Publications by authors named "Diane Morof"

Article Synopsis
  • Verbal autopsy (VA) helps find out causes of death where birth and death records are not kept well, but it's costly. Telephonic VAs can save money. Sometimes, doctors need to agree on the cause, which can take a lot of time and effort.
  • The study looked at how often two doctors agreed on the cause of death using telephonic VAs in South Africa, checking if their agreement was very high (over 0.8).
  • Results showed that doctors agreed on causes like COVID-19 and heart disease most of the time, but not as much on diabetes. This means they might still need more than one doctor to be sure about the causes
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Article Synopsis
  • Verbal autopsy (VA) helps find out how people died when they weren't in a hospital, but it's hard to use it in official death records.
  • In South Africa, researchers talked to families of people who died to collect information about causes of death in 2017/18.
  • They found that while they could gather useful info, there were still challenges in getting enough people to participate, highlighting the need for better systems to record deaths.
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Background: The South African national cause of death validation (NCODV 2017/18) project collected a national sample of verbal autopsies (VA) with cause of death (COD) assignment by physician-coded VA (PCVA) and computer-coded VA (CCVA).

Objective: The performance of three CCVA algorithms (InterVA-5, InSilicoVA and Tariff 2.0) in assigning a COD was compared with PCVA (reference standard).

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Article Synopsis
  • Children under 5 years, especially those with HIV not on antiretroviral treatment, face significantly higher mortality rates compared to older age groups, despite receiving ART.
  • From October 2020 to September 2022, annual death rates among infants aged <1 year and children aged 1-4 years on ART were 4.9% and 2.5%, respectively, which are notably higher than those for individuals aged 5 and older.
  • Improving access to and quality of HIV health services for young children, in line with WHO recommendations, is essential for addressing the poor health outcomes they currently face.
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As COVID-19 cases increased during the first weeks of the pandemic in South Africa, the National Institute of Communicable Diseases requested assistance with epidemiologic and surveillance expertise from the US Centers for Disease Control and Prevention South Africa. By leveraging its existing relationship with the National Institute of Communicable Diseases for >2 months, the US Centers for Disease Control and Prevention South Africa supported data capture and file organization, data quality reviews, data analytics, laboratory strengthening, and the development and review of COVID-19 guidance This case study provides an account of the resources and the technical, logistical, and organizational capacity leveraged to support a rapid response to the COVID-19 pandemic in South Africa.

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Introduction: The high burden of stillbirths and neonatal deaths is driving global initiatives to improve birth outcomes. Discerning stillbirths from neonatal deaths can be difficult in some settings, yet this distinction is critical for understanding causes of perinatal deaths and improving resuscitation practices for live born babies.

Methods: We evaluated data from the Child Health and Mortality Prevention Surveillance (CHAMPS) network to compare the accuracy of determining stillbirths versus neonatal deaths from different data sources and to evaluate evidence of resuscitation at delivery in accordance with World Health Organization (WHO) guidelines.

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To describe the prevalence of unintended pregnancy and its association with HIV status among pregnant women in South Africa. A cross-sectional survey was conducted between October and mid-November 2019 among pregnant women aged 15-49 years in 1589 selected public antenatal care facilities. Pregnancy intention was assessed using two questions from the London Measure of Unplanned Pregnancy.

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Approximately half of all pregnancies in the United States are unintended. However, women who are diagnosed with cancer in their reproductive years may be a unique population. This study examines the prevalence of and identifies factors associated with unplanned pregnancy among cancer survivors.

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Objective: To determine quality of antenatal care (ANC). Most literature focuses on ANC attendance and services. Less is known about quality of care (QoC).

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Background: Saving Mothers, Giving Life (SMGL) is a 5-year initiative implemented in participating districts in Uganda and Zambia that aimed to reduce deaths related to pregnancy and childbirth by targeting the 3 delays to receiving appropriate care: seeking, reaching, and receiving. Approaches to addressing the third delay included adequate health facility infrastructure, specifically sufficient equipment and medications; trained providers to provide quality evidence-based care; support for referrals to higher-level care; and effective maternal and perinatal death surveillance and response.

Methods: SMGL used a mixed-methods approach to describe intervention strategies, outcomes, and health impacts.

