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Global Health Day GLOBAL HEALTH IN THE PANDEMIC ERA

4 December 2020

Thank you for joining us!

The Institute for Global Health's annual Global Health Day event is an exciting opportunity to learn about emerging topics in global health at Northwestern, explore the breadth and depth of current research in Chicago and around the world, network with colleagues, and celebrate the leadership and achievements of our leaders and membership.

The afternoon will include a virtual poster presentation session where students, faculty, community members and partners will be presenting posters on projects relevant to global health. You can view the posters and abstracts below.

Global Health Abstract Categories

Research

SARS-CoV-2 in exhaled breath

The SARS-CoV-2 virus is thought to spread through respiratory droplets contained in exhaled breath of patients who have COVID-19. In our lab, we have successfully developed a method to measure SARS-CoV-2 RNA on the exhaled breath of infected patients.

Presenting author: Gregory Lane

*Winner*

Poster 1

Antituberculosis Therapy and Gut Microbiota: Review of Potential Host Microbiota Directed-Therapies

Tuberculosis (TB) remains a major public health concern with millions of deaths every year. In this review, we will study the role of the gut microbiota in both TB infection and treatment, and its potential link with treatment duration.

Presenting author: Dramane Diallo

Poster 2

Characteristic of Genitourinary Fistula in Kigali Rwanda; 5 year trends

Genitourinary (GU) fistula is a devastating condition that can result from difficult vaginal deliveries or as a surgical complication. Rwanda has seen notable increases in cesarean section rates as a result of a successful universal health care system. A cross-sectional study was conducted of women presenting for evaluation to the International Organization for Women and Development in Kigali, Rwanda, between February 1, 2013 and October 31, 2017.

Presenting author: Stephanie Kielb

Poster 3

Developing Telepathology Program in Promoting Cervical Cancer Research and Training in Nigeria

To promote cancer research and awareness of cervical cancer in Nigeria, a multi-institution collaborative study of epigenetic analysis of cervical cancer, funded by NCI, needs an expert team of clinicians, epidemiologists, pathologists, and basic researchers. This project focuses on identifying epigenetic markers specific to HIV-associated cervical dysplasia and invasive cervical cancer by comparing uninfected cervical cancer women and HIV-infected cervical cancer-free women in one of the most populous nations in Africa.

Presenting author: Olugbenga A. Silas

Poster 4

Potential Value of Circulating microRNA as Diagnostic Biomarkers for Breast Cancer in Lebanese Women

Breast cancer (BC) is the most predominant type of cancer among women. Lebanon is one of the countries in which the incidence of breast cancer is increasing tremendously. The Lebanese Ministry of Public Health recommends mammography for women of age 40 and above for breast cancer screening, yet 20.75% of breast cancer patients in Lebanon are younger than 40 years. Therefore, it is critical to find new biomarkers that can help in the early detection of breast cancer.

Presenting author: Maha Itani

Poster 5

Prevalence of hepatic steatosis among HIV-infected patients in Lagos University Teaching Hospital, and associated risk factors.

Non-Alcoholic Fatty Liver Disease (NAFLD) is the presence of intrahepatic fat of at least five percent of liver weight in the absence of competing liver disease etiologies. NAFLD is increasingly recognized as an important cause of liver disease in HIV-infected patients. The objective of this study was to determine the prevalence of hepatic steatosis in HIV patients in LUTH using abdominal ultrasonography, and determine its associated risk factors.

Presenting author: Emuobor Odeghe

Poster 6

Characteristics of Hepatocellular Carcinoma in Nigerians with and without HIV.

Hepatocellular carcinoma (HCC) is a major public health problem in West African countries. Risk factors including chronic HBV and HCV infection, aflatoxin exposure, and alcohol consumption play a major role in the epidemiology and clinical presentation of this disease entity. In this study we describe clinical, radiological and laboratory features as well as survival in Nigerians with HCC, with and without HIV infection, enrolled in an NCI-funded study examining biomarkers associated with HIV-associated HCC.

Presenting author: Pantong Mark Davwar

Poster 7

The prevalence of Hepatocellular Carcinoma in HIV-infection: results of large-scale liver ultrasound screening program in HIV-infected Nigerians

In Nigeria, over 3 million people are infected with HIV with prevalence rates ranging from 6.1-8.0%. Hepatocellular carcinoma (HCC) is a leading cause of cancer and cancer-related mortality in Nigeria with incidence rates >20 per 100,000 persons. HCC is also common among HIV-infected individuals and, in high income countries, is emerging as a leading cause of non-AIDS related mortality globally as access to antiretroviral therapy (ART) improves.

