Robert H Gilman's research while affiliated with Johns Hopkins University and other places
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Publications (1,000)
Growth faltering in children (low length for age or low weight for length) during the first 1,000 days of life (from conception to 2 years of age) influences short-term and long-term health and survival 1,2 . Interventions such as nutritional supplementation during pregnancy and the postnatal period could help prevent growth faltering, but programm...
Sustainable Development Goal 2.2—to end malnutrition by 2030—includes the elimination of child wasting, defined as a weight-for-length z -score that is more than two standard deviations below the median of the World Health Organization standards for child growth ¹ . Prevailing methods to measure wasting rely on cross-sectional surveys that cannot m...
Globally, 149 million children under 5 years of age are estimated to be stunted (length more than 2 standard deviations below international growth standards) 1,2 . Stunting, a form of linear growth faltering, increases the risk of illness, impaired cognitive development and mortality. Global stunting estimates rely on cross-sectional surveys, which...
Objective
To estimate the association between the aggregation and pair-wise combination of selected cardiovascular risk factors (CVRF) and 10-year all-cause mortality.
Methods
Secondary data analysis of the PERU MIGRANT study, a prospective population-based cohort. Ten-year all-cause mortality was determined for participants originally enrolled in...
Background
The long-term impact of elevated blood pressure on mortality outcomes has been recently revisited due to proposed changes in cut-offs for hypertension. This study aimed at assessing the association between high blood pressure levels and 10-year mortality using the Seventh Report of the Joint National Committee on Prevention, Detection, E...
Genetic and omics analyses frequently require independent observations, which is not guaranteed in real datasets. When relatedness can not be accounted for, solutions involve removing related individuals (or observations) and, consequently, a reduction of available data. We developed a network-based relatedness-pruning method that minimizes dataset...
Background
Limited information exists about the incidence of first-ever stroke at the population level, particularly in low- and middle-income countries (LMIC). Longitudinal data from the CRONICAS Cohort Study includes both altitude and urbanization and allows a detailed assessment of stroke incidence in resource constrained settings. The aim of th...
Cervical cancer, a malignancy caused by persistent human papillomavirus (HPV) infection, develops in more than 500,000 women annually. More than 90% of deaths from cervical cancer occur in low- and middle-income countries. A common epidemiological feature of countries with high cervical cancer incidence is a high burden of intestinal helminth infec...
Background
Substantial evidence exists surrounding the health risks of breast milk substitutes (BMS) in place of exclusive breastfeeding among infants < 6 months of age in resource-poor settings. Yet, mothers’ experiences of selecting and purchasing BMS brands have not been well studied to date. This qualitative study explored the factors influenci...
Toxoplasma gondii is an important foodborne pathogen worldwide, with undercooked meat as the main source of human transmission. In this study, we determined the seroprevalence of T. gondii in free-range pigs from two adjacent villages in the Tumbes region of northern Peru, El Tutumo and Nuevo Progreso. We randomly selected 100 pig serum samples col...
Significance
Native Americans are neglected in human genetics studies, despite recent interest in the study of ancient DNA of their ancestors. Our findings on Andean and Amazonian populations exemplify how the current pattern of genetic diversity in human populations is influenced by the interaction of history and environment. In the present case,...
Background
Maternal immunization has the potential to reduce both maternal and infant morbidity and mortality by protecting women from complications during pregnancy as well as conferring protection for babies who are too young to be vaccinated. Limited evidence is available about the drivers of maternal immunization in middle-income countries such...
Aims
To determine the predictive performance of well-known obesity markers: body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR), and total body fat percentage (TBF%), to identify incident cases of type 2 diabetes mellitus T2DM.
Methods
Secondary data analysis of the CRONICAS Cohort Study, conducted in...
INTRODUCTION:
Patients with Chagas disease (CD), caused by Trypanosoma cruzi, present a higher risk of developing other chronic diseases, which may contribute to CD severity. Since CD is underreported in the southern state of Paraná, Brazil, we aimed to characterize clinical and epidemiological aspects of individuals chronically infected with T. cr...
