Silvia Chiang, MD ScM is a physician-researcher who works on childhood and adolescent tuberculosis. She is board cetified in Pediatric Infectious Diseases and General Pediatrics, and attends on the pediatric infectious disease service and the RISE Tuberculosis Clinic.
After graduating from Stanford University, Dr. Chiang worked as a Peace Corps community health volunteer in rural Peru. She then attended medical school at Case Western Reserve University. In 2012, during her last year of pediatrics residency in Boston, she returned to Peru to work with Socios En Salud (Partners In Health-Peru) on tuberculosis research. She continued her collaboration with Socios En Salud throughout her pediatric infectious diseases fellowship, which she completed at Baylor College of Medicine and Texas Children's Hospital.
Dr. Chiang currently has NIH and foundation grants to conduct adolescent tuberculosis research in Peru. She has additional ongoing research collaborations on pediatric tuberculosis in Ukraine.
In 2021, Dr. Chiang collaborated on evidence reviews to inform the upcoming World Health Organization guideline updates on managing tuberculosis in children and adolescents. This work included leading experts from over 18 different countries to produce consensus recommendations on caring for adolescents with tuberculosis.
During the COVID-19 pandemic, Dr. Chiang has been interviewed about COVID-19 by The New York Times, The Boston Globe, Scientific American, The Associated Press, local news channels including Telemundo, and other media outlets.
With Dr. Tanya Rogo, Dr. Chiang co-directs the Global Health Scholarly Concentration at Alpert Medical School.
|Verkuijl S, Sekadde MP, Dodd PJ, Arinaitwe M, Chiang SS, Brands A, Viney K, Sismanidis C, Jenkins HE. "Addressing the Data Gaps on Child and Adolescent Tuberculosis." Pathogens (Basel, Switzerland), vol. 11, no. 3, 2022.|
|Sulis G, Tavaziva G, Gore G, Benedetti A, Solomons R, van Toorn R, Thee S, Day J, Verkuijl S, Brands A, Viney K, Masini T, Ahmad Khan F, Chiang SS. "Comparative Effectiveness of Regimens for Drug-Susceptible Tuberculous Meningitis in Children and Adolescents: A Systematic Review and Aggregate-Level Data Meta-Analysis." Open Forum Infectious Diseases, vol. 9, no. 6, 2022, pp. ofac108.|
|Oliva Rapoport VE, Altamirano E, Senador L, Wong M, Beckhorn CB, Coit J, Roche SD, Lecca L, Galea JT, Chiang SS. "Impact of prolonged isolation on adolescents with drug-susceptible tuberculosis in Lima, Peru: a qualitative study." BMJ Open, vol. 12, no. 9, 2022, pp. e063287.|
|Kuzyk PV, Padilla R, Rybak NR, Hoshovska II, Kitov VO, Savchyna MO, Jenkins HE, Chiang SS, Horsburgh CR, Dolynska M, Petrenko V, Gychka SG. "Missed Tuberculosis Diagnoses: Analysis of Pediatric Autopsy Data From General Hospitals in Lviv, Ukraine." Journal of the Pediatric Infectious Diseases Society, 2022.|
|Goel AR, Chiang SS, Ibrahim O, Yalcindag A. "Multisystem Inflammatory Syndrome in an Adolescent Following SARS-CoV-2 Exposure Despite Three Doses of a COVID-19 Vaccine." Rhode Island medical journal (2013), vol. 105, no. 5, 2022, pp. 41-45.|
"Mycobacterium tuberculosis." Principles and Practice of Pediatric Infectious Diseases, edited by Sarah S. Long, Charles G. Prober, Marc Fischer, David W. Kimberlin, Philadelphia, Elsevier, 2022, pp. 806-822.
