Emmanuel Peprah

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Associate Professor of Global and Environmental Health

Dr. Emmanuel Peprah’s research interests lie at the confluence of understanding what, why, and how some evidence-based interventions work in some populations and not others. The programattic focus of his research is understanding the contextual factors that influence the burden of co-morbidity in people living with HIV/AIDS (PLWH), with a particular focus on cardiovascular disease risk factors and mental health. As the burden of non-communicable diseases (NCDs) continues to increase, there is an opportunity to integrate NCD management into HIV care with implemention strategies that leverage the global infrasturcture designed to improve care delivery for PLWH. Dr. Peprah has built collaborations with multidisciplinary teams of investigators, both nationally and internationally, to address the high burden of comorbidity in PLWH globally. He is also the founder of the Baakoye Foundation, a nonprofit philanthropic organization dedicated to serving people in sub-Saharan Africa, and co-founder of the Washington Leaders Index (WLI), which aims to empower the next generation of emerging leaders through active, innovative, and inclusive leadership programs. Both nonprofit organizations serve the needs of children and people globally within the domains of education and health.

Before joining GPH, Dr. Peprah was a senior program official at the National Institutes of Health (NIH), where he worked with senior leadership to oversee strategic planning, initiative development, and implementation of research priorities in the areas of translational research, implementation science, and global health. He led and managed HIV/AIDS programs and a $10 million portfolio as part of the National Heart, Lung, and Blood Institute’s Trans-Omics for Precision Medicine Program. He was instrumental in launching the Human, Heredity, and Health in Africa (H3Africa) Initiative, a multimillion trans-NIH program, and served on its executive board. Dr. Peprah has received several awards for strategic planning, management, and implementation of large-scale NIH programs.

Education

BS, Biology, Texas A&M University, Commerce, TX

PhD, Molecular Biology & Biomedical Science, Meharry Medical College, Nashville, TN

Honors and awards

NIH Director’s Award for Leadership H3Africa Stage II Team: For exceptional leadership and dedication in implementing Stage II of the Human Heredity and Health in Africa program (2018)

NHLBI’s Director's for Outstanding Service (2018)

NHLBI’s Director's for Outstanding Service Partnership/Collaboration Award for bringing multiple disciplines together to understand HIV-related co-morbidities and prepare for the challenges presented by the complex conditions of the new HIV era (2018)

NHLBI’s Director's for Outstanding Translational Science Award for demonstrating exemplary leadership and service in advancing translation research (2017)

Federal Service Career Promotion (2016)

NHLBI’s Director's for Outstanding Translational Science Award as part of the Center for Translational Research and Implementation Science (CTRIS) Leadership Team for demonstrating exemplary leadership and service in advancing CTRIS’s translation (2016)

NHLBI’s Director's for Breath of Fresh Air (Innovation) award for exemplary work evaluating NHLBI’s support for multi-project research grants and proposing creative and innovative enhancements to the NHLBI’s program project grants (PPG) (2016)

NHLBI’s Director's for Learning Environment Award for fostering a learning environment through effective administration, knowledge sharing, and thoughtful implementation of the NHLBI R35 Program (2016)

NHLBI’s Director's for Partnership/Collaboration in recognition of outstanding collaborative efforts in developing a conceptual framework for the NHLBI R35 program to provide greater funding stability and flexibility to investigators (2015)

NIH Director's Common Fund Leadership Award for the NIH Common Fund Early Independence Award Program (2013)

NIH Director's Award as a member of the Common Fund Global Health Leadership Team for outstanding service in the coordination of the Common Fund Global Health Initiatives (2012)

Certificate of Appreciation for Invited Presenter, NIH Seminar Series, STEM Careers (2012)

Certificate of Appreciation for Invited Presenter, Washington Mathematics Science Technology Public Charter High School, Washington, DC (2012)

Leadership Award, Postdoctoral Fellows Research Symposium Committee, Emory University, Atlanta, GA (2008)

Areas of research and study

Dissemination and Implementation of Evidence-based Programs

HIV/AIDS

Implementation science

Inter-organizational Networks

Translational science

Publications

Pharmacogenomics of Drugs Used in β-Thalassemia and Sickle-Cell Disease : From Basic Research to Clinical Applications

Gambari, R., Waziri, A. D., Goonasekera, H., & Peprah, E. (n.d.).