Capacity building in public health is an urgent global priority. Recently, there has been an increasing emphasis on South-South and triangular cooperation. We describe our experience with a public health training collaboration between Peru and Bolivia, with Peru providing capacity building and expertise to Bolivia, while receiving supportive fundin...
Background : Novel approaches to reduce diabetic foot ulcers (DFU) in low- and middle-income countries are needed. Our objective was to compare incidence of DFUs in the thermometry plus mobile health (mHealth) reminders (intervention) vs. thermometry-only (control).
Methods : We conducted a randomized trial enrolling adults with type 2 diabetes mel...
Lung ultrasound (LUS) is highly portable and has excellent diagnostic accuracy for pneumonia compared with conventional radiography, but the literature on its use in pulmonary tuberculosis (PTB) is limited. This study characterized lesions using LUS in patients with PTB and compared them with chest X-ray (CXR). Adult patients in Lima, Peru, with PT...
Neurocysticercosis and trichuriasis are difficult-to-treat parasitic infections that affect more than 1.5 billion people worldwide. Oxfendazole, a potent broad-spectrum benzimidazole anthelmintic approved for use in veterinary medicine, has shown substantial antiparasitic activity against neurocysticercosis and intestinal helminths in preclinical s...
Background
Diagnosis of toxoplasmic encephalitis (TE) is challenging under the best clinical circumstances. The poor sensitivity of quantitative polymerase chain reaction (qPCR) for Toxoplasma in blood and CSF and the limited availability of molecular diagnostics and imaging technology leaves clinicians in resource-limited settings with few options...
Background
The MODS is an important assay for early diagnosis of tuberculosis and drug susceptibility. MODS is based in the microscopic observation, underneath, of the characteristic cords of Mycobacterium tuberculosis colonies grown in liquid media. An inverted optical microscope is required to observe and interpret MODS cultures. Unfortunately, t...
Background:
Diagnosis of congenital Chagas disease (CChD) in most endemic areas is based on low-sensitive microscopy at birth and 9-month IgG, which has poor adherence. We aim to evaluate the accuracy of the IgM-Shed Acute Phase Antigen (IgM-SAPA) test in the diagnosis of CChD at birth.
Methods:
Two cohort studies (training and validation cohort...
Objective
To describe and compare attitudes, lifestyle behaviors, and cardiometabolic risk factors between individuals with and without a relative with type 2 diabetes mellitus (T2DM) living in the same household.
Methods
A secondary analysis of baseline data from an implementation study in Peru was conducted. The outcomes were attitudes towards c...
Widespread antibiotic use in human medicine and agriculture has selected for the emergence and spread of various antibiotic resistance (AMR) determinants in microbial populations, posing a major threat to global health. AMR is of particular concern in low- and middle-income countries (LMICs), due to inadequate sanitation, high infectious disease bu...
Background:
Neurocysticercosis (NCC) is a major cause of acquired epilepsy in most of the world. Larval cysts in the human brain eventually resolve and either disappear or leave a calcified scar that is associated with seizures. This study assessed the proportion of residual calcification in parenchymal NCC, and defined risk factors associated wit...
Background:
Indoor air pollution is an important risk factor for health in low- and middle-income countries.
Methods:
We measured indoor fine particulate matter (PM2.5) and carbon monoxide (CO) concentrations in 617 houses across four settings with varying urbanisation, altitude, and biomass cookstove use in Peru, between 2010 and 2016. We asses...
Antimicrobial resistance (AMR) is a growing public health challenge that is expected to disproportionately burden lower- and middle-income countries (LMICs) in the coming decades. Although the contributions of human and veterinary antibiotic misuse to this crisis are well-recognized, environmental transmission (via water, soil or food contaminated...
CD8 T cells are considered important contributors to the immune response against Mycobacterium tuberculosis, yet limited information is currently known regarding their specific immune signature and phenotype. In this study, we applied a cell population transcriptomics strategy to define immune signatures of human latent tuberculosis infection (LTBI...
Background: Rifampicin (RIF) resistance in Mycobacterium tuberculosis is frequently caused by mutations in the rpoB gene. These mutations are associated with a fitness cost, which can be overcome by compensatory mutations in other genes, among which rpoC may be the most important. We analyzed 469 Peruvian M. tuberculosis clinical isolates to identi...