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Saving Mothers, Giving Life (SMGL), a 5-year initiative implemented in selected districts in Uganda and Zambia, was designed to reduce deaths related to pregnancy and childbirth by targeting the 3 delays to receiving appropriate care at birth. While originally the "Three Delays" model was designed to focus on curative services that encompass emergency obstetric care, SMGL expanded its application to primary and secondary prevention of obstetric complications. Prevention of the "first delay" focused on addressing factors influencing the decision to seek delivery care at a health facility.

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Background: Maternal and perinatal mortality is a global development priority that continues to present major challenges in sub-Saharan Africa. Saving Mothers, Giving Life (SMGL) was a multipartner initiative implemented from 2012 to 2017 with the goal of improving maternal and perinatal health in high-mortality settings. The initiative accomplished this by reducing delays to timely and appropriate obstetric care through the introduction and support of community and facility evidence-based and district-wide health systems strengthening interventions.

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Objectives: To examine Ebola virus disease (EVD) symptom prevalence and EVD status among pregnant women in Ebola isolation units in Sierra Leone.

Methods: In an observational study, data were obtained for pregnant women admitted to Ebola isolation units across four districts in Sierra Leone from June 29, 2014, to December 20, 2014. Women were admitted to isolation units if they had suspected EVD exposures or fever (temperature >38°C) and three or more self-reported symptoms suggestive of EVD.

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Objective: To describe maternal and perinatal outcomes among pregnant women with suspected Ebola virus disease (EVD) in Sierra Leone.

Methods: Observational investigation of maternal and perinatal outcomes among pregnant women with suspected EVD from five districts in Sierra Leone from June to December 2014. Suspected cases were ill pregnant women with symptoms suggestive of EVD or relevant exposures who were tested for EVD.

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Previous outbreaks suggest that pregnant women with Ebola virus disease (EVD) are at increased risk for severe disease and death. Healthcare workers who treat pregnant women with EVD are at increased risk of body fluid exposure. Despite the absence of pregnant women with EVD in the United States, CDC activated the Maternal Health Team (MHT), a functional unit dedicated to emergency preparedness and response issues, on October 18, 2014.

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Objective: To assess gender-based violence and mental health outcomes among a population of female urban refugees and asylum seekers.

Methods: In a questionnaire-based, cross-sectional study conducted in 2010 in Kampala, Uganda, a study team interviewed a stratified random sample of female refugees and asylum seekers aged 15-59 years from the Democratic Republic of Congo and Somalia. Questionnaires were used to collect information about recent and lifetime exposure to sexual and physical violence, and symptoms of depression and post-traumatic stress disorder (PTSD).

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Background: Over 40% of all deaths among children under 5 are neonatal deaths (0-28 days), and this proportion is increasing. In 2012, 2.9 million newborns died, with 99% occurring in low- and middle-income countries.

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In 2008-2009, Zimbabwe experienced an unprecedented cholera outbreak with more than 4,000 deaths. More than 60% of deaths occurred at the community level. We conducted descriptive and case-control studies to describe community deaths.

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Objective: To conduct a field-based evaluation of an Early Warning Alert and Response Network (EWARN) in Darfur, Sudan.

Methods: Using adapted surveillance evaluation guidelines, evaluators reviewed EWARN documents and conducted semi-structured in-depth interviews and group discussions with key informantsat national, state, and local levels. Evaluators conducted visits at 18 purposively sampled clinics in all Darfur states.

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Objective: To evaluate the reliability and validity of the London Measure of Unplanned Pregnancy (a U.K.-developed measure of pregnancy intention), in English and Spanish translation, in a U.

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We conducted a survey among female sex workers in Goroka, Eastern Highlands Province, Papua New Guinea to evaluate the frequency of sexually transmitted disease (STD) symptoms they suffered, their STD and HIV (human immunodeficiency virus) transmission knowledge and health-seeking behaviours, the forms that their HIV risk perception took, and the types and quantities of educational resources to which they had access and in fact used. This survey was a part of a larger study of sex workers that was carried out in two other cities, Lae, the capital of Morobe Province, and Port Moresby, the nation's capital. We interviewed 190 self-identified female sex workers who had been recruited between January 1999 and October 1999 through peer-mediated contacts.

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