Publication year

2024

Journal title

International journal of molecular sciences

Volume

Issue

10.3390/ijms25084263

Abstract

Abstract

In this short review we have presented and discussed studies on pharmacogenomics (also termed pharmacogenetics) of the drugs employed in the treatment of β-thalassemia or Sickle-cell disease (SCD). This field of investigation is relevant, since it is expected to help clinicians select the appropriate drug and the correct dosage for each patient. We first discussed the search for DNA polymorphisms associated with a high expression of γ-globin genes and identified this using GWAS studies and CRISPR-based gene editing approaches. We then presented validated DNA polymorphisms associated with a high HbF production (including, but not limited to the HBG2 XmnI polymorphism and those related to the BCL11A, MYB, KLF-1, and LYAR genes). The expression of microRNAs involved in the regulation of γ-globin genes was also presented in the context of pharmacomiRNomics. Then, the pharmacogenomics of validated fetal hemoglobin inducers (hydroxyurea, butyrate and butyrate analogues, thalidomide, and sirolimus), of iron chelators, and of analgesics in the pain management of SCD patients were considered. Finally, we discuss current clinical trials, as well as international research networks focusing on clinical issues related to pharmacogenomics in hematological diseases.

The burden of diseases, injuries, and risk factors by state in the USA, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021

GBD 2021 US Burden of Disease Collaborators, A., Mokdad, A. H., Bisignano, C., Hsu, J. M., Aldridge, R. W., Aravkin, A. Y., Brauer, M., Bryazka, D., Cagney, J., Cogen, R. M., Culbreth, G. T., Dai, X., Daoud, F., Degenhardt, L., Dwyer-Lindgren, L., Feigin, V. L., Flor, L. S., Fu, W., Gardner, W. M., … Peprah, E. (n.d.).

Publication year

2024

Journal title

The Lancet

Volume

404

Issue

10469

Page(s)

