Kirsten E. Wiens

Kirsten E. Wiens
Temple University | TU · Department of Biostatistics/Epidemiology

PhD

About

83
Publications
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Introduction
I’m an infectious disease epidemiologist focused on seroepidemiology, spatial analysis, and disease modeling. The goal of my work is to better understand the burden of pathogens such as Vibrio cholerae and SARS-CoV-2 in the context of imperfect surveillance data. My current research includes highly collaborative studies to examine the degree to which cholera infections that go unobserved by traditional surveillance systems contribute to transmission.

Publications

Publications (83)
Preprint
Vibriocidal antibodies are the best characterized correlate of protection against cholera and are used to gauge immunogenicity in vaccine trials. However, there is no vibriocidal titer threshold associated with absolute protection against infection with Vibrio cholerae or with symptomatic disease in infected individuals. While other circulating ant...
Article
Because of the importance of schools to childhood development, the relationship between in-person schooling and COVID-19 risk has been one of the most important questions of this pandemic. Previous work in the United States during winter 2020-2021 showed that in-person schooling carried some risk for household members and that mitigation measures r...
Article
BACKGROUND: TB was the leading cause of death from a single infectious pathogen globally between 2014 and 2019. Fine-scale estimates of TB prevalence and case notifications can be combined to guide priority-setting for strengthening routine surveillance activities in high-burden countries. We produce policy-relevant estimates of the TB epidemic at...
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Full-text available
Background Timely, accurate, and comprehensive estimates of SARS-CoV-2 daily infection rates, cumulative infections, the proportion of the population that has been infected at least once, and the effective reproductive number (Reffective) are essential for understanding the determinants of past infection, current transmission patterns, and a popula...
Preprint
We apply a new serosurveillance tool to estimate typhoidal Salmonella burden from dried blood spots in Juba, South Sudan, finding an incidence rate of 35 per 100 person-years and cumulative incidence of 78% over four years.
Preprint
The use of biomarkers to measure immune responses in serum is crucial for understanding population-level exposure and susceptibility to human pathogens. Advances in sample collection, multiplex testing, and computational modeling are transforming serosurveillance into a powerful tool for public health program design and response to infectious threa...
Preprint
Because of the importance of schools to childhood development, the relationship between in-person schooling and COVID-19 risk has been one of the most important questions of the COVID-19 pandemic. Previous work using data from the United States in winter 2020-21 showed that in-person schooling carried some risk for household members, and that mitig...
Article
Full-text available
Relatively few coronavirus disease cases and deaths have been reported from sub-Saharan Africa, although the extent of its spread remains unclear. During August 10-September 11, 2020, we recruited 2,214 participants for a representative household-based cross-sectional serosurvey in Juba, South Sudan. We found 22.3% of participants had severe acute...
Preprint
Full-text available
Background Relatively few COVID-19 cases and deaths have been reported through much of sub-Saharan Africa, including South Sudan, although the extent of SARS-CoV-2 spread remains unclear due to weak surveillance systems and few population-representative serosurveys. Methods We conducted a representative household-based cross-sectional serosurvey i...
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We use COVID-19 case and mortality data from 1 February 2020 to 21 September 2020 and a deterministic SEIR (susceptible, exposed, infectious and recovered) compartmental framework to model possible trajectories of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and the effects of non-pharmaceutical interventions in the Unite...
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Background Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many...
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A Correction to this paper has been published: https://doi.org/10.1038/s41591-020-01181-w
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Background Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of...
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Full-text available
Summary Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a sta...
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Full-text available
Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publ...
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Full-text available
Background Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of...
Article
Full-text available
Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardise...
Article
Full-text available
Background Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-res...
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Full-text available
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Full-text available
Background Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of rec...
Article
Full-text available
Background Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of rec...
Article
Full-text available
Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended ho...
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Full-text available
Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational r...
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Full-text available
A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant...
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Full-text available
Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational r...
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Full-text available
Background: Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's compar...
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Background: Repeated outbreaks of emerging pathogens underscore the need for preparedness plans to prevent, detect, and respond. As countries develop and improve National Action Plans for Health Security, addressing subnational variation in preparedness is increasingly important. One facet of preparedness and mitigating disease transmission is hea...
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Lower respiratory infections (LRIs) are the leading cause of death in children under the age of 5, despite the existence of vaccines against many of their aetiologies. Furthermore, more than half of these deaths occur in Africa. Geospatial models can provide highly detailed estimates of trends subnationally, at the level where implementation of hea...