|Leddy AM, Jaganath D, Triasih R, Wobudeya E, Bellotti de Oliveira MC, Sheremeta Y, Becerra MC, Chiang SS. "Social Determinants of Adherence to Treatment for Tuberculosis Infection and Disease Among Children, Adolescents, and Young Adults: A Narrative Review." Journal of the Pediatric Infectious Diseases Society, vol. 11, no. Supplement_3, 2022, pp. S79-S84.|
|Huang CC, Tan Q, Becerra MC, Calderon R, Chiang SS, Contreras C, Lecca L, Jimenez J, Perez-Velez CM, Roya-Pabon CL, Yataco R, Xu H, Zhang Z, Murray M. "The Contribution of Chest Radiography to the Clinical Management of Children Exposed to Tuberculosis." Am J Respir Crit Care Med, 2022.|
|Weng, Chien-Hsiang, Butt, Wesley Wing Wah, Brooks, Meredith B., Clarke, Claudia, Jenkins, Helen E., Holland, Sabina D., Chiang, Silvia S. "Diagnostic value of symptoms for pediatric SARS-CoV-2 infection in a primary care setting." PLOS ONE, vol. 16, no. 12, 2021, pp. e0249980.|
|Khalife S, Jenkins HE, Dolynska M, Terleieva I, Varchenko I, Liu T, Carter EJ, Horsburgh CR, Rybak NR, Petrenko V, Chiang SS. "Incidence and Mortality of Extrapulmonary Tuberculosis in Ukraine: Analysis of National Surveillance Data." Clinical Infectious Diseases, 2021.|
|Wong M, Coit JM, Mendoza M, Chiang SS, Marin H, Galea JT, Lecca L, Franke MF. "Incident Tuberculosis Diagnoses in Children at High Risk for Disease." Open Forum Infectious Diseases, vol. 8, no. 3, 2021, pp. ofab075.|
|Pandita A, Gillani FS, Shi Y, Hardesty A, McCarthy M, Aridi J, Farmakiotis D, Chiang SS, Beckwith CG. "Predictors of severity and mortality among patients hospitalized with COVID-19 in Rhode Island." PLOS ONE, vol. 16, no. 6, 2021, pp. e0252411.|
|Chiang SS, Jenkins HE. "Shedding Light on Tuberculosis Deaths in Children and Adolescents." Pediatrics, 2021.|
|Moscibrodzki P, Enane LA, Hoddinott G, Brooks MB, Byron V, Furin J, Seddon JA, Meyersohn L, Chiang SS. "The Impact of Tuberculosis on the Well-Being of Adolescents and Young Adults." Pathogens (Basel, Switzerland), vol. 10, no. 12, 2021.|
|Snow KJ, Cruz AT, Seddon JA, Ferrand RA, Chiang SS, Hughes JA, Kampmann B, Graham SM, Dodd PJ, Houben RM, Denholm JT, Sawyer SM, Kranzer K. "Adolescent tuberculosis." The Lancet. Child & adolescent health, vol. 4, no. 1, 2020, pp. 68-79.|
|Mbuthia, Grace Wambura, Nyamogoba, Henry D. N., Chiang, Silvia S., McGarvey, Stephen T. "Burden of stigma among tuberculosis patients in a pastoralist community in Kenya: A mixed methods study." PLOS ONE, vol. 15, no. 10, 2020, pp. e0240457.|
|Chiang, Silvia S., Dolynska, Maria, Rybak, Natasha R., Cruz, Andrea T., Aibana, Omowunmi, Sheremeta, Yana, Petrenko, Vasyl, Mamotenko, Andrii, Terleieva, Iana, Horsburgh, C. Robert, Jenkins, Helen E. "Clinical manifestations and epidemiology of adolescent tuberculosis in Ukraine." ERJ Open Research, vol. 6, no. 3, 2020, pp. 00308-2020.|
|Chiang SS, Brooks MB, Jenkins HE, Rubenstein D, Seddon JA, van de Water BJ, Lindeborg MM, Becerra MC, Yuen CM. "Concordance of drug resistance profiles between persons with drug-resistant tuberculosis and their household contacts: a systematic review and meta-analysis." Clinical Infectious Diseases, 2020.|
|Chiang SS, Beckhorn CB, Wong M, Lecca L, Franke MF. "Patterns of suboptimal adherence among adolescents treated for tuberculosis." The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, vol. 24, no. 7, 2020, pp. 723-725.|
|Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, Salazar-Mather TP, Dumenco L, Savaria MC, Aung SN, Flanigan T, Michelow IC. "Predictors of COVID-19 severity: A literature review." Reviews in medical virology, vol. 31, no. 1, 2020, pp. e2146.|
