Trini Mathew - Academia.edu (original) (raw)

Papers by Trini Mathew

Research paper thumbnail of COVID-19 Vaccination Concerns and Reasons for Acceptance Among US Health Care Personnel

Public Health Reports

Objectives: Because health care personnel (HCP) are potentially at increased risk of contracting ... more Objectives: Because health care personnel (HCP) are potentially at increased risk of contracting COVID-19, high vaccination rates in this population are essential. The objective of this study was to assess vaccination status, barriers to vaccination, reasons for vaccine acceptance, and concerns about COVID-19 vaccination among HCP. Methods: We conducted an anonymous online survey at a large US health care system from April 9 through May 4, 2021, to assess COVID-19 vaccination status and endorsement of reasons for acceptance and concerns related to vaccination (based on selections from a provided list). Results: A total of 4603 HCP (12.2% response rate) completed the survey, 3947 (85.7%) had received at least 1 dose of a COVID-19 vaccine at the time of the survey, and 550 (11.9%) reported no plans to receive the vaccine. Unvaccinated HCP were 30 times more likely than vaccinated HCP to endorse religious or personal beliefs as a vaccine concern (odds ratio = 30.95; 95% CI, 21.06-45.48...

Research paper thumbnail of Corrigendum to: Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) Communities and the Coronavirus Disease 2019 Pandemic: A Call to Break the Cycle of Structural Barriers

The Journal of Infectious Diseases, 2021

Research paper thumbnail of Causes of Mortality during Tuberculosis Treatment in Tomsk, Russia

Research paper thumbnail of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) Communities and the Coronavirus Disease 2019 Pandemic: A Call to Break the Cycle of Structural Barriers

The Journal of Infectious Diseases, 2021

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted lesbian, gay, bi... more The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities. Many disparities mirror those of the human immunodeficiency virus (HIV)/AIDS epidemic. These health inequities have repeated throughout history due to the structural oppression of LGBTQ+ people. We aim to demonstrate that the familiar patterns of LGBTQ+ health disparities reflect a perpetuating, deeply rooted cycle of injustice imposed on LGBTQ+ people. Here, we contextualize COVID-19 inequities through the history of the HIV/AIDS crisis, describe manifestations of LGBTQ+ structural oppression exacerbated by the pandemic, and provide recommendations for medical professionals and institutions seeking to reduce health inequities.

Research paper thumbnail of A guide to implementing COVID-19 vaccine as a condition of employment in healthcare facilities

Infection Control & Hospital Epidemiology, 2021

Research paper thumbnail of Racial Disparity of Coronavirus Disease 2019 in African American Communities

The Journal of Infectious Diseases, 2020

The coronavirus disease 2019 (COVID-19) pandemic has unveiled unsettling disparities in the outco... more The coronavirus disease 2019 (COVID-19) pandemic has unveiled unsettling disparities in the outcome of the disease among African Americans. These disparities are not new but are rooted in structural inequities that must be addressed to adequately care for communities of color. We describe the historical context of these structural inequities, their impact on the progression of COVID-19 in the African American (black) community, and suggest a multifaceted approach to addressing these healthcare disparities. (Of note, terminology from survey data cited for this article varied from blacks, African Americans, or both; for consistency, we use African Americans throughout.)

Research paper thumbnail of Multisociety statement on coronavirus disease 2019 (COVID-19) vaccination as a condition of employment for healthcare personnel

Infection Control & Hospital Epidemiology, 2021

This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Soc... more This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Society for Post-Acute and Long-Term Care Medicine (AMDA), the Association for Professionals in Epidemiology and Infection Control (APIC), the HIV Medicine Association (HIVMA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) recommends that coronavirus disease 2019 (COVID-19) vaccination should be a condition of employment for all healthcare personnel in facilities in the United States. Exemptions from this policy apply to those with medical contraindications to all COVID-19 vaccines available in the United States and other exemptions as specified by federal or state law. The consensus statement also supports COVID-19 vaccination of nonemployees functioning at a healthcare facility (eg, students, contract workers, volunteers, etc).

