Emmanuel Peprah

Associate Professor of Global and Environmental Health

Professional overview

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

Publications

2021 APHA Conference 
•       APHA Conference Moderator - HIV and Gender Oct 24, 2021
•       Moderated guest presenters on HIV, gender and syndemics

Peprah, E. (n.d.).

Publication year

2021

Abstract

Abstract

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A global health strategy to capitalize on proven-effective interventions for heart, lung, and blood diseases

Engelgau, M. M., Peprah, E., Sampson, U. K., & Mensah, G. A. (n.d.).

Publication year

2015

Journal title

Global Heart

Volume

10

Issue

1

Page(s)

87-91

10.1016/j.gheart.2015.02.001

Abstract

Abstract

~

A global perspective on using implementation research to address hypertension-associated target organ damage

Peprah, E., Lopez-Class, M., Shero, S., John-Sowah, J., & Engelgau, M. (n.d.).

Publication year

2016

Journal title

Ethnicity and Disease

Volume

26

Issue

3

Page(s)

395-398

10.18865/ed.26.3.395

Abstract

Abstract

Hypertension, a major risk factor for cardiovascular disease, imposes a significant public health burden and challenge to address it worldwide. Scaling up delivery of proven, effective interventions for hypertension could significantly advance the goal of reducing the global burden. Although significant progress has been made in many countries, some lament that large-scale initiatives focused on reducing blood pressure in global populations have not effectively addressed this challenge. Late-stage implementation research plays a critical role in determining effective and sustainable scale-up of these initiatives. In this article, we briefly discuss some of the global initiatives that have been funded by the National Heart, Lung, and Blood Institute of the US National Institutes of Health. Intervention delivery strategies in low resource settings must have demonstrated effectiveness and consideration for the social, cultural and physical context (eg, access, affordability, and availability of medications) in which a program is being delivered in order to be sustainable nationally and globally. Hence, the use of implementation research is central to determining sustainable delivery of evidence-based and tailored interventions focused on hypertension control. The sustained control of hypertension in global populations holds tremendous potential for reducing morbidity, premature mortality, and the adverse economic impact of cardiovascular disease in all regions.

A New Age for African-Driven Genomics Research : Human Heredity and Health in Africa (H3Africa)

Peprah, E., Wiley, K., Sampson, U., & Narula, J. (n.d.).

Publication year

2017

Journal title

Global Heart

Volume

12

Issue

2

Page(s)

67-68

10.1016/j.gheart.2017.05.003

Abstract

Abstract

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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

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

20

Issue

11

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

20

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 strategic framework for utilizing late-stage (t4) translation research to address health inequities

Lopez-Class, M., Peprah, E., Zhang, X., Kaufmann, P. G., & Engelgau, M. M. (n.d.).

Publication year

2016

Journal title

Ethnicity and Disease

Volume

26

Issue

3

Page(s)

387-394

10.18865/ed.26.3.387

Abstract

Abstract

Achieving health equity requires that every person has the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances. Inequity experienced by populations of lower socioeconomic status is reflected in differences in health status and mortality rates, as well as in the distribution of disease, disability and illness across these population groups. This article gives an overview of the health inequities literature associated with heart, lung, blood and sleep (HLBS) disorders. We present an ecological framework that provides a theoretical foundation to study late-stage T4 translation research that studies implementation strategies for proven effective interventions to address health inequities.

Acceptability, barriers and facilitators of using dried blood spots-point-of-care testing for sickle cell disease in Africa : an implementation science protocol for a multinational qualitative study

On behalf of the SickleInAfrica Consortium, A., Nnodu, O. E., Munung, N. S., Chirande, L., Chunda-Liyoka, C., Kiguli, S., Sarfo, F. S., Touré, B. A., Balandya, E., Guindo, A., Kuona, P., Esoh, K., Jonas, M., Nwegbu, M., Masamu, U., Morrice, J., Moru, P. O., Bitoungui, V. N., Nembaware, V., … Peprah, E. (n.d.).