|Chiang SS, Dara M. "TB in children and adolescents." The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, vol. 24, no. 12, 2020, pp. 1231-1233.|
|Coit J, Wong M, Galea JT, Mendoza M, Marin H, Tovar M, Chiang SS, Lecca L, Franke MF. "Uncovering reasons for treatment initiation delays among children with TB in Lima, Peru." The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, vol. 24, no. 12, 2020, pp. 1254-1260.|
|Chiang SS, Cruz AT. "Minding (and Reducing) the Detection Gap: An Algorithm to Diagnose TB With HIV Infection." Pediatrics, vol. 144, no. 3, 2019.|
|Chiang SS, Sheremeta Y, Padilla RS, Jenkins HE, Horsburgh CR Jr, Petrenko V, Rybak NR. "Pediatric Multidrug-resistant Tuberculosis in Kyiv City, Ukraine." Journal of Epidemiology and Global Health, vol. 9, no. 1, 2019, pp. 56-61.|
|Coit J, Mendoza M, Pinedo C, Marin H, Chiang SS, Lecca L, Franke M. "Performance of a household tuberculosis exposure survey among children in a Latin American setting." The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, vol. 23, no. 11, 2019, pp. 1223-1227.|
|Szkwarko D, Bouton TC, Rybak NR, Carter EJ, Chiang SS. "Tuberculosis: An Epidemic Perpetuated by Health Inequalities." Rhode Island medical journal (2013), vol. 102, no. 7, 2019, pp. 47-50.|
|Chiang SS, Park S, White EI, Friedman JF, Cruz AT, Del Castillo H, Lecca L, Becerra MC, Seddon JA. "Using Changes in Weight-for-Age z Score to Predict Effectiveness of Childhood Tuberculosis Therapy." Journal of the Pediatric Infectious Diseases Society, vol. 9, no. 2, 2019, pp. 150-158.|
|Aibana O, Huang CC, Aboud S, Arnedo-Pena A, Becerra MC, Bellido-Blasco JB, Bhosale R, Calderon R, Chiang S, Contreras C, Davaasambuu G, Fawzi WW, Franke MF, Galea JT, Garcia-Ferrer D, Gil-Fortuño M, Gomila-Sard B, Gupta A, Gupte N, Hussain R, Iborra-Millet J, Iqbal NT, Juan-Cerdán JV, Kinikar A, Lecca L, Mave V, Meseguer-Ferrer N, Montepiedra G, Mugusi FM, Owolabi OA, Parsonnet J, Roach-Poblete F, Romeu-García MA, Spector SA, Sudfeld CR, Tenforde MW, Togun TO, Yataco R, Zhang Z, Murray MB. "Vitamin D status and risk of incident tuberculosis disease: A nested case-control study, systematic review, and individual-participant data meta-analysis." PLOS Medicine, vol. 16, no. 9, 2019, pp. e1002907.|
|Tafur KT, Coit J, Leon SR, Pinedo C, Chiang SS, Contreras C, Calderon R, Mendoza MJ, Lecca L, Franke MF. "Feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years old." BMC infectious diseases, vol. 18, no. 1, 2018, pp. 574.|
|Sieiro TLA, Aurílio RB, Soares ECC, Chiang SS, Sant Anna CC. "The role of the Xpert MTB/RIF assay among adolescents suspected of pulmonary tuberculosis in Rio de Janeiro, Brazil." Revista da Sociedade Brasileira de Medicina Tropical, vol. 51, no. 2, 2018, pp. 234-236.|
|Seddon JA, Chiang SS, Esmail H, Coussens AK. "The Wonder Years: What Can Primary School Children Teach Us About Immunity to Mycobacterium tuberculosis?." Frontiers in immunology, vol. 9, 2018, pp. 2946.|
Chiang SS, Furin JJ.
"Treatment of multidrug-resistant tuberculosis in children and adolescents." J Pediatric Infect Dis , vol. 13, 2018, pp. 153-168.
|Chiang SS, Roche S, Contreras C, Del Castillo H, Canales P, Jimenez J, Tintaya K, Becerra MC, Lecca L. "Barriers to the treatment of childhood tuberculous infection and tuberculosis disease: a qualitative study." The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, vol. 21, no. 2, 2017, pp. 154-160.|
Chiang SS, Starke JR.
"Mycobacterium tuberculosis." Principles and Practice of Pediatric Infectious Diseases, edited by Long SS, Prober CG, Fischer M, Elsevier, Inc., 2017.
