Manisha A Kulkarni

Manisha A Kulkarni
University of Ottawa · School of Epidemiology & Public Health

PhD

About

107
Publications
25,850
Reads
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2,120
Citations
Citations since 2017
74 Research Items
1476 Citations
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2017201820192020202120222023050100150200250300
2017201820192020202120222023050100150200250300
Additional affiliations
May 2019 - February 2022
University of Ottawa
Position
  • Professor (Associate)
Description
  • My research program investigates the socio-ecological determinants of infectious disease emergence and risk in global settings, with a focus on malaria and other vector-borne and zoonotic diseases.
April 2014 - May 2019
University of Ottawa
Position
  • Professor (Assistant)
Description
  • My research program investigates the socio-ecological determinants of infectious disease emergence and risk in global settings, with a focus on malaria and other vector-borne and zoonotic diseases.
September 2013 - March 2014
Foreign Affairs, Trade and Development Canada
Position
  • Health Specialist

Publications

Publications (107)
Article
Full-text available
Background Maternal mortality continues to decrease in the world but remain the most important health problems in low-income countries. Although evidence indicates that social support is an important factor influencing health facility delivery, it has not been extensively studied in Ethiopia. Therefore, this study aimed to assess the effect of mate...
Article
Background: Lyme disease (LD) is the most common tick-borne illness in North America. LD is acquired through exposure to the tick vector, Ixodes scapularis, known as the blacklegged tick. In Canada, LD is rapidly emerging, with the establishment of I. scapularis in many newly endemic regions posing a growing risk to local communities. In the Canadi...
Preprint
Background: The effectiveness of malaria vector control interventions is commonly evaluated using parallel-arm cluster randomized trials with outcomes assessed using repeated cross-sectional surveys. A key requirement in designing and analyzing cluster randomized trials is to account for the intra-cluster correlation coefficient (ICC). In addition...
Preprint
Background Childbirth at health institutions is critical to preventing major maternal and newborn deaths. In low and middle-income countries, many women still give childbirth without skilled assistance. Religious leaders may play a crucial role to promote childbirth at health institutions. So, this study aims to explore religious leaders’ experienc...
Article
Full-text available
West Nile neuroinvasive disease (WNND) is a severe neurological illness that can result from West Nile virus (WNV) infection, with long-term disability and death being common outcomes. Although WNV arrived in North America over two decades ago, risk factors for WNND are still being explored. The objective of this study was to identify WNND comorbid...
Article
Lyme disease is an emerging public health threat in Ontario, Canada due to ongoing range expansion of the tick vector, Ixodes scapularis. Tick density is an important predictor of human Lyme disease risk and is typically measured using active tick surveillance via drag sampling, which is time and resource-intensive. New cost-effective tools are nee...
Article
Full-text available
Currently, there is limited knowledge about socioeconomic, neighbourhood, and local ecological factors that contribute to the growing Lyme disease incidence in the province of Ontario, Canada. In this study, we sought to identify these factors that play an important role at the local scale, where people are encountering ticks in their communities....
Article
Full-text available
Background Long-lasting insecticidal nets (LLINs) have successfully reduced malaria in sub-Saharan Africa, but their effectiveness is now partly compromised by widespread resistance to insecticides among vectors. We evaluated new classes of LLINs with two active ingredients with differing modes of action against resistant malaria vectors. Methods...
Article
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Background Progress achieved by long-lasting insecticidal nets (LLINs) against malaria is threatened by widespread selection of pyrethroid resistance among vector populations. LLINs with non-pyrethroid insecticides are urgently needed. This study aims to assess the insecticide and textile durability of three classes of dual-active ingredient (A.I.)...
Article
Full-text available
IntroductionThe global burden of maternal mortality remains high and inequitably distributed between countries. Antenatal care (ANC) was identified as critical component in achieving the Millennium Development Goal of improving maternal health. This scoping review aimed to summarize trends and critically explore research about ANC attendance for Ea...
Article
Full-text available
Background Climate change is expected to alter the global footprint of many infectious diseases, particularly vector-borne diseases such as malaria and dengue. Knowledge of the range and geographical context of expected climate change impacts on disease transmission and spread, combined with knowledge of effective adaptation strategies and response...
