Alexandra Savinkina, MSPH
About
Research
Publications
2024
Strategies for isoniazid preventive therapy in HIV-positive patients who consume alcohol.
Savinkina A, Muyindike W, Hahn J, Emenyonu N, Fatch R, Ngabirano C, Adong J, Jacobson K, Linas B. Strategies for isoniazid preventive therapy in HIV-positive patients who consume alcohol. The International Journal Of Tuberculosis And Lung Disease 2024, 28: 335-342. PMID: 38961548, DOI: 10.5588/ijtld.23.0303.Peer-Reviewed Original ResearchConceptsIsoniazid preventive therapyTB preventive therapyTuberculin skin testPreventive therapyReport alcohol useAlcohol useHIV-positive patientsTB disease incidenceLiver enzyme monitoringLatent TB infectionTB burden settingsSkin testTB infectionBurden settingsConsuming alcoholTB diseaseTB riskWHO guidanceTherapyEnzyme monitoringPLWHIsoniazidEvaluate hepatotoxicityHepatotoxicity concernsAST/ALT
2023
Keep it up! 3.0: Study protocol for a type III hybrid implementation-effectiveness cluster-randomized trial
Mustanski B, Saber R, Jones J, Macapagal K, Benbow N, Li D, Brown C, Janulis P, Smith J, Marsh E, Schackman B, Linas B, Madkins K, Swann G, Dean A, Bettin E, Savinkina A. Keep it up! 3.0: Study protocol for a type III hybrid implementation-effectiveness cluster-randomized trial. Contemporary Clinical Trials 2023, 127: 107134. PMID: 36842763, PMCID: PMC10249332, DOI: 10.1016/j.cct.2023.107134.Peer-Reviewed Original ResearchConceptsHIV riskHybrid effectiveness-implementation clusterCommunity-based organizationsPublic health scaleCluster-randomized trialHIV prevention programsRE-AIM modelHealth technology interventionStudy protocolOutcome measurementsCBO staffHealth ScalePrevention programsEHealth approachesConsolidated FrameworkIntervention implementationTrialsImplementation researchKIUImplementation outcomesYoung menCounty-level population estimatesYMSMConsumer recruitmentMenPlanning for Mpox on a College Campus: A Model-Based Decision-Support Tool.
Savinkina A, Chitwood M, Kwon J, Pitzer V, Gonsalves G, Paltiel A. Planning for Mpox on a College Campus: A Model-Based Decision-Support Tool. Annals Of Internal Medicine 2023, 176: 340-347. PMID: 36716454, PMCID: PMC10338074, DOI: 10.7326/m22-2734.Peer-Reviewed Original ResearchConceptsSustained transmissionNational InstituteLow-risk groupHigh-risk populationPopulation of MSMHealth-National InstituteResidential college campusSymptomatic casesHypothetical cohortCongregate settingsStudy populationPreemptive vaccinationReactive vaccinationInfectious diseasesVaccinationDrug abuseBasic reproductive numberFuture outbreaksFrequent physical contactMSMReproductive numberOutbreakDaysMenTimely detectionEstimated Testing, Tracing, and Vaccination Targets for Containment of the US Mpox Outbreak
Chitwood M, Kwon J, Savinkina A, Walker J, Bilinski A, Gonsalves G. Estimated Testing, Tracing, and Vaccination Targets for Containment of the US Mpox Outbreak. JAMA Network Open 2023, 6: e2250984. PMID: 36637825, PMCID: PMC9857202, DOI: 10.1001/jamanetworkopen.2022.50984.Peer-Reviewed Original Research
2022
Population-Level Strategies for Nirmatrelvir/Ritonavir Prescribing—A Cost-effectiveness Analysis
Savinkina A, Paltiel A, Ross J, Gonsalves G. Population-Level Strategies for Nirmatrelvir/Ritonavir Prescribing—A Cost-effectiveness Analysis. Open Forum Infectious Diseases 2022, 9: ofac637. PMID: 36589482, PMCID: PMC9792084, DOI: 10.1093/ofid/ofac637.Peer-Reviewed Original ResearchCost-effectiveness analysisTrade-offs implicitSevere diseaseDecision analytic modelAllocation decisionsPay thresholdsPolicy strategiesUnvaccinated patientsVaccination statusHigh riskTreatment effectivenessHigh-risk individualsAllocation strategyPopulation-level strategiesWillingnessFurther priorityDrug costsSensitivity analysisCostRitonavir treatmentUnvaccinated personsVaccinated adultsPatient populationClinical trialsLower riskEstimating deaths averted and cost per life saved by scaling up mRNA COVID-19 vaccination in low-income and lower-middle-income countries in the COVID-19 Omicron variant era: a modelling study
Savinkina A, Bilinski A, Fitzpatrick M, Paltiel AD, Rizvi Z, Salomon J, Thornhill T, Gonsalves G. Estimating deaths averted and cost per life saved by scaling up mRNA COVID-19 vaccination in low-income and lower-middle-income countries in the COVID-19 Omicron variant era: a modelling study. BMJ Open 2022, 12: e061752. PMID: 36100306, PMCID: PMC9471205, DOI: 10.1136/bmjopen-2022-061752.Peer-Reviewed Original ResearchConceptsLow-income countriesIncome countriesDeath avertedHigh-income nationsStatistical lifeAvertable deathsIncome nationsCOVID-19 deathsReasonable investmentHigh costKey inputCountriesParameter estimatesAvertedCostSensitivity analysisUniversal vaccinationGlobal vaccinationMRNA COVID-19 vaccinationNationsInvestmentPrimary vaccine seriesLow vaccine effectivenessCOVID-19 vaccinationPublic dataPopulation‐level impact of initiating pharmacotherapy and linking to care people with opioid use disorder at inpatient medically managed withdrawal programs: an effectiveness and cost‐effectiveness analysis
