- Internal Medicine
- Tropical Diseases
Senior Associate Dean of Global Health, Stanford University (2009 - Present)
Director of Center for Innovation in Global Health, Stanford University (2009 - Present)
Director, Yale/Stanford Johnson & Johnson Global Health Scholars Program, Stanford University Site (2009 - Present)
Paul Rogers Ambassador to US Congress, US Congress (2008 - Present)
Senior Fellow, Freeman Spogli Institute (2011 - Present)
Senior Fellow, Woods Institute (2011 - Present)
Fellow, American Society of Tropical Medicine and Hygiene (2011 - Present)
Health Consultant Overseas Programs, Ford Foundation (1995 - 2011)
Honors & Awards
Humanitarian Award, Migration and Refugee, Catholic Services (1981)
Elm-Ivy Mayor's Award-New Haven CT, New Haven Mayor's Office (1993)
Best Doctors in America, Peer Selection--conducted by Connolly-Castle (1996-2010)
President, American Society of Tropical Medicine and Hygiene (2001-2002)
Christopher Krogh Award for caring for the underserved, GHEC (2002)
Distinguished Teacher's Award, Yale University (2002)
Institute of Medicine Elected Member, National Academy of Sciences (2002)
Ben Kean Medal, American Society of Tropical Medicine & Hygiene (2010)
Elizabeth Blackburn Award, American Medical Woman's Association (2017)
Boards, Advisory Committees, Professional Organizations
Councilor, National Council for American Society of Tropical Medicine and Hygiene (1991 - 1996)
Chair, ASTMH Committee for Certification Exam in the United States (1993 - Present)
Advisory Board, Global Health Corps (2008 - Present)
Advisory Board, Foundation for Advancement of International Education (2009 - Present)
Advisory Board, Harmony in Health, Borneo, Indonesia (2009 - Present)
Founding Board Member, (CUGH) Consortium of University for Global Health (2009 - Present)
Board Member, (FAIMER) Foundation for Advancement of International Medical Education and Research (2010 - Present)
Advisory Board, NIH-Fogarty Center (2012 - Present)
Center for Latin American Studies
Fellowship:Yale New Haven Rheumatology Fellowship (1983) CT
Residency:Yale New Haven Hospital (1981) CT
Residency:Yale University Traditional Internal Medicine Residency (1980) CT
Medical Education:Albert Einstein College of Medicine Office of the Registrar (1977) NY
Board Certification: Internal Medicine, American Board of Internal Medicine (1980)
Fellowship, Yale-New Haven Hospital, Rheumatology (1983)
Chief Residency, Yale-New Haven Hospital, Medicine (1981)
Residency, Yale-New Haven Hospital, Medicine (1980)
Internship, Yale-New Haven Hospital, Medicine (1978)
Diploma, Walter Reed Hospital, DC, Tropical Medicine (1980)
M.D., Albert Einstein College (AOA), Medicine (1977)
A.B., Bryn Mawr College (Magna cum laude), A.B. (1974)
Community and International Work
Global Scholars program, Uganda, Borneo,Bangladesh,Eritrea,Liberia,Haiti,South Africa,Liberia
Education in Subsaharan Africa
Twinned with various overseas institutions
Opportunities for Student Involvement
Stanford Global Fellows, Haiti, Uganda,Liberia,Eritrea,Liberia.Borneo
Makerere University - Uganda, Tugela Ferry - South Africa, Orotta Medical School - Eritrea
Opportunities for Student Involvement
Current Research and Scholarly Interests
Michele Barry, MD, FACP is the Senior Associate Dean for Global Health and Director of the Center for Innovation in Global Health. As a co-Founder and co-Director of the Yale/Stanford Johnson and Johnson Global Health Scholar Award,she has sent over 1000 physicians overseas to underserved areas to help strengthen health infrastructure in low resource settings. She also is current co-PI of two NIH initiatives: Global Health Equity Scholars Program and the NIH-MEPI to twin University of Zimbabwe Health Sciences with Stanford. As a past President of the American Society of Tropical Medicine and Hygiene, she led an educational initiative in tropical medicine and travelers health which culminated in diploma courses in tropical medicine both in the U.S. and overseas, as well as a U.S. certification exam. Dr. Barry is an elected member of the Institute of Medicine and National Academy of Science. She also sits on the the Board of Directors of the Consortium of Universities involved in Global Health (CUGH), the Foundation for Advancement in International Education (FAIMER and Fogarty-NIH advisory board.
