hurtado, Ana Magdalena (Thesis advisor) / Stone, Anne (Thesis advisor) / Hruschka, Daniel (Committee member) / Rojas de Arias, Antonieta (Committee member) / Arizona State University (Publisher)
Created2014
Description
Suicide is one of the fastest-growing and least-understood causes of death, particularly in low and middle income countries (LMIC). In low-income settings, where the technical capacity for death surveillance is limited, suicides may constitute a significant portion of early deaths, but disappear as they are filtered through reporting systems shaped by social, cultural, and political institutions. These deaths become unknown and unaddressed. This dissertation illuminates how suicide is perceived, contested, experienced, and interpreted in institutions ranging from the local (i.e., family, community) to the professional (i.e., medical, law enforcement) in Nepal, a country purported to have one of the highest suicide rates in the world. Drawing on a critical medical anthropology approach, I bridge public health and anthropological perspectives to better situate the problem of suicide within a greater social-political context. I argue that these complex, contestable deaths, become falsely homogenized, or lost. During 18 months of fieldwork in Nepal, qualitative, data tracing, and psychological autopsy methodologies were conducted. Findings are shared through three lenses: (1) health policy and world systems; (2) epidemiology and (3) socio-cultural. The first investigates how actors representing familial, legal, and medical institutions perceive, contest, and negotiate suicide documentation, ultimately failing to accurately capture a leading cause of death. Using epidemiologic perspectives, surveillance data from medical and legal agencies are analyzed and pragmatic approaches to better detect and prevent suicidal death in the Nepali context are recommended. The third lens provides perceived explanatory models for suicide. These narratives offer important insights into the material, social, and cultural factors that shape suicidal acts in Nepal. Findings are triangulated to inform policy, prevention, and intervention approaches to reduce suicidal behavior and improve health system capabilities to monitor violent deaths. These approaches go beyond typical psychological investigations of suicide by situating self-inflicted death within broader familial, social, and political contexts. Findings contribute to cultural anthropological theories related to suicide and knowledge production, while informing public health solutions. Looking from the margins towards centers of power, this dissertation explicates how varying institutional numbers can obfuscate and invalidate suffering experienced at local levels.
ContributorsHagaman, Ashley (Author) / Wutich, Amber (Thesis advisor) / Hruschka, Daniel (Committee member) / Kohrt, Brandon (Committee member) / Arizona State University (Publisher)
Created2017
Description
This dissertation explores the impact of environmental dependent risk on disease dynamics within a Lagrangian modeling perspective; where the identity (defined by place of residency) of individuals is preserved throughout the epidemic process. In Chapter Three, the impact of individuals who refuse to be vaccinated is explored. MMR vaccination and birth rate data from the State of California are used to determine the impact of the anti-vaccine movement on the dynamics of growth of the anti-vaccine sub-population. Dissertation results suggest that under realistic California social dynamics scenarios, it is not possible to revert the influence of anti-vaccine
contagion. In Chapter Four, the dynamics of Zika virus are explored in two highly distinct idealized environments defined by a parameter that models highly distinctive levels of risk, the result of vector and host density and vector control measures. The underlying assumption is that these two communities are intimately connected due to economics with the impact of various patterns of mobility being incorporated via
the use of residency times. In short, a highly heterogeneous community is defined by its risk of acquiring a Zika infection within one of two "spaces," one lacking access to health services or effective vector control policies (lack of resources or ignored due to high levels of crime, or poverty, or both). Low risk regions are defined as those with access to solid health facilities and where vector control measures are implemented routinely. It was found that the better connected these communities are, the existence of communities where mobility between risk regions is not hampered, lower the overall, two patch Zika prevalence. Chapter Five focuses on the dynamics of tuberculosis (TB), a communicable disease, also on an idealized high-low risk set up. The impact of mobility within these two highly distinct TB-risk environments on the dynamics and control of this disease is systematically explored. It is found that collaboration and mobility, under some circumstances, can reduce the overall TB burden.
contagion. In Chapter Four, the dynamics of Zika virus are explored in two highly distinct idealized environments defined by a parameter that models highly distinctive levels of risk, the result of vector and host density and vector control measures. The underlying assumption is that these two communities are intimately connected due to economics with the impact of various patterns of mobility being incorporated via
the use of residency times. In short, a highly heterogeneous community is defined by its risk of acquiring a Zika infection within one of two "spaces," one lacking access to health services or effective vector control policies (lack of resources or ignored due to high levels of crime, or poverty, or both). Low risk regions are defined as those with access to solid health facilities and where vector control measures are implemented routinely. It was found that the better connected these communities are, the existence of communities where mobility between risk regions is not hampered, lower the overall, two patch Zika prevalence. Chapter Five focuses on the dynamics of tuberculosis (TB), a communicable disease, also on an idealized high-low risk set up. The impact of mobility within these two highly distinct TB-risk environments on the dynamics and control of this disease is systematically explored. It is found that collaboration and mobility, under some circumstances, can reduce the overall TB burden.
ContributorsMoreno Martínez, Victor Manuel (Author) / Castillo-Chavez, Carlos (Thesis advisor) / Kang, Yun (Committee member) / Mubayi, Anuj (Committee member) / Arizona State University (Publisher)
Created2018