GloCal Fellows 2013-2014
Arti Kundu, UC Davis
Arti Kundu's PhD was based in the Civil and Environmental Engineering department at the University of California, Davis. Her dissertation research focused on estimating human health risks from enteric pathogens in environmental matrices using a probabilistic approach. Dr. Kundu has been involved with national and international research as she has pursued her passion for a career in public health. She recently finished working on a quantitative microbial risk assessment project and its application in the USA and also in a threshold country. These experiences have given her a solid motivation as a researcher and inspired her to make a difference in the world by doing more health-related research. As a result of these multi-cultural experiences, she is aware of the importance of One Health research in a developing country. Her career aspiration is to work with an international organization serving developing countries to improve human health.
Use of Molecular Techniques and Quantitative Microbial Health Risk Assessment (QMRA) to Predict Human Health Risk Assessment in India from Water-borne Pathogens
The goal of Dr. Kundu's proposed research is to investigate the water-borne illnesses in developing countries using molecular techniques and risk assessment approach. Specifically, to characterize the source of fecal contamination in polluted water bodies with the help of real time qPCR. This will help identify the sources of fecal pollution in water bodies in India. This research has two significant attributes – Microbial source tracking (MST) and Quantitative microbial risk assessment (QMRA), that have not been applied in many developing country settings. The overall objectives of this proposed research are: (1) to identify and collect data related to infectious pathogens from contaminated waters; and (2) to compile and analyze the data in a QMRA framework. Over time, it is envisioned that real-time pathogen monitoring and QMRA will help to protect public health and reduce potential health risks associated with fecal pathogens. This is a stepping stone towards application of molecular techniques with risk assessment studies in less developed countries. This research will help the diarrheal disease research group at All India Institutes of Medical Sciences (AIIMS) in developing cutting edge methods to analyze the water-borne disease.
Mentors: Dr. Woutrina Miller (UCD), Dr. Sanjeev Sinha (AIIMS), Dr.Stefan Wuertz (UCD/SCELSE)
John Rose, UC San Diego
John Rose is a resident physician in General Surgery aspiring to an academic career in health systems analysis to improve global health delivery. Over the last five years he participated in various projects aimed at increasing efficiency, reducing costs, and improving quality of surgical care at multiple levels. While a medical student at UC Irvine he collected and published data to assess the utility of pelvic radiography in the American College of Surgeons' (ACS) Adult Trauma Life Support (ATLS) protocol, providing evidence for the elimination of unnecessary scanning to reduce costs and save time for surgical teams. He also worked with the national Ministry of Health in Nicaragua to develop a screening program to address international disparities in cervical cancer mortality. During his MPH degree at the Harvard School of Public Health, he collaborated with the World Health Organization's Safe Surgery Saves Lives team and led a coalition of 1200 students to disseminate the WHO Safety Checklist in 14 countries. Research interests include surgical care quality and the reduction of disparities.
Developing quality metrics for surgical delivery in low-income countries
In an effort to improve the quality of healthcare delivery, provider organizations in the United States have mounted numerous quality improvement initiatives. Such programs include the Health and Human Services' Surgical Care Improvement Project and the American College of Surgeons' National Surgical Quality Improvement Program. The latter example has become increasingly complex and accounts for over 130 clinical variables. However, such programs overlook resource-poor settings where labor-intensive systems of data-gathering are not feasible. As a result, low-income countries cannot and do not routinely participate in efforts to improve the quality of surgical care. As a Fellow, Dr. Rose will implement an innovative data-gathering protocol to monitor the quality of surgical interventions in a resource-poor hospital setting in Mozambique, Africa. The protocol includes less than 10 clinical variables and will be validated in its ability to predict risk-adjusted mortality. This pilot project will eliminate a critical barrier to deploying quality improvement techniques in resource-poor settings around the globe.
Mentors: Dr. Steven Bickler (UCSD), Dr. David Chang (UCSD), Dr. Emilia Virginia Noormahomed (UEM), Dr. Robert Riviello (BWH).
Morgan Bailey, UC San Francisco
Morgan Michael Bailey, PhD, MPH is a post-doctoral fellow investigating environmental health problems associated with water, sanitation, and air quality. After completing his PhD in Environmental Engineering at the University of California Irvine, Dr. Bailey completed a Masters of Public Health to bridge his technical training and environmental background with the health field. Dr. Bailey has since investigated environmental health issues around the globe and has focused on using a multi-disciplinary approach to explore some of the world's most pressing health problems.