Presenting author: David Nyam

Poster 8

Three-year outcomes of chronic hepatitis B and HIV infection after antiviral therapy initiation in Tanzania

Hepatitis B virus (HBV) is a disease of global consequence, infecting >7% of individuals in Tanzania. In addition, HIV affects >4% of individuals in Tanzania with an estimated 5-17% having HBV/HIV co-infection. Little is known about the long-term safety and efficacy of antiviral therapy in HBV/HIV mono-infected individuals and HBV/HIV co-infected individuals in this setting.

Presenting author: Brendan Mullen

Poster 9

Characterizing the Gut Microbiome of Colorectal Cancer Patients in Mali by Disease Stage

It has been demonstrated that the microbiota is associated with the development of many types of cancer including colorectal cancer. Furthermore, the microbiota has been shown to play an essential role in the efficacy of cancer chemotherapy and immunotherapy by modulating the tumor microenvironment, thus, suggesting its direct involvement not only in the development but also in the propagation of cancer.

Presenting author: Diakité Mahamane Talphi

*Winner*

Poster 10

Association of PIN3 16-bp Duplication Polymorphism of TP53 with Breast Cancer Risk in Mali and Meta-analysis

Breast cancer is the most common tumor in women in Mali and worldwide, and has been linked to several risk factors - one of which includes genetic factors such as the PIN3 16-bp duplication polymorphism of TP53. The aim of our study was to evaluate the role of the PIN3 16-bp duplication polymorphism in the susceptibility to breast cancer in the Malian population and to perform a meta-analysis to better understand the correlation with data from other population groups.

Presenting author: Brehima Diakiite

Poster 11

A comparison of risk factors and other clinical characteristics between HIV-infected Nigerians with and without significant fibrosis/cirrhosis.

Liver disease is a major cause of morbidity and the main cause of non-AIDS associated mortality in HIV infected persons in Africa, with liver fibrosis being an important risk factor. Therefore, its early recognition and diagnosis is important to reduce morbidity and mortality.

Presenting author: Ganiat Oyeleke

Poster 12

Evaluating trends in HIV/HBV Co-infection prevalence in the era of HBV-active antiretroviral therapy

Co-infection of HIV and HBV has been shown to be associated with rapid progression of liver disease, accelerated end stage liver disease, liver cancer, and mortality in subjects with HIV. In Nigeria, HIV and HBV are highly endemic with three million people living with HIV and AIDS and 20 million people living with chronic HBV. HIV/HBV co-infection prevalence ranges from 11-17.8%. While HBV is most commonly transmitted horizontally in childhood, there is emerging evidence suggesting sexual transmission of HBV among HIV-infected adults in Africa.

Presenting author: Priyanka Pradhan

Poster 13

Understanding Cys34-Adducts' Stability by Utilizing Intraclass Correlation Coefficient

Diverse pollutions in this mother earth can generate electrophiles which are inherently reactive. These reactive electrophiles can be a few of the major causes of acute and chronical adverse health outcomes. In this respect, discovering the characteristics of these electrophiles in vivo is important for understanding our global environment and human's health.

Presenting author: Yeunook Bae

Poster 14

A Causal Inference Approach to Estimating the External Validity of Clinical Trials

Despite the perception of randomized controlled trials (RCTs) as the highest grade of clinical evidence, inferences from RCTs are threatened by limitations to both their internal and external validity. External validity is difficult to study empirically given confounding due to time, location, and population under study.

Presenting author: Neil Thivalapill

*Winner*

Poster 15

Walking Green II. Lessons Learned from Repeated Measures Experiments of Green Exercise

Although the effects of one-off forest walks on psychological and physiological measures are well documented, evidence of persistent changes in response to long-term interventions is needed to document improved health outcomes.

Presenting author: Arseniy Minasov

Poster 16

Public Health & Epidemiology

Decision Space of Health Facility Managers in Uganda and Associations With Managerial Performance

Since the 1990's, the country of Uganda's healthcare system has undergone an extensive period of devolution, or a decentralization of administrative power away from the central government towards more distal entities in the public sector. This study aimed to determine how, in the Ugandan healthcare system, decision space enumerated by national policies (de jure) differs from that reported by managers of individual facilities (de facto).

