David Dowdy
Dados Biográficos
| ID | 1731171 |
|---|---|
| NOME | David Dowdy |
| PRENOMES | David |
| SOBRENOME | Dowdy |
| ASSINATURA | DOWDY D |
| AFILIAÇÕES | Johns Hopkins University |
| ORCID | 0000-0003-0481-7475 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 31 |
| TOTAL DE CITAÇÕES | 2 |
| TOTAL COMO AUTOR | 31 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2009 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 1 |
Predicted choice and acceptability of regimens for tuberculosis preventive treatment among people living with HIV in Uganda – A discrete choice experiment
Little is known about people living with HIV’s preferences for different tuberculosis preventive treatment (TPT) regimens, or the conditions under which they would accept treatment. Actionable evidence regarding preference for TPT is needed to inform policy and the development of novel TPT regimens. Adults engaged in care at an HIV clinic in Kampala, Uganda, completed a discrete choice experiment survey with nine random choice tasks. In each task…
Resources to implement general population mobile chest x-ray screening for tuberculosis in Uganda
Mobile chest X-ray (CXR) screening interventions are recommended for tuberculosis (TB) screening in high-burden settings, but implementation costs are variable and underreported. Using time-driven activity-based costing, we evaluated the costs of implementing general-population mobile CXR screening in peri-urban Uganda. We conducted a micro-costing analysis of mobile CXR screening using data from an ongoing randomized crossover trial. We adopted …
Cost-effectiveness of in-kind nutritional support for impoverished persons with tuberculosis to reduce mortality and disengagement from care in India
BACKGROUND: Undernutrition is a leading risk factor for tuberculosis (TB) mortality and poor treatment outcomes. We evaluated the cost-effectiveness of providing in-kind nutritional support to impoverished persons with TB (PWTB) in India. METHODS: We developed a Markov model comparing standard care with a household-level nutritional food-basket intervention. Model parameters were informed from systematic reviews and a recent cluster-randomised st…
Combination interventions to control the tuberculosis epidemic in the Karamoja subregion of Uganda
The Karamoja subregion in northeastern Uganda is disproportionately affected by tuberculosis (TB), with an estimated TB prevalence >3 times the national average. Recently introduced health systems strengthening (HSS) interventions, including active symptom screening campaigns covering approximately 20% of the population annually, have substantially increased the number of people initiated on TB treatment, improved TB treatment completion and incr…
An extended cost-effectiveness analysis of decentralised TB diagnostic testing with Molbio Truenat MTB/RIF versus hub-and-spoke GeneXpert MTB/RIF in Mozambique and Tanzania
BACKGROUND: In low- and middle-income countries (LMICs), tuberculosis (TB) regained its status as the leading cause of death from a single infectious agent in 2023, surpassing COVID-19. Rapid and accurate diagnosis is critical, with decentralised diagnostic strategies offering a promising solution. Although decentralised diagnostic strategies have been proven cost-effective, further evidence is needed on affordability and equity in high-burden se…
A cluster-randomized trial of household vs incentive-based tuberculosis contact investigation in rural South Africa
The World Health Organization recommends TB contact investigation in high-burden countries. We examined the implementation reach of two contact investigation strategies in South Africa . Kharitode TB, a cluster-randomized crossover trial, compared household- and incentive-based contact investigation in 28 clinics (July 2016-January 2020). Clinics used each strategy for 18 months (separated by a six-month “washout”). Adults recently diagnosed with…
Decentralized TB diagnostic testing with Truenat MTB Plus and MTB-RIF Dx vs. hub-and-spoke GeneXpert MTB/RIF Ultra in Mozambique and Tanzania
In low-and middle-income countries, missed or delayed tuberculosis (TB) diagnoses contribute to avoidable morbidity, mortality, and transmission. Decentralized testing platforms, such as the Molbio Truenat, may offer solutions by providing accurate point-of-care testing, improving access, and lowering out-of-pocket costs. Despite these advantages, the overall cost and cost-effectiveness of identifying additional TB cases using the Truenat MTB ass…
