Thank you for joining us!
The Havey Institute for Global Health's annual Global Health Day event is an exciting opportunity to draw together global health researchers, educators, and students to celebrate and discover more about global health research, education, and outreach efforts throughout our Northwestern community, Chicago, and beyond.
The event includes a poster and presentation showcase where students, faculty, community members and partners present on projects relevant to global health. You can view the posters and abstracts below.
Characteristics of Hospitalists at Northwestern Interested in Participating in Global Health Activities
Global health as a career focus is increasing across hospital medicine groups and there has been a significant expansion in available programs and interest. In 2013 a survey of members of the Society of Hospital Medicine revealed a growing interest in participating in global health (GH) activities. It also revealed a mismatch between training for and participation in global health activities. We aimed to determine current GH activities, interest and barriers for members in Northwestern's Division of Hospital Medicine and compare it with that of the national survey.
Presenting author: Adeboye B. Ogunseitan
Poster 1
Genomic Basis of Antiviral Resistance in SARS-CoV-2
Since the onset of the SARS-CoV-2 pandemic, there has been an urgent and ongoing effort to identify therapeutic strategies for the treatment of COVID-19. There are three antiviral drugs currently authorized for emergency use: Remdesivir, Molnupiravir, and Paxlovid. Remdesivir is incorporated by NSP12, the viral RNA-dependent RNA polymerase, into nascent viral transcripts resulting in premature chain termination and inhibition of viral replication. Molnupiravir is likewise recognized by NSP12 where it acts as a mutagenizing agent, resulting in 'error catastrophe' during viral replication. Paxlovid is an inhibitor of the SARS-CoV-2 3CL protease, which is required for processing and proper expression of several viral proteins. Genetic diversity within these drug targets may lead to the emergence of antiviral resistant variants within a patient or a population, but the identity and prevalence of these resistance mutations remains uncertain.
Presenting author: Alexandre Machado de Sant'Anna Carvalho
Poster 2
Educational stakeholder perspectives on implementing a computerized neurocognitive battery among youth in Botswana
Background: Human Immunodeficiency Virus (HIV) infection and in utero HIV exposure increase the risk of pediatric neurocognitive impairment. In Botswana, a high HIV-prevalence country, validated cognitive screening is not available, and early identification of impairment is critical for supporting the functional and educational attainment of youth. The Penn Computerized Neurocognitive Battery (CNB), a tool that streamlines assessment of neurocognitive performance, was culturally adapted for use in Botswana, so context-specific implementation strategies for its utilization in this new setting are needed. Previous research investigating medical stakeholder perspectives suggested schools as a potential setting for implementation. To effectively facilitate the uptake of CNB-based screening into routine practice, this research elicited stakeholders' perspectives to identify factors associated with the successful integration of the CNB in public educational settings to prepare for widespread implementation.
Presenting author: Amelia Van Pelt
Poster 3
Recent Trends and Characteristics of Genitourinary Fistulas in Rwanda
Genitourinary fistulas (GU) in Rwanda have significantly increased in recent years. We previously reported an increase in the proportion of vesicouterine, vesicocervical and uterovaginal fistulas, with the majority occurring after Cesarean section. Our goal is to examine the characteristics of our the most recent cohort.
Presenting author: Angie Jang
Poster 4
Implications of the innate immune response to Plasmodium falciparum for modeling: a literature review and modeling analysis
Agent-based models of malaria are increasingly used to support decision-making in malaria-endemic settings and rely on data to inform detailed parameters for human hosts, vectors, and Plasmodium parasites to adequately simulate malaria transmission dynamics. Parameter misspecification affects output credibility and regular review of model inputs is critical. Innate immune response parameters are especially uncertain due to difficulty measuring in the field and can have significant impact on modeled outcomes, such as incidence of fever, uncomplicated malaria, severe malaria, and mortality. It is thus vital that these parameters reflect nature.