2314-2340

10.1016/S0140-6736(24)01446-6

Abstract

Abstract

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides a comprehensive assessment of health and risk factor trends at global, regional, national, and subnational levels. This study aims to examine the burden of diseases, injuries, and risk factors in the USA and highlight the disparities in health outcomes across different states. Methods: GBD 2021 analysed trends in mortality, morbidity, and disability for 371 diseases and injuries and 88 risk factors in the USA between 1990 and 2021. We used several metrics to report sources of health and health loss related to specific diseases, injuries, and risk factors. GBD 2021 methods accounted for differences in data sources and biases. The analysis of levels and trends for causes and risk factors within the same computational framework enabled comparisons across states, years, age groups, and sex. GBD 2021 estimated years lived with disability (YLDs) and disability-adjusted life-years (DALYs; the sum of years of life lost to premature mortality and YLDs) for 371 diseases and injuries, years of life lost (YLLs) and mortality for 288 causes of death, and life expectancy and healthy life expectancy (HALE). We provided estimates for 88 risk factors in relation to 155 health outcomes for 631 risk–outcome pairs and produced risk-specific estimates of summary exposure value, relative health risk, population attributable fraction, and risk-attributable burden measured in DALYs and deaths. Estimates were produced by sex (male and female), age (25 age groups from birth to ≥95 years), and year (annually between 1990 and 2021). 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws (ie, 500 random samples from the estimate's distribution). Uncertainty was propagated at each step of the estimation process. Findings: We found disparities in health outcomes and risk factors across US states. Our analysis of GBD 2021 highlighted the relative decline in life expectancy and HALE compared with other countries, as well as the impact of COVID-19 during the first 2 years of the pandemic. We found a decline in the USA's ranking of life expectancy from 1990 to 2021: in 1990, the USA ranked 35th of 204 countries and territories for males and 19th for females, but dropped to 46th for males and 47th for females in 2021. When comparing life expectancy in the best-performing and worst-performing US states against all 203 other countries and territories (excluding the USA as a whole), Hawaii (the best-ranked state in 1990 and 2021) dropped from sixth-highest life expectancy in the world for males and fourth for females in 1990 to 28th for males and 22nd for females in 2021. The worst-ranked state in 2021 ranked 107th for males (Mississippi) and 99th for females (West Virginia). 14 US states lost life expectancy over the study period, with West Virginia experiencing the greatest loss (2·7 years between 1990 and 2021). HALE ranking declines were even greater; in 1990, the USA was ranked 42nd for males and 32nd for females but dropped to 69th for males and 76th for females in 2021. When comparing HALE in the best-performing and worst-performing US states against all 203 other countries and territories, Hawaii ranked 14th highest HALE for males and fifth for females in 1990, dropping to 39th for males and 34th for females in 2021. In 2021, West Virginia—the lowest-ranked state that year—ranked 141st for males and 137th for females. Nationally, age-standardised mortality rates declined between 1990 and 2021 for many leading causes of death, most notably for ischaemic heart disease (56·1% [95% UI 55·1–57·2] decline), lung cancer (41·9% [39·7–44·6]), and breast cancer (40·9% [38·7–43·7]). Over the same period, age-standardised mortality rates increased for other causes, particularly drug use disorders (878·0% [770·1–1015·5]), chronic kidney disease (158·3% [149·6–167·9]), and falls (89·7% [79·8–95·8]). We found substantial variation in mortality rates between states, with Hawaii having the lowest age-standardised mortality rate (433·2 per 100 000 [380·6–493·4]) in 2021 and Mississippi having the highest (867·5 per 100 000 [772·6–975·7]). Hawaii had the lowest age-standardised mortality rates throughout the study period, whereas Washington, DC, experienced the most improvement (a 40·7% decline [33·2–47·3]). Only six countries had age-standardised rates of YLDs higher than the USA in 2021: Afghanistan, Lesotho, Liberia, Mozambique, South Africa, and the Central African Republic, largely because the impact of musculoskeletal disorders, mental disorders, and substance use disorders on age-standardised disability rates in the USA is so large. At the state level, eight US states had higher age-standardised YLD rates than any country in the world: West Virginia, Kentucky, Oklahoma, Pennsylvania, New Mexico, Ohio, Tennessee, and Arizona. Low back pain was the leading cause of YLDs in the USA in 1990 and 2021, although the age-standardised rate declined by 7·9% (1·8–13·0) from 1990. Depressive disorders (56·0% increase [48·2–64·3]) and drug use disorders (287·6% [247·9–329·8]) were the second-leading and third-leading causes of age-standardised YLDs in 2021. For females, mental health disorders had the highest age-standardised YLD rate, with an increase of 59·8% (50·6–68·5) between 1990 and 2021. Hawaii had the lowest age-standardised rates of YLDs for all sexes combined (12 085·3 per 100 000 [9090·8–15 557·1]), whereas West Virginia had the highest (14 832·9 per 100 000 [11 226·9–18 882·5]). At the national level, the leading GBD Level 2 risk factors for death for all sexes combined in 2021 were high systolic blood pressure, high fasting plasma glucose, and tobacco use. From 1990 to 2021, the age-standardised mortality rates attributable to high systolic blood pressure decreased by 47·8% (43·4–52·5) and for tobacco use by 5·1% (48·3%–54·1%), but rates increased for high fasting plasma glucose by 9·3% (0·4–18·7). The burden attributable to risk factors varied by age and sex. For example, for ages 15–49 years, the leading risk factors for death were drug use, high alcohol use, and dietary risks. By comparison, for ages 50–69 years, tobacco was the leading risk factor for death, followed by dietary risks and high BMI. Interpretation: GBD 2021 provides valuable information for policy makers, health-care professionals, and researchers in the USA at the national and state levels to prioritise interventions, allocate resources effectively, and assess the effects of health policies and programmes. By addressing socioeconomic determinants, risk behaviours, environmental influences, and health disparities among minority populations, the USA can work towards improving health outcomes so that people can live longer and healthier lives. Funding: Bill & Melinda Gates Foundation.

Update on SickleInAfrica : a collaborative and multidimensional approach to conduct research and improve health

SickleInAfrica, A., Nkya, S., Masamu, U., Kuona, P., Kiguli, S., Guindo, A., Sarfo, F. S., Nnodu, O., Wonkam, A., Balandya, E., Makani, J., Bruno, M., Bukini, D., Mgaya, J., Manongi, J., Maro, J., Paul, S., Ondego, J., Shabani, S., … Mupere, E. (n.d.).

