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BIOGRAPHICAL SKETCH Provide the following information for the Senior/key personnel and other significant contributors. Follow this format for each person. DO NOT EXCEED FIVE PAGES. NAME: Susannah Graves, MD eRA COMMONS USER NAME (credential, e.g., agency login): SKGRAVES POSITION TITLE: Research Fellow, Infectious Diseases, Dept of Medicine, University of California, San Diego EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable. Add/delete rows as necessary.) INSTITUTION AND LOCATION Harvard University DEGREE (if applicable) Completion Date MM/YYYY B.A. with Honors 06/2003 Biology; Citation in Spanish Language 06/2010 Medicine 07/2014 Internal Medicine Anticipated 7/2017 Infectious Diseases Anticipated 6/2017 Epidemiology UCSF School of Medicine, San M.D. Francisco, CA UCSD Internal Medicine, San Diego, Internal Med CA Residency UCSD Division of Infectious Diseases, Infectious Department of Internal Medicine, San Disease Diego, CA Fellowship San Diego State University, San Diego, MPH CA FIELD OF STUDY A. Personal Statement In the academic year July 2012 – June 2013 I was based in Maputo, Mozambique as the Site Director for the UCSD Department of Internal Medicine’s medical education partnership initiative (MEPI) collaboration with the Faculty of Medicine at University of Eduardo Mondlane (UEM). During my tenure as site-director I coordinated the academic and clinical activities of visiting UCSD residents and collaborated with local firm chiefs and faculty at UEM to develop a clinical and academic curriculum for residents. Additionally, I worked with colleagues to develop and execute a number of research studies (see “Research Support” below). Working with Mozambican residents, firm chiefs, and faculty on the wards and in the lab, I have been able to see first-hand what my resourceful colleagues are able to do within the constraints of their resources and identify opportunities for them to further their research and educational goals. The year I was there, a distance-learning program in epidemiology and clinical research was initiated through the MEPI partnership, which I helped to facilitate locally, reviewing protocol ideas and advising participants on research question and protocol development, funding options and feasibility. Participants, who are medical school faculty and residents, developed research protocols some of which are in various stages of application for funding and IRB approval or protocol execution at this time. Through my work in the hospital and at the University, I have built relationships with major stakeholders in the education of the next generation of biomedical faculty including junior and senior faculty in the Medicine and Pathology departments, the chief of Internal Medicine at Maputo Central Hospital – Helder Lopes, as well as members of the newly-formed institutional bioethics committee and medical school librarians, as well as many young physicians at the post-graduate (residency) level of training and firm chiefs who are poised to launch into careers in academic medicine and teaching. A major focus of mine at Maputo Central Hospital was the institution of tuberculosis (TB)control measures. Working within the newly commissioned TB control committee piloted by Dr. Elizabete Nunes, we developed a TB control plan and began implementing an educational campaign, environmental controls, and routine TB screening for health workers at Maputo Central Hospital. This program is poised to expand into a more comprehensive infection control program at the Central Hospital and has the support of the hospital director, Dr. João Fumane, who has dedicated resources for the implementation of these projects with supplemental funding from locally active NGOs such as Jhpiego and ICAP. Joining in this inter-institutional collaboration as a peer mentor for Mozambican PhD candidates would provide me with an avenue to push forward my work on TB and infection control in Mozambique; and with my mentoring experience and local alliances along with institutional support from UCSD and the Maputo Central Hospital, I believe I could be an asset to this training collaboration. B. Positions and Honors Positions and Employment 2015 Reviewer, grant applications – Center for Aids Research (CFAR), UCSD 2014 – now Clinical and Research Fellow – Division of Infectious Disease, UCSD Dept of Medicine 2012-2013 Assistant Clinical Professor – Maputo Clinical Site Director, UCSD Dept of Medicine 2010-2014 Medical Resident, Department of Internal Medicine, University of California, San Diego 2009 Research Assistant, TB Control Branch - California Department of Public Health 2008-2009 Research Assistant, Greiner Lab, Humanized Mouse Models of Disease, University of Massachusetts Medical School, Worcester, MA. 2008-2009 Research Assistant, SFGH Emergency Department, University of California, San Francisco 2006 Student Researcher, Bluestone Lab, Diabetes Center, UCSF 2004, 2005 Teaching Fellow, Molecular Immunology Seminar, Harvard 2003-2005 Lab Technician, Dranoff Lab, Cancer Immunity Dana-Farber Cancer Institute, Harvard 2002 Laboratory Intern, Biewener Lab, Locomotion Physiology, Harvard 2001 Laboratory Intern, Androgen-based Therapies at AndroScience Corporation, San Diego, CA Professional Memberships 2015 - now American Thoracic Society, member 2014 – now Infectious Disease Society of America (IDSA), member Honors 2005 Certificate for Distinction in Teaching, Derek Bok Teaching Center, Harvard C. Contribution to Science 1. In Mozambican hospitals, high rates of HIV infection and active pulmonary tuberculosis drives TB transmission resulting in significant morbidity and even mortality of health workers. Together with Dr. Elizabete Nunes and colleagues I designed and conducted a study employing active case finding along with latent TB infection (LTBI) and HIV screening to identify health workers (HW) at