Publications by authors named "Travis Porco"

Prisons have been hotspots for COVID-19 and likely an important driver of racial disparity in disease burden. From the first COVID-19 case detected through March 25, 2022, 66,684 of 196,652 residents of California's state prison system were infected, most of them in two large winter waves of outbreaks that reached all 35 of the state prisons. We used individual-level data on disease timing and nightly room assignments in these prisons to reconstruct locations and pathways of transmission statistically, and from that estimated reproduction numbers, locations of unobserved infection events, and the subsequent magnitude and distribution of long COVID prevalence.

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Children with acute malnutrition are at high risk of morality. Mass azithromycin distribution reduces all-cause mortality among children aged 1-59 months, and effects may be greater in underweight infants. Here, we evaluate the efficacy of azithromycin for reducing all-cause mortality in children aged 6-59 months with acute malnutrition (mid-upper arm circumference, MUAC, < 12.

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Background: Manually analyzing public health-related content from social media provides valuable insights into the beliefs, attitudes, and behaviors of individuals, shedding light on trends and patterns that can inform public understanding, policy decisions, targeted interventions, and communication strategies. Unfortunately, the time and effort needed from well-trained human subject matter experts makes extensive manual social media listening unfeasible. Generative large language models (LLMs) can potentially summarize and interpret large amounts of text, but it is unclear to what extent LLMs can glean subtle health-related meanings in large sets of social media posts and reasonably report health-related themes.

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Purpose: The choroidal thickening and serous retinal detachments that characterize Vogt-Koyanagi-Harada (VKH) disease can be imaged in detail using spectral domain optical coherence tomography (SD-OCT). Whether specific qualitative and quantitative SD-OCT features at presentation were associated with visual outcomes in a randomized controlled trial comparing methotrexate to mycophenolate for steroid-sparing control of uveitis were evaluated.

Methods: An exploratory subanalysis of data from the FAST trial in which SD-OCT images from VKH participants were analyzed for presence/absence of bacillary detachments, retinal pigment epithelium (RPE) folds, and internal limiting membrane (ILM) fluctuations was performed.

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Background: Twice-yearly mass distribution of azithromycin to children is a promising intervention to reduce childhood mortality in sub-Saharan Africa. The World Health Organization recommended restricting distribution to infants 1 to 11 months of age to mitigate antimicrobial resistance, although this more limited treatment had not yet been tested.

Methods: We randomly assigned rural communities in Niger to four twice-yearly distributions of azithromycin for children 1 to 59 months of age (child azithromycin group), four twice-yearly distributions of azithromycin for infants 1 to 11 months of age and placebo for children 12 to 59 months of age (infant azithromycin group), or placebo for children 1 to 59 months of age.

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Feed wastage in laboratory mice, also known as chewing or grinding behavior, is problematic for program management and animal welfare. The destruction of pelleted feed without consumption produces a powder accumulation on the cage floor called orts. Ort accumulation disrupts the cage microenvironment and can clog Lixits resulting in flooding.

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Article Synopsis
  • The study aimed to explore the relationship between weather variables and various pathogens linked to infectious conjunctivitis globally.
  • Researchers analyzed data from 498 cases across 8 countries, correlating pathogen types with weather data, particularly looking at temperature, precipitation, and humidity.
  • Findings indicated that higher humidity and precipitation increased the likelihood of RNA virus and fungal infections while decreasing the odds of DNA virus and bacterial infections, highlighting the complex influence of weather on conjunctivitis-related pathogens.
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Importance: Infectious conjunctivitis can lead to corneal involvement and result in ocular morbidity. The identification of biomarkers associated with corneal involvement has the potential to improve patient care.

Objective: To identify biomarkers in patients with acute infectious conjunctivitis.

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Article Synopsis
  • - The study examines the management of Trachomatous Trichiasis (TT) after eliminating Trachoma inflammation-follicular (TF) in children, focusing on the timeline and program requirements based on data from women in Kongwa, Tanzania.
  • - Using Markov models, the incidence rates of scarring progression (from no scarring to TT) were analyzed, revealing that higher community prevalence of TF significantly increases the risk of scarring.
  • - The findings indicate that even after achieving TF elimination, some districts may continue to experience cases of TT for decades, particularly in areas with a history of TF prevalence above 5%.
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Purpose: To compare the effectiveness of methotrexate (MTX) and mycophenolate mofetil (MMF) in achieving corticosteroid-sparing control of uveitis in patients with Vogt-Koyanagi-Harada (VKH) disease.

Methods: A subanalysis of patients with VKH from the First-line Antimetabolites as Steroid-sparing Treatment Uveitis Trial, a randomized, observer-masked, comparative effectiveness trial, with comparisons by treatment (MTX vs MMF) and disease stage (acute vs chronic). Individuals with noninfectious uveitis were placed on a standardized corticosteroid taper and block randomized 1:1 to either 25 mg weekly oral MTX or 1.

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Objectives: To determine the associated pathogen during the 2023 conjunctivitis outbreak in Vietnam METHODS: RNA-sequencing was used to identify pathogens before and during the outbreak.

Results: 24 patients with infectious conjunctivitis between March and October 2023 from Hai Yen Vision Institute in Vietnam were swabbed. Coxsackievirus A24v was the most common pathogen identified.

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Purpose: Conjunctivitis epidemics and pandemics remain a global burden. This study aims to comprehensively identify pathogens associated with conjunctivitis in Vietnam.

Methods: Patients with acute conjunctivitis presented to an outpatient clinic in Ho Chi Minh City, Vietnam, were enrolled from September 2022 to March 2023.

