2023
Association between cancer stigma and cervical cancer screening uptake among women of Dhulikhel and Banepa, Nepal
Paneru B, Karmacharya A, Bharati A, Makaju S, Adhikari B, Kafle D, Shakya S, Spiegelman D, Seth S, Stangl A, Shrestha A, Shrestha A. Association between cancer stigma and cervical cancer screening uptake among women of Dhulikhel and Banepa, Nepal. PLOS ONE 2023, 18: e0285771. PMID: 37200234, PMCID: PMC10194964, DOI: 10.1371/journal.pone.0285771.Peer-Reviewed Original ResearchConceptsCervical cancer screening uptakeCancer screening uptakeScreening uptakeMultivariable logistic regressionCancer Stigma ScaleCancer stigmaCervical cancerAge of menarcheFirst sexual intercourseLogistic regressionNepalese womenSexual intercourseReproductive health variablesCervical cancer screeningEffective screening programsSemi-urban areasCross-sectional studyPercent of womenMean total scoreFamily planning usersScreening servicesCancer screeningCommon cancerDisease burdenScreening program
2022
The impact of a community health worker intervention on uptake of antenatal care: a cluster-randomized pragmatic trial in Dar es Salaam
Regan M, Cheng C, Mboggo E, Larson E, Lema I, Magesa L, Machumi L, Ulenga N, Sando D, Mwanyika-Sando M, Barnhart D, Hong B, Mungure E, Li N, Siril H, Mujinja P, Naburi H, Kilewo C, Ekström A, Geldsetzer P, Fawzi W, Bärnighausen T, Sudfeld C, Spiegelman D. The impact of a community health worker intervention on uptake of antenatal care: a cluster-randomized pragmatic trial in Dar es Salaam. Health Policy And Planning 2022, 38: 279-288. PMID: 36377764, PMCID: PMC10019560, DOI: 10.1093/heapol/czac100.Peer-Reviewed Original ResearchConceptsMore ANC visitsCommunity health worker interventionHealth worker interventionAntenatal careANC visitsPragmatic trialHigh-quality antenatal carePragmatic cluster-randomized trialUptake of ANCDar es SalaamWorker interventionLarge-scale pragmatic trialsCluster-randomized pragmatic trialModest beneficial effectStandard of careRoutine health system dataCluster-randomized trialHealth system dataANC uptakeCare armCHW interventionPrimary outcomeIntervention armFirst trimesterPregnant womenCardiovascular Risk Factors Mediate the Long-Term Maternal Risk Associated With Hypertensive Disorders of Pregnancy
Stuart JJ, Tanz LJ, Rimm EB, Spiegelman D, Missmer SA, Mukamal KJ, Rexrode KM, Rich-Edwards JW. Cardiovascular Risk Factors Mediate the Long-Term Maternal Risk Associated With Hypertensive Disorders of Pregnancy. Journal Of The American College Of Cardiology 2022, 79: 1901-1913. PMID: 35550687, PMCID: PMC9176211, DOI: 10.1016/j.jacc.2022.03.335.Peer-Reviewed Original ResearchConceptsCVD risk factorsRates of CVDHealth Study IIRisk of CVDBody mass indexGestational hypertensionType 2 diabetesRisk factorsChronic hypertensionHypertensive disordersMass indexNurses' Health Study IIPrepregnancy body mass indexHistory of HDPCardiovascular risk factorsOverweight/obesityProportional hazards modelIncident CVDCVD preventionNormotensive pregnanciesFirst pregnancyPotential confoundersParental historyHypertensionHazards model
2020
Coaching Intensity, Adherence to Essential Birth Practices, and Health Outcomes in the BetterBirth Trial in Utter Pradesh, India