Article
Full-text available
Background Dengue, Zika and chikungunya are arboviruses of significant public health importance that are transmitted by Aedes aegypti and Aedes albopictus mosquitoes. In Colombia, where dengue is hyperendemic, and where chikungunya and Zika were introduced in the last decade, more than half of the population lives in areas at risk. The objective of...
Article
Full-text available
Background The global impact of Zika virus in Latin America has drawn renewed attention to circulating mosquito-borne viruses in this region, such as dengue and chikungunya. Our objective was to assess socio-ecological factors associated with Aedes mosquito vector density as a measure of arbovirus transmission risk in three cities of potentially re...
Preprint
Full-text available
Background: Maternal mortality continues to decrease in the world but remains the most important health problems in low-income countries. Although evidence indicates that social support is important factor influencing health facility delivery, it has not been extensively studied in Ethiopia. Therefore, this study aimed to assess social support in i...
Article
Full-text available
Introduction: The number of maternal deaths remains high in sub-Saharan Africa. Effective antenatal care (ANC) reduces maternal morbidity and mortality; therefore, provision of improved antenatal care services has been prioritised across sub-Saharan Africa. Yet, research is limited on the ANC experiences of Indigenous women in sub-Saharan Africa....
Article
Full-text available
Anopheles funestus is playing an increasing role in malaria transmission in parts of sub-Saharan Africa, where An. gambiae s.s. has been effectively controlled by long-lasting insecticidal nets. We investigated vector population bionomics, insecticide resistance and malaria transmission dynamics in 86 study clusters in North-West Tanzania. An. fune...
Article
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Background: Persisting within-country disparities in maternal health service access are significant barriers to attaining the Sustainable Development Goals aimed at reducing inequalities and ensuring good health for all. Sub-national decision-makers mandated to deliver health services play a central role in advancing equity but require appropriate...
Preprint
Full-text available
Introduction Progress achieved by long-lasting insecticidal nets (LLINs) against malaria is threatened by the widespread selection of pyrethroid resistance among vector populations. LLINs with non-pyrethroid insecticides are urgently needed. This study aims to assess the durability of three novel dual active ingredient LLINs and to parameterise a m...
Preprint
Full-text available
Background The global impact of Zika virus in Latin America and the Caribbean has drawn renewed attention to circulating mosquito-borne viruses in this region, such as dengue and chikungunya. Our objective was to assess socio-ecological factors associated with Aedes mosquito vector density as a measure of arboviral transmission risk in three cities...
Preprint
Full-text available
Anopheles funestus is playing an increasing role in malaria transmission in parts of sub-Saharan Africa, where An. gambiae s.s. has been effectively controlled by long-lasting insecticidal nets. We investigated vector population bionomics, insecticide resistance and malaria transmission dynamics in 86 study clusters in North-West Tanzania. An. fune...
Article
Global emergence of vector-borne and zoonotic diseases presents a rapidly growing ‘wicked’ problem. We outline the need for a transdisciplinary research program that is grounded in ecological and evolutionary theory but integrates fundamentally with research perspectives spanning the health, social, and natural sciences.
Article
Full-text available
Introduction The massive scale-up of long-lasting insecticidal nets (LLINs) has led to major reductions in malaria burden in many sub-Saharan African countries. This progress is threatened by widespread insecticide resistance among malaria vectors. This cluster-randomised controlled trial (c-RCT) compares three of the most promising dual active ing...
Article
Full-text available
Canadians face an emerging threat of Lyme disease due to the northward expansion of the tick vector, Ixodes scapularis . We evaluated the degree of I . scapularis population establishment and Borrelia burgdorferi occurrence in the city of Ottawa, Ontario, Canada from 2017–2019 using active surveillance at 28 sites. We used a field indicator tool de...
Article
Full-text available
Background: The pursuit of health equity is a priority in Ethiopia, especially with regards to maternal, newborn, and child health (MNCH). To date, there has been little characterization of the ‘problem’ of health inequity, and the normative assumptions implicit in the representation of the problem. Yet, such insights have implications for shaping...
