Christine Tedijanto's research while affiliated with UCSF University of California, San Francisco and other places
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Publications (24)
Trachoma, caused by ocular Chlamydia trachomatis infection, is targeted for global elimination as a public health problem by 2030. To provide evidence for use of antibodies to monitor C. trachomatis transmission, we collated IgG responses to Pgp3 antigen, PCR positivity, and clinical observations from 19,811 children aged 1–9 years in 14 population...
Custer randomized trials are often used to study large-scale public health interventions. In large trials, even small improvements in statistical efficiency can have profound impacts on the required sample size and cost. Pair matched randomization is one strategy with potential to increase trial efficiency, but to our knowledge there have been no e...
Trachoma, caused by ocular Chlamydia trachomatis infection, is targeted for global elimination as a public health problem by 2030. To provide evidence for use of antibodies to monitor C. trachomatis transmission, we collated IgG responses to Pgp3 antigen, PCR positivity, and clinical observations from 19,811 children aged 1-9 years in 14 population...
Monitoring trachoma transmission with antibody data requires characterization of decay in IgG to Chlamydia trachomatis antigens. In a three-year longitudinal cohort in a high transmission setting, we estimated a median IgG half-life of 3 years and a seroreversion rate of 2.5 (95% CI: 1.6, 3.8) per 100 person-years.
Trachoma is an infectious disease characterized by repeated exposures to Chlamydia trachomatis ( Ct ) that may ultimately lead to blindness. Efficient identification of communities with high infection burden could help target more intensive control efforts. We hypothesized that IgG seroprevalence in combination with geospatial layers, machine learn...
[This corrects the article DOI: 10.1371/journal.pcbi.1008409.].
Trachoma is an infectious disease characterized by repeated exposures to Chlamydia trachomatis ( Ct ) that may ultimately lead to blindness. District-level estimates of clinical disease are currently used to guide control programs. However, clinical trachoma is a subjective indicator. Serological markers present an objective, scalable alternative f...
Background:
Tremendous progress towards elimination of trachoma as a public health problem has been made. However, there are areas where the clinical indicator of disease, trachomatous inflammation-follicular (TF), remains prevalent. We quantify the progress that has been made, and forecast how TF prevalence will evolve with current interventions....
Background
Empirical antibiotic use is common in the hospital. Here, we characterize patterns of antibiotic use, infectious diagnoses, and microbiological lab results among hospitalized patients and aim to quantify the proportion of antibiotic use that is potentially attributable to specific bacterial pathogens.
Methods
We conducted an observation...
Background
Tremendous progress towards elimination of trachoma as a public health problem has been made. However, there are areas where the clinical indicator of disease, trachomatous inflammation—follicular (TF), remains prevalent. We quantify the progress that has been made, and forecast how TF prevalence will evolve with current interventions. W...
Estimation of the effective reproductive number R t is important for detecting changes in disease transmission over time. During the Coronavirus Disease 2019 (COVID-19) pandemic, policy makers and public health officials are using R t to assess the effectiveness of interventions and to inform policy. However, estimation of R t from available data p...
Estimation of the effective reproductive number, R t , is important for detecting changes in disease transmission over time. During the COVID-19 pandemic, policymakers and public health officials are using R t to assess the effectiveness of interventions and to inform policy. However, estimation of R t from available data presents several challenge...
What happens next?
Four months into the severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) outbreak, we still do not know enough about postrecovery immune protection and environmental and seasonal influences on transmission to predict transmission dynamics accurately. However, we do know that humans are seasonally afflicted by other, less...
The SARS-CoV-2 pandemic is straining healthcare resources worldwide, prompting social distancing measures to reduce transmission intensity. The amount of social distancing needed to curb the SARS-CoV-2 epidemic in the context of seasonally varying transmission remains unclear. Using a mathematical model, we assessed that one-time interventions will...
There is an urgent need to project how transmission of the novel betacoronavirus SARS-CoV-2 will unfold in coming years. These dynamics will depend on seasonality, the duration of immunity, and the strength of cross-immunity to/from the other human coronaviruses. Using data from the United States, we measured how these factors affect transmission o...
The relationship between antibiotic stewardship and population levels of antibiotic resistance remains unclear. In order to better understand shifts in selective pressure due to stewardship, we use publicly available data to estimate the effect of changes in prescribing on exposures to frequently used antibiotics experienced by potentially pathogen...
The relationship between antibiotic stewardship and population levels of antibiotic resistance remains unclear. In order to better understand changes in selective pressure due to stewardship, we use publicly available data to estimate the effect of changes in prescribing on exposures to frequently used antibiotics experienced by potentially pathoge...
Rapid point-of-care resistance diagnostics (POC-RD) are a key tool in the fight against antibiotic resistance. By tailoring drug choice to infection genotype, doctors can improve treatment efficacy while limiting costs of inappropriate antibiotic prescription. Here, we combine epidemiological theory and data to assess the potential of resistance di...
Bystander selection—the selective pressure for resistance exerted by antibiotics on microbes that are not the target pathogen of treatment—is critical to understanding the total impact of broad-spectrum antibiotic use on pathogenic bacterial species that are often carried asymptomatically. However, to our knowledge, this effect has never been quant...