Publication year

2024

Journal title

BMJ open

Volume

14

Issue

11

10.1136/bmjopen-2024-089056

Abstract

Abstract

Background Sickle cell disease (SCD) is a prevalent inherited blood disorder. Globally, approximately 515 000 babies are born with SCD annually, with 75% of these births occurring in Africa. Integrating newborn screening (NBS) for SCD into primary healthcare structures, such as immunisation programmes, holds significant promise, with dried blood spots (DBS)-point-of-care technologies (POCT) like HaemoTypeSC offering cost-effective screening solutions. However, scaling up DBS-POCT for NBS of SCD in Africa remains challenging. Objective This study aims to explore individual, organisational and external factors that may influence the reliability, feasibility, acceptability, adoption and sustainability of using DBS-POCT with HaemoTypeSC for NBS of SCD at primary healthcare centres in African countries. Method This qualitative study will be conducted in seven African countries that are part of the SickleInAfrica consortium sites. The study design is informed by the Consolidated Framework for Implementation Research (CFIR) and the Implementation Outcome Model. Participants will be mothers whose babies have been diagnosed with SCD, healthcare professionals and policy-makers. In-depth interviews and focus group discussions will be used for data collection. Data analysis will be through thematic analysis. Ethics and dissemination Research ethics approvals have been obtained from the seven countries. Written informed consent will be obtained from all participants. The study results will be disseminated in peer-reviewed scientific journals, scientific conferences, reports to national ministries of public health and webinars.

Acceptability, barriers and facilitators of using dried blood spots-point-of-care testing for sickle cell disease in Africa: an implementation science protocol for a multinational qualitative study

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Publication year

2024

Journal title

BMJ open

Volume

14

Issue

11

Page(s)

e089056

Abstract

Abstract

Sickle cell disease (SCD) is a prevalent inherited blood disorder. Globally, approximately 515 000 babies are born with SCD annually, with 75% of these births occurring in Africa. Integrating newborn screening (NBS) for SCD into primary healthcare structures, such as immunisation programmes, holds significant promise, with dried blood spots (DBS)-point-of-care technologies (POCT) like HaemoTypeSC offering cost-effective screening solutions. However, scaling up DBS-POCT for NBS of SCD in Africa remains challenging.

Addressing gaps in international blood availability and transfusion safety in low-and middle-income countries : A nhlbi workshop

Custer, B., Zou, S., Glynn, S. A., Makani, J., Tagny, C. T., Ekiaby, M. E., Sabino, E. C., Choudhury, N., Teo, D., Nelson, K., Peprah, E., Price, L., & Engelgau, M. M. (n.d.).

Publication year

2018

Journal title

Transfusion

Volume

58

Issue

5

Page(s)

1307-1317

10.1111/trf.14598

Abstract

Abstract

In April 2017, a workshop sponsored by the National Heart, Lung, and Blood Institute, Division of Blood Diseases and Resources, and the Center for Translation Research and Implementation Science was held to discuss blood availability and transfusion safety in lowand middle-income countries (LMICs). The purpose of the workshop was to identify research opportunities for implementation science (IS) to improve the availability of safe blood and blood components and transfusion practices in LMICs. IS describes the late stages of the translational research spectrum and studies optimal and sustainable strategies to deliver proven-effective interventions. Regional working groups were formed to focus on opportunities and challenges in East Africa, Central/West Africa, Middle East and North Africa, Latin America and the Caribbean, Southeast Asia, Western Pacific Asia, Eastern Europe, and Central Asia. The need for an “adequate supply of safe blood” emerged as the major overriding theme. Among the regional working groups, common cross-cutting themes were evident. The majority of research questions, priorities, and strategies fell into the categories of blood availability, blood transfusion safety, appropriate use of blood, quality systems, health economics and budgeting, and training and education in IS. The workshop also brought into focus inadequate country-level data that can be used as the basis for IS initiatives. A mixed approach of needs assessment and targeted interventions with sufficient evidence base to move toward sustainment is an appropriate next step for blood availability and transfusion safety research in LMICs.

