Scholars@Duke
Mark Janko

Mark Janko

Assistant Research Professor of Global Health
Duke Global Health Institute

Selected Publications

Disentangling social, environmental, and zoonotic transmission pathways of a gastrointestinal protozoan (Blastocystis spp.) in northeast Madagascar.

Journal Article American journal of biological anthropology · November 2024 ObjectivesUnderstanding disease transmission is a fundamental challenge in ecology. We used transmission potential networks to investigate whether a gastrointestinal protozoan (Blastocystis spp.) is spread through social, environmental, and/or zoo ... Full text Cite

Tuberculosis Is Associated with Chronic Hypoxemia among Kenyan Adults (CHAKA): A Case-Control Study.

Journal Article Ann Am Thorac Soc · August 2024 Rationale: Data on risk factors for chronic hypoxemia in low- and middle-income countries are lacking. Objectives: We aimed to quantify the association between potential risk factors and chronic hypoxemia among adults hospitalized in Kenya. Methods: A hosp ... Full text Link to item Cite

Infectious disease responses to human climate change adaptations.

Journal Article Global change biology · August 2024 Many recent studies have examined the impact of predicted changes in temperature and precipitation patterns on infectious diseases under different greenhouse gas emissions scenarios. But these emissions scenarios symbolize more than altered temperature and ... Full text Cite

Close Proximity to Mining Is Associated with Increased Prevalence of the Drug Resistance-Associated Mutation dhps540E in Eastern Democratic Republic of the Congo.

Journal Article The American journal of tropical medicine and hygiene · August 2024 Increasing sulfadoxine-pyrimethamine (SP) resistance in the Democratic Republic of the Congo (DRC) has threatened its use for prevention of malaria in one of the most malarious countries in the world. Using geographic information on mining operations in th ... Full text Cite

Cost-effectiveness of interventions for HIV/AIDS, malaria, syphilis, and tuberculosis in 128 countries: a meta-regression analysis.

Journal Article The Lancet. Global health · July 2024 BackgroundCost-effectiveness analyses have been conducted for many interventions for HIV/AIDS, malaria, syphilis, and tuberculosis, but they have not been conducted for all interventions that are currently recommended in all countries. To support ... Full text Cite

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.

Journal Article Lancet · May 18, 2024 BACKGROUND: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics t ... Full text Link to item Cite

Study protocol: improving response to malaria in the Amazon through identification of inter-community networks and human mobility in border regions of Ecuador, Peru and Brazil.

Journal Article BMJ open · April 2024 IntroductionUnderstanding human mobility's role in malaria transmission is critical to successful control and elimination. However, common approaches to measuring mobility are ill-equipped for remote regions such as the Amazon. This study develops ... Full text Cite

Mapping the distribution of Lyme disease at a mid-Atlantic site in the United States using electronic health data.

Journal Article PLoS One · 2024 Lyme disease is a spatially heterogeneous tick-borne infection, with approximately 85% of US cases concentrated in the mid-Atlantic and northeastern states. Surveillance for Lyme disease and its causative agent, including public health case reporting and e ... Full text Open Access Link to item Cite

Impact of climate and land use/land cover changes on malaria incidence in the Ecuadorian Amazon.

Journal Article PLOS climate · January 2024 Malaria transmission is influenced by climate and land use/land cover change (LULC). This study examines the impact of climate and LULC on malaria risk in the Ecuadorian Amazon. Weekly malaria surveillance data between 2008 and 2019 from Ecuador's Ministry ... Full text Cite

The burden of antimicrobial resistance in the Americas in 2019: a cross-country systematic analysis

Journal Article The Lancet Regional Health - Americas · September 1, 2023 Background: Antimicrobial resistance (AMR) is an urgent global health challenge and a critical threat to modern health care. Quantifying its burden in the WHO Region of the Americas has been elusive—despite the region's long history of resistance surveilla ... Full text Cite

Government interventions and control policies to contain the first COVID-19 outbreak: An analysis of evidence.