Cost and cost-effectiveness of pediatric home-based versus facility-based TB Preventive Treatment in Ethiopia (CHIP-TB)
Tuberculosis preventive treatment (TPT) is an essential intervention recommended for all child contacts in Ethiopia under 15 years who are at risk of tuberculosis (TB) infection. We conducted a cost and cost-effectiveness analysis of home-based versus facility-based TPT provision for child contacts in Ethiopia. As part of the CHIP TB trial, a pragmatic, cluster-randomized trial conducted at eighteen clinics in Ethiopia, clinics were randomized to…
Evaluating the impact of decentralized testing for tuberculosis in Ghana
Poor geographical accessibility to tuberculosis (TB) diagnostic services in Ghana is a key barrier to timely diagnosis. Decentralizing molecular testing for TB could improve TB case notification among underserved populations and enhance treatment initiation while avoiding unnecessary treatments. This study aims to project the epidemiological impact of decentralized TB testing at the country level. We developed an individual-based simulation of th…
Timeliness of yellow fever specimen collection and transport in Ghana, 2018–2022
Yellow fever is a mosquito-borne viral hemorrhagic fever, and recent outbreaks of yellow fever have occurred in multiple African countries, including Ghana (2021–2022). Delayed diagnosis of yellow fever may cause increased morbidity and mortality. To improve timely detection of yellow fever, we need to better understand the factors contributing to diagnostic delays. We analyzed the diagnostic testing timeline of all suspected yellow fever cases i…
Group-based trajectory modeling to describe the geographical distribution of tuberculosis notifications
GBTM is a powerful tool for identifying geographic clusters of varying levels of TB notification when longitudinal data on the number of TB diagnoses are available. This analysis can inform the planning and evaluation of intervention strategies
How to incorporate social vulnerability into epidemic mathematical modelling
Yellow fever in Ghana
Understanding the epidemiology and ecology of yellow fever in endemic regions is critical for preventing future outbreaks. Ghana is a high-risk country for yellow fever. In this study we estimate the disease burden, ecological cycles, and areas at risk for yellow fever in Ghana based on historical outbreaks. We identify 2387 cases and 888 deaths (case fatality rate 37.7%) from yellow fever reported in Ghana from 1910 to 2022. During the approxima…
Evaluating the implementation of weekly rifapentine-isoniazid (3HP) for tuberculosis prevention among people living with HIV in Uganda
Three months of isoniazid-rifapentine (3HP) is being scaled up for tuberculosis (TB) preventive treatment (TPT) among people living with HIV (PLHIV) in high-burden settings. More evidence is needed to identify factors influencing successful 3HP delivery. We conducted a qualitative assessment of 3HP delivery nested within the 3HP Options Trial, which compared three optimized strategies for delivering 3HP: facilitated directly observed therapy (DOT…
Alcohol use as a mediator of the effect of two alcohol reduction interventions on mental health symptoms of ART clients in Vietnam
We aimed to examine the mediating role of alcohol use in the pathway from the interventions to depression and anxiety symptoms using data from a randomized controlled trial among people living with HIV (PWH) with hazardous alcohol use (n = 440) in Thai Nguyen, Vietnam. Participants were randomized into either a combined intervention (CoI), a brief intervention (BI) and a standard of care arm. Both interventions were based on cognitive behavioral …
A user-centred implementation strategy for tuberculosis contact investigation in Uganda
The trial was registered(ClinicalTrials.gov Identifier NCT05640648) on 16 November 2022, after the trial launch on 7 March 2022
Efficacy of Two Evidence-Based Alcohol Consumption Interventions on Positive, Negative, and Neutral Days Among Hazardous Alcohol Users Living with HIV in Vietnam
Cost-effectiveness analysis of human-centred design for global health interventions
INTRODUCTION: Human-centred design (HCD) is a problem-solving approach that is increasingly used to develop new global health interventions. However, there is often a large initial cost associated with HCD, and global health decision-makers would benefit from an improved understanding of the cost-effectiveness of HCD, particularly the trade-offs between the up-front costs of design and the long-term costs of delivering health interventions. METHO…