Advancing stroke genomic research in the age of Trans-Omics big data science : Emerging priorities and opportunities

Owolabi, M., Peprah, E., Xu, H., Akinyemi, R., Tiwari, H. K., Irvin, M. R., Wahab, K. W., Arnett, D. K., & Ovbiagele, B. (n.d.).

Publication year

2017

Journal title

Journal of the Neurological Sciences

Volume

382

Page(s)

18-28

10.1016/j.jns.2017.09.021

Abstract

Abstract

Background We systematically reviewed the genetic variants associated with stroke in genome-wide association studies (GWAS) and examined the emerging priorities and opportunities for rapidly advancing stroke research in the era of Trans-Omics science. Methods Using the PRISMA guideline, we searched PubMed and NHGRI- EBI GWAS catalog for stroke studies from 2007 till May 2017. Results We included 31 studies. The major challenge is that the few validated variants could not account for the full genetic risk of stroke and have not been translated for clinical use. None of the studies included continental Africans. Genomic study of stroke among Africans presents a unique opportunity for the discovery, validation, functional annotation, Trans-Omics study and translation of genomic determinants of stroke with implications for global populations. This is because all humans originated from Africa, a continent with a unique genomic architecture and a distinctive epidemiology of stroke; as well as substantially higher heritability and resolution of fine mapping of stroke genes. Conclusion Understanding the genomic determinants of stroke and the corresponding molecular mechanisms will revolutionize the development of a new set of precise biomarkers for stroke prediction, diagnosis and prognostic estimates as well as personalized interventions for reducing the global burden of stroke.

An emerging syndemic of smoking and cardiopulmonary diseases in people living with HIV in Africa

Peprah, E., Armstrong-Hough, M., Cook, S. H., Mukasa, B., Taylor, J. Y., Xu, H., Chang, L., Gyamfi, J., Ryan, N., Ojo, T., Snyder, A., Iwelunmor, J., Ezechi, O., Iyegbe, C., O’reilly, P., & Kengne, A. P. (n.d.).

Publication year

2021

Journal title

International journal of environmental research and public health

Volume

18

Issue

6

Page(s)

1-12

10.3390/ijerph18063111

Abstract

Abstract

Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which necessitates increased surveillance of the threats from pernicious risks to which PWH who live longer remain exposed. This includes cardiopulmonary comorbidities, which pose significant public health and economic challenges. A significant contributor to the cardiopulmonary comorbidities is tobacco smoking. Indeed, globally, PWH have a 2–4-fold higher utilization of tobacco compared to the general population, leading to endothelial dysfunction and atherogenesis that result in cardiopulmonary diseases, such as chronic obstructive pulmonary disease and coronary artery disease. In the context of PWH, we discuss (1) the current trends in cigarette smoking and (2) the lack of geographically relevant data on the cardiopulmonary conditions associated with smoking; we then review (3) the current evidence on chronic inflammation induced by smoking and the potential pathways for cardiopulmonary disease and (4) the multifactorial nature of the syndemic of smoking, HIV, and cardiopulmonary diseases. This commentary calls for a major, multi-setting cohort study using a syndemics framework to assess cardiopulmonary disease outcomes among PWH who smoke. Conclusion: We call for a parallel program of implementation research to promote the adoption of evidence-based interventions, which could improve health outcomes for PWH with cardiopulmonary diseases and address the health inequities experienced by PWH in African countries.

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

20

Issue

5

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.

An implementation trial to mAnage siCkle CELl disEase through incReased AdopTion of hydroxyurEa in Nigeria (ACCELERATE): Study protocol

Peprah, E., Peprah, E., Gyamfi, J., Patena, J., Kayalioglu, H., Hameed, T., Ogedegbe, G., Do, H., Ojji, D., Adenikinju, D., Ajaye Oba, T., Nwegbu, M., Isa, H., Shedul, G., Sopekan, A. Y., & Nnodu, O. E. (n.d.).