Savinkina A, Madushani RWMA, Yazdi G, Wang J, Barocas JA, Morgan JR, Assoumou SA, Walley AY, Linas BP, Murphy SM. Population‐level impact of initiating pharmacotherapy and linking to care people with opioid use disorder at inpatient medically managed withdrawal programs: an effectiveness and cost‐effectiveness analysis. Addiction 2022, 117: 2450-2461. PMID: 35315162, PMCID: PMC9377514, DOI: 10.1111/add.15879.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioOpioid use disorderStandard of careUse disordersFatal overdosesDetox patientsMOUD initiationWithdrawal programInitiation of medicationHealth care sector perspectiveRisk of overdoseFatal opioid overdosesCost-effectiveness ratioCost-effectiveness analysisOpioid useHealth care spendingOutpatient careDetox programsOpioid overdosesMOUDPatientsOverdosesPopulation-level impactDisorder populationHealth effectsModeling the cost‐effectiveness and impact on fatal overdose and initiation of buprenorphine–naloxone treatment at syringe service programs
Adams JW, Savinkina A, Fox A, Behrends CN, Madushani RWMA, Wang J, Chatterjee A, Walley AY, Barocas JA, Linas BP. Modeling the cost‐effectiveness and impact on fatal overdose and initiation of buprenorphine–naloxone treatment at syringe service programs. Addiction 2022, 117: 2635-2648. PMID: 35315148, PMCID: PMC9951221, DOI: 10.1111/add.15883.Peer-Reviewed Original ResearchConceptsSyringe services programFatal opioid overdosesBuprenorphine-naloxone treatmentOpioid use disorderTreatment initiationBuprenorphine treatmentOpioid overdosesFatal overdosesSSP clientsActive opioid useCommunity treatment providersObservational cohort studyNational surveillance dataCost-effectiveness analysisCohort studyIntervention scenariosOpioid useBuprenorphine programOUD treatmentStatus quo scenarioClinical trialsFatal overdoseMore QALYsUse disordersTreatment engagementDetermining the lower limit of detection required for HCV viral load assay for test of cure following direct‐acting antiviral‐based treatment regimens: Evidence from a global data set
Morgan JR, Marsh E, Savinkina A, Shilton S, Shadaker S, Tsertsvadze T, Kamkamidze G, Alkhazashvili M, Morgan T, Belperio P, Backus L, Doss W, Esmat G, Hassany M, Elsharkawy A, Elakel W, Mehrez M, Foster GR, Kinge C, Chew KW, Chasela CS, Sanne IM, Thanung YM, Loarec A, Aslam K, Balkan S, Easterbrook PJ, Linas BP. Determining the lower limit of detection required for HCV viral load assay for test of cure following direct‐acting antiviral‐based treatment regimens: Evidence from a global data set. Journal Of Viral Hepatitis 2022, 29: 474-486. PMID: 35278339, PMCID: PMC9248016, DOI: 10.1111/jvh.13672.Peer-Reviewed Original ResearchConceptsDetectable viraemiaDetectable HCV RNALow-level viraemiaVirological treatment failureHCV viral loadTest of cureHepatitis C virusViral load assaysHCV viraemiaHCV RNATreatment failureViral loadC virusClinical trialsMinimal fibrosisSVR12ViraemiaGlobal eliminationLogistic regressionDiagnostic performanceLevel of detectionObservational databaseIULaboratory-based assaysCureSimulated Cost-effectiveness and Long-term Clinical Outcomes of Addiction Care and Antibiotic Therapy Strategies for Patients With Injection Drug Use–Associated Infective Endocarditis
Adams JW, Savinkina A, Hudspeth JC, Gai MJ, Jawa R, Marks LR, Linas BP, Hill A, Flood J, Kimmel S, Barocas JA. Simulated Cost-effectiveness and Long-term Clinical Outcomes of Addiction Care and Antibiotic Therapy Strategies for Patients With Injection Drug Use–Associated Infective Endocarditis. JAMA Network Open 2022, 5: e220541. PMID: 35226078, PMCID: PMC8886538, DOI: 10.1001/jamanetworkopen.2022.0541.Peer-Reviewed Original ResearchConceptsOutpatient parenteral antimicrobial therapyIncremental cost-effectiveness ratioOral antibiotic therapyInjection drug use-associated infective endocarditisUsual care strategyAntibiotic therapyOpioid drug useAntibiotic treatment strategiesAntibiotic strategiesCare servicesTreatment strategiesCare strategiesTreatment discontinuationClinical outcomesInfective endocarditisDrug use-associated infective endocarditisDrug useInpatient intravenous antibiotic therapyLong-term clinical outcomesHigher treatment completion rateIntravenous antibiotic therapyObservational cohort studyPercentage of patientsPostacute care facilityParenteral antimicrobial therapy