Disadvantage and the experience of treatment for multidrug-resistant tuberculosis (MDR-TB)
In the present research, we aimed to demonstrate how exploring patients’ treatment experiences may help decision makers better understand and pay attention to social impacts of health interventions. We take multi-drug-resistant tuberculosis (MDR-TB) as a paradigm case of a disease that disproportionately affects people already living with disadvantage and for which treatment itself is extremely burdensome. We conducted a total of 140 in-depth int…
A controlled study to assess the effects of a Fast Track (FT) service delivery model among stable HIV patients in Lusaka Zambia
Fast Track models—in which patients coming to facility to pick up medications minimize waiting times through foregoing clinical review and collecting pre-packaged medications—present a potential strategy to reduce the burden of treatment. We examine effects of a Fast Track model (FT) in a real-world clinical HIV treatment program on retention to care comparing two clinics initiating FT care to five similar (in size and health care level), standar…
I refused to drink but they still forced me
Effects of Two Alcohol Reduction Interventions on Depression and Anxiety Symptoms of ART Clients in Vietnam
The Cost-Effectiveness of Adapting and Implementing a Brief Intervention to Target Frequent Alcohol Use Among Persons with HIV in Vietnam
Implementation of two alcohol reduction interventions among persons with hazardous alcohol use who are living with HIV in Thai Nguyen, Vietnam
BACKGROUND: Hazardous alcohol use is detrimental to persons with HIV (PWH), impacting medication adherence and liver function, yet globally resources to target alcohol use behavior in this population are limited. Few studies have identified the costs of integrating alcohol reduction interventions into HIV care. OBJECTIVE: To estimate the costs of implementing and delivering two evidence-based behavioral counseling interventions targeting hazardou…
Advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals
Tuberculosis Incidence Among Populations at High Risk in California, Florida, New York, and Texas, 2011–2015
Objectives. To illustrate the magnitude of between-state heterogeneities in tuberculosis (TB) incidence among US populations at high risk for TB that may help guide state-specific strategies for TB elimination. Methods. We used data from the National Tuberculosis Surveillance System and other public sources from 2011 to 2015 to calculate TB incidence in every US state among people who were non–US-born, had diabetes, or were HIV-positive, homeless…
Antiretroviral Therapy Adherence, Virologic and Immunologic Outcomes in Adolescents Compared With Adults in Southern Africa
OBJECTIVE: To determine adherence to and effectiveness of antiretroviral therapy (ART) in adolescents vs. adults in southern Africa. DESIGN: Observational cohort study. SETTING: Aid for AIDS, a private sector disease management program in southern Africa. SUBJECTS: Adolescents (age 11-19 years; n = 154) and adults (n = 7622) initiating ART between 1999 and 2006 and having a viral load measurement within 1 year after ART initiation. MAIN OUTCOME M…
Evaluating the cost of adult voluntary medical male circumcision in a mixed (surgical and PrePex) site compared to a hypothetical PrePex-only site in South Africa
BACKGROUND: Several circumcision devices have been evaluated for a safe and simplified male circumcision among adults. The PrePex device was prequalified for voluntary male medical circumcision (VMMC) in May 2013 by the World Health Organization and is expected to simplify the procedure safely while reducing cost. South Africa is scaling up VMMC. OBJECTIVE: To evaluate the overall unit cost of VMMC at a mixed site vs. a hypothetical PrePex-only s…
Advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals
The effect of partner HIV status on motivation to take antiretroviral and isoniazid preventive therapies
Antiretroviral therapy (ART) and isoniazid preventive therapy (IPT) are important to reduce morbidity and mortality among people newly diagnosed of HIV. The successful uptake of ART and IPT requires a comprehensive understanding of patients' motivation to take such therapies. Partners also play an important role in the decision to be initiated and retained in care. We quantified patients' motivation to take preventive therapies (ART and IPT) and …
Modelling the impact of social protection on tuberculosis