Publication year

2024

Journal title

The Lancet Haematology

Volume

Issue

Page(s)

e565-e566

10.1016/S2352-3026(24)00219-9

Abstract

Abstract

A Review of the COVID-19 Mental Health Impact in Post-Conflict Settings : Bridging the Mental Health Gap with Case Exemplars from an Implementation Science Lens

Noble, E., Adenikinju, D., Ruan, C., Zuniga, S., Thakkar, D., Malburg, C. M., Gyamfi, J., Ojo, T., Islam, F., Diawara, A., Dike, L., Chukwu, C., Tampubolon, S., & Peprah, E. (n.d.).

Publication year

2023

Journal title

International journal of environmental research and public health

Volume

Issue

10.3390/ijerph20116006

Abstract

Abstract

The COVID-19 pandemic has further aggravated the burden of mental health and presents an opportunity for public health research to focus on evidence-based interventions appropriate for populations residing in resource-constrained, post-conflict settings. Post-conflict settings have a higher service gap in mental health and fewer protective factors, such as economic and domestic security. Post-conflict settings are defined as locations where open warfare has ended but resulting challenges have remained for years. A strong emphasis on the engagement of diverse stakeholders is needed to arrive at sustainable and scalable solutions to mental health service delivery. This review discusses mental health service delivery gaps in post-conflict settings, highlights the urgency of the matter in the context of the COVID-19 pandemic, and provides recommendations for service gaps from evidence-based case study exemplars with an implementation science lens using the Consolidated Framework for Implementation Research (CFIR) as guide to improving adaptation and uptake.

A Review of the COVID-19 Mental Health Impact in Post-Conflict Settings: Bridging the Mental Health Gap with Case Exemplars from an Implementation Science Lens

Peprah, E., Noble, E., Adenikinju, D., Ruan, C., Zuniga, S., Thakkar, D., Malburg, C. M., Gyamfi, J., Ojo, T., Islam, F., Diawara, A., Dike, L., Chukwu, C., Tampubolon, S., & Peprah, E. (n.d.).

Publication year

2023

Volume

Abstract

Abstract

An Evolving HIV Epidemic in the Middle East and North Africa (MENA) Region : A Scoping Review

Karbasi, A., Fordjuoh, J., Abbas, M., Iloegbu, C., Patena, J., Adenikinju, D., Vieira, D., Gyamfi, J., & Peprah, E. (n.d.).

Publication year

2023

Journal title

International journal of environmental research and public health

Volume

Issue

10.3390/ijerph20053844

Abstract

Abstract

Human immunodeficiency virus (HIV) in the Middle East and North Africa (MENA) region is severely understudied despite the region’s increase in new HIV infections since 2010. A key population that is particularly affected, due to the lack of adequate knowledge and proper interventional implementation, includes people who inject drugs (PWID). Furthermore, the paucity of HIV data (prevalence and trends) worsens an already critical situation in this region. A scoping review was conducted to address the scarcity of information and to synthesize the available data on HIV prevalence rates within the key population of PWID throughout the MENA region. Information was sourced from major public health databases and world health reports. Of the 1864 articles screened, 40 studies discussed the various factors contributing to the under-reporting of HIV data in the MENA region among PWID. High and overlapping risk behaviors were cited as the most prevalent reason why HIV trends were incomprehensible and hard to characterize among PWID, followed by lack of service utilization, lack of intervention-based programs, cultural norms, lack of advanced HIV surveillance systems, and protracted humanitarian emergencies. Overall, the lack of reported information limits any adequate response to the growing and unknown HIV trends throughout the region.

Analysis of the 2007-2018 National Health Interview Survey (NHIS): Examining Neurological Complications among Children with Sickle Cell Disease in the United States

Peprah, E., Peprah, E., Gyamfi, J., Lee, J. T., Islam, F., Opeyemi, J., Tampubolon, S., Ojo, T., Qiao, W., Mai, A., Wang, C., Vieira, D., Meda, S., Adenikinju, D., Osei-Tutu, N., Ryan, N., & Ogedegbe, G. (n.d.).