Areas of scholarly interest include ethical issues involving research overseas, clinical tropical medicine, emerging infectious diseases, problems of underserved populations and globalization's impact upon health in the developing world.
Stanford Global Health Consortium: Innovation, Design, Evaluation, and Action, Stanford University (2010 - Present)
CIDEA Stanford Global Health Consortium: Innovation, Design, Evaluation, and Action
Yale/Stanford Johnson and Johnson Global Health Scholars Mary Duke Scholar program, Stanford University
The Office of Global Health funds Stanford faculty, residents and students to the above sites for clinical, educational and research purposes depending upon the site chosen. Independent research projects can be developed especially at the Bangladesh site.
Eritrea, Bangladesh, Liberia, Indonesia, Malawi, Nepal, Uganda, South Africa
49729-Programmic: Novel, Stanford University
Programmatic: Novel Education Clinical Trainees and Researchers (NECTAR) Program
Bangladesh Stanford Global Health Collaboration, Stanford University
Global Health Fellows and Scholars Research and Training Program, Stanford University
We propose to establish a Support Center (Consortium) involving University of California- Berkeley, Yale University, Stanford University and Florida International University to train postdoctoral fellows, PhD graduate students, and medical students
Bangladesh, Kenya, Zimbabwe
Fogarty Global Health Equity Scholars Fellowship, Stanford University
The Global Health Equity Scholars (GHES) fellowship is a one-year research training program for post-doctoral fellows, upper-level PhD students and professional school (MD, DVM, DrPH, DDS, PharmD) students.
Bangladesh, Kenya, Zimbabwe
- Pathways in Global Health
MED 16SI (Spr)
- Virtual Student Exchange in Global Health between Lebanon and Stanford
MED 232 (Aut)
Independent Studies (8)
- Directed Individual Study in Earth Systems
EARTHSYS 297 (Win, Spr)
- Directed Reading in Environment and Resources
ENVRES 398 (Aut, Win, Spr, Sum)
- Directed Reading in Medicine
MED 299 (Aut, Win, Spr, Sum)
- Directed Research in Environment and Resources
ENVRES 399 (Aut, Win, Spr, Sum)
- Early Clinical Experience in Medicine
MED 280 (Aut, Win, Spr, Sum)
- Graduate Research
MED 399 (Aut, Win, Spr, Sum)
- Medical Scholars Research
MED 370 (Aut, Win, Spr, Sum)
- Undergraduate Research
MED 199 (Aut, Win, Spr, Sum)
- Directed Individual Study in Earth Systems
- Prior Year Courses
Institutionalizing healthcare hackathons to promote diversity in collaboration in medicine.
BMC medical education
2018; 18 (1): 269
BACKGROUND: Medical students and healthcare professionals can benefit from exposure to cross-disciplinary teamwork and core concepts of medical innovation. Indeed, to address complex challenges in patient care, diversity in collaboration across medicine, engineering, business, and design is critical. However, a limited number of academic institutions have established cross-disciplinary opportunities for students and young professionals within these domains to work collaboratively towards diverse healthcare needs.METHODS: Drawing upon best practices from computer science and engineering, healthcare hackathons bring together interdisciplinary teams of students and professionals to collaborate, brainstorm, and build solutions to unmet clinical needs. Over the course of six months, a committee of 20 undergraduates, medical students, and physician advisors organized Stanford University's first healthcare hackathon (November 2016). Demographic data from initial applications were supplemented with responses from a post-hackathon survey gauging themes of diversity in collaboration, professional development, interest in medical innovation, and educational value. In designing and evaluating the event, the committee focused on measurable outcomes of diversity across participants (skillset, age, gender, academic degree), ideas (clinical needs), and innovations (projects).RESULTS: Demographic data (n=587 applicants, n=257 participants) reveal participants across diverse academic backgrounds, age groups, and domains of expertise were in attendance. From 50 clinical needs presented representing 19 academic fields, 40 teams ultimately formed and submitted projects spanning web (n=13) and mobile applications (n=13), artificial intelligence-based tools (n=6), and medical devices (n=3), among others. In post-hackathon survey responses (n=111), medical students and healthcare professionals alike noted a positive impact on their ability to work in multidisciplinary teams, learn from individuals of different backgrounds, and address complex healthcare challenges.CONCLUSIONS: Healthcare hackathons can encourage diversity across individuals, ideas, and projects to address clinical challenges. By providing an outline of Stanford's inaugural event, we hope more universities can adopt the healthcare hackathon model to promote diversity in collaboration in medicine.
