Melissa Graboyes – Undergraduate Research Symposium Abstracts

Underreporting of Epidemic Rebound and Resurgent Malaria In Nine African Countries

Presenter: Idil Osman – Planning, Public Policy and Management

Faculty Mentor(s): Melissa Graboyes

Session: (In-Person) Data Stories—Data and more Data

This project focuses on the underreporting of epidemic rebound and resurgent malaria in nine African countries— The Gambia, Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Uganda, Zanzibar and Zimbabwe— over the span of a century. Currently, malaria resurgence and rebound, occurring when malaria returns to a region after having been successfully controlled, have a history of being under-counted and under-reported, especially in the African continent. My research attempts to fill in these gaps by providing an overview and analysis of malaria prevalence from 1920-2020, and documenting unreported cases of malaria resurgence. I collected, organized, and analyzed historical epidemiological data of malaria prevalence and control measures and compiled it into a longer frame– essentially creating an entirely new panel dataset– so I could see longer trends in time and identify instances of rebound. My primary results have shown there to be multiple unreported cases of malaria rebound in my researched countries. This finding not only fills a wide gap in the field of malaria research, but also implicates the nature of data collection methodology and presentation on a global scale. The results will provide a framework in determining cases of resurgent malaria and in shifting the way the WHO and other public health organizations present their epidemiological data.

Defining and Characterizing COVID-19 Quarantine Hesitancy in Lane County

Presenter: Marlee Odell – Biology

Faculty Mentor(s): Melissa Graboyes

Session: (In-Person) Oral Panel—Covering Covid

Contact tracing and subsequent quarantine of individuals exposed to COVID-19 has been a useful tool throughout the pandemic. While trying to implement such measures, however, it has become clear that some people are hesitant to agree to quarantine, for a variety of reasons. The term “hesitancy” appears in similar areas of public health such as with vaccine hesitancy, however, it has not been defined for COVID-19 quarantine hesitancy. Arising from personal experience as a contact monitor (CM) for the UO Corona Corps, this thesis intended to define COVID-19 quarantine hesitancy and to identify the determinants behind a contact’s hesitancy. Semi-structured, open-ended interviews were conducted with UO Corona Corps CMs about their experience with hesitant contacts. The interviews were thematically analyzed to reveal themes rooted in the firsthand experiences of CMs. This work suggests that COVID-19 quarantine hesitancy is when there is a discrepancy between public health officials’ recommendations and the actions of COVID-19 contacts. In addition, it suggests that there are multiple types of hesitancy and stages in the quarantine process in which they can arise. The thematic analysis also revealed three categories of COVID-19 quarantine hesitancy determinants: situational determinants, personal determinants, and quarantine comprehension. The results from this thesis can help inform future public health work that involves quarantine, whether for COVID-19 or other health issues.

Zanzibari Perceptions of Acquired Immunity and Rebound Malaria

Presenter: Ava Minu-Sepehr – Anthropology

Faculty Mentor(s): Melissa Graboyes, Karl Reasoner

Session: (In-Person) Oral Panel—HURF

This work-in-progress talk presents initial findings from 38 Swahili-English interviews conducted with Zanzibaris about the history of malaria and their understandings of rebound malaria and the biomedical concept of acquired immunity. Over the past century, periods of intense malarial interventions in Zanzibar reduced malaria tremendously, while subsequent withdrawals led to dangerous rebound epidemics. This project weaves together contemporary interview data and historical context to present “vernacular knowledge” about malaria. “Vernacular knowledge” captures different and fluid forms of thinking, knowing, and meaning-making using local language, recognizing the impact of foreign. I will report initial findings from this research, as we complete coding of the interview transcripts using a modified grounded theory approach. Salient themes across oral interviews include danger, education, and responsibility, as well as the role of the environment and foreign funding in discussions about malaria. Our research demonstrates that Zanzibari’s don’t share the same biomedical framings of “rebound malaria” and “acquired immunity,” but that their understandings vary based on age, gender, and expertise with malaria. This research challenges what types of knowledge are valued and disseminated, and allows us to ask how the work of decolonizing diverse knowledge can be performed. This project is part of a larger NSF grant led by Professor Graboyes on the history of malaria in Africa.

