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Article ; Online: Beta testing the monkey model.

Moore, John P / Gounder, Celine R

2021 Volume 22, Issue 10, Page(s) 1201–1203

Language	English
Publishing date	2021-09-16
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2016987-5
ISSN	1529-2916 ; 1529-2908
ISSN (online)	1529-2916
ISSN	1529-2908
DOI	10.1038/s41590-021-01033-w
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Article ; Online: A National Strategy for the "New Normal" of Life With COVID.

Emanuel, Ezekiel J / Osterholm, Michael / Gounder, Celine R

JAMA

2022 Volume 327, Issue 3, Page(s) 211–212

MeSH term(s)	COVID-19/epidemiology ; COVID-19/virology ; Data Collection ; Endemic Diseases/prevention & control ; Endemic Diseases/statistics & numerical data ; Health Workforce/organization & administration ; Hospitalization/statistics & numerical data ; Humans ; National Health Programs/organization & administration ; Pandemics ; Risk Assessment ; SARS-CoV-2 ; Trust ; United States/epidemiology
Language	English
Publishing date	2022-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2021.24282
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Article ; Online: Strategy for the "New Normal" of Life With COVID-Reply.

Emanuel, Ezekiel J / Osterholm, Michael / Gounder, Céline R

JAMA

2022 Volume 327, Issue 18, Page(s) 1824

MeSH term(s)	COVID-19/psychology ; Humans ; SARS-CoV-2 ; Social Conditions ; Social Environment ; Social Norms
Language	English
Publishing date	2022-05-10
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2022.4305
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Article ; Online: Racial and ethnic disparities in COVID-19 vaccinations in the United States during the booster rollout.

Faust, Jeremy Samuel / Renton, Benjamin / Essien, Utibe R / Gounder, Celine R / Lin, Zhenqiu / Krumholz, Harlan

medRxiv

Abstract: Background: We sought to quantify whether there were statistically significant disparities along race and ethnicity lines during the early rollout of Covid-19 vaccine booster doses in the United States. We also studied whether such disparities replicated ...

Abstract	Background: We sought to quantify whether there were statistically significant disparities along race and ethnicity lines during the early rollout of Covid-19 vaccine booster doses in the United States. We also studied whether such disparities replicated or widened disparities that had already been observed during the initial series rollout as of 2 months earlier (Janssen) or 6 months earlier (Pfizer-BioNTech or Moderna), which comprised the booster-eligible population. Methods: This cross-sectional study of US adults (ages ≥18 years) used public data from US Centers for Disease Control and Prevention. The observed shares of vaccine doses for each race and ethnicity were compared to the expected shares, predicted based upon the compositions of the booster-eligible and initial series-eligible populations. Results: As of November 16, 2021, 123.5 million US adults were eligible for a booster dose of either the Pfizer-BioNTech, Moderna, or Janssen vaccines. Of these, 21.7 million had received a booster dose, among whom race and ethnicity information was available for 18.8 million booster recipients. A statistically significant higher share of Non-Hispanic White and Non-Hispanic Multiple/Other race individuals had received a booster vaccination than projected based on the composition of the booster-eligible population. A statistically significant lower share of Hispanic, Non-Hispanic American Indian/Alaskan Native, Non-Hispanic Asian, Non-Hispanic Black, and Non-Hispanic Native Hawaiian/Other Pacific Islander individuals had received a booster vaccination than expected based on the booster-eligible population. A secondary analysis of the booster-eligible population found that some of these disparities had already occurred at the time of the initial series. However, the booster campaign widened all of those disparities and added new disparities for Non-Hispanic American Indian/Alaskan Native and Non-Hispanic Native Hawaiian/Other Pacific Islander individuals. Conclusion: Disparities in Covid-19 vaccine administration on race and ethnicity lines occurred during the initial series rollout in the US. However, these disparities were not merely replicated but widened by the early booster rollout.
Keywords	covid19
Language	English
Publishing date	2021-12-14
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2021.12.12.21267663
Database	COVID19

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Article ; Online: A diagonal approach to building primary healthcare systems in resource-limited settings: women-centred integration of HIV/AIDS, tuberculosis, malaria, MCH and NCD initiatives.

Gounder, Celine R / Chaisson, Richard E

Tropical medicine & international health : TM & IH

2012 Volume 17, Issue 12, Page(s) 1426–1431

MeSH term(s)	Child ; Child Health Services/organization & administration ; Chronic Disease/therapy ; Communicable Disease Control/organization & administration ; Delivery of Health Care, Integrated/organization & administration ; Female ; Global Health ; HIV Infections/therapy ; Humans ; Malaria/therapy ; Maternal Health Services/organization & administration ; Models, Organizational ; Primary Health Care/organization & administration ; Tuberculosis/therapy ; Women's Health
Language	English
Publishing date	2012-11-01
Publishing country	England
Document type	Editorial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1314080-2
ISSN	1365-3156 ; 1360-2276
ISSN (online)	1365-3156
ISSN	1360-2276
DOI	10.1111/j.1365-3156.2012.03100.x
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Article: Gender-related barriers and delays in accessing tuberculosis diagnostic and treatment services: a systematic review of qualitative studies.