Publication year

2025

Journal title

PloS one

Volume

20

Issue

1

Page(s)

e0311900

Abstract

Abstract

Despite the proven efficacy of evidence-based healthcare interventions in reducing adverse outcomes and mortality associated with Sickle Cell Disease (SCD), a vast majority of affected individuals in Africa remain deprived of such care. Hydroxyurea (HU) utilization among SCD patients in Sub-Saharan Africa (SSA) stands at less than 1%, while in Nigeria, approximately 13% of patients benefit from HU therapy. To enhance HU utilization, targeted implementation strategies addressing provider-level barriers are imperative. Existing evidence underscores the significance of addressing barriers such as inadequate healthcare worker training to improve HU adoption. The ACCELERATE study aims to evaluate the adoption of HU among providers through the Screen, Initiate, and Maintain (SIM) intervention, facilitated by healthcare worker training, clinical reminders, and task-sharing strategies, thereby enhancing patient-level SCD management in Nigeria.

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

20

Issue

12

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.

Application of the Consolidated Framework for Implementation Research to examine nurses' perception of the task shifting strategy for hypertension control trial in Ghana

Gyamfi, J., Allegrante, J. P., Iwelunmor, J., Williams, O., Plange-Rhule, J., Blackstone, S., Ntim, M., Apusiga, K., Peprah, E., & Ogedegbe, G. (n.d.).

Publication year

2020

Journal title

BMC health services research

Volume

20

Issue

1

10.1186/s12913-020-4912-5

Abstract

Abstract

Background: The burden of hypertension in many low-and middle-income countries is alarming and requires effective evidence-based preventative strategies that is carefully appraised and accepted by key stakeholders to ensure successful implementation and sustainability. We assessed nurses' perceptions of a recently completed Task Shifting Strategy for Hypertension control (TASSH) trial in Ghana, and facilitators and challenges to TASSH implementation. Methods: Focus group sessions and in-depth interviews were conducted with 27 community health nurses from participating health centers and district hospitals involved in the TASSH trial implemented in the Ashanti Region, Ghana, West Africa from 2012 to 2017. TASSH evaluated the comparative effectiveness of the WHO-PEN program versus provision of health insurance for blood pressure reduction in hypertensive adults. Qualitative data were analyzed using open and axial coding techniques with emerging themes mapped onto the Consolidated Framework for Implementation Research (CFIR). Results: Three themes emerged following deductive analysis using CFIR, including: (1) Patient health goal setting- relative priority and positive feedback from nurses, which motivated patients to make healthy behavior changes as a result of their health being a priority; (2) Leadership engagement (i.e., medical directors) which influenced the extent to which nurses were able to successfully implement TASSH in their various facilities, with most directors being very supportive; and (3) Availability of resources making it possible to implement the TASSH protocol, with limited space and personnel time to carry out TASSH duties, limited blood pressure (BP) monitoring equipment, and transportation, listed as barriers to effective implementation. Conclusion: Assessing stakeholders' perception of the TASSH implementation process guided by CFIR is crucial as it provides a platform for the nurses to thoroughly evaluate the task shifting program, while considering the local context in which the program is implemented. The feedback from the nurses informed barriers and facilitators to implementation of TASSH within the current healthcare system, and suggested system level changes needed prior to scale-up of TASSH to other regions in Ghana with potential for long-term sustainment of the task shifting intervention. Trial registration: Trial registration for parent TASSH study: NCT01802372. Registered February 27, 2013.

Applying the WHO ICD-MM classification system to maternal deaths in a tertiary hospital in Nigeria : A retrospective analysis from 2014–2018

Akaba, G. O., Nnodu, O. E., Ryan, N., Peprah, E., Agida, T. E., Anumba, D. O., & Ekele, B. A. (n.d.).

