A5057442418- Respiratory viral infections research
- Pneumonia and Respiratory Infections
- Influenza Virus Research Studies
- Antibiotic Use and Resistance
- SARS-CoV-2 and COVID-19 Research
- COVID-19 Clinical Research Studies
- Viral gastroenteritis research and epidemiology
- Kawasaki Disease and Coronary Complications
- vaccines and immunoinformatics approaches
- Emergency and Acute Care Studies
- Long-Term Effects of COVID-19
- HIV/AIDS Research and Interventions
- Pediatric health and respiratory diseases
- SARS-CoV-2 detection and testing
- COVID-19 epidemiological studies
- COVID-19 and Mental Health
- Child and Adolescent Health
- Immunotherapy and Immune Responses
- Streptococcal Infections and Treatments
- Vaccine Coverage and Hesitancy
- COVID-19 Impact on Reproduction
- Bacterial Infections and Vaccines
- Sepsis Diagnosis and Treatment
- Neonatal and Maternal Infections
- Adolescent Sexual and Reproductive Health
Vanderbilt University Medical Center
2016-2025
Vanderbilt University
2013-2024
Office of Infectious Diseases
2022-2024
Tulane University
2023
Ministero della Salute
2023
University of Pittsburgh
2016-2019
Instituto de Investigación Nutricional
2019
Emory University
2019
Vanderbilt Health
2015-2017
Monroe Carell Jr. Children's Hospital
2015
Little is known about the epidemiology and outcomes of neurologic complications associated with coronavirus disease 2019 (COVID-19) in children.We performed a cross-sectional study children 2 months to <18 years age COVID-19 discharged from 52 children's hospitals March 2020 2022. Neurologic were defined as encephalopathy, encephalitis, aseptic meningitis, febrile seizure, nonfebrile brain abscess bacterial Reye's syndrome, cerebral infarction. We assessed length stay (LOS), ICU...
Systems biology is an approach to comprehensively study complex interactions within a biological system. Most published systems vaccinology studies have utilized whole blood or peripheral mononuclear cells (PBMC) monitor the immune response after vaccination. Because human comprised of multiple hematopoietic cell types, potential for masking responses under-represented populations increased when analyzing PBMC. To investigate contribution individual types vaccination, we established rapid...
Vaccine development for influenza A/H5N1 is an important public health priority, but H5N1 vaccines are less immunogenic than seasonal vaccines. Adjuvant System 03 (AS03) markedly enhances immune responses to vaccine antigens, the underlying molecular mechanisms incompletely understood.We compared safety (primary endpoint), immunogenicity (secondary), gene expression (tertiary) and cytokine (exploratory) between AS03-adjuvanted unadjuvanted inactivated split-virus In a double-blinded clinical...
We examined nasopharyngeal pneumococcal colonization density patterns surrounding acute respiratory illnesses (ARI) in young children Peru. Pneumococcal densities were dynamic, gradually increasing leading up to an ARI, peaking during the and decreasing after ARI. Rhinovirus co-infection was associated with higher densities.
Abstract Background The spectrum of illness and predictors severity among children with SARS-CoV-2 infection are incompletely understood. Methods Active surveillance was performed for by polymerase chain reaction symptomatic pediatric patients in a quaternary care academic hospital laboratory beginning March 12, 2020. We obtained sociodemographic clinical data 5 (+/-3) 30 days after diagnosis via phone follow-up medical record review. Logistic regression used to assess hospitalization....
Abstract Diarrheal disease, still a major cause of childhood illness, is caused by numerous, diverse infectious microorganisms, which are differentially sensitive to environmental conditions. Enteropathogen‐specific impacts climate remain underexplored. Results from 15 studies that diagnosed enteropathogens in 64,788 stool samples 20,760 children 19 countries were combined. Infection status for 10 common enteropathogens—adenovirus, astrovirus, norovirus, rotavirus, sapovirus, Campylobacter ,...
Increased nasopharyngeal pneumococcal (Streptococcus pneumoniae) colonization density has been associated with invasive disease, but factors that increase are poorly understood. We evaluated densities in samples from asymptomatic young children Peru and their association subsequent acute respiratory illness (ARI). Total (encompassing all present serotypes) during periods were significantly higher when a virus was detected versus no (p<0.001). In adjusted analyses, increased the risk for ARI...
Abstract Background Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections in young children worldwide. With the recent wave regulatory approvals and authorizations for nirsevimab maternal RSV vaccines across several countries, understanding current burden seasonality crucial implementing effective preventive strategies globally. We aimed to determine burden, seasonality, co-detections hospitalized &lt; 2 years old Amman, Jordan.Figure 1.Monthly proportion...
ABSTRACT Inappropriate antibiotic use drives antimicrobial resistance, a global health threat causing increased morbidity and mortality. Understanding practices in low-resource settings is essential to identify intervention targets. This study investigates prescription Amman, Jordan. We conducted three prospective viral surveillance studies at the largest public hospital Jordan (2010–2013, 2020, 2023) included children <2 years old hospitalized with fever or respiratory symptoms. The data...