Krishnan, Lakshmi / Akande, Tokunbo / Shankar, Anita V / McIntire, Katherine N / Gounder, Celine R / Gupta, Amita / Yang, Wei-Teng

Tuberculosis research and treatment

2014 Volume 2014, Page(s) 215059

Abstract: Background. Tuberculosis (TB) remains a significant global public health problem with known gender-related (male versus female) disparities. We reviewed the qualitative evidence (written/spoken narrative) for gender-related differences limiting TB ... ...

Abstract	Background. Tuberculosis (TB) remains a significant global public health problem with known gender-related (male versus female) disparities. We reviewed the qualitative evidence (written/spoken narrative) for gender-related differences limiting TB service access from symptom onset to treatment initiation. Methods. Following a systematic process, we searched 12 electronic databases, included qualitative studies that assessed gender differences in accessing TB diagnostic and treatment services, abstracted data, and assessed study validity. Using a modified "inductive coding" system, we synthesized emergent themes within defined barriers and delays limiting access at the individual and provider/system levels and examined gender-related differences. Results. Among 13,448 studies, 28 studies were included. All were conducted in developing countries and assessed individual-level barriers; 11 (39%) assessed provider/system-level barriers, 18 (64%) surveyed persons with suspected or diagnosed TB, and 7 (25%) exclusively surveyed randomly sampled community members or health care workers. Each barrier affected both genders but had gender-variable nature and impact reflecting sociodemographic themes. Women experienced financial and physical dependence, lower general literacy, and household stigma, whereas men faced work-related financial and physical barriers and community-based stigma. Conclusions. In developing countries, barriers limiting access to TB care have context-specific gender-related differences that can inform integrated interventions to optimize TB services.
Language	English
Publishing date	2014-05-11
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2628178-8
ISSN	2090-1518 ; 2090-150X
ISSN (online)	2090-1518
ISSN	2090-150X
DOI	10.1155/2014/215059
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Article ; Online: The ethics of testing a test: randomized trials of the health impact of diagnostic tests for infectious diseases.

Dowdy, David W / Gounder, Celine R / Corbett, Elizabeth L / Ngwira, Lucky G / Chaisson, Richard E / Merritt, Maria W

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2012 Volume 55, Issue 11, Page(s) 1522–1526

Abstract: In the last decade, many new rapid diagnostic tests for infectious diseases have been developed. In general, these new tests are developed with the intent to optimize feasibility and population health, not accuracy alone. However, unlike drugs or ... ...

Abstract	In the last decade, many new rapid diagnostic tests for infectious diseases have been developed. In general, these new tests are developed with the intent to optimize feasibility and population health, not accuracy alone. However, unlike drugs or vaccines, diagnostic tests are evaluated and licensed on the basis of accuracy, not health impact (eg, reduced morbidity or mortality). Thus, these tests are sometimes recommended or scaled up for purposes of improving population health without randomized evidence that they do so. We highlight the importance of randomized trials to evaluate the health impact of novel diagnostics and note that such trials raise distinctive ethical challenges of equipoise, equity, and informed consent. We discuss the distinction between equipoise for patient-important outcomes versus diagnostic accuracy, the equity implications of evaluating health impact of diagnostics under routine conditions, and the importance of offering reasonable choices for informed consent in diagnostic trials.
MeSH term(s)	Communicable Diseases/diagnosis ; Diagnostic Tests, Routine/ethics ; Diagnostic Tests, Routine/methods ; Ethics, Research ; Humans ; Informed Consent ; Randomized Controlled Trials as Topic/ethics ; Randomized Controlled Trials as Topic/methods ; Reproducibility of Results
Language	English
Publishing date	2012-08-23
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/cis736
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Article ; Online: Active tuberculosis case-finding among pregnant women presenting to antenatal clinics in Soweto, South Africa.

Gounder, Celine R / Wada, Nikolas I / Kensler, Caroline / Violari, Avy / McIntyre, James / Chaisson, Richard E / Martinson, Neil A

Journal of acquired immune deficiency syndromes (1999)

2011 Volume 57, Issue 4, Page(s) e77–84

Abstract: Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) are among the leading causes of death among women of reproductive age worldwide. TB is a significant cause of maternal morbidity. Detection of TB during pregnancy could provide ... ...

