Publications by authors named "Daniel Westreich"

Background: Few studies have assessed the impact of first-trimester malaria infection during pregnancy. We estimated this impact on adverse maternal and pregnancy outcomes.

Methods: In a convenience sample of women from the ASPIRIN (Aspirin Supplementation for Pregnancy Indicated risk Reduction In Nulliparas) trial in Kenya, Zambia, and the Democratic Republic of the Congo, we tested for first-trimester Plasmodium falciparum infection using quantitative polymerase chain reaction.

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Selection bias has long been central in methodological discussions across epidemiology and other fields. In epidemiology, the concept of selection bias has been continually evolving over time. In this issue of the Journal, Mathur and Shpitser (Am J Epidemiol.

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Most prior work in quantitative approaches to generalizability and transportability emphasizes extending causal effect estimates from randomized trials to target populations. Extending findings from observational studies is also of scientific interest, and identifiability assumptions and estimation methods differ from randomized settings when there is selection on both the exposure and exposure-outcome mediators in combination with exposure-outcome confounders (and both confounders and mediators can modify exposure-outcome effects). We argue that this causal structure is common in observational studies, particularly in the field of life course epidemiology, for example, when extending estimates of the effect of an early-life exposure on a later-life outcome from a cohort enrolled in midlife or late life.

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In sub-Saharan Africa, adolescent girls and young women aged 15-24 (AGYW) experience high risk of early and unintended pregnancy. We assessed the impact of youth-friendly health services (YFHS) on pregnancy risk among AGYW who participated in the Girl Power study. In 2016, Girl Power randomly assigned four government-run health centers in Lilongwe, Malawi, to provide a standard (n=1) or youth-friendly (n=3) model of service delivery.

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Article Synopsis
  • A survey of 103 reproductive-aged women with HIV in the U.S. South was conducted after the approval of long-acting injectable (LAI) cabotegravir/rilpivirine.
  • About two-thirds of the participants indicated they were open to trying LAI antiretroviral therapy (ART).
  • Most women preferred LAI over daily oral ART and had few concerns about how using LAI-ART might affect their reproductive health.
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Background: Data on long-term neurodevelopmental outcomes of normocephalic children (born with normal head circumference) exposed to Zika virus in utero are scarce. We aimed to compare neurodevelopmental outcomes in normocephalic children up to age 48 months with and without Zika virus exposure in utero.

Methods: In this prospective cohort study, we included infants from two cohorts of normocephalic children born in León and Managua, Nicaragua during the 2016 Zika epidemic.

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  • The article addresses the challenge of applying treatment effect estimates from randomized trials to real-world clinical settings, due to effect measure modification.* -
  • It presents a practical roadmap and four visual tools to aid researchers in selecting variables for models that extend trial effects, specifically using adjuvant chemotherapy for colon cancer as an example.* -
  • The visualizations help identify modifiers, assess overlap between populations, and guide model specification, ultimately enhancing the validity of treatment effect extensions to clinical practice.*
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Objective: We estimated the effect of early initiation of dual therapy vs monotherapy on drug administration and related outcomes in mechanically ventilated, critically ill children.

Methods: We used the electronic medical record at a single tertiary medical center to conduct an active comparator, new user cohort study. We included children <18 years of age who were exposed to a sedative or analgesic within 6 hours of intubation.

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Approaches to address measurement error frequently rely on validation data to estimate measurement error parameters (e.g., sensitivity and specificity).

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  • Trachomatous trichiasis (TT) is a painful eye problem that can cause blindness, and women are affected more than men.
  • Researchers studied data from 20 African countries to see how men and women are treated for TT and if there are differences.
  • The results showed that women are more likely to have complications after surgery and are more likely to refuse surgery, suggesting there are some gender differences in how TT is managed.
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In epidemiology, collider stratification bias, the bias resulting from conditioning on a common effect of two causes, is oftentimes considered a type of selection bias, regardless of the conditioning methods employed. In this commentary, we distinguish between two types of collider stratification bias: collider restriction bias due to restricting to one level of a collider (or a descendant of a collider) and collider adjustment bias through inclusion of a collider (or a descendant of a collider) in a regression model. We argue that categorizing collider adjustment bias as a form of selection bias may lead to semantic confusion, as adjustment for a collider in a regression model does not involve selecting a sample for analysis.

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Studies assessing patient-centred outcomes of novel rifampicin resistant tuberculosis (RR-TB) diagnostics are rare and mostly apply conventional methods which may not adequately address biases. Even though the Xpert MTB/RIF molecular assay was endorsed a decade ago for simultaneous diagnosis of tuberculosis and RR-TB, the impact of the assay on mortality among people with RR-TB has not yet been assessed. We analysed data of an observational prospective cohort study (EXIT-RIF) performed in South Africa.

