Effects of prenatal lead, mercury, cadmium, and arsenic exposure on children's neurodevelopment in an artisanal small-scale gold mining area in Northwestern Tanzania using a multi-chemical exposure model.

An estimated 250 million children under five fail to reach their cognitive development potential in Africa. Growing evidence suggests reduced neurodevelopments for children from environmental exposures, yet research on this topic in Sub-Saharan Africa remains limited. This study examined the effects of multi-chemical prenatal exposure to heavy metals on developmental milestones for children aged 3-4 in artisanal and small gold mining areas in northwestern Tanzania.

A retrospective study of congenital anomalies and associated risk factors among children admitted at a tertiary hospital in northwestern Tanzania.

Congenital anomalies in Sub-Sahara Africa (SSA) are understudied despite the significant pediatric health burden. This retrospective longitudinal hospital-based study evaluated the records of 326 inpatient children under the age of two years with congenital anomalies at Bugando Medical Centre, a tertiary referral hospital in northwestern Tanzania. Classical logistic regression was used in the analysis of congenital malformation of muscles, gastrointestinal malformation, oral facial clefts, neural tube defects, and skeletal malformations.

Informal welders' occupational safety and environmental health risks in northwestern Tanzania.

Often with minimal formal training and protections, informal welders face significant occupational health and safety (OSH) risks. This cross-sectional study of 219 adult informal welders at 70 informal welding sites in Mwanza City, Tanzania aimed to: 1) capture knowledge and awareness of occupational risks and safety precautions, training, and self-reported work-related injuries and illness and 2) observe worker use of personal protective equipment and site safety. We hypothesized that knowledge, awareness, and site inspections would improve use of PPE and that improved safety and site inspections would reduce self-reported injuries and illness.

The role of geophagy and artisanal gold mining as risk factors for elevated blood lead levels in pregnant women in northwestern Tanzania.

Neither artisanal and small-scale gold mining (ASGM) or geophagy practices have received substantial attention related to blood lead levels despite the well documented deleterious effects of lead. This cross-sectional analytical study aimed to document the risk of lead exposure from geophagy and mining-related occupational activities for pregnant women. The study recruited 1056 pregnant women (883 in an ASGM area and 173 in a non-ASGM area) between April 2015 -April 2017.

Influence of intermittent iron and folic acid supplementation on cognitive abilities among adolescent girls in northwestern Tanzania.

Iron and folic acid (IFA) supplementation to reduce anemia is key for improving substantial lost disability adjusted life years (DALYs) for adolescent girls. This study assessed the impact of weekly IFA supplementation (WIFAS) on cognitive ability among adolescent girls in the Simiyu Region in northernwestern Tanzania. This cross-sectional comparative evaluation study of 770 adolescent girls (396 -WIFAS supplemented; 374 -not supplemented) evaluated the association between WIFAS and cognitive ability through a face-to-face survey and cognitive ability assessment using standardized tests (Span-forward Test, Span-backward Test and Maze Test).

Spatial distribution of suspected and confirmed cholera cases in Mwanza City, Northern Tanzania.

Cholera, which is caused by Vibrio cholerae, persists as a devastating acute diarrheal disease. Despite availability of information on socio-cultural, agent and hosts risk factors, the disease continues to claim lives of people in Tanzania. The present study explores spatial patterns of cholera cases during a 2015-16 outbreak in Mwanza, Tanzania using a geographical information system (GIS) to identify concentrations of cholera cases.

Ambient air pollution during pregnancy and DNA methylation in umbilical cord blood, with potential mediation of associations with infant adiposity: The Healthy Start study.

Background: Prenatal exposure to ambient air pollution has been associated with adverse offspring health outcomes. Childhood health effects of prenatal exposures may be mediated through changes to DNA methylation detectable at birth.

Methods: Among 429 non-smoking women in a cohort study of mother-infant pairs in Colorado, USA, we estimated associations between prenatal exposure to ambient fine particulate matter (PM) and ozone (O), and epigenome-wide DNA methylation of umbilical cord blood cells at delivery (2010-2014).

Ambient air pollution during pregnancy and cardiometabolic biomarkers in cord blood.

Unlabelled: Prenatal air pollution exposure has been associated with adverse childhood cardiometabolic outcomes. It is unknown whether evidence of metabolic disruption associated with air pollution is identifiable at birth. We examined exposure to prenatal ambient air pollution and cord blood cardiometabolic biomarkers among 812 mother-infant pairs in the Healthy Start study.

Prenatal exposure to ambient air pollution and traffic and indicators of adiposity in early childhood: the Healthy Start study.

Background: Prenatal exposure to ambient air pollution and traffic have been related to a lower birth weight and may be associated with greater adiposity in childhood. We aimed to examine associations of maternal exposure to ambient air pollution and traffic during pregnancy with indicators of adiposity in early childhood.

Methods: We included 738 participants of the Colorado-based Healthy Start study whose height, weight, waist circumference and/or fat mass were measured at age 4-6 years.

Adult Population Coverage With Influenza Vaccine and Influenza Hospitalization Rates-Is There a Role for Active Outreach to Immunize At-Risk Neighborhoods?

We evaluated whether Denver neighborhoods with elevated rates of adult hospitalizations for laboratory-confirmed influenza had lower adult coverage with influenza vaccine. Overall vaccine coverage was low. Hospitalization rates were associated with demographic and socioeconomic characteristics.

Cascades - Mapping the multi-disciplinary landscape in a post-pandemic world.

This paper introduces the Special Issue on . It reviews the contributions and highlights their multi-disciplinary interpretations of cascades. It proceeds to discuss whether the on-going unfolding of the COVID-19 pandemic illustrates the cascades metaphor.