Journal Article Scandinavian journal of public health · July 2023 BackgroundThe overarching aim of this study was to evaluate the effectiveness over time of government interventions and policy restrictions and the impact of determinants on spread and mortality during the first-wave of the COVID-19 pandemic, glob ... Full text Cite

The impact of sustained malaria control in the Loreto region of Peru: a retrospective, observational, spatially-varying interrupted time series analysis of the PAMAFRO program.

Journal Article Lancet regional health. Americas · April 2023 BackgroundAlthough malaria control investments worldwide have resulted in dramatic declines in transmission since 2000, progress has stalled. In the Amazon, malaria resurgence has followed withdrawal of Global Fund support of the Project for Malar ... Full text Cite

Identifying individual, household and environmental risk factors for malaria infection on Bioko Island to inform interventions.

Journal Article Malaria journal · March 2023 BackgroundSince 2004, malaria transmission on Bioko Island has declined significantly as a result of the scaling-up of control interventions. The aim of eliminating malaria from the Island remains elusive, however, underscoring the need to adapt c ... Full text Cite

Hotspots in a cold land-reported cases of rabies in wildlife and livestock in Mongolia from 2012-2018.

Journal Article Zoonoses Public Health · September 2022 The epidemiological profile of rabies virus within Mongolia remains poorly characterized despite 21,302 domestic animal cases being reported between 1970-2005. This lack of knowledge is particularly concerning given that roughly 26% of the population lives ... Full text Link to item Cite

Cost-effectiveness of rotavirus vaccination in children under five years of age in 195 countries: A meta-regression analysis.

Journal Article Vaccine · June 2022 BackgroundRotavirus caused an estimated 151,714 deaths from diarrhea among children under 5 in 2019. To reduce mortality, countries are considering adding rotavirus vaccination to their routine immunization program. Cost-effectiveness analyses (CE ... Full text Cite

Finding gaps in routine TB surveillance activities in Bangladesh.

Journal Article The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · April 2022 BACKGROUND: TB was the leading cause of death from a single infectious pathogen globally between 2014 and 2019. Fine-scale estimates of TB prevalence and case notifications can be combined to guide priority-setting for strengthening routine surveill ... Full text Cite

Evaluating malaria prevalence and land cover across varying transmission intensity in Tanzania using a cross-sectional survey of school-aged children.

Journal Article Malaria journal · March 2022 BackgroundTransmission of malaria in sub-Saharan Africa has become increasingly stratified following decades of malaria control interventions. The extent to which environmental and land cover risk factors for malaria may differ across distinct str ... Full text Cite

Impact of extractive industries on malaria prevalence in the Democratic Republic of the Congo: a population-based cross-sectional study.

Journal Article Scientific reports · February 2022 Extraction of natural resources through mining and logging activities provides revenue and employment across sub-Saharan Africa, a region with the highest burden of malaria globally. The extent to which mining and logging influence malaria transmission in ... Full text Cite

Environmental Correlates of Lyme Disease Emergence in Southwest Virginia, 2005-2014.

Journal Article J Med Entomol · July 16, 2021 Lyme disease is the most common tick-borne disease in North America. Though human infection is mostly transmitted in a limited geography, the range has expanded in recent years. One notable area of recent expansion is in the mountainous region of southwest ... Full text Link to item Cite

Estimating the COVID-19 Spread Through Real-time Population Mobility Patterns: Surveillance in Low- and Middle-Income Countries.

Journal Article Journal of medical Internet research · June 2021 BackgroundOn January 21, 2020, the World Health Organization reported the first case of severe acute respiratory syndrome coronavirus 2, which rapidly evolved to the COVID-19 pandemic. Since then, the virus has also rapidly spread among Latin Amer ... Full text Cite

Geospatial Variations and Neighborhood Deprivation in Drug-Related Admissions and Overdoses.

Journal Article J Urban Health · December 2020 Drug overdoses are a national and global epidemic. However, while overdoses are inextricably linked to social, demographic, and geographical determinants, geospatial patterns of drug-related admissions and overdoses at the neighborhood level remain poorly ... Full text Link to item Cite

Malaria Transmission and Spillover across the Peru-Ecuador Border: A Spatiotemporal Analysis.

