Richard Rheingans Ph.D.

Type: Core Faculty Highest Degree: Ph.D. Office: 222 Living Learning Academic Phone: 828-262-7248 Email: rheingansrd@appstate.edu Research & Teaching Interests: Interaction between socio-economic factors, the environment and health, global environmental health and equity issues, small farm agroforestry, basic food production, global health and development, water and sanitation, the effect of disparities on vaccine preventable diseases, and poverty Ph.D. Forestry and Environmental Studies, Yale M.A. International Relations, Yale B.A. Political Science, Yale Teaching Senior Seminar, Foundations of Sustainable Development, Environmental Humanities, Special Topics. Background Dr. Rheingans comes to Appalachian after several years as an associate professor with a joint appointment in the Department of Environmental and Global Health and the Center for African Studies at the University of Florida. His extensive teaching and research experience includes positions as impact director and visiting researcher at the SHARE Research Consortium at the London School of Hygiene and Tropical Medicine, as assistant and associate professor at Emory University’s Hubert Department of Global Health and health economist at the Centers for Disease Control and Prevention. Rheingans was recognized as the University of Florida International Educator of the Year in 2012 and has several active grants funded by organizations including the World Bank, the Bill and Melinda Gates Foundation and the U.S. Agency for International Development.

There are 49 included publications by Richard Rheingans Ph.D.:

TitleDateViewsBrief Description
Anal Cleansing Practices And Fecal Contamination: A Preliminary Investigation Of Behaviors And Conditions In Schools In Rural Nyanza Province, Kenya 2011 688 Objective: To learn how children in rural schools in Nyando District, Kenya clean themselves after defecation.Methods: Six focus group discussions were held with boys and girls ages 12–15 in three rural schools in mid-2009. Parents were interviewed i...
Assessing The Impact Of A School-Based Latrine Cleaning And Handwashing Program On Pupil Absence In Nyanza Province, Kenya: A Cluster-Randomized Trial 2014 1507 Improving school water, sanitation and hygiene (WASH) conditions reduces pupil absence and illness. However, these benefits may depend on the conditions of the latrines and availability of consumables. We sought to determine whether a low-cost, polic...
Assessing The Impact Of A School-Based Water Treatment, Hygiene And Sanitation Programme On Pupil Absence In Nyanza Province, Kenya: A Cluster-Randomized Trial 2012 1826 Objectives: There has been increased attention to access to water, sanitation and hygiene (WASH) at schools in developing countries, but a dearth of empirical studies on the impact. We conducted a cluster- randomized trial of school-basedWASH on pupi...
Assessment of the Economic Impact of the Antiretroviral Vaccine in Venezuela 2006 362 Objective. To assess the cost of medical care for rotavirus gastroenteritis and the cost-effectiveness of the antiretroviral vaccine in Venezuelan children under five. Methods. We used an economic model that comprises epidemiologic information, vacci...
Burden Of Enterotoxigenic Escherichia coli And Shigella Non-Fatal Diarrhoeal Infections In 79 Low-Income And Lower Middle-Income Countries: A Modelling Analysis 2019 654 Enterotoxigenic Escherichia coli (ETEC) and shigella are two major pathogens that cause moderate-to-severe diarrhoea in children younger than 5 years. Diarrhoea is associated with an increased risk of stunting, which puts children at risk of death du...
A Cluster-Randomized Trial Assessing The Impact Of School Water, Sanitation, And Hygiene Improvements On Pupil Enrollment And Gender Parity In Enrollment 2013 615 We employed a cluster randomized trial design to measure the impact of a school based water, sanitation, and hygiene (WASH) improvement on pupil enrollment and on gender parity in enrollment, in primary schools in Nyanza Province, Kenya (2007-2009). ...
A Controlled, Before-And-After Trial Of An Urban Sanitation Intervention To Reduce Enteric Infections In Children: Research Protocol For The Maputo Sanitation (Mapsan) Study, Mozambique 2015 823 Introduction:Access to safe sanitation in low-income, informal settlements of Sub-Saharan Africa has not significantly improved since 1990. The combination of a high faecal-related disease burden and inadequate infrastructure suggests that investment...
Cost-Effectiveness of Rotavirus Vaccination in Bolivia From the State Perspective 2011 625 Background: In Bolivia, in 2008, the under-five mortality rate is 54 per 1000 live births. Diarrhea causes 15% of these deaths, and 40% of pediatric diarrhea-related hospitalizations are caused by rotavirus illness (RI). Rotavirus vaccination (RV), s...