Research paper thumbnail of COVID-19 Pandemic: Disparate Health Impact on the Hispanic/Latinx Population in the United States

The Journal of Infectious Diseases, 2020

In December 2019, a novel coronavirus known as SARS-CoV-2, emerged in Wuhan, China, causing the c... more In December 2019, a novel coronavirus known as SARS-CoV-2, emerged in Wuhan, China, causing the coronavirus disease 2019 we now refer to as COVID-19. The World Health Organization declared COVID-19 a pandemic on 12 March 2020. In the United States, the COVID-19 pandemic has exposed preexisting social and health disparities among several historically vulnerable populations, with stark differences in the proportion of minority individuals diagnosed with and dying from COVID-19. In this article we will describe the emerging disproportionate impact of COVID-19 on the Hispanic/Latinx (henceforth: Hispanic or Latinx) community in the United States, discuss potential antecedents, and consider strategies to address the disparate impact of COVID-19 on this population.

Research paper thumbnail of 458. Molecular SARS-CoV-2 Testing During the COVID-19 Outbreak: Experiences of a Hospital in Southeast Michigan, USA

Open Forum Infectious Diseases, 2020

Background The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of di... more Background The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of diagnostic testing kits. In early March 2020, leadership at Beaumont Hospital, Royal Oak Michigan (Beaumont) identified the need to develop high capacity testing modalities with appropriate sensitivity and specificity and rapid turnaround time. We describe the molecular diagnostic testing experience since initial rollout on March 16, 2020 at Beaumont, and results of repeat testing during the peak of the COVID-19 pandemic in MI. Methods Beaumont is an 1100 bed hospital in Southeast MI. In March, testing was initially performed with the EUA Luminex NxTAG CoV Extended Panel until March 28, 2020 when testing was converted to the EUA Cepheid Xpert Xpress SARS-CoV-2 for quicker turnaround times. Each assay was validated with a combination of patient samples and contrived specimens. Results During the initial week of testing there was > 20 % specimen positivity. As the prevalence grew the posi...

Research paper thumbnail of 960. Implementation and Evaluation of Alcohol Screening Tool in HIV Patients

Open Forum Infectious Diseases, 2020

Background In November 2018, the US Preventative Service Task Force (USPSTF) advised screening fo... more Background In November 2018, the US Preventative Service Task Force (USPSTF) advised screening for Alcohol Use Disorder (AUD) in primary care settings for all adults. Given the consequences of AUD for immunocompromised patients, this recommendation was implemented using the Alcohol Use Disorders Identification Test (AUDIT) for patients with Human Immunodeficiency Virus (HIV) at Beaumont Hospital in Royal Oak, Michigan. This is a medical-student led, retrospective study to determine the impact of AUD in HIV patients that were screened using the AUDIT self-administered questionnaire. Methods All HIV patients undergoing outpatient care at the Beaumont Hospital HIV clinic were provided this self-administered AUDIT questionnaire as part of routine, check-in procedure by clinic staff starting on February 5, 2019. Scores were divided into “At Risk” or “Not At Risk” categories. Men (aged 18-60) screened positive for at-risk drinking if they scored 8 or higher. Men (older than 60) and women ...

Research paper thumbnail of Policy statement from the Society for Healthcare Epidemiology of America (SHEA): Only medical contraindications should be accepted as a reason for not receiving all routine immunizations as recommended by the Centers for Disease Control and Prevention

Infection Control & Hospital Epidemiology, 2020

SummarySHEA endorses adhering to the recommendations by the CDC and ACIP for immunizations of all... more SummarySHEA endorses adhering to the recommendations by the CDC and ACIP for immunizations of all children and adults. All persons providing clinical care should be familiar with these recommendations and should routinely assess immunization compliance of their patients and strongly recommend all routine immunizations to patients. All healthcare personnel (HCP) should be immunized against vaccine-preventable diseases as recommended by the CDC/ACIP (unless immunity is demonstrated by another recommended method). SHEA endorses the policy that immunization should be a condition of employment or functioning (students, contract workers, volunteers, etc) at a healthcare facility. Only recognized medical contraindications should be accepted for not receiving recommended immunizations.

