About

Stephen Luby is a physician, researcher, and educator who joined the Stanford faculty in 2012. He has extensive international experience, having lived and worked for five years in Pakistan at the Aga Khan University and for eight years in Bangladesh with the Centers for Disease Control and Prevention (CDC) and icddr,b. His professional background includes fellowship training in Epidemiology at the Centers for Disease Control and Prevention, and board certification in Internal Medicine by the American Board of Internal Medicine. Dr. Luby's academic credentials include an MD from the University of Texas, Southwestern, and a BA in Philosophy from Creighton University. His work focuses on medicine, infectious diseases, and global health, with a particular emphasis on public health issues in developing countries. As a researcher and educator, he contributes to the Stanford Program in Science, Technology & Society, and his professional activities are supported by his lab and external profiles. Dr. Luby's career reflects a commitment to advancing health through research and education, especially in the context of infectious diseases and health systems in resource-limited settings.

Research topics

• Medicine
• Environmental health
• Computer Science
• Internal medicine
• Biology
• Psychology
• Surgery
• Political Science
• Virology
• Nursing
• Sociology
• Geography
• Psychiatry
• Microbiology
• Obstetrics
• Immunology
• Economics
• Pathology
• Ecology
• Demography
• Pediatrics
• Mathematics
• Risk analysis (engineering)
• Environmental science

Selected publications

• From Prototype to Production: Redesigning the Automatic Coal Feeder for Manufacturability and Field-Trial Deployment in Bangladesh Brick Kilns

  Stanford Digital Repository · 2026-03-18

  articleOpen access

  Bangladesh’s brick industry is critical to construction and economic development, but it relies heavily on traditional kilns with manual, uneven coal feeding. When shovelfuls of coal dust are dumped into portholes in these kilns at irregular intervals, combustion is incomplete, and tremendous quantities of fuel go unburned, being ejected out the smokestack as harmful particulates. The scale of the resulting environmental crisis is massive: in Dhaka, one of the world's most polluted cities, some 5,000 football-field-sized kilns in the area are responsible for up to 60% of local particulate pollution due to these inefficient firing practices. In collaboration with the Bangladesh University of Engineering and Technology (BUET), the Automatic Coal Feeder (ACF) program has run for some six years with the aim of mitigating these severe health and environmental impacts by delivering coal at a controlled, consistent rate while remaining compatible with existing kiln infrastructure. The objective of the AY26 effort is to transition an existing, functional ACF prototype into a cost-effective design optimized for manufacturability and moderate-scale production in Bangladesh, enabling around 100 units to be deployed for a field trial during the October 2026 kiln season. This report details the final design, engineering rationale, and experimental plan for this manufacturability-driven redesign. Major updates include: (1) transitioning the coal metering (“sandwich”) mechanism to a hybrid aluminum and bronze insert system, which reduces costs while maintaining clearance, sealing against coal dust, and localizing wear; (2) redesigning the motor mount for greater adjustability and reduced tolerance sensitivity; (3) integrating a cost-effective motor matched to ACF operating loads; and (4) replacing an expensive purchased component with a locally fabricable square drive turntable-shaft coupling. Initial bench-scale testing confirms that the redesign preserved core functionality, achieving an average dispense rate of 5.55 g/s across four outlets at 2 RPM using 15% moisture coal (15% water by weight)—successfully meeting the core 2–10 g/s requirement. Furthermore, the DFM-driven updates achieved a 33% reduction in prototype cost and streamlined the manufacturing process, bringing assembly time down to 12 man-hours. While full-load verification and long-term reliability testing remain necessary, the AY26 redesign successfully demonstrates that the ACF can be optimized for scalable local fabrication without sacrificing metering performance, advancing the system toward deployment readiness for the October 2026 field trials.