Presenting author: John Chen

Poster 17

Health Information System's Response to COVID-19 in China

After the outbreak of COVID-19 pandemic, Chinese hospitals and health information technology (HIT) vendors collaborated to provide comprehensive information technology support for the pandemic prevention and control. Up to now, the pandemic situation in China has been basically controlled, achieving a milestone.

Presenting author: Jiancheng Ye

Poster 18

The Global COVID Surveillance System: Policy, Persistence, and Transmission in Latin America and the Caribbean

SARS-CoV-19, the virus that causes COVID-19, is a global pandemic that has placed unprecedented stress on national economies, food systems and healthcare resources in Latin America and the Caribbean (LAC). This region has become an epicenter for the coronavirus, with Brazil and Argentina leading the region in caseload and deaths. Existing surveillance provides a proxy on COVID-19 reported morbidity and mortality; however, these measures make it difficult to identify shifts to the pandemic and changes in the speed and acceleration in COVID-19, or those cases that persist as a function of new cases last week.

Presenting author: Ramael Ohiomoba, Ashley Maras, and Sean Watts

Poster 19

Sub-Saharan Africa SARS-CoV-2 Surveillance System: Policy, Persistence & Transmission

In sub-Saharan Africa (SSA), many countries responded aggressively to COVID-19 with lockdown measures and border closures. Insufficient testing, asymptomatic infections, and poor reporting practices in many countries limit our understanding of the virus's impact, creating a need for enhanced surveillance.

Presenting author: Cameron Jones

Poster 20

East Asian and the Pacific Surveillance of SARS-CoV-2 Wave Two

The COVID-19 pandemic has had a profound global impact on governments, healthcare systems, economies, and populations around the world. Within the East Asia and Pacific region, some countries have mitigated the spread of the novel coronavirus effectively and largely avoided severe negative consequences, while others still struggle with containment. As the second wave reaches East Asia and the Pacific, it becomes more obvious that additional SARS-CoV-2 surveillance is needed to track recent shifts in the pandemic, rates of increase, and persistence.

Presenting author: Jasmine Lin

Poster 21

The Global Surveillance Project: Persistence and Transmission of SARS-CoV-2 in Western Europe

The COVID-19 global pandemic has severely impacted Western Europe. The varying severity between countries is likely explained by differences in prevention efforts in the form of public health policy and subsequent adherence, as well as socio-cultural, climate, and population characteristics. The goal of this study is to provide advanced surveillance metrics for COVID-19 transmission that account for shifts in the pandemic week over week, speed, acceleration, jerk and persistence, in order to better understand each country's risk for explosive growth.

Presenting author: Kasen Culler

*Winner*

Poster 22

South Asia SARS-CoV-2 Surveillance System: Race to the Top

The SAR-CoV-2 virus, that causes COVID-19, has led to a global pandemic resulting in significant morbidity and mortality. Public health surveillance is needed to inform South Asian leaders and understand when and where transmission rates are increasing.

Presenting author: Dinushi Kulasekere

Poster 23

The Global COVID Surveillance System: Policy, Persistence, and Transmission in Central Asia

The COVID-19 pandemic has swept the world, including Central Asia. Political leaders and their public health advisors responded with a variety of measures that ranged from restrictive lockdowns to denying a single infection within their country. For nations looking to develop policies that will quell the spread of the virus, an accurate surveillance system is required.

Presenting author: Elana Tori Benishay

Poster 24

Social, Educational and Economic Empowerment of Underprivileged Women in Lebanon to Combat COVID-19 and Spread Cancer Prevention Awareness

Over a million refugees were displaced out of their country and were forced to move to Lebanon. This influx has, with no doubt, augmented the pressure on the already weakened Lebanese infrastructure. In collaboration with the Center for Global Oncology at Northwestern University, we at AMALOUNA (meaning "Hope" in English), an educational organization affiliated with the American University of Beirut, that has been active since 2014 in cancer awareness and prevention campaigns tailored to the underserved population, aim at developing an approach to meet the needs of the refugees and cancer patients during this pandemic.

