A5066684736- Malaria Research and Control
- Mosquito-borne diseases and control
- Computational Drug Discovery Methods
- Global Maternal and Child Health
- Hepatitis C virus research
- Drug Transport and Resistance Mechanisms
- HIV/AIDS drug development and treatment
- Pharmacological Effects and Toxicity Studies
- Influenza Virus Research Studies
- Antibiotics Pharmacokinetics and Efficacy
- Diversity and Career in Medicine
- Pharmacological Effects and Assays
- Hepatitis B Virus Studies
- Innovations in Medical Education
- SARS-CoV-2 and COVID-19 Research
- Scientific Measurement and Uncertainty Evaluation
- Liver Disease Diagnosis and Treatment
- Travel-related health issues
- Healthcare professionals’ stress and burnout
- Parasites and Host Interactions
- Infectious Encephalopathies and Encephalitis
- Primary Care and Health Outcomes
- Clostridium difficile and Clostridium perfringens research
- Bacterial Infections and Vaccines
- Health and Medical Research Impacts
University of California, San Francisco
2016-2024
Epidemic Intelligence Service
2023-2024
Centers for Disease Control and Prevention
2013-2024
Universidad Católica de Santa Fe
2021
University of California System
2020
San Francisco General Hospital
2019
Neurological Surgery
2017
Vanderbilt University Medical Center
2013-2015
Vanderbilt University
2013
Mayo Clinic in Florida
2013
Disease outbreaks associated with drinking water drawn from untreated groundwater sources represent a substantial proportion (30.3%) of the 818 reported to CDC's Waterborne and Outbreak Surveillance System (WBDOSS) during 1971 2008. The objectives this study were identify underlying contributing factors, suggest improvements for data collection outbreaks, inform outbreak prevention efforts. Two researchers independently reviewed all qualifying reports (1971 2008), assigned factors abstracted...
Hydroxychloroquine (HCQ) is a promising candidate for Coronavirus disease of 2019 (COVID-19) treatment. The optimal dosing HCQ unknown. Our goal was to integrate historic and emerging pharmacological toxicity data understand safe efficacious strategies COVID-19 sources included were (i) longitudinal clinical, pharmacokinetic (PK), virologic from patients with severe acute respiratory syndrome-2 (SARS-CoV-2) infection who received or without azithromycin (n = 116), (ii) in vitro viral...
Immune checkpoint inhibitors such as ipilimumab and targeted BRAF have dramatically altered the landscape of melanoma therapeutics over past few years. Agents targeting programmed cell death-1/ligand (PD-1/PD-L1) axis are now being developed appear to be highly active clinically with favorable toxicity profiles. We report two patients V600E mutant who were treated anti-PD-1 agents first-line therapy without significant toxicity, followed by vemurafenib at disease progression. Both severe...
Abstract Background In Uganda, artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DHA-PQ) showed excellent treatment efficacy for uncomplicated malaria in prior trials. Because the frequency of resistance to artemisinins piperaquine is increasing Southeast Asia prevalence Plasmodium falciparum polymorphisms associated with has changed, we reassessed efficacies at 3 sites Uganda. Methods For this randomized, single-blinded clinical trial, children aged 6–59 months were assigned...
We describe the prevalence and risk factors for advanced liver fibrosis (≥9.3 kPa) using transient elastography in human immunodeficiency virus (HIV)-monoinfected HIV/HBV (hepatitis B virus)-coinfected, antiretroviral naive adults Nigeria.HBV coinfection HBV DNA levels significantly increased of HIV patients, respectively.
In a recent trial of intermittent preventive treatment in pregnancy (IPTp) Uganda, dihydroartemisinin-piperaquine (DP) was superior to sulfadoxine-pyrimethamine (SP) preventing maternal and placental malaria.We compared genotypes using sequencing, fluorescent microsphere, quantitative polymerase chain reaction assays at loci associated with drug resistance Plasmodium falciparum isolated from subjects receiving DP or SP.Considering aminoquinoline resistance, increased prevalences mutations...
Dihydroartemisinin-piperaquine (DHA-PQ) is highly efficacious as intermittent preventive therapy for malaria during pregnancy (IPTp). Determining associations between piperaquine (PQ) exposure, risk, and adverse birth outcomes informs optimal dosing strategies.Human immunodeficiency virus-uninfected pregnant women (n = 300) were enrolled in a placebo-controlled trial of IPTp at 12-20 weeks' gestation randomized to sulfadoxine-pyrimethamine every 8 weeks, DHA-PQ or 4 weeks pregnancy....
Background Intermittent preventive treatment of malaria in pregnancy (IPTp) with dihydroartemisinin-piperaquine (IPTp-DP) has been shown to reduce the burden during compared sulfadoxine-pyrimethamine (IPTp-SP). However, limited data exist on how IPTp regimens impact risk infancy. We conducted a double-blinded randomized controlled trial (RCT) test hypothesis that children born mothers given IPTp-DP would have lower incidence infancy who received IPTp-SP. Methods and findings metrics among...
Despite scale-up of seasonal malaria chemoprevention (SMC) with sulfadoxine-pyrimethamine and amodiaquine (SP-AQ) in children 3-59 months age Burkina Faso, incidence remains high, raising concerns regarding SMC effectiveness selection drug resistance. Using a case-control design, we determined associations between levels, resistance markers, presentation malaria.
