151
|
Tepper NK, Chowdhury J, Moore CA, Werler MM, Mishkin K, Reefhuis J. Public health priorities for gastroschisis: Summary of a meeting sponsored by the Centers for Disease Control and Prevention and the March of Dimes. Birth Defects Res 2024; 116:e2299. [PMID: 38277411 PMCID: PMC10983047 DOI: 10.1002/bdr2.2299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Gastroschisis has increased worldwide over several decades; however, there are significant gaps in understanding risk factors for development of the defect, particularly those that might be modifiable. Despite advances in survival, little is known about longer-term outcomes for affected individuals. METHODS On April 27- and 28, 2023, the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention (CDC) and March of Dimes sponsored a meeting entitled "Public Health Priorities for Gastroschisis". The meeting goals were to review current knowledge on gastroschisis, discuss research gaps, and identify future priorities for public health surveillance, research, and action related to gastroschisis. Meeting participants encompassed a broad range of expertise and experience, including public health, clinical care of individuals with gastroschisis, affected individuals and families, and representatives from professional organizations and federal agencies. RESULTS Several goals were identified for future public health surveillance and research, including focused theory-driven research on risk factors and increased study of longer-term effects of gastroschisis through improved surveillance. Certain public health actions were identified, that which could improve the care of affected individuals, including increased education of providers and enhanced resources for patients and families. CONCLUSIONS These efforts may lead to an improved understanding of pathogenesis, risk factors, and outcomes and to improved care throughout the lifespan.
Collapse
Affiliation(s)
- Naomi K. Tepper
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Julia Chowdhury
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | | | - Jennita Reefhuis
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
152
|
Campbell K, Siegel DA, Umaretiya PJ, Dai S, Heczey A, Lupo PJ, Schraw JM, Thompson TD, Scheurer ME, Foster JH. A comprehensive analysis of neuroblastoma incidence, survival, and racial and ethnic disparities from 2001 to 2019. Pediatr Blood Cancer 2024; 71:e30732. [PMID: 37867409 PMCID: PMC11018254 DOI: 10.1002/pbc.30732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND We characterize the incidence and 5-year survival of children and adolescents with neuroblastoma stratified by demographic and clinical factors based on the comprehensive data from United States Cancer Statistics (USCS) and the National Program of Cancer Registries (NPCR). METHODS We analyzed the incidence of neuroblastoma from USCS (2003-2019) and survival data from NPCR (2001-2018) for patients less than 20 years old. Incidence trends were calculated by average annual percent change (AAPC) using joinpoint regression. Differences in relative survival were estimated comparing non-overlapping confidence intervals (CI). RESULTS We identified 11,543 primary neuroblastoma cases in USCS. Age-adjusted incidence was 8.3 per million persons [95% CI: 8.2, 8.5], with an AAPC of 0.4% [95% CI: -0.1, 0.9]. Five-year relative survival from the NPCR dataset (n = 10,676) was 79.7% [95% CI: 78.9, 80.5]. Patients aged less than 1 year had the highest 5-year relative survival (92.5%). Five-year relative survival was higher for non-Hispanic White patients (80.7%) or Hispanic patients (80.8%) compared to non-Hispanic Black patients (72.6%). CONCLUSION Neuroblastoma incidence was stable during 2003-2019. Differences in relative survival exist by sex, age, race/ethnicity, and stage; patients who were male, older, non-Hispanic Black, or with distant disease had worse survival. Future studies could seek to assess the upstream factors driving disparities in survival, and evaluate interventions to address inequities and improve survival across all groups.
Collapse
Affiliation(s)
- Kevin Campbell
- Division of Hematology-Oncology and Bone Marrow Transplantation, Children’s Mercy Hospitals and Clinics, Kansas City, Missouri, USA
| | - David A. Siegel
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Puja J. Umaretiya
- Division of Hematology-Oncology and Bone Marrow Transplantation, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Shifan Dai
- Cyberdata Technologies, Inc., Herndon, Virginia, USA
| | - Andras Heczey
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
| | - Philip J. Lupo
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Jeremy M. Schraw
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Trevor D. Thompson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael E. Scheurer
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Jennifer H. Foster
- Division of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Cancer and Hematology Centers, Texas Children’s Hospital, Houston, Texas, USA
| |
Collapse
|
153
|
Alger J, Cafferata ML, López R, Wiggins LD, Callejas A, Castillo M, Fúnes J, Rico F, Valencia D, Varela D, Alvarez Z, Berrueta M, Bock H, Bustillo C, Calderón A, Ciganda A, García-Aguilar J, García K, Gibbons L, Gilboa SM, Harville EW, Hernández G, López W, Lorenzana I, Luque MT, Maldonado C, Moore C, Ochoa C, Parham L, Pastrana K, Paternina-Caicedo A, Rodríguez H, Stella C, Tannis AF, Wesson DM, Zúniga C, Tong VT, Buekens P. Neurodevelopmental assessment of normocephalic children born to Zika virus exposed and unexposed pregnant people. Pediatr Res 2024; 95:566-572. [PMID: 38057577 PMCID: PMC11045253 DOI: 10.1038/s41390-023-02951-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/12/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Studies examining the association between in utero Zika virus (ZIKV) exposure and child neurodevelopmental outcomes have produced varied results. METHODS We aimed to assess neurodevelopmental outcomes among normocephalic children born from pregnant people enrolled in the Zika in Pregnancy in Honduras (ZIPH) cohort study, July-December 2016. Enrollment occurred during the first prenatal visit. Exposure was defined as prenatal ZIKV IgM and/or ZIKV RNA result at enrollment. Normocephalic children, >6 months old, were selected for longitudinal follow-up using the Bayley Scales of Infant and Toddler Development (BSID-III) and the Ages & Stages Questionnaires: Social-Emotional (ASQ:SE-2). RESULTS One hundred fifty-two children were assessed; after exclusion, 60 were exposed and 72 were unexposed to ZIKV during pregnancy. Twenty children in the exposed group and 21 children in the unexposed group had a composite score <85 in any of the BSID-III domains. Although exposed children had lower cognitive and language scores, differences were not statistically significant. For ASQ:SE-2 assessment, there were not statistically significant differences between groups. CONCLUSIONS This study found no statistically significant differences in the neurodevelopment of normocephalic children between in utero ZIKV exposed and unexposed. Nevertheless, long-term monitoring of children with in utero ZIKV exposure is warranted. IMPACT This study found no statistically significant differences in the neurodevelopment in normocephalic children with in utero Zika virus exposure compared to unexposed children, although the exposed group showed lower cognitive and language scores that persisted after adjustment by maternal age and education and after excluding children born preterm and low birth weight from the analysis. Children with prenatal Zika virus exposure, including those normocephalic and have no evidence of abnormalities at birth, should be monitored for neurodevelopmental delays. Follow-up is important to be able to detect developmental abnormalities that might not be detected earlier in life.