Presenting author: Yasmina Al Ghadban

Poster 25

Helping Babies Survive: Lessons Learned from Global Facilitators-The First Decade

Helping Babies Breathe (HBB) was first launched in 2010 as an evidence-based educational package to train healthcare workers in neonatal resuscitation in low- and middle- income countries (LMIC). Two subsequent courses, Essential Care for Every Baby (ECEB) and Essential Care for Small Babies (ECSB), were later added to teach immediate newborn care and management of complications of prematurity. Together, these courses create the Helping Babies Survive (HBS) curriculum.

Presenting author: Renate Savich

*Winner*

Poster 26

Urban-rural differentials in the determinants of malaria transmission in Nigeria

Nigeria accounted for roughly a quarter of global malaria cases and deaths in 2018. However, malaria transmission is heterogeneous at lower spatial scales, and understanding the drivers of transmission can inform decisions on where interventions should be prioritized. As such, we aimed to identify factors associated with high levels of malaria transmission within urban and rural areas.

Presenting author: Chilochibi Chiziba

Poster 27

Estimating the potential effectiveness of wide-scale implementation of intermittent preventive therapy in infants in Southern Nigeria

Nigeria accounts for 23% of malaria deaths globally with the highest burden in children under the age of five. Intermittent preventive therapy in infants (IPTi) aims to reduce clinical malaria episodes and deaths in infants and is recommended in moderate to high, non-seasonal, transmission areas. However, the impact of IPTi is highly uncertain and will depend on the achievable coverage.

Presenting author: Manuela Runge

Poster 28

The Middle East and North Africa SARS-CoV-2 Surveillance System: Policy, Persistence & Transmission

The COVID-19 global pandemic has disrupted the lives of millions and forced countries to devise public health policies to reduce the pace of transmission. In the Middle East and North Africa, falling oil prices, disparities in wealth, public health infrastructure, and proportion of refugee populations, have significantly increased the COVID-19 disease burden. In light of these mitigating factors, public health surveillance is particularly necessary to help leaders understand and implement effective disease control policies to reduce Sars-CoV-2 persistence and transmission.

Presenting author: Emily Marogi

Poster 29

Literature Review & Case Presentation

Global Pediatric Surgical Workforce Density Correlates with Pediatric Mortality

Approximately 1.7 billion children worldwide lack access to surgical care, especially in low- and middle income (LMIC) countries. Complex, congenital care requires pediatric surgeons, thus the pediatric surgical workforce density (PSWD) is an indicator of access to complete pediatric care. Adult surgical workforce density correlates with maternal mortality rates and PSWD has demonstrated correlation with improved survival of complex pediatric surgical conditions.

Presenting author: Megan Bouchard

*Winner*

Poster 30

Evaluating the Mental Health Impacts of the COVID-19 Pandemic in Urban South Africa: Perceived Risk of COVID-19 Infection and Childhood Trauma Predict Adult Depressive Symptoms

South Africa's national lockdown introduced serious threats to public mental health in a society where one in three individuals develops a psychiatric disorder during their life. We aimed to evaluate the mental health impacts of the COVID-19 pandemic using a mixed-methods design.

Presenting author: Andrew Wooyoung Kim

Poster 31

A 10,000 Foot View: A Spanish Immersion and Clinical Global Health Experience for the Family Medicine Resident in Quito, Ecuador

Global Health experiences are a valuable part of graduate medical education which increase both domestic and international medical understanding for physicians and may help to supplement healthcare efforts in underserved populations abroad. This poster is a review of a 4-week Spanish immersion elective in Quito, Ecuador through Child and Family Health International (CFHI) and Northwestern University.

Presenting author: Samuel J. Randall

Poster 32

Intercultural Health Reform in Ecuador: Exploring Effectiveness in Addressing Sexual & Reproductive Inequities

By the numbers, Ecuador boasts a rich multicultural population. Yet for many years, social, economic and health inequities contributed to poor sexual and reproductive outcomes among rural and indigenous populations.

Presenting author: Laura Hurley

Poster 33

Adverse Birth Outcomes in Adolescents in Botswana

Adolescent pregnancy remains a significant social, economic, and health care problem in sub-Saharan Africa. The adolescent birth rate in Botswana was 50 per 1000 in 2017, exceeding the global rate of 44 per 1000. The primary goal of our study was to characterize adverse birth outcomes in adolescent women in comparison with adult women in Botswana.