Intermittent preventive treatment (IPT) with dihydroartemisinin-piperaquine (DP) is highly protective against malaria in children, but not standard malaria-endemic countries. Optimal DP dosing regimens will maximize efficacy and reduce toxicity resistance selection. We analyze piperaquine (PPQ) concentrations (n = 4573), incidence data 326), P. falciparum drug markers from a trial of children randomized to IPT every 12 weeks 184) or 4 96) 2 24 months age (NCT02163447). use nonlinear mixed...
A monthly treatment course of dihydroartemisinin-piperaquine (DHA-PQ) effectively prevents malaria during pregnancy. However, a drug-drug interaction pharmacokinetic (PK) study found that pregnant human immunodeficiency virus (HIV)-infected women receiving efavirenz-based antiretroviral therapy (ART) had markedly reduced piperaquine (PQ) exposure. This suggests the need for alternative DHA-PQ chemoprevention regimens in this population.Eighty-three HIV-infected who received and efavirenz...
Nursing home residents are at elevated risk for severe complications from respiratory viruses, including SARS-CoV-2, influenza, and syncytial virus (RSV). homes required to report COVID-19 vaccination coverage can voluntarily influenza RSV among CDC's National Healthcare Safety Network. The purpose of this study was assess COVID-19, nursing early in the 2024-25 season. As November 10, 2024, 29.7% had received a 2024-2025 vaccine. Among facilities that elected against (59.4% facilities)...
Dihydroartemisinin-piperaquine (DHA-PQ) is under study for intermittent preventive treatment during pregnancy (IPTp), but it may accelerate selection drug resistance. Understanding the relationships between piperaquine concentration, prevention of parasitemia, and decreased sensitivity can inform control policies optimization DHA-PQ dosing. Piperaquine concentrations, measures Plasmodium falciparum genotypes associated with aminoquinoline in Africa (pfmdr1 86Y, pfcrt 76T) were obtained from...
This query of North American infectious diseases physicians reviews current and anticipated practice patterns related to hepatitis C virus (HCV) care. Less than 20% survey respondents evaluated and/or treated >10 HCV-infected individuals in the past year. We review HCV patterns, barriers management, education among physicians.
Intermittent preventive treatment with monthly dihydroartemisinin-piperaquine (DHA-PQ) is highly effective at preventing both malaria during pregnancy and placental malaria. Piperaquine prolongs the corrected QT interval (QTc), it possible that repeated dosing could lead to progressive QTc prolongation. Intensive characterization of relationship between piperaquine concentration throughout can inform effective, safe prevention guidelines.
Background A considerable challenge in quantification of the antimalarial piperaquine plasma is carryover analyte signal between assays. Current intensive pharmacokinetic studies often rely on merging venous and capillary sampling. Drug levels may be different from those plasma, Thus, correlation drug needs to established. Methods Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) was used develop method. Piperaquine measured 205 pairs samples collected simultaneously at...
Shortcomings in the current pipeline of infectious disease physician scientists are well documented. With a focus on transition early stage investigators to research independence, we outline challenges existing training pathways for scientists. We urge leaders societies, divisions, and governmental nongovernmental funding organizations reinvigorate vision nurturing trainees with interests research, seek transparency scientist mechanisms, encourage efforts improve reproducibility outcomes...
Dihydroartemisinin ( DHA )‐piperaquine is being evaluated as intermittent preventive therapy for malaria, but dosing has not been optimized children. We assessed exposure to and piperaquine in Ugandan children at two ages during infancy. Intensive sampling was performed 32 weeks of age, 31 104 weeks, 30 female adult controls. Compared with adults, area under the concentration‐time curve AUC 0–8 hr ) 52% higher comparable weeks. 0–21 d 35% lower 53% Terminal concentrations on days 7, 14, 21...
Dihydroartemisinin-piperaquine (DHA-PQ) provides highly effective therapy and chemoprevention for malaria in pregnant African women. PQ concentrations of >10.3 ng/ml have been associated with reduced maternal parasitemia, placental malaria, improved birth outcomes. We characterized the population pharmacokinetics (PK) a post hoc analysis human immunodeficiency virus (HIV)-infected -uninfected women receiving DHA-PQ as every 4 or 8 weeks.
Abstract African children are at risk of malaria and malnutrition. We quantified relationships between malnutrition among young Ugandan in a high transmission region. Data were used from randomized controlled trial where HIV‐unexposed ( n = 393) HIV‐exposed 186) to receive no chemoprevention, monthly sulfadoxine‐pyrimethamine, daily trimethoprim‐sulfamethoxazole, or dihydroartemisinin‐piperaquine (DP) age 6–24 months, then followed off chemoprevention until 36 months. Monthly height weight,...
Abstract Background Malaria community case management (CCM) can improve timely access to healthcare, and CCM programmes in sub-Saharan Africa are expanding from serving children under 5 years (CU5) only all ages. This report characterizes malaria the setting of an age-expanded programme Chadiza District, Zambia. Methods Thirty-three households each 73 eligible communities were randomly selected participate a household survey preceding trial proactive (NCT04839900). All members asked about...
Abstract Background Artemether-lumefantrine is the most widely used treatment for uncomplicated malaria and it dosed based on weight bands according to World Health Organization (WHO) guidelines. However, children are vulnerable underdosing. Inadequate dosing can lead failure drug resistance. Methods Nutritional parameters 372 363 <5 years old in 25 high-malaria-burden countries were acquired from Demographic Surveys program. Prevalence of attaining day 7 lumefantrine concentrations...