Browsing by Author "Bartlett, JA"

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    Meningococcemia in a patient coinfected with hepatitis C virus and HIV.
    (Emerg Infect Dis, 2000-11) Nelson, CG; Iler, MA; Woods, CW; Bartlett, JA; Fowler, VG
    We describe the first reported case of meningococcemia in a patient coinfected with hepatitis C virus and HIV. Hypocomplementemia secondary to hepatic dysfunction may have enhanced the patient's susceptibility to meningococcal infection.
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    Partnership Conference
    (Annals of Global Health, 2017-10-27) Bartlett, JA; Cao, S; Mmbaga, B; Qian, X; Merson, M; Kramer, R
    © 2017 Icahn School of Medicine at Mount Sinai. Background: The Duke Global Health Institute (DGHI) was founded in 2006 with a goal to foster interdisciplinary global health education and research across Duke University and Duke Medical Center. Critical to achieving this goal is the need to develop and sustain strong international partnerships. Objective: To host a conference with multiple international partners and strengthen existing relationships. Methods: After a deliberate year-long planning process, DGHI convened a Partnership Conference with its international partners on the Duke University campus in conjunction with its 10th Anniversary Celebration. The Partnership Conference sought to promote an exchange of novel ideas in support of global health education and research, explore new collaborations in South-South relationships, and identify and facilitate pursuit of new educational and research opportunities. Findings: A total of 25 partners from 10 countries and 46 DGHI faculty members participated in the 3-day event in October 2016. Activities included workshops on preselected research topics, educational symposia on novel teaching methods and harnessing technological advances, introduction of the Health Humanities Laboratory to prepare students and trainees for fieldwork, and discussions of research infrastructure and training needs. Surveys from visiting partners revealed a high degree of satisfaction. Proposed action items include methods to realize improved communications, enhancement of mutual education opportunities, support and mentoring to build local research capacity, and more exchange of faculty and students between partnering institutions. Conclusions: With careful planning from all parties, a multilateral partnership conference including both university and medical center faculty can be a productive forum for exchange on global health education and research. Sustaining such partnerships is vital to the success of global health scholarship.
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    The impact of out-of-pocket expenditures on missed appointments at HIV care and treatment centers in Northern Tanzania
    (Global Health Journal, 2021-06-01) Mhina, C; Bosworth, H; Bartlett, JA; Vilme, H; Mosha, JH; Shoo, DF; Kakumbi, TJ; Jacob, G; Muiruri, C
    Background: Missed clinic appointments negatively impact clinic patient flow and health outcomes of people living with HIV (PLHIV). PLHIV likelihood of missing clinic appointments is associated with direct and indirect expenditures made while accessing HIV care. The objective of this study was to examine the relationship between out-of-pocket (OOP) health expenditures and the likelihood of missing appointments. Method: Totally 618 PLHIV older than 18 years attending two HIV care and treatment centres (CTC) in Northern Tanzania were enrolled in the study. Clinic attendance and clinical characteristics were abstracted from medical records. Information on OOP health expenditures, demographics, and socio-economic factors were self-reported by the participants. We used a hurdle model. The first part of the hurdle model assessed the marginal effect of a one Tanzanian Shillings (TZS) increase in OOP health expenditure on the probability of having a missed appointment and the second part assessed the probability of having missed appointments for those who had missed an appointment over the study period. Results: Among these 618 participants, 242 (39%) had at least one missed clinic appointment in the past year. OOP expenditure was not significantly associated with the number of missed clinic appointments. The median amount of OOP paid was 5 100 TZS per visit, about 7% of the median monthly income. Participants who were separated from their partners (adjusted odds ratio [AOR] = 1.83, 95% confidence interval [CI]:1.11‒8.03) and those aged above 50 years (AOR = 2.85, 95% CI: 1.01‒8.03) were significantly associated with missing an appointment. For those who had at least one missed appointment over the study period, the probability of missing a clinic appointment was significantly associated with seeking care in a public CTC (P = 0.49, 95% CI: 0.88‒0.09) and aged between > 25‒35 years (P = 0.90, 95% CI: 0.11‒1.69). Conclusion: Interventions focused on improving compliance to clinic appointments should target public CTCs, PLHIV aged between > 25‒35 years, above 50 years of age and those who are separated from their partners.