A5011724495- Streptococcal Infections and Treatments
- Viral gastroenteritis research and epidemiology
- Antimicrobial Resistance in Staphylococcus
- Viral Infections and Vectors
- COVID-19 Clinical Research Studies
- Bacterial Identification and Susceptibility Testing
- SARS-CoV-2 and COVID-19 Research
- Otolaryngology and Infectious Diseases
- Vaccine Coverage and Hesitancy
- Viral Infections and Outbreaks Research
- Infective Endocarditis Diagnosis and Management
- Respiratory viral infections research
- COVID-19 epidemiological studies
- Public Health Policies and Education
- Pulmonary Hypertension Research and Treatments
- Sepsis Diagnosis and Treatment
- Child Nutrition and Water Access
- Food Security and Health in Diverse Populations
- Pneumonia and Respiratory Infections
- Vector-borne infectious diseases
- Hematological disorders and diagnostics
- Nosocomial Infections in ICU
- COVID-19 Digital Contact Tracing
- Iron Metabolism and Disorders
- Indigenous Health, Education, and Rights
Indian Health Service
2017-2025
MaineHealth
2024
Maine Medical Center
2024
Food Safety and Inspection Service
2023
University of Pennsylvania
2016-2022
Children's Hospital of Philadelphia
2016-2019
Hospital of the University of Pennsylvania
2016-2017
Columbia University
2006
University of Liège
1993
Long-term effects of COVID-19 on multiple organ systems have been reported. Indigenous persons experienced disproportionate morbidity and mortality from COVID-19; however, Post-COVID-19 Conditions (PCC) not well described in this population. We conducted a longitudinal cohort study among living the Navajo Nation or White Mountain Apache Tribal lands Southwest United States who tested positive for SARS-CoV-2 between February 1, 2021 August 31, 2022. Participants were enrolled during their...
Abstract The aetiology of idiopathic Parkinson's disease (PD) is poorly defined but environmental aggressions may be relevant. Here, we report a new model PD in mice, based on chronic inoculation with neurotoxins the nasal cavity, which natural route contact environment. C57BL/6 submitted to daily intranasal MPTP for 30 days, developed motor deficits that correlated progressive and severe depletion striatal dopamine levels, loss tyrosine hydroxylase transporter staining substantia nigra...
Contact Tracing for Native Americans in Rural Arizona On a reservation eastern Arizona, most of the with Covid-19 live others who are at high risk. Identifying patients who...
Statin-associated autoimmune myopathy is a rare condition associated with the formation of autoantibodies to 3-hydroxy-3-methylglutaryl-coenzyme A reductase. Underlying environmental and genetic risk factors remain poorly understood. American Indians have high rates cardiovascular disease co-morbidities that require lipid-lowering therapies. We observed this in series Indian statin users rural Arizona.We reviewed charts six patients statin-associated myopathy. provide an illustrative case...
Indigenous populations have been disproportionally affected by COVID-19, particularly those in rural and remote locations. Their unique environments risk factors demand an equally public health response. Our Native American community experienced one of the highest prevalence outbreaks world, we developed aggressive management strategy that appears to had a considerable effect on mortality reduction. The results implications far beyond pandemic response, reframed how our addresses several...
Despite the disproportionate morbidity and mortality experienced by American Indian Alaska Native (AI/AN) persons during coronavirus disease 2019 (COVID-19) pandemic, few studies have reported vaccine effectiveness (VE) estimates among these communities. We conducted a test-negative case-control analysis AI/AN aged ≥12 years presenting for care from January 1, 2021, through November 30, to evaluate of mRNA COVID-19 vaccines against COVID-19-associated outpatient visits hospitalizations....
Abstract Background Rocky Mountain spotted fever (RMSF) is a deadly tickborne disease disproportionately affecting Arizona tribal communities. While the acute clinical effects of RMSF are well-documented, more complete understanding long-term health consequences needed to provide guidance for providers and patients in highly impacted areas. Methods We performed retrospective review hospitalized cases from 2 communities during 2002–2017. Medical records illness were abstracted information on...
Background American Indians face significant barriers to diagnosis and management of cardiovascular disease. We sought develop a real‐world implementation model for improving access echocardiography within the Indian Health Service, Structural Heart Disease Partnership. Methods Results The Partnership was implemented evaluated via 4‐step process characterizing system where it would be instituted, building point‐of‐care capacity, deploying active case finding structural heart disease,...