View details for DOI 10.1186/s12909-018-1385-x
View details for PubMedID 30458759
Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention
GLOBAL HEALTH ACTION
2018; 11 (1): 1452357
Child malnutrition, a leading cause of death and disability worldwide, is particularly severe in Madagascar, where 47% of children under 5 years are stunted (low height-for-age) and 8% are wasted (low weight-for-height). Widespread poverty and a weak health system have hindered attempts to implement life-saving malnutrition interventions in Madagascar during critical periods for growth faltering.This study aimed to shed light on the most important factors associated with child malnutrition, both acute and chronic, and the timing of growth faltering, in Ifanadiana, a rural district of Madagascar.We analyzed data from a 2014 district-representative cluster household survey, which had information on 1175 children ages 6 months to 5 years. We studied the effect of child health, birth history, maternal and paternal health and education, and household wealth and sanitation on child nutritional status. Variables associated with stunting and wasting were modeled separately in multivariate logistic regressions. Growth faltering was modeled by age range. All analyses were survey-adjusted.Stunting was associated with increasing child age (OR = 1.03 (95%CI 1.02-1.04) for each additional month), very small birth size (OR = 2.32 (1.24-4.32)), low maternal weight (OR = 0.94 (0.91-0.97) for each kilogram, kg) and height (OR = 0.95 (0.92-0.99) for each centimeter), and low paternal height (OR = 0.95 (0.92-0.98)). Wasting was associated with younger child age (OR = 0.98 (0.97-0.99)), very small birth size (OR = 2.48 (1.23-4.99)), and low maternal BMI (OR = 0.84 (0.75-0.94) for each kg/m2). Height-for-age faltered rapidly before 24 months, then slowly until age 5 years, whereas weight-for-height faltered rapidly before 12 months, then recovered gradually until age 5 years but did not reach the median.Intergenerational transmission of growth faltering and early life exposures may be important determinants of malnutrition in Ifanadiana. Timing of growth faltering, in the first 1000 days, is similar to international populations; however, child growth does not recover to the median.
View details for DOI 10.1080/16549716.2018.1452357
View details for Web of Science ID 000428701700001
View details for PubMedID 29595379
View details for PubMedCentralID PMC5912446
Medical Education Partnership Initiative (MEPI) in Zimbabwe: Outcomes and Challenges
GLOBAL HEALTH-SCIENCE AND PRACTICE
2018; 6 (1): 82–92
Sub-Saharan Africa has an inadequate number of health professionals, leading to a reduced capacity to respond to health challenges, including HIV/AIDS. From 2010 to 2015, the Medical Education Partnership Initiative (MEPI)-sponsored by the U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR) and the National Institutes of Health (NIH)-was enthusiastically taken up by the University of Zimbabwe College of Health Sciences (UZCHS) and 12 other sub-Saharan African universities to develop models of training to improve medical education and research capacity. In this article, we describe the outcomes and challenges of MEPI in Zimbabwe.UZCHS in partnership with the University of Colorado, Denver; Stanford University; University of Cape Town; University College London; and King's College London designed the Novel Education Clinical Trainees and Researchers (NECTAR) program and 2 linked awards addressing cardiovascular disease and mental health to pursue MEPI objectives. A range of medical education and research capacity-focused programs were implemented, including faculty development, research support, mentored scholars, visiting professors, community-based education, information and technology support, cross-cutting curricula, and collaboration with partner universities and the ministries of health and education. We analyzed quantitative and qualitative data from several data sources, including annual surveys of faculty, students, and other stakeholders; workshop exit surveys; and key informant interviews with NECTAR administrators and leaders and the UZCHS dean.Improved Internet connectivity and electronic resource availability were early successes of NECTAR. Over the 5-year period, 69% (115 of 166) of faculty members attended at least 1 of 15 faculty development workshops. Forty-one faculty members underwent 1-year advanced faculty development training in medical education and leadership. Thirty-three mentored research scholars were trained under NECTAR, and 52 and 12 in cardiovascular and mental health programs, respectively. Twelve MEPI scholars had joined faculty by 2015. Full-time faculty grew by 36% (122 to 166), annual postgraduate and medical student enrollment increased by 61% (75 to 121) and 71% (123 to 210), respectively. To institutionalize and sustain MEPI innovations, the Research Support Center and the Department of Health Professions Education were established at UZCHS.MEPI has synergistically revitalized medical education, research capacity, and leadership at UZCHS. Investments in creating a new research center, health professions education department, and, programs have laid the foundation to help sustain faculty development and research capacity in the country.
