Michael H Merson
Michael Howard Merson
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Interim Chair and Clinical Professor of the Department of Global and Environmental Health
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Professional overview
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Michael Merson is Interim Chair of the Department of Global and Environmental Health and Clinical Professor of Global and Environmental Health. He is the William Joklik Emeritus Professor of Medicine and Global Health at Duke University, where he served as the founding director of the Duke Global Health Institute and as Vice President and Vice Provost for Global Affairs. His current research is focused on policy issues related to the response to pandemics, evaluating the rollout of Paxlovid in low-income countries and on ways to regain trust in public health.
Prior to NYU, he joined the faculty at Yale University as its first Dean of Public Health. Before entering academia, between 1980 and 1995, Dr. Merson served as director of the World Health Organization (WHO) programs on Diarrheal Diseases and Acute Respiratory Infections, and subsequently the WHO Global Program on AIDS. He has authored over 150 articles, is the senior editor of a leading global health textbook “Global Health: Disease, Programs, Systems, and Policies” and lead author of The AIDS Pandemic: Searching for a Global Response on the history of the global response to AIDS. He has served in advisory capacities for UNAIDS, WHO, the Global Fund to Fight AIDS, TB and Malaria, World Bank, World Economic Forum, Bill & Melinda Gates Foundation, and was an advisor to various private sector entities on the COVID-19 pandemic. He has two honorary degrees and is a member of the National Academy of Medicine.
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Education
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B.A., 1966, cum laude, Amherst College, Amherst, MassachusettsM.D., 1970, summa cum laude, SUNY, Health Sciences Center at Brooklyn, New York
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Honors and awards
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Consortium of Universities for Global Health (CUGH) Distinguished Leadership Award (2018)Duke Medical Alumni Association Distinguished Faculty Award (2017)Master Teacher Award in Preventive Medicine, Downstate Medical Center (2010)Outstanding Contribution to the Campaign Against HIV/AIDS, Russian Association Against AIDS (2000)Connecticut Health Commissioner’s AIDS Leadership Award (1998)Connecticut Health Commissioner’s AIDS Leadership Award (1997)Frank Babbott Alumni Award (1995)Surgeon General's Exemplary Service Medal (1993)Commendation Medal, US Public Health Service; (1986)Arthur S. Flemming Award for Outstanding Federal Service (1983)Commendation Medal, US Public Health Service (1975)
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Publications
Publications
Low antibody levels associated with significantly increased rate of SARS-CoV-2 infection in a highly vaccinated population from the US National Basketball Association
AbstractTai, C. G., Haviland, M. J., Kissler, S. M., Lucia, R. M., Merson, M., Maragakis, L. L., Ho, D. D., Anderson, D. J., DiFiori, J., Grubaugh, N. D., Grad, Y. H., & Mack, C. D. F. (n.d.).Publication year
2024Journal title
Journal of Medical VirologyVolume
96Issue
3AbstractSARS-CoV-2 antibody levels may serve as a correlate for immunity and could inform optimal booster timing. The relationship between antibody levels and protection from infection was evaluated in vaccinated individuals from the US National Basketball Association who had antibody levels measured at a single time point from September 12, 2021, to December 31, 2021. Cox proportional hazards models were used to estimate the risk of infection within 90 days of serologic testing by antibody level (<250, 250–800, and >800 AU/mL1), adjusting for age, time since last vaccine dose, and history of SARS-CoV-2 infection. Individuals were censored on date of booster receipt. The analytic cohort comprised 2323 individuals and was 78.2% male, 68.1% aged ≤40 years, and 56.4% vaccinated (primary series) with the Pfizer-BioNTech mRNA vaccine. Among the 2248 (96.8%) individuals not yet boosted at antibody testing, 77% completed their primary vaccine series 4–6 months before testing and the median (interquartile range) antibody level was 293.5 (interquartile range: 121.0–740.5) AU/mL. Those with levels <250 AU/mL (adj hazard ratio [HR]: 2.4; 95% confidence interval [CI]: 1.5–3.7) and 250–800 AU/mL (adj HR: 1.5; 95% CI: 0.98–2.4) had greater infection risk compared to those with levels >800 AU/mL. Antibody levels could inform individual COVID-19 risk and booster scheduling.The "Bubble": What Can Be Learned from the National Basketball Association (NBA)'s 2019-20 Season Restart in Orlando during the COVID-19 Pandemic