Journal Article International journal of environmental research and public health · October 2020 Border regions have been implicated as important hot spots of malaria transmission, particularly in Latin America, where free movement rights mean that residents can cross borders using just a national ID. Additionally, rural livelihoods largely depend on ... Full text Cite

Estimating the COVID-19 Spread Through Real-time Population Mobility Patterns: Surveillance in Low- and Middle-Income Countries (Preprint)

Journal Article · July 29, 2020 BACKGROUNDOn January 21, 2020, the World Health Organization reported the first case of severe acute respiratory syndrome coronavirus 2, which rapidly evolved to the COVID-19 pandemic. Si ... Full text Cite

Geospatial analysis of dengue emergence in rural areas in the Southern Province of Sri Lanka.

Conference Trans R Soc Trop Med Hyg · June 1, 2020 BACKGROUND: Dengue is a major cause of acute febrile illness in Sri Lanka. Dengue has historically been considered an urban disease. In 2012-2013, we documented that acute dengue was surprisingly associated with self-reported rural residence in the Souther ... Full text Link to item Cite

A Bayesian Spatiotemporal Analysis of Pediatric Group A Streptococcal Infections.

Journal Article Open Forum Infect Dis · December 2019 BACKGROUND: Pharyngitis due to group A Streptococcus (GAS) is a common pediatric infection. Physicians might diagnose GAS pharyngitis more accurately when given biosurveillance information about GAS activity. The availability of geographic GAS testing data ... Full text Link to item Cite

Extending multilevel spatial models to include spatially varying coefficients.

Journal Article Health & place · November 2019 Multilevel models have long been used by health geographers working on questions of space, place, and health. Similarly, health geographers have pursued interests in determining whether or not the effect of an exposure on a health outcome varies spatially. ... Full text Cite

False-negative malaria rapid diagnostic test results and their impact on community-based malaria surveys in sub-Saharan Africa

Journal Article BMJ Global Health · July 1, 2019 Surveillance and diagnosis of Plasmodium falciparum malaria relies predominantly on rapid diagnostic tests (RDT). However, false-negative (FN) RDT results are known to occur for a variety of reasons, including operator error, poor storage conditions, pfhrp ... Full text Cite

Beyond the Window: Patient Characteristics and Geographic Locations Associated with Late Prenatal Care in Women Eligible for 17-P Preterm Birth Prevention.

Journal Article J Racial Ethn Health Disparities · June 2019 INTRODUCTION: To reduce the risk of recurrence, women with a history of spontaneous preterm birth (PTB) are recommended to receive 17-hydroxyprogesterone caproate (17-P) injections starting by the 20th week of pregnancy. In women eligible for 17-P, we aime ... Full text Link to item Cite

Strengthening long-lasting insecticidal nets effectiveness monitoring using retrospective analysis of cross-sectional, population-based surveys across sub-Saharan Africa.

Journal Article Scientific reports · November 2018 Bed nets averted 68% of malaria cases in Africa between 2000 and 2015. However, concerns over insecticide resistance, bed net durability and the effectiveness of long-lasting insecticidal nets (LLIN) are growing. To assess the effectiveness of LLINs of dif ... Full text Cite

Drug-Resistance and Population Structure of Plasmodium falciparum Across the Democratic Republic of Congo Using High-Throughput Molecular Inversion Probes.

Journal Article The Journal of infectious diseases · August 2018 A better understanding of the drivers of the spread of malaria parasites and drug resistance across space and time is needed. These drivers can be elucidated using genetic tools. Here, a novel molecular inversion probe (MIP) panel targeting all major drug- ... Full text Cite

Correction to: Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo.

Journal Article Malaria journal · August 2018 Unfortunately after publication of the original article [1], it came to the author's attention that there is an error in the caption of Fig. 2. ... Full text Cite

Atmospheric teleconnection influence on North American land surface phenology

Journal Article Environmental Research Letters · March 1, 2018 Short-term forecasts of vegetation activity are currently not well constrained due largely to our lack of understanding of coupled climate-vegetation dynamics mediated by complex interactions between atmospheric teleconnection patterns. Using ecoregion-sca ... Full text Cite

The links between agriculture, <i>Anopheles</i> mosquitoes, and malaria risk in children younger than 5 years in the Democratic Republic of the Congo: a population-based, cross-sectional, spatial study.

