Publications by authors named "Trini Mathew"

15 Publications

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The LGBTQ+ communities and the COVID-19 pandemic: a call to break the cycle of structural barriers.

J Infect Dis 2021 Jul 29. Epub 2021 Jul 29.

Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; USA.

The COVID-19 pandemic has disproportionately impacted LGBTQ+ communities. Many disparities mirror those of the HIV/AIDS epidemic. These health inequities have repeated throughout history due to the structural oppression of LGBTQ+ people. We aim to demonstrate that the familiar patterns of LGBTQ+ health disparities reflect a perpetuating, deeply rooted cycle of injustice imposed on LGBTQ+ people. Here, we contextualize COVID-19 inequities through the history of the HIV/AIDS crisis, describe manifestations of LGBTQ+ structural oppression exacerbated by the pandemic, and provide recommendations for medical professionals and institutions seeking to reduce health inequities.
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http://dx.doi.org/10.1093/infdis/jiab392DOI Listing
July 2021

Multisociety statement on coronavirus disease 2019 (COVID-19) vaccination as a condition of employment for healthcare personnel.

Infect Control Hosp Epidemiol 2021 Jul 13:1-9. Epub 2021 Jul 13.

Denver Health Medical Center, Denver, Colorado.

This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Society for Post-Acute and Long-Term Care Medicine (AMDA), the Association for Professionals in Epidemiology and Infection Control (APIC), the HIV Medicine Association (HIVMA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) recommends that coronavirus disease 2019 (COVID-19) vaccination should be a condition of employment for all healthcare personnel in facilities in the United States. Exemptions from this policy apply to those with medical contraindications to all COVID-19 vaccines available in the United States and other exemptions as specified by federal or state law. The consensus statement also supports COVID-19 vaccination of nonemployees functioning at a healthcare facility (eg, students, contract workers, volunteers, etc).
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http://dx.doi.org/10.1017/ice.2021.322DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8376851PMC
July 2021

Location Matters: Geographic Disparities and Impact of Coronavirus Disease 2019.

J Infect Dis 2020 Nov;222(12):1951-1954

Meharry Medical College, Department of Medicine, Division of Infectious Diseases, Nashville, Tennessee, USA.

The coronavirus disease 2019 (COVID-19) pandemic in the United States has revealed major disparities in the access to testing and messaging about the pandemic based on the geographic location of individuals, particularly in communities of color, rural areas, and areas of low income. This geographic disparity, in addition to deeply rooted structural inequities, have posed additional challenges to adequately diagnose and provide care for individuals of all ages living in these settings. We describe the impact that COVID-19 has had on geographically disparate populations in the United States and share our recommendations on what might be done to ameliorate the current situation.
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http://dx.doi.org/10.1093/infdis/jiaa583DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543383PMC
November 2020

Policy statement from the Society for Healthcare Epidemiology of America (SHEA): Only medical contraindications should be accepted as a reason for not receiving all routine immunizations as recommended by the Centers for Disease Control and Prevention.

Infect Control Hosp Epidemiol 2021 01 17;42(1):1-5. Epub 2020 Sep 17.

Christiana Care Health System, Newark, Delaware.

SHEA endorses adhering to the recommendations by the CDC and ACIP for immunizations of all children and adults. All persons providing clinical care should be familiar with these recommendations and should routinely assess immunization compliance of their patients and strongly recommend all routine immunizations to patients. All healthcare personnel (HCP) should be immunized against vaccine-preventable diseases as recommended by the CDC/ACIP (unless immunity is demonstrated by another recommended method). SHEA endorses the policy that immunization should be a condition of employment or functioning (students, contract workers, volunteers, etc) at a healthcare facility. Only recognized medical contraindications should be accepted for not receiving recommended immunizations.
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http://dx.doi.org/10.1017/ice.2020.342DOI Listing
January 2021

Tuberculosis Screening, Testing, and Treatment of US Health Care Personnel: ACOEM and NTCA Joint Task Force on Implementation of the 2019 MMWR Recommendations.

J Occup Environ Med 2020 07;62(7):e355-e369

American College of Occupational and Environmental Medicine, Elk Grove, Illinois.