AbstractMack, C. D., Merson, M. H., Sims, L., Maragakis, L. L., Davis, R., Tai, C. G., Meisel, P., Grad, Y. H., Ho, D. D., Anderson, D. J., Lemay, C., & Difiori, J. (n.d.).Publication year
2023Journal title
Journal of Applied Laboratory MedicineVolume
8Issue
6Page(s)
1017-1027AbstractBackground: The National Basketball Association (NBA) suspended operations in response to the COVID-19 pandemic in March 2020. To safely complete the 2019-20 season, the NBA created a closed campus in Orlando, Florida, known as the NBA "Bubble."More than 5000 individuals lived, worked, and played basketball at a time of high local prevalence of SARS-CoV-2. Methods: Stringent protocols governed campus life to protect NBA and support personnel from contracting COVID-19. Participants quarantined before departure and upon arrival. Medical and social protocols required that participants remain on campus, test regularly, physically distance, mask, use hand hygiene, and more. Cleaning, disinfection, and air filtration was enhanced. Campus residents were screened daily and confirmed cases of COVID-19 were investigated. Results: In the Bubble population, 148 043 COVID-19 reverse transcriptase PCR (RT-PCR) tests were performed across approximately 5000 individuals; Orlando had a 4% to 15% test positivity rate in this timeframe. There were 44 COVID-19 cases diagnosed either among persons during arrival quarantine or in non-team personnel while working on campus after testing but before receipt of a positive result. No cases of COVID-19 were identified among NBA players or NBA team staff living in the Bubble once cleared from quarantine. Conclusions: Drivers of success included the requirement for players and team staff to reside and remain on campus, well-trained compliance monitors, unified communication, layers of protection between teams and the outside, activation of high-quality laboratory diagnostics, and available mental health services. An emphasis on data management, evidence-based decision-making, and the willingness to evolve protocols were instrumental to successful operations. These lessons hold broad applicability for future pandemic preparedness efforts.Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection: A Case Series From a 12-Month Longitudinal Occupational Cohort
AbstractMack, C. D., Tai, C., Sikka, R., Grad, Y. H., Maragakis, L. L., Grubaugh, N. D., Anderson, D. J., Ho, D., Merson, M., Samant, R. M., Fauver, J. R., Barrett, J., Sims, L., & Difiori, J. (n.d.).Publication year
2022Journal title
Clinical Infectious DiseasesVolume
74Issue
9Page(s)
1682-1685AbstractFindings are described in 7 patients with severe acute respiratory syndrome coronavirus 2 reinfection from the National Basketball Association 2020-2021 occupational testing cohort, including clinical details, antibody test results, genomic sequencing, and longitudinal reverse-transcription polymerase chain reaction results. Reinfections were infrequent and varied in clinical presentation, viral dynamics, and immune response.World Health Organization and knowledge translation in maternal, newborn, child and adolescent health and nutrition
Failed generating bibliography.AbstractPublication year
2022Journal title
Archives of Disease in ChildhoodVolume
107Issue
7Page(s)
644-649AbstractThe World Health Organization (WHO) has a mandate to promote maternal and child health and welfare through support to governments in the form of technical assistance, standards, epidemiological and statistical services, promoting teaching and training of healthcare professionals and providing direct aid in emergencies. The Strategic and Technical Advisory Group of Experts (STAGE) for maternal, newborn, child and adolescent health and nutrition (MNCAHN) was established in 2020 to advise the Director-General of WHO on issues relating to MNCAHN. STAGE comprises individuals from multiple low-income and middle-income and high-income countries, has representatives from many professional disciplines and with diverse experience and interests. Progress in MNCAHN requires improvements in quality o services, equity of access and the evolution of services as technical guidance, community needs and epidemiology changes. Knowledge translation of WHO guidance and other guidelines is an important part of this. Countries need effective and responsive structures for adaptation and implementation of evidence-based interventions, strategies to improve guideline