News & Events

The Ethics of Medical Volunteerism

Medical Clinics of North America article by Geren S. Stone, MD, DTM&H and Kristian R. Olson, MD, MPH, DTM&H, of Mass General Global Health.

Critical Guidelines for Health Care Workers Who Deploy

Responder Tools: Academic Institutions’ Critical Guidelines for Health Care Workers Who Deploy to West Africa for the Ebola Response and Future Crises*. Disaster Medicine and Public Health Preparedness.

The Mountains Are Angry

New England Journal of Medicine Perspective article by Annekathryn Goodman, M.D..

Sign Me Up: Rules of the Road for Humanitarian Volunteers During the Ebola Outbreak

The current Ebola outbreak is the worst global public health emergency of our generation, and our global health care community must and will rise to serve those affected. Aid organizations participating in the Ebola response must carefully plan to carry out their responsibility to ensure the health, safety, and security of their responders. At the same time, individual health care workers and their employers must evaluate the ability of an aid organization to protect its workers in the complex environment of this unheralded Ebola outbreak. We present a minimum set of operational standards developed by a consortium of Boston-based hospitals that a professional organization should have in place to ensure the health, safety, and security of its staff in response to the Ebola virus disease outbreak. Disaster Medicine and Public Health Preparedness, Vol 9, Num 1, Feb 2015.

Social Integration and Suicide Mortality Among Men: 24-Year Cohort Study of U.S. Health (cont’d)

Social Integration and Suicide Mortality Among Men: 24-Year Cohort Study of U.S. Health Professionals. Social Integration and Suicide Mortality Among Men: 24-Year Cohort Study of U.S. Health Professionals CGH affiliate Alexander Tsai leads a study published in the Annals of Internal Medicine showing that social networks drastically reduce the risk of suicide deaths among men. An accompanying editorial (http://annals.org/article.aspx?articleid=1887035) reinforces their argument that a public health approach to suicide prevention is urgently needed.

Impact of Geographic and Transportation-Related Barriers on HIV Outcomes in Sub-Saharan (cont’d)

Impact of Geographic and Transportation-Related Barriers on HIV Outcomes in Sub-Saharan Africa: A Systematic Review. CGH affiliates Mark Siedner and Alexander Tsai, and director David Bangsberg, summarize the extensive body of literature linking geographic and transportation-related barriers in sub-Saharan Africa to poor outcomes across the continuum of HIV care.

Declining Prevalence of Probable Depression Among Patients Presenting for Antiretroviral (cont’d)

Declining Prevalence of Probable Depression Among Patients Presenting for Antiretroviral Therapy in Rural Uganda: The Role of Early Treatment Initiation. Depression severity at enrollment appears to be declining among participants in the NIH-funded UARTO study led by CGH director David Bangsberg, and this finding may be driven by the push for earlier treatment initiation.

Antenatal depression case finding by community health workers in South Africa: feasibility (cont’d)

Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application. A multi-site study led by CGH affiliate Alexander Tsai and UCLA researcher Mary-Jane Rotheram-Borus, and published in the Archives of Women's Mental Health, shows that community health workers can be trained to screen for depression during pregnancy using a simple mHealth application.

Global Health Training in US Graduate Psychiatric Education

CGH affiliates Vanessa Kerry, Alexander Tsai, Courtney Ng, and David Bangsberg report in Academic Psychiatry their findings from a systematic review of global health training in U.S. psychiatry residency training programs.

The Dynamic Relationship Between Social Support and HIV-Related Stigma in Rural Uganda

In an analysis of data from the NIH-funded UARTO study led by CGH director David Bangsberg, researchers find important evidence of a dynamic relationship between social support and HIV-related stigma. An editorial by Seth Kalichman (http://link.springer.com/article/10.1007%2Fs12160-014-9620-0) accompanying their publication in the Annals of Behavioral Medicine emphasizes the need for new theoretical advances in HIV stigma like these.

Joint Rapid Health Facility Capacity and Utilization Assessment

Conducted by the Ministry of Health of the Hashemite Kingdom of Jordan, with support from the World Health Organization, the International Advisory, Products and Systems, the Massachusetts General Hospital Center for Global Health, Harvard University and the Jordan University for Science and Technology

Treatment as long-term prevention: sustained reduction in HIV sexual transmission risk with (cont’d)

Treatment as long-term prevention: sustained reduction in HIV sexual transmission risk with use of antiretroviral therapy in rural Uganda. Mark Siedner and other CGH affiliates on the NIH-funded UARTO study led by CGH director David Bangsberg identified a long-term, sustained reduction in HIV transmission risk behaviors during the course of HIV treatment and published these findings in AIDS.

