D. Rebecca Prevots, Ph.D., M.P.H.

The vision of the Epidemiology and Population Studies Section (EPSS) 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 have collaborations throughout DIR and have collaborated on studies of viral, fungal, and parasitic conditions. The section 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 predictors of disease
• Machine learning
• Household transmission studies

Using these methods, EPSS 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 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 disease prevalence in high-risk areas and the relative contributions of clinical, environmental, and genetic factors to these patterns.

In 2024, EPSS began a cooperative research effort through the East Asia Joint Research Program (eAsia JRP) related to “nontuberculous mycobacterial (NTM) infections, which includes enhancing surveillance and mitigation strategies,” jointly with investigators in Australia, Thailand, Cambodia, and Japan. This collaboration will use standardized approaches to elucidate the epidemiology of NTM across countries and identify predictors of disease incidence.