Publications by authors named "Natasha Hochberg"

In this prospective cohort of 2006 individuals with drug-susceptible tuberculosis in India, 18% had unfavorable treatment outcomes (4.7% treatment failure, 2.5% recurrent infection, 4.

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  • Blood-based gene signatures for tuberculosis (TB) have potential for diagnosing the disease, but it's unclear if gene set enrichment analysis alone is enough for accurate predictions compared to original models.
  • The study compared the performance of 19 TB gene signatures using various scoring methods across 24 datasets, evaluating how well these methods correlate with original trained models.
  • Results showed that many gene scoring methods produced similar or better prediction accuracy for active TB compared to original models, supporting their use in predicting TB risk and treatment outcomes.
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Chagas disease is an underrecognized, chronic, and potentially life-threatening disease caused by the parasite Trypanosoma cruzi. We aimed to improve awareness and screening for Chagas disease among patients from endemic areas using a large safety-net academic hospital system in the United States. We developed an educational intervention consisting of a case-based didactic session presented to physicians, trainees, and other healthcare providers at conferences across different departments.

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Background: Limited data exist regarding cardiac manifestations of Chagas disease in migrants living in non-endemic regions.

Methods: A retrospective cohort analysis of 109 patients with Chagas disease seen at Boston Medical Center (BMC) between January 2016 and January 2023 was performed. Patients were identified by screening and testing migrants from endemic regions at a community health center and BMC.

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Novel therapies for chronic indeterminate Chagas disease (CICD) are needed, but trials are limited by the absence of tests to detect infection and early treatment efficacy. This perspective highlights the shortfalls and strengths of polymerase chain reaction (PCR) as a study endpoint for anti-parasitic drug development. Serologic reversion, the gold standard test of cure, may take decades to occur in adults and therefore is challenging as an endpoint for drug development.

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  • * In 2018, the IDSA established the IDA&E Task Force to implement these priorities, while a 2021 meeting focused on best practices for training infectious disease fellows.
  • * The document highlights specific goals and strategies related to recruitment, clinical training, and faculty development, serving as a resource for ID training program directors.
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India has the highest global burden of tuberculosis (TB), accounting for a quarter of the worldwide TB disease incidence. Given the magnitude of India's epidemic, TB has enormous economic implications. Indeed, the majority of individuals with TB disease are in their prime years of economic productivity.

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The rapid emergence of immune-evading viral variants of SARS-CoV-2 calls into question the practicality of a vaccine-only public-health strategy for managing the ongoing COVID-19 pandemic. It has been suggested that widespread vaccination is necessary to prevent the emergence of future immune-evading mutants. Here, we examined that proposition using stochastic computational models of viral transmission and mutation.

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SARS-CoV-2 vaccinations were initially shown to substantially reduce risk of severe disease and death. However, pharmacokinetic (PK) waning and rapid viral evolution degrade neutralizing antibody (nAb) binding titers, causing loss of vaccinal protection. Additionally, there is inter-individual heterogeneity in the strength and durability of the vaccinal nAb response.