Publication year

2021

Journal title

PloS one

Volume

16

Issue

1

10.1371/journal.pone.0244984

Abstract

Abstract

Background Addressing the problem of maternal mortality in Nigeria requires proper identification of maternal deaths and their underlying causes in order to focus evidence-based interventions to decrease mortality and avert morbidity. Objectives The objective of the study was to classify maternal deaths that occurred at a Nigerian teaching hospital using the WHO International Classification of Diseases Maternal mortality (ICD-MM) tool. Methods This was a retrospective observational study of all maternal deaths that occurred in a tertiary Nigerian hospital from 1st January 2014 to 31st December,2018. The WHO ICD-MM classification system for maternal deaths was used to classify the type, group, and specific underlying cause of identified maternal deaths. Descriptive analysis was performed using Statistical Package for Social Sciences (SPSS). Categorical and continuous variables were summarized respectively as proportions and means (standard deviations). Results The institutional maternal mortality ratio was 831/100,000 live births. Maternal deaths occurred mainly amongst women aged 25–34 years;30(57.7%), without formal education; 22(42.3%), married;47(90.4%), unbooked;24(46.2%) and have delivered at least twice;34 (65.4%). The leading causes of maternal death were hypertensive disorders in pregnancy, childbirth, and the puerperium (36.5%), obstetric haemorrhage (30.8%), and pregnancy related infections (17.3%). Application of the WHO ICD-MM resulted in reclassification of underlying cause for 3.8% of maternal deaths. Postpartum renal failure (25.0%), postpartum coagulation defects (17.3%) and puerperal sepsis (15.4%) were the leading final causes of death. Among maternal deaths, type 1, 2, and 3 delays were seen in 30(66.7%), 22(48.9%), and 6(13.3%), respectively. Conclusion Our institutional maternal mortality ratio remains high. Hypertensive disorders during pregnancy, childbirth, and the puerperium and obstetric haemorrhage are the leading causes of maternal deaths. Implementation of evidence-based interventions both at the hospital and community levels may help in tackling the identified underlying causes of maternal mortality in Nigeria.

Arvin Karbasi, Judy Fordjuoh, Dorice Vieria, Joyce Gyamfi, Temitope Ojo, Emmanuel Peprah. An evolving HIV epidemic in the Middle East and North Africa (MENA) region amongst People Who Inject Drugs (PWID): A scoping review. American Public Health Association 2022 Annual Meeting and Expo Boston, MA Nov 6- 9 2022 (Oral Presentation)

Peprah, E. (n.d.).

Publication year

2022

Abstract

Abstract

~

Assess : A comprehensive tool to support reporting and critical appraisal of qualitative, quantitative, and/or mixed methods implementation research outcomes

Peprah, E., Ryan, N., Vieira, D., Gyamfi, J., Ojo, T., & Peprah, E. (n.d.).

Publication year

2021

Journal title

Implementation Science

Volume

16

Issue

SUPPL 1

Abstract

Abstract

~

Assessing descriptions of scalability for hypertension control interventions implemented in low-and middle-income countries : A systematic review

Gyamfi, J., Vieira, D., Iwelunmor, J., Watkins, B. X., Williams, O., Peprah, E., Ogedegbe, G., & Allegrante, J. P. (n.d.).