Identifying COVID-19 Vaccine Hesitancy Motivators for People Who Inject Drugs in Lane County

Presenter: Blake Hardin − Economics, Global Studies

Faculty Mentor(s): Melissa Graboyes, Camille Cioffi

Session: (In-Person) Oral Panel—Covering Covid

People who use intravenous drugs (PWID) are at greater risk of mortality from vaccine-preventable diseases yet also express higher levels of vaccine hesitancy than the general public. For the COVID-19 pandemic, identifying common vaccine hesitancy motivators among intravenous drug users is key to ongoing vaccination campaigns against the disease. However, very little research has used qualitative methods to examine why intravenous drug users are often more vaccine hesitant. This thesis used a mixed-methods design, conducting 41 semi-structured interviews and 260 quantitative surveys with PWID in Lane County to understand better the most influential contributors to vaccine hesitancy among this demographic group. The interviews and surveys demonstrated a consistent connection between the poor social determinants of health and frequent dehumanization of intravenous drug users and their reduced willingness to receive a COVID-19 vaccine. This thesis proposes a new model for assessing vaccine hesitancy among PWID, directly informed by the actual experiences shared by collaborators for this project. Moreover, the results of this thesis elucidate the need to address systemic barriers in healthcare that inhibit accessibility, trust, and confidence in preventative services like vaccines among marginalized communities. Current and future vaccine outreach programs for PWID must first establish a foundation of trust to alleviate vaccine hesitancy and encourage vaccine uptake.

Use of Dichloro-diphenyl-trichloro-ethane and Alternative Methods to Fight Malaria in Sub- Saharan Africa

Presenter(s): Sarah Wheeler − Biology

Faculty Mentor(s): William Bradshaw, Melissa Graboyes

Poster 17

Research Area: Natural/Physical Science

Malaria is a disease that seems foreign to many; a distant memory. Despite the lack of awareness of the breadth of this disease, the World Health Organization reported 216 million cases of malaria across the world in 2016, 445,000 of which resulted in fatalities. While malaria was eradicated in the US in 1951, it’s present across the globe, with the epicenter of the endemic in Sub-Saharan Africa. Malaria is a vector-borne disease, meaning an organism transfers the disease to a host.
The vector for malaria is Anopheles gambiae, which infects the host with the parasite Plasmodium. Eradication has been successful through the use of dichloro-diphenyl-trichloro-ethane (DDT) by spraying the interior of homes in the past, but the organic pesticide has been banned in many countries. This research focuses on how eradication occurred in the past, what is used today to fight malaria in Sub-Saharan Africa and methods currently being developed in laboratories. Specifically, a meta-analysis was conducted of studies concerning the effects of DDT on the environment and human health, mechanisms of A. gambiae mutations that lead to DDT resistance, alternative methods of fighting malaria and their success rate, as well as cultural and financial barriers that prevent eradication. Comparison of these studies suggests that a rotation of pesticides, including DDT in IRS is effective when paired with pesticide-treated nets.

Representations of Madness in Zanzibar, Tanzania; An Analysis of Colonial Mental Health Diagnostic Labels

Presenter(s): Anne Peters − International Studies

Faculty Mentor(s): Kristin Yarris, Melissa Graboyes

Oral Session 4M

Research Area: Humanities

Franz Fanon has shown how ideas of mental health and illness reflect historical and political constructs, especially for racialized and colonial subjects and their subjugators. “Confronted with a world configured by the colonizer, the colonized subject is always presumed guilty.” (Fanon, 1961). Drawing on Fanon and other post-colonial scholars, my research asks
the question: what influence did colonial ideas about race and mental illness have on mental health care practices in East Africa during British colonialism? I explore this question by examining primary source materials from archives of the British Superintendent-directed “lunatic asylum” in Zanzibar, Tanzania, from 1914 to 1947. In particular, I conducted a close reading and analysis of the diagnostic labels used during this time, how they were variously applied to African patients (colonial subjects) as compared to patients in British mental hospitals in the same period. My research reveals the colonial motives of the British Protectorate in both the diagnosis and the treatment of patients, and considers the broader political purpose these diagnoses may have served. Not only were the staff in charge inadequate to make such diagnoses, but also it was a commonly held belief that the native populations admitted to the asylum were mentally incapable of having the same diagnoses as their English counterpart. My research also contributes an historical perspective to the broader field of Global Mental Health, as I examine how shifts in psychiatric diagnoses reflect social interests, political power, and racialized ideas.

