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Browsing by Author "Salgado, Christina"
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Item Pipelines to Leadership: Strategies for Executive Board Recruitment at a Student-Run Free Clinic(2022-03-30) Kabir, Jason; Salgado, Christina; Class, Jon; Brown, LucyIntroduction/Problem: The Covid-19 pandemic placed restrictions on student-run free clinics (SRFCs) across the nation. Guidelines set forth by our medical school’s administration restricted in-person participation at our SRFC from April 2020 to March 2021 for clinical students and April 2020 to September 2021 for pre-clinical students. With medical executive board elections occurring annually in October, it was uncertain whether eligible pre-clinical students would feel confident enough in their experience to run for and fulfill the responsibilities of a board position. In this paper, we will present leadership opportunities and strategies to recruit candidates for an executive board at an SRFC. Methods/Interventions: Additional volunteer positions, including a new Assistant Clinic Manager position, were added for pre-clinical students prior to the election. Members of the clinic’s established teams, such as the Continuity of Care Team, were encouraged to run in the election. An additional board position was transitioned to a two-year position. The current board members participated in a question and answer session about their positions and informally mentored interested candidates outside of this session. Candidates’ written platforms and volunteer sign-up records were analyzed to determine the impact of these interventions. Results: Twenty-seven candidates ran for 14 board positions up for election. Fifty-six percent of the candidates were pre-clinical students, of which 47% had the opportunity to serve in the Assistant Clinic Manager position. Eighty-five percent of candidates were members of one of the clinic’s teams, and 100% of the candidates elected had previously served on a team or as a board member, which are higher percentages than in previous years. Conclusion: Despite pre-clinical students eligible to run for a board position given the opportunity of only 7 clinic days over 2 months (with a limit of one general volunteer shift per month) to serve in-person, the election attracted a similar number of candidates as previous years. In addition, candidates’ motivation to improve upon things they had been involved with at the clinic, often beyond their responsibilities on clinic day, played a large role in the 2021 election. While a variety of methods can be used to motivate volunteers to pursue executive board positions, our work shows SRFCs can offer leadership positions outside of the executive board, possibly through clinic teams, to serve as a pipeline for volunteers to pursue increasing clinic ownership and responsibilities.Item The prevalence and density of asymptomatic Plasmodium falciparum infections among children and adults in three communities of western Kenya(BMC, 2021-09-17) Salgado, Christina; Ayodo, George; Macklin, Michael D.; Gould, Meetha P.; Nallandhighal, Srinivas; Odhiambo, Eliud O.; Obala, Andrew; Prudhomme O’Meara, Wendy; John, Chandy C.; Tran, Tuan M.; Medicine, School of MedicineBackground: Further reductions in malaria incidence as more countries approach malaria elimination require the identification and treatment of asymptomatic individuals who carry mosquito-infective Plasmodium gametocytes that are responsible for furthering malaria transmission. Assessing the relationship between total parasitaemia and gametocytaemia in field surveys can provide insight as to whether detection of low-density, asymptomatic Plasmodium falciparum infections with sensitive molecular methods can adequately detect the majority of infected individuals who are potentially capable of onward transmission. Methods: In a cross-sectional survey of 1354 healthy children and adults in three communities in western Kenya across a gradient of malaria transmission (Ajigo, Webuye, and Kapsisywa-Kipsamoite), asymptomatic P. falciparum infections were screened by rapid diagnostic tests, blood smear, and quantitative PCR of dried blood spots targeting the varATS gene in genomic DNA. A multiplex quantitative reverse-transcriptase PCR assay targeting female and male gametocyte genes (pfs25, pfs230p), a gene with a transcriptional pattern restricted to asexual blood stages (piesp2), and human GAPDH was also developed to determine total parasite and gametocyte densities among parasitaemic individuals. Results: The prevalence of varATS-detectable asymptomatic infections was greatest in Ajigo (42%), followed by Webuye (10%). Only two infections were detected in Kapsisywa. No infections were detected in Kipsamoite. Across all communities, children aged 11-15 years account for the greatest proportion total and sub-microscopic asymptomatic infections. In younger age groups, the majority of infections were detectable by microscopy, while 68% of asymptomatically infected adults (> 21 years old) had sub-microscopic parasitaemia. Piesp2-derived parasite densities correlated poorly with microscopy-determined parasite densities in patent infections relative to varATS-based detection. In general, both male and female gametocytaemia increased with increasing varATS-derived total parasitaemia. A substantial proportion (41.7%) of individuals with potential for onward transmission had qPCR-estimated parasite densities below the limit of microscopic detection, but above the detectable limit of varATS qPCR. Conclusions: This assessment of parasitaemia and gametocytaemia in three communities with different transmission intensities revealed evidence of a substantial sub-patent infectious reservoir among asymptomatic carriers of P. falciparum. Experimental studies are needed to definitively determine whether the low-density infections in communities such as Ajigo and Webuye contribute significantly to malaria transmission.