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Abstract
From molecular-level determinants such as host and pathogen genetics to ecosystem-scale factors such as spatial distributions and climate patterns, the determinants of infectious diseases are highly variable. Due to this biocomplexity, researchers have called for a more comprehensive view of infectious diseases, their determinants and affected populations. An “across-scales” perspective of infectious disease epidemiology acknowledges the role of each biological level of organization in the complexity of overall disease distribution, while maintaining a focus on human population health. The aims of this dissertation represent work toward understanding the transmission, severity, or prevention of three different infectious pathogens using such an approach: SARS-CoV-2, Mycobacterium tuberculosis, and Zika virus. While each disease can itself be studied across multiple scales, these studies focus on specific biological levels of organization. COVID-19 mortality is modeled using spatiotemporal methods, illustrating the effect of community and ecosystem level dynamics. Population and community social and medical contacts are examined for patterns associated with delay to diagnosis of pulmonary tuberculosis disease. Finally, individual, population, and ecosystem dynamics are included in a simulation study of a Zika virus vaccine clinical trial. Together, these projects highlight some of the biological scales contributing to the epidemiology of these emerging or reemerging infectious diseases, and illustrate the broader necessity for an across-scales framework in infectious disease research.