A. Figueroa

C. Murphy

C.M. Vélez Vega

Annals of Global Health

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New and Emerging Priorities for Global Health A n n a l s o f G l o b a l H e a l t h , V O L . 8 2 , N O . 3 , 2 0 1 6M a yeJ u n e 2 0 1 6 : 5 3 2 – 5 7 4566which all providers mentioned as central to PPD’s etiology. Whenasked about symptoms, most providers focused on more observablesymptoms such as crying, whereas fewer providers mentioned lessobservable symptoms such as anxiety. Though providers haddifferent ideas about how women seek help for PPD, they allbelieved that the best way to recognize and treat PPD is to talkwith women and learn about their lives.Interpretation: Results suggest that providers have limited knowl-edge of PPD and minimal experience working with PPD patients.In addition, there appears to be no unified system in place for iden-tifying and treating PPD. Thus, PPD may go unnoticed, and manywomen experiencing PPD may not recognize or seek help for theircondition. Hence, a need exists for the following: a system to iden-tify and treat PPD, more research about how Mongolian womenexperience PPD, and education of patients and providers about itsetiology, symptoms, and treatment.Funding: Dhablania and Kim Family Global Medicine Fellowship.Abstract #: 2.081_NEPCauses for and Percentage of Maternal Mortalities in Otuzco,Peru: A Comparison to National and Urban StatisticsElly Untermeyer1, Kay Daniels2; 1Stanford University Undergraduate,2Dept. of Obstetrics and Gynecology, Stanford University School ofMedicineBackground: Women are over 3 times more likely to die in child-birth in Peru compared to the United States. Peru has had consider-able success in diminishing maternal mortality rate (MMR, definedas the annual number of female deaths per 100,000 live births);nonetheless, poor, rural populations remain underserved medically.This study is designed to compare the MMR in urban areas tothe rural mountain town of Otuzco, Peru.Methods: The data for this study was collected from the ElpidioBerovides Hospital in Otuzco, which serves the local populationas well as outlying villages. Records were reviewed on all hospital-based deliveries between 2010 and 2013. Comparison data onnational averages was obtained from the National Institute ofHealth of Peru. This study was approved by Stanford IRB.Analysis: The primary outcome was comparison of the MMRbetween the national average and the Otuzco average. The secondaryoutcome was analysis of causes of maternal mortality in Otuzco.Findings: From 2010 through 2013, the average MMR for Otuzco(577.3) was almost 5 times higher than the national average in Peru(115.5). 38% of deaths in Otuzco were caused by hemorrhage, 29%pregnancy induced hypertension, 9% infections related to preg-nancy, and 24% respiratory failure and preexisting conditions.Interpretation: The Otuzco MMR remained significantlyelevated above the national average during the years 2010-2013.Through discussions with health care providers in Elpidio BerovidesHospital, it was proposed that the elevated MMR was due to lowlevels of funding and inability to access updated equipment. Thiselevated rate is particularly concerning given that the national Peru-vian MMR has greatly decreased over the past decade, while theMMR in Otuzco has remained unacceptably high. A limitation ofthis study was that the number of women giving birth at home isunknown; however, a strength is the comprehensive data of thehospital records. The stated WHO Millennium DevelopmentGoal for Peru was to decrease the national MMR to 50 by 2015,but in order to achieve this more attention must be given to womenin rural areas.Funding: Stanford Undergraduate Advising and Research.Abstract #: 2.082_NEPKnowledge, opinions, and experiences concerning clinical andgenetic testing: Voices of research participants in Puerto RicoC.M. Vélez Vega, C. Murphy, A. Figueroa; University of Puerto Rico,Medical Sciences Campus, Global and Territorial Health ResearchNetwork, Timothy Dye University of Rochester, Global and TerritorialHealth Research Network José Pérez-Ramos, Scott McIntosh, Globaland Territorial Health Research NetworkIntroduction: Genetic research is increasingly common throughoutthe world, although the degree to which attitudes of communities,researchers, and clinicians align is often unclear. The purpose ofthis study was to examine reasons for acceptance or refusal to allowgenetic testing among a group of participants of the Puerto RicoTestsite for Examining Contamination Threats (PROTECT)research project that follows a cohort of pregnant women and theirexposure to environmental agents, and includes genetic testing.Data from the PROTECT study show there are concerns aboutallowing genotyping for both the primary and future studies. Thereasons for allowing and denying testing are not known, but enhancedunderstanding may provide valuable insight on how to inform indi-viduals about the importance of genomic testing and to addresscommunity concerns that may represent barriers.Methods: Five focus groups were conducted in CommunityHealth Center Facilities and PROTECT study sites. A total of36 individuals participated in the focus groups. The focus groupswere digitally recorded (audio), and selectively transcribed. Thetranscribed text was analyzed for content pertaining to the categoriesthat arising from the initial analysis to identify common themes anddivergence among participants and groups.Results: Most participants were familiar with the idea of genetictesting because of their experience with PROTECT. “Biorepositories”as a concept was unfamiliar, except for private banks for umbilical cordstorage. Most participants identified their experience in researchinvolving biological samples as positive, and stated they wouldcurrently consent to donating biological samples for the primaryresearch request.While consent for future research beyond the primaryresearch would be considered, women indicated that they wouldrequire that they be consulted before initiating a new study using theirsamples. Most participants were very interested in knowing the resultsof the research and how it relates to preterm birth.Conclusions: There is a distinct need for information that is clearand understandable for potential participants in order to facilitateinformed consent in genomic research. Information obtained in theprocess provides a basis for technology-driven approaches to informand educate individuals about the benefits of genomic testing.Abstract #: 2.083_NEP

Knowledge, opinions, and experiences concerning clinical and genetic testing: Voices of research participants in Puerto Rico

http://www.annalsofglobalhealth.org/articles/10.1016/j.aogh.2016.04.520/galley/1372/download/

Knowledge, opinions, and experiences concerning clinical and genetic testing: Voices of research participants in Puerto Rico

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