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  1. A Dynamic Global Invader: A Genetic Analysis of Aedes albopictus in Costa Rica

    O'Marr, Jamieson
    June 17, 2018

    The mosquito Aedes albopictus, originating from southeast Asia, has expanded throughout the world during the 20th century, adapting to a variety of different regions and habitats and spreading diseases such as dengue, chikungunya, and Zika. Within these invasive populations little is known about the genetic diversity and population structure, particularly in Central America. Previous studies on the diversity of Ae. albopictus have been performed in countries such as the United States and Malaysia; however, few studies have examined population structure, genetic diversity, and phylogenetic relationship of Ae. albopictus populations in Central America, where dengue and other viruses are actively spreading. Understanding these important genetic markers and relationships will guide future research to allow for more direct targeting of vector control efforts. Ae. albopictus were captured using five different trapping methods in locations covering a wide range of land uses and temperatures across southern Costa Rica. We assessed population genetic structure by sequencing the mitochondrial Cytochrome C Oxidase 1 (CO1) gene. A phylogenetic tree constructed from our Costa Rican sequences and other world population sequences revealed a slight clustering of the Costa Rican population with populations from temperate regions. Examination of our sequences also revealed little population structuring, which indicates that the geographically separated populations are still intermixing despite the barriers that exist. Understanding the genetics of the Ae. albopictus within Costa Rica will be fundamental to future research to determine how the species will respond to the anthropogenic changes in temperature and land use in southern in Costa Rica. This in turn could aid in proactive mosquito control and public health management to reduce the incidence of the mosquito-borne viral infections.

  2. Controlling Tuberculosis: Understanding the Effects of Incarceration on Tuberculosis Treatment Outcomes In Brazil

    O'Marr, Jamieson
    May 31, 2019

    Prisoners bear a disproportionate and increasing burden of tuberculosis (TB) in Brazil. They make up only 0.4% of Brazil’s total population yet represent 8.7% of Brazil’s total TB cases. Prior research has demonstrated that TB in prisons acts like a reservoir for the surrounding communities and is responsible for a sizeable percentage of TB cases in the general population. TB treatment success in Brazil is among the lowest in the world for high burden countries with only 72% of cases who begin treatment successfully completing it. However, given the substantial burden little is known about incarceration’s relationship to TB treatment outcomes and care gaps in this population. The goal of this study was to assess the relationship between incarceration and treatment outcomes within Brazil. We obtained data on sociodemographic and clinical characteristics and TB treatment outcomes using Brazil’s national disease registry from 2009 to 2017.We conducted multivariable logistic regression and propensity score analysis to quantify the effect of incarceration on the probability of treatment success among new adult TB cases, controlling for sex, age, self-reported race, education status, diagnosis year, HIV status, and reported use of alcohol and tobacco. TB treatment outcomes were reported for 97.3 % of non-incarcerated and 94.4 % of prisoners. Among these, the treatment success was 71.1% among non-incarcerated individuals and 77.4% among prisoners. In multivariable regression, prisoners were more likely to have treatment success (adjusted odds ratio [AOR] 1.24 % CI 1.2-1.29). Among prisoners, self-reported black (AOR 0.74, 95% CI 0.67-0.81) or mixed-race individuals (AOR 0.91, 95% CI 0.84-0.98), HIV-coinfected (AOR 0.40, 95% CI 0.36-0.44), and those reporting alcohol use (AOR 0.64, 95% CI 0.58-0.71) were less likely to have treatment success. However, prisoners enrolled on Directly Observed Therapy (DOT) seemed to have improved treatment outcomes with DOT being associated with treatment success (AOR 1.87, 95 % CI 1.73-2.02). Access to DOT was significantly higher among prisoners (77.0%) compared to those outside prison (56.1%) (p<.0001), and this partially explained the superior outcomes among prisoners as an effect modification was observed when our cohort was stratified on DOT enrollment (DOT+ 1.61 (1.54-1.68) vs. DOT- 0.97 (0.91-1.03)). Prisoners have a greater odds of treatment success than those outside prisoners, an effect mediated in part by an increased exposure to DOT. Treatment success among both incarcerated and non-incarcerated populations is below international targets. Expanding access to DOT and other interventions to improve outcomes is needed, particularly in populations with poorer outcomes such as black or mixed- race inmates, HIV co-infected individuals and those reporting alcohol use.

  3. Jamieson O'Marr's NSC Portfolio

    O'Marr, Jamieson Michael
    [ca. June 2018]

    This document is an archive of an electronic portfolio (ePortfolio) produced as a capstone requirement for the Notation in Science Communication. In their ePortfolios, NSC students demonstrate how they have met the NSC learning outcomes. These learning portfolios detail students’ growth and development as scientists and science communicators rather than showcasing only their best work. ePortfolios are reviewed and approved by faculty, earning students a special designation on their official Stanford transcript that reflects their science communication acumen.

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