2024
Demonstrating service delivery models for effective initiation and retention on pre-exposure prophylaxis (PrEP) among female bar workers in Dar es Salaam, Tanzania: A double randomized intervention study protocol
Chebet J, Akyoo W, Goymann H, Harling G, Barnhart D, Mosha I, Kamori D, Gandhi M, Mbunda T, Kipeleka J, Sando D, Spiegelman D, Mpembeni R, Bärnighausen T. Demonstrating service delivery models for effective initiation and retention on pre-exposure prophylaxis (PrEP) among female bar workers in Dar es Salaam, Tanzania: A double randomized intervention study protocol. PLOS ONE 2024, 19: e0304077. PMID: 38935796, PMCID: PMC11210872, DOI: 10.1371/journal.pone.0304077.Peer-Reviewed Original ResearchConceptsFemale bar workersPre-exposure prophylaxisIntention-to-treatBar workersPrimary outcomeRisk of HIV infectionAdherence to PrEPRisk of HIV acquisitionImprove PrEP adherenceGerman Clinical Trials RegisterPublic sector clinicsService delivery modelsRandomized trial designHIV negative womenPrevent HIV infectionHIV infectionPrEP provisionClinical Trials RegisterHIV testingPrEP initiationHealth facilitiesPromote PrEPPrEP adherenceDelivery modelsReduce barriersEffects of a dietary intervention on cardiometabolic risk and food consumption in a workplace
Shrestha A, Tamrakar D, Ghinanju B, Shrestha D, Khadka P, Adhikari B, Shrestha J, Waiwa S, Pyakurel P, Bhandari N, Karmacharya B, Shrestha A, Shrestha R, Bhatta R, Malik V, Mattei J, Spiegelman D. Effects of a dietary intervention on cardiometabolic risk and food consumption in a workplace. PLOS ONE 2024, 19: e0301826. PMID: 38656951, PMCID: PMC11042715, DOI: 10.1371/journal.pone.0301826.Peer-Reviewed Original ResearchConceptsConsumption of whole grainsHealthy foodPre-post intervention studyWhole grainsMedian consumptionCardiovascular risk factor profileRisk factor profileBlood pressureWorksite settingWorksite interventionsUnhealthy foodsHealth programsMeasured blood pressurePre-hypertensionCardiometabolic riskDiastolic blood pressureIntervention studiesFactors dietPaired-t testFactor profileFasting glucose levelsDhulikhel HospitalHospital premisesEmployee healthHospital employees
2021
Longitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped‐wedge trial
Boeke CE, Khan S, Walsh FJ, Lejeune C, Hettema A, Spiegelman D, Okello V, Bärnighausen T. Longitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped‐wedge trial. HIV Medicine 2021, 22: 854-859. PMID: 34293243, DOI: 10.1111/hiv.13144.Peer-Reviewed Original ResearchConceptsImpact of UTTStepped-wedge trialAntiretroviral therapyAppointment adherencePublic sector health systemJoint United Nations ProgrammeMultivariable-adjusted modelsHIV/AIDSUniversal testClient adherenceUTT strategyVisit adherenceHIV clientsUnited Nations ProgrammeStudy enrollmentClinical benefitTreat strategyHealth facilitiesART statusHealth systemAdherenceMarital statusNations ProgrammeMeasures analysisLongitudinal analysisAnalysis of Survival Among Adults With Early-Onset Colorectal Cancer in the National Cancer Database
Cheng E, Blackburn HN, Ng K, Spiegelman D, Irwin ML, Ma X, Gross CP, Tabung FK, Giovannucci EL, Kunz PL, Llor X, Billingsley K, Meyerhardt JA, Ahuja N, Fuchs CS. Analysis of Survival Among Adults With Early-Onset Colorectal Cancer in the National Cancer Database. JAMA Network Open 2021, 4: e2112539. PMID: 34132794, PMCID: PMC8209612, DOI: 10.1001/jamanetworkopen.2021.12539.Peer-Reviewed Original ResearchConceptsEarly-onset colorectal cancerOnset colorectal cancerNational Cancer DatabaseColorectal cancerAge 51Overall survivalCancer DatabaseIncidence of CRCCox proportional hazards regressionPrimary colorectal cancerKaplan-Meier analysisProportional hazards regressionAge 50 yearsAge 25 yearsAnalysis of survivalCohort studySurvival benefitHazards regressionUnadjusted analysesCancer incidenceMAIN OUTCOMEAge 35Survival advantageLower riskStage I
2020
Early access to antiretroviral therapy versus standard of care among HIV‐positive participants in Eswatini in the public health sector: the MaxART stepped‐wedge randomized controlled trial