Publication year

2023

Journal title

International journal of environmental research and public health

Volume

Issue

Abstract

Abstract

This study compared neurological complications among a national sample of United States children with or without sickle cell disease (SCD) and evaluated health status, healthcare and special education utilization patterns, barriers to care, and association of SCD status and demographics/socioeconomic status (SES) on comorbidities and healthcare utilization. Data was acquired from the National Health Interview Survey (NHIS) Sample Child Core questionnaire 2007-2018 dataset that included 133,542 children. An affirmation from the guardian of the child determined the presence of SCD. Regression analysis was used to compare the associations between SCD and demographics/SES on neurological conditions at < 0.05. Furthermore, adjusted odds ratios (AORs) were estimated for having various neurological conditions. Of the 133,481 children included in the NHIS, the mean age was 8.5 years (SD: 0.02) and 215 had SCD. Of the children with SCD, the sample composition included male ( = 110), and Black ( = 82%). The SCD sample had higher odds of having neuro-developmental conditions ( < 0.1). Families of Black children (55% weighted) reported household incomes < 100% of federal poverty level. Black children were more likely to experience longer wait times to see the doctor (AOR, 0.3; CI 0.1-1.1). Compared to children without SCD, those with SCD had a greater chance of seeing a medical specialist within 12 months (AOR 2.3; CI 1.5-3.7). This representative sample of US children with SCD shows higher odds of developing neurological complications, increased healthcare and special education services utilization, with Black children experiencing a disproportionate burden. This creates the urgency to address the health burden for children with SCD by implementing interventions in healthcare and increasing education assistance programs to combat neurocognitive impairments, especially among Black children.

Characterisation of medical conditions of children with sickle cell disease in the USA : findings from the 2007-2018 National Health Interview Survey (NHIS)

Gyamfi, J., Tampubolon, S., Lee, J. T., Islam, F., Ojo, T., Opeyemi, J., Qiao, W., Mai, A., Wang, C., Vieira, D., Ryan, N., Osei-Tutu, N. H., Adenikinju, D., Meda, S., Ogedegbe, G., & Peprah, E. (n.d.).

Publication year

2023

Journal title

BMJ open

Volume

Issue

10.1136/bmjopen-2022-069075

Abstract

Abstract

Objectives We used the National Health Interview Survey (NHIS) data set to examine the prevalence of comorbid medical conditions; explore barriers to accessing healthcare and special educational services; and assess the associations between sickle cell disease (SCD) status and demographics/socioeconomic status (SES), and social determinants of health (SDoH) on comorbidities among children in the USA. Design Cross-sectional. Setting NHIS Sample Child Core questionnaire 2007-2018 data set. Participants 133 481 children; presence of SCD was determined by an affirmative response from the adult or guardian of the child. Main outcome measures Multivariate logistic regression was used to compare the associations between SCD status, SES and SDoH for various medical conditions for all races and separately for black children at p

Characterisation of medical conditions of children with sickle cell disease in the USA: findings from the 2007-2018 National Health Interview Survey (NHIS)

Peprah, E., Gyamfi, J., Tampubolon, S., Lee, J. T., Islam, F., Ojo, T., Opeyemi, J., Qiao, W., Mai, A., Wang, C., Vieira, D., Ryan, N., Osei-Tutu, N. H., Adenikinju, D., Meda, S., Ogedegbe, G., & Peprah, E. (n.d.).

Publication year

2023

Journal title

BMJ open

Volume

Issue

Page(s)

e069075

Abstract

Abstract

Evidence-based interventions to reduce maternal malnutrition in low and middle-income countries: a systematic review

Peprah, E., Shenoy, S., Sharma, P., Rao, A., Aparna, N., Adenikinju, D., Iloegbu, C., Pateña, J., Vieira, D., Gyamfi, J., & Peprah, E. (n.d.).