Research paper thumbnail of Location Matters: Geographic Disparities and Impact of Coronavirus Disease 2019

The Journal of Infectious Diseases, 2020

The coronavirus disease 2019 (COVID-19) pandemic in the United States has revealed major disparit... more The coronavirus disease 2019 (COVID-19) pandemic in the United States has revealed major disparities in the access to testing and messaging about the pandemic based on the geographic location of individuals, particularly in communities of color, rural areas, and areas of low income. This geographic disparity, in addition to deeply rooted structural inequities, have posed additional challenges to adequately diagnose and provide care for individuals of all ages living in these settings. We describe the impact that COVID-19 has had on geographically disparate populations in the United States and share our recommendations on what might be done to ameliorate the current situation.

Research paper thumbnail of 1653. Strong Partnership and Effective Communication Between a Tertiary Hospital and a County Health Department Were Critical in Controlling a 2019 Measles Outbreak in Southeast Michigan (SEM)

Open Forum Infectious Diseases, 2019

Background Measles, declared eliminated in the US 2000, is a reemerging vaccine-preventable airbo... more Background Measles, declared eliminated in the US 2000, is a reemerging vaccine-preventable airborne disease. The 2019 case count (704 as of April 30, 2019) has surpassed the number of 2014 cases (667), the highest since 1994. Many healthcare personnel (HCP) have not seen a case of measles, and this lack of clinical experience may contribute to missed or delayed diagnoses leading to its spread. We describe the processes and measures implemented at Beaumont Hospital, Royal Oak (B-RO) Michigan in collaboration with the Oakland County Health Department (OCHD) to prevent secondary spread during an outbreak. Methods Soon after the initial report of the index case in Oakland County in March, the B-RO epidemiology team connected with OCHD. As both exposed and suspected cases were expected to seek care at B-RO, a one-page informational document was sent to B-RO providers. This document detailed isolation precautions and testing methods, post-exposure prophylaxis (PEP), and contact informati...

Research paper thumbnail of Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019

MMWR. Morbidity and Mortality Weekly Report, 2019

Research paper thumbnail of Alcohol Consumption among Men and Women with Tuberculosis in Tomsk, Russia

Central European Journal of Public Health, 2010

Drinking behavior among Russian women remains poorly described. We analyzed gender differences in... more Drinking behavior among Russian women remains poorly described. We analyzed gender differences in alcohol use among 374 tuberculosis patients in Tomsk, Siberia. Twenty-six (28.3%) women had lifetime alcohol abuse or dependence, compared with 70.6% of men. Women with alcohol use disorders drank 12.7±14.0 standard drinks per day and 34.6% drank  three days per week. Among individuals with a lifetime alcohol use disorder, age of onset and typical consumption did not differ significantly by gender. We conclude that Russian women with alcohol use disorders consume almost as much alcohol as men and may be at greater risk for negative social and medical consequences.

Research paper thumbnail of Tuberculosis Control in Acute Disaster Settings: Case Studies from the 2010 Haiti Earthquake

Disaster Medicine and Public Health Preparedness, 2013

The articles mentioned above (first published online March, April 2013) were originally published... more The articles mentioned above (first published online March, April 2013) were originally published with incorrect article headings. The correct headings are as follows: > 'Tuberculosis Control in Acute Disaster Settings: Case Studies from the 2010 Haiti Earthquake' by Furin, et al. is a From the Field. > 'Trauma Signature Analysis of the Great East Japan Disaster: Guidance for Psychological Consequences' by Shultz, et al. is a Special Focus. > 'Self-Immunization with Live Attenuated Influenza Vaccine in a Mass Vaccination Clinic' by Zhan, et al. is a Commentary.

Research paper thumbnail of Performance of the Alcohol Use Disorders Identification Test Among Tuberculosis Patients in Russia

Substance Use & Misuse, 2010

The Alcohol Use Disorders Identification Test (AUDIT), a screening instrument to identify individ... more The Alcohol Use Disorders Identification Test (AUDIT), a screening instrument to identify individuals at risk of alcohol use problems, has not been validated in a Russian primary care population. We assessed the reliability, factor structure, sensitivity and specificity of AUDIT scores among 254 subjects initiating tuberculosis treatment from 2005-2007 in Tomsk City. Our findings support the use of the AUDIT as a screening instrument among Russian individuals seeking primary care. We discuss implications, limitations and future research. BACKGROUND Tuberculosis (TB) rates increased dramatically after the disintegration of Soviet Union and continues to be a critical public health issue in present day Russia (Shilova and Dye 2001).

