scholarly journals The Centennial of the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health: A Century of Epidemiologic Discovery and Education

2019 ◽  
Vol 188 (12) ◽  
pp. 2043-2048
Author(s):  
David D Celentano ◽  
Elizabeth Platz ◽  
Shruti H Mehta
Keyword(s):  
Public Health ◽  
New Technologies ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Early Years ◽  
Epidemiologic Transition ◽  
Disease Etiology ◽  
Disease Epidemiology ◽  
Infectious Disease Epidemiology ◽  
New Methods

Abstract The Department of Epidemiology at Johns Hopkins School of Hygiene and Public Health was founded in 1919, with Wade Hampton Frost as inaugural chair. In our Centennial Year, we review how our research and educational programs have changed. Early years focused on doctoral education in epidemiology and some limited undergraduate training for practice. Foundational work on concepts and methods linked to the infectious diseases of the day made major contributions to study designs and analytical methodologies, largely still in use. With the epidemiologic transition from infectious to chronic disease, new methods were developed. The Department of Chronic Diseases merged with the Department of Epidemiology in 1970, under the leadership of Abraham Lilienfeld. Leon Gordis became chair in 1975, and multiple educational tracks were developed. Genetic epidemiology began in 1979, followed by advances in infectious disease epidemiology spurred by the human immunodeficiency virus/acquired immune deficiency syndrome epidemic. Collaborations with the Department of Medicine led to development of the Welch Center for Prevention, Epidemiology, and Clinical Research in 1989. Between 1994 and 2008, the department experienced rapid growth in faculty and students. A new methods curriculum was instituted for upper-level epidemiologic training in 2006. Today’s research projects are increasingly collaborative, taking advantage of new technologies and methods of data collection, responding to “big data” analysis challenges. In our second century, the department continues to address issues of disease etiology and epidemiologic practice.

President's Emergency Plan for AIDS Relief (PEPFAR) Policy Process and the Conversation around HIV/AIDS in the United States

2020 ◽  
Vol 5 (2) ◽  
pp. 149-166
Author(s):  
Laura E. Jacobson
Keyword(s):  
Public Health ◽  
Policy Process ◽  
Immune Deficiency Syndrome ◽  
The United States ◽  
Deficiency Syndrome ◽  
Policy Framework ◽  
Emergency Plan ◽  
Aids Epidemic ◽  
Process Factors ◽  
Hiv Aids

In 2003, the George W. Bush administration passed the President’s Emergency Plan for AIDS Relief (PEPFAR), a US government initiative to address the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic primarily in Africa. PEPFAR’s US$18 billion budget remains the largest commitment from any nation towards a single disease and has saved countless lives. Given the historical and current political resistance to foreign aid, PEPFAR’s drastic spike in spending on HIV/AIDS raises questions over how the policy process resulted in bipartisan support. Using two policy process theories, punctuated equilibrium theory (PET) and the Narrative Policy Framework (NPF), this analysis helps explain the framing of the global HIV/AIDS epidemic and the factors that resulted in the creation of PEPFAR. The analysis of the PEPFAR policy process reveals a ‘tipping point’ in the early 2000s, when political actors, the media and advocacy coalitions benefitted from issue framing, narrative change and measures of political attention to elevate the global HIV/AIDS crisis to the public agenda. The findings highlight an increase in presidential attention, the evolution of the HIV/AIDS narrative away from stigma and the formation of powerful coalitions. Looking back on the combination of policy process factors that led to PEPFAR’s bipartisan success might lead to insights for dismantling the grand public health challenges of the present and future. This study’s findings have implications for currently stigmatised public health crises, such as the opioid epidemic.

Lessons Learnt From Exercise Celestial Navigation: The Application of a Geographic Information System to Inform Legionnaires’ Disease Control Activity

2018 ◽  
Vol 13 (02) ◽  
pp. 372-374 ◽  
Author(s):  
Emma Quinn ◽  
Kai Hsiao ◽  
George Truman ◽  
Nectarios Rose ◽  
Richard Broome
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Disease Outbreaks ◽  
Field Investigation ◽  
Geographic Information ◽  
Local Health ◽  
Control Activity ◽  
Disease Epidemiology ◽  
Infectious Disease Epidemiology ◽  
Legionnaires Disease