uptake, education and training and mechanisms to monitor quality and safety. This paper summarises STAGE’s recommendations on how to improve knowledge translation in MNCAHN. They include support for national and regional technical advisory groups and subnational committees that coordinate maternal and child health; support for national plans for MNCAHN and their implementation and monitoring; the production of a small number of consolidated MNCAHN guidelines to promote integrated and holistic care; education and quality improvement strategies to support guidelines uptake; monitoring of gaps in knowledge translation and operational research in MNCAHN.Chinese medical teams in Africa: A flagship program facing formidable challenges
Chen, S., Pender, M., Jin, N., Merson, M., Tang, S., & Gloyd, S. (n.d.).Publication year
2019Journal title
Journal of Global HealthVolume
9Issue
1Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030
AbstractBlack, R., Fontaine, O., Lamberti, L., Bhan, M., Huicho, L., El Arifeen, S., Masanja, H., Walker, C. F., Mengestu, T. K., Pearson, L., Young, M., Orobaton, N., Chu, Y., Jackson, B., Bateman, M., Walker, N., & Merson, M. (n.d.).Publication year
2019Journal title
Journal of Global HealthVolume
9Issue
2AbstractBackground Childhood diarrhea deaths have declined more than 80% from 1980 to 2015, in spite of an increase in the number of children in low-and middle-income countries (LMIC). Possible drivers of this remarkable accomplishment can guide the further reduction of the half million annual child deaths from diarrhea that still occur. Methods We used the Lives Saved Tool, which models effects on mortality due to changes in coverage of preventive or therapeutic interventions or risk factors, for 50 LMIC to determine the proximal drivers of the diarrhea mortality reduction. Results Diarrhea treatment (oral rehydration solution [ORS], zinc, antibiotics for dysentery and management of persistent diarrhea) and use of rotavirus vaccine accounted for 49.7% of the diarrhea mortality reduction from 1980 to 2015. Improvements in nutrition (stunting, wasting, breastfeeding practices, vitamin A) accounted for 38.8% and improvements in water, sanitation and handwashing for 11.5%. The contribution of ORS was greater from 1980 to 2000 (58.0% of the reduction) than from 2000 to 2015 (30.7%); coverage of ORS increased from zero in 1980 to 29.5% in 2000 and more slowly to 44.1% by 2015. To eliminate the remaining childhood diarrhea deaths globally, all these interventions will be needed. Scaling up diarrhea treatment and rotavirus vaccine, to 90% coverage could reduce global child diarrhea mortality by 74.1% from 2015 levels by 2030. Adding improved nutrition could increase that to 89.1%. Finally, adding increased use of improved water sources, sanitation and handwashing could result in a 92.8% reduction from the 2015 level. Conclusions Employing the interventions that have resulted in such a large reduction in diarrhea mortality in the last 35 years can virtually eliminate remaining childhood diarrhea deaths by 2030.Evolution of the world health organization's programmatic actions to control diarrheal diseases
AbstractWolfheim, C., Fontaine, O., & Merson, M. (n.d.).Publication year
2019Journal title
Journal of Global HealthVolume
9Issue
2AbstractThe Program for the Control of Diarrheal Diseases (CDD) of the World Health Organization (WHO) was created in 1978, the year the Health for All Strategy was launched at the Alma Ata International Conference on Primary Health Care. CDD quickly became one of the pillars of this strategy, with its primary goal of reducing diarrhea-associated mortality among infants and young children in developing countries. WHO expanded the previous cholera-focused unit into one that addressed all diarrheal diseases, and uniquely combined support to research and to national CDD Programs. We describe the history of the Program, summarize the results of the research it supported, and illustrate the outcome of the Program's control efforts at country and global levels. We then relate the subsequent evolution of the Program to an approach that was more technically broad and programmatically narrow and describe how this affected diarrheal diseases-related activities globally and in countries.Factors associated with the decline in under-five diarrhea mortality in India: A LiST analysis
AbstractChoudhary, T. S., Sinha, B., Khera, A., Bhandari, N., Chu, Y., Jackson, B., Walker, N., Black, R. E., Merson, M., & Bhan, M. K. (n.d.).Publication year
2019Journal title
Journal of Global HealthVolume
9Issue