high risk for active TB. Nearly 700 HW were enrolled and screened with symptom questionnaires, X-ray, skin and Quantiferon testing and HIV antibody testing, and we found 4 active cases of TB during our initial screen. Additionally we found that 62% of health workers had LTBI, and 2/3 of these were identified as “high risk” given concurrent HIV infection or Quantiferon >1.0 in addition to a positive skin test. All of these were offered isoniazid preventive therapy and an analysis of the follow-up results is underway. A multivariate analysis showed that duration of service at MCH for >10 years had a significant positive association with TB infection (OR 1.67, 95%CI 1.21 – 2.30), as did service in the departments of Surgery (OR 4.25, 95%CI 2.337.75), Emergency and Critical Care (OR 3.36, 95%CI 1.41-7.97), Pathology (OR 2.76, 95%CI 1.42-5.38), and Obstetrics (OR 1.98, 95%CI 1.15-3.41) when compared with the Internal Medicine department suggesting occupational risk and targets for high-priority for intervention. The results of this research were used to gain support from hospital leadership to fund the introduction of environmental controls (UV lights to clean air) and administrative support for ongoing TB monitoring of health workers. They were also presented at several national and international conferences (below) and a manuscript is in preparation. My role in this work, is outlined in “(Nunes) 1/5/11 - 1/5/13” in the Research Support section below. 1. Graves SK, David C, Viegas S, Torriani F, Hassane A, Amade S, Paleve S, Nunes E. Tuberculosis and HIV infection in health workers in the Maputo Central Hospital, the national reference hospital of Mozambique. Oral presentation, 44th Union World Conference on Lung Health in Barcelona, Spain, Oct 30, 2014. 2. Graves SK, Lee K, Viegas S, Lederer P, Hassane A, David C, Cossa A, Nunes E. Tuberculosis screening campaign and control measures to decrease transmission of occupational TB in health workers at the flagship public hospital of Mozambique. Oral presentation, 44th Union World Conference on Lung Health in Paris, France, Nov 3, 2013. 3. Nunes E, Graves S, Lee K, Cossa A, Hassane A, Lederer P, Pondo J, Viegas S, Torriani F. Tuberculosis Screening in Healthcare Workers at Maputo Central Hospital. IDSA ID Week Conference, San Diego, CA October, 2012. 2. While in Maputo, as the site director for the UCSD-UEM MEPI collaboration, I developed a computerresource based introductory evidence-based-medicine (EBM) curriculum for Mozambican Internal Medicine residents and medical students at Maputo Central Hospital / UEM. Working together with local medical residents and visiting US residents, we conducted a local educational needs-assessment for residents and medical students. With this information, we developed a problem based training module on how to use online resources newly available at their institution to answer clinical questions about patients. This training dovetailed with existing educational courses available locally on how to access research articles using HINARI, a program set up by WHO together with major publishers to provide access to biomedical literature. Additionally, we developed a library portal: http://medicinahcm.org/biblioteca.html from which relevant online resources could be accessed. Additionally, we negotiated to obtain VPN account access to our institution’s online library resources (linked on the website). A list of my peer-reviewed published articles can be found here: http://www.ncbi.nlm.nih.gov/sites/myncbi/1HMimEGnJC5kG/bibliograpahy/43851241/public/?sort=da te&direction=ascending D. Research Support Ongoing Research Support 5 P30 AI036214 (Patel) 2014-2016 Role: Co-Investigator (No Salary) Mortality in HIV patients with severe sepsis in Maputo Central Hospital. Major Goal: To assess current management of septic patients at Maputo Central Hospital, and identify areas for improvement in early recognition and treatment of sepsis. Maputo Central Hospital, Mozambique Responsibilities: Designed protocol in collaboration with PI, obtained funding and IRB approval, helped design electronic mobile data collection tool. Data collection is ongoing. Plan to assist with data analysis and manuscript writing. Completed Research Support 1R24TW008908 (Schooley) 9/30/2010-9/29/2015 Role: Site Director, Maputo Mozambique Universidade Eduardo Mondlane-UCSD Medical Education Partnership Major Goal: To develop the infrastructure for medical education and medical research at the Universidade Eduardo Mondlane in Maputo, Mozambique Responsibilities: described above in Personal Statement. 5 P30 AI36214 (Liu, YT) 1/5/11 - 1/5/13 Role: Co-Investigator (No Salary) Etiologic role of HPV in conjunctival squamous cell carcinoma in Mozambique Major Goal: To determine the etiologic role in squamous cell carcinoma of the eye using cases and controls from the Opthalmology clinic at Hospital Central Maputo in Maputo, Mozambique. Responsibilities: Assisted with development of SOP, database development and data management, This study had difficulties with enrolling sufficient numbers of control patients, which delayed completion, and an amendment was made to the protocol to allow inclusion of controls undergoing cataract surgery. Data collection and analysis is ongoing. 5 P30 AI 36214 (Nunes) 1/5/11 - 1/5/13 Role: Co-Investigator (No Salary) Tuberculosis screening in healthcare workers at Maputo Central Hospital Major Goal: To assess the prevalence and incidence of active and latent tuberculosis in Health Workers at Maputo Central Hospital in Mozambique. Responsibilities: Collaborated on protocol design, grant application writing and submission, SOP development, as well as with data collection, analysis. To date, I have written two abstracts that have been presented orally at an international conference and one poster presentation at a US research conference (see presentations above), and manuscript is in progress.