Publication year

2023

Journal title

Frontiers in health services

Volume

Page(s)

1155928

Abstract

Abstract

Despite remarkable strides in global efforts to reduce maternal mortality, low-and middle-income countries (LMICs) continue to grapple with a disproportionate burden of maternal mortality, with malnutrition emerging as a significant contributing factor to this enduring challenge. Shockingly, malnourished women face a mortality risk that is twice as high as their well-nourished counterparts, and a staggering 95% of maternal deaths in 2020 occurred within LMICs. The critical importance of addressing maternal malnutrition in resource-constrained settings cannot be overstated, as compelling research studies have demonstrated that such efforts could potentially save thousands of lives. However, the landscape is marred by a scarcity of evidence-based interventions (EBIs) specifically tailored for pregnant individuals aimed at combatting maternal malnutrition and reducing mortality rates. It is against this backdrop that our study endeavors to dissect the feasibility, adoption, sustainability, and cost-effectiveness of EBIs designed to combat maternal malnutrition.

Global Burden of Cardiovascular Diseases and Risks, 1990-2022

Global Burden of Cardiovascular Diseases and Risks Collaborators, A., Mensah, G. A., Habtegiorgis Abate, Y., Abbasian, M., Abd-Allah, F., Abdollahi, A., Abdollahi, M., Morad Abdulah, D., Abdullahi, A., Abebe, A. M., Abedi, A., Abedi, A., Olusola Abiodun, O., Ali, H. A., Abu-Gharbieh, E., Abu-Rmeileh, N. M., Aburuz, S., Abushouk, A. I., Abu-Zaid, A., … Peprah, E. (n.d.).

Publication year

2023

Journal title

Journal of the American College of Cardiology

Volume

Issue

Page(s)

2350-2473

10.1016/j.jacc.2023.11.007

Abstract

Abstract

Global Burden of Cardiovascular Diseases and Risks, 1990-2022

Failed generating bibliography.

Publication year

2023

Journal title

Journal of the American College of Cardiology

Volume

Issue

Page(s)

2350-2473

Abstract

Abstract

Implementation of non-insulin-dependent diabetes self-management education (DSME) in LMICs : a systematic review of cost, adoption, acceptability, and fidelity in resource-constrained settings

Fitzpatrick, R., Pant, S., Li, J., Ritterman, R., Adenikinju, D., Iloegbu, C., Pateña, J., Vieira, D., Gyamfi, J., & Peprah, E. (n.d.).

Publication year

2023

Journal title

Frontiers in Health Services

Volume

10.3389/frhs.2023.1155911

Abstract

Abstract

Background: Type II diabetes (T2D), is a serious health issue accounting for 10.7% of mortality globally. 80% of cases worldwide are found in low- and middle-income countries (LMIC), with rapidly increasing prevalence. Diabetes-self management education (DSME) is a cost-effective program that provides at-risk individuals with the knowledge and skills they need to adopt lifestyle changes that will improve their health and well-being. This systematic review examined the application of DSME in LMICs and identified the corresponding implementation results (cost, fidelity, acceptance, and adoption) associated with successful implementation in low-resource settings. Methods and analysis: The available research on T2D and the use of DSME in LMIC were systematically searched for using six electronic databases (PubMed, Embase, Cochrane, Web of Science, Google Scholar, PAIS, and EBSCO Discovery) between the months of October and November of 2022. The articles that met the search criteria were subsequently imported into EndNote and Covidence for analysis. The Cochrane RoB methodology for randomized trials was used to evaluate the risk of bias (RoB) in the included studies. A narrative synthesis was used to summarize the results. Results: A total of 773 studies were imported for screening, after 203 duplicates were removed, 570 remained. Abstract and title screenings resulted in the exclusion of 487 articles, leaving 83 for full-text review. Following a full-text review, 76 articles were excluded and seven were found to be relevant to our search. The most common reasons for exclusion were study design (n = 23), lack of results (n = 14), and wrong patient population (n = 12). Conclusion: Our systemic review found that DSME can be an acceptable and cost-effective solution in LMIC. While we intended to analyze cost, adoption, acceptability, and fidelity, our investigation revealed a gap in the literature on those areas, with most studies focusing on acceptability and cost and no studies identifying fidelity or adoption. To further evaluate the efficacy of DSME and enhance health outcomes for T2D in LMICs, more research is needed on its application. Systematic Review Registration: osf.io/7482t.