Costs of Diarrheal Disease and the Cost-Effectiveness of a Rotavirus Vaccination Program in Kyrgyzstan 2009 1463 Introduction. We examined the cost-effectiveness of a rotavirus immunization program in Kyrgyzstan, a country eligible for vaccine funding from the GAVI Alliance.Methods. We estimated the burden of rotavirus disease and its economic consequences b...
Determinants Of Quality Of Shared Sanitation Facilities In Informal Settlements: Case Study Of Kisumu, Kenya 2017 734 Background: Shared facilities are not recognised as improved sanitation due to challenges of maintenance as they easily can be avenues for the spread of diseases. Thus there is need to evaluate the quality of shared facilities, especially in informal...
Distributional Impact Of Rotavirus Vaccination In 25 GAVI Countries: Estimating Disparities In Benefits And Cost Effectiveness 2012 1500 Background: Other studies have demonstrated that the impact and cost effectiveness of rotavirus vacci-nation differs among countries, with greater mortality reduction bene?ts and lower cost-effectiveness ratios in low-income and high-mortality countr...
Economic and Health Burden of Rotavirus Gastroenteritis in Latin America 2007 493 Objective. To estimate the health and economic burden of rotavirus gastroenteritis in hos-pital and outpatient settings in eight Latin American and Caribbean countries (Argentina, Brazil, Chile, Dominican Republic, Honduras, Mexico, Panama, and Venez...
Economic Costs of Rotavirus Gastroenteritis and Cost-Effectiveness of Vaccination in Developing Countries 2009 1781 Background. Rotavirus is the leading cause of severe gastroenteritis in children worldwide. We evaluated the economic burden of rotavirus and the cost-effectiveness of vaccination from the health care perspective. Methods. Estimates were based on exi...
Economic Evaluation Of An Eventual Incorporation Of Anti-Rotavirus Vaccine Into Childhood Immunization Program In Honduras 2006 450 We present an economic evaluation of rotavirus vaccine in less than five year-old Honduran population. An economic model was applied with the purpose to compare the implementation of an anti-rotavirus immunization program with the strategy of no vac...
Economic Impact Of A Rotavirus Vaccination Program In Mexico 2009 514 Objectives. To evaluate the cost and benefits of a national rotavirus childhood vaccination program in Mexico. Methods. A decision-analysis model was designed to take the Mexican health care system’s perspective on a comparison of two alternatives: t...
Economics of Rotavirus Gastroenteritis and Vaccination in Europe: What Makes Sense? 2006 823 Rotavirus is a major cause of gastroenteritis in children throughout Europe and the world. In addition to causing morbidity and mortality in children, rotavirus gastroenteritis (RVGE) creates a major economic burden on health care systems and familie...
The Effect Of Costs On Kenyan Households' Demand For Medical Care: Why Time And Distance Matter 2017 117 In an environment of constrained resources, policymakers must identify solutions for financing and delivering health services that are efficient and sustainable. However, such solutions require that policymakers understand the complex interaction bet...
Effects Of Geographic And Economic Heterogeneity On The Burden Of Rotavirus Diarrhea And The Impact And Cost-Effectiveness Of Vaccination In Nigeria 2020 665 Child mortality from rotavirus gastroenteritis remains high in Nigeria, representing 14% of all rotavirus deaths worldwide. Here, we examine the potential impact and cost-effectiveness of national rotavirus vaccine introduction in geographic and econ...
Effects Of Geographic And Economic Heterogeneity On The Burden Of Rotavirus Diarrhea And The Impact And Cost-Effectiveness Of Vaccination In Pakistan 2018 807 Globally, rotavirus is a leading cause of childhood diarrhea and related mortality. Although rotavirus vaccination has been introduced in many countries worldwide, there are numerous low- to middle-income countries that have not yet introduced. Pakis...
Effects Of Geographic And Economic Heterogeneity On Rotavirus Diarrhea Burden And Vaccination Impact And Cost-Effectiveness In The Lao People's Democratic Republic 2018 798 Rotavirus enteritis is responsible for nearly 200,000 child deaths worldwide in 2015. Globally, many low- and middle-income countries have introduced rotavirus vaccine, resulting in documented reductions in hospitalizations and child mortality. We ex...
Estimated Impact And Cost-Effectiveness Of Rotavirus Vaccination In India: Effects Of Geographic And Economic Disparities 2014 709 India accounts for 23% of global rotavirus mortality in under-five children, with more than 100,000 deaths from rotavirus annually. Introduction of a vaccine in India is considered to be the most effective intervention for preventing rotavirus mortal...
Estimating The Cost And Payment For Sanitation In The Informal Settlements Of Kisumu, Kenya: A Cross Sectional Study 2017 75 Lack of sanitation facilities is a common occurrence in informal settlements that are common in most developing countries. One challenge with sanitation provision in these settlements is the cost and financing of sanitation. This study aimed at estim...