View details for DOI 10.9745/GHSP-D-17-00052
View details for Web of Science ID 000432977500008
View details for PubMedID 29602867
View details for PubMedCentralID PMC5878082
- Health Education Advanced Leadership for Zimbabwe (Healz): Developing the Infrastructure to Support Curriculum Reform ANNALS OF GLOBAL HEALTH 2018; 84 (1): 176–82
- A new vision for global health leadership LANCET 2017; 390 (10112): 2536–37
- The impact of megacities on health: preparing for a resilient future. The Lancet. Planetary health 2017; 1 (5): e176–e178
- Making Online Outbreak Surveillance Work for all ANNALS OF GLOBAL HEALTH 2017; 83 (3-4): 625–29
- The Perils of Trumping Science in Global Health - The Mexico City Policy and Beyond. New England journal of medicine 2017
Community outreach programs and major adherence lapses with antiretroviral therapy in rural Kakamega, Kenya
We investigated features of major adherence lapses in antiretroviral therapy (ART) at public Emusanda Health Centre in rural Kakamega County, Kenya using medical records from 2008 to 2015 for all 306 eligible patients receiving ART. Data were modelled using survival analysis. Patients were more likely to lapse if they received stavudine (hazard ratio (HR) 2.54, 95% confidence interval (95%CI):1.44-4.47) or zidovudine (HR 1.64, 95%CI:1.02-2.63) relative to tenofovir. Each day a patient slept hungry per month increased risk of major adherence lapse by 3% (95%CI:0-7%). Isolated home visits by community health workers (CHWs) were more effective to assist patients to return to the health centre than isolated phone calls (HR 2.52, 95%CI:1.02-6.20).
View details for DOI 10.1080/09540121.2017.1391987
- PROTECTING, BALANCING, AND CONFRONTING: HEALTH-SEEKING AMONG HOMELESS YOUTH IN HO CHI MINH CITY, VIETNAM INTERNATIONAL JOURNAL OF CHILD YOUTH & FAMILY STUDIES 2017; 8 (3-4): 1–25
Minimally Symptomatic Infection in an Ebola 'Hotspot': A Cross-Sectional Serosurvey
PLOS NEGLECTED TROPICAL DISEASES
2016; 10 (11)
Evidence for minimally symptomatic Ebola virus (EBOV) infection is limited. During the 2013-16 outbreak in West Africa, it was not considered epidemiologically relevant to published models or projections of intervention effects. In order to improve our understanding of the transmission dynamics of EBOV in humans, we investigated the occurrence of minimally symptomatic EBOV infection in quarantined contacts of reported Ebola virus disease cases in a recognized 'hotspot.'We conducted a cross-sectional serosurvey in Sukudu, Kono District, Sierra Leone, from October 2015 to January 2016. A blood sample was collected from 187 study participants, 132 negative controls (individuals with a low likelihood of previous exposure to Ebola virus), and 30 positive controls (Ebola virus disease survivors). IgG responses to Ebola glycoprotein and nucleoprotein were measured using Alpha Diagnostic International ELISA kits with plasma diluted at 1:200. Optical density was read at 450 nm (subtracting OD at 630nm to normalize well background) on a ChroMate 4300 microplate reader. A cutoff of 4.7 U/mL for the anti-GP ELISA yielded 96.7% sensitivity and 97.7% specificity in distinguishing positive and negative controls. We identified 14 seropositive individuals not known to have had Ebola virus disease. Two of the 14 seropositive individuals reported only fever during quarantine while the remaining 12 denied any signs or symptoms during quarantine.By using ELISA to measure Zaire Ebola virus antibody concentrations, we identified a significant number of individuals with previously undetected EBOV infection in a 'hotspot' village in Sierra Leone, approximately one year after the village outbreak. The findings provide further evidence that Ebola, like many other viral infections, presents with a spectrum of clinical manifestations, including minimally symptomatic infection. These data also suggest that a significant portion of Ebola transmission events may have gone undetected during the outbreak. Further studies are needed to understand the potential risk of transmission and clinical sequelae in individuals with previously undetected EBOV infection.