Presenting author: Anne Stahlfeld
Poster 5
ViralVar: a web tool for multilevel visualization of SARS-CoV-2 genomes
The unprecedented growth of available SARS-CoV-2 genome sequences has created challenges for data analysis, increasing demands from researchers and public health officials for effective SARS-CoV-2 data analysis tools. Most currently available tools and databases are restricted to fixed subsets of SARS-CoV-2 genomes and mutations. Here, we present ViralVar, a publicly available webtool that gives users the freedom to investigate and visualize user-selected subsets of SARS-CoV-2 genomes and metadata obtained from the GISAID public database. ViralVar includes two main features to enable: 1) visualization of spatiotemporal trends in SARS-CoV-2 genetic variation over a given timeframe, and 2) visualization and analysis of mutation distributions within viral proteins in both linear and 3-dimensional space.
Presenting author: Arghavan Alisoltani
Poster 6
Attitudes towards scale-up of Intensive Combination Approach to Rollback the Epidemic in Nigerian Adolescents (iCARE) interventions for youth in Nigeria
Background: The burden of HIV/AIDS in Nigeria is the fourth largest in the world, with young men who have sex with men (YMSM) disproportionately impacted. iCARE Nigeria combination interventions, which include peer navigation and mHealth components, engaged YMSM for HIV testing and linkage-to-care (testing arm) and improved viral suppression among youth living with HIV (treatment arm) in a pilot trial. The results informed the scale-up of iCARE to six sites in Nigeria.
Presenting author: Arthi Kozhumam
Poster 7
The Role of COVID-19 on the Mental and Physical Health of Pregnant or Non-Pregnant Mothers of Young Children in Food Insecure Households
The purpose of this study was to ascertain the prevalence and effects of food insecurity on a specific sample of participants during the COVID-19 pandemic. The data were collected by using a questionnaire completed by participants who were pregnant, lactating, or mothers of living children during the COVID-19 pandemic. Collected data were used to analyze differences in food insecurity between pregnant and non-pregnant women and to investigate the perceptions of study participants regarding the effects on pregnancy from food insecurity and the pandemic.
Presenting author: Aylin G Galvan
Poster 8
Design of effective outpatient sentinel surveillance for COVID-19 decision-making: a modeling study
Background: Decision-makers impose COVID-19 mitigations based on public health indicators such as reported cases, which are sensitive to fluctuations in supply and demand for diagnostic testing, and hospital admissions, which lag infections by up to two weeks. Imposing mitigations too early has unnecessary economic costs, while imposing too late leads to uncontrolled epidemics with unnecessary cases and deaths. Sentinel surveillance of recently-symptomatic individuals in outpatient testing sites may overcome biases and lags in conventional indicators, but the minimal outpatient sentinel surveillance system needed for reliable trend estimation remains unknown.
Presenting author: Ben Toh
Poster 9
Disparities in Pediatric Healthcare Access Among Femur Fracture Patients
Background and Purpose: Previous studies have examined the relationship between patient health insurance provider, socioeconomic status (SES), and the distance traveled to receive medical care. However, this relationship has not been investigated in pediatric patients seeking care for femur fractures. The aim of this study was to investigate the relationship between patient insurance status, SES, and distance traveled to receive healthcare for pediatric femur fractures.
Presenting author: Christopher Reynolds
Poster 10
COVID-19 clinical rebound among adult patients following completion of nirmatrelvir/ritonavir therapy at Northwestern Medicine
Background: Nirmatrelvir/ritonavir (Paxlovid) is a safe and effective oral antiviral therapeutic used for treatment of mild-to-moderate COVID-19. Given its ease of dosing, this medication has potential to impact COVID-19 disease severity and improve outcomes worldwide. Case reports have described a "rebound" phenomenon whereby individuals experience a relapse or recrudescence of COVID-19 symptoms shortly after completing treatment with improvement in symptoms. There is a paucity of information on frequency of nirmatrelvir/ritonavir rebound, what factors may be contributing, and outcomes from real-world clinical data.