Collapse
Affiliation(s)
- Jackeline Alger
- Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras.
| | | | - Raquel López
- Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras
| | - Lisa D Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Allison Callejas
- Servicio de Neonatología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras
| | - Mario Castillo
- Servicio de Neonatología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras
| | - Jenny Fúnes
- Servicio de Neonatología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras
| | - Fátima Rico
- Departamento de Pediatría, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Diana Valencia
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Douglas Varela
- Servicio de Neurología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras
| | - Zulma Alvarez
- Unidad de Vigilancia de la Salud, Región Sanitaria Metropolitana del Distrito Central, Secretaría de Salud de Honduras, Tegucigalpa, Honduras
| | - Mabel Berrueta
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Harry Bock
- Dirección General, Región Sanitaria Metropolitana del Distrito Central, currently Centro de Salud Dra. Nerza Paz, Región Sanitaria Metropolitana del Distrito Central, Secretaría de Salud de Honduras, Tegucigalpa, Honduras
| | - Carolina Bustillo
- Departamento de Ginecología y Obstetricia, Hospital Escuela, Tegucigalpa, Honduras
| | - Alejandra Calderón
- Centro de Salud Alonso Suazo, Región Sanitaria Metropolitana del Distrito Central, currently Centro de Salud Villanueva, Región Sanitaria Metropolitana del Distrito Central, Secretaría de Salud de Honduras, Tegucigalpa, Honduras
| | - Alvaro Ciganda
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Jorge García-Aguilar
- Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras
| | - Kimberly García
- Centro de Investigaciones Genéticas, Instituto de Investigaciones en Microbiología, Facultad de Ciencias, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Luz Gibbons
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Suzanne M Gilboa
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Gustavo Hernández
- Departamento de Pediatría, Hospital de Especialidades San Felipe, Tegucigalpa, Honduras
| | - Wendy López
- Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras
| | - Ivette Lorenzana
- Centro de Investigaciones Genéticas, Instituto de Investigaciones en Microbiología, Facultad de Ciencias, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Marco T Luque
- Servicio de Infectología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras
| | - Carlos Maldonado
- Servicio de Oftalmología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras
| | - Cynthia Moore
- Goldbelt Professional Services, LLC, Chesapeake, VA, USA
| | - Carlos Ochoa
- Servicio de Maternidad, Hospital de Especialidades San Felipe, Tegucigalpa, Honduras
| | - Leda Parham
- Centro de Investigaciones Genéticas, Instituto de Investigaciones en Microbiología, Facultad de Ciencias, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Karla Pastrana
- Departamento de Ginecología y Obstetricia, Hospital Escuela, Tegucigalpa, Honduras
| | - Angel Paternina-Caicedo
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Heriberto Rodríguez
- Departamento de Ginecología y Obstetricia, Hospital Escuela, Tegucigalpa, Honduras
| | - Candela Stella
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | | | - Dawn M Wesson
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Concepción Zúniga
- Departamento de Vigilancia de la Salud, Hospital Escuela, Tegucigalpa, Honduras
| | - Van T Tong
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pierre Buekens
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| |
Collapse
|
154
|
Surie D, Sathyanarayanan MK, Lavanya J, Smith JP, Shanmugam SK, Tamilzhalagan S, Selvaraj A, Ramesh G, Tripathy S, Khaparde SD, Ho CS, Hall-Eidson PJ, Ranganathan UDK, Selvaraju S, Moonan PK. Long-term follow-up of persons diagnosed with multidrug-resistant TB in Chennai, India, 2013-2020. Int J Tuberc Lung Dis 2024; 28:54-56. [PMID: 38178300 PMCID: PMC10859871 DOI: 10.5588/ijtld.23.0272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Affiliation(s)
- D Surie
- Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, GA, United States of America
| | - M K Sathyanarayanan
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai
| | - J Lavanya
- Chennai Municipal Corporation, Chennai
| | - J P Smith
- Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, GA, United States of America
| | - S K Shanmugam
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai
| | - S Tamilzhalagan
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai
| | - A Selvaraj
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai
| | - G Ramesh
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai
| | - S Tripathy
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai
- Dr. D Y Patil Medical College, Hospital and Research Centre, Pune
| | - S D Khaparde
- Government of India, Ministry of Health and Family Welfare, Directorate of Health Services - Central TB Division, New Delhi, India
| | - C S Ho
- Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, GA, United States of America
| | - P J Hall-Eidson
- Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, GA, United States of America
| | - U D K Ranganathan
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai
| | - S Selvaraju
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai
| | - P K Moonan
- Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, GA, United States of America
| |
Collapse
|
155
|
Ellick KL, Kroelinger CD, Chang K, McGown M, McReynolds M, Velonis AJ, Bronson E, Riehle-Colarusso T, Pliska E, Akbarali S, Mueller T, Dronamraju R, Cox S, Barfield WD. Increasing access to quality care for pregnant and postpartum people with opioid use disorder: Coordination of services, provider awareness and training, extended postpartum coverage, and perinatal quality collaboratives. J Subst Use Addict Treat 2024; 156:209208. [PMID: 37939904 PMCID: PMC10711679 DOI: 10.1016/j.josat.2023.209208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/02/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Fifteen states participating in the Opioid Use Disorder, Maternal Outcomes, and Neonatal Abstinence Syndrome Initiative Learning Community (OMNI LC) developed action plan goals and activities to address the rise in opioid use disorder (OUD) among birthing persons. In a separate initiative, Perinatal Quality Collaboratives (PQCs) from 12 states participating in Centers for Disease Control and Prevention (CDC)-supported activities hosted trainings to improve