: On May 17, 2019, the US Centers for Disease Control and Prevention and National Tuberculosis Controllers Association issued new Recommendations for Tuberculosis Screening, Testing, and Treatment of Health Care Personnel, United States, 2019, updating the health care personnel-related sections of the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005. This companion document offers the collective effort and experience of occupational health, infectious disease, and public health experts from major academic and public health institutions across the United States and expands on each section of the 2019 recommendations to provide clarifications, explanations, and considerations that go beyond the 2019 recommendations to answer questions that may arise and to offer strategies for implementation.
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http://dx.doi.org/10.1097/JOM.0000000000001904DOI Listing
July 2020

COVID-19 Pandemic: Disparate Health Impact on the Hispanic/Latinx Population in the United States.

J Infect Dis 2020 10;222(10):1592-1595

Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

In December 2019, a novel coronavirus known as SARS-CoV-2, emerged in Wuhan, China, causing the coronavirus disease 2019 we now refer to as COVID-19. The World Health Organization declared COVID-19 a pandemic on 12 March 2020. In the United States, the COVID-19 pandemic has exposed preexisting social and health disparities among several historically vulnerable populations, with stark differences in the proportion of minority individuals diagnosed with and dying from COVID-19. In this article we will describe the emerging disproportionate impact of COVID-19 on the Hispanic/Latinx (henceforth: Hispanic or Latinx) community in the United States, discuss potential antecedents, and consider strategies to address the disparate impact of COVID-19 on this population.
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http://dx.doi.org/10.1093/infdis/jiaa474DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454709PMC
October 2020

Racial Disparity of Coronavirus Disease 2019 in African American Communities.

J Infect Dis 2020 08;222(6):890-893

Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

The coronavirus disease 2019 (COVID-19) pandemic has unveiled unsettling disparities in the outcome of the disease among African Americans. These disparities are not new but are rooted in structural inequities that must be addressed to adequately care for communities of color. We describe the historical context of these structural inequities, their impact on the progression of COVID-19 in the African American (black) community, and suggest a multifaceted approach to addressing these healthcare disparities. (Of note, terminology from survey data cited for this article varied from blacks, African Americans, or both; for consistency, we use African Americans throughout.).
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http://dx.doi.org/10.1093/infdis/jiaa372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337812PMC
August 2020

Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019.

MMWR Morb Mortal Wkly Rep 2019 May 17;68(19):439-443. Epub 2019 May 17.

The 2005 CDC guidelines for preventing Mycobacterium tuberculosis transmission in health care settings include recommendations for baseline tuberculosis (TB) screening of all U.S. health care personnel and annual testing for health care personnel working in medium-risk settings or settings with potential for ongoing transmission (1). Using evidence from a systematic review conducted by a National Tuberculosis Controllers Association (NTCA)-CDC work group, and following methods adapted from the Guide to Community Preventive Services (2,3), the 2005 CDC recommendations for testing U.S. health care personnel have been updated and now include 1) TB screening with an individual risk assessment and symptom evaluation at baseline (preplacement); 2) TB testing with an interferon-gamma release assay (IGRA) or a tuberculin skin test (TST) for persons without documented prior TB disease or latent TB infection (LTBI); 3) no routine serial TB testing at any interval after baseline in the absence of a known exposure or ongoing transmission; 4) encouragement of treatment for all health care personnel with untreated LTBI, unless treatment is contraindicated; 5) annual symptom screening for health care personnel with untreated LTBI; and 6) annual TB education of all health care personnel.
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http://dx.doi.org/10.15585/mmwr.mm6819a3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522077PMC
May 2019

Tuberculosis control in acute disaster settings: case studies from the 2010 Haiti earthquake.

Disaster Med Public Health Prep 2013 Apr;7(2):129-30

Department of Infectious Diseases, University of Connecticut Health Center, Farmington, Connecticut, USA.

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http://dx.doi.org/10.1017/dmp.2013.7DOI Listing
April 2013

Alcohol use disorders (AUD) among tuberculosis patients: a study from Chennai, South India.