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Full-text available
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Full-text available
Exclusive breastfeeding (EBF)—giving infants only breast-milk (and medications, oral rehydration salts and vitamins as needed) with no additional food or drink for their first six months of life—is one of the most effective strategies for preventing child mortality1–4. Despite these advantages, only 37% of infants under 6 months of age in Africa we...
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Full-text available
HIV/AIDS is a leading cause of disease burden in sub-Saharan Africa. Existing evidence has demonstrated that there is substantial local variation in the prevalence of HIV; however, subnational variation has not been investigated at a high spatial resolution across the continent. Here we explore within-country variation at a 5 × 5-km resolution in s...
Data
Web appendix for: GBD Tuberculosis Collaborators (Murray CJL, et al.). Global, regional, and national burden of tuberculosis, 1990–2016: results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study. Lancet Infectious Diseases. 2018 Dec; 18(12):1329–1349.
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Background Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and prog...
Article
Full-text available
Background Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and prog...
Article
Full-text available
Background The host, microbial, and environmental factors that contribute to variation in tuberculosis (TB) disease are incompletely understood. Accumulating evidence suggests that one driver of geographic variation in TB disease is the local ecology of mycobacterial genotypes or strains, and there is a need for a comprehensive and systematic synth...
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Background: Brazil has high burdens of tuberculosis (TB) and HIV, as previously estimated for the 26 states and the Federal District, as well as high levels of inequality in social and health indicators. We improved the geographic detail of burden estimation by modelling deaths due to TB and HIV and TB case fatality ratios for the more than 5400 m...
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Full-text available
Insufficient growth during childhood is associated with poor health outcomes and an increased risk of death. Between 2000 and 2015, nearly all African countries demonstrated improvements for children under 5 years old for stunting, wasting, and underweight, the core components of child growth failure. Here we show that striking subnational heteroge...
Data
This file contains Supplementary Figures 1-46, Supplementary Tables 1-19, Supplementary Data, a Supplementary Discussion, Supplementary Methods and Supplementary References – see contents page for details.
Article
Type I interferons (including IFNαβ) contribute to pathogenesis of Mycobacterium tuberculosis strains that induce high IFNαβ levels. Here we examined the role of IFNαβ during infection with a Mycobacterium africanum (Maf) strain that induces low IFNαβ levels. We infected wild type and IFNαβ receptor knock out mice with Maf and monitored bacterial g...
Article
Full-text available
Type I interferons (including IFNαβ) are innate cytokines that may contribute to pathogenesis during Mycobacterium tuberculosis (Mtb) infection. To induce IFNβ, Mtb must gain access to the host cytosol and trigger stimulator of interferon genes (STING) signaling. A recently proposed model suggests that Mtb triggers STING signaling through bacterial...
Data
Mycobacterial strains used in this study. (PDF)
Data
Access to the host cytosol does not vary by mycobacterial strain. A-B) BMDM were infected with the indicated dsRed-expressing bacterial strains at an MOI of 10, and then incubated with the LiveBLAzer FRET substrate at 24 hr post infection. Mtb in the cytosol cleaves the substrate and disrupts FRET; emission signals at 520 nm indicate no Mtb cytosol...
Data
Differences in bacterial numbers and TNF do not explain differences in IFNβ induction between MTBC strains. ANCOVA models were run with IFNβ secretion at 48 hr post infection as the dependent variable, strain (1182, H37Rv, 4334) as a fixed factor, CFU collected at 3, 24 and 48 hr post infection as a covariate, and TNF secretion at 48 hr post infect...
Data
mtDNA in the cytosol is positively correlated with IFNβ induction during Mtb infection. A-C) BMDM were treated with MitoQ or control (dTPP) for 4 hours and then infected with the indicated bacterial strains at an MOI of 5. 24 hr post infection supernatants were collected for IFNβ quantification by ELISA and cells were fractionated. Amount of DNA in...
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Full-text available
Macrophages adopt an alternatively activated phenotype (AAMs) when activated by the interleukin-4receptor(R)α. AAMs can be derived either from proliferation of tissue resident macrophages or recruited inflammatory monocytes, but it is not known whether these different sources generate AAMs that are phenotypically and functionally distinct. By trans...
Article
Gene flow among populations in different selective environments should favor the evolution of phenotypic plasticity over local adaptation. Plasticity in development is a common response to long-term hypoxia in some widespread African fishes, including Pseudocrenilabrus multicolor, a cichlid that exploits both normoxic (high oxygen) rivers/lakes and...
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The HLA (human leukocyte antigen) molecules that present pathogen-derived epitopes to T cells are highly diverse. Correspondingly, many pathogens such as HIV evolve epitope variants in order to evade immune recognition. In contrast, another persistent human pathogen, Mycobacterium tuberculosis, has highly conserved epitope sequences. This raises th...
Data
HLA-DR, -A, -B allele promiscuity across all epitopes. Kernel density estimates of epitope promiscuity and graphs of mean HLA allele promiscuity (see Methods) of B. anthracis and C. tetani (BA & CT; blue), S. pyogenes and (SP; purple), HIV (green) and M. tuberculosis complex (MTBC; orange) across HLA-DR (A), HLA-A (B) and HLA-B (C) alleles. Differe...
Data
T cell epitope promiscuity across HLA class I alleles grouped by supertype. Graphs of mean epitope promiscuity (see Methods) of B. anthracis and C. tetani (BA and CT), S. pyogenes and (SP), HIV and M. tuberculosis complex (MTBC) across alleles within HLA-A supertypes (A01, A02, A03, A24) and within HLA-B supertypes (B07, B08, B27, B44, B58, B62). F...
Data
Full-text available
All HLA-DR, -A, -B alleles used in this study. (PDF)