Active surveillance of invasive group A Streptococcus (iGAS) disease indicates that its incidence in the US general population is low, but limited studies show rates for American Indians and Alaska Natives (AI/AN) are severalfold higher. Major disparities iGAS exist between Indigenous non-Indigenous populations Australia, New Zealand, Canada, much less understood about among AI/AN United States. Although complex host-pathogen interactions influence iGAS, including strain variation virulence,...
This study was done to determine the burden of invasive Staphylococcus aureus on White Mountain Apache Tribal lands.Active population and laboratory-based surveillance for S infections conducted from May 2016 April 2018. A case defined as a Native American individual living or around lands with isolated normally sterile body site.Fifty-three cases were identified. Most adults (90.6%) had ≥1 underlying medical condition (86.8%), most common which diabetes (49.1%) obesity (41.5%). total 26.4%...
Iron deficiency and iron anemia affect billions of people worldwide. Infants young children are the most vulnerable. The Niños Primeros en Salud pediatric clinic aims to follow American Academy Pediatrics (AAP) recommendation screen all at 12 months age, a vital period for development time greatest risk.To evaluate clinic's performance screening for, diagnosing, treating anemia; describe prevalence severity in infants attending perirural Dominican Republic.A total 293 charts were reviewed...
SARS-CoV-2 has exposed limitations of public health mitigation measures such as traditional case investigations and contact tracing. The Whiteriver Service Unit is a rural, acute care hospital on the Fort Apache Indian Reservation in Arizona with integrated delivery services. During first wave COVID-19 cases May-June 2020, we developed an innovative investigation tracing approach that relied heavily cross-trained personnel, in-person encounters, baseline clinical evaluations. A second surge...
Abstract We identified 2 fatal cases of persons infected with hantavirus in Arizona, USA, 2020; 1 person was co-infected SARS-CoV-2. Delayed identification the cause death led to a public health investigation that lasted ≈9 months after their deaths, which complicated vector or exposure.
Abstract Background Widespread transmission of COVID-19 continues to threaten public health, particularly rural, American Indian communities. Although risk factors for severe disease and clinical characteristics are well described in the general population, there has been little shared on hospitalized populations. Methods In this observational study, we performed chart extractions all persons with from April 1 through July 31, 2020 among an exclusively population living or near Tribal lands...
Contemporary studies of rheumatic heart disease (RHD) within American Indian communities are lacking, despite recent work indicating high rates group A streptococcus, the precursor to RHD. Utilizing retrospective chart review Health Service, we sought characterize burden acute fever and RHD an tribe in Eastern Arizona. Our study found that, line with other high-income countries, US continues disproportionately impact native peoples, 10 times that general population.
COVID-19 has disproportionately affected Indigenous communities. The Whiteriver Service Unit (WRSU) took an integrated public health-health care system delivery approach in collaboration with the White Mountain Apache Tribe to decrease case fatality rate (CFR). WRSU performed daily data analyses identifying risk factors, expeditiously treating and proactively vaccinating people during at-home visits. WRSU's CFR was 0.3% lower than Arizona's (
Abstract Background Native Americans are overrepresented in outbreaks of Group A Streptococcus (GAS) the United States (US). In 2016, several invasive cases GAS were detected at Whiteriver Indian Health Service (IHS) Hospital Arizona that primarily serves White Mountain Apache (WMA) Tribe. The objective this study was to determine burden and severe disease among on WMA Tribal lands. Methods Prospective population laboratory-based surveillance for GASinfections conducted two years from March...
Abstract Background In April 2020, a COVID-19 outbreak at rural, resource-limited Department of Corrections on Native American reservation in Arizona led to multiple epidemiologically linked cases household contacts recently incarcerated individuals. We describe the role medical recovery site for isolation released inmates with active infection reducing transmission tied correctional facility. Methods On 16th, an individual was contact traced facility and laboratory-confirmed positive,...
Abstract Background COVID research and reporting has focused on large urban populations. However, limited data suggests that rural Native American (NA) populations are disparately impacted. We serve a well-defined NA population of ≈18,000 is relatively geographically isolated in the White Mountains eastern Arizona. Our first case SARS-CoV-2 was confirmed April 1st. have since an attack rate significantly higher than most United States. provide testing trends addition to characteristics 800...
Abstract Background Skin and soft-tissue infections (SSTIs) involve the skin, subcutaneous tissue, fascia, or muscle. Hospitalizations due to SSTIs represent a significant health disparity for American Indians (AI), but specific literature is limited. We characterized SSTI hospitalizations at our critical access hospital that exclusively serves an AI population in Southwest. Methods identified patients hospitalized (admitted transferred) with from June 2017 May 2018. Relevant cases underwent...