Khan S, Spiegelman D, Walsh F, Mazibuko S, Pasipamire M, Chai B, Reis R, Mlambo K, Delva W, Khumalo G, Zwane M, Fleming Y, Mafara E, Hettema A, Lejeune C, Chao A, Bärnighausen T, Okello V. Early access to antiretroviral therapy versus standard of care among HIV‐positive participants in Eswatini in the public health sector: the MaxART stepped‐wedge randomized controlled trial. Journal Of The International AIDS Society 2020, 23: e25610. PMID: 32949103, PMCID: PMC7507004, DOI: 10.1002/jia2.25610.Peer-Reviewed Original ResearchConceptsViral suppressionStandard of careAntiretroviral treatmentCox proportional hazards modelHealth systemART-naïve participantsHIV-positive patientsHIV-positive adultsViral load monitoringHIV-positive participantsAppropriate care managementProportional hazards modelEarly accessPublic sector health facilitiesHealth system effectsPublic health systemHealth system's abilityClinic transitionAntiretroviral therapyCD4 countCare retentionVL monitoringPublic health sectorDisease stageEndpoint rateUniversal test and treat in relation to HIV disease progression: results from a stepped‐wedge trial in Eswatini
Boeke C, Khan S, Walsh F, Hettema A, Lejeune C, Spiegelman D, Okello V, Harwell J, Mazibuko S, Bärnighausen T. Universal test and treat in relation to HIV disease progression: results from a stepped‐wedge trial in Eswatini. HIV Medicine 2020, 22: 54-59. PMID: 32876360, DOI: 10.1111/hiv.12941.Peer-Reviewed Original ResearchConceptsBody mass indexStepped-wedge trialDisease progressionCD4 countSevere diseaseMultivariate Cox proportional hazards modelWorld Health Organization stageCox proportional hazards modelHIV disease progressionMorbidity/mortalityCells/Proportional hazards modelLower ratesIncident tuberculosisCD4 declineMass indexUniversal testHealth facilitiesBaseline valuesHazards modelHealth outcomesCrowded hospitalsWeight lossProgressionHIVThe Association of Cooking Fuel Use, Dietary Intake, and Blood Pressure among Rural Women in China
Bellows AL, Spiegelman D, Du S, Jaacks LM. The Association of Cooking Fuel Use, Dietary Intake, and Blood Pressure among Rural Women in China. International Journal Of Environmental Research And Public Health 2020, 17: 5516. PMID: 32751678, PMCID: PMC7432946, DOI: 10.3390/ijerph17155516.Peer-Reviewed Original ResearchConceptsBlood pressureHigh blood pressureHousehold air pollutionDietary intakeDiastolic blood pressureSystolic blood pressureRole of dietYears of ageFatty acid-rich foodsNonpregnant womenSolid fuel useLinear mixed effects modelsSolid cooking fuelsAdverse effectsIntakeWomenMixed effects modelsPossible mediationLower ratesCooking fuel useEffects modelRural womenCooking fuelAssociationDietMortality under early access to antiretroviral therapy vs. Eswatini’s national standard of care: the MaxART clustered randomized stepped‐wedge trial
Chao A, Spiegelman D, Khan S, Walsh F, Mazibuko S, Pasipamire M, Chai B, Reis R, Mlambo K, Delva W, Khumalo G, Zwane M, Fleming Y, Mafara E, Hettema A, Lejeune C, Bärnighausen T, Okello V. Mortality under early access to antiretroviral therapy vs. Eswatini’s national standard of care: the MaxART clustered randomized stepped‐wedge trial. HIV Medicine 2020, 21: 429-440. PMID: 32458567, DOI: 10.1111/hiv.12876.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyMortality rateDisease-related mortality rateCox proportional hazards modelCause mortality ratesStepped-wedge trialProportional hazards modelStepped-wedge designQuality of lifeEvidence of harmClinic transitionSecondary outcomesSOC participantsHealth clinicsLong-term consequencesImplementation trialHazards modelHIVStudy participantsMortalityHealth systemDecrease infectionEarly accessClinicTherapy
2019
Glycemic Index and Microstructure Evaluation of Four Cereal Grain Foods
RamyaBai M, Wedick N, Shanmugam S, Arumugam K, Nagarajan L, Vasudevan K, Gunasekaran G, Rajagopal G, Spiegelman D, Malik V, Anjana R, Hu F, Unnikrishnan R, Willett W, Malleshi N, Njelekela M, Gimbi D, Krishnaswamy K, Henry C, Mohan V, Sudha V. Glycemic Index and Microstructure Evaluation of Four Cereal Grain Foods. Journal Of Food Science 2019, 84: 3373-3382. PMID: 31762024, DOI: 10.1111/1750-3841.14945.Peer-Reviewed Original ResearchConceptsGlycemic indexMedium glycemic indexTest foodGrain foodsCapillary blood samplesHigh glycemic indexCereal grain foodsWhole grain foodsHigh GI foodsMean ageBlood glucoseBlood samplesGI valuesGI foodsHealthy participantsSeparate occasionsHealthy optionsRegular brown riceWhole grainsStandard protocolLoss of intactnessHealthy alternativeLoss of integrityAvailable carbohydrateGlucoseSubstituting brown rice for white rice on diabetes risk factors in India: a randomised controlled trial