Results are to be confirmed with further analysis. However, by developing a generalizable modelling framework, S-PROTECT proved that the modelling of social protection is complex, but doable and allowed to draw the research road map for the future in this field
Maternal Motivation to Take Preventive Therapy in Antepartum and Postpartum Among HIV-Positive Pregnant Women in South Africa
Tuberculosis Incidence Among Populations at High Risk in California, Florida, New York, and Texas, 2011–2015
Objectives. To illustrate the magnitude of between-state heterogeneities in tuberculosis (TB) incidence among US populations at high risk for TB that may help guide state-specific strategies for TB elimination. Methods. We used data from the National Tuberculosis Surveillance System and other public sources from 2011 to 2015 to calculate TB incidence in every US state among people who were non–US-born, had diabetes, or were HIV-positive, homeless…
Implementation of two alcohol reduction interventions among persons with hazardous alcohol use who are living with HIV in Thai Nguyen, Vietnam
BACKGROUND: Hazardous alcohol use is detrimental to persons with HIV (PWH), impacting medication adherence and liver function, yet globally resources to target alcohol use behavior in this population are limited. Few studies have identified the costs of integrating alcohol reduction interventions into HIV care. OBJECTIVE: To estimate the costs of implementing and delivering two evidence-based behavioral counseling interventions targeting hazardou…
Effects of Two Alcohol Reduction Interventions on Depression and Anxiety Symptoms of ART Clients in Vietnam
The Cost-Effectiveness of Adapting and Implementing a Brief Intervention to Target Frequent Alcohol Use Among Persons with HIV in Vietnam
Cost-effectiveness analysis of human-centred design for global health interventions
INTRODUCTION: Human-centred design (HCD) is a problem-solving approach that is increasingly used to develop new global health interventions. However, there is often a large initial cost associated with HCD, and global health decision-makers would benefit from an improved understanding of the cost-effectiveness of HCD, particularly the trade-offs between the up-front costs of design and the long-term costs of delivering health interventions. METHO…
Disadvantage and the experience of treatment for multidrug-resistant tuberculosis (MDR-TB)
In the present research, we aimed to demonstrate how exploring patients’ treatment experiences may help decision makers better understand and pay attention to social impacts of health interventions. We take multi-drug-resistant tuberculosis (MDR-TB) as a paradigm case of a disease that disproportionately affects people already living with disadvantage and for which treatment itself is extremely burdensome. We conducted a total of 140 in-depth int…
A controlled study to assess the effects of a Fast Track (FT) service delivery model among stable HIV patients in Lusaka Zambia
Fast Track models—in which patients coming to facility to pick up medications minimize waiting times through foregoing clinical review and collecting pre-packaged medications—present a potential strategy to reduce the burden of treatment. We examine effects of a Fast Track model (FT) in a real-world clinical HIV treatment program on retention to care comparing two clinics initiating FT care to five similar (in size and health care level), standar…
I refused to drink but they still forced me
Alcohol use as a mediator of the effect of two alcohol reduction interventions on mental health symptoms of ART clients in Vietnam
We aimed to examine the mediating role of alcohol use in the pathway from the interventions to depression and anxiety symptoms using data from a randomized controlled trial among people living with HIV (PWH) with hazardous alcohol use (n = 440) in Thai Nguyen, Vietnam. Participants were randomized into either a combined intervention (CoI), a brief intervention (BI) and a standard of care arm. Both interventions were based on cognitive behavioral …
A user-centred implementation strategy for tuberculosis contact investigation in Uganda
The trial was registered(ClinicalTrials.gov Identifier NCT05640648) on 16 November 2022, after the trial launch on 7 March 2022
Efficacy of Two Evidence-Based Alcohol Consumption Interventions on Positive, Negative, and Neutral Days Among Hazardous Alcohol Users Living with HIV in Vietnam
Yellow fever in Ghana