Presenting author: Maya Jackson-Gibson

Poster 34

Longitudinal Trend Analysis of Static and Dynamic Surveillance Metrics of SARS-CoV-2 Transmission in the United States

The emergence of SARS-CoV-2 has led to a widespread pandemic that has affected all corners of the world. The United States, especially, has been severely affected, accounting for the most COVID-19 cases and deaths around the world. Without a national COVID-19 public health response, the effects of the COVID-19 pandemic have varied regionally due to differences in socio-cultural factors and local governmental policy responses.

Presenting author: Tariq Ziad Issa

Poster 35

Using routine case data to quantify the protective efficacy of seasonal malaria chemoprevention under programmatic implementation in Burkina Faso

The emergence of digitized routine health facility data in sub-Saharan countries with a high burden of malaria presents an opportunity to analyze the changes in malaria incidence using readily available incidence data with national spatial coverage and long temporal resolution. However, issues inherent to passively collected malaria data from health facilities brings bias to analysis which fails to control for these imperfections.

Presenting author: Sebastian Rodriguez

Poster 36

Prospects and Potential for Expanding Women's Oncofertility Options

Cancer is a global disease that is expanding across socioeconomic statuses in both high-income countries (HICs) and low-middle income countries (LMICs). Oncofertility has become an interdisciplinary field that aims to connect reproductive endocrinology and oncology in order to assess the efficacy of reproduction in cancer patients. Various treatments, such as chemotherapy, surgery, and radiation, have raised survival rates for cancer patients.

Presenting author: Gabriella Tran

Poster 37

Economic Analysis of Female Genital Mutilation in the United States: Tangible and Intangible Costs

Female Genital Mutilation (FGM) is defined by the WHO as "all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons". This practice exists on a continuum of severity and has often been linked to ancient empires in regions of modern-day Northern Africa and the Middle East. However, FGM persists as a problem today, with over 200 million cases worldwide and over 500,000 within the U.S.

Presenting author: Jimmy Wester

Poster 38

Trends in Global Surgeon, Anesthesiologist, and Obstetrician Physician Ratios

Inadequate access to surgical and anesthesia care is one of the greatest global health crises, affecting over 5 billion people, with 9/10 people in low-income (LIC) and lower-middle income (L-MIC) countries unable to access safe essential and emergency surgery. A large contributing factor to this crisis is inadequate workforce, quantified by the Surgeon, Anesthesiologist and Obstetrician (SAO) workforce density (specialist physicians/100,000 population).

Presenting author: Sam Linton

Poster 39

Thematic Content Analysis of POST

Global health professionals and trainees frequently participate in activities during short-term experiences in global health (STEGH) in low or middle-income countries (LMICs) where they are confronted with the dilemma of performing outside of their scope of training (POST). The goal of this thematic content analysis is to provide qualitative descriptions of the themes that emerged regarding the ethical challenges, context, and experience with POST for clinical health professionals and trainees who participate in STEGHs.

Presenting author: Sai Maddike

Poster 40

Jobs in the Garden (JIG): A Mixed Methods, Evaluative Study of the Chicago Botanic Garden's Veteran Internship Program (VIP)

Military veterans face challenges when transitioning from active duty to civilian life. While much attention is given to veterans suffering from trauma-related symptoms, even veterans without trauma-related symptoms often find it difficult to find a job in the civilian sector.

Presenting author: Mira Yang

*Winner*

Poster 41

Haiti Project Mission: Eliminate Avoidable Blindness in Haiti

FOCUS's long range mission is to Eliminate Avoidable Blindness in Haiti. We intend to do this by developing a stronger sustainable residency affiliated with HUEH, using Grace Hospital for private and some government public care. We will work with established NGOs and the private Grace Hospital, as they are on the ground in Port au Prince, with connections to the local medical community and government.

Presenting author: William Myers

Poster 42

Survey development to measure the awareness and acceptance of the health benefits of nature

Environmental protection and the creation of green spaces is a major challenge faced by our society and has led to many studies on the process of pro-ecological behavior and the drivers of that behavior. Previous studies have found that while people are generally aware of their environmental impact, they are likely to only to change their behaviors when they are low cost and impose the fewest restrictions.

Presenting author: Lucy Weidner

Poster 43

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