Profile Assistant Professor, Department of Medicine (Pulmonary Medicine)
Dr. O'Donnell's interests are in tuberculosis (TB), HIV, and global health including ethical issues in global health research. Current research is centered in South Africa and involves collaboration with the Jacobs' lab at Einstein, the KwaZulu-Natal Research Institute on TB/HIV (K-RITH), and the Centre for AIDS Programme of Research in South Africa (CAPRISA).
Tuberculosis (TB) and human immunodeficiency virus (HIV) are tightly interwoven in a catastrophic, global syndemic. TB/HIV has important impacts on the pathogenesis, epidemiology, clinical characteristics, and survival of co-infected patients.
Drug-resistant tuberculosis is an important global public health concern because of increasing incidence, low cure rates, and high reported mortality. Nowhere has this increased incidence generated more concern than in South Africa where interactions between TB and generaliz ed HIV/AIDS epidemics are causing explosive increases in TB incidence and TB case-fatality rates. The most drug-resistant form of tuberculosis, extensively drug resistant tuberculosis (XDR-TB), is increasingly prevalent in South Africa.
Our team has published describing widespread transmission of MDR-TB and XDR-TB among South African health care workers. We have also shown that female gender is an independent risk factor for XDR-TB among women in South Africa not explained by higher rates of HIV infection or increased previous treatment for TB.
Our team has described 12 month clinical treatment outcomes for patients with XDR-TB and HIV co-infection. Ongoing work includes a cohort study of using later generation fluoroquinolones for XDR-TB treatment; characterizing ADRs in a cohort of XDR-TB patients with and without HIV.
Working with the Jacobs lab, I am involved in designing clinical studies to use the fluoromycobacteriaphage assay to quantify response to treatment, predict early treatment outcome, and detect worsening of drug-resistance in real-time among XDR-TB patients on treatment.
Working with the Spivack lab, I am involved in a study to diagnose TB based on genetic testing of exhaled breath condensate.