Article
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Background Maternity waiting homes (MWHs), residential spaces for pregnant women close to obstetric care facilities, are being used to tackle physical barriers to access. However, their effectiveness has not been rigorously assessed. The objective of this cluster randomized trial was to evaluate the effectiveness of functional MWHs combined with co...
Article
Full-text available
Background: Lyme disease is an emerging vector-borne zoonotic disease of increasing public health importance in Canada. As part of its mandate, the Canadian Lyme Disease Research Network (CLyDRN) launched a pan-Canadian sentinel surveillance initiative, the Canadian Lyme Sentinel Network (CaLSeN), in 2019. Objectives: To create a standardized, n...
Article
Full-text available
The blacklegged tick, Ixodes scapularis, is established in several regions of Ontario, Canada, and continues to spread into new geographic areas across the province at a rapid rate. This poses a significant public health risk since I. scapularis transmits the Lyme disease-causing bacterium, Borrelia burgdorferi, and other pathogens of potential pub...
Article
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Background: Analysis of disaggregated national data suggest uneven access to essential maternal healthcare services within countries. This is of concern as it hinders equitable progress in health outcomes. Mounting an effective response requires identification of subnational areas that may be lagging behind. This paper aims to explore spatial vari...
Article
Full-text available
Blacklegged ticks (Ixodes scapularis) are considered to be the main vector of Lyme disease in eastern North America. They may parasitize a wide range of bird and mammal hosts. Northward dispersal of blacklegged ticks has been attributed largely to movement of hosts to areas outside of the current range of the tick, in conjunction with climate chang...
Article
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Objectives: In this systematic review, we synthesize the current evidence on health-related quality of life (HRQoL) for the two of the most relevant outcomes of Zika virus infection in humans, microcephaly and Guillain-Barré Syndrome (GBS). Methods: We searched the following databases: MEDLINE, Embase, CINAHL, LILACS, WHO's ICTRP clinical trials...
Article
Full-text available
Human infections with viruses of the genus Flavivirus, including dengue virus (DENV) and Zika virus (ZIKV), are of increasing global importance. Owing to antibody-dependent enhancement (ADE), secondary infection with one Flavivirus following primary infection with another Flavivirus can result in a significantly larger peak viral load with a much h...
Article
Full-text available
Background Three arthropod-borne viruses (arboviruses) causing human disease have been the focus of a large number of studies in the Americas since 2013 due to their global spread and epidemiological impacts: Zika, dengue, and chikungunya viruses. A large proportion of infections by these viruses are asymptomatic. However, all three viruses are ass...
Article
Full-text available
Background: Ethiopia is one of the ten countries in the world that together account for almost 60% of all maternal deaths. Recent reductions in maternal mortality have been seen, yet just 26% of women who gave birth in Ethiopia in 2016 reported doing so at a health facility. Maternity waiting homes (MWHs) have been introduced to overcome geographi...
Article
Full-text available
Background Access to trusted health information has contribution to improve maternal and child health outcomes. However, limited research to date has explored the perceptions of communities regarding credible messenger and messaging in rural Ethiopia. Therefore, this study aimed to explore sources of trusted maternal health information and preferen...
Article
Full-text available
Background Health equity is a cross-cutting theme in the United Nations 2030 Agenda for Sustainable Development, and a priority in health sector planning in countries including Ethiopia. Subnational health managers in Ethiopia are uniquely positioned to advance health equity, given the coordination, planning, budgetary, and administration tasks tha...
Article
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Recent studies have highlighted the occurrence and distribution of Ixodes scapularis ticks infected with Borrelia burgdorferi sensu stricto (s.s.) around the city of Ottawa, Ontario, Canada, and the need for strategies to mitigate the risk of human exposure and infection. We conducted a field study from July to October 2018 to examine the effective...
Article
Full-text available
In eastern North America, including Canada, Lyme disease is caused by Borrelia burgdorferi sensu stricto and transmitted to humans by the blacklegged tick, Ixodes scapularis. The last decade has seen a growing incidence of Lyme disease in Canada, following the northward range expansion of I. scapularis tick populations from endemic areas in eastern...
