A5018745830- Antibiotic Use and Resistance
- Reproductive tract infections research
- COVID-19 epidemiological studies
- Global Maternal and Child Health
- Bacterial Identification and Susceptibility Testing
- Child Nutrition and Water Access
- Urinary Tract Infections Management
- Cervical Cancer and HPV Research
- SARS-CoV-2 and COVID-19 Research
- Influenza Virus Research Studies
- Vaccine Coverage and Hesitancy
- COVID-19 and healthcare impacts
- COVID-19 Pandemic Impacts
- COVID-19 Impact on Reproduction
- Patient Satisfaction in Healthcare
- Syphilis Diagnosis and Treatment
- Antibiotic Resistance in Bacteria
- Food Security and Health in Diverse Populations
- Assisted Reproductive Technology and Twin Pregnancy
- Gut microbiota and health
- Neonatal and Maternal Infections
- Reproductive System and Pregnancy
- Demographic Trends and Gender Preferences
- Hepatitis Viruses Studies and Epidemiology
- Antimicrobial Resistance in Staphylococcus
San Francisco Foundation
2021-2024
University of California, San Francisco
2021-2024
University of San Francisco
2022
Harvard University
2018-2021
Center for Disease Dynamics, Economics & Policy
2017-2020
It is urgent to understand the future of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) transmission. We used estimates seasonality, immunity, and cross-immunity for human coronavirus OC43 (HCoV-OC43) HCoV-HKU1 using time-series data from United States inform a model SARS-CoV-2 projected that recurrent wintertime outbreaks will probably occur after initial, most pandemic wave. Absent other interventions, key metric success social distancing whether critical care capacities are...
Estimation of the effective reproductive number Rt is important for detecting changes in disease transmission over time. During Coronavirus Disease 2019 (COVID-19) pandemic, policy makers and public health officials are using to assess effectiveness interventions inform policy. However, estimation from available data presents several challenges, with critical implications interpretation course pandemic. The purpose this document summarize these illustrate them examples synthetic data, and,...
Abstract There is an urgent need to project how transmission of the novel betacoronavirus SARS-CoV-2 will unfold in coming years. These dynamics depend on seasonality, duration immunity, and strength cross-immunity to/from other human coronaviruses. Using data from United States, we measured these factors affect betacoronaviruses HCoV-OC43 HCoV-HKU1. We then built a mathematical model simulate through year 2025. that recurrent wintertime outbreaks probably occur after initial pandemic wave....
Abstract The SARS-CoV-2 pandemic is straining healthcare resources worldwide, prompting social distancing measures to reduce transmission intensity. amount of needed curb the epidemic in context seasonally varying remains unclear. Using a mathematical model, we assessed that one-time interventions will be insufficient maintain COVID-19 prevalence within critical care capacity United States. Seasonal variation facilitate control during summer months but could lead an intense resurgence...
Bystander selection-the selective pressure for resistance exerted by antibiotics on microbes that are not the target pathogen of treatment-is critical to understanding total impact broad-spectrum antibiotic use pathogenic bacterial species often carried asymptomatically. However, our knowledge, this effect has never been quantified. We quantify bystander selection a range clinically relevant antibiotic-species pairs as proportion all exposures received conditions in which was causative...
Test-negative designs are commonplace in assessments of influenza vaccination effectiveness, estimating this value from the exposure odds ratio among individuals treated for acute respiratory illness who test positive virus infection. This approach is widely believed to recover vaccine direct effect by correcting differential health-care-seeking behavior vaccinated and unvaccinated persons. However, relationship measured true effectiveness poorly understood. We derived under circumstances...
Abstract Estimation of the effective reproductive number, R t , is important for detecting changes in disease transmission over time. During COVID-19 pandemic, policymakers and public health officials are using to assess effectiveness interventions inform policy. However, estimation from available data presents several challenges, with critical implications interpretation course pandemic. The purpose this document summarize these illustrate them examples synthetic data, and, where possible,...
Health systems are often weakened by public health emergencies that make it harder to access services. We aimed assess maternal, newborn and child (MNCH) service utilisation during the first 6 months of COVID-19 pandemic compared with prior pandemic.
Trachoma, caused by ocular Chlamydia trachomatis infection, is targeted for global elimination as a public health problem 2030. To provide evidence use of antibodies to monitor C. transmission, we collated IgG responses Pgp3 antigen, PCR positivity, and clinical observations from 19,811 children aged 1-9 years in 14 populations. We demonstrate that age-seroprevalence curves consistently shift along gradient transmission intensity: rising steeply populations with high levels infection active...
Cluster randomized trials are often used to study large-scale public health interventions. In large trials, even small improvements in statistical efficiency can have profound impacts on the required sample size and cost. Location integrates many socio-demographic environmental characteristics into a single, readily available feature. Here we show that pair matching by geographic location leads substantial gains for 14 child outcomes span growth, development, infectious disease through...