Presenting author: Daniel Camp
Poster 11
CPSF6 Regulates the Innate Immune Response to HIV-1
Human Immunodeficiency Virus (HIV) remains a salient public health concern nearly 40 years after its discovery, with 38.4 million people living with HIV worldwide and 1.5 million new cases occurring in 2021 [1]. One barrier to developing new therapeutic and curative strategies is an incomplete understanding of the molecular interactions between virus and host that drive viral replication.
Presenting author: Daphne Cornish
Poster 12
Molecular Epidemiology of Respiratory Syncytial Virus in the Chicagoland Area (2018-2022)
Respiratory Syncytial Virus (RSV) is a single-stranded, negative-sense RNA virus that is a major cause of global acute respiratory tract infections (ARTIs). Among infants alone, RSV results in nearly 34 million severe annual ARTIs and accounts for the large disease burden in vulnerable populations. Despite the high disease burden, no effective therapeutics or vaccines are currently available. While some studies have associated RSV serotype with disease severity in children, it is unclear if the same holds in adult populations and what the mechanism of this association might be. We aim to measure the association between RSV genetic diversity and clinical severity in inpatient adult populations.
Presenting author: Estefany Rios Guzman
Poster 13
Using Supply-Chain Information to Improve Regulatory Actions in Pharmaceutical Quality Assurance
Substandard and falsified pharmaceuticals, prevalent in low- and middle-income countries, substantially increase levels of morbidity, mortality, and drug resistance. Regulatory agencies combat this quality problem using post-market surveillance by collecting and testing samples where consumers purchase products. Existing tools for the generation and analysis of post-market surveillance data focus on the locations of detected positive samples.
Presenting author: Eugene Wickett
Poster 14
Incidence and Risk Factors of Omicron variant SARS-CoV-2 Breakthrough Infection among Vaccinated and Boosted Individuals
SARS-CoV-2 vaccines have been shown to be safe and effective against infection and severe COVID-19 disease worldwide. Certain co-morbid conditions cause immune dysfunction and may reduce immune response to vaccination. In contrast, those with co-morbidities may practice infection prevention strategies such as masking, social distancing, and receipt of monoclonal antibodies. Thus, the real-world clinical impact of immune altering co-morbidities on SARS-CoV-2 infection in the recent post-vaccination period is not well established.
Presenting author: Fabiola Moreno Echevarria
Poster 15
AN OBSERVATIONAL STUDY OF LONG-TERM NEUROLOGICAL SEQUELAE OF SARS-CoV-2 INFECTION IN LAGOS, NIGERIA
Long-term symptoms following SARS-CoV-2 infection constitute the Long COVID syndrome, also called post-acute sequelae of SARS-CoV-2 (PASC). Neurological manifestations of PASC (Neuro-PASC) are amongst the most frequent and affect quality of life and cognition. Data about the burden of Neuro-PASC in Africa is lacking. The objective of this study was to characterize and compare the range of neurologic manifestations in post-hospitalization Neuro-PASC (PNP) and non-hospitalized Neuro-PASC (NNP) patients in Lagos, Nigeria.
Presenting author: Gina S. Perez-Giraldo
Poster 16
Cardiovascular Imaging Partnership Model Between Northwestern Medicine and Alfardan Medical with Northwestern Medicine
Cardiovascular Disease (CVD) plays a significant role in global mortality, and low- and middle-income countries (LMICs) have the highest mortality and morbidity rates in CVD patients. This is primarily due to limitations in providers' ability to diagnose and manage CVD. Cardiovascular imaging (CVI) is an essential aspect of clinical care management for CVD patients. Unfortunately, other than echocardiography, there is limited access to CVI modalities including coronary angiography, positron emission tomography, cardiac computed tomography, and cardiac magnetic resonance imaging due to the high cost and limitations in training physicians and technicians.