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Inverse probability weighting can be used to correct for missing data. New estimators for the weights in the nonmonotone setting were introduced in 2018. These estimators are the unconstrained maximum likelihood estimator (UMLE) and the constrained Bayesian estimator (CBE), an alternative if UMLE fails to converge.

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Background: SARS-CoV-2 infection has caused variable clinical outcomes including hospitalization and death. We analyzed state-level data from the North Carolina COVID-19 Surveillance System (NC COVID) to describe demographics of those infected with SARS-CoV-2 and to describe factors associated with infection-fatality in North Carolina.

Methods: This was a retrospective cohort study using surveillance data on positive SARS-CoV-2-infected individuals (N = 214,179) identified between March 1, 2020, and September 30, 2020.

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  • Trachoma is a serious eye disease that can cause blindness, and improving water, sanitation, and hygiene (WaSH) is important to help prevent it.
  • The study looked at how increasing access to clean water for washing faces and using toilets can reduce the number of children with trachoma.
  • Findings suggest that having at least 65% of people using clean water for washing and 85% using proper toilets can help lower trachoma cases significantly.
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Objective: Hypertension is a critical cause of cardiovascular disease, and women with HIV have a higher prevalence of hypertension than women without HIV. The relationship between hypertension and mortality has not been well characterized in women with treated HIV. Here, we estimate the effect of hypertension on 1-year risk of all-cause mortality among women with HIV on antiretroviral therapy (ART) in the United States.

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Importance: Delivery of adjuvant chemotherapy can differ substantially between trial and real-world populations. Adherence metrics like relative dose intensity (RDI) cannot capture the timing of modifications and mask differences in the total amount of chemotherapy received.

Objective: To compare oxaliplatin delivery between MOSAIC trial participants and patients treated in the US Oncology Network with stage III colon cancer using a longitudinal cumulative dose (LCD).

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Pooled testing has been successfully used to expand SARS-CoV-2 testing, especially in settings requiring high volumes of screening of lower-risk individuals, but efficiency of pooling declines as prevalence rises. We propose a differentiated pooling strategy that independently optimizes pool sizes for distinct groups with different probabilities of infection to further improve the efficiency of pooled testing. We compared the efficiency (results obtained per test kit used) of the differentiated strategy with a traditional pooling strategy in which all samples are processed using uniform pool sizes under a range of scenarios.

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Background: The association between HIV and asthma prevalence and manifestations remains unclear, with few studies including women.

Setting: A retrospective observational cohort study from the Multicenter AIDS Cohort Study and Women's Interagency HIV Study.

Methods: Asthma was defined in 2 ways: (1) self-report and (2) robust criteria requiring all the following: lack of fixed airflow obstruction, presence of wheeze on the St.

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Purpose: We aim to assess the reporting of key patient-level demographic and clinical characteristics among COVID-19 related randomized controlled trials (RCTs).

Methods: We queried English-language articles from PubMed, Web of Science, clinicaltrials.gov, and the CDC library of gray literature databases using keywords of "coronavirus," "covid," "clinical trial" and "randomized controlled trial" from January 2020 to June 2021.

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People living in rural regions in the United States face more health challenges than their non-rural counterparts which could put them at additional risks during the COVID-19 pandemic. Few studies have examined if rurality is associated with additional mortality risk among those hospitalized for COVID-19. We studied a retrospective cohort of 3,991 people hospitalized with SARS-CoV-2 infections discharged between March 1 and September 30, 2020 in one of 17 hospitals in North Carolina that collaborate as a clinical data research network.

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Article Synopsis
  • - Neonatal mortality is a significant issue, accounting for nearly half of all child deaths under 5, and identifying the causes of neonatal infections is challenging due to non-specific symptoms.
  • - The study analyzed data from the ANISA cohort involving infants in South Asia to categorize acute neonatal illnesses based on WHO criteria, focusing on infectious causes identified through PCR and blood culture.
  • - Findings showed that bacterial infections were responsible for approximately 32.7% of critically ill cases, with a high percentage (58-82%) of infants in various illness categories remaining without identified infectious causes.
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  • The study looked at how having a short cervix during pregnancy affects the chances of giving birth early (before 37 weeks).
  • Out of 1409 pregnant women studied, only a small number had a short cervix, but those with it had a much higher risk of preterm birth compared to those without.
  • However, most babies were still born on time, showing that fixing short cervixes wouldn't really change the overall rate of preterm births in the population.
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Selection bias remains a subject of controversy. Existing definitions of selection bias are ambiguous. To improve communication and the conduct of epidemiologic research focused on estimating causal effects, we propose to unify the various existing definitions of selection bias in the literature by considering any bias away from the true causal effect in the referent population (the population before the selection process), due to selecting the sample from the referent population, as selection bias.

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