Publication year

2022

Journal title

PloS one

Volume

17

Issue

7

10.1371/journal.pone.0272071

Abstract

Abstract

BACKGROUND: The prevalence of hypertension continues to rise in low- and middle-income- countries (LMICs) where scalable, evidence-based interventions (EBIs) that are designed to reduce morbidity and mortality attributed to hypertension have yet to be fully adopted or disseminated. We sought to evaluate evidence from published randomized controlled trials using EBIs for hypertension control implemented in LMICs, and identify the WHO/ExpandNet scale-up components that are relevant for consideration during "scale-up" implementation planning.METHODS: Systematic review of RCTs reporting EBIs for hypertension control implemented in LMICs that stated "scale-up" or a variation of scale-up; using the following data sources PubMed/Medline, Web of Science Biosis Citation Index (BCI), CINAHL, EMBASE, Global Health, Google Scholar, PsycINFO; the grey literature and clinicaltrials.gov from inception through June 2021 without any restrictions on publication date. Two reviewers independently assessed studies for inclusion, conducted data extraction using the WHO/ExpandNet Scale-up components as a guide and assessed the risk of bias using the Cochrane risk-of-bias tool. We provide intervention characteristics for each EBI, BP results, and other relevant scale-up descriptions.MAIN RESULTS: Thirty-one RCTs were identified and reviewed. Studies reported clinically significant differences in BP, with 23 studies reporting statistically significant mean differences in BP (p < .05) following implementation. Only six studies provided descriptions that captured all of the nine WHO/ExpandNet components. Multi-component interventions, including drug therapy and health education, provided the most benefit to participants. The studies were yet to be scaled and we observed limited reporting on translation of the interventions into existing institutional policy (n = 11), cost-effectiveness analyses (n = 2), and sustainability measurements (n = 3).CONCLUSION: This study highlights the limited data on intervention scalability for hypertension control in LMICs and demonstrates the need for better scale-up metrics and processes for this setting.TRIAL REGISTRATION: Registration PROSPERO (CRD42019117750).

Assessing Stakeholder Engagement for Translation Research and Implementation Science in Low- and Middle-Income Countries : Lessons From Ghana, Guatemala, India, Kenya, Malawi, Nepal, Rwanda, and Vietnam

Peprah, E., Iwelunmor, J., & Price, L. S. (n.d.).

Publication year

2019

Journal title

Global Heart

Volume

14

Issue

2

Page(s)

99-101

10.1016/j.gheart.2019.05.009

Abstract

Abstract

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Assessment of musical interventions and its effect on blood pressure among United States populations : a systematic review and meta-analysis

Meda, S., Gyamfi, J., Patel, K., Islam, F., Vieira, D., Nyame, S., Ruan, C., Boradia, K., Chhetri, H., Thunga, S., Adenikinju, D., Amesimeku, E., Diawara, A., Opeyemi, J., Ojo, T., Chirinos, C., Williams, O., Ogedegbe, O., & Peprah, E. (n.d.).

Publication year

2024

Journal title

Frontiers in Cardiovascular Medicine

Volume

11

10.3389/fcvm.2024.1405455

Abstract

Abstract

Background: Hypertension (HTN) currently affects over 120 million Americans, in the United States (US). Thus, the implementation of evidence-based interventions (EBI) for blood pressure (BP) reduction is pivotal in minimizing this burden. We sought to evaluate evidence from published literature on the effectiveness of musical interventions for BP reduction within the US. Methods: A systematic review of studies that utilize music interventions to manage BP was conducted in October of 2022. An extensive search of several databases utilizing MeSH terms and relevant keywords was conducted for articles published through October 2022. An updated search was conducted in October 2023 to identify additional studies. Results: 2,381 studies were screened for title/abstract relevancy. 1,885 studies were deemed irrelevant, and 495 studies were examined for full-text review; of which 384 were excluded due to being non-US-based. Overall, 25 studies were found where BP was the primary outcome and discussed musical interventions within the US. Of the 25 studies, 72% reported a significant decrease in BP after the administration of a musical intervention and only 28% reported the race and ethnicity of participants. Conclusion: There are limited studies that examine the effect of music interventions on BP reduction in the US, as a primary outcome. However, based on the evidence, musical interventions are effective for BP reduction. Moreover, the studies that were conducted in the US include a low percentage of high-risk racial and ethnic minority populations. Future EBI should target this underserved/high-burden group to improve disparity gaps within BP reduction via non-pharmacological means. Systematic Review Registration: Open Science Framework, doi: 10.17605/OSF.IO/4G3EB.

Assessment of musical interventions and its effect on blood pressure among United States populations: a systematic review and meta-analysis

Peprah, E., Meda, S., Gyamfi, J., Patel, K., Islam, F., Vieira, D., Nyame, S., Ruan, C., Boradia, K., Chhetri, H., Thunga, S., Adenikinju, D., Amesimeku, E., Diawara, A., Opeyemi, J., Ojo, T., Chirinos, C., Williams, O., Ogedegbe, O., & Peprah, E. (n.d.).