2AbstractBackground India has achieved 86% reduction in the number of under-five diarrheal deaths from 1980 to 2015. Nonetheless diarrhea is still among the leading causes of under-five deaths. The aim of this analysis was to study the contribution of factors that led to decline in diarrheal deaths in the country and the effect of scaling up of intervention packages to address the remaining diarrheal deaths. Methods We assessed the attribution of different factors and intervention packages such as direct diarrhea case management interventions, nutritional factors and WASH interventions which contributed to diarrhea specific under-five mortality reduction (DSMR) during 1980 to 2015 using the Lives Saved Tool (LiST). The potential impact of scaling up different packages of interventions to achieve universal coverage levels by year 2030 on reducing the number of remaining diarrheal deaths were estimated. Results The major factors associated with DSMR reduction in under-fives during 1980 to 2015, were increase in ORS use, reduction in stunting prevalence, improved sanitation, changes in age appropriate breastfeeding practices, increase in the vitamin-A supplementation and persistent diarrhea treatment. ORS use and reduction in stunting were the two key interventions, each accounting for around 32% of the lives saved during this period. Scaling up the direct diarrhea case management interventions from the current coverage levels in 2015 to achieve universal coverage levels by 2030 can save around 82 000 additional lives. If the universal targets for nutritional factors and WASH interventions can be achieved, an additional 23 675 lives can potentially be saved. Conclusions While it is crucial to improve the coverage and equity in ORS use, an integrated approach to promote nutrition, WASH and direct diarrhea interventions is likely to yield the highest impact on reducing the remaining diarrheal deaths in under-five children.Introductory commentary: a strategic review of options for building on lessons learnt from IMCI and iCCM
Jacobs, M., & Merson, M. (n.d.).Publication year
2018Journal title
BMJ (Clinical research ed.)Volume
362Page(s)
bmj.k3013Corporate citizenship, aids and Africa
AbstractHartwig, K. A., Rosenberg, A., & Merson, M. (n.d.). In Corporate Citizenship in Africa: Lessons from bristol-myers squibb company’s secure the future™ (1–).Publication year
2017Page(s)
132-143AbstractThe title of Alan Paton’s South African novel, Ah, But Your Land is Beautiful, reflects the common impression of most visitors and residents as they travel across the widely differing terrains of sub-Saharan Africa. As the story tells, however, the beauty is often eclipsed by the evidence of human suffering, social injustices, environmental degradation and exploitation of resources exerted by ever-changing political elites. Today’s South Africa and its neighbouring states are living on the foundations of this history, some with constitutions barely ten years old. Infrastructure and economic development were fostered within the urban and suburban centres allowing the rural areas with the majority of the population to remain in living conditions of decades past. The economic and human resources in southern Africa remain strong, but generating future economic development that will correct some of the current human and ecological imbalances will require new social contracts with businesses and corporations. Historically in this region, governments and corporations have often worked against the civil, social and political rights of the majority of its citizens, and worker-corporate relations have been tense, leaving the majority of the population suspicious of corporations and their motives (Bauer and Taylor 2005).Global hearing health care: new findings and perspectives
AbstractWilson, B. S., Tucci, D. L., Merson, M. H., & O’Donoghue, G. M. (n.d.).Publication year
2017Journal title
The LancetVolume
390Issue
10111Page(s)
2503-2515AbstractIn 2015, approximately half a billion people had disabling hearing loss, about 6·8% of the world's population. These numbers are substantially higher than estimates published before 2013, and point to the growing importance of hearing loss and global hearing health care. In this Review, we describe the burden of hearing loss and offer our and others' recommendations for halting and then reversing the continuing increases in this burden. Low-cost possibilities exist for prevention of hearing loss, as do unprecedented opportunities to reduce the generally high treatment costs. These possibilities and opportunities could and should be exploited. Additionally, a comprehensive worldwide initiative like VISION 2020 but for hearing could provide a focus for support and also enable and facilitate the increased efforts that are needed to reduce the burden. Success would produce major personal and societal gains, including gains that would help to fulfil the “healthy lives” and “disability inclusive” goals in the UN's new 2030 Agenda for Sustainable Development.Partnership Conference