PLoS One 2011 17;6(5):e19485. Epub 2011 May 17.

Tuberculosis Research Centre, Chetput, Chennai, Tamilnadu, India.

Background: Alcohol Use Disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. Studies from Tuberculosis Research Centre (TRC), Chennai have reported that alcoholism has been one of the major reasons for default and mortality in under the DOTS programme in South India. Hence, it is planned to conduct a study to estimate prevalence of alcohol use and AUDs among TB patients attending the corporation health centres in Chennai, India.

Methodology: This is a cross-sectional cohort study covering 10 corporation zones at Chennai and it included situational assessment followed by screening of TB patients by a WHO developed Alcohol Use Disorders Identification Test AUDIT scale. Four zones were randomly selected and all TB patients treated during July to September 2009 were screened with AUDIT scale for alcohol consumption.

Results: Out of 490 patients, 66% were males, 66% were 35 years and above, 57% were married, 58% were from the low monthly income group of 8. Age (>35 years), education (less educated), income (
Conclusions: AUD among TB patients needs to be addressed urgently and the findings suggest the importance of integrating alcohol treatment into TB care.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0019485PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096635PMC
September 2011

Alcohol consumption among men and women with tuberculosis in Tomsk, Russia.

Cent Eur J Public Health 2010 Sep;18(3):132-8

Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA 02115, USA.

Drinking behavior among Russian women remains poorly described. We analyzed gender differences in alcohol use among 374 tuberculosis patients in Tomsk, Siberia. Twenty-six (28.3%) women had lifetime alcohol abuse or dependence, compared with 70.6% of men. Women with alcohol use disorders drank 12.7 +/- 14.0 standard drinks per day and > or = 34.6% drank 2 three days per week. Among individuals with a lifetime alcohol use disorder, age of onset and typical consumption did not differ significantly by gender. We conclude that Russian women with alcohol use disorders consume almost as much alcohol as men and may be at greater risk for negative social and medical consequences.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062936PMC
http://dx.doi.org/10.21101/cejph.a3590DOI Listing
September 2010

Performance of the alcohol use disorders identification test among tuberculosis patients in Russia.

Subst Use Misuse 2010 Mar;45(4):598-612

The University of Mississippi Medical Center, Infectious Diseases, 2500 North State Street, Jackson, Mississippi, USA.

The alcohol use disorders identification test (AUDIT), a screening instrument to identify individuals at risk of alcohol use-related problems, has not been validated in a Russian primary care population. We assessed the reliability, factor structure, sensitivity, and specificity of AUDIT scores among 254 subjects initiating tuberculosis treatment from 2005 to 2007 in Tomsk City. Our findings support the use of the AUDIT as a screening instrument among Russian individuals seeking primary care. We discuss implications, limitations, and future research.
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http://dx.doi.org/10.3109/10826080903464194DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042366PMC
March 2010

Integrated Management of Physician-delivered Alcohol Care for Tuberculosis Patients: Design and Implementation.

Alcohol Clin Exp Res 2010 Feb 20;34(2):317-30. Epub 2009 Nov 20.

Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, MA 02478, USA.

Background: While the integration of alcohol screening, treatment, and referral in primary care and other medical settings in the U.S. and worldwide has been recognized as a key health care priority, it is not routinely done. In spite of the high co-occurrence and excess mortality associated with alcohol use disorders (AUDs) among individuals with tuberculosis (TB), there are no studies evaluating effectiveness of integrating alcohol care into routine treatment for this disorder.

Methods: We designed and implemented a randomized controlled trial (RCT) to determine the effectiveness of integrating pharmacotherapy and behavioral treatments for AUDs into routine medical care for TB in the Tomsk Oblast Tuberculosis Service (TOTBS) in Tomsk, Russia. Eligible patients are diagnosed with alcohol abuse or dependence, are newly diagnosed with TB, and initiating treatment in the TOTBS with Directly Observed Therapy-Short Course (DOTS) for TB. Utilizing a factorial design, the Integrated Management of Physician-delivered Alcohol Care for Tuberculosis Patients (IMPACT) study randomizes eligible patients who sign informed consent into 1 of 4 study arms: (1) Oral Naltrexone + Brief Behavioral Compliance Enhancement Therapy (BBCET) + treatment as usual (TAU), (2) Brief Counseling Intervention (BCI) + TAU, (3) Naltrexone + BBCET + BCI + TAU, or (4) TAU alone.