Publication year

2024

Journal title

Frontiers in cardiovascular medicine

Volume

11

Page(s)

1405455

Abstract

Abstract

Hypertension (HTN) currently affects over 120 million Americans, in the United States (US). Thus, the implementation of evidence-based interventions (EBI) for blood pressure (BP) reduction is pivotal in minimizing this burden. We sought to evaluate evidence from published literature on the effectiveness of musical interventions for BP reduction within the US.

at Scientific Sessions 2023: Moving Toward Social Justice in Cardiovascular Health in the United States

Peprah, E., Baker-Smith, C. M., Waddy, S. P., Hassani, S., Mujahid, M., Okwuosa, T., Peprah, E., & Boden-Albala, B. (n.d.).

Publication year

2024

Journal title

Journal of the American Heart Association

Volume

13

Issue

22

Page(s)

e037936

Abstract

Abstract

Attention to social justice is essential to improving cardiovascular health outcomes. In the absence of social justice, equitable cardiovascular health is impossible. This viewpoint provides a brief synopsis of the 2023 -sponsored session titled "Moving Towards Social Justice in Cardiovascular Health." We define social justice and summarize the burden of cardiovascular disease inequity in the United States. We also highlight strategies for achieving social justice, including addressing workforce diversity, integrating social determinants into cardiovascular research, designing cardiovascular interventions to close the equity gap, and improving inclusivity in cardiovascular disease trials.

Barriers to Therapeutic Use of Hydroxyurea for Sickle Cell Disease in Nigeria : A Cross-Sectional Survey

Okocha, E. C., Gyamfi, J., Ryan, N., Babalola, O., Etuk, E. A., Chianumba, R., Nwegbu, M., Isa, H., Madu, A. J., Adegoke, S., Nnebe-Agumandu, U., Brown, B., Peprah, E., & Nnodu, O. E. (n.d.).

Publication year

2022

Journal title

Frontiers in Genetics

Volume

12

10.3389/fgene.2021.765958

Abstract

Abstract

Background: Sickle cell disease, the inherited blood disorder characterized by anemia, severe pain and other vaso-occlusive complications, acute chest syndrome, disproportionate hospitalization, and early mortality, has significant financial, social, and psychosocial impacts and drains individuals, families, and health systems globally. Hydroxyurea could improve the health of the 300,000 individuals born each year with sickle cell disease in sub-Saharan Africa; however, challenges to adoption and adherence persist. This study assessed the barriers to therapeutic use of hydroxyurea for sickle cell disease within the Nigerian healthcare system, specifically from the level of the patient, provider, and health system. Methods: We used purposive sampling to recruit participants from 13 regions in Nigeria. A cross-sectional survey was administered to physicians (n = 70), nurses or counselors (n = 17), and patients or their caregivers (n = 33) at 13 health centers. Findings were mapped onto the appropriate Consolidated Framework for Implementation Research (CFIR) domains. Results: This study was able to identify factors that mapped onto the inner setting, outer setting, and characteristics of individuals domains of CFIR. The majority of physicians (74.3%) prescribe hydroxyurea, and half stated hydroxyurea is the standard of care. Among clinicians, barriers included limited knowledge of the drug, as well as low self-efficacy to prescribe among physicians and to counsel among nurses; perceived side effects; perceived patient preference for traditional medicine; cost for patient and expense of accompanying laboratory monitoring; and limited availability of the drug and equipment for laboratory monitoring. Among patients and caregivers, barriers included lack of knowledge; perceived side effects; cost; religious beliefs of disease causation; and lack of pediatric formulation. Conclusions: Findings suggest that patient, provider, and health systems-level interventions are needed to improve hydroxyurea uptake among providers and adherence among patients with sickle cell disease in Nigeria. Interventions such as patient education, provider training, and policy change could address the disproportionate burden of sickle cell disease in sub-Saharan Africa and thus improve health equity.