AbstractBartlett, J. A., Cao, S., Mmbaga, B., Qian, X., Merson, M., & Kramer, R. (n.d.).Publication year
2017Journal title
Annals of Global HealthVolume
83Issue
3Page(s)
630-636AbstractBackground The Duke Global Health Institute (DGHI) was founded in 2006 with a goal to foster interdisciplinary global health education and research across Duke University and Duke Medical Center. Critical to achieving this goal is the need to develop and sustain strong international partnerships. Objective To host a conference with multiple international partners and strengthen existing relationships. Methods After a deliberate year-long planning process, DGHI convened a Partnership Conference with its international partners on the Duke University campus in conjunction with its 10th Anniversary Celebration. The Partnership Conference sought to promote an exchange of novel ideas in support of global health education and research, explore new collaborations in South-South relationships, and identify and facilitate pursuit of new educational and research opportunities. Findings A total of 25 partners from 10 countries and 46 DGHI faculty members participated in the 3-day event in October 2016. Activities included workshops on preselected research topics, educational symposia on novel teaching methods and harnessing technological advances, introduction of the Health Humanities Laboratory to prepare students and trainees for fieldwork, and discussions of research infrastructure and training needs. Surveys from visiting partners revealed a high degree of satisfaction. Proposed action items include methods to realize improved communications, enhancement of mutual education opportunities, support and mentoring to build local research capacity, and more exchange of faculty and students between partnering institutions. Conclusions With careful planning from all parties, a multilateral partnership conference including both university and medical center faculty can be a productive forum for exchange on global health education and research. Sustaining such partnerships is vital to the success of global health scholarship.The AIDS pandemic: Searching for a global response
AbstractAbstractThis ambitious book provides a comprehensive history of the World Health Organization (WHO) Global Programme on AIDS (GPA), using it as a unique lens to trace the global response to the AIDS pandemic. The authors describe how WHO came initially to assume leadership of the global response, relate the strategies and approaches WHO employed over the years, and expound on the factors that led to the Programme's demise and subsequent formation of the Joint United Nations Programme on HIV/AIDS(UNAIDS). The authors examine the global impact of this momentous transition, portray the current status of the global response to AIDS, and explore the precarious situation that WHO finds itself in today as a lead United Nations agency in global health. Several aspects of the global response - the strategies adopted, the roads taken and not taken, and the lessons learned - can provide helpful guidance to the global health community as it continues tackling the AIDS pandemic and confronts future global pandemics. Included in the coverage: The response before the global response; Building and coordinating a multi-sectoral response; Containing the global spread of HIV; Addressing stigma, discrimination, and human rights; Rethinking global AIDS governance; UNAIDS and its place in the global response. The AIDS Pandemic: Searching for a Global Response recounts the global response to the AIDS pandemic from its inception to today. Policymakers, students, faculty, journalists, researchers, and health professionals interested in HIV/AIDS, global health, global pandemics, and the history of medicine will find it highly compelling and consequential. It will also interest those involved in global affairs, global governance, international relations, and international development.The Future Role of the United States in Global Health: Emphasis on Cardiovascular Disease
Failed generating bibliography.AbstractPublication year
2017Journal title
Journal of the American College of CardiologyVolume
70Issue
25Page(s)