Barnhart DA, Spiegelman D, Zigler CM, Kara N, Delaney MM, Kalita T, Maji P, Hirschhorn LR, Semrau KEA. Coaching Intensity, Adherence to Essential Birth Practices, and Health Outcomes in the BetterBirth Trial in Utter Pradesh, India. Global Health Science And Practice 2020, 8: ghsp-d-19-00317. PMID: 32127359, PMCID: PMC7108945, DOI: 10.9745/ghsp-d-19-00317.Peer-Reviewed Original ResearchConceptsEssential birth practicesSafe Childbirth ChecklistPerinatal health outcomesBirth attendantsHealth outcomesBetterBirth trialWorld Health Organization Safe Childbirth ChecklistBirth practicesQuality of careSustain behavior changeCoaching-based interventionBehavior changeFrequent coachingPerinatal mortalityBirth facilityAdherenceOutcomesGreater improvementAttendantsVisitsTrialsMonthsRegression modelsAssociationUtter Pradesh
2013
Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study
Ezeamama A, Duggan C, Manji K, Spiegelman D, Hertzmark E, Bosch R, Kupka R, Okuma J, Kisenge R, Aboud S, Fawzi W. Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study. HIV Medicine 2013, 15: 276-285. PMID: 24215465, PMCID: PMC4299572, DOI: 10.1111/hiv.12111.Peer-Reviewed Original ResearchConceptsPregnant HIV-positive womenHIV-positive womenRelative riskFever symptomsHIV MTCTHIV infectionPolymerase chain reactionHIV-positive pregnant womenMultivariable logistic regression modelCent of HIVChild's HIV statusHIV MTCT riskInfants of womenPerinatal HIV infectionChild HIV infectionLaboratory-confirmed diagnosisConfidence intervalsPrenatal health careWeeks of lifeLogistic regression modelsHIV motherMaternal malariaMTCT programmeMTCT riskChild transmissionDeterminants of anemia in postpartum HIV-negative women in Dar es Salaam, Tanzania
Petraro P, Duggan C, Urassa W, Msamanga G, Makubi A, Spiegelman D, Fawzi WW. Determinants of anemia in postpartum HIV-negative women in Dar es Salaam, Tanzania. European Journal Of Clinical Nutrition 2013, 67: 708-717. PMID: 23612515, PMCID: PMC3775569, DOI: 10.1038/ejcn.2013.71.Peer-Reviewed Original ResearchMeSH KeywordsAnemia, Iron-DeficiencyCD4 Lymphocyte CountDietDietary SupplementsErythrocyte IndicesFemaleFolic AcidHemoglobinsHIV InfectionsHumansIron, DietaryMaternal Nutritional Physiological PhenomenaMultivariate AnalysisPostpartum PeriodPregnancyProportional Hazards ModelsProspective StudiesRisk FactorsSocioeconomic FactorsTanzaniaConceptsIron/folate supplementationIron deficiency anemiaDeterminants of anemiaDeficiency anemiaFolate supplementationDelivery complicationsPregnant womenRisk factorsMultivariate Cox proportional hazards modelNon-anemic pregnant womenCox proportional hazards modelCD4 cell countHIV-negative womenModifiable risk factorsProspective cohort studyMaternal nutritional statusWeeks of gestationManagement of infectionsProportional hazards modelDar es SalaamSub-Saharan African womenBaseline anemiaIncident anemiaAnemic womenPostpartum anemiaDietary Patterns, Nutrient Intake, and Sociodemographic Characteristics in HIV-Infected Tanzanian Pregnant Women
Lukmanji Z, Hertzmark E, Spiegleman D, Fawzi WW. Dietary Patterns, Nutrient Intake, and Sociodemographic Characteristics in HIV-Infected Tanzanian Pregnant Women. Ecology Of Food And Nutrition 2013, 52: 34-62. PMID: 23282190, DOI: 10.1080/03670244.2012.705768.Peer-Reviewed Original ResearchConceptsPregnant womenNutrient intakeTanzanian pregnant womenWorld Health Organization recommendationsDietary macronutrient intakeLongitudinal clinical trialsVitamin supplementationClinical trialsDietary intakeMacronutrient intakeDietary patternsDiet intakeFood composition tablesHigh riskWomen's ageSociodemographic characteristicsIntakeInadequate foodDar es SalaamWomenHIVTwo-thirdsEducation levelComposition tablesAge
2012
PREDICTORS OF INCIDENT TUBERCULOSIS IN HIV-EXPOSED CHILDREN IN TANZANIA.