AbstractGeographic information systems (GIS) have emerged in the past few decades as a technology capable of assisting in the control of infectious disease outbreaks. A Legionnaires’ disease cluster investigation in May 2016 in Sydney, New South Wales (NSW), Australia, demonstrated the importance of using GIS to identify at-risk water sources in real-time for field investigation to help control any immediate environmental health risk, as well as the need for more staff trained in the use of this technology. Sydney Local Health District Public Health Unit (PHU) subsequently ran an exercise (based on this investigation) with 11 staff members from 4 PHUs across Sydney to further test staff capability to use GIS across NSW. At least 80% of exercise participants reported that the scenario progression was realistic, assigned tasks were clear, and sufficient data were provided to complete tasks. The exercise highlighted the multitude of geocoding applications and need for inter-operability of systems, as well as the need for trained staff with specific expertise in spatial analysis to help assist in outbreak control activity across NSW. Evaluation data demonstrated the need for a common GIS, regular education and training, and guidelines to support the collaborative use of GIS for infectious disease epidemiology in NSW. (Disaster Med Public Health Preparedness. 2019;13:372–374)

scholarly journals Delay between Discharge and Admit Time Delay in ADT-A03 messages via LEEDS

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Jose Serrano
Keyword(s):  
Public Health ◽  
Syndromic Surveillance ◽  
Surveillance Systems ◽  
Hospital Emergency ◽  
Timely Manner ◽  
Disease Epidemiology ◽  
Infectious Disease Epidemiology ◽  
The Difference ◽  
Disease Specific

ObjectiveTo explore the difference between the reported date of admissionand discharge date using discharge messages (A03), from hospitalemergency departments participating in the Louisiana Early EventDetection System (LEEDS.IntroductionThe Infectious Disease Epidemiology Section (IDEpi) within theOffice of Public Health (LaOPH) conducts syndromic surveillanceof emergency departments by means of the Louisiana Early EventDetection System (LEEDS). LEEDS accepts ADT (admit-discharge-transfer) messages from participating hospitals, predominately A04(registration) and A03 (discharge), to obtain symptom or syndromeinformation on patients reporting to hospital emergency departments.Capturing the data using discharge messages (A03) only could resultin a delay in receipt of data by LaOPH, considering the variability inthe length of stay of a patient in the ED.MethodsEmergency department data from participating hospitals isimported daily to LEEDS and processed for syndrome classification.IDEpi syndromic surveillance messages received for the period ofCDC week 1632 and 1636 (8/8/16-9/8/16) using MS Access andExcel to calculate the difference (in days) between the reported admitdate and discharge date in A03 messages.Results88.1% of the A03 messages submitted in the 4 week analysisperiod exhibited no delay (delay=0 days) between the admit date andthe reported discharge date, compared to only 10.7% showing a delayof one day (delay = 1 day) and 1.06% showing a delay of 2 days ormore (delay≥2 days). Less than 0.2% of the messages had missinginformation regarding discharge date (Table 1).ConclusionsSyndromic surveillance systems operate under a constant need forimprovement and enhancement. The quality of the data, independentof the quality of the system, should always strive to be of the highestpedigree in order to inform disease-specific programs and detectpublic health aberrations. In order to identify these potential concerns,it is imperative that the data be submitted to public health agenciesin a timely manner. Based on this analysis, the lapse in time betweenadmit and discharge results in little to no patient syndromic data delayfor those hospital ED’s that exclusively send A03 messages. Thisstatement is supported by the finding that close to 99% of messagesdemonstrated a delay between admit date and discharge date of oneday or less.Table 1. Delay between reported Admit and Discharge date in A03 messagessubmitted to LEEDS

scholarly journals AIDS and the Psychogeriatrician

1988 ◽  
Vol 12 (5) ◽  
pp. 187-189
Author(s):  
Cornelius L. E. Katona
Keyword(s):  
Public Health ◽  
Immune Deficiency ◽  
World Wide ◽  
Immune Deficiency Syndrome ◽  
Acquired Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Public Health Issue ◽  
Aids Epidemic ◽  
Acquired Immune Deficiency ◽  
American Geriatric Society

It might at first sight appear that old age psychiatrists and geriatricians are relatively well protected from having to deal with the problems of patients suffering from the Acquired Immune Deficiency Syndrome (AIDS). It is therefore perhaps surprising that the major article in the newsletter of the American Geriatric Society is devoted to AIDS and concludes that “there is no question that the AIDS epidemic is the most important world wide public health issue of this century”.