View details for DOI 10.1371/journal.pntd.0005087
View details for Web of Science ID 000392154400022
View details for PubMedID 27846221
Mortality outcomes for Chinese and Japanese immigrants in the USA and countries of origin (Hong Kong, Japan): a comparative analysis using national mortality records from 2003 to 2011.
2016; 6 (10)
With immigration and minority populations rapidly growing in the USA, it is critical to assess how these populations fare after immigration, and in subsequent generations. Our aim is to compare death rates and cause of death across foreign-born, US-born and country of origin Chinese and Japanese populations.We analysed all-cause and cause-specific age-standardised mortality rates and trends using 2003-2011 US death record data for Chinese and Japanese decedents aged 25 or older by nativity status and sex, and used the WHO Mortality Database for Hong Kong and Japan decedents in the same years. Characteristics such as age at death, absolute number of deaths by cause and educational attainment were also reported.We examined a total of 10 458 849 deaths. All-cause mortality was highest in Hong Kong and Japan, intermediate for foreign-born, and lowest for US-born decedents. Improved mortality outcomes and higher educational attainment among foreign-born were observed compared with developed Asia counterparts. Lower rates in US-born decedents were due to decreased cancer and communicable disease mortality rates in the US heart disease mortality was either similar or slightly higher among Chinese-Americans and Japanese-Americans compared with those in developed Asia counterparts.Mortality advantages in the USA were largely due to improvements in cancer and communicable disease mortality outcomes. Mortality advantages and higher educational attainments for foreign-born populations compared with developed Asia counterparts may suggest selective migration. Findings add to our limited understanding of the racial and environmental contributions to immigrant health disparities.
View details for DOI 10.1136/bmjopen-2016-012201
View details for PubMedID 27793837
View details for PubMedCentralID PMC5093623
Sex differences in obesity, dietary habits, and physical activity among urban middle-class Bangladeshis.
International journal of health sciences
2016; 10 (3): 363-372
The sustained economic growth in Bangladesh during the previous decade has created a substantial middle-class population, who have adequate income to spend on food, clothing, and lifestyle management. Along with the improvements in living standards, has also come negative impact on health for the middle class. The study objective was to assess sex differences in obesity prevalence, diet, and physical activity among urban middle-class Bangladeshi.In this cross-sectional study, conducted in 2012, we randomly selected 402 adults from Mohammedpur, Dhaka. The sampling technique was multi-stage random sampling. We used standardized questionnaires for data collection and measured height, weight, and waist circumference.Mean age (standard deviation) was 49.4 (12.7) years. The prevalence of both generalized (79% vs. 53%) and central obesity (85% vs. 42%) were significantly higher in women than men. Women reported spending more time watching TV and spending less time walking than men (p<.05); however, men reported a higher intake of unhealthy foods such as fast food and soft drinks.We conclude that the prevalence of obesity is significantly higher in urban middle-class Bangladeshis than previous urban estimates, and the burden of obesity disproportionately affects women. Future research and public health efforts are needed to address this severe obesity problem and to promote active lifestyles.
View details for PubMedID 27610059
View details for PubMedCentralID PMC5003579
Medical "Brain Drain" and Health Care Worker Shortages: How Should International Training Programs Respond?
AMA journal of ethics
2016; 18 (7): 665-675
The movement of health care workers from countries with resource scarcity and immense need ("source" countries) to areas of resource abundance and greater personal opportunity ("destination" countries) presents a complex set of decisions and relationships that affect the development of international health care systems. We explore the extent to which ethical quandaries arising from this movement are the responsibility of the said actors and the implications of these ethical quandaries for patients, governments, and physicians through the case of Dr. R, a surgeon from Nigeria who is considering working in the United States, where he is being trained to help develop surgical capacity in his country. We suggest how Dr. R, the United States, and Nigeria all contribute to "brain drain" in different but complementary ways.