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Background: The risk of antibiotic resistance is complicated by the potential for spillover effects from one treated population to another. Azithromycin mass drug administration programs report higher rates of antibiotic resistance among treatment arms in targeted groups. This study aimed to understand the risk of spillover of antibiotic resistance to nontarget groups in these programs.

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Background: Randomized controlled trials found that twice-yearly mass azithromycin administration (MDA) reduces childhood mortality, presumably by reducing infection burden. World Health Organization (WHO) issued conditional guidelines for mass azithromycin administration in high-mortality settings in sub-Saharan Africa given concerns for antibiotic resistance. While prolonged twice-yearly MDA has been shown to increase antibiotic resistance in small randomized controlled trials, the objective of this study was to determine if macrolide and non-macrolide resistance in the gut increases with the duration of azithromycin MDA in a larger setting.

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Assessing the feasibility of 2030 as a target date for global elimination of trachoma, and identification of districts that may require enhanced treatment to meet World Health Organization (WHO) elimination criteria by this date are key challenges in operational planning for trachoma programmes. Here we address these challenges by prospectively evaluating forecasting models of trachomatous inflammation-follicular (TF) prevalence, leveraging ensemble-based approaches. Seven candidate probabilistic models were developed to forecast district-wise TF prevalence in 11 760 districts, trained using district-level data on the population prevalence of TF in children aged 1-9 years from 2004 to 2022.

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Article Synopsis
  • Millions of doses of azithromycin are distributed yearly for trachoma, but its effectiveness for treating ocular Chlamydia in children hasn't been well studied.
  • In a study involving four villages in Niger, 426 children aged 0-5 were monitored for ocular Chlamydia after receiving a single dose of azithromycin, revealing 6% were still infected after 6 months and 15% after 12 months.
  • The study highlighted that children already infected before treatment had a higher risk of persistent infection, suggesting that targeting those children with additional interventions may improve treatment outcomes.
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Article Synopsis
  • - The study explored the potential of large language models, specifically GPT-3.5 and GPT-4, to analyze social media posts for signs of conjunctivitis outbreaks by evaluating 12,194 related tweets across various countries from 2012 to 2023.
  • - Results showed that GPT-3.5's probabilistic assessments correlated well with evaluations from human raters and with tweet volumes in some regions, while GPT-4 demonstrated even stronger correlations.
  • - Overall, the research indicates that using AI to analyze social media could serve as an effective early warning system for identifying potential infectious disease outbreaks, particularly conjunctivitis.
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Importance: Repeated mass distribution of azithromycin has been shown to reduce childhood mortality by 14% in sub-Saharan Africa. However, the estimated effect varied by location, suggesting that the intervention may not be effective in different geographical areas, time periods, or conditions.

Objective: To evaluate the efficacy of twice-yearly azithromycin to reduce mortality in children in the presence of seasonal malaria chemoprevention.

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Background: Mass distribution of azithromycin to children 1 to 59 months of age has been shown to reduce childhood all-cause mortality in some sub-Saharan African regions, with the largest reduction seen among infants younger than 12 months of age. Whether the administration of azithromycin at routine health care visits for infants would be effective in preventing death is unclear.

Methods: We conducted a randomized, placebo-controlled trial of a single dose of azithromycin (20 mg per kilogram of body weight) as compared with placebo, administered during infancy (5 to 12 weeks of age).

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Mass antibiotic distribution to preschool children resulted in alterations of the gut microbiome months after distribution. This individually randomized, placebo-controlled trial evaluated changes in the gut microbiome and resistome in children aged 8 days to 59 months after one dose of oral azithromycin in Burkina Faso. A total of 450 children were randomized in a 1:1 ratio to either placebo or azithromycin.

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Article Synopsis
  • The text serves as a correction for a previously published article, identified by the DOI 10.1371/journal.pmed.1003793.
  • It indicates that there were errors or inaccuracies in the original publication that needed to be addressed.
  • The correction ensures the integrity and accuracy of the scientific record for readers and researchers.
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Importance: Acute infectious conjunctivitis is a common ocular condition with major public health consequences.

Objective: To assess regional variations and microbial etiologies of acute infectious conjunctivitis to guide treatment.

Design, Setting, And Participants: In this cross-sectional study, patients with presumed acute infectious conjunctivitis were enrolled in the study at 5 sites (Honolulu, Hawaii; Los Angeles, San Francisco, and San Diego, California; and Petah-Tikva, Israel) from March 2021 to March 2023.

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Azithromycin mass drug administration decreases child mortality but also selects for antibiotic resistance. Herein, we evaluate macrolide resistance of nasopharyngeal Streptococcus pneumoniae after azithromycin MDA. In a cluster-randomized trial, children 1-59 months received azithromycin or placebo biannually.

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Clinic-based recruitment for preventative interventions for child health may select for healthier populations compared with community-based outreach. Nutritional status during infancy as measured by anthropometry is predictive of mortality, growth faltering later in life, and poor cognitive development outcomes. We evaluated baseline differences in infant nutritional status among children recruited directly in their community versus clinic recruitment among infants participating in a trial of azithromycin compared with placebo for prevention of mortality in three districts of Burkina Faso.

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Background: Open tibial fractures have a high risk of infection that can lead to severe morbidity. Antibiotics administered locally at the site of the open wound are a potentially effective preventive measure, but there are limited data evaluating aminoglycoside antibiotics. The objective of this study was to assess the feasibility of a clinical trial to test the efficacy of local gentamicin in reducing the risk of fracture-related infection after open tibial fracture.

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