Capstone Proejcts - Central America // Eck Institute for Global Health // University of Notre Dame

Eck Institute for Global Health

Capstone Proejcts - Central America



Name: Brian Kaltenecker  MS '13
Degree and Year: Biology
Chapman University, 2010

Capstone Project:  HPV Vaccination in Honduras: Exploring the implementation, vaccination coverage and cost-analysis of a school based delivery model

kaltenecker

Abstract:  Cancer rates continue to increase in the developing world. Cervical cancer rates heavily burden Latin America. Cervical cancer is the leading cause of cancer deaths in Central America.  HPV infections cause ~99% of cervical cancers cases. Two vaccines have been developed to prevent infection with 2 oncogenic strains of HPV. Implementation of these vaccines into the national vaccine schedule of developing countries remains a challenge. Completion of the three required doses of the vaccine contributes to the challenge of implementation. Along with this challenge, cost is one of the heaviest burdens facing implementation. In this research study we evaluated the three doses completion rate of girls in Honduras receiving the HPV vaccine Gardasil through a school based delivery model and performed a cost analysis to determine total cost of this particular program. Girls in Honduras showed a very high rate of compliance and vaccine completion rate (80.9%) but our cost analysis highlighted specifically the financial challenges facing such a task.

“The working environment at CMMB was very fun and laid back. I was able to volunteer while also working on my capstone project and report.”
 



Name: Michael Clark  MS '14
Degree and Year: Biology
University of Notre Dame, 2012

Capstone Project:   Design and assessment of a mobile database management system for arthropod-borne disease surveillance in Belize

clark

Abstract:  Dengue fever is an emerging public health burden in the tropics and subtropics. With the looming threat of insecticide resistance and the lack of a vaccine, surveillance has been proposed as the most effective way to prevent outbreaks of this emerging disease. This project introduces a mobile database management system, Skeeter Tracker, to improve upon a paper based on dengue vector surveillance program in Belize, Central America. Members of the Belize Ministry of Health vector control program underwent a three-tier training program designed to compare data capture using a tablet and digitized form to data capture using the standard paper form, moving from a controlled setting to a more complex semi-field setting and finally routine surveillance environments. Weekly technical training sessions informed changes to tablet forms and provided knowledge transfer on the use of the tablet system. Proof of concept risk maps were generated from dengue vector surveillance data collected by the newly developed Skeeter Tracker system, environmental parameters, and human case data reported from Orange Walk, Cayo, and Corozal districts. Under controlled conditions the digitized premise inspection form was both more accurate and faster to populate per data field than the paper-and-pen model. These advantages were neutralized when tested under semi-field conditions; however, sunlight did not significantly negatively affect accuracy of data input when using the tablet outdoors. Collaborative data collection indicated tablet and paper data capture do not provide 100% agreement most likely based on observer bias during premise inspection. The newly developed system introduced in the current study matches or improves upon currently employed paper-and-pen model by: 1) potentially faster data entry, 2) potentially more accurate data recording, 3) not being limited by environmental parameters encountered during routine surveillance activities, such as sunlight, 4) the ability to geo-reference data, 5) the ability to transmit data in near real time with Wi-Fi connection, 6) diversified reporting capabilities, 7) potential to alter surveillance paradigms from response to preventative; and 8) potential for expansion of surveillance for other diseases and/or country settings using a single platform. Perhaps most important, data collected using the Skeeter Tracker system can be fed into complex mapping systems for development of disease transmission risk maps thereby reducing the probability of disease transmission in at-risk populations.

“For my project we introduced a novel mobile database management system, called the Skeeter Tracker surveillance system, and assessed the early successes and shortcomings.”