the provision of OUD services and implement protocols for screening and treatment in delivery facilities. METHODS This descriptive study synthesizes qualitative data extracted from 15 OMNI LC state action plans, excerpts from qualitative interviews conducted with OMNI LC state teams, and quantitative data from quarterly project performance monitoring reports from 12 CDC-funded PQCs implementing quality improvement activities to address clinical service gaps for pregnant and postpartum people with OUD. Qualitative data were deidentified, coded as barriers or facilitators, then aggregated into emergent themes. Count data are presented for quantitative results. RESULTS The OMNI LC states identified a lack of coordinated care among providers, stigma toward people with OUD, discontinued insurance coverage, and inconsistencies in screening and treating birthing people with OUD as barriers to accessing quality care. State-identified facilitators for access to quality care included: 1) improving engagement and communication between providers and other partners to integrate medical and behavioral health services post-discharge, and facilitate improved patient care postpartum; 2) training providers to prescribe medications for OUD, and to address bias and reduce patient stigma; 3) extending Medicaid coverage up to one year postpartum to increase access to and continuity of services; and 4) implementing screening, brief intervention, and referral to treatment (SBIRT) in clinical practice. PQCs demonstrated that increased provider trainings to treat OUD, improvements in implementation of standardized protocols, and use of evidence-based tools can facilitate access to and coordination of services in delivery facilities. CONCLUSION State-identified facilitators for increasing access to care include coordinating integrated services, extending postpartum coverage, and provider trainings to improve screening and treatment. PQCs provide a platform for identifying emerging areas for quality improvement initiatives and implementing clinical best practices to provide comprehensive, quality perinatal care for birthing populations.
Collapse
Affiliation(s)
- Kecia L Ellick
- CDC Foundation (CDCF), 600 Peachtree St. NE #1000, Atlanta, GA 30308, United States of America
| | - Charlan D Kroelinger
- Centers for Disease Control and Prevention (CDC), 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341, United States of America.
| | - Karen Chang
- Centers for Disease Control and Prevention (CDC), 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341, United States of America
| | - Molly McGown
- University of Illinois Chicago (UIC), School of Public Health, 1603 W. Taylor St., Chicago, IL 60612, United States of America; Access Community Health Network, 600 W. Fulton St., Chicago, IL 60661, United States of America
| | - Matthew McReynolds
- University of Illinois Chicago (UIC), School of Public Health, 1603 W. Taylor St., Chicago, IL 60612, United States of America
| | - Alisa J Velonis
- University of Illinois Chicago (UIC), School of Public Health, 1603 W. Taylor St., Chicago, IL 60612, United States of America
| | - Emily Bronson
- CDC Foundation (CDCF), 600 Peachtree St. NE #1000, Atlanta, GA 30308, United States of America
| | - Tiffany Riehle-Colarusso
- Centers for Disease Control and Prevention (CDC), 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341, United States of America
| | - Ellen Pliska
- Association of State and Territorial Health Officials (ASTHO), 2231 Crystal Dr. Ste. 450, Arlington, VA 22202, United States of America
| | - Sanaa Akbarali
- Association of State and Territorial Health Officials (ASTHO), 2231 Crystal Dr. Ste. 450, Arlington, VA 22202, United States of America
| | - Trish Mueller
- Centers for Disease Control and Prevention (CDC), 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341, United States of America
| | - Ramya Dronamraju
- Association of State and Territorial Health Officials (ASTHO), 2231 Crystal Dr. Ste. 450, Arlington, VA 22202, United States of America
| | - Shanna Cox
- Centers for Disease Control and Prevention (CDC), 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341, United States of America
| | - Wanda D Barfield
- Centers for Disease Control and Prevention (CDC), 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341, United States of America
| |
Collapse
|
156
|
Pazol K, Tian LH, DiGuiseppi C, Durkin MS, Fallin MD, Moody EJ, Nadler C, Powell PS, Reyes N, Robinson B, Ryerson AB, Thierry JM, Tinker SC, Wiggins LD, Yeargin-Allsopp M. Health and Education Services During the COVID-19 Pandemic Among Young Children with Autism Spectrum Disorder and Other Developmental Disabilities. J Dev Behav Pediatr 2024; 45:e31-e38. [PMID: 38364085 PMCID: PMC10963045 DOI: 10.1097/dbp.0000000000001227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/29/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Understanding how the COVID-19 pandemic affected children with disabilities is essential for future public health emergencies. We compared children with autism spectrum disorder (ASD) with those with another developmental disability (DD) and from the general population (POP) regarding (1) missed or delayed appointments for regular health/dental services, immunizations, and specialty services; (2) reasons for difficulty accessing care; and (3) use of remote learning and school supports. METHOD Caregivers of children previously enrolled in the Study to Explore Early Development, a case-control study of children with ASD implemented during 2017 to 2020, were recontacted during January-June 2021 to learn about services during March-December 2020. Children were classified as ASD, DD, or POP during the initial study and were aged 3.4 to 7.5 years when their caregivers were recontacted during the pandemic. RESULTS Over half of all children missed or delayed regular health/dental appointments (58.4%-65.2%). More children in the ASD versus DD and POP groups missed or delayed specialty services (75.7%, 58.3%, and 22.8%, respectively) and reported difficulties obtaining care of any type because of issues using telehealth and difficulty wearing a mask. During school closures, a smaller proportion of children with ASD versus another DD were offered live online classes (84.3% vs 91.1%), while a larger proportion had disrupted individualized education programs (50.0% vs 36.2%). CONCLUSION Minimizing service disruptions for all children and ensuring continuity of specialty care for children with ASD is essential for future public health emergencies. Children may need additional services to compensate for disruptions during the pandemic.