Rapid point-of-care resistance diagnostics (POC-RD) are a key tool in the fight against antibiotic resistance. By tailoring drug choice to infection genotype, doctors can improve treatment efficacy while limiting costs of inappropriate prescription. Here, we combine epidemiological theory and data assess potential (RD) innovations public health context, as means limit or even reverse selection for POC-RD be used impose nonbiological fitness cost on resistant strains by enabling...
Infections are one of the most common causes neonatal mortality, and maternal colonization has been associated with infection. In this study, we sought to quantify carriage prevalence extended-spectrum-beta-lactamase (ESBL) -producing carbapenem-resistant Enterobacterales (CRE) among pregnant women their neonates characterize risk factors for in rural Amhara, Ethiopia.
The relationship between antibiotic stewardship and population levels of resistance remains unclear. In order to better understand shifts in selective pressure due stewardship, we use publicly available data estimate the effect changes prescribing on exposures frequently used antibiotics experienced by potentially pathogenic bacteria that are asymptomatically colonizing microbiome. We quantify this impact under four hypothetical strategies. one scenario, elimination all unnecessary...
Trachoma is an infectious disease characterized by repeated exposures to Chlamydia trachomatis (Ct) that may ultimately lead blindness. Efficient identification of communities with high infection burden could help target more intensive control efforts. We hypothesized IgG seroprevalence in combination geospatial layers, machine learning, and model-based geostatistics would be able accurately predict future community-level ocular Ct infections detected PCR. used measurements from 40 the...
Abstract Trachoma, caused by ocular Chlamydia trachomatis infection, is targeted for global elimination as a public health problem 2030. To provide evidence use of antibodies to monitor C. transmission, we collated IgG responses Pgp3 antigen, PCR positivity, and clinical observations from 19,811 children aged 1– 9 years in 14 populations. We demonstrate that age-seroprevalence curves consistently shift along gradient transmission intensity: rising steeply populations with high levels...
Monitoring trachoma transmission with antibody data requires characterization of decay in IgG to Chlamydia trachomatis antigens. In a 3-year longitudinal cohort high-transmission setting, we estimated median half-life 3 years and seroreversion rate 2.5 per 100 person-years (95% confidence interval, 1.6-3.5). Clinical Trials Registration NCT02754583.
Abstract Bystander selection -- the selective pressures exerted by antibiotics on microbial flora that are not target pathogen of treatment is critical to understanding total impact broad-spectrum antibiotic use; however, our knowledge, this effect has never been quantified. Using 2010-2011 National Ambulatory Medical Care Survey and Hospital (NAMCS/NHAMCS), Human Microbiome Project, additional carriage etiological data from existing literature, we estimate magnitude bystander for a range...
ABSTRACT Test-negative designs have become commonplace in assessments of seasonal influenza vaccine effectiveness. Vaccine effectiveness is measured from the exposure odds ratio (OR) vaccination among individuals seeking treatment for acute respiratory illness and receiving a laboratory test infection. This approach widely believed to correct differential healthcare-seeking behavior vaccinated unvaccinated persons. However, relation OR true poorly understood. We derive under circumstances...
ABSTRACT Monitoring trachoma transmission with antibody data requires characterization of decay in IgG to Chlamydia trachomatis antigens. In a three-year longitudinal cohort high setting, we estimated median half-life 3 years and seroreversion rate 2.5 (95% CI: 1.6, 3.5) per 100 person-years.
Abstract Rapid point-of-care resistance diagnostics (POC-RD) are a key tool in the fight against antibiotic resistance. By tailoring drug choice to infection genotype, doctors can improve treatment efficacy while limiting costs of inappropriate prescription. Here we combine epidemiological theory and data assess potential RD innovations public health context, as means limit or even reverse selection for POC-RD be used impose non-biological fitness cost on resistant strains, by enabling...
Abstract Background Empirical antibiotic use is common in the hospital. Here, we characterize patterns of use, infectious diagnoses, and microbiological laboratory results among hospitalized patients aim to quantify proportion that potentially attributable specific bacterial pathogens. Methods We conducted an observational study using electronic health records from acute care facilities US Veterans Affairs Healthcare System. From October 2017 September 2018, 482 381 hospitalizations for 332...
Abstract Introduction Ethiopia registered its first case of COVID-19 on March 13, 2020. We aimed to assess maternal, newborn, and child health care (MNCH) utilization during the six months pandemic, as well potential barriers enablers service from providers clients. Methods Mixed study design was conducted part Birhan Health Demographic Surveillance System in Ethiopia. The trend compared corresponding time data points preceding year. Result Service new family planning visits (43.2...