Implementation of non-insulin-dependent diabetes self-management education (DSME) in LMICs: a systematic review of cost, adoption, acceptability, and fidelity in resource-constrained settings

Peprah, E., Fitzpatrick, R., Pant, S., Li, J., Ritterman, R., Adenikinju, D., Iloegbu, C., Pateña, J., Vieira, D., Gyamfi, J., & Peprah, E. (n.d.).

Publication year

2023

Journal title

Frontiers in health services

Volume

Page(s)

1155911

Abstract

Abstract

Type II diabetes (T2D), is a serious health issue accounting for 10.7% of mortality globally. 80% of cases worldwide are found in low- and middle-income countries (LMIC), with rapidly increasing prevalence. Diabetes-self management education (DSME) is a cost-effective program that provides at-risk individuals with the knowledge and skills they need to adopt lifestyle changes that will improve their health and well-being. This systematic review examined the application of DSME in LMICs and identified the corresponding implementation results (cost, fidelity, acceptance, and adoption) associated with successful implementation in low-resource settings.

Implementation outcomes and strategies for delivering evidence-based hypertension interventions in lower-middle-income countries : Evidence from a multi-country consortium for hypertension control

Gyamfi, J., Iwelunmor, J., Patel, S., Irazola, V., Aifah, A., Rakhra, A., Butler, M., Vedanthan, R., Hoang, G. N., Nyambura, M., Nguyen, H., Nguyen, C., Asante, K. P., Nyame, S., Adjei, K., Amoah, J., Apusiga, K., Adjei, K. G., Ramierz-Zea, M., … Ogedegbe, G. (n.d.).

Publication year

2023

Journal title

PloS one

Volume

Issue

5 May

10.1371/journal.pone.0286204

Abstract

Abstract

Guidance on contextually tailored implementation strategies for the prevention, treatment, and control of hypertension is limited in lower-middle income countries (Lower-MIC). To address this limitation, we compiled implementation strategies and accompanying outcomes of evidence-based hypertension interventions currently being implemented in five Lower-MIC. The Global Research on Implementation and Translation Science (GRIT) Coordinating Center (CC) (GRIT-CC) engaged its global network sites at Ghana, Guatemala, India, Kenya, and Vietnam. Purposively sampled implementation science experts completed an electronic survey assessing implementation outcomes, in addition to implementation strategies used in their ongoing hypertension interventions from among 73 strategies within the Expert Recommendations for Implementing Change (ERIC). Experts rated the strategies based on highest priority to their interventions. We analyzed the data by sorting implementation strategies utilized by sites into one of the nine domains in ERIC and summarized the data using frequencies, proportions, and means. Seventeen implementation experts (52.9% men) participated in the exercise. Of Proctor's implementation outcomes identified across sites, all outcomes except for appropriateness were broadly assessed by three or more countries. Overall, 59 out of 73 (81%) strategies were being utilized in the five countries. The highest priority implementation strategies utilized across all five countries focused on evaluative and iterative strategies (e.g., identification of context specific barriers and facilitators) to delivery of patient- and community-level interventions, while the lowest priority was use of financial and infrastructure change strategies. More capacity building strategies (developing stakeholder interrelationships, training and educating stakeholders, and supporting clinicians) were incorporated into interventions implemented in India and Vietnam than Ghana, Kenya, and Guatemala. Although robust implementation strategies are being used in Lower -MICs, there is minimum use of financial and infrastructure change strategies. Our study contributes to the growing literature that demonstrates the use of Expert Recommendations for Implementing Change (ERIC) implementation strategies to deliver evidence-based hypertension interventions in Lower-MICs and will inform future cross-country data harmonization activities in resource-constrained settings.

Implementation outcomes and strategies for delivering evidence-based hypertension interventions in lower-middle-income countries: Evidence from a multi-country consortium for hypertension control

Peprah, E., Gyamfi, J., Iwelunmor, J., Patel, S., Irazola, V., Aifah, A., Rakhra, A., Butler, M., Vedanthan, R., Hoang, G. N., Nyambura, M., Nguyen, H., Nguyen, C., Asante, K. P., Nyame, S., Adjei, K., Amoah, J., Apusiga, K., Adjei, K. G. A., … Ogedegbe, G. (n.d.).