View details for DOI 10.1001/journalofethics.2016.18.7.ecas1-1607
View details for PubMedID 27437816
- The Global Health Implications of e-Cigarettes. JAMA 2015; 314 (7): 663-664
- Is a Cholera Outbreak Preventable in Post-earthquake Nepal? PLoS neglected tropical diseases 2015; 9 (8)
- Is a Cholera Outbreak Preventable in Post-earthquake Nepal? PLoS neglected tropical diseases 2015; 9 (8)
Effects of Land Use on Plague (Yersinia pestis) Activity in Rodents in Tanzania
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
2015; 92 (4): 776-783
Understanding the effects of land-use change on zoonotic disease risk is a pressing global health concern. Here, we compare prevalence of Yersinia pestis, the etiologic agent of plague, in rodents across two land-use types-agricultural and conserved-in northern Tanzania. Estimated abundance of seropositive rodents nearly doubled in agricultural sites compared with conserved sites. This relationship between land-use type and abundance of seropositive rodents is likely mediated by changes in rodent and flea community composition, particularly via an increase in the abundance of the commensal species, Mastomys natalensis, in agricultural habitats. There was mixed support for rodent species diversity negatively impacting Y. pestis seroprevalence. Together, these results suggest that land-use change could affect the risk of local transmission of plague, and raise critical questions about transmission dynamics at the interface of conserved and agricultural habitats. These findings emphasize the importance of understanding disease ecology in the context of rapidly proceeding landscape change.
View details for DOI 10.4269/ajtmh.14-0504
View details for Web of Science ID 000352828200018
View details for PubMedID 25711606
View details for PubMedCentralID PMC4385772
International aid and natural disasters: a pre- and post-earthquake longitudinal study of the healthcare infrastructure in leogane, haiti.
American journal of tropical medicine and hygiene
2015; 92 (2): 448-453
The reconstruction of healthcare systems in developing countries after natural disasters is poorly understood. Using data collected before and after the 2010 Haiti earthquake, we detail the response of aid agencies and their interaction with local healthcare providers in Leogane, the city closest to the epicenter. We find that the period after the earthquake was associated with an increase in the total number of healthcare facilities, inpatient beds, and surgical facilities and that international aid has been a driving force behind this recovery. Aid has funded 12 of 13 new healthcare facilities that have opened since the earthquake as well as the reconstruction of 7 of 8 healthcare facilities that have been rebuilt. Despite increases in free, aid-financed healthcare, private Haitian healthcare facilities have remained at a constant number. The planned phase-out of several aid-financed facilities, however, will leave Leogane with fewer inpatient beds and healthcare services compared with the pre-earthquake period.
View details for DOI 10.4269/ajtmh.14-0379
View details for PubMedID 25510716
View details for PubMedCentralID PMC4347354
Innovations to Enhance the Quality of Health Professions Education at the University of Zimbabwe College of Health Sciences-NECTAR Program
2014; 89 (8): S88-S92
The University of Zimbabwe College of Health Sciences (UZCHS) is Zimbabwe's premier health professions training institution. However, several concerns were raised during the past decade over the quality of health education at UZCHS. The number of faculty and students declined markedly until 2010, when there was a medical student intake of 147 while the faculty comprised only 122 (39%) of a possible 314 positions. The economic and political crises that the country experienced from 1999 to 2009 compounded the difficulties faced by the institution by limiting the availability of resources. The Medical Education Partnership Initiative funding opportunity has given UZCHS the stimulus to embark on reforms to improve the quality of health education it offers. UZCHS, in partnership with the University of Colorado School of Medicine, the University of Colorado Denver Evaluation Center, and Stanford University, designed the Novel Education Clinical Trainees and Researchers (NECTAR) program to implement a series of health education innovations to meet this challenge. Between 2010 and 2013, innovations that have positively affected the quality of health professions education at UZCHS include the launch of comprehensive faculty development programs and mentored clinical and research programs for postgraduate students. A competency-based curriculum reform process has been initiated, a health professions department has been established, and the Research Support Center has been strengthened, providing critical resources to institutionalize health education and research implementation at the college. A core group of faculty trained in medical education has been assembled, helping to ensure the sustainability of these NECTAR activities.