The impact of community led total sanitation on health perception, behavior, and environmental risks
Globally over 2 billion people lack access to basic sanitation, resulting in millions of preventable deaths every year. Decades of subsidizing sanitation infrastructure have failed to reduce this burden, illustrating the need for more comprehensive solutions. Sanitation interventions aimed at behavioral modification have shown promise, however, whether these interventions modify behaviors momentarily or influence deeper changes in health beliefs is not well understood. Dr. Bailey's research as a UCGHI GloCal Fellow will investigate the sustainability of one such intervention, Community Led Total Sanitation (CLTS). This research aims to evaluate the degree to which CLTS influences health perceptions, behavior, environmental risk factors, and consumer demand for sanitation services. The results of this study will help us better understand and design sanitation interventions that could significantly reduce the global environmental burden of disease.
Mentors: Dr. Craig Cohen (UCSF), Dr. Elizabeth Bukusi (KEMRI), Dr. Brandon Brown (UCI)
Argentina Servin, UC San Diego
Argentina E. Servin, MD, MPH is a bilingual and bicultural clinician trained in preventive medicine, infectious disease and clinical epidemiology. Her research focuses on HIV education, health service utilization and risk behavior among high-risk populations in Mexico and Central America, including female sex workers (FSWs), injection drug users (IDUs) and persons living with HIV. She received her MD and MPH from Universidad Xochicalco in Baja California, Mexico and is currently a post-doctoral fellow at the University of California, San Diego in the Division of Global Public Health. Presently, she serves as a Co-investigator on an NIH funded study examining the role of sex trafficking in HIV risk and control in the US-Mexico border region. She is the first US-Mexico Drug Abuse Research Fellow, a collaborative effort between the National Institute on Drug Abuse (NIDA) and the National Institute of Psychiatry Ramón de la Fuente Muñoz, along with participation from the National Commission against Addictions (CONADIC) and the Society for Prevention Research. This study is examining the association between HIV risk and childcare responsibilities among FSW-IDUs with dependent children living with them in two Mexico-US border cities.
Exploring the relationship between parental sex work, minor entry into sex work, substance use and HIV risk among FSWs from two Mexico - U.S. border cities
During her GloCal Fellowship, Dr. Servin will assess the complex and intersecting epidemics of second–generation sex work, drug use and risk for HIV in the U.S.-Mexico border context, and develop the necessary skills to implement and evaluate evidence-based HIV prevention interventions targeting vulnerable populations, such as FSW, IDUs and their children.
Mentors: Dr. Jay Silverman (UCSD), Dr. Gudelia Rangel (COLEF), Dr. Maria Luisa Zuñiga (SDSU)
Jennifer L. Syvertsen, UC San Diego
Jennifer Syvertsen, PhD, MPH is a medical anthropologist whose work combines epidemiologic methods to describe patterns of drug use with ethnographic approaches that uniquely humanize and illuminate the powerful compulsion of drug addiction and its breadth of social and health consequences. She joined the Division of Global Public Health in the UCSD School of Medicine in 2009 as graduate research fellow and bi-national coordinator for Proyecto Parejas, a study of the social epidemiology of HIV/STI risk among female sex workers and their intimate, non-commercial partners in the Mexico-U.S. border region (PI: Steffanie Strathdee, PhD). Her recent work has examined the social and emotional dimensions of HIV risk among these couples, including using photo elicitation and ethnographic observations to better understand injection drug-related harms. Dr. Syvertsen received her PhD in Anthropology from the University of South Florida in 2012, where she also earned her MPH with a concentration in epidemiology. She is currently a postdoctoral fellow at UCSD and has accepted a faculty position in the Department of Anthropology at the Ohio State University slated to begin in 2014.
Emergent injection drug use and HIV risk in Nyanza Province, Kenya
Dr. Syvertsen's study will combine ethnographic fieldwork with epidemiologic surveys and in-depth interviews to examine the emergent phenomenon of injection drug use in Nyanza Province, Western Kenya, and identify risks for drug-related health harms including HIV, Hepatitis, abscesses, and fatal overdose. The specific aims of this exploratory project are to 1) describe the social and cultural contexts of injection drug use, 2) examine the risk profiles of injectors, and 3) identify the role of migration and mobility in the diffusion of injection drug-related knowledge and practices into the region. This work will help inform local HIV service provision for injection drug users and serve as pilot data for the development of a larger study of drug-related harms in the region.
