Tara Bouton

• Professor (Assistant) at Boston University

Background Successful recruitment of study participants is a challenging component of research, and recruitment barriers are amplified in safety-net hospital (SNH) settings. However, engaging historically underrepresented groups in research is critically important to improve health disparities and outcomes. We summarize challenges we encountered wh...

Sputum cultures are the gold standard for tuberculosis (TB) diagnosis and treatment monitoring. However, cultures in MGIT liquid media are susceptible to microbial contamination, often rendering them uninterpretable. Research has shown that maintaining strict cold chains and supervised sample collection can reduce contamination rates, but few longi...

Background: Successful recruitment of study participants is a challenging component of research, and recruitment barriers are amplified in safety-net hospital (SNH) settings. However, engaging historically underrepresented groups in research is critically important to improve health disparities and outcomes. We summarize challenges we encountered w...

Background The COVID-19 pandemic negatively impacted tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared DOT adherence embedded in a research study before and after COVID-19 lockdowns in South Africa. Methods We analyzed data from 263 observational study partici...

sec id="st1"> BACKGROUND There is substantial heterogeneity in disease presentation for individuals with TB disease, which may correlate with disease outcomes. We estimated disease outcomes by disease severity at presentation among individuals with TB during the pre-chemotherapy era. METHODS We extracted data on people with TB enrolled between 1917...

Background The COVID-19 pandemic negatively impacted all levels of tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared the rate of adherence to DOT before and during the pandemic among observational research study participants on drug-susceptible (DS)-TB therapy...

BACKGROUND: An estimated 40% of people who developed TB in 2021 were not diagnosed or treated. Pre-chemotherapy era data are a rich resource on survival of people with untreated TB. We aimed to identify heterogeneities in these data to inform their more precise use.METHODS: We extracted survival data from pre-chemotherapy era papers reporting TB-sp...

BACKGROUND: Smoking of illicit drugs may lead to more rapid TB disease progression or late treatment presentation, yet research on this topic is scant. We examined the association between smoked drug use and bacterial burden among patients newly initiated on drug-susceptible TB (DS-TB) therapy.METHODS: Data from 303 participants initiating DS-TB tr...

Background An estimated 40% of people who developed tuberculosis in 2021 were not diagnosed or treated. Pre-chemotherapy era data are a rich resource on survival for people with untreated TB. We aimed to identify heterogeneities in these data to inform more precise use of them. Methods We extracted survival data from pre-chemotherapy era papers re...

Background Omicron rapidly replaced delta as the predominant strain causing COVID-19 related illness in the United States (US) in December 2021, the same month the US CDC reduced the recommended isolation period from 10 to 5 days for asymptomatic individuals or those with resolving symptoms. New evidence suggests some asymptomatic individuals with...

Background Vaccination is a fundamental element of pandemic control; however, insufficient data exists on vaccine’s impact on SARS-CoV-2 viral dynamics. We aimed to evaluate the relationship between time to negative viral culture conversion after diagnosis and time since most recent COVID-19 vaccination. Scatterplot illustrating relationship betwee...

Background The occurrence and timing of mycobacterial culture conversion is used as a proxy for tuberculosis treatment response. When researchers serially sample sputum during tuberculosis studies, contamination or missed visits leads to missing data points. Traditionally, this is managed by ignoring missing data or simple carry-forward techniques....

Background Throughout the SARS-CoV-2 pandemic, healthcare workers (HCWs) have faced risk of infection from within the workplace via patients and staff as well as from the outside community, complicating our ability to resolve transmission chains in order to inform hospital infection control policy. Here we show how the incorporation of sequences fr...

Background: In January 2022, United States guidelines shifted to recommend isolation for 5 days from symptom onset, followed by 5 days of mask wearing. However, viral dynamics and variant and vaccination impact on culture conversion are largely unknown. Methods: We conducted a longitudinal study on a university campus, collecting daily anterior...