Abstract Background Peru implemented restrictive social distancing policies during the COVID-19 pandemic. Few studies have examined patterns of nasopharyngeal pneumococcal carriage and related antimicrobial resistant genes (ARGs), particularly in community-based settings with intense policies. Methods Nasopharyngeal swabs were systematically obtained weekly from children adults enrolled two household-based prospective pre-pandemic (2019-2020) pandemic (2020-2021) cohorts Lima, Peru. Selected...
The role of health literacy on HIV outcomes has not been evaluated widely in Africa, part because few appropriate measures exist. We developed a 16-item scale, the Literacy Test (HIV-LT) to assess literacy-related tasks needed participate care. Items were scored as correct or incorrect; higher scores indicated skill (range 0–100 %). tested internal reliability (Kuder–Richardson coefficient) HIV-LT convenience sample 319 Portuguese-speaking, infected adults antiretroviral treatment Maputo,...
Abstract Background. Human rhinoviruses (HRVs) are frequently detected in children with acute respiratory illnesses (ARIs) but also asymptomatic children. We compared features of ARI HRV species (A, B, C) and determined genotypes associated repeated detections within individuals. Methods. used clinical data samples obtained from &lt;3 years old during weekly active household-based surveillance. A random subset which was individuals both an period 120 days the were genotyped. Features...
Human metapneumovirus (HMPV) is a leading cause of respiratory tract infections. Few studies have compared the clinical characteristics and severity HMPV-associated pneumonia with other pathogens.Active, population-based surveillance was previously conducted for radiographically confirmed, community-acquired hospitalizations among children adults in 8 United States hospitals. Clinical data specimens pathogen detection were systematically collected. We described features all and, after...
Parainfluenza virus (PIV) is a leading cause of lower respiratory tract infections. Although there are several distinct PIV serotypes, few studies have compared the clinical characteristics and severity infection among individual serotypes between other pathogens in patients with community-acquired pneumonia.We conducted active population-based surveillance for radiographically confirmed pneumonia hospitalizations children adults 8 US hospitals systematic collection data respiratory, blood,...
Viruses are commonly detected in children with acute respiratory illnesses (ARIs) and asymptomatic children. Longitudinal studies of viral detections during periods surrounding ARI could facilitate interpretation but currently scant.We used reverse transcription polymerase chain reaction to analyze samples from young Andean for viruses within 8-120 days index (cough or fever). We compared over time explored cycle thresholds (CTs) as surrogates loads.At least 1 virus was 367 (43%) 859...
Little is known about adult caregivers' ability to accurately dose pediatric antiretroviral medications. We aimed characterize the frequency of dosing errors for liquid zidovudine using two devices and evaluate association between HIV literacy in adults living with infection.Cross-sectional study enrolling 316 receiving combination therapy (cART) infection Maputo Province, Mozambique.Participants were administered Literacy Test (HIV-LT) asked measure 2.5 ml both a cup syringe. Dosing...
Adjuvant System 03 (AS03) markedly enhances responses to influenza A/H5N1 vaccines, but the mechanisms of this enhancement are incompletely understood. Using ribonucleic acid sequencing on peripheral blood mononuclear cells (PBMCs) from AS03-adjuvanted and unadjuvanted inactivated H5N1 vaccine recipients, we identified differentially expressed genes, enriched pathways, genes that correlated with serologic responses. We compared bulk PBMC findings our previously published assessments...
Patient complexity at US children's hospitals is increasing. Hospitals experience concurrent pressure to reduce length of stay (LOS) and readmissions, yet little known about how these common measures resource use quality have changed over time. Our aim was examine temporal trends in medical complexity, hospital LOS, readmissions across a sample hospitals.Retrospective cohort study hospitalized patients from 42 the Pediatric Health Information System 2013 2017. After excluding deaths, healthy...
Abstract Background Multisystem inflammatory syndrome in children (MIS‐C) is a rare but serious complication of severe acute respiratory coronavirus 2 infection. Features MIS‐C overlap with those Kawasaki disease (KD). Objective The study objective was to develop prediction model assist this diagnostic dilemma. Methods Data from retrospective cohort hospitalized KD before the 2019 pandemic were compared prospective MIS‐C. A bootstrapped backwards selection process used logistic regression...
We detected human metapneumovirus (HMPV) in 54 (5%) of 1055 children aged 5 to 13 years with acute respiratory illness (ARI) identified by outpatient and emergency department surveillance between November May 2003–2009. Its clinical features were similar those HMPV-negative ARI, except a diagnosis pneumonia was more likely (13% vs 4%, respectively; P = .005) pharyngitis (7% 24%, less patients HMPV- positive ARI than ARI.
Indoor smoke exposure is common in developing countries and may influence nasopharyngeal (NP) pneumococcal colonization density risk of acute respiratory illness. We compared among Andean children living households previously enrolled a randomized controlled trial home intervention package including improved stoves to reduce smoke, kitchen sinks, water disinfection. 260 aged <3 years made weekly household visits assess for illness (ARI) collect nasal swabs virus polymerase chain reaction...