Browsing by Author "Emmett, Susan D"

Now showing 1 - 5 of 5
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    Gestational vitamin A deficiency: A novel cause of sensorineural hearing loss in the developing world?
    (Medical Hypotheses, 2014-01) Emmett, Susan D; West, Keith P
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    Hearing Loss Is Associated With Decreased Nonverbal Intelligence in Rural Nepal
    (Otology & Neurotology, 2014-10) Emmett, Susan D; Schmitz, Jane; Pillion, Joseph; Wu, Lee; Khatry, Subarna K; Karna, Sureshwar L; LeClerq, Steven C; West, Keith P
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    Nutrition and hearing loss: a neglected cause and global health burden
    (American Journal of Clinical Nutrition, 2015-11-01) Emmett, Susan D; West, Keith P
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    Predicting virologic failure among HIV-1-infected children receiving antiretroviral therapy in Tanzania: a cross-sectional study.
    (J Acquir Immune Defic Syndr, 2010-08) Emmett, Susan D; Cunningham, Coleen K; Mmbaga, Blandina T; Kinabo, Grace D; Schimana, Werner; Swai, Mark E; Bartlett, John A; Crump, John A; Reddy, Elizabeth A
    BACKGROUND: Many HIV care and treatment programs in resource-limited settings rely on clinical and immunologic monitoring of antiretroviral therapy (ART), but accuracy of this strategy to detect virologic failure (VF) among children has not been evaluated. METHODS: A cross-sectional sample of HIV-infected children aged 1-16 years on ART >or=6 months receiving care at a Tanzanian referral center underwent clinical staging, CD4 lymphocyte measurement, plasma HIV-1 RNA level, and complete blood count. Associations with VF (HIV-1 RNA >or=400 copies/mL) were determined utilizing bivariable and multivariate analyses; accuracy of current clinical and immunologic guidelines in identifying children with VF was assessed. FINDINGS: Of 206 children (median age 8.7 years, ART duration 2.4 years), 65 (31.6%) demonstrated VF at enrollment. Clinical and immunological criteria identified 2 (3.5%) of 57 children with VF on first-line therapy, exhibiting 3.5% sensitivity and 100% specificity. VF was associated with younger age, receipt of nevirapine vs. efavirenz-based regimen, CD4% < 25%, and physician documentation of maladherence (P < 0.05 on bivariable analysis); the latter 2 factors remained significant on multivariate logistic regression. INTERPRETATION: This study demonstrates poor performance of clinical and immunologic criteria in identifying children with virologic failure. Affordable techniques for measuring HIV-1 RNA level applicable in resource-limited settings are urgently needed.
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    The Socioeconomic Impact of Hearing Loss in U.S. Adults
    (Otology & Neurotology, 2015-03) Emmett, Susan D; Francis, Howard W