Presenting author: Jay B Bisen
Poster 17
Establishment of Essential Primary Healthcare in Rural Tanzania
Diabetes Mellitus (DM) is a systemic disease that poses a significant risk for progressive disease due to general inflammation and ischemia, due to the body's limited ability to process sugars. The global prevalence of diabetes (8.3%) has reached epidemic proportions, and more than 80% of people with diabetes live in Low- and Middle-Income Countries. Specifically, the African region is expected to experience the highest increase in coming years with an estimated increase in prevalence rates of 98% for sub-Saharan Africa. Education and information can help people assess their risk of diabetes, motivate them to seek proper treatment and care, and inspire them to take charge of their disease.
Presenting author: Jay Bisen
Poster 18
HIV Hijacks RNA Processing Mechanisms to Control and Avoid Detection by the Cellular Innate Immune Response
Human Immunodeficiency Virus (HIV) continues to be a major global public health issue with approximately 1.5 million new diagnoses and 650,000 HIV-related deaths each year. After infecting T cells in the blood, HIV inserts its genetic material into the host DNA where it can either produce new viruses or remain dormant and avoid recognition. The dormantly infected T cells form a latent reservoir that can reactivate in the future to restart viral production. Whilst over 30 antiretroviral therapy (ART) drugs have been approved by the Food and Drug Administration (FDA), none of them target the latent reservoir of dormantly infected T cells meaning there is no cure for the estimated 38.4 million people currently living with HIV.
Presenting author: Kathryn A Jackson-Jones
Poster 19
Mutations in Persistent SARS-CoV-2 Cases
The evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with decreased susceptibility to neutralizing antibodies are of clinical importance. While several demographic and clinical correlates of Coronavirus Disease 2019 (COVID-19) outcome have been identified, their relationship to virological and immunological parameters remain poorly defined. Here, we evaluate viral diversity and the accumulation of intra-host mutations over time in a population of hospitalized adults positive for SARS-CoV-2.
Presenting author: Lacy Simons
Poster 20
Workplace preparedness and perceived stress among maternal and neonatal health care workers during the COVID-19 pandemic
The COVID-19 pandemic presents increased risks for health care workers (HCWs), physically through exposure to the virus, and psychologically through work-related stress. Maternal and neonatal HCWs face various challenges during the pandemic including inadequate means of protection while continuing to provide essential healthcare services. Understanding maternal and neonatal HCWs' levels of stress, and factors associated with this psychological impact is crucial to inform strategies to support and protect HCWs in response to current and future pandemics.
Presenting author: Lilly Liang
Poster 21
Mental Health and Adolescent Safety
Mental Health and Adolescent safety is a global crisis with a ripple effect worst than that of HIV Aids. With 1 in 4 persons globally anticipated to experience a form of mental mental condition in their lifetime, Mental health is the leading cause of disability worldwide. Our youths are the population most vulnerable. Particularly those age 14 who are at a critical transition point into Adolescence.
Presenting author: Lora Fogam
Poster 22
POTENTIAL FOR THE MODULATION OF NEURODENERATIVE PROCESSES BY ALOE VERA EXTRACTS and Magnetic Resonance Focus Ultrasoun MRgFUS
POTENTIAL FOR THE MODULATION OF NEURODENERATIVE PROCESSES BY ALOE VERA EXTRACTS and Magnetic Resonance Focus Ultrasound MRgFUS ABSTRACT Inflammation has been implicated in a significant number of human diseases. Typically, one of the deleterious agents released in such diseases, including Parkinson's disease, is reactive oxygen species (ROS) typically released from activated immune cells. Aloe Vera (Aloe barbadensis Mill) extracts have multiple established therapeutic benefits in these disease processes with a demonstrated ability to modulate pro-inflammatory processes and potentially excite Neuro-regeneration.
Presenting author: Lora Fogam
Poster 23
Addressing the mental health needs of Ukrainian refugees: An analysis of intervention methods
Since the start of Russia's war against Ukraine, millions of Ukrainian women and children have had to seek refuge in foreign countries. Despite their resilience, many of these individuals risk developing complex mental health illnesses. These illnesses include post-traumatic stress disorder, depression, generalized anxiety disorder, and panic disorder. Manifestations of these illnesses may not present themselves immediately but develop over time. This is especially the case for children, who are adept at masking their symptoms. In addition to the trauma experienced in their home country, Ukrainian refugees face additional challenges upon seeking asylum. These challenges include language barriers, stigmatization, social seclusion, survivor guilt, and academic difficulties.