3140-3156AbstractU.S. global health investment has focused on detection, treatment, and eradication of infectious diseases such as tuberculosis, malaria, and human immunodeficiency virus/acquired immunodeficiency syndrome, with significant results. Although efforts should be maintained and expanded to provide ongoing therapy for chronic infectious disease, there is a pressing need to meet the challenge of noncommunicable diseases, which constitute the highest burden of diseases globally. A Committee of the National Academies of Sciences, Engineering, and Medicine has made 14 recommendations that require ongoing commitments to eradication of infectious disease and increase the emphasis on chronic diseases such as cardiovascular disease. These include improving early detection and treatment, mitigating disease risk factors, shifting global health infrastructure to include management of cardiovascular disease, developing global partners and private-public ventures to meet infrastructure and funding challenges, streamlining medical product development and supply, increasing research and development capacity, and addressing gaps in global political and institutional leadership to meet the shifting challenge.Research in action: From AIDS to global health to impact. A symposium in recognition of the scientific contributions of Professor Joep Lange
Boender, T. S., Barré-Sinoussi, F., Cooper, D., Goosby, E., Hankins, C., Heidenrijk, M., De Jong, M., Kazatchkine, M., Laoye, F., Merson, M., Reiss, P., Rinke De Wit, T. F., Rogo, K., Schellekens, O., Schultsz, C., Sigaloff, K. C., Simon, J., & Zewdie, D. (n.d.).Publication year
2015Journal title
Antiviral TherapyVolume
20Issue
1Page(s)
101-108University engagement in global health
Merson, M. H. (n.d.).Publication year
2014Journal title
New England Journal of MedicineVolume
370Issue
18Page(s)
1676-1678The president's Emergency Plan for AIDS relief: From successes of the emergency response to challenges of sustainable action
AbstractMerson, M. H., Curran, J. W., Griffith, C. H., & Ragunanthan, B. (n.d.).Publication year
2012Journal title
Health AffairsVolume
31Issue
7Page(s)
1380-1388AbstractThe Presidents Emergency Plan for AIDS Relief (PEPFAR) has made a major contribution to the reduction of the global HIV/AIDS burden. The program initially focused on rapidly scaling up treatment and prevention services in fifteen low-income countries, then transitioned to an approach that emphasizes sustainability, defined as the capacity to maintain program services after financial, managerial, and technical assistance from the United States and other external donors essentially ceases. Today, PEPFAR continues to expand its HIV prevention, treatment, and care activities while also supporting capacity building initiatives, coordination efforts, and implementation science. The latter is research focused on improving service delivery, maximizing cost-effectiveness, and achieving public health impact. Recent advances in both scientific knowledge and the provision of prevention, treatment, and care services have bred cautious optimism about greatly reducing the spread of HIV. However, success will require a substantial increase in resources, strengthened health systems, renewed commitment to HIV prevention, and well-financed efforts to develop an effective HIV vaccine.Informing the 2011 UN session on noncommunicable diseases: Applying lessons from the AIDS response
Lamptey, P., Merson, M., Piot, P., Reddy, K. S., & Dirks, R. (n.d.).Publication year
2011Journal title
PLoS MedicineVolume
8Issue
9Perspective: Global medicine: Opportunities and challenges for academic health science systems
AbstractAckerly, D. C., Udayakumar, K., Taber, R., Merson, M. H., & Dzau, V. J. (n.d.).Publication year
2011Journal title
Academic MedicineVolume
86Issue
9Page(s)
1093-1099AbstractGlobalization is having a growing impact on health and health care, presenting challenges as well as opportunities for the U.S. health care industry in general and for academic health science systems (AHSSs) in particular. The authors believe that AHSSs must develop long-term strategies that address their future role in global medicine. AHSSs should meet global challenges through planning, engagement, and innovation that combine traditional academic activities with entrepreneurial approaches to health care delivery, research, and education, including international public-private partnerships. The opportunities for U.S.-based AHSSs to be global health care leaders and establish partnerships that improve health locally and globally more than offset the potential financial, organizational, politico-legal, and reputational risks that exist in the global health care arena. By examining recent international activities of leading AHSSs, the authors review the risks and the critical factors for success and discuss external policy shifts in workforce development and accreditation that would further support the growth of global medicine.Surgical capacity building in uganda through twinning, technology, and training camps