Understanding the epidemiology and ecology of yellow fever in endemic regions is critical for preventing future outbreaks. Ghana is a high-risk country for yellow fever. In this study we estimate the disease burden, ecological cycles, and areas at risk for yellow fever in Ghana based on historical outbreaks. We identify 2387 cases and 888 deaths (case fatality rate 37.7%) from yellow fever reported in Ghana from 1910 to 2022. During the approxima…
Evaluating the implementation of weekly rifapentine-isoniazid (3HP) for tuberculosis prevention among people living with HIV in Uganda
Three months of isoniazid-rifapentine (3HP) is being scaled up for tuberculosis (TB) preventive treatment (TPT) among people living with HIV (PLHIV) in high-burden settings. More evidence is needed to identify factors influencing successful 3HP delivery. We conducted a qualitative assessment of 3HP delivery nested within the 3HP Options Trial, which compared three optimized strategies for delivering 3HP: facilitated directly observed therapy (DOT…
An extended cost-effectiveness analysis of decentralised TB diagnostic testing with Molbio Truenat MTB/RIF versus hub-and-spoke GeneXpert MTB/RIF in Mozambique and Tanzania
BACKGROUND: In low- and middle-income countries (LMICs), tuberculosis (TB) regained its status as the leading cause of death from a single infectious agent in 2023, surpassing COVID-19. Rapid and accurate diagnosis is critical, with decentralised diagnostic strategies offering a promising solution. Although decentralised diagnostic strategies have been proven cost-effective, further evidence is needed on affordability and equity in high-burden se…
A cluster-randomized trial of household vs incentive-based tuberculosis contact investigation in rural South Africa
The World Health Organization recommends TB contact investigation in high-burden countries. We examined the implementation reach of two contact investigation strategies in South Africa . Kharitode TB, a cluster-randomized crossover trial, compared household- and incentive-based contact investigation in 28 clinics (July 2016-January 2020). Clinics used each strategy for 18 months (separated by a six-month “washout”). Adults recently diagnosed with…
Decentralized TB diagnostic testing with Truenat MTB Plus and MTB-RIF Dx vs. hub-and-spoke GeneXpert MTB/RIF Ultra in Mozambique and Tanzania
In low-and middle-income countries, missed or delayed tuberculosis (TB) diagnoses contribute to avoidable morbidity, mortality, and transmission. Decentralized testing platforms, such as the Molbio Truenat, may offer solutions by providing accurate point-of-care testing, improving access, and lowering out-of-pocket costs. Despite these advantages, the overall cost and cost-effectiveness of identifying additional TB cases using the Truenat MTB ass…
Cost and cost-effectiveness of pediatric home-based versus facility-based TB Preventive Treatment in Ethiopia (CHIP-TB)
Tuberculosis preventive treatment (TPT) is an essential intervention recommended for all child contacts in Ethiopia under 15 years who are at risk of tuberculosis (TB) infection. We conducted a cost and cost-effectiveness analysis of home-based versus facility-based TPT provision for child contacts in Ethiopia. As part of the CHIP TB trial, a pragmatic, cluster-randomized trial conducted at eighteen clinics in Ethiopia, clinics were randomized to…
Evaluating the impact of decentralized testing for tuberculosis in Ghana
Poor geographical accessibility to tuberculosis (TB) diagnostic services in Ghana is a key barrier to timely diagnosis. Decentralizing molecular testing for TB could improve TB case notification among underserved populations and enhance treatment initiation while avoiding unnecessary treatments. This study aims to project the epidemiological impact of decentralized TB testing at the country level. We developed an individual-based simulation of th…
Timeliness of yellow fever specimen collection and transport in Ghana, 2018–2022
Yellow fever is a mosquito-borne viral hemorrhagic fever, and recent outbreaks of yellow fever have occurred in multiple African countries, including Ghana (2021–2022). Delayed diagnosis of yellow fever may cause increased morbidity and mortality. To improve timely detection of yellow fever, we need to better understand the factors contributing to diagnostic delays. We analyzed the diagnostic testing timeline of all suspected yellow fever cases i…
Medicine (23 obras) · Tuberculosis (12 obras) · Tuberculosis Research and Epidemiology (12 obras) · HIV/AIDS Research and Interventions (11 obras) · Public health (11 obras) · Psychological intervention (10 obras) · Environmental health (8 obras) · Internal Medicine (8 obras) · Family medicine (7 obras) · Nursing (6 obras)