Finkelstein J, Manji K, Duggan C, Hertzmark E, Mehta S, Msamanga G, Spiegelman D, Fawzi W. PREDICTORS OF INCIDENT TUBERCULOSIS IN HIV-EXPOSED CHILDREN IN TANZANIA. East African Medical Journal 2012, 89: 183-92. PMID: 26856040, PMCID: PMC10864092.Peer-Reviewed Original ResearchConceptsRisk of tuberculosisChild mid-upper arm circumferenceMid-upper arm circumferenceT-cell countsArm circumferenceReduced riskCD4 T-cell countCD8 T-cell countsLow vitamin E levelsAppropriate infant feedingDuration of breastfeedingLongitudinal cohort studyVitamin E levelsIncident tuberculosisAntenatal clinicCohort studyLymphocyte countHIV infectionTuberculosis infectionChild tuberculosisHIV statusNutritional interventionImmunological statusInfant feedingE levelsElevated alanine aminotransferase in antiretroviral‐naïve HIV‐infected African patients: magnitude and risk factors
Nagu T, Kanyangarara M, Hawkins C, Hertmark E, Chalamila G, Spiegelman D, Mugusi F, Fawzi W. Elevated alanine aminotransferase in antiretroviral‐naïve HIV‐infected African patients: magnitude and risk factors. HIV Medicine 2012, 13: 541-548. PMID: 22416813, PMCID: PMC3391335, DOI: 10.1111/j.1468-1293.2012.01006.x.Peer-Reviewed Original ResearchConceptsElevated alanine aminotransferaseIU/LAlanine aminotransferaseAntiretroviral therapyHigh riskWorld Health Organization clinical stageCD4 T-lymphocyte countFirst-line antiretroviral therapyHepatitis B virus coinfectionALT measurementsLow-density lipoprotein cholesterolLog-binomial regression modelsB virus coinfectionT-lymphocyte countsART-naïve HIVCells/μLHepatotoxic side effectsCurrent tuberculosis (TB) treatmentResource-limited settingsCross-sectional analysisAdvanced immunosuppressionHBV coinfectionART-naïveHIV careLipoprotein cholesterol
2010
Lipid-soluble vitamins A, D, and E in HIV-infected pregnant women in Tanzania
Mehta S, Spiegelman D, Aboud S, Giovannucci EL, Msamanga GI, Hertzmark E, Mugusi FM, Hunter DJ, Fawzi WW. Lipid-soluble vitamins A, D, and E in HIV-infected pregnant women in Tanzania. European Journal Of Clinical Nutrition 2010, 64: 808-817. PMID: 20517330, PMCID: PMC3078753, DOI: 10.1038/ejcn.2010.76.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnemia, Iron-DeficiencyAvitaminosisBlood SedimentationCD8-Positive T-LymphocytesCell CountDietFemaleGestational AgeHemoglobinsHIV InfectionsHumansNutritional StatusPregnancyPrevalenceRegression AnalysisSeleniumTanzaniaVitamin AVitamin A DeficiencyVitamin DVitamin D DeficiencyVitamin EVitamin E DeficiencyYoung AdultConceptsErythrocyte sedimentation rateVitamin E statusPregnant womenLipid-soluble vitaminsVitamin APlasma vitaminGestational ageLow vitaminE statusLow vitamin D statusHigh erythrocyte sedimentation rateLow vitamin E statusLipid-soluble vitamins ACD8 cell countsVitamin D statusHuman immunodeficiency virusPlasma vitamin EPoor nutritional statusPlasma vitamin ALow plasma vitamin AResource-limited settingsD statusLaboratory parametersImmunodeficiency virusSevere anemia
2006
HIV-1 infection and fertility in Dar es Salaam, Tanzania.
