A5038559170- Tuberculosis Research and Epidemiology
- Pneumocystis jirovecii pneumonia detection and treatment
- Mycobacterium research and diagnosis
- Infectious Diseases and Tuberculosis
- Diagnosis and treatment of tuberculosis
- Vaccine Coverage and Hesitancy
- COVID-19 Impact on Reproduction
- Global Maternal and Child Health
- Pneumonia and Respiratory Infections
- Hematological disorders and diagnostics
- Infective Endocarditis Diagnosis and Management
- Orthopedic Infections and Treatments
- HIV/AIDS drug development and treatment
- HIV-related health complications and treatments
- COVID-19 Clinical Research Studies
- Malaria Research and Control
- HIV/AIDS Research and Interventions
- Parasite Biology and Host Interactions
- Parasites and Host Interactions
- HIV/AIDS Impact and Responses
- Streptococcal Infections and Treatments
- Data-Driven Disease Surveillance
- Artificial Intelligence in Healthcare and Education
- Autoimmune and Inflammatory Disorders Research
- Soft tissue tumors and treatment
Massachusetts General Hospital
2016-2025
Harvard University
2013-2025
International Rescue Committee
2018-2019
International Trachoma Initiative
2015
Harvard University Press
2012
Brigham and Women's Hospital
2003-2011
Boston University
2011
Hôpital Xavier Arnozan
2008
Partners In Health
2004
Johns Hopkins Medicine
1998
Extensively drug-resistant tuberculosis has been reported in 45 countries, including countries with limited resources and a high burden of tuberculosis. We describe the management extensively treatment outcomes among patients who were referred for individualized outpatient therapy Peru.
<h3>Background</h3> In Africa, fewer than half of patients receiving therapy for multidrug-resistant TB (MDR TB) are successfully treated, with poor outcomes reported HIV-coinfected patients. <h3>Methods</h3> A standardised second-line drug (SLD) regimen was used in a non-governmental organisation–Ministry Health (NGO-MOH) collaborative community and hospital-based programme Ethiopia that included intensive side effect monitoring, adherence strategies nutritional supplementation. Clinical at...
Many people living with HIV (PLWH) have comorbidities which are risk factors for severe coronavirus disease 2019 (COVID-19) or exposures that may lead to acquisition of acute respiratory distress syndrome 2. There few studies, however, on the demographics, comorbidities, clinical presentation, outcomes COVID-19 in HIV.To evaluate factors, manifestations, and a large cohort PLWH COVID-19.We systematically identified all who were diagnosed at hospital from 3 March 26 April 2020 during an...
Multidrug-resistant tuberculosis (MDR-TB) disproportionately affects young adults, including women of childbearing age; however, treatment MDR-TB during pregnancy is still controversial. This study looks at the and outcomes in a cohort who were treated for period 10 years.A retrospective case was performed using standardized data collection form from 3 ranked sources patient records. All 38 participants with individualized regimens that included second-line TB medications. We examined...
Rationale A better understanding of the composition optimal treatment regimens for multidrug-resistant tuberculosis (MDR-TB) is essential expanding universal access to effective and developing new therapies MDR-TB. Analysis observational data may inform definition an optimized regimen. Objectives This study assessed impact aggressive regimen–one containing at least five likely drugs, including a fluoroquinolone injectable–on outcomes in large MDR-TB patient cohort. Methods was retrospective...
The study objective was to develop and validate a clinical decision support system (CDSS) guide clinicians through the diagnostic evaluation of hospitalized individuals with suspected pulmonary tuberculosis (TB) in low-prevalence settings. "TBorNotTB" CDSS developed using modified Delphi method. assigns points based on epidemiologic risk factors, TB history, symptoms, chest imaging, sputum/bronchoscopy results. Below set point threshold, airborne isolation precautions are automatically...