Collapse
Affiliation(s)
- Karen Pazol
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lin H. Tian
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Carolyn DiGuiseppi
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | | | - Eric J. Moody
- University of Wyoming Institute for Disabilities, Laramie, WY
| | - Cy Nadler
- Children’s Mercy Kansas City, Kansas City, MO
| | - Patrick S. Powell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Nuri Reyes
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Britney Robinson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - JoAnn M. Thierry
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sarah C. Tinker
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lisa D. Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| |
Collapse
|
157
|
Newton SM, Distler S, Woodworth KR, Chang D, Roth NM, Board A, Hutcherson H, Cragan JD, Gilboa SM, Tong VT. Leveraging automated approaches to categorize birth defects from abstracted birth hospitalization data. Birth Defects Res 2024; 116:e2267. [PMID: 37932954 PMCID: PMC10872559 DOI: 10.1002/bdr2.2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND The Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET) collects data abstracted from medical records and birth defects registries on pregnant people and their infants to understand outcomes associated with prenatal exposures. We developed an automated process to categorize possible birth defects for prenatal COVID-19, hepatitis C, and syphilis surveillance. By employing keyword searches, fuzzy matching, natural language processing (NLP), and machine learning (ML), we aimed to decrease the number of cases needing manual clinician review. METHODS SET-NET captures International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes and free text describing birth defects. For unstructured data, we used keyword searches, and then conducted fuzzy matching with a cut-off match score of ≥90%. Finally, we employed NLP and ML by testing three predictive models to categorize birth defect data. RESULTS As of June 2023, 8326 observations containing data on possible birth defects were submitted to SET-NET. The majority (n = 6758 [81%]) were matched to an ICD-10-CM code and 1568 (19%) were unable to be matched. Through keyword searches and fuzzy matching, we categorized 1387/1568 possible birth defects. Of the remaining 181 unmatched observations, we correctly categorized 144 (80%) using a predictive model. CONCLUSIONS Using automated approaches allowed for categorization of 99.6% of reported possible birth defects, which helps detect possible patterns requiring further investigation. Without employing these analytic approaches, manual review would have been needed for 1568 observations. These methods can be employed to quickly and accurately sift through data to inform public health responses.
Collapse
Affiliation(s)
- Suzanne M Newton
- Division of Birth Defects and Infant Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Samantha Distler
- Division of Birth Defects and Infant Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kate R Woodworth
- Division of Birth Defects and Infant Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Daniel Chang
- Eagle Global Scientific, LLC, San Antonio, Texas, USA
| | - Nicole M Roth
- Division of Birth Defects and Infant Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amy Board
- Division of Birth Defects and Infant Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Janet D Cragan
- Division of Birth Defects and Infant Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Suzanne M Gilboa
- Division of Birth Defects and Infant Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Van T Tong
- Division of Birth Defects and Infant Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
158
|
Giri S, Chhabra P, Kulkarni R, Reju S, Sabapathy SK, Selvarajan S, Varghese T, Kalaivanan M, Dorairaj P, Kalrao V, Mankar S, Sangamnerkar M, Purushothaman GKC, Srikanth P, Kang G, Vinjé J. Hospital-based norovirus surveillance in children <5 years of age from 2017 to 2019 in India. J Med Virol 2024; 96:e29384. [PMID: 38235830 PMCID: PMC10875411 DOI: 10.1002/jmv.29384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/17/2023] [Accepted: 12/28/2023] [Indexed: 01/19/2024]
Abstract
After the introduction of the rotavirus vaccine into the Universal Immunization Program in India in 2016, relatively few studies have assessed the prevalence and epidemiological patterns of acute gastroenteritis (AGE) among hospitalized children ≤5 years of age. We used a uniform protocol to recruit children with AGE as well as standardized testing and typing protocols. Stool specimens from children with AGE younger than 5 years of age admitted to six hospitals in three cities in India were collected from January 2017 through December 2019. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-qPCR) followed by typing positive specimens by conventional RT-PCR and Sanger sequencing. Norovirus was detected in 322 (14.8%) of 2182 specimens with the highest rate in 2018 (17.6%, 146/829), followed by 2019 (14.4%, 122/849) and 2017 (10.7%, 54/504). Rotavirus vaccine status was known for 91.6% of the children of which 70.4% were vaccinated and 29.6% not. Norovirus positivity in rotavirus-vaccinated children was 16.3% and 12% in unvaccinated children. GII.4 Sydney[P16] (39.3%), GII.4 Sydney[P31] (18.7%), GII.2[P16] (10%), GI.3[P13] (6.8%), GII.3[P16] (5.9%), and GII.13[P16] (5%) accounted for 85.8% (188/219) of the typed strains. Our data highlight the importance of norovirus in Indian children hospitalized with AGE.
