Publications by authors named "Christopher LeBoa"

Article Synopsis
  • In 2018, the Navi Mumbai Municipal Corporation launched a typhoid vaccine campaign aimed at children aged 9 months to 14 years.
  • The study analyzed factors influencing vaccine receipt using statistical methods and found that school enrollment, low household income, and community-level socioeconomic status significantly increased vaccine uptake.
  • The campaign effectively targeted and vaccinated underserved populations, improving access to healthcare among the most vulnerable demographics.
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Typbar-TCV®, a typhoid conjugate vaccine (TCV), was prequalified by the World Health Organization in 2017. We evaluated its effectiveness in a mass vaccination program targeting children 9 months to 14 years in Navi Mumbai, India, from September 2018 to July 2020. We compared laboratory-confirmed typhoid cases from six clinical sites with age-matched community controls.

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Background: Environmental surveillance, using detection of Salmonella Typhi DNA, has emerged as a potentially useful tool to identify typhoid-endemic settings; however, it is relatively costly and requires molecular diagnostic capacity. We sought to determine whether S. Typhi bacteriophages are abundant in water sources in a typhoid-endemic setting, using low-cost assays.

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Introduction: Salmonella Typhi and Salmonella Paratyphi, fecal-oral transmitted bacterium, have temporally and geographically heterogeneous pathways of transmission. Previous work in Kathmandu, Nepal implicated stone waterspouts as a dominant transmission pathway after 77% of samples tested positive for Salmonella Typhi and 70% for Salmonella Paratyphi. Due to a falling water table, these spouts no longer provide drinking water, but typhoid fever persists, and the question of the disease's dominant pathway of transmission remains unanswered.

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India has one of the highest estimated burdens of enteric fever globally. Prior to the implementation of Typbar-TCV typhoid conjugate vaccine (TCV) in a public sector pediatric immunization campaign in Navi Mumbai, India, we conducted a retrospective review of blood culture-confirmed cases of typhoid and paratyphoid fevers to estimate the local burden of disease. This review included all blood cultures processed at a central microbiology laboratory, serving multiple hospitals, in Navi Mumbai (January 2014-May 2018) that tested positive for either Salmonella Typhi or Salmonella Paratyphi A.

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Article Synopsis
  • The study involved whole-genome sequencing of 174 Typhi and 54 Paratyphi A samples in Navi Mumbai, focusing on the emergence and spread of antimicrobial resistance during a typhoid vaccine rollout.
  • Most of the bacteria showed resistance to fluoroquinolones, with some carrying genetic mutations linked to ceftriaxone resistance, indicating independent evolution of resistant strains.
  • Results revealed two main clades of Typhi in the area, suggesting repeated introductions of the bacteria and a strong correlation between genetic clustering of isolates and their geographical distance, emphasizing the need for better water and sanitation measures alongside vaccination efforts.
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Background: The World Health Organization recommends vaccines for prevention and control of typhoid fever, especially where antimicrobial-resistant typhoid circulates. In 2018, the Navi Mumbai Municipal Corporation (NMMC) implemented a typhoid conjugate vaccine (TCV) campaign. The campaign targeted all children aged 9 months through 14 years within NMMC boundaries (approximately 320 000 children) over 2 vaccination phases.

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Background: No validated perioperative risk assessment models currently exist for use in humanitarian settings. To inform the development of a perioperative mortality risk assessment model applicable to humanitarian settings, we conducted a scoping review of the literature to identify reports that described perioperative risk assessment in surgical care in humanitarian settings and LMICs.

Methods: We conducted a scoping review of the literature to identify records that described perioperative risk assessment in low-resource or humanitarian settings.

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Background: Billions of people living in poverty are at risk of environmentally mediated infectious diseases-that is, pathogens with environmental reservoirs that affect disease persistence and control and where environmental control of pathogens can reduce human risk. The complex ecology of these diseases creates a global health problem not easily solved with medical treatment alone.

Methods: We quantified the current global disease burden caused by environmentally mediated infectious diseases and used a structural equation model to explore environmental and socioeconomic factors associated with the human burden of environmentally mediated pathogens across all countries.

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Purpose: The Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot (OPP) allows for the online purchase of groceries using SNAP benefits. First implemented in California in late April 2020, little is known about program usage. This study assessed initial implementation of SNAP Online in California using SNAP OPP transaction data from April - October 2020.

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Article Synopsis
  • The text discusses progress made by sustainable development practitioners in reducing human infectious diseases while promoting conservation through a systematic literature review of 46 proposed solutions.
  • Some solutions showed medium to high-quality evidence of success, but there were significant evidence gaps indicating a need for further research.
  • Stakeholders are encouraged to use the Review and an online database to discover, customize, or innovate new win-win interventions.
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Humans live in complex socio-ecological systems where we interact with parasites and pathogens that spend time in abiotic and biotic environmental reservoirs (e.g., water, air, soil, other vertebrate hosts, vectors, intermediate hosts).

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Background: Carceral facilities are high-risk settings for COVID-19 transmission. Little is known about the hidden burden of infection or practical barriers to infection control in these settings, especially in jails. There is also limited research on the mental health impacts of the pandemic among people living and working in carceral facilities.

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During the COVID-19 pandemic in 2020, the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot (OPP) was rapidly expanded across the US. This program, enabling direct-to-home grocery delivery, could be a transformative step towards improving fresh-food access. However, lack of information on which areas are serviced by SNAP OPP hinders the identification of potential demographic and regional disparities in access.

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Carceral facilities are high-risk settings for COVID-19 transmission. Factors associated with COVID-19 vaccine acceptance and hesitancy among incarcerated individuals are poorly understood, especially among jail residents. Here, we conducted a retrospective review of electronic health record (EHR) data on COVID-19 vaccine uptake in custody and additionally administered a survey to assess reasons for vaccine hesitancy, sources of COVID-19 information, and medical mistrust among residents of four Northern California jails.

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Many healthcare professionals have been forced, under acute shortages, to extend medical exam gloves beyond their intended single use. Despite limited available literature, the CDC proposed a set of guidelines for repeated exam gloves use, indicating a maximum number of treatments for three widely available disinfectants. This study examines how these treatments affect the mechanical properties of latex and nitrile gloves.

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COVID-19 has created shortages of personal protective equipment. In resource-constrained situations, limited cycles of disinfection and extended use of gloves is recommended by the U.S.

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Background: Children represent a significant percentage of casualties in modern conflict. Yet, the epidemiology of conflict-related injury among children is poorly understood. A comprehensive analysis of injuries sustained by children in 21-century armed conflict is necessary to inform planning of local, military, and humanitarian health responses.

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Background: Conflict-related injuries sustained by civilians and local combatants are poorly described, unlike injuries sustained by US, North Atlantic Treaty Organization, and coalition military personnel. An understanding of injury epidemiology in twenty-first century armed conflict is required to plan humanitarian trauma systems capable of responding to population needs.

Methods: We conducted a systematic search of databases (e.

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