Publication year

2023

Journal title

Abstract

Reducing Dietary Sodium Intake among Young Adults in Ghana: A Call to Action

Peprah, E., Peprah, E., Amegbor, P., Laar, A., Akasoe, B., & Commodore-Mensah, Y. (n.d.).

Publication year

2023

Journal title

Nutrients

Volume

Issue

Abstract

Abstract

The positive association between excessive dietary sodium intake, hypertension, and cardiovascular disease (CVD) has been widely investigated in observational studies and clinical trials. Reducing sodium intake is a proven strategy to prevent hypertension and the onset of CVD, a major cause of morbidity and mortality globally. Africa has the youngest population globally, which is key to the continent's sustainable development. However, in Africa, the epidemics of hypertension and CVD negatively impact life expectancy and economic growth. Ghana, like other African countries, is no exception. The factors contributing to the increasing burden of CVD and excessive sodium consumption are multi-faceted and multi-level, including individual lifestyle, neighborhood and built environments, and socio-economic and health policies. Thus, the implementation of evidence-based interventions such as the World Health Organization Best Buys that target the multi-level determinants of sodium consumption is urgently needed in Ghana and other African countries. The aim of this commentary is to highlight factors that contribute to excessive sodium consumption. Second, the commentary will showcase lessons of successful implementation of sodium reduction interventions in other countries. Such lessons may help avert CVD in young adults in Ghana and Africa.

Scaling-up Evidence-based Interventions for Communities of Color With Marked Health Disparities: Lessons Learned From COVID-19 Can Be Applied to Reduce Morbidity and Mortality and Achieve Health Equity

Peprah, E., Gyamfi, J., & Peprah, E. (n.d.).

Publication year

2023

Journal title

Medical care

Volume

Issue

Page(s)

417-420

Abstract

Abstract

Shivani Shenoy, Priyanka Sharma, Aishwarya Rao, Nusrat Aparna, Deborah Adenikinju, Chukwuemeka Iloegbu, John Pateña, Dorice Vieira, Joyce Gyamfi, Emmanuel Peprah. Evidence-based interventions to reduce maternal malnutrition in low and middle-income countries: A systematic review. APHA 2023. Nov 12-16 2023: Atlanta, GA (Poster)

Peprah, E. (n.d.).

Publication year

2023

Abstract

Abstract

Emmanuel Peprah

Emmanuel Peprah

Associate Professor of Global and Environmental Health

Professional overview

Education

Honors and awards

Areas of research and study

Publications

Publications

Pharmacogenomics of Drugs Used in β-Thalassemia and Sickle-Cell Disease : From Basic Research to Clinical Applications

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The burden of diseases, injuries, and risk factors by state in the USA, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021

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Update on SickleInAfrica : a collaborative and multidimensional approach to conduct research and improve health

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A Review of the COVID-19 Mental Health Impact in Post-Conflict Settings : Bridging the Mental Health Gap with Case Exemplars from an Implementation Science Lens

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A Review of the COVID-19 Mental Health Impact in Post-Conflict Settings: Bridging the Mental Health Gap with Case Exemplars from an Implementation Science Lens

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An Evolving HIV Epidemic in the Middle East and North Africa (MENA) Region : A Scoping Review

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Analysis of the 2007-2018 National Health Interview Survey (NHIS): Examining Neurological Complications among Children with Sickle Cell Disease in the United States

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Characterisation of medical conditions of children with sickle cell disease in the USA : findings from the 2007-2018 National Health Interview Survey (NHIS)

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Characterisation of medical conditions of children with sickle cell disease in the USA: findings from the 2007-2018 National Health Interview Survey (NHIS)

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Evidence-based interventions to reduce maternal malnutrition in low and middle-income countries : a systematic review

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Evidence-based interventions to reduce maternal malnutrition in low and middle-income countries: a systematic review

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Global Burden of Cardiovascular Diseases and Risks, 1990-2022

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Global Burden of Cardiovascular Diseases and Risks, 1990-2022

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Implementation of non-insulin-dependent diabetes self-management education (DSME) in LMICs : a systematic review of cost, adoption, acceptability, and fidelity in resource-constrained settings