Results: Utilizing an iterative, collaborative approach, a multi-disciplinary U.S. and Russian team has implemented a model of alcohol management that is culturally appropriate to the patient and TB physician community in Russia. Implementation to date has achieved the integration of routine alcohol screening into TB care in Tomsk; an ethnographic assessment of knowledge, attitudes, and practices of AUD management among TB physicians in Tomsk; translation and cultural adaptation of the BCI to Russia and the TB setting; and training and certification of TB physicians to deliver oral naltrexone and brief counseling interventions for alcohol abuse and dependence as part of routine TB care. The study is successfully enrolling eligible subjects in the RCT to evaluate the relationship of integrating effective pharmacotherapy and brief behavioral intervention on TB and alcohol outcomes, as well as reduction in HIV risk behaviors.

Conclusions: The IMPACT study utilizes an innovative approach to adapt 2 effective therapies for treatment of alcohol use disorders to the TB clinical services setting in the Tomsk Oblast, Siberia, Russia, and to train TB physicians to deliver state of the art alcohol pharmacotherapy and behavioral treatments as an integrated part of routine TB care. The proposed treatment strategy could be applied elsewhere in Russia and in other settings where TB control is jeopardized by AUDs. If demonstrated to be effective, this model of integrating alcohol interventions into routine TB care has the potential for expanded applicability to other chronic co-occurring infectious and other medical conditions seen in medical care settings.
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http://dx.doi.org/10.1111/j.1530-0277.2009.01094.xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898509PMC
February 2010

Knowledge, attitudes, and practices of physicians in Tomsk Oblast tuberculosis services regarding alcohol use among tuberculosis patients in Tomsk, Russia.

Cult Med Psychiatry 2009 Dec;33(4):523-37

University of Mississippi Medical Center, Jackson, MS 39216, USA.

In recent years, the Russian Federation has seen a dramatic rise in morbidity and mortality from tuberculosis (TB), attributed in part to an increase in alcohol use disorders (AUDs), which are associated with worse TB treatment outcomes. This study describes the knowledge, attitudes and practices of physicians who treat TB patients in Tomsk, Russia. We conducted semistructured interviews with 16 TB physicians and 1 addiction specialist. Interviews were audiorecorded, transcribed, translated and systematically analyzed. We identified four key domains: definitions of alcohol use and abuse and physicians' knowledge, attitudes and practices regarding these problems. Physicians described patients as largely precontemplative and reluctant to seek treatment. Physicians recognized their limited knowledge in diagnosing and treating AUDs but expressed interest in acquiring these skills. Few options are currently available for treatment of AUDs in TB patients in Tomsk. These findings suggest that Tomsk physicians are aware of the need to engage AUDs in TB patients but identify a knowledge gap that restricts their ability to do so. Training TB physicians to use simple screening instruments and deliver evidence-based alcohol interventions improves TB outcomes among patients with co-occurring AUDs.
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http://dx.doi.org/10.1007/s11013-009-9148-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042364PMC
December 2009

Integration of alcohol use disorders identification and management in the tuberculosis programme in Tomsk Oblast, Russia.

Eur J Public Health 2009 Jan 26;19(1):16-8. Epub 2008 Dec 26.

Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS 39216, USA.

Alcohol use disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. We developed a multidisciplinary model to manage AUDs among TB patients in Tomsk, Russia. First, we assessed current standards of care through stakeholder meetings and ethnographic work. The Alcohol Use Disorders Identification Test (AUDIT) was incorporated into routine assessment of all patients starting TB treatment. We established treatment algorithms based on AUDIT scores. We then hired specialists and addressed licensing requirements to provide on-site addictions care. Our experience offers a successful model in the management of co-occurring AUDs among patients with chronic medical problems.
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http://dx.doi.org/10.1093/eurpub/ckn093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720714PMC
January 2009
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