|Chiang SS, Starke JR, Miller AC, Cruz AT, Del Castillo H, Valdivia WJ, Tunque G, García F, Contreras C, Lecca L, Alarcón VA, Becerra MC. "Baseline Predictors of Treatment Outcomes in Children With Multidrug-Resistant Tuberculosis: A Retrospective Cohort Study." Clinical Infectious Diseases, vol. 63, no. 8, 2016, pp. 1063-71.|
|Aibana O, Acharya X, Huang CC, Becerra MC, Galea JT, Chiang SS, Contreras C, Calderon R, Yataco R, Velásquez GE, Tintaya K, Jimenez J, Lecca L, Murray MB. "Nutritional Status and Tuberculosis Risk in Adult and Pediatric Household Contacts." PLoS ONE, vol. 11, no. 11, 2016, pp. e0166333.|
|Chiang SS, Roche S, Contreras C, Alarcón V, Del Castillo H, Becerra MC, Lecca L. "Barriers to the diagnosis of childhood tuberculosis: a qualitative study." The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, vol. 19, no. 10, 2015, pp. 1144-52.|
|Chiang SS, Cruz AT, Del Castillo H, Contreras C, Becerra MC, Lecca L. "Evaluation of health-care providers' knowledge of childhood tuberculosis in Lima, Peru." Paediatrics and international child health, vol. 35, no. 1, 2015, pp. 29-35.|
|Chiang SS, Swanson DS, Starke JR. "New Diagnostics for Childhood Tuberculosis." Infectious disease clinics of North America, vol. 29, no. 3, 2015, pp. 477-502.|
|Chiang SS, Paulus JK, Huang CC, Newby PK, Castellón Quiroga D, Boynton-Jarrett R, Antkowiak L. "Tuberculosis screening among Bolivian sex workers and their children." Journal of Epidemiology and Global Health, vol. 5, no. 2, 2015, pp. 205-10.|
|Chiang SS, Khan FA, Milstein MB, Tolman AW, Benedetti A, Starke JR, Becerra MC. "Treatment outcomes of childhood tuberculous meningitis: a systematic review and meta-analysis." The Lancet Infectious Diseases, vol. 14, no. 10, 2014, pp. 947-57.|
|Wu X, Gu J, Wu TT, Swisher SG, Liao Z, Correa AM, Liu J, Etzel CJ, Amos CI, Huang M, Chiang SS, Milas L, Hittelman WN, Ajani JA. "Genetic variations in radiation and chemotherapy drug action pathways predict clinical outcomes in esophageal cancer." Journal of Clinical Oncology, vol. 24, no. 23, 2006, pp. 3789-98.|
|Wu X, Roth JA, Zhao H, Luo S, Zheng YL, Chiang S, Spitz MR. "Cell cycle checkpoints, DNA damage/repair, and lung cancer risk." Cancer Research, vol. 65, no. 1, 2005, pp. 349-57.|
|Yao JC, Tseng JF, Worah S, Hess KR, Mansfield PF, Crane CH, Schnirer II, Reddy S, Chiang SS, Najam A, Yu C, Giacco GG, Xie K, Wu TT, Feig BW, Pisters PW, Ajani JA. "Clinicopathologic behavior of gastric adenocarcinoma in Hispanic patients: analysis of a single institution's experience over 15 years." Journal of Clinical Oncology, vol. 23, no. 13, 2005, pp. 3094-103.|
|Wu X, Lu C, Chiang SS, Ajani JA. "Pharmacogenetics in esophageal cancer." Seminars in oncology, vol. 32, no. 6 Suppl 9, 2005, pp. S87-9.|
|Yao JC, Schnirer II, Reddy S, Chiang S, Najam A, Yu C, Giacco G, Hess K, Rashid A, Xie K, Lynch P, Ajani JA. "Effects of sex and racial/ethnic group on the pattern of gastric cancer localization." Gastric Cancer, vol. 5, no. 4, 2002, pp. 208-12.|
I am a clinician-investigator who practices pediatric infectious diseases and studies childhood and adolescent tuberculosis (TB). My overarching goal as an investigator is to conduct epidemiologic and clinical research that will improve outcomes for children and adolescents with TB. Most of my research takes place in Lima, Peru, where I work with Partners In Health-Peru (PIH-Peru), a non-governmental organization that aims to improve the health of vulnerable populations through healthcare delivery and research. I have worked with PIH-Peru on five TB studies, which have led to multiple publications. One of these publications shows that weight gain early in therapy predicts treatment success in children and adolescents with TB. Another publication identifies risk factors for treatment failure and death in pediatric multidrug-resistant (MDR) TB, and suggests targets for intervention to improve outcomes. I have also published qualitative studies that evaluate barriers to childhood TB diagnosis and treatment.
In 2017, I began collaborating on pediatric TB work in Ukraine with colleagues at Bogomolets National Medical University and the Center for Public Health of the Ministry of Health. Together we have published a paper on the treatment of children with MDR-TB and another on the clinical manifestations and epidemiology TB disease in nearly 2500 adolescents.