Factors Associated With Pupil Toilet Use In Kenyan Primary Schools 2014 658 The purpose of this study was to quantify how school sanitation conditions are associated with pupils‘ use of sanitation facilities. We conducted a longitudinal assessment in 60 primary schools in Nyanza Province, Kenya, using structured observations...
‘The Girl With Her Period Is The One To Hang Her Head’ Reflections On Menstrual Management Among Schoolgirls In Rural Kenya 2011 1609 Background: The onset of menstruation is a landmark event in the life of a young woman. Yet the complications and challenges that can accompany such an event have been understudied, specifically in resource-poor settings. As interventions aim to impr...
Global Challenges in Water, Sanitation and Health 2006 5671 The year 2005 marks the beginning of the “International Decade for Action: Water for Life” and renewed effort to achieve the Millennium Development Goals (MDGs) to reduce by half the proportion of the world’s population without sustainable access to ...
Heterogeneity In Enterotoxigenic Escherichia coli And Shigella Infections In Children Under 5 Years Of Age From 11 African Countries: A Subnational Approach Quantifying Risk, Mortality, Morbidity, And Stunting 2020 715 Diarrhoea, a global cause of child mortality and morbidity, is linked to adverse consequences including childhood stunting and death from other diseases. Few studies explore how diarrhoeal mortality varies subnationally, especially by cause, which is...
Heterogeneity In Potential Impact And Cost-Effectiveness Of ETEC And Shigella Vaccination In Four Sub-Saharan African Countries 2019 147 Diarrheal disease burden has become more heterogenous in low- and lower middle-income countries as access to clean water, sanitation and health care has increased in wealthier urban populations. Enterotoxigenic Escherichia coli (ETEC) and Shigella ar...
Household Costs Of Diarrhea By Etiology In 7 Countries: The Global Enterics Multicenter Study (GEMS) 2019 104 BACKGROUND: Although there are many overlapping features, pediatric diarrheal diseases can vary in severity, duration, clinical manifestations, and sequelae according to the causal pathogen, which in turn can impact the economic burden on patients an...
The Impact Of A School-Based Water Supply And Treatment, Hygiene, And Sanitation Programme On Pupil Diarrhoea: A Cluster-Randomized Trial 2013 2097 The impact of improved water, sanitation, and hygiene (WASH) access on mitigating illness is well documented, although impact of school-based WASH on school-aged children has not been rigorously explored. We conducted a cluster-randomized trial in Ny...
Increasing Equity of Access to Point-of-Use Water Treatment Products Through Social Marketing and Entrepreneurship: A Case Study in Western Kenya 2010 1460 Point-of-use water chlorination reduces diarrhoea risk by 25–85%. Social marketing has expanded access to inexpensive sodium hypochlorite for water treatment, at a cost of less than US$0.01 per day, in Kenya. To increase product access, women’s group...
Is soapy water a viable solution for handwashing in schools? 2010 1547 Despite the known health benefi ts of washing hands with soap, global handwashing rates are low. In Nyanza Province, Kenya, a follow-up of 55 pilot primary schools three years after the implementation of a safe water and hygiene intervention revealed...
Measuring Disparities In Sanitation Access: Does The Measure Matter? 2014 1423 Initiatives to monitor progress in health interventions like sanitation are increasingly focused on disparities in access. We explored three methodological challenges to monitoring changes in sanitation coverage across socioeconomic and demographic d...
National Mass Drug Administration Costs For Lymphatic Filariasis Elimination 2007 547 Background: Because lymphatic filariasis (LF) elimination efforts are hampered by a dearth of economic information about the cost of mass drug administration (MDA) programs (using either albendazole with diethylcarbamazine [DEC] or albendazole with i...
Potential cost effectiveness of a rotavirus vaccine in Chile 2006 371 Background: Cost effectiveness studies are essential to assess the real value of interventions with preventive or therapeutic objectives. Aim: To assess the theoretical cost-effectiveness of a vaccine against rotavirus in Chilean children of less tha...
Potential Cost-Effectiveness Of Vaccination For Rotavirus Gastroenteritis In Eight Latin American And Caribbean Countries 2007 1550 Objectives. To estimate the costs, benefits and cost-effectiveness of vaccination for ro-tavirus gastroenteritis in eight Latin American and Caribbean countries: Argentina, Brazil,Chile, the Dominican Republic, Honduras, Mexico, Panama, and Venezuela...
Potential Impact And Cost-Effectiveness Of Future ETEC And Shigella Vaccines In 79 Low- And Lower Middle-Income Countries 2019 691 While diarrhea mortality in children has declined over the last two decades, there has been a slower decline in diarrheal episodes. Repeated diarrheal episodes are associated with childhood stunting, which leads to increased mortality risk from infec...