Abstract	Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) are among the leading causes of death among women of reproductive age worldwide. TB is a significant cause of maternal morbidity. Detection of TB during pregnancy could provide substantial benefits to women and their children. Methods: This was a cross-sectional implementation research study of integrating active TB case-finding into existing antenatal and prevention of mother-to-child transmission services in six clinics in Soweto, South Africa. All pregnant women 18 years of age or older presenting for routine care to these public clinics were screened for symptoms of active TB, cough for 2 weeks or longer, sputum production, fevers, night sweats, or weight loss, regardless of their HIV status. Participants with any symptom of active TB were asked to provide a sputum specimen for smear microscopy, mycobacterial culture and drug-susceptibility testing. Results: Between December 2008 and July 2009, 3963 pregnant women were enrolled and screened for TB, of whom 1454 (36.7%) were HIV-seropositive. Any symptom of TB was reported by 23.1% of HIV-seropositive and 13.8% of HIV-seronegative women (P < 0.01). Active pulmonary TB was diagnosed in 10 of 1454 HIV-seropositve women (688 per 100,000) and 5 of 2483 HIV-seronegative women (201 per 100,000, P = 0.03). The median CD4⁺ T-cell count among HIV-seropositive women with TB was similar to that of HIV-seropositive women without TB (352 versus 333 cells/μL, P = 0.85). Conclusions: There is a high burden of active TB among HIV-seropositive pregnant women. TB screening and provision of isoniazid preventive therapy and antiretroviral therapy should be integrated with prevention of mother-to-child transmission services.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Female ; HIV Infections/complications ; Humans ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology ; Prenatal Care ; South Africa/epidemiology ; Tuberculosis, Pulmonary/complications ; Tuberculosis, Pulmonary/epidemiology ; Young Adult
Language	English
Publishing date	2011-04-15
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0b013e31821ac9c1
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Article: Barriers and delays in tuberculosis diagnosis and treatment services: does gender matter?

Yang, Wei-Teng / Gounder, Celine R / Akande, Tokunbo / De Neve, Jan-Walter / McIntire, Katherine N / Chandrasekhar, Aditya / de Lima Pereira, Alan / Gummadi, Naveen / Samanta, Santanu / Gupta, Amita

Tuberculosis research and treatment

2014 Volume 2014, Page(s) 461935

Abstract: Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. ...

Abstract	Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.
Language	English
Publishing date	2014-04-28
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2628178-8
ISSN	2090-1518 ; 2090-150X
ISSN (online)	2090-1518
ISSN	2090-150X
DOI	10.1155/2014/461935
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Article ; Online: Undiagnosed tuberculosis among HIV clinic attendees: association with antiretroviral therapy and implications for intensified case finding, isoniazid preventive therapy, and infection control.

Kufa, Tendesayi / Mngomezulu, Victor / Charalambous, Salome / Hanifa, Yasmeen / Fielding, Katherine / Grant, Alison D / Wada, Nikolas / Chaisson, Richard E / Churchyard, Gavin J / Gounder, Celine R

Journal of acquired immune deficiency syndromes (1999)

2012 Volume 60, Issue 2, Page(s) e22–8

Abstract: Objectives: Initiation of antiretroviral therapy (ART) and the 3I's are strategies to prevent HIV-associated tuberculosis (TB). We describe factors associated with undiagnosed TB among HIV-infected patients attending an HIV clinic in South Africa and ... ...

Abstract	Objectives: Initiation of antiretroviral therapy (ART) and the 3I's are strategies to prevent HIV-associated tuberculosis (TB). We describe factors associated with undiagnosed TB among HIV-infected patients attending an HIV clinic in South Africa and discuss implications for the 3 Is. Design: Convenience sample of HIV clinic attendees. Methods: HIV-infected participants were assessed for TB using a symptom screen, sputum-smear microscopy, sputum and blood mycobacterial culture, fine needle aspiration of enlarged lymph nodes, and chest radiography. Results: Four hundred twenty-two participants were enrolled. The median age and CD4+ T-cell count were 37 years [interquartile range (IQR): 31-44 years] and 215 cells per microliter (IQR: 107-347 cells/μL). Forty-seven percent had been on ART for a median duration of 8 months (IQR: 3.3-22.8 months). Three hundred sixty-one participants (85.6%) reported TB symptoms. Twenty-seven participants (6.4%) met criteria for bacteriologically confirmed TB and 50 (11.6%) for any form of TB. Bacteriologically confirmed TB was associated with CD4+ T-cell counts ≤100 cells per microliter (odds ratio: 5.05, 95% confidence interval: 1.69 to 15.12) when compared with CD4+ T-cell counts >200 cells per microliter and hemoglobin {hemoglobin < 10 g/dL [odds ratio 3.12 (95% confidence interval: 1.26 to 7.72)]}. Conclusions: Undiagnosed TB among HIV-infected ambulatory patients was associated with low CD4+ T-cell counts regardless of ART status. TB screening algorithms which include CD4+ T-cell count and hemoglobin testing may be an effective way to identify HIV-infected clinic attendees at highest risk of undiagnosed TB. Isoniazid preventive therapy and TB infection control are essential for reducing occurrence of HIV-associated TB even after ART initiation.
MeSH term(s)	Adult ; Antiretroviral Therapy, Highly Active ; Bacteriological Techniques ; Biopsy, Fine-Needle ; Chemoprevention/methods ; Female ; HIV Infections/complications ; HIV Infections/drug therapy ; Humans ; Infection Control/methods ; Isoniazid/administration & dosage ; Latent Tuberculosis/diagnosis ; Latent Tuberculosis/epidemiology ; Lymph Nodes/microbiology ; Lymph Nodes/pathology ; Male ; Prevalence ; Radiography, Thoracic ; South Africa/epidemiology
Chemical Substances	Isoniazid (V83O1VOZ8L)
Language	English
Publishing date	2012-05-22
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0b013e318251ae0b
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