Health Disparities Research Among Small Tribal Populations: Describing Appropriate Criteria for Aggregating Tribal Health Data Abstracts

摘要

Aynslie Hinds, Kristine Kroeker, and Laetitia Guillemette, Co-Chairs CSEB 2016 National Student Conference Planning Committee.Investigating the similarities and differences in the global, regional, and local factors that influence vector-borne disease transmission is a critical public health need. Yet we still lack a synthetic understanding of the spatial and multi-scalar drivers of vector-borne disease ecology despite the critical contribution spatially-explicit investigations have in intervention strategies. The primary objective of this study is to describe the spatial patterns of malaria vector mosquito in rural villages in Tanzania and to evaluate the relative contribution of ecological factors over multiple scales. Trap density of Anopheles mosquitoes were collected from villages in the Hai and Machame districts in the Kilimanjaro region. Key environmental factors collected include temperature, precipitation, land-cover, elevation, vegetation and population density via satellite remote sensing from MODIS, LandScan, BIOCLIM and other sources identified in the literature. Local-scale factors were extracted from raster layers at the household level and at 2 buffer zones (1.5km and 3.0km from the household, determined by maximum mosquito dispersal range) using ArcGIS. The relationship between Anopheles abundance and these environmental factors was determined using stepwise regression and models were compared based on their adjusted-R2 values. Vegetation and water explained vector density at the household scale, whereas temperature explained vector densities at a regional scale. Predictive strength of different environmental factors on vector distributions varied over different spatial scales. We identified that spatial scale is an important consideration when assessing the impact of environmental factors on vector density. This work suggests that a multi-scalar spatial approach can allow researchers to understand the scale at which environmental factors operate to influence vector density and subsequent disease transmission.Pulmonary tuberculosis (TB) is an airborne bacterial infection that can lead to poor respiratory health. Healthcare workers and trainees working in crowded hospitals in high burden countries such as India are at great risk of being exposed to and acquiring the infection. We examined prevalence of latent TB infection and its demographic and occupational risk factors among medical and nursing undergraduates in Manipal, India. Eligible participants (n=443) included trainees before exposure to clinical settings (pre-clinical) and trainees exposed to clinical settings for at least 2 years (clinical). Cross-sectional questionnaires and physical assessment were conducted to obtain demographic and health information, and to evaluate exposure to TB in clinical and community settings. Each participant underwent the tuberculin skin test (TST) procedure to assess their latent TB infection status. Differences in infection prevalence across groups were examined using descriptive data. Risk factors for TST reaction induration size and binary TST positivity status based on a cut-off of 10mm were assessed using adjusted multivariable models. The overall prevalence of TB infection among all trainees was 5.1% (95% CI 3.1-7.2). Among medical trainees, we found a prevalence of 4.8% (95% CI 1.3-8.3) and 9.3% (95% CI 4.4-14.1) before and after clinical exposure, respectively. Among nursing trainees, we found a prevalence of 1.6% (95% CI 0-4.7) and 1.8% (95% CI 0-5.3) before and after clinical exposure, respectively.