US medical specialty global health training and the global burden of disease

CGH affiliates Vanessa Kerry, Alexander Tsai, and David Bangsberg report in the Journal of Global Health their findings from a systematic review of global health training in U.S. residency training programs, showing that global health programs tend to track with the global burden of disease.

Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis

Adherence to HIV antiretroviral therapy (ART) is a critical determinant of HIV-1 RNA viral suppression and health outcomes. It is generally accepted that HIV-related stigma is correlated with factors that may undermine ART adherence, but its relationship with ART adherence itself is not well established. We therefore undertook this review to systematically assess the relationship between HIV-related stigma and ART adherence.

PEPFAR in Transition — Implications for HIV Care in South Africa

Over the past decade, PEPFAR has funded HIV–AIDS treatment for more than 5 million people in resource-limited settings in sub-Saharan Africa. Now, the U.S. government has reached a turning point in its emergency response and has decided to reduce funding to many of these countries, including South Africa, recipient of the most PEPFAR dollars.

Incidence and Predictors of Pregnancy among a Cohort of HIV-Positive Women Initiating (cont’d)

Incidence and Predictors of Pregnancy among a Cohort of HIV-Positive Women Initiating Antiretroviral Therapy in Mbarara, Uganda. Research from the Uganda AIDS Rural Treatment Outcomes (UARTO) study, led by CGH director Dr. David Bangsberg with collaborators at UCSF and Mbarara University, documents the incidence of pregnancy among HIV-positive women on treatment and call for more integrated services to prevent unintended pregnancies and reduce periconception risks for HIV-positive women who choose to conceive.

Malaria is an uncommon cause of adult sepsis in south-western Uganda

A study conducted by colleagues from Mbarara, Uganda along with CGH affiliate Mark Siedner finds that malaria is an uncommon cause of adult sepsis and that adult patients presenting for sepsis should be investigated thoroughly for other potential causes of disease.

Shang Ring versus forceps-guided adult male circumcision: a randomized controlled (cont’d)

Shang Ring versus forceps-guided adult male circumcision: a randomized controlled effectiveness study in southwestern Uganda. A randomized controlled trial from Uganda supervised by CGH affiliate Mark Siedner found that adult male circumcision using the Shang Ring was acceptable and achieved comparable outcomes to forceps-guided adult male circumcision.

Adjunctive Atypical Antipsychotic Treatment for Major Depressive Disorder: (cont’d)

Adjunctive Atypical Antipsychotic Treatment for Major Depressive Disorder: A Meta-Analysis of Depression, Quality of Life, and Safety Outcomes. A study supervised by CGH affiliate Alexander Tsai finds that atypical antipsychotic medications used for adjunctive treatment of depression provide some mind evidence of reducing depression symptoms, minimal evidence of improving overall well being and quality of life, and abundant evidence of potential treatment-related harm

Dissemination of Research Findings to Research Participants Living with HIV in Rural Uganda - PLOS

Community participatory research emphasizes communication of study findings to research participants of vulnerable populations. Most dissemination activities in sub-Saharan Africa have occurred after the completion (or termination) of randomized clinical trials of a defined intervention. Sharing research findings with participants during observational research can avoid therapeutic misconception as well as evaluate the validity of research involving knowledge, attitudes, or behavior through a “member check” procedure in which investigators conduct interviews regarding the relevancy and saliency of their findings. Nonetheless, the communication of research findings to participants living with HIV enrolled in observational research in a rural sub-Saharan African setting is less straightforward and presents significant challenges with respect to literacy, language, logistics, and confidentiality.

Score Zero: Making Stillbirths Count

CGH collaborator and maternal-fetal medicine specialist Blair Wylie reflects on her experience helping to address the problem of stillbirth at Mbarara Regional Referral Hospital.

Higher Baseline CD4 Cell Count Predicts Treatment Interruptions and Persistent Viremia in (cont’d)

Higher Baseline CD4 Cell Count Predicts Treatment Interruptions and Persistent Viremia in Patients Initiating ARVs in Rural Uganda: Based on their research from rural Uganda, CGH researchers show that early HIV treatment may be associated with lower adherence, suggesting the need for adherence support interventions to accompany the expansion of drug access to healthy populations.

Scaling Up mHealth: Where Is the Evidence? - PLOS Medicine

There have been hundreds of mHealth pilot studies, but the evidence base to support their scale-up has lagged. Researchers from Stellenbosch University, UCLA, and CGH recommend the development of robust standards to facilitate scalable and sustainable health information systems.