Picture This: The Role of Digital Storytelling in Motivating Action for Refugee Relief

Presenter(s): Mitra Lebuhn Lebuhn − International Studies

Faculty Mentor(s): Melissa Graboyes, Stephen Wooten

Oral Session 1C

Research Area: Humanitarian Communication, International Studies, Psychology, Social Science

Funding: Presidential Scholarship, Summit Scholarship, SIT study abroad scholarship

It is often assumed that powerful photographs and film footage have the ability to move viewers in the developed population to action. Frank Fournier, the photographer who captured the face of 13-year-old Omayra Sanchez in her last hours of life, said, “I believe the photo helped raise money from around the world in aid and helped highlight the irresponsibility and lack of courage of the country’s leaders (BBC, 2005).” His statement encompasses the common perspective that imagery can motivate action, but there is a lack in data regarding this transition from emotion to action. This study is concerned with the effectiveness of various digital storytelling appeals (shock effect, positive images, and post-humanitarian communication) in encouraging agency in refugee relief efforts. Refugees are perhaps more distant from the donor population than any other victimized group, and have struggled through periods of severe anti-refugee sentiments that have made the collection of aid and process of reintegration challenging. The extreme discourse between populations and the ever-growing number of displaced persons makes refugees the ideal population to study. This study asks what in a digital story, particularly the imagery, motivates developed populations to not only react emotionally towards refugee issues but also make contributive action for refugee relief efforts? Through literature and interviews regarding image-evoked empathy, identity, and group influenced responding, and the analysis of photographs and digital storytelling platforms that unpack various imagery appeals, it is evident that image use for humanitarian campaigns has evolved to it’s most effective form yet. This study explores how advancements in technology have brought forth digital storytelling, which combined with the implementation of the post- humanitarian communication appeal generates evocative and accessible campaigns that fit the framework necessary to motivate action for refugees relief more effectively and ethically than has been done in the past.

“I Don’t Have Deaths on my Conscience”: Perspectives of Intravenous Drug Users on a Peer-Delivered Naloxone Program in Eugene, Oregon

Presenter(s): Eleanor Rochester

Faculty Mentor(s): Melissa Graboyes

Oral Session 1 C

The United States is in the midst of an epidemic of overdose deaths. In response, harm reduction programs commonly distribute the opioid antagonist naloxone directly to drug users so that they can act as first responders to overdose. When injected, naloxone reverses respiratory depression and can save the life of a person overdosing on opioids. As evidence for the effectiveness of these programs at reducing deaths continues to be collected, little research has been conducted into the impact of serving in this role on drug users themselves. To better understand the lived experiences of drug users with naloxone, semi-structured interviews were conducted with seventeen syringe exchange participants who currently carry naloxone. Interviews revealed that carrying and using naloxone is empowering for many drug users, because it contrasts with the powerlessness they may feel in other aspects of their lives. Peer administrators use naloxone in a way that reinforces the community of care among drug users. This aligns with the goals of harm reduction programs, which seek to empower drug users to make choices to improve their lives, without abstinence as the ultimate goal. Future programs distributing naloxone to drug users should be aware of it’s potential not only to save lives, but to increase drug users’ self- confidence and strengthen the network of overdose care in their communities.

Observations of Mobile Health Clinics in Honduras: A Case Study on El Centro De Salud Integral Zoé

Presenter(s): Mitchell Yep—International Studies, General Science

Faculty Mentor(s): Lesley Weaver, Melissa Graboyes

Session 1: Time for Your Check-Up—Decolonizing Global Health

Visual impairment and blindness are debilitating conditions with increasing rates around the globe . The World Health Organization estimates at least 2 .2 billion people have a vision impairment or blindness, of whom at least 1 billion are preventable or remain unaddressed (Bourne et al ., 2017; World Health Organization, 2019) . El Centro de Salud Integral Zoé uses an innovative Mobile Health Clinic model to deliver cataract screenings and visual acuity exams to populations marginalized from the Honduran health care system . Zoé ́s outreach model actively removes systemic barriers that prevent individuals from seeking care such as cost, distance, logistics, and lack of knowledge . The colonial legacy and proposed neoliberal development policies have resulted in the underdevelopment of health infrastructure and widespread exclusion from these services . The expansion of accessible health care is a pressing national issue as the State›s Ministry of Health estimates 18% of the population (over 1 .5 million Hondurans) do not have access to health services (Secretary of Health, 2015) . Implementing the Right to Health under the 1948 Universal Declaration of Human Rights and achieving the 2015 United Nations Millennium Development Goals requires the foundation of accessible health care . Mobile Health Clinics present an alternative development strategy to ease disparities of access to health care by bringing medical services to communities that would not receive them .

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