  PublisherDOI

• National burden and optimal vaccine policy for Japanese encephalitis virus in Bangladesh

  medRxiv · 2025-07-07 · 1 citations

  preprintOpen access

  Background: Bangladesh first reported Japanese encephalitis virus (JEV) in 1977 and has seen regular cases since, however, no JEV vaccination program currently exists. A barrier to the use of JEV vaccines has been a limited understanding of the underlying burden. Methods: We conducted a nationally representative serological community study in 70 communities in individuals of all ages (N=2,938, October 2015-January 2016). Serum samples were tested for IgG antibodies against JEV. We developed spatially explicit serocatalytic models to estimate the underlying force of infection across the country. We then used mathematical models to estimate the annual JE disease burden currently and under different vaccination strategies. Findings: The overall JEV seroprevalence in Bangladesh was 3.4% (95%CI: 2.8-4.1, range 0-28% across communities). The annual probability of infection was 0.005 (95%CI: 0.003-0.009), with risk greatest near border regions. We estimated that annually there are 157 clinical cases (95%CI: 89-253) and 31 deaths (95%CI: 18-52). A vaccination strategy in the 10 most affected districts in 60% of 1-15 year olds would require 5 million doses and avert 1 case per 100,000 doses over five years compared to 35 million doses and 0.5 cases averted for a nationwide campaign. No vaccination scenario was cost-effective under a willingness-to-pay of three-times gross domestic product. Interpretation: A spatially targeted vaccine campaign would be most effective in reducing JEV burden, however, would still not meet standard cost effectiveness targets. Funding: CDC.

  PublisherOA PDFDOI

• Associations Between Micronutrient Status, Hormones, and Immune Status During Pregnancy and Child Growth in Rural Bangladesh: A Prospective Cohort Study

  Current Developments in Nutrition · 2025-11-08

  articleOpen access

  Background: Poor growth in early childhood is associated with increased mortality, impaired cognitive development, and reduced adult economic productivity, which may result in higher risks of social immobility and intergenerational poverty. Objective: We aimed to evaluate whether maternal hormones, immune status, and micronutrient status during all trimesters of pregnancy were associated with child growth outcomes in the first two years after birth. Methods: values were adjusted using the Benjamini-Hochberg procedure. We used generalized additive models, adjusted for covariates, and reported the mean difference in outcomes between the 25th and 75th percentiles of the exposure distribution. Results: = 636), at 3 mo of age, maternal AGP and RBP were positively associated with infant WLZ. By 14 mo, higher maternal estriol was linked with higher LAZ, and RBP remained positively associated with WLZ. At 28 mo, maternal estriol showed a negative association with IGF-1, and a higher cytokine sum score was negatively associated with WLZ. Conclusions: These findings suggest the possible pathways through which maternal biomarkers influence early childhood growth, highlighting the intrauterine environment's critical role in shaping developmental outcomes.The parent trial was registered at clinicaltrials.gov (NCT01590095).

  PublisherDOI

• Perinatal colonization with extended-spectrum beta-lactamase-producing and carbapenem-resistant Gram-negative bacteria among home births in Bangladesh

  medRxiv · 2025-05-15

  preprintOpen access

  Background: Hospital-acquired neonatal infections are increasingly caused by antibiotic-resistant bacteria. It is unknown to what extent home-based births, which account for nearly a third of deliveries in Bangladesh, may also result in exposure to antibiotic-resistant bacteria. Methods: We enrolled mothers who delivered at home and their newborns from a rural community in Bangladesh during April-June, 2022. Within 2-7 days after delivery, we collected vaginal and rectal swabs from mothers and rectal swabs from the newborns. Swabs were cultured on chromogenic culture media selective for extended-spectrum β-lactamase-producing bacteria (ESBL-PB) and carbapenem-resistant bacteria (CRB). Demographic and risk factor data were collected via surveys. Birth attendants who facilitated the deliveries were interviewed regarding infection prevention practices. We performed descriptive analyses to identify potential risk factors associated with colonization. Results: Of the 50 mothers enrolled, the median age was 23 years (range 18 to 26). Thirty-eight (76%) mothers had at least one antenatal care visit. Only one mother reported hospitalization during pregnancy, and 4 reported antibiotic use during pregnancy. Following delivery, 47 (94%) mothers were colonized with ESBL-PB, and 37 (74%) were colonized with CRB. Of the newborns, 36 (72%) were colonized with ESBL-PB, and 27 (54%) were colonized with CRB. No associations were found with any perinatal exposures, though all households reported incomes below the international poverty level. Of the 9 birth attendants were able to be interviewed, 7 (78%) reported performing hand hygiene before delivery, and 8 (89%) reported glove use during the delivery. Attendants reported cleaning equipment shared across deliveries with soap and water and using boiled water for delivery (89%, n=8). Conclusions: Women and newborns in this rural population were frequently colonized with both ESBL-PB and CRB following home deliveries. This demonstrates the importance of community-based antibiotic-resistant bacterial transmission and need for further understanding community exposures driving antibiotic resistance.