Malik V, Sudha V, Wedick N, RamyaBai M, Vijayalakshmi P, Lakshmipriya N, Gayathri R, Kokila A, Jones C, Hong B, Li R, Krishnaswamy K, Anjana R, Spiegelman D, Willett W, Hu F, Mohan V. Substituting brown rice for white rice on diabetes risk factors in India: a randomised controlled trial. British Journal Of Nutrition 2019, 121: 1389-1397. PMID: 31006420, PMCID: PMC6948352, DOI: 10.1017/s000711451900076x.Peer-Reviewed Original ResearchConceptsBrown rice groupMetabolic syndromePrimary outcomeRisk factorsHigh-sensitivity C-reactive proteinRandomised cross-over trialT2D risk factorsDiabetes risk factorsC-reactive proteinCross-over trialType 2 diabetesWhite rice groupMeals/dHs-CRPSecondary outcomesElevated BMIWashout periodInsulin resistanceBlood glucoseEpidemiological evidenceWhite riceT2D riskUrban South IndiaBMISyndrome
2013
Micronutrient supplementation and T cell-mediated immune responses in patients with tuberculosis in Tanzania
KAWAI K, MEYDANI SN, URASSA W, WU D, MUGUSI FM, SAATHOFF E, BOSCH RJ, VILLAMOR E, SPIEGELMAN D, FAWZI WW. Micronutrient supplementation and T cell-mediated immune responses in patients with tuberculosis in Tanzania. Epidemiology And Infection 2013, 142: 1505-1509. PMID: 24093552, PMCID: PMC5639693, DOI: 10.1017/s0950268813002495.Peer-Reviewed Original ResearchConceptsCell-mediated immune responsesTB patientsMicronutrient supplementationMicronutrient supplementsImmune responseProliferative responseT cell-mediated immune responsesHIV-negative TB patientsHIV-positive TB patientsLymphocyte proliferative responsesLymphocyte proliferation responseHigher proliferative responsesT cell mitogensPlacebo groupPulmonary TBTB treatmentDaily doseEligible participantsNutritional interventionTuberculosis treatmentTime of initiationClinical relevanceMicronutrient groupProliferation responsePatientsDietary 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 stunting, wasting and underweight among Tanzanian children born to HIV-infected women
McDonald CM, Kupka R, Manji KP, Okuma J, Bosch RJ, Aboud S, Kisenge R, Spiegelman D, Fawzi WW, Duggan CP. Predictors of stunting, wasting and underweight among Tanzanian children born to HIV-infected women. European Journal Of Clinical Nutrition 2012, 66: 1265-1276. PMID: 23031850, PMCID: PMC3491141, DOI: 10.1038/ejcn.2012.136.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBody HeightBody WeightDouble-Blind MethodEducational StatusFemaleGrowth DisordersHIV InfectionsHumansInfantInfant, Low Birth WeightInfant, NewbornInfant, PrematureInfectious Disease Transmission, VerticalMaleMalnutritionPremature BirthPrevalenceProportional Hazards ModelsReference ValuesSex FactorsSocioeconomic FactorsTanzaniaThinnessWasting SyndromeYoung AdultConceptsBirth weightFirst episodeTanzanian childrenMultivariate Cox proportional hazards methodMaternal educationLow infant birth weightCox proportional hazards methodDevelopment of undernutritionInfant birth weightLow Apgar scoreModifiable risk factorsLow birth weightChild HIV infectionHuman immunodeficiency virusPredictors of stuntingRisk of undernutritionProportional hazards methodsLow maternal educationWeeks of ageMorbidity historiesApgar scoreChild transmissionMedian durationPreterm infantsHIV infectionPREDICTORS 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
2011
Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania
Kawai K, Villamor E, Mugusi FM, Saathoff E, Urassa W, Bosch RJ, Spiegelman D, Fawzi WW. Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania. The International Journal Of Tuberculosis And Lung Disease 2011, 15: 1380-1389. PMID: 22283899, PMCID: PMC3404808, DOI: 10.5588/ijtld.10.0784.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnemiaAntitubercular AgentsBiomarkersBody Mass IndexCoinfectionFemaleHealth Status IndicatorsHemoglobinsHIV InfectionsHumansLinear ModelsMaleMalnutritionMultivariate AnalysisNutritional StatusNutritional SupportProspective StudiesTanzaniaTime FactorsTreatment OutcomeTuberculosis, PulmonaryYoung AdultConceptsLow CD4 cell countsHuman immunodeficiency virusBody mass indexCD4 cell countHIV-positive patientsTB treatmentCell countPredictors of changeTB patientsHemoglobin statusHIV-negative TB patientsHIV-positive TB patientsOlder ageHIV-negative adultsHIV-negative patientsPrevious TB infectionHIV-negative participantsAdequate nutritional supportHigh viral loadProfound malnutritionTB infectionPulmonary tuberculosisNutritional recoveryNutritional supportHemoglobin levels
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