Projected Health And Economic Impact Of Rotavirus Vaccination In GAVI-Eligible Countries: 2011–2030 2012 2168 Rotavirus is the leading cause of diarrheal disease in children under 5 years of age. It is responsible for more than 450,000 deaths each year, with more than 90% of these deaths occurring in low-resource countries eligible for support by the GAVI Al...
Public Finance Of Rotavirus Vaccination In India And Ethiopia: An Extended Cost-Effectiveness Analysis 2013 2240 An estimated 4% of global child deaths (approximately 300,000 deaths) were attributed to rotavirus in 2010. About a third of these deaths occurred in India and Ethiopia. Public finance of rotavirus vaccination in these two countries could substantial...
Rotavirus disease in Uzbekistan: Cost-effectiveness of a new vaccine 2006 802 We evaluated the cost-effectiveness of rotavirus vaccination in Uzbekistan from the healthcare system and societal perspectives. Disease burden was estimated using national statistics on hospitalizations and deaths, and international estimates of und...
Rotavirus Vaccination: Cost-Effectiveness and Impact on Child Mortality in Developing Countries 2009 1947 Background. Rotavirus is the leading cause of severe gastroenteritis in children !5 years of age and is responsible for 1500,000 deaths annually; 85% of this burden is in low-income countries eligible for financial support from the GAVI Alliance. We ...
Rotavirus Vaccination: Cost-Effectiveness and Impact on Child Mortality in Developing Countries 2009 1947 Background. Rotavirus is the leading cause of severe gastroenteritis in children !5 years of age and is responsible for 1500,000 deaths annually; 85% of this burden is in low-income countries eligible for financial support from the GAVI Alliance. We ...
Shamba Maisha: Pilot Agricultural Intervention For Food Security And HIV Health Outcomes In Kenya: Design, Methods, Baseline Results And Process Evaluation Of A Cluster-Randomized Controlled Trial 2015 689 Background: Despite advances in treatment of people living with HIV, morbidity and mortality remains unacceptably high in sub-Saharan Africa, largely due to parallel epidemics of poverty and food insecurity.Methods/Design: We conducted a pilot cluste...
Sustaining School Hand Washing And Water Treatment Programmes: Lessons Learned And To Be Learned 2011 1962 In Nyanza Province, Kenya, a sustainability evaluation of 55 pilot primary schools 2.5 years after the implementation of the Safe Water System (SWS) intervention revealed that programme activities were not successfully sustained in any of the schools...
Systematic Review Of The Economic Value Of Diarrheal Vaccines 2014 1993 Diarrheal disease is a leading cause of child mortality in low-income settings and morbidity across a range of settings. A growing number of studies have addressed the economic value of new and emerging vaccines to reduce this threat. We conducted a ...
Using Structural-Nested Models To Estimate The Effect Of Cluster-Level Adherence On Individual-Level Outcomes With A Three-Armed Cluster-Randomized Trial 2013 2367 Much attention has been paid to estimating the causal effect of adherence to a randomized protocol using instrumental variables to adjust for unmeasured confounding. Researchers tend to use the instrumental variable within one of the three main frame...
Water Insecurity In 3 Dimensions: An Anthropological Perspective On Water And Women’s Psychosocial Distress In Ethiopia 2012 1035 Water insecurity is a primary underlying determinant of global health disparities. While public health research on water insecurity has focused mainly on two dimensions, water access and adequacy, an anthropological perspective highlights the cultura...
Water, Sanitation And Hygiene Conditions In Kenyan Rural Schools: Are Schools Meeting The Needs Of Menstruating Girls? 2014 852 Water, sanitation and hygiene (WASH) programs in African schools have received increased attention, particularlyaround the potential impact of poor menstrual hygiene management (MHM) on equity for girls’ education. This studywas conducted prior to a ...
Water, Sanitation, And Primary School Attendance: A Multi-Level Assessment Of Determinants Of Household-Reported Absence In Kenya 2013 5377 This cross-sectional analysis examined the influence of school and household water, sanitation, and hygiene (WASH)conditions on recent primary school absence in light of other individual, household, and school characteristics in western Kenya. School...
‘We Keep It Secret So No One Should Know’ – A Qualitative Study To Explore Young Schoolgirls Attitudes And Experiences With Menstruation In Rural Western Kenya 2013 922 Keeping girls in school offers them protection against early marriage, teen pregnancy, and sexual harms, and enhances social and economic equity. Studies report menstruation exacerbates school-drop out and poor attendance, although evidence is sparse...