A5035383267- HIV/AIDS Research and Interventions
- Hepatitis C virus research
- Hepatitis B Virus Studies
- Cancer Risks and Factors
- Liver Disease Diagnosis and Treatment
- HIV Research and Treatment
- Nutritional Studies and Diet
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- SARS-CoV-2 and COVID-19 Research
- Global Maternal and Child Health
- Vaccine Coverage and Hesitancy
- Obesity, Physical Activity, Diet
- Poverty, Education, and Child Welfare
- Birth, Development, and Health
- Mobile Health and mHealth Applications
- Viral Infections and Outbreaks Research
- Cancer, Lipids, and Metabolism
- Regulation of Appetite and Obesity
- HIV/AIDS drug development and treatment
- Syphilis Diagnosis and Treatment
- Preterm Birth and Chorioamnionitis
- Respiratory viral infections research
- Diverse Scientific Research Studies
- Plant-Microbe Interactions and Immunity
Clinton Health Access Initiative
2016-2025
Harvard University
2010-2015
Brigham and Women's Hospital
2013-2015
Johns Hopkins University
2008-2009
Animal models indicate that exposure to choline in utero improves visual memory through cholinergic transmission and/or epigenetic mechanisms. Among 895 mothers Project Viva (eastern Massachusetts, 1999-2002 2008-2011), we estimated the associations between intakes of choline, vitamin B12, betaine, and folate during first second trimesters pregnancy offspring (measured by Wide Range Assessment Memory Learning, Second Edition (WRAML2), Design Picture subtests) intelligence using Kaufman Brief...
Given that it is not feasible to use dual x-ray absorptiometry (DXA) or other reference methods measure adiposity in all pediatric clinical and research settings, important identify reasonable alternatives. Therefore, we sought determine the extent which measures were correlated with DXA fat mass school-aged children. In 1110 children aged 6.5-10.9 years pre-birth cohort Project Viva, calculated Spearman correlation coefficients between (n=875) including body index (BMI), skinfold thickness,...
Maternal diet affects offspring DNA methylation in animal models, but evidence from humans is limited. We investigated the extent to which gestational intake of methyl donor nutrients global maternal and umbilical cord blood. Among mother-infant pairs Project Viva, a folate-replete US population, we estimated intakes vitamin B12, betaine, choline, folate, cadmium, zinc iron periconceptionally during second trimester. examined associations these with methylation, measured as %5-methyl...
Objectives Kenya is one of the first African countries to scale up a national HIV viral load monitoring program. We sought assess program using database and identify areas for systems strengthening. Methods Data from January 2012 March 2016 were extracted Kenya's database. Characteristics 1,108,356 tests assessed over time, including reason testing, turnaround times, test results, treatment regimens, socio-demographic information. Results The number facilities offering testing increased...
Objective To examine associations of perinatal and 3‐year leptin with weight gain adiposity through 7 years. Design Methods In Project Viva, plasma from mothers at 26‐28 weeks' gestation ( n = 893), umbilical cord vein delivery 540), children 3 years 510) was assessed in relation to BMI z ‐score, waist circumference, skinfold thicknesses, dual X‐ray absorptiometry body fat. Results 50.1% were male 29.5% non‐white. Mean (SD) maternal, cord, age concentrations 22.9 (14.2), 8.8 (6.4), 1.8 (1.7)...
Preterm birth affects over 12% of all infants born in the US yet biology early delivery remains unclear, including whether epigenetic mechanisms are involved. We examined associations maternal and umbilical cord blood long interspersed nuclear element-1 (LINE-1) DNA methylation with length gestation odds preterm singleton pregnancies Project Viva. In white cells from during 1(st) trimester (n=914) 2(nd) (n=922), venous at (n=557), we measured LINE-1 by pyrosequencing (expressed as %5 methyl...
Poor sleep in childhood is associated with increased obesity risk, possibly by affecting appetite-regulating hormones such as leptin. We examined short- and long-term duration quality relation to leptin two US pediatric cohorts. Analysis of data from prospective cohort studies. Population-based. Adolescent polysomnography assessments performed a clinical research unit. Children Project Viva (n = 655) adolescents the Cleveland Children's Sleep & Health Study 502). N/A. In Viva, mothers...
While Giardia duodenalis infection has been consistently associated with nutrient malabsorption and stunting in children, the effects of other protozoans on nutritional status or gastrointestinal morbidity are less clear. We sought to determine whether common intestinal including duodenalis, Entamoeba coli Blastocystis hominis was anthropometric micronutrient status, symptoms, visits doctor school absenteeism children 5–12 years age from Bogotá, Colombia. obtained stool samples 442 enrolled...
