Our research interests focus on studying the epidemiology of diseases and assessing the impact of interventions. Our main interest is on infectious disease epidemiology with an emphasis on sexually transmitted infections. In addition to HIV and other sexually transmitted infections, we conducted or are currently working on research projects in relation to hepatitis C virus, tuberculosis, influenza, SARS, within-host virology, and the ecology and evolution of infectious diseases. Our methodology expertise emphasizes conventional epidemiologic methods as well as quantitative methods including mathematical modeling and related standard epidemiologic statistical analyses.
Among our research projects:
Quantifying the adverse impact of rising diabetes prevalence on tuberculosis global burden, and estimating the impact of targeted interventions on tuberculosis transmission
Building on a tuberculosis (TB) population-level mathematical model that we developed earlier, global estimates of future diabetes mellitus (DM) prevalence, and statistical analyses of data of fieldwork being carried out as part of the four continent TANDEM (TB-DM) screening and treatment studies, we will develop a model to explore the impact of changes in DM prevalence on the dynamics of TB infection, and to assess whether screening TB patients for DM and DM patients for active or latent TB could help meet global developmental goals for TB.
The specific aims are to
- Extend our TB model to include DM with parameterisation based on statistical analyses on the TANDEM project database and systematic literature reviews.
- Describe the likely impact of future trends in DM on TB incidence and prevalence in TB endemic regions, and
- Estimate the epidemiological impact on TB transmission of targeted interventions including a) screening and treating pulmonary TB patients for DM, and DM patients for latent and active TB and b) preventive and therapeutic TB vaccination among people with DM.
The principal investigators of this project are Dr. Julia Critchley at St. George’s, University of London and Dr. Laith Abu-Raddad at WCM-Q.
Analyzing the impact of voluntary medical male circumcision as an HIV intervention in select countries in sub-Saharan Africa
The aim of this study is to explore, using mathematical modeling, the impact of voluntary medical male circumcision (VMMC) as an HIV prevention intervention in select countries in sub-Saharan Africa. The study is conducted in collaboration with the Bill and Melinda Gates Foundation and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) Teams.
The specific aims are to
- Describe the heterosexual HIV epidemic and impact of VMMC programs and evaluate the effectiveness of VMMC scale-up scenarios with varying proportions of HIV positive males.
- Determine the optimal program efficiency through subpopulation prioritization, based on age, geography, and risk profile. Assess program efficiency and policy outcomes using program expansion pathway curves and policy frontier plots.
Dr. Abu-Raddad is the principal investigator of this scientific study.
Understanding the sexual network determinants of the epidemiology of sexually transmitted infections: Quantitative assessment
The global burden of sexually transmitted infections (STIs) is a major public health challenge. The spread of STIs is through sexual networks, but the structure of sexual networks and their role in the epidemiology of STIs are not well understood, particularly in the Middle East and North Africa region (MENA). Even though STIs share the same mode of transmission, the nature of sexual networks can drive different transmission patterns for the different STIs. The proposed research provides an approach to study key STIs collectively, and explore their epidemiological links, using a standardized methodology where all STIs are propagated on the same sexual network structure, thus facilitating comparative analysis.
The specific aims are to
- Examine the role of sexual networks in driving STI transmission for a range of STI pathogens.
- Infer the structure of sexual networks from STI population-level biomarkers.
- Understand the epidemiological overlap and links between different STIs and use this knowledge to infer HIV epidemic potential.
- Generate insights and recommendations for informing the design and analysis of STI epidemiologic field studies and surveillance systems.
- Generate insights and recommendations for informing the design and analysis of STI epidemiologic field studies and surveillance systems.
Dr. Abu-Raddad is the principal investigator of this scientific study.
Critical assessment of the drivers of the hepatitis C virus epidemic in Egypt: A quantitative approach
Multiple studies have been conducted worldwide to document the prevalence and distribution of hepatitis C virus (HCV) infection in human populations. Even though HCV currently affects about 2% of the world's population, Egypt has the highest prevalence in the world with 15% of the population infected with the virus. HCV infection and its complications are among the leading and most pressing public health problems in Egypt.