Abstract Background Infections from non-tuberculous mycobacteria (NTM) cause significant morbidity and mortality. NTM species are typically highly drug-resistant, requiring prolonged courses of multiple antimicrobials with toxicities side effects. Bedaquiline, a diarylquinolone approved for treatment multidrug-resistant tuberculosis, has been shown to have bacteriostatic activity against appears clinically effective in small case series. We aimed describe clinical characteristics,...
Multidrug-resistant tuberculosis (MDR-TB) is a global public health problem affecting women of childbearing age. Little known, however, about the safety drugs used to treat MDR-TB during pregnancy. We describe 7 patients who were treated for These had chronic that caused extensive parenchymal damage and high-grade resistance antituberculous drugs. All received individualized therapy prior delivery healthy term infants. Neither obstetrical complications nor perinatal transmission MDB-TB was...
Objective-We sought to determine the accuracy and role of rapid C-reactive protein (CRP) testing in HIV-infected tuberculosis suspects.Design-We enrolled adults (≥18 years) with a cough for ≥2 weeks negative sputum smears acid-fast bacilli (AFB) KwaZulu-Natal, South Africa.Participants were evaluated pulmonary by nurse CRP, independently physician chest radiograph.Rapid CRP test results compared laboratory sent confirmation tuberculosis.Results-Among 93 participants, 55 (59%) female, mean...
Multidrug-resistant tuberculosis (MDR-TB) and the human immunodeficiency virus (HIV) pose two of greatest threats to global (TB) control. Given expanding access antiretroviral therapy (ART) second-line TB drugs, more data are needed on experiences treating MDR-TB HIV co-infection in resource-poor settings.To describe clinical characteristics, management, outcomes, factors associated with survival among HIV-positive individuals receiving treatment for MDR-TB.This was a retrospective case...
Sputum cultures are an important tool in monitoring the response to tuberculosis treatment, especially multidrug-resistant tuberculosis. There has, however, been little study of effect treatment regimen composition on culture conversion. Well-designed clinical trials new anti-tuberculosis drugs require this information establish optimized background regimens for comparison. We conducted a retrospective cohort assess whether use aggressive was associated with more rapid sputum Cox...
Abstract Background For persons with suspected pulmonary tuberculosis, the guidelines of Centers for Disease Control and Prevention recommend collecting 3 respiratory specimens 8 to 24 hours apart acid-fast bacilli (AFB) smear culture, in addition 1 nucleic acid amplification test (NAAT). However, data supporting this approach are limited. Our objective was estimate performance 1, 2, or AFB smears without NAATs detect tuberculosis a low-prevalence setting. Methods We conducted retrospective...
The category II retreatment regimen for management of tuberculosis in previously treated patients was first introduced the early 1990s. It consists 8 months total therapy with addition streptomycin to standard first-line medications. A review 6500 on Georgia showed poor outcomes and high rates resistance.The National Tuberculosis Program used an evidence-based analysis national data convince policy-makers that should be eliminated from guidelines Georgia.The World Health Organization...
Although multidrug-resistant tuberculosis (MDR-TB) is a major global health problem, there gap in programmatic treatment implementation.This study describes MDR-TB models three countries--Peru, Russia and Lesotho-- using qualitative data collected over 13-year period.A program analysis presented for each country focusing on baseline medical care, initial implementation evolution. A pattern revealed six overarching themes common to all programs: 1) importance of assessments, 2) early...
Abstract Background Isolation of hospitalized persons under investigation (PUIs) for coronavirus disease 2019 (COVID-19) reduces nosocomial transmission risk. Efficient evaluation PUIs is needed to preserve scarce healthcare resources. We describe the development, implementation, and outcomes an inpatient diagnostic algorithm clinical decision support system (CDSS) evaluate PUIs. Methods conducted a pre-post study CORAL (COvid Risk cALculator), CDSS that guides frontline clinicians through...
Nontuberculous Mycobacterial InfectionsNontuberculous mycobacteria are pathogens found in the environment that can cause a variety of infections.