Introduction: Access to oral antivirals like nirmatrelvir/ritonavir treat COVID-19 remains largely unavailable across Africa. Ghana, Malawi, Rwanda and Zambia, all members of the COVID Treatment QuickStart Consortium, leveraged existing infrastructure rapidly commence test-and-treat programs. We describe individual-level impact within cascade care.Methods: A retrospective cohort study was conducted in 36 facilities four countries that captured data on SARS-CoV-2 positive individuals who were...
Abstract Sofosbuvir/velpatasvir/voxilaprevir is recommended for hepatitis C virus (HCV) retreatment in those who fail initial treatment but unavailable resource-limited settings. We describe a government sofosbuvir/velpatasvir + ribavirin (SOF/VEL RBV) × 24 weeks program Rwanda (November 2021–October 2022). Of 231 participants, 174 were cured (75.3% intention-to-treat analysis). SOF/VEL RBV may be considered HCV
Sub-Saharan Africa had a significant burden of infections and deaths from COVID-19. However, throughout the pandemic, region experienced delays more limited access to diagnostics treatment than high-income countries. From late 2022 2023, nirmatrelvir/ritonavir was introduced in four sub-Saharan African countries (Ghana, Malawi, Rwanda Zambia) test treat (T&T) model. This manuscript aims understand perspectives key stakeholders, Ministry Health, public sector personnel health care workers...
Punjab, India's public sector hepatitis C virus (HCV) program has initiated >60,000 patients on free-of-cost treatment. However, >10% of but did not complete To assess reasons for early HCV treatment discontinuation in India. Telephonic interviews were conducted among 475 people living with who discontinued (2018-2019) to identify primary self-reported discontinuation. Eighty-nine percent respondents male; 59% aged 18-35 years. The leading feeling better/well (24%), relocation (20%), and...
While antiretroviral therapy (ART) availability for HIV patients has increased dramatically in Uganda, patient linkage to and retention care remains a challenge. We assessed patterns of engagement 20 Ugandan health facilities with low based on national reporting.We (defined as registering pre-ART or ART at the facility within 1 month diagnosis) 6-month (having visit 3-6 months after initiation) associations patient-/facility-level factors using multivariate logistic regression.Among 928...
Abstract Background Our goal is to study the triggers of spontaneous preterm delivery using a case‐crossover design. Methods In pilot study, we enrolled 50 women with labour ( PTL ) and premature rupture membranes PPROM between 2011 2012. To assess non‐transient risk factors, also control group 158 pregnant at their regular prenatal care visits matched cases by gestational age calendar time. The index time was defined as onset / (for cases) or interview controls). Detailed data were...
Carotenoids may reduce risk of benign breast disease (BBD), an independent factor for cancer, through antioxidative or antiproliferative mechanisms. Exposure to carotenoids be most important during adolescence when tissue is still developing. We examined adolescent carotenoid intake in relation BBD young women.In 6593 girls the prospective Growing Up Today Study cohort, intakes α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, and lycopene were assessed by using means from...
To describe factors associated with mother-to-child HIV transmission (MTCT) in Kenya and identify opportunities to increase testing/care coverage.Cross-sectional analysis of national early infant diagnosis (EID) database.365,841 Kenyan infants were tested for from January 2007-July 2015 results, demographics, treatment information entered into a database. risk assessed using multivariable logistic regression.11.1% positive 2007-2010 6.9% 2014-2015. Greater odds infection observed females...
Abstract Introduction In many low‐ and middle‐income countries, HIV viral load (VL) testing occurs at centralized laboratories time‐to‐result‐delivery is lengthy, preventing timely monitoring of treatment adherence. Near point‐of‐care (POC) devices, which are placed within health facility rather than clinics themselves (i.e. “true” POC), can offer VL in conjunction with to expedite clinical decision making improve outcomes, especially for patients high risk failure. We assessed impacts...
Abstract Introduction Point‐of‐care (POC) early infant diagnosis (EID) testing has been shown to dramatically decrease turnaround times from sample collection caregiver result receipt and time ART initiation for HIV‐positive infants compared centralized laboratory testing. As governments in sub‐Saharan Africa implement POC EID technologies, we report on the feasibility effectiveness of impact same‐day delivery rapid within national programmes across six countries. Methods This...