Research paper thumbnail of Integration of alcohol use disorders identification and management in the tuberculosis programme in Tomsk Oblast, Russia

The European Journal of Public Health, 2008

Alcohol use disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence an... more Alcohol use disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. We developed a multidisciplinary model to manage AUDs among TB patients in Tomsk, Russia. First, we assessed current standards of care through stakeholder meetings and ethnographic work. The Alcohol Use Disorders Identification Test (AUDIT) was incorporated into routine assessment of all patients starting TB treatment. We established treatment algorithms based on AUDIT scores. We then hired specialists and addressed licensing requirements to provide on-site addictions care. Our experience offers a successful model in the management of co-occurring AUDs among patients with chronic medical problems.

Research paper thumbnail of Knowledge, Attitudes, and Practices of Physicians in Tomsk Oblast Tuberculosis Services Regarding Alcohol Use Among Tuberculosis Patients in Tomsk, Russia

Culture, Medicine, and Psychiatry, 2009

In recent years, the Russian Federation has seen a dramatic rise in morbidity and mortality from ... more In recent years, the Russian Federation has seen a dramatic rise in morbidity and mortality from tuberculosis (TB), attributed in part to an increase in alcohol use disorders (AUDs), which are associated with worse TB treatment outcomes. This study describes the knowledge, attitudes and practices of physicians who treat TB patients in Tomsk, Russia. We conducted semi-structured interviews with 16 TB physicians and one addiction specialist. Interviews were audio-recorded, transcribed, translated, and systematically analyzed. We identified four key domains: definitions of alcohol use and abuse, and physicians' knowledge, attitudes, and practices regarding these problems. Physicians described patients as largely pre-contemplative and reluctant in seeking treatment. Physicians recognized their limited knowledge in diagnosing and treating AUDs but expressed interest in acquiring these skills. Few options are currently available for treatment of AUDs in TB patients in Tomsk, Russia. These findings suggest that Tomsk physicians are aware of the need to engage AUDs in TB patients but identify a knowledge gap that restricts their ability to do so. Training TB physicians to use simple screening instruments and deliver evidence-based alcohol interventions improve TB outcomes among patients with co-occurring AUDs.

Research paper thumbnail of Integrated Management of Physician-delivered Alcohol Care for Tuberculosis Patients: Design and Implementation

Alcoholism: Clinical and Experimental Research, 2010

Background-While the integration of alcohol screening, treatment and referral in primary care and... more Background-While the integration of alcohol screening, treatment and referral in primary care and other medical settings in the U.S. and worldwide has been recognized as a key health care priority, it is not routinely done. In spite of the high co-occurrence and excess mortality associated with alcohol use disorders (AUDs) among individuals with tuberculosis (TB), there are no studies evaluating effectiveness of integrating alcohol care into routine treatment for this disorder. Methods-We designed and implemented a randomized controlled trial (RCT) to determine the effectiveness of integrating pharmacotherapy and behavioral treatments for AUDs into routine medical care for TB in the Tomsk Oblast Tuberculosis Service (TOTBS) in Tomsk, Russia. Eligible patients are diagnosed with alcohol abuse or dependence, are newly diagnosed with TB and initiating treatment in the TOTBS with Directly Observed Therapy-Short Course (DOTS) for TB. Utilizing a factorial design, the Integrated Management of Physician-delivered Alcohol Care for Tuberculosis Patients (IMPACT) study randomizes eligible patients who sign informed consent into one of four study arms: (1) Oral Naltrexone + Brief Behavioral Compliance Enhancement Therapy (BBCET) + treatment as usual (TAU), (2) Brief Counseling Intervention (BCI) + TAU, (3) Naltrexone + BBCET + BCI + TAU, or (4) TAU alone. Results-Utilizing an iterative, collaborative approach, a multidisciplinary U.S. and Russian team has implemented a model of alcohol management that is culturally appropriate to the patient and TB physician community in Russia. Implementation to date has achieved the integration of routine alcohol screening into TB care in Tomsk; an ethnographic assessment of knowledge, attitudes and practices of AUD management among TB physicians in Tomsk; translation and cultural adaptation of the BCI to Russia and the TB setting; and training and certification of TB physicians to deliver