Mentors: Dr. Steffanie Strathdee (UCSD), Dr. Ohaga Spaga (Impact), Dr. Carol Camlin (UCSF)
Lianne Urada, UC San Diego
Lianne A. Urada, PhD, MSW, LCSW is an Assistant Professor in the Division of Global Public Health in the Department of Medicine at UC San Diego. Dr. Urada's research focuses on adapting structural interventions for female sex workers (FSWs) to diverse global contexts. Her expertise in this area stems from prior work in social welfare that provided the groundwork for her current work. Funded by the UC Pacific Rim Research Program, she led HIV prevention intervention research on 500 female bar/spa workers and their managers in the Philippines, collaborating with a multidisciplinary team. She also received Fordham Research Ethics Training Institute funding to investigate the ethical conduct of research of female sex workers. Formerly, as Field Faculty at UCLA, she created collaborative networks (e.g. in South Africa) that allowed other students to experience global health rotations. She has systematically attained research training for the past decade and has 13 relevant publications.
Mujeres Unidas: Barriers and Facilitators to Community Mobilization among Female Sex Workers in Tijuana, Mexico
Dr. Urada's research, “Mujeres Unidas” (Women United), will investigate barriers and facilitators to community mobilization (a structural intervention mobilizing FSWs around their safety/human rights) in Tijuana, Mexico. Her proposed work builds on successful experiences of research conducted in India, Brazil and the Dominican Republic. Her project addresses a significant global health problem associated with HIV/STI transmission and substance use. Specifically, she seeks to understand the role of community mobilization in reducing HIV/STI risks for FSWs, the role of substance use in participation, and will adapt measures of community mobilization to the Tijuana context.
Mentors: Dr. Anita Raj (UCSD), Dr. Kimberly Brouwer (UCSD), Dr. Gudelia Rangel (El Colegio de la Frontera del Norte)
Kelika Konda, UC Los Angeles
Kelika Konda, PhD, MHS, has an MHS in Social and Behavioral Interventions and PhD in Infectious Disease Epidemiology from the Johns Hopkins Bloomberg School of Public Health. She recently completed a Postdoctoral Fellowship with Dr. Thomas Coates at the UCLA Program in Global Health. Dr. Konda's primary research interest is the development and implementation of multi-component interventions to prevent HIV and other sexually transmitted infections (STIs) among men who have sex with men in Latin America. Dr. Konda has worked on HIV/STI prevention research with men who have sex with men in Peru since 2004.
Adapting Couples Voluntary Counseling and Testing for Gay Men in Peru
Dr. Konda's research will begin by using qualitative data to assess stable sexual relationships between gay men in Peru. The study will also gather information on the feasibility and acceptability of implementing couples' voluntary counseling and testing (CVCT) in this context from gay men and other key informants. Then based on the information gathered, Dr. Konda will adapt the CVCT protocol for MSM in Peru and conduct a small pilot of CVCT in this context.
Mentors: Dr. Thomas Coates (UCLA), Dr. Carlos Caceres (UPCH), Dr. Susan Kegeles (UCSF)
Aggrey S. Semeere, Makerere University
Aggrey S. Semeere, M.B., Ch.B, M.Med, M.A.S, is a Clinical Research Fellow at the Infectious Diseases Institute (IDI), Makerere University College of Health Sciences in Kampala, Uganda. Dr. Semeere is a certified Internal Medicine physician in Uganda and a graduate of the Advanced Training in Clinical Research program at the University of California, San Francisco (UCSF) as a beneficiary of an NIH funded D43 training grant program. He was also a recipient of the NIH Fogarty Clinical Research Scholar (FICRS) award in 2010, tenured at IDI. Dr. Semeere has previously worked with various clinical HIV research programs in Uganda, over time developing interest in the epidemiology of chronic disease complications and comorbidities (especially cancer and cardiovascular disease) associated with HIV infection and its attendant therapy. More recently, using HIV clinic databases from Sub Saharan Africa, he is working to provide key epidemiologic information concerning HIV related chronic disease complications and comorbidities. Specifically, he is implementing projects to describe the epidemiology of Kaposi's sarcoma (KS) in the antiretroviral therapy era using the NIH-sponsored International Epidemiologic Database to Evaluate AIDS (IeDEA) consortium databases in Sub-Saharan Africa.