Sedgh G, Larsen U, Spiegelman D, Msamanga G, Fawzi WW. HIV-1 infection and fertility in Dar es Salaam, Tanzania. African Journal Of Reproductive Health 2006, 10: 41-52. PMID: 17518130, DOI: 10.2307/30032470.Peer-Reviewed Original ResearchConceptsHIV-1 infectionUninfected womenHIV infectionPregnancy lossMultivariate analysisHIV-1 infected womenPregnancy rate ratioRetrospective cohort studyPredictors of pregnancyHIV-positive womenNumber of pregnanciesRate of pregnancyDar es SalaamHigher pregnancy rateAdvanced diseaseCohort studyHIV seropositivityInfected womenBorderline significancePregnancy rateAdvanced stageInfectionPregnancyWomenRate ratioSocio-economic and demographic factors associated with prevalence of HIV infection among pregnant women in Dar es Salaam, Tanzania
Msamanga G, Fawzi W, Hertzmark E, McGrath N, Kapiga S, Kagoma C, Spiegelman D, Hunter D. Socio-economic and demographic factors associated with prevalence of HIV infection among pregnant women in Dar es Salaam, Tanzania. East African Medical Journal 2006, 83: 311-321. PMID: 16989376, DOI: 10.4314/eamj.v83i6.9438.Peer-Reviewed Original ResearchConceptsHIV infectionAntenatal clinicHIV-1-positive womenDar es SalaamMaternal-foetal transmissionMid-arm circumferenceHIV-1 infectionDemographic characteristicsLow HIV prevalenceCross-sectional studyHIV prevalence ratesHIV/AIDS epidemicOpt-out approachLow-resource settingsPositive womenNevirapine treatmentHIV prevalencePregnant womenMaternal ageHigh prevalenceRegular partnersPrevalence ratesPartner's occupationTanzanian womenOlder ageAlcohol intake and ovarian cancer risk: a pooled analysis of 10 cohort studies
Genkinger JM, Hunter DJ, Spiegelman D, Anderson KE, Buring JE, Freudenheim JL, Goldbohm RA, Harnack L, Hankinson SE, Larsson SC, Leitzmann M, McCullough ML, Marshall J, Miller AB, Rodriguez C, Rohan TE, Schatzkin A, Schouten LJ, Wolk A, Zhang SM, Smith-Warner SA. Alcohol intake and ovarian cancer risk: a pooled analysis of 10 cohort studies. British Journal Of Cancer 2006, 94: 757-762. PMID: 16495916, PMCID: PMC2361197, DOI: 10.1038/sj.bjc.6603020.Peer-Reviewed Original ResearchConceptsOvarian cancer riskCohort studyCancer riskPooled analysisAlcohol intakeRelative riskStudy-specific relative risksCox proportional hazards modelDepletion of folateModerate alcohol intakeOral contraceptive useProspective cohort studyHormone replacement therapyBody mass indexConfidence intervalsLevels of estrogenSerous ovarian cancerProportional hazards modelRandom-effects modelOvarian casesMenopausal statusMass indexReplacement therapyFolate intakeOvarian cancer
2005
HIV-1 Disease Progression and Fertility in Dar es Salaam, Tanzania
Sedgh G, Larsen U, Spiegelman D, Msamanga G, Fawzi WW. HIV-1 Disease Progression and Fertility in Dar es Salaam, Tanzania. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2005, 39: 439-445. PMID: 16010167, DOI: 10.1097/01.qai.0000148529.58963.83.Peer-Reviewed Original ResearchConceptsHIV-1 disease progressionPregnancy rate ratioPregnancy incidenceDisease progressionRate ratioStage IHIV-1-infected womenHIV-1-positive womenCox proportional hazards modelClinical stage IIHIV-1 diseaseProspective cohort studyLive birth rateProportional hazards modelDar es SalaamLive birth incidenceCohort studyMenstrual dysfunctionIndependent predictorsRecent pregnancyHIV statusClinical progressionPregnancy rateOlder womenHazards modelSelenium levels in relation to morbidity and mortality among children born to HIV-infected mothers
Kupka R, Msamanga GI, Spiegelman D, Rifai N, Hunter DJ, Fawzi WW. Selenium levels in relation to morbidity and mortality among children born to HIV-infected mothers. European Journal Of Clinical Nutrition 2005, 59: 1250-1258. PMID: 16015252, DOI: 10.1038/sj.ejcn.1602236.Peer-Reviewed Original ResearchConceptsPlasma selenium levelsMorbidity informationSelenium levelsChild mortalityMaternal vitamin supplementsMonthly clinic visitsProspective cohort studyTertiary care hospitalMuhimbili National HospitalRisk of diarrheaChild health outcomesMonths of ageSelenium statusCause mortalityClinic visitsCohort studyRespiratory outcomesMedian ageStudy clinicNational HospitalVitamin supplementsHealth outcomesStudy childrenFogarty International CenterStudy participantsSelenium status, pregnancy outcomes, and mother-to-child transmission of HIV-1.