Research paper thumbnail of COVID-19 Vaccination Concerns and Reasons for Acceptance Among US Health Care Personnel

Public Health Reports

Objectives: Because health care personnel (HCP) are potentially at increased risk of contracting ... more Objectives: Because health care personnel (HCP) are potentially at increased risk of contracting COVID-19, high vaccination rates in this population are essential. The objective of this study was to assess vaccination status, barriers to vaccination, reasons for vaccine acceptance, and concerns about COVID-19 vaccination among HCP. Methods: We conducted an anonymous online survey at a large US health care system from April 9 through May 4, 2021, to assess COVID-19 vaccination status and endorsement of reasons for acceptance and concerns related to vaccination (based on selections from a provided list). Results: A total of 4603 HCP (12.2% response rate) completed the survey, 3947 (85.7%) had received at least 1 dose of a COVID-19 vaccine at the time of the survey, and 550 (11.9%) reported no plans to receive the vaccine. Unvaccinated HCP were 30 times more likely than vaccinated HCP to endorse religious or personal beliefs as a vaccine concern (odds ratio = 30.95; 95% CI, 21.06-45.48...

Research paper thumbnail of Corrigendum to: Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) Communities and the Coronavirus Disease 2019 Pandemic: A Call to Break the Cycle of Structural Barriers

The Journal of Infectious Diseases, 2021

Research paper thumbnail of Causes of Mortality during Tuberculosis Treatment in Tomsk, Russia

Research paper thumbnail of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) Communities and the Coronavirus Disease 2019 Pandemic: A Call to Break the Cycle of Structural Barriers

The Journal of Infectious Diseases, 2021

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted lesbian, gay, bi... more The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities. Many disparities mirror those of the human immunodeficiency virus (HIV)/AIDS epidemic. These health inequities have repeated throughout history due to the structural oppression of LGBTQ+ people. We aim to demonstrate that the familiar patterns of LGBTQ+ health disparities reflect a perpetuating, deeply rooted cycle of injustice imposed on LGBTQ+ people. Here, we contextualize COVID-19 inequities through the history of the HIV/AIDS crisis, describe manifestations of LGBTQ+ structural oppression exacerbated by the pandemic, and provide recommendations for medical professionals and institutions seeking to reduce health inequities.

Research paper thumbnail of A guide to implementing COVID-19 vaccine as a condition of employment in healthcare facilities

Infection Control & Hospital Epidemiology, 2021

Research paper thumbnail of Racial Disparity of Coronavirus Disease 2019 in African American Communities

The Journal of Infectious Diseases, 2020

The coronavirus disease 2019 (COVID-19) pandemic has unveiled unsettling disparities in the outco... more The coronavirus disease 2019 (COVID-19) pandemic has unveiled unsettling disparities in the outcome of the disease among African Americans. These disparities are not new but are rooted in structural inequities that must be addressed to adequately care for communities of color. We describe the historical context of these structural inequities, their impact on the progression of COVID-19 in the African American (black) community, and suggest a multifaceted approach to addressing these healthcare disparities. (Of note, terminology from survey data cited for this article varied from blacks, African Americans, or both; for consistency, we use African Americans throughout.)

Research paper thumbnail of Multisociety statement on coronavirus disease 2019 (COVID-19) vaccination as a condition of employment for healthcare personnel

Infection Control & Hospital Epidemiology, 2021

This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Soc... more This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Society for Post-Acute and Long-Term Care Medicine (AMDA), the Association for Professionals in Epidemiology and Infection Control (APIC), the HIV Medicine Association (HIVMA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) recommends that coronavirus disease 2019 (COVID-19) vaccination should be a condition of employment for all healthcare personnel in facilities in the United States. Exemptions from this policy apply to those with medical contraindications to all COVID-19 vaccines available in the United States and other exemptions as specified by federal or state law. The consensus statement also supports COVID-19 vaccination of nonemployees functioning at a healthcare facility (eg, students, contract workers, volunteers, etc).