As a junior clinician-investigator, I am working towards research independence and developing expertise in adolescent TB. Few disaggregated data exist for adolescents with TB, and their needs have been neglected in TB research and policy. To achieve my career goals, I have obtained a K01 International Research Scientist Development Award (IRSDA), which is funding my study “Teens on TB Treatment.” This study, which will continue through late 2021, uses in-depth interviews and quantitative data from a prospective cohort (n=250) to evaluate barriers and facilitators to treatment adherence in adolescents with TB disease in Lima, Peru. I also have a grant from the Charles Hood Foundation to evaluate respiratory sequelae in adolescents from the Teens on TB Treatment cohort. Compared to the general population, adults with pulmonary TB have a higher risk of chronic fixed airflow obstruction, bronchiectasis, and poor respiratory-related quality of life, even despite successful TB treatment. No pediatric studies have examined post-TB lung sequelae. Knowing whether residual lung problems occur in children and adolescents is important for optimizing patient management.
Charles Hood Foundation Child Health Award (Chiang)
Evaluation of Post-Tuberculosis Lung Function in Adolescents
Compared to the general population, adults with a history of tuberculosis are at risk of chronic fixed airflow obstruction and poor respiratory-related quality of life, even despite successful tuberculosis treatment. No pediatric studies have examined post-tuberculosis lung sequelae, yet knowing whether residual lung problems occur in children and adolescents is important for optimizing patient management and improving public health. The proposed project will evaluate respiratory sequelae in adolescents who are successfully treated for pulmonary tuberculosis.
Providence/Boston CFAR Developmental Grant (Rybak)
Counting Kids: Enhancing Detection of Pediatric Tuberculosis in Ukraine
Through a review of autopsy and hospital records in Ukraine, this study will identify and quantify children with tuberculosis disease who were not diagnosed. A prospective arm will evaluate whether the addition of diagnostic tools to clinicians’ armamentarium can enhance detection of childhood tuberculosis disease.
Teens on TB Treatment: Can We Predict Adherence?
This International Research Scientist Development Award (IRSDA) will characterize adolescent-specific risk factors for poor adherence to TB treatment. The study will culminate in the derivation and validation of a clinically applicable prediction rule that identifies adolescents at risk for poor adherence to therapy for drug-susceptible pulmonary TB. At the same time, this IRSDA will serve as a vehicle for the PI to become an independent physician-scientist in global health research.
Children’s Miracle Network Scholar Award (Chiang)
Pubertal Development and Cytokines Involved in Host Response to Mycobacterium tuberculosis
In a cohort of adolescents and pre-adolescents with latent tuberculosis infection, this exploratory study aims to examine associations between cytokines involved in host response to Mycobacterium tuberculosis and dehydroepiandrosterone sulfate, leptin, Tanner stage.
Grant No. 20164368 (Chiang)
Rhode Island Foundation
TB Treatment among Adolescents in Lima, Peru
This pilot study evaluated adolescent adherence to and adverse events from therapy for multidrug-resistant tuberculosis in Lima, Peru.
Early Career Award 12442 (Chiang)
Thrasher Research Fund
Optimizing Treatment Regimens for Pediatric Multidrug-resistant Tuberculosis
This study aimed to identify baseline predictors of death, treatment failure, and treatment default among children with MDR-TB disease treated with second-line drugs.
|2009||MD||Case Western Reserve University|
|Clinical Postdoctoral Fellow||Baylor College of Medicine, Texas Children's Hospital, pediatric infectious diseases||-||Houston, TX, USA|
|Resident||Boston Children's Hospital and Boston Medical Center, Pediatrics||-|
|Research Fellow||Harvard Medical School, Global Health and Social Medicine||-||Boston, MA, USA|
Loan Repayment Program Award, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 2018-2020, 2020-present
Early Career Research Achievement Award, Brown University, 2020
Commendation for Excellence in Mentoring of Student Research, Emerging Infectious Disease Scholars Program of Brown University, 2019
Young Physician-Scientist Award, American Society for Clinical Investigation, 2018
Fred Lovejoy Research Award, Boston Children’s Hospital, 2011
Paul Schliesman Fellowship, Boston Children’s Hospital, 2011, 2010
Von L. Meyer Award, Boston Children’s Hospital, 2011, 2010
Daniel Lewis Ravin, M.D. Memorial Award in Environmental Health, Case Western Reserve University School of Medicine, 2009
Chinese American Medical Society Scholarship, 2008
|Friedman, Jennifer||Professor of Pediatrics, Professor of Epidemiology|
|Holland, Sabina||Assistant Professor of Pediatrics, Clinician Educator|
|Rybak, Natasha||Assistant Professor of Medicine, Clinician Educator|
|Attending Physician. Hasbro Children's Hospital, -|