View details for DOI 10.1097/ACM.0000000000000336
View details for Web of Science ID 000340290200023
View details for PubMedID 25072588
- Treating hepatitis C in lower-income countries. New England journal of medicine 2014; 370 (20): 1869-1871
High prevalence of chronic kidney disease in a community survey of urban Bangladeshis: a cross-sectional study.
Globalization and health
2014; 10 (1): 9-?
The burden of chronic kidney disease (CKD) will rise in parallel with the growing prevalence of type two diabetes mellitus in South Asia but is understudied. Using a cross-sectional survey of adults living in a middle-income neighborhood of Dhaka, Bangladesh, we tested the hypothesis that the prevalence of CKD in this group would approach that of the U.S. and would be strongly associated with insulin resistance.We enrolled 402 eligible adults (>30 years old) after performing a multi-stage random selection procedure. We administered a questionnaire, and collected fasting serum samples and urine samples. We used the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate glomerular filtration rate, and sex-specific cut offs for albuminuria: > 1.9 mg/mmol (17 mg/g) for men, and >2.8 mg/mmol (25 mg/g) for women. We assessed health-related quality of life using the Medical Outcomes Study Short Form-12 (SF-12).A total of 357 (89%) participants with serum samples comprised the analytic cohort. Mean age of was 49.5 (± 12.7) years. Chronic kidney disease was evident in 94 (26%). Of the participants with CKD, 58 (62%) had albuminuria only. A participant with insulin resistance had a 3.6-fold increase in odds of CKD (95% confidence interval 2.1 to 6.4). Participants with stage three or more advanced CKD reported a decrement in the Physical Health Composite score of the SF-12, compared with participants without CKD.We found an alarmingly high prevalence of CKD-particularly CKD associated with insulin resistance-in middle-income, urban Bangladeshis.
View details for DOI 10.1186/1744-8603-10-9
View details for PubMedID 24555767
View details for PubMedCentralID PMC3944963
- Meeting the Challenges of Global Health; pages 37-41 Stanford Social Innovation Review 2014; 12 (Number 2)
An ethics curriculum for short-term global health trainees
GLOBALIZATION AND HEALTH
Interest in short-term global health training and service programs continues to grow, yet they can be associated with a variety of ethical issues for which trainees or others with limited global health experience may not be prepared to address. Therefore, there is a clear need for educational interventions concerning these ethical issues.We developed and evaluated an introductory curriculum, "Ethical Challenges in Short-term Global Health Training." The curriculum was developed through solicitation of actual ethical issues experienced by trainees and program leaders; content drafting; and external content review. It was then evaluated from November 1, 2011, through July 1, 2012, by analyzing web usage data and by conducting user surveys. The survey included basic demographic data; prior experience in global health and global health ethics; and assessment of cases within the curriculum.The ten case curriculum is freely available at http://ethicsandglobalhealth.org. An average of 238 unique visitors accessed the site each month (standard deviation, 19). Of users who had been abroad before for global health training or service, only 31% reported prior ethics training related to short-term work. Most users (62%) reported accessing the site via personal referral or their training program; however, a significant number (28%) reported finding the site via web search, and 8% discovered it via web links. Users represented different fields: medicine (46%), public health (15%), and nursing (11%) were most common. All cases in the curriculum were evaluated favorably.The curriculum is meeting a critical need for an introduction to the ethical issues in short-term global health training. Future work will integrate this curriculum within more comprehensive curricula for global health and evaluate specific knowledge and behavioral effects, including at training sites abroad.
View details for DOI 10.1186/1744-8603-9-5
View details for Web of Science ID 000315939700001
View details for PubMedID 23410089
- Reflecting on Short-Term International Service-Learning Trips ACADEMIC MEDICINE 2013; 88 (1): 10-11
High prevalence of type 2 diabetes among the urban middle class in Bangladesh.
BMC public health
2013; 13: 1032-?