Collapse
Affiliation(s)
- Sidhartha Giri
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Preeti Chhabra
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ruta Kulkarni
- Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth, Pune, India
| | - Sudhabharathi Reju
- Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - Satheesh Kumar Sabapathy
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology (NIE), Chennai, India
| | - Sribal Selvarajan
- Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - Tintu Varghese
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | | - Vijay Kalrao
- Bharati Hospital, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India
| | | | | | | | - Padma Srikanth
- Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
159
|
Seiler N, Pearson WS, Organick-Lee P, Washington M, Turner T, Ryan L, Horton K. Medicaid, Sexually Transmitted Infections, and Social Determinants of Health. Sex Transm Dis 2024; 51:33-37. [PMID: 37889947 PMCID: PMC10777296 DOI: 10.1097/olq.0000000000001887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Affiliation(s)
- Naomi Seiler
- Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - William S. Pearson
- Department of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Paige Organick-Lee
- Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Mekhi Washington
- Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Taylor Turner
- Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Lily Ryan
- Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Katie Horton
- Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| |
Collapse
|
160
|
Greenberg JD, van der Mars H, McKenzie TL, Battista RA, Chriqui JF, Cornett K, Graber KC, Kern BD, Russell JA, Ward DS, Wilson WJ. The Role of Physical Education Within the National Physical Activity Plan. J Phys Educ Recreat Dance 2024; 95:7-16. [PMID: 38463632 PMCID: PMC10922003 DOI: 10.1080/07303084.2023.2291641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Affiliation(s)
- Jayne D Greenberg
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Hans van der Mars
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Thomas L McKenzie
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Rebecca A Battista
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Jamie F Chriqui
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Kelly Cornett
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Kim C Graber
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Ben D Kern
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Jared A Russell
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Dianne S Ward
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| | - Wesley J Wilson
- Jayne D. Greenberg is the Education Sector Committee chair, NPAP and North America chair at the International Sport and Culture Association in Weston, FL. Hans van der Mars is a professor emeritus at Arizona State University in Tempe, AZ. Thomas L. McKenzie is a professor emeritus in the School of Exercise and Nutritional Sciences at San Diego State University in San Diego, CA. Rebecca A. Battista is a professor in the Department of Public Health and Exercise Science at Appalachian State University in Boone, NC. Jamie F. Chriqui is a senior associate dean in the School of Public Health; a Professor in the Health Policy and Administration; and a director in Health Policy Research at the Institute for Health Research and Policy at the University of Illinois-Chicago in Chicago, IL. Kelly Cornett is a health scientist in the Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health at the Centers for Disease Control and Prevention in Atlanta, GA. Kim C. Graber is a professor and department head in the Department of Kinesiology and Community Health, at the University of Illinois-Urbana/Champaign in Urbana, IL. Ben D. Kern is an assistant professor and PETE program coordinator in the Division of Kinesiology and Health at the University of Wyoming in Laramie, WY. Jared A. Russell is an associate dean for Academic and Faculty Affairs and professor in the School of Kinesiology at Auburn University in Auburn, AL. Dianne S. Ward is a professor and director of the Intervention and Policy Division in the Department of Nutrition at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Wesley J. Wilson is an assistant professor in the Department of Kinesiology and Community Health at the University of Illinois-Urbana/Champaign in Urbana, IL
| |
Collapse
|
161
|
He S, Park S, Fujii Y, Pierce SL, Kraus EM, Wall HK, Therrien NL, Jackson SL. State-Level Hypertension Prevalence and Control Among Adults in the U.S. Am J Prev Med 2024; 66:46-54. [PMID: 37877903 PMCID: PMC10898652 DOI: 10.1016/j.amepre.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/26/2023]
Abstract
INTRODUCTION Improving hypertension control is a national priority. Electronic health record data have the potential to augment traditional surveillance systems. This study aimed to assess hypertension prevalence and control at the state level using a previously established electronic health record-based phenotype for hypertension. METHODS Adult patients (N=11,031,368) were included from the IQVIA ambulatory electronic medical record-U.S. 2019 data set. IQVIA ambulatory electronic medical record comprises electronic health records from >100,000 providers and includes patients from every U.S. state and Washington DC. Authors compared hypertension prevalence and control estimates against those from the Behavioral Risk Factor Surveillance System 2019. Results were age-standardized and stratified by state and sociodemographic characteristics. Statistical analyses were conducted in 2022-2023. RESULTS IQVIA ambulatory electronic medical record-U.S. patients had a median age of 55 years, and 56.7% were women. Overall age-standardized hypertension prevalence was higher in IQVIA ambulatory electronic medical record-U.S. (35.0%) than in the Behavioral Risk Factor Surveillance System (29.7%), however, state-level geographic patterns were similar, with the highest burden in the South and Appalachia. Similar patterns were also observed by sociodemographic characteristics in both data sets: hypertension prevalence was higher in older age groups (than younger), men (than women), and Black patients (than other races). Hypertension control varied widely across states: among states with >1% data coverage, control rates were lowest in Nevada (51.1%), Washington DC (52.0%), and Mississippi (55.2%); highest in Kansas (73.4%), New Jersey (72.3%), and Iowa (71.9%). CONCLUSIONS This study provided the first-ever estimates of hypertension control for all states and Washington DC. Electronic health record-based surveillance could support hypertension prevention and control efforts at the state level.