AbstractHaglund, M. M., Kiryabwire, J., Parker, S., Zomorodi, A., MacLeod, D., Schroeder, R., Muhumuza, M., & Merson, M. (n.d.).Publication year
2011Journal title
World Journal of SurgeryVolume
35Issue
6Page(s)
1175-1182AbstractBackground: Neurosurgical capacity is extremely deficient in East African countries where 27 neurosurgeons serve more than 250 million people. To build capacity, the Duke University Medical Center and New Mulago Hospital in Uganda applied a two-pronged twinning approach that placed usable surplus equipment in a developing country's National Hospital, combined with dedicated comprehensive surgical training camps. Methods: Neurosurgery, anesthesiology, nursing, and clinical engineering personnel supported three training camps. More than 21 tons of essential equipment was delivered to New Mulago Hospital in Uganda. Data was collected during the 2-year period preceding and following the initiation of the program. Results: During the 2 years after the program began, neurosurgery demonstrated a significant increase (180%) in the number and complexity of cases performed (p < 0.0001). Multiple cases performed in a single day increased eightfold (p < 0.0001), with utilization of elective operating room days improving from 43 to 98%. There was no change in the number of hospital admissions over the 4 years (p > 0.1), but there was a dramatic increase in the overall number of procedures performed by all surgical specialties (106%, p < 0.0001). Conclusions: Through a twinning program combining delivery of surplus equipment and training camps, capacity building was accomplished and maintained. The program not only built overall surgical capacity, it improved the efficiency and increased the complexity of operative cases performed at the National Hospital in Uganda. This program could serve as a model for twinning, capacity building, and training in other developing countries where surgical disparities are among the greatest.Two-year impacts on employment and income among adults receiving antiretroviral therapy in Tamil Nadu, India: A cohort study
AbstractThirumurthy, H., Jafri, A., Srinivas, G., Arumugam, V., Saravanan, R. M., Angappan, S. K., Ponnusamy, M., Raghavan, S., Merson, M., & Kallolikar, S. (n.d.).Publication year
2011Journal title
AIDSVolume
25Issue
2Page(s)
239-246AbstractObjectives: To estimate the economic impact of antiretroviral therapy (ART) on employment and income of treated patients as well as a comparison group of pre-ART patients who receive care and support in Tamil Nadu, India. Methods: A cohort of 1238 HIV-infected patients was followed between 2005 and 2007. Socioeconomic data were collected at 6-month intervals. A total of 515 patients initiated ART during the study period, whereas a comparison group of 723 patients were pre-ART. The impact of ART on four employment outcomes was analyzed: participation in economic activities in the past week, number of hours worked in the past week, individual income earned in the past 30 days and 6 months. Regression models including patient fixed effects were estimated. Data from the comparison group of patients were used to adjust for time trends in employment outcomes. Results: At 6 months after initiation of ART, patients were 10 percentage points more likely to be economically active (P < 0.01) and worked 5.5 additional hours per week (P < 0.01). These increases were over and above those experienced by the comparison group. The estimated 24-month impacts represent a doubling of patients' employment levels at baseline. At 24 months after ART initiation, employment increases remained large and significant. Effects were almost twice as large for men compared with women. Income earned in the past 30 days and 6 months also rose significantly. Conclusion: ART resulted in a rapid and sustained increase in employment and income for patients. The results demonstrate that ART can improve the economic outcomes of HIV-infected patients.A summary of the literature on global hearing impairment: Current status and priorities for action
AbstractTucci, D. L., Merson, M. H., & Wilson, B. S. (n.d.).Publication year
2010Journal title
Otology and NeurotologyVolume
31Issue
1Page(s)