Research paper thumbnail of COVID-19 Pandemic: Disparate Health Impact on the Hispanic/Latinx Population in the United States

The Journal of Infectious Diseases, 2020

In December 2019, a novel coronavirus known as SARS-CoV-2, emerged in Wuhan, China, causing the c... more In December 2019, a novel coronavirus known as SARS-CoV-2, emerged in Wuhan, China, causing the coronavirus disease 2019 we now refer to as COVID-19. The World Health Organization declared COVID-19 a pandemic on 12 March 2020. In the United States, the COVID-19 pandemic has exposed preexisting social and health disparities among several historically vulnerable populations, with stark differences in the proportion of minority individuals diagnosed with and dying from COVID-19. In this article we will describe the emerging disproportionate impact of COVID-19 on the Hispanic/Latinx (henceforth: Hispanic or Latinx) community in the United States, discuss potential antecedents, and consider strategies to address the disparate impact of COVID-19 on this population.

Research paper thumbnail of 458. Molecular SARS-CoV-2 Testing During the COVID-19 Outbreak: Experiences of a Hospital in Southeast Michigan, USA

Open Forum Infectious Diseases, 2020

Background The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of di... more Background The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of diagnostic testing kits. In early March 2020, leadership at Beaumont Hospital, Royal Oak Michigan (Beaumont) identified the need to develop high capacity testing modalities with appropriate sensitivity and specificity and rapid turnaround time. We describe the molecular diagnostic testing experience since initial rollout on March 16, 2020 at Beaumont, and results of repeat testing during the peak of the COVID-19 pandemic in MI. Methods Beaumont is an 1100 bed hospital in Southeast MI. In March, testing was initially performed with the EUA Luminex NxTAG CoV Extended Panel until March 28, 2020 when testing was converted to the EUA Cepheid Xpert Xpress SARS-CoV-2 for quicker turnaround times. Each assay was validated with a combination of patient samples and contrived specimens. Results During the initial week of testing there was > 20 % specimen positivity. As the prevalence grew the posi...

Research paper thumbnail of 960. Implementation and Evaluation of Alcohol Screening Tool in HIV Patients

Open Forum Infectious Diseases, 2020

Background In November 2018, the US Preventative Service Task Force (USPSTF) advised screening fo... more Background In November 2018, the US Preventative Service Task Force (USPSTF) advised screening for Alcohol Use Disorder (AUD) in primary care settings for all adults. Given the consequences of AUD for immunocompromised patients, this recommendation was implemented using the Alcohol Use Disorders Identification Test (AUDIT) for patients with Human Immunodeficiency Virus (HIV) at Beaumont Hospital in Royal Oak, Michigan. This is a medical-student led, retrospective study to determine the impact of AUD in HIV patients that were screened using the AUDIT self-administered questionnaire. Methods All HIV patients undergoing outpatient care at the Beaumont Hospital HIV clinic were provided this self-administered AUDIT questionnaire as part of routine, check-in procedure by clinic staff starting on February 5, 2019. Scores were divided into “At Risk” or “Not At Risk” categories. Men (aged 18-60) screened positive for at-risk drinking if they scored 8 or higher. Men (older than 60) and women ...

Research paper thumbnail of Policy statement from the Society for Healthcare Epidemiology of America (SHEA): Only medical contraindications should be accepted as a reason for not receiving all routine immunizations as recommended by the Centers for Disease Control and Prevention

Infection Control & Hospital Epidemiology, 2020

SummarySHEA endorses adhering to the recommendations by the CDC and ACIP for immunizations of all... more SummarySHEA endorses adhering to the recommendations by the CDC and ACIP for immunizations of all children and adults. All persons providing clinical care should be familiar with these recommendations and should routinely assess immunization compliance of their patients and strongly recommend all routine immunizations to patients. All healthcare personnel (HCP) should be immunized against vaccine-preventable diseases as recommended by the CDC/ACIP (unless immunity is demonstrated by another recommended method). SHEA endorses the policy that immunization should be a condition of employment or functioning (students, contract workers, volunteers, etc) at a healthcare facility. Only recognized medical contraindications should be accepted for not receiving recommended immunizations.