Kaposi's Sarcoma Survival in sub-Saharan Africa in the Antiretroviral Therapy Era
Dr Semeere's GloCal project will focus on evaluating survival after a diagnosis of Kaposi's sarcoma (KS) among adult HIV infected patients in sub-Saharan Africa. While data from resource-rich settings have shown substantial improvement in survival among patients with KS since the availability of antiretroviral therapy, little is known about KS survival in the resource-limited settings where majority of the KS is found, especially now that ART is more available. Moreover, the few available estimates are unreliable since they are plagued by substantial losses to follow-up usually as high as 40%. In his project, Dr Semeere will examine over 1000 patients diagnosed with KS from all 4 African regions in the NIH-sponsored IeDEA consortium (East Africa, Central Africa, West Africa, and Southern Africa) to estimate KS survival in the antiretroviral therapy era, while addressing the key concern of loss to follow-up. Differences in survival will be evaluated by region, mode of clinical presentation, and calendar date. Finally, he shall also evaluate the reasons why patients with KS in sub-Saharan Africa become lost to follow-up across the regions.
Mentors: Dr. Jeffrey Martin (UCSF), Dr. Andrew Kambugu (MaKCHS), Dr. Elvin Geng (UCSF)
Kedar Radhakrishna, St. John's Research Institute
Kedar Radhakrishna, MD is a Senior Resident in the Division of Medical Informatics at St. John's Research Institute, Bangalore, India. He is also a PhD Scholar registered with the University of Maastricht Medical Centre, Netherlands where he is studying systems for developing predictive models for outcomes measurement and quality control in Indian critical care units. After receiving his medical degree, he pursued a Master's in Health Systems Research. He has worked extensively in the field of Electronic Health Records and Data Management. He has been working with developers for designing and developing solutions for clinical documentation, clinical decision support, and laboratory information systems and data portability. In 2010, he was chosen as one of the lead coordinators for writing up a proposal for India's National Health Portal which would be responsible for the dissemination of multi-lingual health information to the masses. His research objectives include using the tools of informatics to improve clinical workflows, improve clinical outcomes and thereby improve access and delivery of quality care to the masses especially in resource-constrained settings.
A novel way for monitoring hand hygiene compliance and infection control protocols: The use of sustainable technology to bring about a change in behavior that decreases healthcare associated infections.
Dr. Radhakrishna's study focuses on hand hygiene compliance and healthcare associated infections (HCAIs) in critical care units. It is a known fact that unclean health-workers' hands are the most common vehicle for transmission of pathogens from one patient to another within a healthcare setting. Prior research suggests that there is a need to develop efficient, reliable and reproducible methods for establishing adherence to hand hygiene. Evidence also indicates that multimodal interventional strategies are required to improve compliance and reduction in HCAIs. Therefore, the pilot study aims to (1) design and develop low-cost technologies that will increase hand hygiene compliance among the staff in critical care units and (2) bring about a reduction in the occurrence of HCAIs in these critical areas. This combined with healthcare provider interactions with patients will add value and continue to build evidence and possibly initiate the development of newer strategies for decreasing the occurrence of HCAIs. The study provides an excellent opportunity to utilize and analyze data meaningfully to improve patient outcomes.
Mentors: Dr. Maria Ekstrand (UCSF), Dr. Sriram Sampath (SJRI), Dr. Tony Raj (SJRI)
Luis Menacho, Universidad Peruana Cayetano Heredia (UPCH)
Luis Menacho MD, MPH is a Physician and Epidemiologist of the Unit of Epidemiology, HIV and STIs at the Peruvian Cayetano Heredia University (UPCH). He obtained a Masters in Public Health from the University of Washington in 2010 with a focus on Epidemiology and Global Health. Dr. Menacho's career has been focused on high risk population in Peru, such as men who have sex with men, and to implement HIV prevention interventions using technology such as Internet, online chat, emails and mobiles.
Exploring Peruvian Bisexual Men's Needs for Sexual Health and Preferences for HIV/STIs Interventions
Bisexual men are an important risk group with unique problems and prevention needs that do not access to HIV/STIs services in Peru due to the lack of tailored strategies. Dr. Menacho will perform formative research to explore bisexual men's needs for sexual health and preferences for HIV/STIs interventions. His work will gather information regarding how to tailor and deliver prevention interventions, and how to recruit and link them to health care.
Mentors: Dr. Jesse Clark (UCLA), Dr. Patricia Garcia (UPCH), Dr. Joseph Zunt (UW)