Collapse
Affiliation(s)
- Siran He
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Soyoun Park
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta Georgia
| | - Yui Fujii
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Bizzell U.S., New Carrollton, Maryland
| | - Samantha L Pierce
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily M Kraus
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Taskforce for Global Health, Decatur, Georgia; Kraushold Consulting, Denver, Colorado
| | - Hilary K Wall
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicole L Therrien
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sandra L Jackson
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
162
|
Jefferds MED, Addo OY, Scanlon KS, Cogswell ME, Brittenham GM, Mei Z. The Centers for Disease Control and Prevention does not recommend race-adjusted thresholds to define anemia. Am J Clin Nutr 2024; 119:232-233. [PMID: 38176777 PMCID: PMC10880865 DOI: 10.1016/j.ajcnut.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 01/06/2024] Open
Affiliation(s)
- Maria Elena D Jefferds
- Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - O Yaw Addo
- Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kelley S Scanlon
- Food and Nutrition Service, US Department of Agriculture, Alexandria, VA, United States
| | - Mary E Cogswell
- Retired, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gary M Brittenham
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Zuguo Mei
- Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| |
Collapse
|
163
|
Hassan R, Wondmeneh S, Jimenez NG, Chapman K, Mangla A, Ashley P, Willut C, Lee M, Rhodes T, Gillani S, Copen C, Jackson DA, Waltenburg M, Delaney KP, Miles G, Agnew-Brune C, Oakley LP. Mpox Knowledge, Attitudes, and Practices Among Persons Presenting for JYNNEOS Vaccination-District of Columbia, August to October 2022. Sex Transm Dis 2024; 51:47-53. [PMID: 37921836 PMCID: PMC11027964 DOI: 10.1097/olq.0000000000001893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND More than 30,000 mpox cases have been confirmed in the United States since May 2022. Mpox cases have disproportionally occurred among adult gay, bisexual, and other men who have sex with men; transgender persons; and Black and Hispanic/Latino persons. We examined knowledge, attitudes, and practices regarding mpox vaccination among adults presenting for vaccination to inform prevention efforts. METHODS We collected mixed-methods data from a convenience sample of adults presenting for JYNNEOS vaccination at 3 DC Health mpox vaccine clinics during August-October 2022. Survey and interview topics included knowledge about mpox symptoms and vaccine protection, beliefs about vaccine access, and trusted sources of information. RESULTS In total, 352 participants completed self-administered surveys and 62 participants completed an in-depth interview. Three main themes emerged from survey and interview data. First, most participants had a general understanding about mpox, but gaps remained in comprehensive understanding about mpox symptoms, modes of transmission, vaccine protection, personal risk, and vaccine dosing strategies. Second, participants had high trust in public health agencies. Third, participants wanted more equitable and less stigmatizing access to mpox vaccine services. CONCLUSIONS Nonstigmatizing, inclusive, and clear communication from trusted sources, including public health agencies, is needed to address mpox knowledge gaps and increase vaccine access and uptake in affected communities. Mpox outreach efforts should continue innovative approaches, including person-level risk assessment tools, to address community needs.
Collapse
Affiliation(s)
- Rashida Hassan
- Multinational Mpox Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sarah Wondmeneh
- Epidemic Intelligence Service, National Center for State, Tribal, Local and Territorial Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Kelly Chapman
- Epidemic Intelligence Service, National Center for State, Tribal, Local and Territorial Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | | | | | | | | | - Casey Copen
- Multinational Mpox Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - David A. Jackson
- Multinational Mpox Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michelle Waltenburg
- Multinational Mpox Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kevin P. Delaney
- Multinational Mpox Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gillian Miles
- Multinational Mpox Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Christine Agnew-Brune
- Multinational Mpox Response, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lisa P. Oakley
- Multinational Mpox Response, Centers for Disease Control and Prevention, Atlanta, GA
| | | |
Collapse
|
164
|
Convery C, Diesel J, Brantley A, Miller J, Karram S. Brief Report: Ryan White Participation Increased the Prevalence of COVID-19 Vaccination Among People Living with HIV in Michigan. J Acquir Immune Defic Syndr 2024; 95:6-9. [PMID: 37797232 PMCID: PMC10841853 DOI: 10.1097/qai.0000000000003315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION People living with HIV (PLWH) have higher prevalence of adverse COVID-19 outcomes, and many reside in socially vulnerable communities. Our aim was to evaluate how engagement in HIV care may increase vaccination likelihood. METHODS Michigan HIV surveillance data were extracted from the Enhanced HIV/AIDS Reporting System and matched at the person-level to COVID-19 vaccination records from the Michigan Care Improvement Registry (through December 31, 2021 [n = 15,537]). Based on residential census tract, we classified PLWH into quartiles (<25th percentile [least vulnerable], 25th to <50th, 50th to <75th, ≥75th [most vulnerable]) of the 2018 CDC Social Vulnerability Index. Using log binomial regression, we estimated the relative prevalence of COVID-19 vaccine series initiation among PLWH by quartile of social vulnerability and Ryan White participation; models were adjusted for covariates. RESULTS By December 31, 2021, 67% of PLWH in Michigan had initiated a COVID-19 vaccine series; 47% resided in an area deemed most vulnerable and 54% had participated in Ryan White services. Compared with PLWH in the most vulnerable quartile, those who resided in least vulnerable quartiles had higher prevalence of vaccine initiation (Prevalence Ratio [95% Confidence Interval]: 1.67 [1.50 to 1.86]). Participants in Ryan White had greater prevalence of initiation (1.52 [1.42 to 1.62]) compared with those who were not participants; initiation remained higher when adjusted for covariates including social vulnerability quartile. CONCLUSIONS Ryan White participation was associated with increased COVID-19 vaccine initiation regardless of community-level vulnerability. Wraparound services may be key in vaccine promotion interventions in this vulnerable population.