Taenia solium neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in developed countries because of immigration and travel, NCC is one of few diseases targeted for eradication. This paper reviews all aspects of its life cycle (taeniasis, porc...
The COVID-19 virus expanded from China into western Asia, Europe, and North America, impacting many of the world’s wealthiest countries. Brazil reported Latin America’s first case in late February, 2020, and in less than a month, over 7,000 COVID-19 cases have been confirmed among nearly every country and territory in Latin America and the Caribbea...
Background
Global tuberculosis policy increasingly emphasises broad tuberculosis impacts and highlights the lack of evidence concerning tuberculosis-related quality of life (QOL).
Methods
Participants were recruited in 32 Peruvian communities 13/7/2016–24/2/2018 and followed-up until 8/11/2019. Inclusion criteria were: age ≥15 years for “patients”...
We generated nine coding-complete chikungunya virus genome sequences from blood samples collected during the early 2015 outbreak in Bolivia. Relative to other publicly available chikungunya sequences, the Bolivian samples represent a monophyletic group, suggesting that a single lineage was widely circulating in the country between February and May...
Aims
Explore potential of 31 tear biomarkers involved in screening for diabetic peripheral neuropathy (DPN). Assess the utility of aesthesiometry for measuring corneal damage in DPN and determine optimal cutoff point for detecting DPN.
Methods
Screening test pilot study recruited 90 participants from a tertiary hospital in Lima, Peru. Participants...
Pyrazinamide (PZA) is one of the most important drugs used in combined anti-tuberculous therapy. After the drug enters Mycobacterium tuberculosis it is hydrolyzed by pyrazinamidase (PZAse) to the bactericidal molecule pyrazinoic acid (POA). Ribosomal protein S1 (RpsA) was recently identified as a possible target of PZA based on its binding activity...
Pyrazinamide (PZA) is considered the pivot drug in all tuberculosis treatment regimens, due to its particular action on the persistent forms of Mycobacterium tuberculosis. However, no drug susceptibility test (DST) is considered sufficiently reliable for routine application. Although molecular tests are endorsed, their application is limited to kno...
The Transatlantic Slave Trade transported more than 9 million Africans to the Americas between the early 16th and the mid-19th centuries. We performed a genome-wide analysis using 6,267 individuals from 25 populations to infer how different African groups contributed to North-, South-American and Caribbean populations, in the context of geographic...
Replacement of regular salt with potassium-enriched substitutes reduces blood pressure in controlled situations, mainly among people with hypertension. We report on a population-wide implementation of this strategy in a stepped-wedge cluster randomized trial (NCT01960972). The regular salt in enrolled households was retrieved and replaced, free of...
Cysticercosis, infection by larvae of the pork tapeworm Taenia solium , is the most common helminthic infection of the human central nervous system. It accounts for up to 30% of all seizures and epilepsy in endemic countries, and travel and immigration now lead to its more frequent presentation in industrialized countries. Ingestion of raw or under...
Background : Three previous clinical trials have found that thermometry use reduced diabetic foot ulcers (DFUs) incidence four- to ten-fold among individuals with diabetes at high-risk of developing a DFU. However, these benefits depend on patient adherence to self-assessment. Therefore, novel approaches to improve self-management thermometry adher...
Vaccine implementation planning in low- and middle-income countries (LMIC) often focuses on children without considering special adult populations. We adapted an economic model developed by the United States Department of Defense (DoD) to evaluate the cost-effectiveness of vaccine acquisition strategies for Campylobacter-, ETEC-, Shigella-, and nor...
Western South America was one of the worldwide cradles of civilization. The well known Inca Empire was the tip of the iceberg of a cultural and biological evolutionary process that started 14-11 thousand years ago. Genetic data from 18 Peruvian populations reveal that: (1) The between-population homogenization of the central-southern Andes and its...
Background Indoor air pollution is an important risk factor for health in low- and middle-income countries.
