A5028939977- Tuberculosis Research and Epidemiology
- Mycobacterium research and diagnosis
- COVID-19 Impact on Reproduction
- Diagnosis and treatment of tuberculosis
- HIV/AIDS Research and Interventions
- Pneumocystis jirovecii pneumonia detection and treatment
- Adolescent Sexual and Reproductive Health
- Vaccine Coverage and Hesitancy
- Reproductive System and Pregnancy
- Child Nutrition and Water Access
- Pregnancy and Medication Impact
- Pregnancy and preeclampsia studies
- HIV, Drug Use, Sexual Risk
- Military and Defense Studies
- Infant Nutrition and Health
- Respiratory viral infections research
- Rural development and sustainability
- European Politics and Security
- HIV Research and Treatment
- Inhalation and Respiratory Drug Delivery
- Religious Education and Schools
- Middle East Politics and Society
- Adolescent and Pediatric Healthcare
- Library Science and Information Systems
- Migration, Refugees, and Integration
University of Washington
2020-2025
BackgroundTuberculosis remains a leading cause of global mortality, especially for adults and children living with HIV (CLHIV) underdiagnosed by sputum-based assays. Non-sputum-based assays are needed to improve tuberculosis diagnosis treatment monitoring. Our aim in this study was determine whether ultrasensitive detection Mycobacterium cell-free DNA (Mtb-cfDNA) blood can diagnose evaluate responses.MethodsIn molecular diagnostics we analysed archived serum from two patient populations...
Abstract Sensitive and specific blood-based assays for the detection of pulmonary extrapulmonary tuberculosis would reduce mortality associated with missed diagnoses, particularly in children. Here we report a nanoparticle-enhanced immunoassay read by dark-field microscopy that detects two Mycobacterium virulence factors (the glycolipid lipoarabinomannan its carrier protein) on surface circulating extracellular vesicles. In cohort study 147 hospitalized severely immunosuppressed children...
Discontinuation of daily oral pre-exposure prophylaxis (PrEP) is frequent among adolescent girls and young women (AGYW) in African settings. We explored factors influencing early PrEP discontinuation persistence Kenyan AGYW who accepted within a programmatic setting.
Pregnancy increases Mycobacterium tuberculosis (Mtb) reactivation risk and alters immune responses. We assessed Mtb-specific CD4+ T-cell responses in pregnant women with HIV (WLHIV) without, including those receiving isoniazid preventive therapy (IPT). measured adaptive from 33 participants (HIV+ 21, HIV- 12) positive interferon-gamma release assay during pregnancy (20-34 weeks' gestation), 6 weeks, 12 months postpartum by intracellular cytokine staining. overall using COMPASS made...
In pregnant people with prior SARS-CoV-2 infection, hybrid immunity (infection plus vaccination) before delivery provided more durable maternally-derived antibody responses than infection or vaccination alone in infants through 6 months of age.
We conducted a population-level short message service (SMS)-based survey among individuals aged 18–34 years in six HIV high-burden counties Western Kenya to assess pre-exposure prophylaxis (PrEP) awareness, acceptability of non-facility PrEP delivery, and willingness pay for PrEP. In January 2019, anonymous data were collected using mSurvey Inc., Nairobi, Kenya, which sends SMS messages via mobile provider networks ‘general audience’ pool subscribers ≥18 years. Subscribers’ demographic...
Escudero, Jaclyn N. MPH; Dettinger, Julia C. Pintye, Jillian RN, MPH, PhD; Kinuthia, John MBChB, MMed, Lagat, Harison BSN, Abuna, Felix BA; Kohler, Pamela Baeten, Jared M. MD, O'Malley, Gabrielle John-Stewart, Grace Beima-Sofie, Kristin PhD Author Information
HIV and pregnancy may affect latent TB infection (LTBI) diagnostics. Tuberculin skin test (TST) newer generation QuantiFERON-TB Gold Plus (QFT-Plus) evaluations in pregnant women living with (WLHIV) without are lacking.
Isoniazid preventive therapy (IPT) decreases risk of tuberculosis (TB) disease; impact on long-term infant growth is unknown. In a recent randomized trial (RCT), we assessed IPT effects without known TB exposure.
Introduction HIV-exposed uninfected (HEU) infants in tuberculosis (TB) endemic settings are at high risk of Mycobacterium (Mtb) infection and TB disease, even the absence known Mtb exposure. Because infancy is a time rapid progression from primary to active it important define when how preventive interventions exert their effect order develop effective prevention strategies this high-risk population. Methods analysis We designed non-blinded randomised controlled trial determine efficacy...
Human immunodeficiency virus (HIV)-exposed uninfected (HEU) infants in endemic settings are at high risk of tuberculosis (TB). For infants, progression from primary Mycobacterium (Mtb) infection to TB disease can be rapid. We assessed whether isoniazid (INH) prevents Mtb infection.
We sought to understand influences on PrEP uptake among Kenyan adolescent girls and young women (AGYW) whose decision use was misaligned with their risk for HIV acquisition. In-depth interviews were conducted 47 HIV-negative AGYW aged 15–24 years who offered during routine maternal child health family planning services. sampled from two groups (1) declined had ≥1 sexual partner(s) of unknown status (2) initiated reported having one partner. partners due known or suspected infidelity....