31-41AbstractBackground: Hearing loss (HL) and deafness are global issues that affect at least 278 million people worldwide. Two thirds of the people who have HL worldwide live in developing countries. Importantly, it is estimated that 50% of this HL can be prevented. In developing countries, funding for prevention, early detection, and rehabilitative programs is severely limited, and therefore, agencies must compete against priorities to treat life-threatening, pandemic diseases such as human immunodeficiency virus, malaria, and tuberculosis. Delays in diagnosis are common, and social attitudes, local customs, and cultural bias are contributing factors. Objective: The purpose of this review is to gain an understanding of the prevalence of HL in the developing world and to focus attention on the growing need for both prevention and effective treatment programs. A second goal is to use this information to suggest priorities and approaches to address these problems worldwide. Data Sources: The data were compiled from a review of the literature on the global impacts of hearing impairment and recently published reports on the prevalence and cause of hearing impairment in developing nations. Conclusion:: The high prevalence of HL in the developing world is due to a variety of factors, including lack of widespread comprehensive immunization programs and other medical care, and inadequate funds for intervention once HL is identified. International organizations, governments, and nongovernment organizations have many opportunities to prevent and treat HL through cost-effective means.Results of the NIMH collaborative HIV/Sexually transmitted disease prevention trial of a community popular opinion leader intervention
Failed generating bibliography.AbstractPublication year
2010Journal title
Journal of Acquired Immune Deficiency SyndromesVolume
54Issue
2Page(s)
204-214AbstractOBJECTIVE: To determine whether community populations in community popular opinion leader intervention venues showed greater reductions in sexual risk practices and lower HIV/sexually transmitted disease (STD) incidence than those in comparison venues. METHODS: A 5-country group-randomized trial, conducted from 2002 to 2007, enrolled cohorts from 20 to 40 venues in each country. Venues, matched within country on sexual risk and other factors, were randomly assigned within matched pairs to the community popular opinion leader intervention or an AIDS education comparison. All participants had access to condoms and were assessed with repeated in-depth sexual behavior interviews, STD/HIV testing and treatment, and HIV/STD risk-reduction counseling. Sexual behavior change and HIV/STD incidence were measured over 2 years. RESULTS: Both intervention and comparison conditions showed declines of approximately 33% in risk behavior prevalence and had comparable diseases incidence within and across countries. CONCLUSIONS: The community-level intervention did not produce greater behavioral risk and disease incidence reduction than the comparison condition, perhaps due to the intensive prevention services received by all participants during the assessment. Repeated detailed self-review of risk behavior practices coupled with HIV/STD testing, treatment, HIV risk-reduction counseling, and condom access can themselves substantially change behavior and disease acquisition.Diagnosis of Acute HIV infection in Connecticut
AbstractDubrow, R., Sikkema, K. J., Mayer, K. H., Bruce, R. D., Julian, P., Rodriguez, I., Beckwith, C., Roome, A., Dunne, D., Boeving, A., Kidder, T. J., Jenkins, H., Dobson, M., Becker, J., & Merson, M. H. (n.d.).Publication year
2009Journal title
Connecticut medicineVolume
73Issue
6Page(s)
325-331AbstractAcute HIV infection (AHI) is the earliest stage of HIV disease, when plasma HIV viremia, but not HIV antibodies, can be detected. Acute HIV infection often presents as a nonspecific viral syndrome. However, its diagnosis, which enables linkage to early medical care and limits further HIV transmission, is seldom made. We describe the experience of Yale's Center for Interdisciplinary Research on AIDS with AHI diagnosis in Connecticut, as a participating center in the National Institute of Mental Health Multisite AHI Study. We sought to identify AHI cases by clinical referrals and by screening for AHI at two substance abuse care facilities and an STD clinic. We identified one case by referral and one through screening of 590 persons. Screening for AHI is feasible and probably cost effective. Primary care providers should include AHI in the differential diagnosis when patients present with a nonspecific viral syndrome.Identifying acute HIV infection in Rhode Island.
Beckwith, C. G., Cornwall, A. H., Dubrow, R., Chapin, K., Ducharme, R., Rodriguez, I., Velasquez, L., Merson, M. H., Sikkema, K. J., & Mayer, K. (n.d.).Publication year
2009Journal title
Medicine and health, Rhode IslandVolume
92Issue
7Page(s)
231-233