scholarly journals The Fifth International Neonatal and Maternal Immunization Symposium (INMIS 2019): Securing Protection for the Next Generation

mSphere ◽  
2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Manish Sadarangani ◽  
Tobias Kollmann ◽  
Gordean Bjornson ◽  
Paul Heath ◽  
Ed Clarke ◽  
...  
Keyword(s):  
Public Health ◽  
Vaccine Development ◽  
Scientific Progress ◽  
Neonatal Infection ◽  
Lessons Learned ◽  
Current Status ◽  
Disease Epidemiology ◽  
Infectious Disease Epidemiology ◽  
Maternal Immunization ◽  
Development Goals

ABSTRACT Despite significant progress in reaching some milestones of the United Nations Sustainable Development Goals, neonatal and early infant morbidity and mortality remain high, and maternal health remains suboptimal in many countries. Novel and improved preventative strategies with the potential to benefit pregnant women and their infants are needed, with maternal and neonatal immunization representing effective approaches. Experts from immunology, vaccinology, infectious diseases, clinicians, industry, public health, and vaccine-related social sciences convened at the 5th International Neonatal and Maternal Immunization Symposium (INMIS) in Vancouver, Canada, from 15 to 17 September 2019. We critically evaluated the lessons learned from recent clinical studies, presented cutting-edge scientific progress in maternal and neonatal immunology and vaccine development, and discussed maternal and neonatal immunization in the broader context of infectious disease epidemiology and public health. Focusing on practical aspects of research and implementation, we also discussed the safety, awareness, and perception of maternal immunization as an existing strategy to address the need to improve maternal and neonatal health worldwide. The symposium provided a comprehensive scientific and practical primer as well as an update for all those with an interest in maternal and neonatal infection, immunity, and vaccination. The summary presented here provides an update of the current status of progress in maternal and neonatal immunization.

Magnitude of anemia and its associated factors among adult patients with HIV/AIDS on anti-retroviral therapy at Jinka town public health facilities, South Omo zone, Southern Ethiopia; cross-sectional study

2020 ◽  
Author(s):  
Samuel Dessu ◽  
Yordanos Sisay ◽  
Meseret Girma ◽  
Eshetu Zerihun
Keyword(s):  
Public Health ◽  
Immune Deficiency ◽  
Multivariable Analysis ◽  
Immune Deficiency Syndrome ◽  
Acquired Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Acquired Immune Deficiency

Abstract Background: Anemia is Public health problem in persons living with Human immune virus/acquired immune deficiency syndrome particularly in peoples taking antiretroviral therapy. It has effect on their quality of life and disease progression to acquired immune deficiency syndrome (AIDS). Studies regarding anemia among Human immune virus/acquired immune deficiency syndrome (HIV/AIDS) patients taking antiretroviral therapy (ART) and its associated factors are scarce specifically in remote areas.Method: An institution based Cross-sectional study was employed in Jinka town public health facilities from Feb 18, 2019-March 29, 2019. Systematic random sampling method was used, and a total sample size was 422 were determined. Data was entered using Epi data version 4.4 and analyzed by using SPSS version 25 statistical software. Variables which had a p-value ≤ 0.25 in bivariate analysis were considered as candidates for multivariable regression analysis and variables which had a p-value of ≤0.05 in the multivariable analysis were considered as statistically significant.Result: The overall magnitude of anemia was 33.5 %( 95%CI: 28.8, 38.1). Multivariable analysis showed that unable to read and write (AOR:4.3; 95%CI:1.56,11.96), AZT users(AOR:3.0;95%CI:1.73,5.36), CD4 count less than 200 cells/mm3 (AOR:3.6;95%CI:1.63,8.09) and history of opportunistic infection (AOR:4.3; 95%CI:2.43,7.68) were significantly associated with the occurrence of anemia.Conclusion: More than one third of study participants were anemic. Unable to read and write, AZT users, CD4 count less than 200cells/mm3 and history of opportunistic infection were significantly associated with anemia.