Presenting author: Maria Bandriwsky
Poster 24
Resolution of SARS-CoV-2 Variants and Mixed Populations through Sanger Sequencing
Viral whole genome sequencing (WGS) for the discovery and identification of SARS-CoV-2 variants has played an important role in identifying functional mutations that alter viral transmission, immune evasion, and pathogenesis. However, specimens harboring complex mixtures of viral variants and those with low viral loads are not amenable for analysis by most WGS approaches. To overcome this limitation, we developed a single amplicon sequencing approach over the viral Spike open reading frame (ORF) to deconvolute mixed viral populations.
Presenting author: Maria Francesca Reyes Agnes
Poster 25
Characterization of the HIV Reservoir at the Population, Tissue and Genomic Level
Human Immunodeficiency Virus (HIV) is a retrovirus that establishes a chronic infection that results in acquired immunodeficiency syndrome (AIDS) if left untreated. Current anti-retroviral therapies (ART) are comprised of combinations of drugs that inhibit viral replication to below the limit of detection. ART regimens have significantly increased the life expectancy and quality of life for infected persons, but they are not curative.
Presenting author: Maryam Shaaban
Poster 26
Longitudinal assessment of early Omicron variant SARS-CoV-2 infection using DASH rapid PCR
Minute Molecular Diagnostics (M2Dx) has developed DASH (Diagnostic Analyzer for Selective Hybridization), a sample-to-answer platform designed for point-of-care (POC) use. In a series of pilot and larger clinical studies, we found that DASH POC PCR platform performed with 98% accuracy compared to laboratory-based PCR platforms and can replace expensive and time-consuming lab PCR at the POC. However, further research is needed to understand how the DASH POC PCR might be used to evaluate longitudinal changes in SARS-CoV-2 detection and virus levels from nasal and throat swabs over time.
Presenting author: Matthew Caputo
Poster 27
Evaluating trends in HIV/HBV Co-infection prevalence in the era of HBV-active antiretroviral therapy
Co-infection of HIV and HBV has been shown to be associated with rapid progression of liver disease, accelerated end-stage liver disease, liver cancer, and mortality in subjects with HIV. In Nigeria, HIV and HBV are highly endemic with three million people living with HIV and AIDS and 20 million people living with chronic HBV. HIV/HBV co-infection prevalence ranges from 11-17.8%. While HBV is most commonly transmitted horizontally in childhood, there is emerging evidence suggesting sexual transmission of HBV among HIV-infected adults in Africa.
Presenting author: Nithya Mahakala
Poster 28
Survey of Gynecologic Healthcare Access in Eastern Samar
Geographical location plays a large role in the access to health services and the quality of care received. Currently, a large disparity in access to women's health care exists for low-income countries, such as the Philippines. This global inequity is more significant when pertaining to gynecologic surgical procedures for which patients have scarcer access, receive inferior quality of care and are offered less shared decision making. Although it is tempting to assume that hurdles to care are general and apply ubiquitously to all low-income countries, it is important to identify the specific needs of a population in order to target efforts to bridge access gaps.
Presenting author: Princess Urbina
Poster 29
Advocacy at the WHO for the Prevention Neural Tube Defects through Global Mandatory Folic Acid Fortification
The 75th World Health Assembly (WHA) gathered in Geneva, Switzerland in May 2022. WHA is the decision making body of the World Health Organization (WHO). Organized neurosurgery had a presence at WHA this year, advocating for mandatory folic acid fortification for the prevention of spina bifida and anencephaly through the Global Alliance for Prevention of Spina Bifida F (GAPSBi-F). Spina bifida is a type of neural tube defect that affects one in 500 pregnancies globally, and Spina bifida-folate is 92% preventable with adequate amounts of folate in the woman's body before conception. Mandatory folic acid fortification is the most effective public health strategy to prevent spina bifida and anencephaly, yet over 100 countries lack this intervention, adversely impacting the most vulnerable populations .