Background: Exposure to HIV and antiretroviral therapy (ART) in utero may influence infant growth development. Most available evidence predates adoption of universal ART (Option B+ regimens). In a recent cohort, we compared development HIV-exposed uninfected (HEU) HIV-unexposed (HUU) infants. Design: Prospective cohort study: data from Impact Maternal on Mycobacterium Tuberculosis Infection among Peripartum Women their Infants (MiTIPS) Western Kenya. Methods: were enrolled during pregnancy....
Abstract Background Hybrid immunity (infection plus vaccination) may increase maternally derived SARS-CoV-2 antibody responses and durability versus infection alone. Methods Prospective cohort of pregnant participants with prior (anti-nucleocapsid IgG, RT-PCR, or antigen positive) their infants had blood collected in pregnancy, at delivery/birth, postpartum tested for anti-spike (anti-S) IgG neutralizing antibodies (neutAb). Results Among 107 enrollment, 40% were unvaccinated 60% vaccinated...
Abstract Background Pregnancy and human immunodeficiency virus (HIV) may influence tuberculosis infection detection using interferon (IFN)-γ release assay (QFT-Plus; Qiagen) tuberculin skin test (TST). Methods Participants in Western Kenya underwent QFT-Plus TST pregnancy, 6 weeks postpartum (6wkPP) 12 months (12moPP). Results 400 participants (200 with HIV [WHIV], 200 HIV-negative) enrolled during pregnancy (median 28 weeks’ gestation [interquartile range, 24–30]). positivity prevalence was...
Abstract Background Novel approaches that allow early diagnosis and treatment monitoring of both human immunodeficiency virus-1 (HIV-1) tuberculosis disease (TB) are essential to improve patient outcomes. Methods We developed validated an immuno-affinity liquid chromatography–tandem mass spectrometry (ILM) assay simultaneously quantifies single peptides derived from HIV-1 p24 Mycobacterium (Mtb) 10-kDa culture filtrate protein (CFP10) in trypsin-digested serum cryopreserved archives cohorts...
Abstract Cumulative 24-month Mycobacterium tuberculosis infection incidence (measured primarily by tuberculin skin test [TST]) was high among human immunodeficiency virus exposed but uninfected infants (8.7 [95% confidence interval, 6.3–11.9] per 100 person-years). Trend for decreased TST positivity at trial end (12 months postenrollment) randomized to isoniazid 6 weeks of age not sustained through observational follow-up 24 age. Clinical Trials Registration NCT02613169.
Despite immune restoration after initiation of antiretroviral treatment (ART), the risk tuberculosis (TB) persists in children living with HIV (CLHIV). We determined patterns mycobacteria-specific T cells following ART CLHIV.
Background: Antenatal care provides unique opportunities to assess severe acute respiratory syndrome coronavirus 2 seroprevalence and antibody response duration after natural infection detected during pregnancy; transplacental transfer may inform peripartum neonatal protection. We estimated durability of antibodies from (anti-nucleocapsid immunoglobulin G) among pregnant people, evaluated efficiency. Objective design: conducted a cross-sectional study measure seroprevalence, prospective...
The effect of maternal HIV on infant Mycobacterium tuberculosis (Mtb) infection risk is not well-characterized.
We assessed adherence in an infant tuberculosis prevention trial Kenya with a urine isoniazid metabolite–detecting dipstick. Ninety-seven infants had 155 assays performed; 77 (49.7%) were found to be positive despite caregiver-reported adherence. Positive associated maternal secondary education, HIV suppression and no reported missed doses past 3 days, suggesting caregiver education self-medication use influenced
Abstract Importance Antenatal care provides unique opportunities to assess SARS-CoV-2 seroprevalence and antibody response duration after natural infection detected during pregnancy; transplacental transfer may inform peripartum neonatal protection. Objective Estimate durability of antibodies from (anti-nucleocapsid (anti-N) IgG) among pregnant people, evaluate efficiency. Design Seroprevalence study: cross-sectional screening people December 9, 2020-June 19, 2021. Cohort Pregnant screened...
Aim: Financial incentives improve response to electronic health surveys, yet little is known about how unconditional (guaranteed regardless of survey completion), conditional incentives, and various combinations influence rates. We compared completion with two different financial incentive structures. Methods: invited women aged 30-64 years enrolled in a U.S. healthcare system overdue for Pap screening complete web-based after receiving mailed human papillomavirus (HPV) self-sampling kit...
Background: Isoniazid preventive therapy (IPT) decreases risk of tuberculosis (TB) disease; impact on long-term infant growth is unknown. In a recent randomized trial (RCT), we assessed IPT effects without known TB exposure. Methods: The Infection Prevention Study (iTIPS) was non-blinded RCT among HIV-exposed uninfected (HEU) infants in Kenya. Inclusion criteria included age 6-10 weeks, birthweight >2.5 kg, and gestation >37 weeks. Infants the arm received 10 mg/kg isoniazid daily for...