The prevalence of type-2 diabetes and metabolic syndrome are increasing in the developing world; we assessed their prevalence among the urban middle class in Bangladesh.In this cross-sectional survey (n = 402), we randomly selected consenting adults (≥ 30 years) from a middle-income neighborhood in Dhaka. We assessed demography, lifestyle, and health status, measured physical indices and blood pressure and obtained blood samples. We evaluated two primary outcomes: (1) type-2 diabetes (fasting blood glucose ≥ 7.0 mmol/L or hemoglobin A1C ≥ 6.5% (48 mmol/mol) or diabetes medication use) and (2) insulin resistance (type-2 diabetes or metabolic syndrome using International Diabetes Federation criteria).Mean age and Quételet's (body mass) index were 49.4 ± 12.6 years and 27.0 ± 5.1 kg/m²; 83% were married, 41% had ≥12 years of education, 47% were employed, 47% had a family history of diabetes. Thirty-five percent had type-2 diabetes and 45% had metabolic syndrome. In multivariate models older age and family history of diabetes were significantly associated with type-2 diabetes. Older age, female sex, overweight or obese, high wealth index and positive family history of diabetes were significantly associated with insulin resistance. Participants with type-2 diabetes or insulin resistance had significantly poorer physical health only if they had associated cardiovascular disease.The prevalence of type-2 diabetes and metabolic syndrome among the middle class in Dhaka is alarmingly high. Screening services should be implemented while researchers focus on strategies to lessen the incidence and morbidity associated with these conditions.
View details for DOI 10.1186/1471-2458-13-1032
View details for PubMedID 24172217
- Reuters - Opinion, The Great Debate Internet access is a vital healthcare tool 2013
Transient Facial Swellings in a Patient With a Remote African Travel History
JOURNAL OF TRAVEL MEDICINE
2012; 19 (3): 183-185
We present a case of Loa loa infection in a patient, 21 years after visiting an endemic area for only 4 days. To our knowledge, this case represents the longest time for the diagnosis of loiasis to be made post-exposure in a traveler and emphasizes that even short exposures can place travelers at risk.
View details for DOI 10.1111/j.1708-8305.2012.00612.x
View details for Web of Science ID 000303197900009
View details for PubMedID 22530826
- Tb in a Global Health Exchange Program JOURNAL OF GENERAL INTERNAL MEDICINE 2012; 27 (1): 7-7
- Health Technologies and Innovation in the Global Health Arena NEW ENGLAND JOURNAL OF MEDICINE 2011; 365 (9): 779-782
Short-Term Global Health Research Projects by US Medical Students: Ethical Challenges for Partnerships
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
2010; 83 (2): 211-214
Recent interest in global health among medical students has grown drastically, and many students now spend time abroad conducting short-term research projects in low-resource settings. These short-term stints in developing countries present important ethical challenges to US-based students and their medical schools as well as the institutions that host such students abroad. This paper outlines some of these ethical issues and puts forth recommendations for ethically mindful short-term student research.
View details for DOI 10.4269/ajtmh.2010.09-0692
View details for Web of Science ID 000280694300003
View details for PubMedID 20682858
- GLOBAL HEALTH Fifty Years of US Embargo: Cuba's Health Outcomes and Lessons SCIENCE 2010; 328 (5978): 572-573
- Ethics and Best Practice Guidelines for Training Experiences in Global Health Am J Trop Med Hyg 2010; 83 (6): 1178-1182
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- Suburban Leptospirosis: Atypical Lymphocytosis and Gamma-delta T cell response. Clinical Infectious Diseases 2006; 43 (Nov 15): 1306
- Presidential Address - Disease without borders: globalization's challenge to the American Society of Tropical Medicine and Hygiene: A call for public advocacy and activism. Am J Trop Med Hyg 2003; 69 (1): 3-7
- The International Health Program: The fifteen year experience with Yale University's Internal Medicine Residency Program. Am J Trop Med Hyg 1999; 61 (6): 1019-1023
- Treatment of a Laboratory Acquired Infection of Sabiá Virus. NEJM 1995; 333: 294-296
- Zimbabwe: Health care changes after independence and transition to majority rule. JAMA 1990; 263 (5): 638-640
- Ethical considerations of human investigation in developing countries: The AIDS dilemma. NEJM 1988; 319 (16): 1083-1086