Research paper thumbnail of Location Matters: Geographic Disparities and Impact of Coronavirus Disease 2019

The Journal of Infectious Diseases, 2020

The coronavirus disease 2019 (COVID-19) pandemic in the United States has revealed major disparit... more The coronavirus disease 2019 (COVID-19) pandemic in the United States has revealed major disparities in the access to testing and messaging about the pandemic based on the geographic location of individuals, particularly in communities of color, rural areas, and areas of low income. This geographic disparity, in addition to deeply rooted structural inequities, have posed additional challenges to adequately diagnose and provide care for individuals of all ages living in these settings. We describe the impact that COVID-19 has had on geographically disparate populations in the United States and share our recommendations on what might be done to ameliorate the current situation.

Research paper thumbnail of 1653. Strong Partnership and Effective Communication Between a Tertiary Hospital and a County Health Department Were Critical in Controlling a 2019 Measles Outbreak in Southeast Michigan (SEM)

Open Forum Infectious Diseases, 2019

Background Measles, declared eliminated in the US 2000, is a reemerging vaccine-preventable airbo... more Background Measles, declared eliminated in the US 2000, is a reemerging vaccine-preventable airborne disease. The 2019 case count (704 as of April 30, 2019) has surpassed the number of 2014 cases (667), the highest since 1994. Many healthcare personnel (HCP) have not seen a case of measles, and this lack of clinical experience may contribute to missed or delayed diagnoses leading to its spread. We describe the processes and measures implemented at Beaumont Hospital, Royal Oak (B-RO) Michigan in collaboration with the Oakland County Health Department (OCHD) to prevent secondary spread during an outbreak. Methods Soon after the initial report of the index case in Oakland County in March, the B-RO epidemiology team connected with OCHD. As both exposed and suspected cases were expected to seek care at B-RO, a one-page informational document was sent to B-RO providers. This document detailed isolation precautions and testing methods, post-exposure prophylaxis (PEP), and contact informati...

Research paper thumbnail of Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019

MMWR. Morbidity and Mortality Weekly Report, 2019

Research paper thumbnail of Alcohol Consumption among Men and Women with Tuberculosis in Tomsk, Russia

Central European Journal of Public Health, 2010

Drinking behavior among Russian women remains poorly described. We analyzed gender differences in... more Drinking behavior among Russian women remains poorly described. We analyzed gender differences in alcohol use among 374 tuberculosis patients in Tomsk, Siberia. Twenty-six (28.3%) women had lifetime alcohol abuse or dependence, compared with 70.6% of men. Women with alcohol use disorders drank 12.7±14.0 standard drinks per day and 34.6% drank  three days per week. Among individuals with a lifetime alcohol use disorder, age of onset and typical consumption did not differ significantly by gender. We conclude that Russian women with alcohol use disorders consume almost as much alcohol as men and may be at greater risk for negative social and medical consequences.

Research paper thumbnail of Tuberculosis Control in Acute Disaster Settings: Case Studies from the 2010 Haiti Earthquake

Disaster Medicine and Public Health Preparedness, 2013

The articles mentioned above (first published online March, April 2013) were originally published... more The articles mentioned above (first published online March, April 2013) were originally published with incorrect article headings. The correct headings are as follows: > 'Tuberculosis Control in Acute Disaster Settings: Case Studies from the 2010 Haiti Earthquake' by Furin, et al. is a From the Field. > 'Trauma Signature Analysis of the Great East Japan Disaster: Guidance for Psychological Consequences' by Shultz, et al. is a Special Focus. > 'Self-Immunization with Live Attenuated Influenza Vaccine in a Mass Vaccination Clinic' by Zhan, et al. is a Commentary.

Research paper thumbnail of Performance of the Alcohol Use Disorders Identification Test Among Tuberculosis Patients in Russia

Substance Use & Misuse, 2010

The Alcohol Use Disorders Identification Test (AUDIT), a screening instrument to identify individ... more The Alcohol Use Disorders Identification Test (AUDIT), a screening instrument to identify individuals at risk of alcohol use problems, has not been validated in a Russian primary care population. We assessed the reliability, factor structure, sensitivity and specificity of AUDIT scores among 254 subjects initiating tuberculosis treatment from 2005-2007 in Tomsk City. Our findings support the use of the AUDIT as a screening instrument among Russian individuals seeking primary care. We discuss implications, limitations and future research. BACKGROUND Tuberculosis (TB) rates increased dramatically after the disintegration of Soviet Union and continues to be a critical public health issue in present day Russia (Shilova and Dye 2001).