Rapid point-of-care resistance diagnostics (POC-RD) are thought to be a key tool in the fight against antibiotic resistance. By tailoring drug choice to infection genotype, doctors can improve treatment efficacy while limiting costs of inappropriate antibiotic prescription. Here we combine epidemiological theory and data to assess the potential of...
Test-negative designs are commonplace in assessments of influenza vaccination effectiveness, estimating this value from the exposure odds ratio (OR) of vaccination among individuals treated for acute respiratory illness who test positive for influenza virus infection. This approach is widely believed to recover the vaccine direct effect by correcti...
Background:
Seasonality in tuberculosis incidence has been widely observed across countries and populations; however, its drivers are poorly understood. We conducted a systematic review of studies reporting seasonal patterns in tuberculosis to identify demographic and ecologic factors associated with timing and magnitude of seasonal variation.
Me...
Bystander selection -- the selective pressures exerted by antibiotics on microbial flora that are not the target pathogen of treatment -- is critical to understanding the total impact of broad-spectrum antibiotic use; however, to our knowledge, this effect has never been quantified. Using the 2010-2011 National Ambulatory Medical Care Survey and Na...
Test-negative designs have become commonplace in assessments of seasonal influenza vaccine effectiveness. Vaccine effectiveness is measured from the exposure odds ratio (OR) of vaccination among individuals seeking treatment for acute respiratory illness and receiving a laboratory test for influenza infection. This approach is widely believed to co...
Citations
... For most studies, we expected stable transmission among 1-9-year-olds in the recent past. Our analysis used an estimate of seroreversion from one longitudinal cohort 48 , but data beyond this cohort is limited and seroreversion may be lower in higher transmission settings 49 . In a sensitivity analysis no single seroreversion value resulted in the best model fit across populations ( Supplementary Fig. 8). ...
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... Models in [24][25][26] all captured the dynamics of both the PCR and TF positivity that is the most relevant to the WHO elimination goal. The impact of COVID-19 on control and elimination of trachoma was considered in [5] and the prediction of prevalence based on various data was modeled in [27]. ...
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... The quantity ρ(t) in the Poisson process model (Examples 2 and 16), in contrast, is a time varying transmission rate, i.e., scaled by time, and therefore exists on a different scale. An alternative way of analysing R(·) is to use the case reproduction number R(t) (Gostic et al. 2020;Wallinga and Teunis 2004), which represents the average number of secondary cases arising from a primary case infected at time t, i.e., transmissibility after time t. It is similarly possible to also analyse ρ(·) through the case reproduction number and therefore compare the rates of transmission in both models commensurably. ...
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... Differences in results may be due to differences in data collection methods, the types of antimicrobials evaluated (antibacterial and selected antimycobacterial and antiviral medications in the CDC EIP study vs antibacterials only in our study), how use was defined, or to recent inpatient antimicrobial stewardship efforts. A more recent study of antibiotic use and presumptive pathogens in Veterans Affairs acute care facilities reported antibiotic use in 41.9% of all hospital stays between October 2017 and September 2018, with 10.2 to 31.4% of antibiotic days of therapy linked to a potential bacterial pathogen [16]. ...
... The definition of the effective reproductive number R t as "the expected number of new infections caused by an infectious individual in a population where some individuals may no longer be susceptible" [1] has become widely known even outside of the scientific community during the COVID-19 pandemic. Values above 1 imply epidemic growth, while values below 1 correspond to a decline. ...
... Moreover, trivalent vaccines are effective against influenza B even in seasons dominated by a lineage that mismatches the vaccine [29,34]. Thus, based on TND studies, which measure vaccine-induced protection against clinical influenza infection (albeit with some bias [68]), we expect no difference in the ratios of vaccine-unmatched to matched influenza B lineages between the more vaccinated United States and less vaccinated Europe. ...
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... The model considers the evolution of resistance in bacterial species with a mainly commensal lifestyle, whereby the population experiences antibiotic treatment at a low rate and largely independently of colonization by the focal species. This situation is different from an obligate bacterial pathogen, where asymptomatic carriage is rare and antibiotic selection arises principally due to infection itself [29]. We begin by introducing the model describing the epidemiology and evolution of an antibiotic-sensitive and an antibiotic-resistance bacterial strain. ...
... Finally, the reproduction number represents the expected number of new infections that an infectious individual could generate within a population, taking into account that some individuals may no longer be susceptible. Estimating RT is valuable for assessing how policy changes, population immunity, and other factors have affected the virus transmission at specific time points (Cauchemez et al. 2006;Flaxman et al. 2020;Gostic et al. 2020;Kucharski et al. 2020;Pan et al. 2020;Scirè et al. 2020). ...
... Nonetheless, many other respiratory viruses, including influenza and other human coronaviruses (of which COVID-19 is an instance) are susceptible to weather [8,9]. This is due to the virus being less stable in warmer and more humid weather, as well as these conditions limiting the distance the virus can travel, and the susceptibility of the host [10]. ...
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... Our literature reviews show that social distancing is an effective way to contain the spread of an infectious disease, especially when little is known about the virus and no vaccine or other drug intervention is available [19]. Social distancing and isolation along with other nonpharmacological measures such as hygiene and wearing a mask have a direct impact on infection rates and thus on the spread of the virus [20,21]. In the present study, a notable observation has been made regarding the efficacy of social distancing as the third most crucial measure in disease control. ...