Background The Omicron variant of SARS-CoV-2 is highly transmissible in vaccinated and unvaccinated populations. The dynamics governing its establishment and propensity towards fixation (reaching 100% frequency in the SARS-CoV-2 population) in communities remain unknown. In this work, we describe the dynamics of Omicron at three institutions of hig...

Background In January 2022, United States guidelines shifted to recommend isolation for 5 days from symptom onset, followed by 5 days of mask wearing. However, viral dynamics and variant and vaccination impact on culture conversion are largely unknown. Methods We conducted a longitudinal study on a university campus, collecting daily anterior nasa...

Globally, an estimated 107 million people have an alcohol use disorder (AUD) leading to 2.8 million premature deaths each year. Tuberculosis (TB) is one of the leading causes of death globally and over 8% of global TB cases are estimated to be attributable to AUD. Social determinants of health such as poverty and undernutrition are often shared amo...

The Omicron variant of SARS-CoV-2 is transmissible in vaccinated and unvaccinated populations. Here, we describe the rapid dominance of Omicron following its introduction to three Massachusetts universities with asymptomatic surveillance programs. We find that Omicron was established and reached fixation earlier on these campuses than in Massachuse...

Background Accurate measurement of antibodies is a necessary tool for assessing exposure to SARS-CoV-2 and facilitating understanding of the role of antibodies in immunity. Most assays are qualitative in nature and employ a threshold to determine presence of antibodies. Semi-quantitative assays are now available. Here we evaluate the semi-quantitat...

Background SARS-CoV-2 continues to spread globally, including in limited resource settings. It is therefore important to derive general case definitions that can be useful and accurate in the absence of timely test results. We aim to validate the World Health Organization (WHO) case definition, a symptom-screening tool currently used to identify SA...

Background COVID-19 vaccine trials and post-implementation data suggest vaccination decreases SARS-CoV-2 infections. We examine COVID-19 vaccination’s impact on SARS-CoV-2 case rates and viral diversity among healthcare workers (HCW) during a high community prevalence period. Methods A prospective cohort study from Boston Medical Center (BMC)’s HC...

Background The COVID-19 pandemic disrupted access to and uptake of hepatitis C (HCV) care services in the U.S. It is unknown how substantially the pandemic will impact long-term HCV-related outcomes. Methods We used a microsimulation to estimate the 10-year impact of COVID-19 disruptions in healthcare delivery on HCV outcomes including identified...

To determine the association between immunosuppression and time to SARS-CoV-2 PCR clearance, we studied 3758 adults re-tested following initial SARS-CoV-2 infection. Cox proportional hazards models demonstrated delayed PCR clearance with older age, multiple comorbidities and solid organ transplant but not by degree of immunocompromise. These findin...

Background: South Africa temporarily banned alcohol and tobacco sales for about 20 weeks during the COVID-19 lockdown. We described changes in alcohol and tobacco consumption after implementation of these restrictions among a small number of participants in a tuberculosis treatment cohort. Method: The timeline follow-back procedure and Fägerstro...

Healthcare workers (HCWs) are at an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus that causes Coronavirus Disease (COVID-19). We aim to assess the seroprevalence of SARS-CoV-2 IgG among healthcare workers and compare risk-factors between seropositive and seronegative HCWs. In this observational study,...

Background: COVID-19 vaccine trials and post-implementation data suggest vaccination decreases SARS-CoV-2 infections. Objective: Estimate COVID-19 vaccinations impact on SARS-CoV-2 case rates and viral diversity among healthcare workers (HCW) during a high community prevalence period. Design, Setting, Participants: A prospective cohort study from B...

In 2011, South Africa implemented a policy to decentralize treatment for rifampin-resistant tuberculosis (TB) to reduce durations of hospitalization and enable local treatment. We assessed policy implementation in Western Cape Province, where services expanded from 6 specialized TB hospitals to 406 facilities, by analyzing National Health Laborator...