  PublisherOA PDFDOI

• Examining the effect of neighborhood sanitation coverage on childhood diarrheal disease in rural Bangladesh

  International Journal of Hygiene and Environmental Health · 2025-12-09

  articleOpen access
  PublisherOA PDFDOI

• Associations between floor material and E. coli contamination in rural Bangladeshi households

  International Journal of Hygiene and Environmental Health · 2025-07-29 · 1 citations

  articleOpen access

  BACKGROUND: Soil floors are common in low-income countries and can harbor contamination from fecal waste. Soil/dust ingestion from floors or indirectly via hands, water and food can contribute to children's ingestion of fecal organisms. We assessed if finished (e.g., concrete) floors are associated with lower E. coli contamination in the domestic environment in rural Bangladesh. METHODS: We collected samples from 1864 households over 3.5 years, including stored drinking water, child and caregiver hand rinses, courtyard soil, food, and flies (n = 24,118 samples), and enumerated E. coli using IDEXX Quanti-Tray/2000. RESULTS: Controlling for socio-demographics, water/sanitation status, and animal ownership, households with finished floors had slightly lower log10-transformed E. coli counts (Δlog10 = -0.10 (-0.20, 0.00)) and prevalence (prevalence ratio [PR] = 0.90 (0.83, 0.98)) on child hands than households with soil floors; floor material was not associated with contamination levels in other sample types. In subgroup analyses, finished floors were associated with lower E. coli on child hands following heavy rainfall (Δlog10 = -0.23 (-0.39, -0.07)), above-median temperature (Δlog10 = -0.18 (-0.30, -0.06)), and in households with more domestic animals (Δlog10 = -0.16 (-0.32, -0.01)). Finished floors were also associated with slightly lower contamination of stored water following heavy rainfall (PR = 0.89 (0.81, 0.99)) and above-median temperature (PR = 0.91 (0.84, 0.98)), and lower contamination of stored food following higher rainfall and temperature but the associations for food were not statistically significant. DISCUSSION: Measures to control enteric infections in low-income countries should test flooring improvements to reduce exposure to fecal contamination.

  PublisherDOI

• A framework for guiding integrated disease control measures through multipathogen surveillance

  medRxiv · 2025-11-04

  preprintOpen access

  Global health programs have traditionally focused on single diseases. There is potential for synergy through integrated intervention delivery, particularly in areas with overlapping geographic disease burden, but there is limited methodology developed for assessing potential efficiency gains through integration. Here, we applied a measure of diversity, Rao's quadratic index, to quantify multipathogen burden across two large-scale surveys: Bangladesh (90 clusters, 2,396 children) and Cambodia (100 clusters, 2,150 women). In both settings, we observed geographic clustering of multiple pathogens, indicating potential for more efficient, integrated disease control strategies. We assessed the efficiency of a multipathogen-targeted strategy compared to traditional single-pathogen approaches by calculating the percent reduction in the number of spatial clusters needed to reach 75% of the disease burden (infections or unvaccinated individuals) in a hypothetical intervention. In Bangladesh, integrating deworming with measles vaccination guided by Rao's quadratic index improved efficiency by 15% for Ascaris lumbricoides, 31% for hookworm, and 38% for Trichuris trichiura, compared to a measles-focused approach. In Cambodia, a Rao-guided strategy performed similarly to the best single-pathogen strategy for Strongyloides stercoralis, and reduced the number of spatial clusters that would need to be targeted by 57% (lymphatic filariasis), 83% (Plasmodium falciparum), and 59% (Plasmodium vivax). We also found that higher multipathogen burden was significantly associated with lower household wealth, suggesting that Rao-guided strategies may be more effective in reaching under-resourced populations. These findings support the use of multipathogen burden metrics to guide integrated program delivery, offering potential for greater efficiency in disease control.