Research paper thumbnail of Integration of alcohol use disorders identification and management in the tuberculosis programme in Tomsk Oblast, Russia

The European Journal of Public Health, 2008

Alcohol use disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence an... more Alcohol use disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. We developed a multidisciplinary model to manage AUDs among TB patients in Tomsk, Russia. First, we assessed current standards of care through stakeholder meetings and ethnographic work. The Alcohol Use Disorders Identification Test (AUDIT) was incorporated into routine assessment of all patients starting TB treatment. We established treatment algorithms based on AUDIT scores. We then hired specialists and addressed licensing requirements to provide on-site addictions care. Our experience offers a successful model in the management of co-occurring AUDs among patients with chronic medical problems.

Research paper thumbnail of Knowledge, Attitudes, and Practices of Physicians in Tomsk Oblast Tuberculosis Services Regarding Alcohol Use Among Tuberculosis Patients in Tomsk, Russia

Culture, Medicine, and Psychiatry, 2009

In recent years, the Russian Federation has seen a dramatic rise in morbidity and mortality from ... more In recent years, the Russian Federation has seen a dramatic rise in morbidity and mortality from tuberculosis (TB), attributed in part to an increase in alcohol use disorders (AUDs), which are associated with worse TB treatment outcomes. This study describes the knowledge, attitudes and practices of physicians who treat TB patients in Tomsk, Russia. We conducted semi-structured interviews with 16 TB physicians and one addiction specialist. Interviews were audio-recorded, transcribed, translated, and systematically analyzed. We identified four key domains: definitions of alcohol use and abuse, and physicians' knowledge, attitudes, and practices regarding these problems. Physicians described patients as largely pre-contemplative and reluctant in seeking treatment. Physicians recognized their limited knowledge in diagnosing and treating AUDs but expressed interest in acquiring these skills. Few options are currently available for treatment of AUDs in TB patients in Tomsk, Russia. These findings suggest that Tomsk physicians are aware of the need to engage AUDs in TB patients but identify a knowledge gap that restricts their ability to do so. Training TB physicians to use simple screening instruments and deliver evidence-based alcohol interventions improve TB outcomes among patients with co-occurring AUDs.

Research paper thumbnail of Integrated Management of Physician-delivered Alcohol Care for Tuberculosis Patients: Design and Implementation

Alcoholism: Clinical and Experimental Research, 2010

Background-While the integration of alcohol screening, treatment and referral in primary care and... more Background-While the integration of alcohol screening, treatment and referral in primary care and other medical settings in the U.S. and worldwide has been recognized as a key health care priority, it is not routinely done. In spite of the high co-occurrence and excess mortality associated with alcohol use disorders (AUDs) among individuals with tuberculosis (TB), there are no studies evaluating effectiveness of integrating alcohol care into routine treatment for this disorder. Methods-We designed and implemented a randomized controlled trial (RCT) to determine the effectiveness of integrating pharmacotherapy and behavioral treatments for AUDs into routine medical care for TB in the Tomsk Oblast Tuberculosis Service (TOTBS) in Tomsk, Russia. Eligible patients are diagnosed with alcohol abuse or dependence, are newly diagnosed with TB and initiating treatment in the TOTBS with Directly Observed Therapy-Short Course (DOTS) for TB. Utilizing a factorial design, the Integrated Management of Physician-delivered Alcohol Care for Tuberculosis Patients (IMPACT) study randomizes eligible patients who sign informed consent into one of four study arms: (1) Oral Naltrexone + Brief Behavioral Compliance Enhancement Therapy (BBCET) + treatment as usual (TAU), (2) Brief Counseling Intervention (BCI) + TAU, (3) Naltrexone + BBCET + BCI + TAU, or (4) TAU alone. Results-Utilizing an iterative, collaborative approach, a multidisciplinary U.S. and Russian team has implemented a model of alcohol management that is culturally appropriate to the patient and TB physician community in Russia. Implementation to date has achieved the integration of routine alcohol screening into TB care in Tomsk; an ethnographic assessment of knowledge, attitudes and practices of AUD management among TB physicians in Tomsk; translation and cultural adaptation of the BCI to Russia and the TB setting; and training and certification of TB physicians to deliver