Journal Article The Lancet. Planetary health · February 2018 BackgroundThe relationship between agriculture, Anopheles mosquitoes, and malaria in Africa is not fully understood, but it is important for malaria control as countries consider expanding agricultural projects to address population growth ... Full text Cite

Effect of individual and community-level bed net usage on malaria prevalence among under-fives in the Democratic Republic of Congo.

Journal Article Malaria journal · January 2018 BackgroundUnderstanding the contribution of community-level long-lasting, insecticidal net (LLIN) coverage to malaria control is critical to planning and assessing intervention campaigns. The Democratic Republic of Congo (DRC), which has one of th ... Full text Cite

Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo.

Journal Article Malaria journal · November 2017 BackgroundThe Democratic Republic of the Congo (DRC) bears a large share of global malaria burden despite efforts to control and eliminate the disease. More detailed understanding of individual and household level characteristics associated with m ... Full text Cite

Pfhrp2-Deleted Plasmodium falciparum Parasites in the Democratic Republic of the Congo: A National Cross-sectional Survey.

Journal Article The Journal of infectious diseases · July 2017 BackgroundRapid diagnostic tests (RDTs) account for more than two-thirds of malaria diagnoses in Africa. Deletions of the Plasmodium falciparum hrp2 (pfhrp2) gene cause false-negative RDT results and have never been investigated on a national leve ... Full text Cite

Malaria surveillance in the Democratic Republic of the Congo: comparison of microscopy, PCR, and rapid diagnostic test.

Journal Article Diagn Microbiol Infect Dis · May 2016 Malaria surveillance is critical for control efforts, but diagnostic methods frequently disagree. Here, we compare microscopy, PCR, and a rapid diagnostic test in 7137 samples from children in the Democratic Republic of the Congo using latent class analysi ... Full text Link to item Cite

Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013.

Journal Article Health & place · May 2016 The Democratic Republic of the Congo (DRC) has one of the lowest HIV prevalence in sub-Saharan Africa, estimated at 1.1% [0.9-1.3] of adults aged 15-49 in 2013 (UNAIDS). Within the 2 million km(2) country, however, there exists spatial variation in HIV pre ... Full text Cite

The geography of malaria genetics in the Democratic Republic of Congo: A complex and fragmented landscape.

Journal Article Soc Sci Med · May 2015 Understanding how malaria parasites move between populations is important, particularly given the potential for malaria to be reintroduced into areas where it was previously eliminated. We examine the distribution of malaria genetics across seven sites wit ... Full text Link to item Cite

A cross-sectional survey of Plasmodium falciparum pfcrt mutant haplotypes in the Democratic Republic of Congo.

Journal Article Am J Trop Med Hyg · June 2014 In the Democratic Republic of the Congo (DRC), artesunate-amodiaquine is first-line therapy for falciparum malaria; little is known about the prevalence of molecular markers of parasite drug resistance. Across the DRC, we genotyped 166 parasites in Plasmod ... Full text Link to item Cite

Genetic Evidence of Importation of Drug-Resistant Plasmodium falciparum to Guatemala from the Democratic Republic of the Congo.

Journal Article Emerg Infect Dis · June 2014 Imported malaria threatens control and elimination efforts in countries that have low rates of transmission. In 2010, an outbreak of Plasmodium falciparum malaria was reported among United Nations peacekeeping soldiers from Guatemala who had recently retur ... Full text Link to item Cite

Plasmodium falciparum sulfadoxine resistance is geographically and genetically clustered within the DR Congo.

Journal Article Sci Rep · 2013 Understanding the spatial clustering of Plasmodium falciparum populations can assist efforts to contain drug-resistant parasites and maintain the efficacy of future drugs. We sequenced single nucleotide polymorphisms (SNPs) in the dihydropteroate synthase ... Full text Link to item Cite