Digital Commons Network^™

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C. Becerra, Juan B. Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Silvia Chiang, Jerome Galea

Social Work Faculty Publications

Background: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.

Methods and findings: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Early Progression To Active Tuberculosis Is A Highly Heritable Trait Driven By 3q23 In Peruvians, Yang Luo, Sara Suliman, Samira Asagari, Tiffany Amariuta, Yuriy Baglaenko, Marta Martinez-Bonet, Kazuyoshi Ishigaki, Maria Gutierrez-Arcelus, Roger Calderon, Jerome Galea

Social Work Faculty Publications

Of the 1.8 billion people worldwide infected with Mycobacterium tuberculosis, 5–15% will develop active tuberculosis (TB). Approximately half will progress to active TB within the first 18 months after infection, presumably because they fail to mount an effective initial immune response. Here, in a genome-wide genetic study of early TB progression, we genotype 4002 active TB cases and their household contacts in Peru. We quantify genetic heritability h_g² of early TB progression to be 21.2% (standard error 0.08). This suggests TB progression has a strong genetic basis, and is comparable to traits with well-established genetic bases. We …

Whole Genome Sequencing Identifies Bacterial Factors Affecting Transmission Of Multidrug-Resistant Tuberculosis In A High-Prevalence Setting, Avika Dixit, Luca Freschi, Roger Vargas, Roger Calderon, James Sacchettini, Francis Drobniewski, Jerome Galea, Carmen Contreras, Rosa Yataco, Zibiao Zhang

Social Work Faculty Publications

Whole genome sequencing (WGS) can elucidate Mycobacterium tuberculosis (Mtb) transmission patterns but more data is needed to guide its use in high-burden settings. In a household-based TB transmissibility study in Peru, we identified a large MIRU-VNTR Mtb cluster (148 isolates) with a range of resistance phenotypes, and studied host and bacterial factors contributing to its spread. WGS was performed on 61 of the 148 isolates. We compared transmission link inference using epidemiological or genomic data and estimated the dates of emergence of the cluster and antimicrobial drug resistance (DR) acquisition events by generating a time-calibrated phylogeny. Using a set of …

Transmissibility And Potential For Disease Progression Of Drug Resistant Mycobacterium Tuberculosis: Prospective Cohort Study, Mercedes C. Becerra, Chuan-Chin Huang, Leonid Lecca, Jaime Bayona, Carmen Contreras, Roger Calderon, Rosa Yataco, Jerome Galea, Zibiao Zhang, Sidney Atwood, Ted Cohen, Carole D. Mitnick, Paul Farmer, Megan Murray

Social Work Faculty Publications

Objective: To measure the association between phenotypic drug resistance and the risk of tuberculosis infection and disease among household contacts of patients with pulmonary tuberculosis.

Setting: 106 district health centers in Lima, Peru between September 2009 and September 2012.

Design: Prospective cohort study.

Participants: 10 160 household contacts of 3339 index patients with tuberculosis were classified on the basis of the drug resistance profile of the patient: 6189 were exposed to drug susceptible strains of Mycobacterium tuberculosis, 1659 to strains resistant to isoniazid or rifampicin, and 1541 to strains that were multidrug resistant (resistant to isoniazid and rifampicin).

Main outcome …

Endure, Evolve, Achieve: Stakeholder Perspectives On The Effectiveness Of The Swamp Apes Program In Restoring Biopsychosocial Functioning Of American Veterans, Manisha Joshi, Joshua Zaris Goldman

Social Work Faculty Publications

A growing body of evidence highlights the benefits of recreational outdoor therapy for veterans experiencing posttraumatic stress disorder. We employed the Hawkins Model for “Nature as Strengths-based Recreational Therapy Intervention for Military Members” to assess the Swamp Apes/Volunteer Wilderness Alliance (SA/VWA) in South Florida, which has among its key objectives ridding the Everglades National Park of invasive species (e.g., Burmese python). Focus group and interviews with 10 veterans and seven non-veterans (i.e., family, health providers) were conducted to assess benefits, risks, and potential for developing SA/VWA activities into a formal therapy program for veterans rooted in the American Therapeutic Recreation …

Understanding Health-Related Behavior Among Adolescents Living With Hiv In Lima, Peru, Carly A. Rodriguez, Emiliano Valle, Jerome Galea, Milagros Wong, Lenka Kolevic, Maribel Muñoz, Leonid Lecca, Molly F. Franke

Social Work Faculty Publications

Background: The global HIV burden among adolescents ages 10–19 is growing. This population concurrently confronts the multifaceted challenges of adolescence and living with HIV. With the goal of informing future interventions tailored to this group, we assessed sexual activity, HIV diagnosis disclosure, combination antiretroviral therapy (cART) adherence, and drug use among adolescents living with HIV (ALHIV) in Lima, Peru.

Methods: Adolescents at risk or with a history of suboptimal cART adherence completed a self-administered, health behaviors survey and participated in support group sessions, which were audio recorded and used as a qualitative data source. Additionally, we conducted in-depth interviews with …