  PublisherOA PDFDOI

• Adult hospitalizations due to hepatitis A virus infection in six tertiary hospitals across Bangladesh: December 2014 – September 2017

  medRxiv · 2025-06-28

  preprintOpen access

  Abstract Hepatitis A virus (HAV) is spread through the fecal-oral route. The age of infection largely determines the clinical severity; children typically have asymptomatic or mild illness, but infected adults more commonly develop clinical disease. Many countries have experienced improvements in water and sanitation which could lead to increases in the burden of HAV due to increases in the age of infection. This report summarizes the contribution of HAV to hospitalizations among patients aged >14 years from acute jaundice during 2014 - 2017 across Bangladesh. Among 1,923 patients, 148 (8%) had anti-HAV IgM antibodies in their serum; 26% were co-infected with hepatitis E or B viruses, or both, including 3 of the 4 deaths among patients with HAV infection. An outbreak of HAV was detected at one hospital during 2016. HBV vaccination was introduced in 2005, but additional hepatitis vaccination strategies may be needed to further reduce hepatitis hospitalizations and deaths.

  PublisherOA PDFDOI

• Evaluation of a multicomponent child development intervention delivered through the government health system: a feasibility study

  BMJ Global Health · 2025-07-01

  articleOpen access

  INTRODUCTION: Small efficacy trials have demonstrated that multicomponent interventions can improve early child development. We evaluated the large-scale delivery of a multicomponent intervention delivered by government health workers throughout a rural subdistrict in northwestern Bangladesh. METHODS: We evaluated a group-based, multicomponent intervention with a curriculum covering responsive parenting, caregivers' mental health, lead exposure prevention strategies at the household level, water, sanitation, hygiene and nutrition. Group sessions were held throughout a rural subdistrict of Bangladesh (August 2019-March 2020). A longitudinal sample of caregivers (n=517) of children 6-24 months was assessed at baseline and endline (primary cohort), and 1179 additional caregivers were assessed only at endline (supplementary cross-sectional). Outcomes were the variety of child play activities and materials, number of books, caregiver depressive symptoms and nutrition and lead knowledge. For primary analyses, we used difference-in-difference. RESULTS: Over half (n=276, 53%) of the cohort participants attended any of the 16 intervention sessions and of these, 83% (228) attended 2+. Caregivers attending 2+ sessions, compared with ≤1 session, had more play materials (adjusted mean difference: 0.58; 95% CI: 0.30, 0.85) and were more likely to have any children's books (adjusted prevalence difference (aPD): 0.26; 95% CI: 0.18, 0.34), to have heard of lead (aPD: 0.13; 95% CI: 0.07, 0.19) or to know how to avoid harm from lead (unadjusted PD: 0.13; 95% CI: 0.08, 0.17). These findings were similar to those from the supplementary cross-sectional analysis. There were no differences in caregiver depressive symptoms in either analysis. More child play activities and nutrition knowledge were associated with attendance in the cross-sectional sample. CONCLUSIONS: A multicomponent child development intervention delivered by government health workers increased the presence of children's toys and books and caregiver knowledge of lead in families who attended two or more sessions. Further adaptation and alternative delivery methods are likely to improve the reach and the breadth of impacts. TRIAL REGISTRATION NUMBER: NCT04111016.

  PublisherOA PDFDOI

• National burden of and optimal vaccine policy for Japanese encephalitis virus in Bangladesh: a seroprevalence and modelling study

  The Lancet Infectious Diseases · 2025-11-19 · 1 citations

  article
  PublisherDOI

Recent grants

• Global Epidemiology of Infectious Diseases

  NIH · $3.5M · 2002–2027

Frequent coauthors

• Emily S. Gurley

  Johns Hopkins University

  446 shared

• Mahmudur Rahman

  Institute of Epidemiology, Disease Control and Research

  239 shared

• Peter Daszak

  EcoHealth Alliance

  229 shared

• Leanne Unicomb

  International Centre for Diarrhoeal Disease Research

  216 shared

• Salah Uddin Khan

  King Saud University

  212 shared

• Jonathan H. Epstein

  EcoHealth Alliance

  170 shared

• Hossain M. S. Sazzad

  UNSW Sydney

  167 shared

• Benjamin F. Arnold

  Global Brain Health Institute

  165 shared

Labs

• Luby LabPI

  Not provided

Education

• Residency, Preventive Medicine

  Centers for Disease Control and Prevention Center for Global Health

  1993

• Fellowship, Epidemiology - Epidemic Intelligence Service

  Centers for Disease Control and Prevention Center for Global Health

  1992

• Internship and Residency, Internal Medicine

  University of Rochester Medical Center

  1989

• MD, Medicine

  University of Texas Medical Branch

  1986

• Bachelor of Arts, summa cum laude, Philosophy

  Creighton University

  1981

Awards & honors

• Fellowship, Centers for Disease Control and Prevention, Epid…