The CHASMS conceptual model of cascading disasters and social vulnerability: The COVID-19 case example.

Complex environmental, economic, and social conditions in the places we live provide strong cues to our longevity, livelihood, and well-being. Although often distinct and evolving relatively independently, health disparity, social vulnerability and environmental justice research and practice intertwine and inform one another. Together, they increasingly provide evidence of how social processes intensify disasters almost predictably giving rise to inequitable disruptions and consequences.

Evaluation of rates of laboratory-confirmed influenza hospitalization in rural and urban census tracts over eight influenza seasons.

The burden of influenza in rural areas is largely unstudied. Rural populations may be vulnerable yet isolated from circulating virus. Laboratory-confirmed influenza hospitalizations in rural Colorado census tracts over eight influenza seasons were inconsistently distributed across seasons.

Prenatal exposure to traffic and ambient air pollution and infant weight and adiposity: The Healthy Start study.

Background: Prenatal exposures to ambient air pollution and traffic have been associated with adverse birth outcomes, and may also lead to an increased risk of obesity. Obesity risk may be reflected in changes in body composition in infancy.

Objective: To estimate associations between prenatal ambient air pollution and traffic exposure, and infant weight and adiposity in a Colorado-based prospective cohort study.

An mHealth pilot designed to increase the reach of prevention of mother-to-child transmission of HIV (PMTCT) across the treatment cascade in a resource-constrained setting in Tanzania.

Background: Data collection and integrated reporting between the multiple health facilities for supporting more efficient care linkages is an indispensable element for prevention of mother-to-child transmission of HIV (PMTCT) by fostering continuity of patient care and improving the treatment cascade for HIV-infected pregnant women. mHealth potentially presents timely solutions to the data challenges related to efficient and effective care delivery in resource-constrained settings, particularly in low- and middle-income countries.

Methods: This randomized controlled pilot study used stratified random sampling for the selection of seven intervention and seven control sites in Misungwi, Tanzania, a rural district in the northwestern region.

The sources and chemical content of edible soil sticks sold in markets in Tanzania: a cross-sectional analytical study.

Geophagy, or eating soil, is common in various countries including Tanzania. Studies have reported on the levels of different chemicals in consumed soil, some of which can be harmful to the health of individuals practicing geophagy. Dried soil sticks for eating, referred to as pemba, are commercially available in many markets in sub-Saharan Africa, but few studies have established the sources of the soils.

Knowledge of and Adherence to the Cyanide Code Among Small-scale Gold Miners in Northern Tanzania.

Background: Tanzania has seen explosive development in small scale gold mining (SGM) operations. Recently, the use of cyanide has become more common in SGM, especially in the reprocessing of mercury-amalgamated tailings from artisanal mining sites.

Objectives: The primary objective of this study was to examine the level of knowledge and adherence to the Cyanide Code among workers and managers at SGM operations in northwestern Tanzania that use cyanide for gold extraction, focusing on workers' safety.

Metabolic Testing for Adults in a State Medicaid Program Receiving Antipsychotics: Remaining Barriers to Achieving Population Health Prevention Goals.

Importance: Medicaid quality indicators track diabetes mellitus and cardiovascular disease screening in adults receiving antipsychotics and/or those with serious mental illness.

Objective: To inform performance improvement interventions by evaluating the relative importance of patient, prescriber, and practice factors affecting metabolic testing.

Design, Setting, And Participants: A retrospective cohort study was conducted using Missouri Medicaid administrative claims data (January 1, 2010, to December 31, 2012) linked with prescriber market data.

Glucose Testing for Adults Receiving Medicaid and Antipsychotics: A Population-Based Prescriber Survey on Behaviors, Attitudes, and Barriers.

Objective: This study aimed to assess provider attitudes about glucose testing for adults prescribed second-generation antipsychotic medication.

Methods: Missouri Medicaid prescribers of antipsychotics in 2011 were surveyed (N=924, 25% response rate). Pearson's chi square test was used to compare responses between prescriber specialty setting.

Health Worker mHealth Utilization: A Systematic Review.

This systematic review describes mHealth interventions directed at healthcare workers in low-resource settings from the PubMed database from March 2009 to May 2015. Thirty-one articles were selected for final review. Four categories emerged from the reviewed articles: data collection during patient visits, communication between health workers and patients, communication between health workers, and public health surveillance.

Vulnerable Populations in Hospital and Health Care Emergency Preparedness Planning: A Comprehensive Framework for Inclusion.

Introduction: As attention to emergency preparedness becomes a critical element of health care facility operations planning, efforts to recognize and integrate the needs of vulnerable populations in a comprehensive manner have lagged. This not only results in decreased levels of equitable service, but also affects the functioning of the health care system in disasters. While this report emphasizes the United States context, the concepts and approaches apply beyond this setting.

An Interactive Computer Session to Initiate Physical Activity in Sedentary Cardiac Patients: Randomized Controlled Trial.

Background: Physical activity (PA) improves many facets of health. Despite this, the majority of American adults are insufficiently active. Adults who visit a physician complaining of chest pain and related cardiovascular symptoms are often referred for further testing.

Disease mapping for informing targeted health interventions: childhood pneumonia in Bohol, Philippines.

Background: Acute lower respiratory tract infections (ALRI) are the leading cause of childhood mortality worldwide. Currently, most developing countries assign resources at a district level, and yet District Medical Officers have few tools for directing targeted interventions to high mortality or morbidity areas. Mapping of ALRI at the local level can guide more efficient allocation of resources, coordination of efforts and targeted interventions, which are particularly relevant for health management in resource-scarce settings.