Epidemiology and Population Studies Unit
Established in 2003
D. Rebecca Prevots, Ph.D., M.P.H. (She/Her/Hers)
Chief, Epidemiology and Population Studies Unit
Major Areas of Research
- Nontuberculous mycobacteria (NTM) and bronchiectasis
- COVID studies
- Household transmission, Costa Rica
- SARS-CoV-2 vaccine response among persons with Primary Immune Deficiencies
- Seroprevalence and evaluation of serologic assays, Mali
- Malaria natural history studies vaccine evaluation
- Spatio-temporal mapping and ecology of infectious diseases
The vision of the Epidemiology and Population Studies Unit is to enhance the epidemiologic capacity for population-based and clinical research within the Division of Intramural Research, NIAID.
Our research is currently focused on establishing the burden and trends of nontuberculous mycobacterial disease in the United States, as well as elucidating environmental determinants of infection. We also have a focus on the clinical epidemiology of nontuberculous mycobacterial disease, including determinants of host susceptibility and disease progression. We also have extensive collaborations throughout DIR, and have collaborated on studies viral, fungal, and parasitic conditions. The unit leverages a broad array of epidemiological methods:
- Disease burden studies using national morbidity and mortality datasets (hospital discharge datasets, Medicare, Electronic Medical Records, registries, as well as population-based data from integrated health care systems (HMOs))
- Multivariable modeling, e.g., integrated analysis of observational cohorts with clinical and microbiologic data to identify relative host and pathogen contributions to infection and disease, including molecular and genetic markers of disease susceptibility and progression
- Geospatial models to identify disease clustering and environmental predictors of disease,
- Machine learning
- Household transmission studies
Using these methods, the Epidemiology and Population Studies Unit conducts pre- and post-licensure vaccine evaluation; defines optimal clinical endpoints for clinical trials of vaccines or new therapeutics; evaluates data underlying science-to-policy issues; designs clinical and population-based studies; develops and tests hypotheses regarding disease prevalence, trends, and risk factors; develops “electronic phenotypes” and clinical algorithms for selected infectious diseases.
We have used population-based studies applying geospatial analytic methods to identify environmental determinants of NTM pulmonary disease, and studies in high-risk areas of the U.S. using these approaches are ongoing. Clinical-epidemiologic studies are examining racial\ethnic disparities in disease prevalence in high-risk areas, and the relative contributions of clinical, environmental, and genetic factors to these patterns.
More recently, the Epidemiology and Population Studies Unit has been collaborating with the National Cancer Institute and the Costa Rican Agency for Biomedical Research (ACIB) to design and implement studies of SARS-CoV-2 household transmission.
Ph.D., M.P.H., University of Michigan
Languages SpokenFrench, Spanish, Portuguese
Dr. Prevots joined NIAID in 2003 to build an epidemiology research group and enhance epidemiologic capacity within NIAID. In 2007, she became head of the newly created Epidemiology and Population Studies Unit (EPSU) within the intramural program at NIAID and has led fundamental studies to establish the burden of nontuberculous mycobacterial disease in the United States and to identify clinical and environmental risk factors for disease susceptibility and progression. The EPSU has also played a key role in pandemic research response, particularly with respect to SARS-CoV-2. Dr. Prevots began her public health research career at the New York City Department of Health in 1985, working as a public health advisor in the AIDS surveillance and epidemiology unit. From there she went to the University of Michigan, where she earned her M.P.H. in 1988 and her Ph.D. in epidemiology in 1991. Upon completing her Ph.D., she joined the Epidemic Intelligence Service at the Centers for Disease Control and Prevention (CDC). The vision of the EPSU is to enhance epidemiologic capacity within the Division of Intramural Research, and the group has had numerous collaborations on a broad range of infectious diseases.
EM Lipner, French JP, Mercaldo RA, Nelson S, Zelazny AM, Marshall J, Strong M, Falkinham J, Prevots DR. The risk of pulmonary NTM infections and water-quality constituents among persons with cystic fibrosis in the United States, 2010-2019. Environmental Epidemiology. DOI: 10.1097/EE9.0000000000000266 (2023 Aug).
Sun K, Loria V, Aparicio A, Porras C, Vanegas JC, Zúñiga M, Morera M, Avila C, Abdelnour A, Gail MH, Pfeiffer R, Cohen JI, Burbelo PD, Abed MA, Viboud C, Hildesheim A, Herrero R, Prevots DR; RESPIRA Study Group. Behavioral factors and SARS-CoV-2 transmission heterogeneity within a household cohort in Costa Rica. Commun Med (Lond). 2023 Jul 22;3(1):102.
Lipner EM, French JP, Nelson S, Falkinham Iii JO, Mercaldo RA, Blakney RA, Daida YG, Frankland TB, Messier KP, Honda JR, Honda S, Prevots DR. Vanadium in groundwater aquifers increases the risk of MAC pulmonary infection in O'ahu, Hawai'i. Environ Epidemiol. 2022 Sep 2;6(5):e220.
Blakney RA, Ricotta EE, Frankland TB, Honda S, Zelazny A, Mayer-Barber KD, Dean SG, Follmann D, Olivier KN, Daida YG, Prevots DR. Incidence of Nontuberculous Mycobacterial Pulmonary Infection, by Ethnic Group, Hawaii, USA, 2005-2019. Emerg Infect Dis. 2022 Aug;28(8):1543-1550.
Blakney RA, Ricotta EE, Follmann D, Drew J, Carey KA, Glass LN, Robinson C, MacDonald S, McShane PJ, Olivier KN, Fennelly K, Prevots DR. The 6-minute walk test predicts mortality in a pulmonary nontuberculous mycobacteria-predominant bronchiectasis cohort. BMC Infect Dis. 2022 Jan 21;22(1):75.
Marshall JE, Mercaldo RA, Lipner EM, Prevots DR. Incidence of nontuberculous mycobacteria infections among persons with cystic fibrosis in the United States (2010-2019). BMC Infect Dis. 2023 Jul 24;23(1):489.
Training and Employment Opportunities
Training is vital to the mission of the Epidemiology and Population Studies Unit, and we maintain ties to schools of public health in the Washington, D.C., and Maryland areas, as well as around the country. We provide research training opportunities to post-baccalaureate, postdoctoral, M.P.H., and Ph.D. students. In addition, we maintain ties with national organizations (e.g., Centers for Disease Control and Prevention, Food and Drug Administration), and international organizations (e.g., World Health Organization, Pan American Health Organization) to embed trainees within ongoing research in a public health context.
We focus on the epidemiology of NTM disease, estimating burden & trends in the United States & risk factors for disease susceptibility & progression. We are a dynamic & friendly group with advanced training in epidemiologic study design & analysis & experience in public health settings & clinical & lab research. We conduct research & mentoring in a collaborative environment & value a team…