Presenting author: Priyanka K. Mathur
Poster 30
Analyzing the Efficacy of COVID-19 Vaccination Strategy in the Elderly Population: A Comparison between the US and Italy
This study aimed to compare vaccine distribution and impact in Italy and the US. The study focused on the elderly as this population was prioritized for vaccination in both countries and hypothesized that the first impact of vaccination could be evident in this age group. Comparing COVID-19 vaccine distribution strategies and impact will serve to inform future public health initiatives.
Presenting author: Priyanka K. Mathur
Poster 31
Analyzing the Activities of the G4 Alliance from 2019-2023
The Global Alliance for Surgical, Obstetric, Trauma and Anaesthesia Care (G4 Alliance) is an international organization committed to making essential surgical, obstetric, trauma and anesthesia (SOTA) care accessible to all. The G4 alliance seeks to generate impact through a combination of events, publications and dissemination of written work, and focused, high impact projects. The Alliance is supported by several themed working groups across a variety of surgical domains, as well as a team of Global SOTA Fellows that help to facilitate the activities of these working groups. In this analysis, we sought to describe the activities (present and future) of the G4 Alliance from 2019-2023 to provide insight into its impact on the global surgery landscape.
Presenting author: Rushmin Khazanchi
Poster 32
Age-Friendly Services for Older Adults: Assessing the Implementation in Primary Health Care Centres in Lagos, Nigeria
Presenting author: Sarah Welch
Poster 33
Epidemiology burn injuries among youth from Peshawar Pakistan; An explanatory sequential mixed methods study
Background: The burden of unintentional injuries among youth 16-24 years is high. Objective: To determine the incidence, characteristics, and risk factors of non-fatal self-reported unintentional injuries among youth. Methods: Design: This was a mixed methods study done on youth recruited from vocational training centers in Peshawar Pakistan between February 2022 to August 2022. Participants: 547 study participants with 365 males and 182 females We collected data on self-reported counts of injuries in 12 months, sociodemographic and behavioral independent variables using an interviewer-administered WHO survey tool for injuries. Interviews were then conducted with injured youth with burn injuries.
Presenting author: Sarwat Masud
Poster 34
Exploring unique barriers faced by the Asian populations to further create a culturally relevant transplant access and education programs
Background: The evolution of transplant education and access programs have improved the lives of transplant recipients and allowed for more open conversations around transplants. Particularly, notable strides have been made to recognize and reduce the gaps of healthcare inequities. The Asian population is made of a diverse group of nationalities, religions, and languages. However, the variances of inequalities and disparities exist among the different subgroups. By shedding light into the unique barriers faced by the Asian population, transplant education and access programs can be further improved and tailored to this community. Objectives: Determine how transplant education and access programs have been and can be evolved for people of color (POC) Understand the barriers faced by Asian population towards overall healthcare ecosystem and particularly in solid organ donation
Presenting author: Swati Goyal
Poster 35
Constructing, Calibrating, and Validating an Agent-Based Model of Interventions to Detect & Treat Asymptomatic Malaria: Simulating the INDIE Trial in Burkina Faso
A major barrier to malaria elimination in endemic areas is the abundance of chronic infections with asexual parasite densities low enough to avoid symptoms – and thus treatment – but gametocyte densities high enough to perpetuate transmission. Screening, testing, and treatment (STT) interventions detect and treat asymptomatic gametocyte carriers, interrupting the chain of transmission. Various forms of STT have been evaluated through clinical trials, and mathematical models of malaria transmission have been used to further predict the impact of permutations of STT and extrapolate STT impact to new settings. To make accurate predictions, models must reproduce key quantitative relationships between parasites, symptoms, gametocytes, and infectiousness within modeled human hosts.
Presenting author: Tobias M. Holden
Poster 36