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  • * The disease is caused by a parasite transmitted mainly by the triatomine bug, but can also spread through blood transfusions, organ transplants, and from mother to child.
  • * About 30% of those infected may develop serious heart or digestive issues over time, so early screening and treatment with medications like benznidazole or nifurtimox are essential to prevent complications.
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  • Latent tuberculosis infection (LTBI) is diagnosed using the tuberculin skin test (TST) and Interferon-Gamma Release Assay (IGRA), though research on TB infection in women of reproductive age is limited.
  • In a study of married women aged 18-49, the prevalence of LTBI was 69%, with IGRA showing a higher positivity rate than TST; however, about 40% of participants had discordant test results indicating poor agreement between the two methods.
  • The findings suggest that IGRA may be a more reliable diagnostic tool for LTBI, highlighting the need for more extensive longitudinal studies across diverse populations to better understand and control tuberculosis.
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  • Many blood-based transcriptional gene signatures for tuberculosis (TB) aim to improve diagnosis, predict disease progression, and assess treatment outcomes, but there's uncertainty about whether gene set enrichment analysis (GSEA) alone is enough for effective predictions.
  • This study compares 19 TB gene signatures across multiple datasets using both original statistical models and gene set scoring methods to determine if the latter can reliably substitute the former.
  • The research includes open-access software for the 19 signatures and evaluates performance through various methods, finding that predictions from gene set scoring methods often align closely with the original models, suggesting they may be a viable alternative.
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  • COVID-19 symptoms differ greatly, and a study was conducted to assess the effectiveness of three clinical screening tools (NTS, ED ROS, and attending physician PA) in identifying COVID-19 cases confirmed by RT-PCR tests in patients admitted to Boston Medical Center.* -
  • Results showed that the attending physician's probability assessment (PA) was more sensitive and specific than the other methods, indicating it was better at predicting COVID-19 presence, but none were sufficient enough to serve as a standalone diagnostic tool.* -
  • The study concluded that while the attending PA was the most reliable screening method, all tools were not accurate enough to replace RT-PCR testing; thus, universal testing for COVID-19 before patient admissions is recommended.*
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In the face of a long-running pandemic, understanding the drivers of ongoing SARS-CoV-2 transmission is crucial for the rational management of COVID-19 disease burden. Keeping schools open has emerged as a vital societal imperative during the pandemic, but in-school transmission of SARS-CoV-2 can contribute to further prolonging the pandemic. In this context, the role of schools in driving SARS-CoV-2 transmission acquires critical importance.

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Background: Timika scoring system is a radiographic grading tool, widely employed for grading the severity of tuberculosis (TB). We evaluated the predictive accuracy of this tool for adverse treatment outcomes among TB patients in Indian setting.

Methods: We undertook a longitudinal analysis of cohort data under the RePORT-India consortium.

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Background: Tuberculosis (TB) is well-known for causing wasting. Patients on treatment gain weight and weight loss is associated with unfavorable treatment outcomes. There is limited description of weight loss and its predictors during intensive treatment phase.

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Background: Undernutrition is the leading risk factor for tuberculosis (TB) globally. Its impact on treatment outcomes is poorly defined.

Methods: We conducted a prospective cohort analysis of adults with drug-sensitive pulmonary TB at 5 sites from 2015-2019.

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Background: Most individuals exposed to (Mtb) develop latent tuberculosis infection (LTBI) and remain at risk for progressing to active tuberculosis disease (TB). Malnutrition is an important risk factor driving progression from LTBI to TB. However, the performance of blood-based TB risk signatures in malnourished individuals with LTBI remains unexplored.

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Background: Development of a prediction model using baseline characteristics of tuberculosis (TB) patients at the time of diagnosis will aid us in early identification of the high-risk groups and devise pertinent strategies accordingly. Hence, we did this study to develop a prognostic-scoring model for predicting the death among newly diagnosed drug sensitive pulmonary TB patients in South India.

Methods: We undertook a longitudinal analysis of cohort data under the Regional Prospective Observational Research for Tuberculosis India consortium.

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Mycobacterium tuberculosis (Mtb) is a complex pathogen causing multiple possible disease states in its host including latency, active disease, and elimination. While there is reasonable indirect evidence of elimination of tuberculosis (TB) in the absence of treatment, direct reports of autoregression are rare. We report a case of smear-negative, polymerase chain reaction (PCR)-positive TB disease regression in the absence of therapy due to severe adverse effects from antimycobacterial drugs.

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Background: A better understanding of the complex interplay between risk factors of tuberculosis (TB) is essential. This study was part of the Regional Prospective Observational Research for Tuberculosis (RePORT) India consortium and includes newly diagnosed TB patients in Puducherry between 2014 and 2018. We employed mediation analysis to identify the effect of treatment adherence on association between sex and unfavourable TB treatment outcomes.

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Tuberculosis (TB) is a major cause of death worldwide, with 1.5 million deaths in 2020. While TB incidence and mortality had previously been on a downwards trend, in 2020, TB mortality actually rose for the first time in a decade, largely due to the COVID-19 pandemic.

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