Methods We measured indoor fine particulate matter (PM 2.5 ) and carbon monoxide (CO) concentrations in 617 houses across four settings with varying urbanisation, altitude, and biomass cookstove use in Peru, between 2010 and 2016. We assesse...
Background: Indoor air pollution is an important risk factor for health in low- and middle-income countries.
Methods: We measured indoor fine particulate matter (PM 2.5 ) and carbon monoxide (CO) concentrations in 617 houses across four settings with varying urbanisation, altitude, and biomass cookstove use in Peru, between 2010 and 2016. We assess...
Mycobacterium tuberculosis is the cause of one of the diseases with the highest mortality and morbidity rate in the Americas and in the world. In developing countries the diagnosis of tuberculosis is based on baciloscopy and bacteriological cultures. The first method has a low sensitivity, and the second can take several weeks to reach a confirmato...
We report multiple nontypeable genotype II noroviruses circulating in South America; nucleotides differed by >25% from those of other genotypes. These viruses have been circulating in the Americas for ≈20 years and show recombination with other genotypes. Clues to norovirus natural history can guide development of treatment and prevention plans.
Tapeworms are a type of platyhelminth, or flatworm, and make up the taxonomic class Cestoda. Infections by tapeworms cause significant morbidity to humans worldwide as well as major production losses in livestock. Adult tapeworms live within the gastrointestinal tract of their definitive hosts, which can be human, other mammals, or fish. Several ta...
Sparganosis is a rare parasitic infection caused by tapeworm larvae of the genus Spirometra. It is most prevalent in Southeast Asia. Drinking contaminated water that contains copepods, ingesting undercooked meat, and using contaminated meat as a poultice are the main routes of infection. After migration of larvae to a subcutaneous location in any t...
Neurocysticercosis is the invasion of the human nervous system by larvae of the pork tapeworm Taenia solium; it is a major cause of seizures and neurologic morbidity worldwide. Parenchymal brain disease results in seizures and can follow a benign course, whereas extraparenchymal (intraventricular or subarachnoid) cysticercosis presents with hydroce...
Background
Individuals’ self-perceptions of weight often differ from objective measurements of body fat. This study aimed to 1) measure agreement between self-perceptions of weight and objective measurement of body fat by bioelectric impedance analysis (BIA) among Peruvian adults; and 2) quantify the association between body fat and a) baseline sel...
BACKGROUND: It is very difficult to observe tuberculosis (TB) transmission chains and thus, identify superspreaders. We investigate cough duration as a proxy measure of transmission to assess the presence of potential TB superspreaders. DESIGN: We analyzed six studies from China, Peru, The Gambia and Uganda, and determined the distribution of cough...
Background:
Serological tools for the accurate detection of recent malaria exposure are needed to guide and monitor malaria control efforts. IgG responses against P. vivax and P. falciparum merozoite surface protein-10 (MSP10) were measured as a potential way to identify recent malaria exposure in the Peruvian Amazon.
Methods:
A field-based stud...
We compared different diagnostic tests for Chagas disease in 150 samples in Mexico City and 146 samples in Baltimore.
Admixed populations are a resource to study the global genetic architecture of complex phenotypes, which is critical, considering that non-European populations are severely under-represented in genomic studies. Leveraging admixture in Brazilians, whose chromosomes are mosaics of fragments of Native American, European and African origins, we used ge...
Objective
To characterize the prevalence and clustering of multimorbidity in four diverse geographical settings in Peru.
Methods
Multimorbidity, defined as having ≥2 chronic conditions, was studied in adults aged ≥35 years in four diverse settings in Peru: Lima, Tumbes, and urban and rural Puno. Six of these conditions (alcohol disorder, asthma, c...
Autism is a developmental disorder that affects social interaction and communication of children. The gold standard diagnostic tools are very difficult to use and time consuming. However, diagnostic could be deduced from child gaze preferences by looking a video with social and abstract scenes. In this work, we propose an algorithm based on convolu...
Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis and remains one of the major causes of disease and death worldwide. Pyrazinamide is a key drug used in the treatment of tuberculosis, yet its mechanism of action is not fully understood, and testing strains of M. tuberculosis for pyrazinamide resistance is not...