UNSTRUCTURED A major challenge for prospective, clinical tuberculosis (TB) research is accurately defining a metric for measuring medication adherence. We present the design and methodology of a mobile health (mHealth)-based directly observed therapy (DOT) program developed for the purpose of measuring anti-TB medication adherence for a prospective...

Background A major challenge for prospective, clinical tuberculosis (TB) research is accurately defining a metric for measuring medication adherence. Objective We aimed to design a method to capture directly observed therapy (DOT) via mobile health carried out by community workers. The program was created specifically to measure TB medication adhe...

Objectives: The global pandemic of coronavirus disease 2019 (Covid-19) may disproportionately affect persons in congregate settings, including those in residential substance use treatment facilities. To limit the spread of SARS-CoV-2 through congregate settings, universal testing may be necessary. We aimed to determine the point prevalence of SARS...

South Africa led the world with guidelines on bedaquiline (BDQ) use as a single drug substitution to manage rifampin resistant tuberculosis regimen toxicity. We examined reasons for giving BDQ in a retrospective cohort: >75% of patients were switched to BDQ for toxicity (ototoxicity or renal dysfunction) rather than drug resistance.

Tuberculosis (TB) is the leading single-agent infectious disease killer worldwide. The World Health Organization (WHO)'s End TB Strategy aims to achieve tuberculosis (TB) elimination by 2030, and in September 2018, the United Nations General Assembly held a High-Level Meeting on TB to address the urgency of the TB epidemic and the health inequaliti...

In the United States, high concern for iatrogenic reactivation to tuberculosis (TB) disease secondary to prescribed immunosuppression has resulted in increased use of the QuantiFERON-TB Gold In-Tube test (QFT-GIT) to screen for Mycobacterium tuberculosis (Mtb) infection. The aim of our study was to determine indications for QFT-GIT testing and risk...

Introduction: High mortality among individuals receiving retreatment for tuberculosis (RT-TB) persists, although reasons for these poor outcomes remain unclear. Methods: We retrospectively reviewed 394 RT-TB patients diagnosed between January 2010 and June 2016 in Accra, Ghana. Results: Of RT-TB patients, 161 (40.9%) were treated empirically (...

Background: An estimated 10% of tuberculosis (TB) deaths are attributable to problematic alcohol use globally, however the causal pathways through which problem alcohol use has an impact on TB treatment outcome is not clear. This study aims to improve understanding of these mechanisms. Specifically, we aim to 1) assess whether poor TB treatment ou...

Background Current guidelines for treatment of multidrug-resistant tuberculosis (MDR-TB) are largely based on expert opinion and observational data. Fluoroquinolones remain an essential part of MDR-TB treatment, but the optimal dose of fluoroquinolones as part of the regimen has not been defined. Methods/design We designed a randomized, blinded, p...

We describe a case of acute vertebral osteomyelitis with associated prevertebral abscess due to Erysipelothrix rhusiopathiae in an immunocompetent adult with recent known traumatic inoculation from the barb of a fish.

Neurofibromatosis type 1 is a genetic condition associated with increased risk of abnormal brain development. The relationship between a specific type of brain malformation and a distinct cognitive sign/deficiency remains unknown. This study investigated the frequency of brain malformations in children with neurofibromatosis type 1, and the impact...

Large colonies of nesting ciconiiform birds have recently become an important tourist attraction in the Brazilian Pantanal. Visits to these colonies are uncontrolled and there is growing concern about disturbance to the breeding birds. In 1998, an experiment was conducted using different treatments within a single, large, heavily visited colony to...

We report for the first time on Buff-necked Ibis (Theristicus caudatus) greeting and courtship displays during nest building. Displays included both individual and simultaneous Up-down Displays and Stick Shaking. The nesting attempt was brought to an abrupt end, apparently by interactions with Crested Caracaras (Polyborus plancus) and/or interspeci...