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Title: Impact of COVID-19 on tuberculosis prevention and control in Brazil: Analysis of social protection policies, epidemiological situation, and technology incorporation (CoV-TB Project – BRAZIL) Lead Investigator: Dr. Ricardo A. Arcêncio

Brazil is on the list of affected countries in which, prevention, diagnosis, and treatment of TB are challenging. Treatment success among those diagnosed is slightly more than 70%. COVID-19 has turned the situation even more critical by dismantling policies aimed at confronting the disease, the stress generated within health services, and changes in the epidemiology of TB in the Brazilian context. Essential strategies such as DOTS, which were successful in controlling the disease have had their activities suspended. The inclusion of TB in the political agenda has been questionable by Social Movements, and their actions may have had a portentous effect in protecting families affected by TB. Technological innovations are needed by TB health services, to monitor people affected by the disease remotely. However, many professionals found themselves without this resource. Thus, this study aims to evaluate the impact of COVID-19 on TB prevention and control. The project is structured in three domains: Domain 1: Policy approach: interviews will be conducted with key informants from institutions, management of social movements, and collection of official documents, with subsequent triangulation. In Domain 2: Epidemiologic evaluation: A survey of TB data and COVID-19 to conform the cohorts and thus evaluate the real impact of the pandemic impact on TB. In Domain 3: digital technology impact assessment: users with TB (using the VDOT system) in some municipalities of the five macro-regions will be selected based on Domain 2. The vDOT will be verified and the impact of vDOT on adherence and care will be assessed. This project is being sponsored by CNPQ – The National Council for Scientific and Technological Development) in Brazil.

Title: Community collaboration to combat coronavirus (C-Forward). A Johns Hopkins COVID Community Research Initiative Lead Investigator: Dr. Jason E. Farley

This is a randomized comparative effectiveness trial where households will be randomized to determine the optimal SARS-CoV-2 (COVID-19) testing modality in a population-representative sample of households in Baltimore City, Maryland. 1,386 households in Baltimore City will be randomized 1:1:1 to one of three testing modalities: 1) fixed-site standard of care testing; 2) community-based mobile van testing; or 3) self-collected home, based testing.

The target population will include English- and Spanish-speaking families residing in Baltimore City households (N=238,427). The sample size goal is 1,386 households (0.44% of households) or 3,000 individual household members.

Title: SARS-CoV-2 prevalence study (CoVPN 5002 – The COMPASS Study) Lead Investigator: Dr. Jason E. Farley

This COVID study is funded by the COVID-19 Prevention Network (CoVPN) of the National Institute of Allergy and Infectious Diseases. This surveillance study seeks to estimate the number of people who have or have had the SARS-CoV-2 virus using venue-time sampling approaches.

Title: Prevalence and predictors of forgone healthcare during the COVID-19 pandemic in Baltimore City Lead Investigator: Dr. Diane Meyer Faculty Mentor: Dr. Jason E. Farley

Description: The Coronavirus 2019 (COVID-19) pandemic has led to widespread disruptions in healthcare utilization in the United States, including increases in forgone care, and has disproportionately impacted vulnerable and minority communities. The purpose of this study is to further understand the prevalence and predictors of forgone care in Baltimore, MD using a population representative sampling strategy with oversampling of populations currently underrepresented in the current COVID-19 forgone healthcare literature. The knowledge gained from this study will be critical to better understanding how the social determinants of health intersect with healthcare utilization during large-scale public health emergencies and will help inform efforts to improve health system resilience for future health threats.

Hypotheses: H1: African American and Latinx people will have a higher prevalence odds ratio (POR) for forgone healthcare after controlling for health insurance status; H2: Impoverished people, regardless of race/ethnicity, will have a higher POR for forgone healthcare.

Title: Continuation of COVID-19 vaccinations and infectious disease testing co-located with the Baltimore City health department’s syringe services program Lead Investigator: Dr. Omeid Heidari Faculty Mentor: Dr. Jason E. Farley

This project involves collaboration of the Center for Infectious Disease, Baltimore City Health Department and the Syringe Support Services (SSP) van by collaborating to provide access to vaccines, HIV, HCV and STI testing and needle exchange services in the community.