Pau Da Lima Cohort

The Pau da Lima Cohort is a pioneering, long-term research initiative focused on understanding and addressing the health challenges faced by residents of urban slum communities. Established in 2001 in the community of Pau da Lima (13°32’53.47” S; 38°43’51.10” W) in Salvador, Bahia, this cohort study has become a reference in urban epidemiology, particularly advancing our understanding of infectious disease dynamics.

The Pau da Lima community shares socio-environmental characteristics common to many informal settlements in tropical regions. In 2003, the neighborhood was home to 14,122 residents within just 0.46 km², with 85% lacking legal land ownership and a per capita income of only US$1.30 per day. The area experienced a high burden of leptospirosis, with a hospital incidence rate of 57.8 cases per 100,000 people and an infection rate of 37.8 per 1,000 person-years. These conditions create a setting highly favorable for the transmission of various infectious diseases. The Pau da Lima Cohort was established to study the transmission dynamics of illnesses such as leptospirosis, dengue, Zika, and more recently, COVID-19, within this vulnerable population.

The Pau da Lima Cohort has produced influential research that informs how we understand and respond to infectious disease risks in underserved urban settings

Lab Contacts: Pablo Aguilar, Nivison Nery Jr., Jaqueline Cruz, Gabriel Ribeiro dos Santos

Understanding the efficacy of COVID-19 vaccines at preventing infection and hospitalization.
Using novel serological assays to determine the correlates of protection against infection by SARS-CoV-2 or hospitalization with SARS-CoV-2.
Determining differences in SARS-CoV-2 circulation in general population compared to vulnerable populations such as incarcerated or immunocompromised populations.
Investigating the within-host evolution of SARS-CoV-2 in immunocompromised people.
Using machine learning methods to predict emergence of novel SARS-CoV-2 lineages.

Vector-Borne Diseases

With climate change, rapid urbanization, and increasing globalization, the global burden of vector-borne diseases has been swiftly growing in the past few decades. At the Ko Lab, we are focused on equitable strategies to mitigate the impact of these diseases. Our research primarily focuses on mosquito-borne diseases, such as dengue, Zika, and chikungunya. Through a combination of infrastructural and socioeconomic conditions, these urban diseases disproportionately affect the most vulnerable groups in society, such as those with low socioeconomic status, often living in unplanned urban settlements. With no specific treatments available, vector control and novel vaccines are at the forefront of mitigation strategies. Our work is mainly focused in Brazil – at our main research site in Salvador, in Belo Horizonte, and in Rio de Janeiro. We are constantly collaborating across the globe, with new projects always on the horizon…

Lab Contacts: Gabriel Ribeiro dos Santos, Elisabeth Nelson, Paloma Cárcamo, Ruchira Khosavanna, Pablo Aguilar, Youngsuk Ko, and Jaqueline Cruz

Understanding the local-scale epidemiology of chikungunya and Zika, and characterizing high risk groups.
In collaboration with SUNY Upstate Medical University, developing novel diagnostics to detect specific arboviral infections in areas of high co-circulation of dengue, Zika, and chikungunya.
Identifying vaccine roll-out strategies for novel chikungunya and dengue vaccines.
Evaluating the effectiveness of wMel Wolbachia-based vector control interventions in preventing arboviral incidence through the EVITA Dengue cluster-randomized control trial.
Optimizing the release and monitoring of wMel Wolbachia-based interventions to ensure effective, equitable scale-up across Brazil, in collaboration with the World Mosquito Program.

Leptospirosis

Leptospirosis is a zoonotic bacterial infection that thrives in conditions of poor sanitation and environmental degradation, making it a significant public health concern in tropical and subtropical regions. At the Ko Lab, we focus on equitable strategies to mitigate the impact of leptospirosis, particularly in urban slum communities where vulnerable populations are disproportionately affected.Our research is centered in Salvador, Brazil, where informal settlements face recurring flooding and rodent infestations. These environmental and social factors create ideal conditions for leptospirosis transmission. Through long-term studies, we have identified critical risk factors, including exposure to floodwaters, rodent infestations, and inadequate waste disposal, providing evidence to inform public health interventions.

Lab Contacts: Pablo Aguilar and Nivison Nery Jr.

Identifying how socioeconomic inequities, such as inadequate housing and poor waste management, increase exposure to Leptospira.
Understanding how climate variability, including extreme rainfall events, exacerbates the risk of leptospirosis outbreaks in flood-prone areas.
Improving diagnostic tools to differentiate leptospirosis from other tropical febrile illnesses.
Collaborating with local communities to implement strategies that reduce exposure, such as improved waste disposal, rodent control, and educational campaigns.
Exploring genetic variations in Leptospira strains to trace transmission pathways and understand pathogen adaptability to diverse environments and hosts.

SARS-CoV-2

The SARS-CoV2 pandemic has significantly impacted the lives of millions of people worldwide, and its ongoing circulation continues to affect people’s everyday lives. Our research on COVID-19 aims to understand the overall epidemiology of COVID-19 in the State of Connecticut, and investigates vaccine efficacy, correlates of protection, emergence of new lineages of concern and circulation in vulnerable populations, such as in incarcerated people or immunocompromised people. Through this work, we collaborate with several partners in the public and private industries, including hospitals, pharmaceutical companies and state departments, to address these and other important questions. This work will inform policy decisions that are vital to the control of SARS-CoV-2 and will also inform effective response and control of future infectious disease outbreaks.

Lab Contacts: Sindiso Nyathi, Lianhan Shang, and Margaret Lind

Understanding the efficacy of COVID-19 vaccines at preventing infection or hospitalization outcomes
Using novel serological assays to determine the correlates of protection against infection by SARS-CoV-2 or hospitalization with SARS-CoV-2
Determining differences in SARS-CoV-2 circulation in general population compared to vulnerable populations such as incarcerated or immunocompromised populations
Investigating the within-host evolution of SARS-CoV-2 in immunocompromised people
Using machine learning methods to predict emergence of novel SARS-CoV-2 lineages
Using machine learning methods to predict emergence of novel SARS-CoV-2 lineages

Pau Da Lima Cohort

Vector-Borne Diseases

Leptospirosis

SARS-CoV-2

Funding sources