Kupka R, Garland M, Msamanga G, Spiegelman D, Hunter D, Fawzi W. Selenium status, pregnancy outcomes, and mother-to-child transmission of HIV-1. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2005, 39: 203-10. PMID: 15905738.Peer-Reviewed Original ResearchConceptsPregnancy outcomesPregnant womenChild transmissionLow selenium statusHIV transmissionMaternal HIV disease progressionHIV-positive pregnant womenSelenium statusDirect epidemiologic evidenceMTCT of HIVLow plasma selenium levelsHIV disease progressionPoor pregnancy outcomesRisk of motherWeeks of gestationMother-child pairsPlasma selenium levelsAdequate selenium statusFetal deathGestational ageEpidemiologic evidenceLow birthweightDisease progressionGenital tractHIV-1Pregnancy Increases BMI in Adolescents of a Population-Based Birth Cohort 1 2
Fawzi W, Msamanga G, Spiegelman D, Hunter DJ. Pregnancy Increases BMI in Adolescents of a Population-Based Birth Cohort 1 2. Journal Of Nutrition 2005, 135: 938-944. PMID: 15795466, DOI: 10.1093/jn/135.4.938.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyMultivitamin supplementsPregnant womenHIV-negative pregnant womenDaily multivitamin supplementEarly childhood infectionsAdverse pregnancy outcomesHIV disease progressionHIV-1 infectionAdequate dietary intakeEfficacy of vitaminAdverse health outcomesFurther studiesLow-cost interventionMo of ageUninfected childrenHIV diseasePregnancy outcomesPregnant HIVHIV infectionChildhood infectionsRandomized trialsNutritional interventionDietary intakeDisease progression
2004
In utero exposures and the incidence of endometriosis
Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Michels KB, Hunter DJ. In utero exposures and the incidence of endometriosis. Fertility And Sterility 2004, 82: 1501-1508. PMID: 15589850, DOI: 10.1016/j.fertnstert.2004.04.065.Peer-Reviewed Original ResearchConceptsHealth Study IIIncidence of endometriosisMultiple gestationsFetal environmentNurses' Health Study IIRate of endometriosisProspective cohort studyBody mass indexDiethylstilbestrol exposurePast infertilityPremature deliveryCohort studyMass indexUtero exposureInfertility statusIncidence rateEndometriosis diagnosisMAIN OUTCOMEUS womenEndometriosisAge 18BirthweightStudy IIEffect estimatesWomenSelenium Status Is Associated with Accelerated HIV Disease Progression among HIV-1–Infected Pregnant Women in Tanzania
Kupka R, Msamanga GI, Spiegelman D, Morris S, Mugusi F, Hunter DJ, Fawzi WW. Selenium Status Is Associated with Accelerated HIV Disease Progression among HIV-1–Infected Pregnant Women in Tanzania. Journal Of Nutrition 2004, 134: 2556-2560. PMID: 15465747, DOI: 10.1093/jn/134.10.2556.Peer-Reviewed Original ResearchConceptsPlasma selenium levelsCD4 cell countRisk of mortalityDisease progressionHIV-1-infected pregnant womenCell countSelenium levelsLow plasma selenium levelsHIV disease progressionAccelerated disease progressionCox multivariate modelSelenium statusMedian followHIV diseaseClinical outcomesPregnant womenPoor survivalTanzanian womenMultivariate modelL increaseCells/ProgressionWomenMortalityFirst yearA Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality
Fawzi WW, Msamanga GI, Spiegelman D, Wei R, Kapiga S, Villamor E, Mwakagile D, Mugusi F, Hertzmark E, Essex M, Hunter DJ. A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality. New England Journal Of Medicine 2004, 351: 23-32. PMID: 15229304, DOI: 10.1056/nejmoa040541.Peer-Reviewed Original ResearchConceptsVitamin AHIV diseaseMultivitamin supplementsHuman immunodeficiency virus (HIV) diseasePlacebo-controlled trialHIV disease progressionStage 4 diseaseLow viral loadHigher CD4Antiretroviral therapyPrimary outcomeImmunodeficiency syndromeRandomized trialsViral loadPregnant womenDisease progressionRelative riskObservational studyDaily supplementCell countEnd pointMicronutrient statusMultivitaminsDiseaseProgression