Collapse
Affiliation(s)
| | - Jill Diesel
- Michigan Department of Health and Human Services
- Centers for Disease Control and Prevention
| | | | | | - Sarah Karram
- Michigan Department of Health and Human Services
| |
Collapse
|
165
|
Halsey ES, Plucinski MM. Out of Africa: Increasing reports of artemether-lumefantrine treatment failures of uncomplicated Plasmodium falciparum infection. J Travel Med 2023; 30:taad159. [PMID: 38109778 PMCID: PMC10893888 DOI: 10.1093/jtm/taad159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/20/2023]
Abstract
Studies of travellers returning from Africa with uncomplicated Plasmodium falciparum infection are starting to provide signals of failure of artemether-lumefantrine, a first-line treatment of uncomplicated malaria. Traveller-based reports offer an important adjunct to antimalarial efficacy studies performed in endemic regions.
Collapse
Affiliation(s)
- Eric S Halsey
- Division of Global Migration Health, Travelers' Health Branch, Centers for Disease Control and Prevention, Atlanta 30329-4027, USA
| | - Mateusz M Plucinski
- Division of Parasitic Diseases and Malaria, Malaria Branch, Centers for Disease Control and Prevention, Atlanta 30329-4027, USA
- U.S. President's Malaria Initiative, Centers for Disease Control and Prevention, Atlanta 30329-4027, USA
| |
Collapse
|
166
|
Freelander L, Rickless DS, Anderson C, Curriero F, Rockhill S, Mirsajedin A, Colón CJ, Lusane J, Vigo-Valentín A, Wong D. The impact of COVID-19 on healthcare coverage and access in racial and ethnic minority populations in the United States. Geospat Health 2023; 18:10.4081/gh.2023.1222. [PMID: 38150046 PMCID: PMC10790404 DOI: 10.4081/gh.2023.1222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/22/2023] [Indexed: 12/28/2023]
Abstract
This study described spatiotemporal changes in health insurance coverage, healthcare access, and reasons for non-insurance among racial/ethnic minority populations in the United States during the COVID-19 pandemic using four national survey datasets. Getis-Ord Gi* statistic and scan statistics were used to analyze geospatial clusters of health insurance coverage by race/ethnicity. Logistic regression was used to estimate odds of reporting inability to access healthcare across two pandemic time periods by race/ethnicity. Racial/ethnic differences in insurance were observed from 2010 through 2019, with the lowest rates being among Hispanic/Latino, African American, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander populations. Pre-pandemic insurance coverage rates were geographically clustered. The percentage of adults citing change in employment status as the reason for non-insurance increased by about 7% after the start of the pandemic, with a small decrease observed among African American adults. Almost half of adults reported reduced healthcare access in June 2020, with 38.7% attributing reduced access to the pandemic; however, by May 2021, the percent of respondents reporting reduced access for any reason and due to the pandemic fell to 26.9% and 12.7%, respectively. In general, racial/ethnic disparities in health insurance coverage and healthcare access worsened during the pandemic. Although coverage and access improved over time, pre-COVID disparities persisted with African American and Hispanic/Latino populations being the most affected by insurance loss and reduced healthcare access. Cost, unemployment, and eligibility drove non-insurance before and during the pandemic.
Collapse
Affiliation(s)
- Lauren Freelander
- Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services, Atlanta, GA.
| | - David S Rickless
- Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services, Atlanta, GA.
| | - Corey Anderson
- Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services, Atlanta, GA.
| | - Frank Curriero
- Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services, Atlanta, GA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
| | - Sarah Rockhill
- Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services, Atlanta, GA.
| | - Amir Mirsajedin
- Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services, Atlanta, GA.
| | - Caleb J Colón
- US Department of Health and Human Services, Office of Minority Health, Rockville, MD.
| | - Jasmine Lusane
- US Department of Health and Human Services, Office of Minority Health, Rockville, MD.
| | | | - David Wong
- US Department of Health and Human Services, Office of Minority Health, Rockville, MD.
| |
Collapse
|
167
|
Kobernik EK, Ford ND, Levecke M, Galang RR, Hoots B, Roehler DR, Ko JY. Marijuana Use among Pregnant and Nonpregnant Women of Reproductive Age, 2013-2019. Subst Use Misuse 2023; 59:690-698. [PMID: 38132561 PMCID: PMC11000143 DOI: 10.1080/10826084.2023.2294974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND Marijuana is the most commonly used federally illicit substance among reproductive-age women in the United States. Updated information on marijuana use in this population can inform clinical and public health interventions. METHODS Data from the 2013-2019 National Survey on Drug Use and Health was used to report weighted prevalence estimates of marijuana use in the past month, past 2-12 months, and past year among women aged 18-44 years with self-reported pregnancy status. Bivariate analyses and general linear regression models with Poisson distribution using appropriate survey procedures identified factors associated with past-year marijuana use by pregnancy status. RESULTS Among pregnant women, 4.9% (95% confidence interval [CI]: 4.1-5.6) reported marijuana use in the past month, 10.4% (95% CI: 9.3-11.5) in the past 2-12 months, and 15.2% (95% CI: 13.9-16.6) in the past year. Among nonpregnant women, 11.8% (95% CI: 11.5-12.0) reported marijuana use in the past month, 7.8% (95% CI: 7.6-8.0) in the past 2-12 months, and 19.5% (95% CI: 19.2-19.9) in the past year. After adjusting for sociodemographic characteristics, past-year marijuana use was 2.3-5.1 times more likely among pregnant, and 2.1 to 4.6 times more likely among nonpregnant women who reported past-year tobacco smoking, alcohol use, or other illicit drug use compared to those reporting no substance use. CONCLUSIONS Pregnant and nonpregnant women reporting marijuana use, alone or with other substances, can benefit from substance use screening and treatment facilitation.