A number of studies have suggested that the HCV epidemic in Egypt was driven by the past implementation of parenteral antischistosomiasis therapy (PAT) in the health campaigns against schistosomiasis. The exact drivers and their relative roles in the epidemic are still not well-understood. Our study is an attempt to evaluate the role of PAT in driving the HCV epidemic, and to identify other drivers and determinants of HCV transmission in Egypt.
The specific aims are
- Quantitative assessment of the contribution of PAT and other drivers to the HCV epidemic in Egypt.
- Quantitative assessment of the current determinants of HCV transmission in Egypt.
Dr. Diego Cuadros and Dr. Laith Abu-Raddad are the principal investigators of this scientific study.
The Middle East and North Africa HIV/AIDS epidemiology synthesis project
The Middle East and North Africa (MENA) continues to be viewed as the anomaly in the HIV/AIDS world map and real hole in terms of HIV/AIDS epidemiological data's. The apparent lack of HIV data has led to many controversies on the status of the epidemic in MENA, with conflicting views as to the role of MENA socio-cultural values in shaping the epidemic in this region. None of these views has been substantiated by epidemiological data. It is essential to understand where HIV is being transmitted in MENA in order to take advantage of probably a narrowing window of opportunity to stem the tide of HIV transmission in the region.
The Middle East and North Africa HIV/AIDS Epidemiology Synthesis Project is the most comprehensive research project on HIV/AIDS in the history of the MENA region. It is a scientific assessment and data-driven epidemiological synthesis of HIV spread in MENA based on a systematic literature review and analysis of thousands of widely unrecognized publications, reports and data sources extracted from the scientific literature or collected from sources at the local, regional and national levels. The project is conducted through a collaborative partnership with the World Bank, the Joint United Nations Programme on HIV and AIDS and the World Health Organization.
The specific aims are to conduct epidemiological analyses and systematic reviews on MENA to
- Synthesize the biological evidence on HIV in high risk groups, bridge populations, vulnerable populations, and the general population.
- Synthesize the evidence on risk behavior to better understand sexual risk patterns, sexual networks, and injecting drug use patterns in the same risk population groups in Aim 1.
- Review the settings of vulnerability such as those of prisoners, youth, street children, refugees, internally displaced persons, migrant workers, mobile populations, runaway women and military personnel.
- Review levels, sources, and nature of HIV/AIDS knowledge in the same risk population groups in Aim 1.
- Synthesize the biological evidence on proxy measures and biological markers including herpes simplex virus type 2 (HSV-2), human papillomavirus (HPV) and cervical cancer levels, bacterial sexual transmitted infections (STIs), and hepatitis C virus (HCV) to probe nature of sexual risk patterns, sexual networks, and injecting drug use patterns in the same risk population groups in Aim 1.
Dr. Abu-Raddad is the principal investigator of this scientific study.
The Middle East and North Africa hepatitis C virus epidemiology synthesis project
Transmission of blood-borne pathogens occur routinely in resource-limited settings and are conceived as a major public health problem in the developing world. The Middle East and North Africa (MENA) is no exception to this rule and there appears to be a lack of sufficient resources to screen blood and to sterilize medical equipment in several countries. Reuse of needles/syringes and major/minor surgery in hospitals were repeatedly linked to hepatitis C (HCV) infection in MENA. One of the countries of the region, Egypt, has by far the highest prevalence of this infection worldwide.
HCV is about six times as infectious as HIV through the parenteral route and is most often transmitted before HIV; therefore it can be used as a proxy biomarker to explore the HIV epidemic potential through this mode of transmission. HCV prevalence levels draw a map of the risk of HIV parenteral transmission across the different risk groups in a population.
The specific aims of this project are to:
- Synthesize the biological evidence on HCV in populations at direct risk, indirect risk, special clinical populations and the general population by conducting a systematic review of HCV prevalence and incidence in different population groups in MENA.
- Characterize potential HIV spread through the parenteral route using the synthesized biological evidence on HCV as a proxy measure.
Dr. Abu-Raddad is the principal investigator of this scientific study.