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Gene Kwan, MD

Lecturer on Global Health and Social Medicine, Harvard Medical School
Assistant Professor of Medicine, Boston University School of Medicine
Associate Director of Cardiovascular Research and Training, Partners In Health

I am a cardiologist and global health researcher developing expertise in the intersection between these two fields. My primary professional goal is to push the frontier of global cardiovascular disease epidemiology and health service delivery (implementation) research through the development, implementation, evaluation, improvement and dissemination of integrated chronic care programs targeted to overcome specific barriers in rural low- and middle-income countries (LMIC). 

My research stems from experience in the field in rural Rwanda and Haiti since 2008 in collaboration with local Ministries of Health and the non-governmental organizations Partners In Health and Zanmi Lasante. I have developed and implemented care models using the strategy of task-shifting: training in-country nurses and generalist physicians in simplified protocols to aid in specialty care for the diagnosis and management of non-communicable diseases (NCD) including hypertension, diabetes, heart failure, stroke, and respiratory disease. My research has helped determine that heart failure in rural Rwanda and Haiti is generally from endemic causes (as opposed to coronary heart disease) and a leading cause of hospitalization. In addition, we demonstrated that nurse-directed management improves control of blood pressure for patients with hypertension and improves symptoms for those with heart failure. I also study the prevalence of poverty among patients with NCDs and develop approaches to overcome poverty-related barriers. My long-term goal is to develop and utilize evidence-based approaches for the understanding of cardiovascular disease in LMICs and influence programmatic development, implementation and policy.

I have active academic collaborations with projects in Haiti, Rwanda, Malawi, Liberia, and India. I am one of the principal authors of the implementation guide and clinician handbook The Partners In Health Guide to Chronic Care Integration for Endemic Non-Communicable Diseases. I have presented my work at several American Heart Association conferences including the Annual Scientific Sessions, Epidemiology, Nutrition, Prevention and Metabolism, and Quality and Clinical Outcomes Research sessions. I have also been an invited speaker both nationally and in Haiti and Rwanda. I continue to serve as an Advisor for Non-Communicable Diseases at Partners In Health in Boston, Haiti and Rwanda.

An investment case for the prevention and management of rheumatic heart disease in the African Union 2021-30: a modelling study.
Authors: Authors: Coates MM, Sliwa K, Watkins DA, Zühlke L, Perel P, Berteletti F, Eiselé JL, Klassen SL, Kwan GF, Mocumbi AO, Prabhakaran D, Habtemariam MK, Bukhman G.
Lancet Glob Health
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RESPONSE: Multilateral Cardiovascular Education and Training in Haiti.
Authors: Authors: Huffman MD, Kwan GF.
J Am Coll Cardiol
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Burden of non-communicable diseases from infectious causes in 2017: a modelling study.
Authors: Authors: Coates MM, Kintu A, Gupta N, Wroe EB, Adler AJ, Kwan GF, Park PH, Rajbhandari R, Byrne AL, Casey DC, Bukhman G.
Lancet Glob Health
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The COVID-19 Pandemic: A Massive Threat for Those Living With Cardiovascular Disease Among the Poorest Billion.
Authors: Authors: Klassen SL, Kwan GF, Bukhman G.
Circulation
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Does distance from a clinic and poverty impact visit adherence for noncommunicable diseases? A retrospective cohort study using electronic medical records in rural Haiti.
Authors: Authors: Yan LD, Pierre-Louis D, Isaac BD, Jean-Baptiste W, Vertilus S, Fenelon D, Hirschhorn LR, Hibberd PL, Benjamin EJ, Bukhman G, Kwan GF.
BMC Public Health
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Availability of equipment and medications for non-communicable diseases and injuries at public first-referral level hospitals: a cross-sectional analysis of service provision assessments in eight low-income countries.
Authors: Authors: Gupta N, Coates MM, Bekele A, Dupuy R, Fénelon DL, Gage AD, Getachew T, Karmacharya BM, Kwan GF, Lulebo AM, Masiye JK, Mayige MT, Ndour Mbaye M, Mridha MK, Park PH, Dagnaw WW, Wroe EB, Bukhman G.
BMJ Open
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Postoperative Rheumatic Heart Disease Follow-Up: Creating a National Registry and First Results from Rwanda.
Authors: Authors: Ntaganda E, Rusingiza E, Rukundo G, Ng'ang'a L, Hedt-Gauthier B, El-Khatib Z, Kwan GF, Gapira G, Worrall NK, Swain J, Kagame A, Mutumbira C, Ruhamya N, Bolman C, Sewase J, Ndayisaba G, Bolman Iii RM, Goldberg H, Mucumbitsi J.
Ann Glob Health
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Protocolized emergency department observation care improves quality of ischemic stroke care in Haiti.
Authors: Authors: Rouhani SA, Marsh RH, Rimpel L, Anderson K, Outhay M, Edmond MC, Checkett KA, Berkowitz AL, Kwan GF, Baugh CW, Schuur JD.
Afr J Emerg Med
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High Poverty and Hardship Financing Among Patients with Noncommunicable Diseases in Rural Haiti.
Authors: Authors: Kwan GF, Yan LD, Isaac BD, Bhangdia K, Jean-Baptiste W, Belony D, Gururaj A, Martineau L, Vertilus S, Pierre-Louis D, Fenelon DL, Hirschhorn LR, Benjamin EJ, Bukhman G.
Glob Heart
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10-Year Heart Failure Outcomes From Nurse-Driven Clinics in Rural Sub-Saharan Africa.
Authors: Authors: Eberly LA, Rusingiza E, Park PH, Ngoga G, Dusabeyezu S, Mutabazi F, Gahamanyi C, Ntaganda E, Kwan GF, Bukhman G.
J Am Coll Cardiol
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