Article
Full-text available
Background: In Ethiopia, malaria infections and other complications during pregnancy contribute to the high burden of maternal morbidity and mortality. Preventive measures are available, however little is known about the factors influencing the uptake of maternal health services and interventions by pregnant women in Ethiopia. Methods: We analyz...
Article
Dengue is a climate-sensitive disease with an increasing global burden. Although the relationship between meteorological conditions and dengue incidence is well established, less is known about the modifying nature of sociodemographic variables on that relationship. We assess the strength and direction of sociodemographic effect modification of the...
Article
Full-text available
Background: Maternal and child morbidity and mortality remains one of the most important public health challenges in developing countries. In rural settings, the promotion of household and community health practices through health extension workers in collaboration with other community members is among the key strategies to improve maternal and ch...
Article
Full-text available
Background: Despite improvements in recent years, Ethiopia faces a high burden of maternal morbidity and mortality. Antenatal care (ANC) may reduce maternal morbidity and mortality through the detection of pregnancy-related complications, and increased health facility-based deliveries. Midwives and community-based Health Extension Workers (HEWs) c...
Article
Full-text available
Objective To identify individual-, household- and community-level factors associated with maternity waiting home (MWH) use in Ethiopia. Design Cross-sectional analysis of baseline household survey data from an ongoing cluster-randomised controlled trial using multilevel analyses. Setting Twenty-four rural primary care facility catchment areas in...
Preprint
Full-text available
Background Three arthorpod-borne viruses (arboviruses) causing human disease have been the focus of a large number of studies in the Americas since 2013 due to their global spread and epidemiological impacts: Zika, dengue, and chikungunya viruses. A large proportion of infections by these viruses are asymptomatic. However, all three viruses are ass...
Article
Full-text available
In Ethiopia, maternal waiting areas (MWAs)–residential areas near health facilities where women can stay while waiting to give birth–are community-based, equity-oriented interventions to improve maternal outcomes among rural populations. In this qualitative study we sought to explore the barriers and enablers that Health Extension Workers (HEWs) en...
Article
Full-text available
Health management information system (HMIS) data are important for guiding the attainment of health targets in low- and middle-income countries. However, the quality of HMIS data is often poor. High-quality information is especially important for populations experiencing high burdens of disease and mortality, such as pregnant women, newborns, and c...
Article
Full-text available
Analysis of surveillance data for 2010-2016 in eastern Ontario, Canada, demonstrates the rapid northward spread of Ixodes scapularis ticks and Borrelia burgdorferi, followed by increasing human Lyme disease incidence. Most spread occurred during 2011-2013. Continued monitoring is essential to identify emerging risk areas in this region.
Article
Full-text available
West Nile virus (WNV; family Flaviviridae) causes a disease in humans that may develop into a deadly neuroinvasive disease. In North America, several peridomestic bird species can develop sufficient viremia to infect blood-feeding mosquito vectors without succumbing to the virus. Mosquito species from the genus Culex, Aedes and Ochlerotatus display...
Article
Human infection by West Nile virus (WNV; family Flaviviridae), in some cases, develops into a deadly neuroinvasive disease. WNV risk is thought to be influenced by factors affecting the density of species that promote replication and transmission of the virus, namely peridomestic bird and mosquito species. Factors influencing contact between perido...
Article
Full-text available
Background: The incidence of Lyme disease has increased in many regions of Canada in recent years, including in Ottawa, Ontario. To date there has been limited active tick surveillance in the region. Objectives: To estimate both the distribution and density of Ixodes scapularis ticks in the city of Ottawa, and the infection rates of ticks with Bor...
Article
Full-text available
Contexte : Au cours des dernières années, l’incidence de la maladie de Lyme a augmenté dans plusieurs régions au Canada, y compris à Ottawa (Ontario). Jusqu’à maintenant, la surveillance active des tiques était limitée dans cette région. Objectifs : Estimer la distribution géographique et la densité des tiques Ixodes scapularis dans la ville d’Ott...
Article
Full-text available
Background: The Safe Motherhood Research Project studies the implementation and scale-up of maternal, newborn and child health (MNCH) initiatives in Jimma Zone, Ethiopia. This qualitative rapid assessment study was undertaken to explore community perceptions and experiences related to health, health inequality and other MNCH themes. Methods: We...