The Impact of Routine HTLV-III Antibody Testing on Public Health

1987 ◽  
Vol 3 (2) ◽  
pp. 306-318
Keyword(s):  
Public Health ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Hiv Positive ◽  
Antibody Testing ◽  
Widespread Application ◽  
The Past ◽  
Immunodeficiency Virus ◽  
The Impact ◽  
Acquired Immune Deficiency

The appearance of acquired immune deficiency syndrome (AIDS) has brought suffering and death to those who are afflicted and, at the same time, has posed daunting challenges to those who care for the sufferers, to biomedicai scientists, and to those responsible for public health and public policy. Among these challenges is the protection of the nation's blood supply from contamination by human immunodeficiency virus (HIV),1 the causative agent of AIDS. This challenge was met rapidly by the development of laboratory tests to detect the presence of antibody against the virus. The application of these tests makes it possible to determine whether the person has been infected by the virus at some time and thus to exclude persons from donating blood or to discard blood already donated. In the past 15 months, the widespread application of these tests along with self-deferral and removal of HIV-positive subjects from the pool of donors has sharply reduced the likelihood of the virus being spread by way of blood products.

scholarly journals Invited Commentary: A Landmark Study Launched in a Public Health Maelstrom

2017 ◽  
Vol 185 (11) ◽  
pp. 1157-1160 ◽  
Author(s):  
Eric A. Engels ◽  
Charles S. Rabkin ◽  
James J. Goedert
Keyword(s):  
Public Health ◽  
Cohort Study ◽  
Los Angeles ◽  
Age Groups ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Hiv Replication ◽  
Aids Epidemic ◽  
Major Turning Point ◽  
History Of

Abstract The acquired immune deficiency syndrome (AIDS) epidemic was first recognized in 1981, and it quickly became a public health emergency. In a 1987 paper in the American Journal of Epidemiology (Am J Epidemiol. 1987;126(2): 310–318), Richard Kaslow et al. described the launch of the Multicenter AIDS Cohort Study (MACS), a cohort study of homosexual men in 4 US cities, the purpose of which was to better understand the natural history of AIDS and its determinants. The MACS enrolled participants through a range of community contacts. These efforts facilitated rapid recruitment, but given the targeted approaches, participants tended to comprise high-risk social networks. At baseline, 4%–26% of participants at the 4 sites reported having a sexual partner who had developed AIDS. Kaslow et al. also described baseline testing for the causative agent of AIDS, the human immunodeficiency virus (HIV). HIV seroprevalence was remarkably high, ranging from 11%–26% across age groups in Pittsburgh to 38%–53% in Los Angeles. The major turning point in the epidemic occurred in 1995–1996 when combination antiretroviral therapy was introduced, effectively blocking HIV replication and markedly reducing AIDS morbidity and mortality. The MACS cohort continues to be followed actively 3 decades after its launch and has proven to be an important resource for information on HIV infection and AIDS.

scholarly journals Comparative analysis of access to patented HIV/AIDS pharmaceutical medicines through the Canadian and EU TRIPS flexibilities measures: are they efficacious or overly burdensome and ineffective measures?

2017 ◽  
Vol 15 (2) ◽  
pp. 520 ◽  
Author(s):  
Omphemetse S Sibanda
Keyword(s):  
Public Health ◽  
Essential Medicine ◽  
Immune Deficiency Syndrome ◽  
World Trade Organisation ◽  
Deficiency Syndrome ◽  
Sub Saharan Africa ◽  
Pharmaceutical Drugs ◽  
Council Decision ◽  
Ssa Countries ◽  
Hiv Aids

This paper evaluates the Canadian and the European Union's (EU) implementation of the World Trade Organisation (WTO) General Council Decision of 2003, which resolved that developed nations could export patented pharmaceutical drugs to member states in order to address public health challenges such as Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), tuberculosis, malaria and other epidemics, such states including Sub-Saharan Africa (SSA). The author makes a primarily textual appraisal of how and to what extent the Canada Access to Medicine Regime (CAMR) and European Union (EU) Regulations benefit, for instance, SSA countries in the WTO in their quest to make essential medicine more accessible. The author argues that although there are identifiable complexities inherent in the Canadian and the EU's access to pharmaceutical product regimes, there are far more important incentives and benefits that can be reaped in taking advantage of the respective systems. The author recommends that countries facing public health crises/emergencies, such as SSA countries, and non-governmental organisations (NGOs) take advantage of the regulatory flexibilities of Canada and the EU in their efforts to provide their communities with essential HIV/AIDS treatment, and treatment for other diseases such as malaria. The author dismisses the arguments against TRIPS (Trade-Related Aspects of Intellectual Property) flexibilities-inspired legislation and similar measures as mostly mere rhetoric and hair-splitting, because they sometimes unwarrantedly dismiss a workable solution to public-health problems. 

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