BACKGROUND
Thermometry monitoring has proven to reduce the occurrence of diabetic foot ulcers (DFU). mHealth may contribute to enhance adherence to this effective intervention.
OBJECTIVE
Our objective was to compare incidence of DFU in the thermometry plus mHealth reminders intervention arm vs. thermometry-only control arm.
METHODS
We conducted a...
Background:
The epidemiological impact and cost-effectiveness of social protection and biomedical interventions for tuberculosis-affected households might be improved by risk stratification. We therefore derived and externally validated a household-level risk score to predict tuberculosis among contacts of patients with tuberculosis.
Methods:
In...
The Millennium Development Goals (MDGs) are a set of 8 aims adopted by the United Nations to create a more peaceful, prosperous, and just world. Four MDGs directly concern public health, and public health schools should be involved in meeting them. The Johns Hopkins University-directed Fogarty Global Infectious Disease Research Training Program in...
Aims:
This study aimed to (1) estimate the prevalence of prediabetes according to different definitions, (2) evaluate regression to normal glucose levels and progression towards T2DM, and (3) determine factors associated with regression and progression across four diverse geographical settings in a Latin American country.
Methods:
The CRONICAS C...
Our results highlight for the first time that a significant proportion of cell doublets in flow cytometry, previously believed to be the result of technical artifacts and thus ignored in data acquisition and analysis, are the result of biological interaction between immune cells. In particular, we show that cell:cell doublets pairing a T cell and a...
Objective
To determine the association between excess body fat, assessed by skinfold thickness, and the incidence of type 2 diabetes mellitus (T2DM) and hypertension (HT).
Design
Data from the ongoing PERU MIGRANT Study were analysed. The outcomes were T2DM and HT, and the exposure was skinfold thickness measured in bicipital, tricipital, subscapu...
The Transatlantic Slave Trade transported more than 9 million Africans to the Americas between the early 16th and the mid-19th centuries. We performed genome-wide analysis of 6,267 individuals from 22 populations and observed an enrichment in West-African ancestry in northern latitudes of the Americas, whereas South/East African ancestry is more pr...
Background:
Kidney health needs to be studied in low- and middle-income countries with populations living at high altitude and undergoing urbanization. We studied whether greater level of urbanization was associated with worse kidney function and higher hemoglobin was associated with worse kidney function at high altitude.
Methods:
Cross-sectional...
Triatomine vectors transmit Trypanosoma cruzi, the etiological agent of Chagas disease in humans. Transmission to humans typically occurs when contaminated triatomine feces come in contact with the bite site or mucosal membranes. In the Southern Cone of South America, where the highest burden of disease exists, Triatoma infestans is the principal v...
Background
Assessing Mycobacterium tuberculosis (TB) viability by fluorescein diacetate (FDA) microscopy can predict TB culture results, treatment response and infectiousness. However, diverse methods have been published. We aimed to optimise FDA microscopy, minimising sputum processing, biohazard and complexity for use in resource-constrained sett...
Background:
Active case-finding among contacts of patients with tuberculosis is a global health priority, but the effects of active versus passive case-finding are poorly characterised. We assessed the contribution of active versus passive case-finding to tuberculosis detection among contacts and compared sex and disease characteristics between co...
Production of MMP-9 by human PBMC stimulated with T. solium and T. saginata form antigen.
(TIF)
Production of cytokines by human PBMCs stimulated with AO and PO antigen.
A) Taenia solium antigen B) Taenia saginata antigen.
(TIF)
Taenia solium is known to cause human cysticercosis while T. saginata does not. Comparative in vitro and in vivo studies on the oncosphere and the postoncospheral (PO) forms of T. solium and T. saginata may help to elucidate why cysticercosis can occur from one and not the other. The aim of this study was to use in vitro culture assays and in vivo...
Feeding of infant formula using contaminated bottles may be an important transmission pathway of enteric pathogens during early life. Determinants of suboptimal bottle hygiene and the feasibility and acceptability of intervention strategies have not been well assessed. We evaluated the extent of bottle contamination, its contributing factors, and o...