Collapse
Affiliation(s)
- Emily K Kobernik
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation, Atlanta, GA, USA
| | - Nicole D Ford
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Madison Levecke
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, ORISE Fellow, Oak Ridge, TN, USA
| | - Romeo R Galang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brooke Hoots
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
- U.S. Public Health Service Commissioned Corps, Atlanta, GA, USA
| | - Douglas R Roehler
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jean Y Ko
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- U.S. Public Health Service Commissioned Corps, Atlanta, GA, USA
| |
Collapse
|
168
|
Petras JK, Elrod MG, Ty MC, Dawson P, O'Laughlin K, Gee JE, Hanson J, Boutwell C, Ainsworth G, Beesley CA, Saile E, Tiller R, Gulvik CA, Ware D, Sokol T, Balsamo G, Taylor K, Salzer JS, Bower WA, Weiner ZP, Negrón ME, Hoffmaster AR, Byers P. Locally Acquired Melioidosis Linked to Environment - Mississippi, 2020-2023. N Engl J Med 2023; 389:2355-2362. [PMID: 38118023 PMCID: PMC10773590 DOI: 10.1056/nejmoa2306448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Melioidosis, caused by Burkholderia pseudomallei, is a rare but potentially fatal bacterial disease endemic to tropical and subtropical regions worldwide. It is typically acquired through contact with contaminated soil or fresh water. Before this investigation, B. pseudomallei was not known to have been isolated from the environment in the continental United States. Here, we report on three patients living in the same Mississippi Gulf Coast county who presented with melioidosis within a 3-year period. They were infected by the same Western Hemisphere B. pseudomallei strain that was discovered in three environmental samples collected from the property of one of the patients. These findings indicate local acquisition of melioidosis from the environment in the Mississippi Gulf Coast region.
Collapse
Affiliation(s)
- Julia K Petras
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Mindy G Elrod
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Maureen C Ty
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Patrick Dawson
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Kevin O'Laughlin
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Jay E Gee
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Jennifer Hanson
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Carla Boutwell
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Gail Ainsworth
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Cari A Beesley
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Elke Saile
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Rebekah Tiller
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Christopher A Gulvik
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Daphne Ware
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Theresa Sokol
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Gary Balsamo
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Kathryn Taylor
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Johanna S Salzer
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - William A Bower
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Zachary P Weiner
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - María E Negrón
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Alex R Hoffmaster
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| | - Paul Byers
- From the Centers for Disease Control and Prevention, Atlanta (J.K.P., M.G.E., M.C.T., P.D., K.O., J.E.G., C.A.B., E.S., R.T., C.A.G., J.S.S., W.A.B., Z.P.W., M.E.N., A.R.H.); the Mississippi State Department of Health, Jackson (J.H., C.B., G.A., D.W., K.T., P.B.); the Arizona Department of Health Services, Phoenix (C.A.B.); and the Louisiana Department of Health, Baton Rouge (T.S., G.B.)
| |
Collapse
|
169
|
Wolter N, Walaza S, von Mollendorf C, von Gottberg A, Tempia S, McMorrow ML, Moyes J, Treurnicht F, Hellferscee O, Moleleki M, Makhasi M, Baute N, Cohen C. Association of HIV Exposure and HIV Infection With In-hospital Mortality Among Hospitalized Infants <1 Year of Age, South Africa, 2016-2018. J Pediatric Infect Dis Soc 2023; 12:646-651. [PMID: 37952237 PMCID: PMC10838708 DOI: 10.1093/jpids/piad100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/10/2023] [Indexed: 11/14/2023]
Abstract
We enrolled 1323 hospitalized infants aged <1 year in 2016-2018, and examined the association between HIV status and in-hospital mortality. After controlling for confounders, HIV-exposed uninfected infants did not have an increased risk of mortality, whereas infants living with HIV had 4 times greater risk compared with HIV-uninfected infants.
Collapse
Affiliation(s)
- Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Claire von Mollendorf
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Meredith L. McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Florette Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Malefu Moleleki
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mvuyo Makhasi
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Neydis Baute
- Department of Paediatrics, Mapulaneng Hospital, Mpumalanga, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
170
|
Cochran SJ, Acosta L, Divjan A, Lemons AR, Rundle AG, Miller RL, Sobek E, Green BJ, Perzanowski MS, Dannemiller KC. Fungal diversity in homes and asthma morbidity among school-age children in New York City. Environ Res 2023; 239:117296. [PMID: 37806477 PMCID: PMC10842248 DOI: 10.1016/j.envres.2023.117296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Asthma development has been inversely associated with exposure to fungal diversity. However, the influence of fungi on measures of asthma morbidity is not well understood. OBJECTIVES This study aimed to test the hypothesis that fungal diversity is inversely associated with neighborhood asthma prevalence and identify specific fungal species associated with asthma morbidity. METHODS Children aged 7-8 years (n = 347) living in higher (11-18%) and lower (3-9%) asthma prevalence neighborhoods were recruited within an asthma case-control study. Fungal communities were analyzed from floor dust using high-throughput DNA sequencing. A subset of asthmatic children (n = 140) was followed to age 10-11 to determine asthma persistence. RESULTS Neighborhood asthma prevalence was inversely associated with fungal species richness (P = 0.010) and Shannon diversity (P = 0.059). Associations between neighborhood asthma prevalence and diversity indices were driven by differences in building type and presence of bedroom carpet. Among children with asthma at age 7-8 years, Shannon fungal diversity was inversely associated with frequent asthma symptoms at that age (OR 0.57, P = 0.025) and with asthma persistence to age 10-11 (OR 0.48, P = 0.043). Analyses of individual fungal species did not show significant associations with asthma outcomes when adjusted for false discovery rates. DISCUSSION Lower fungal diversity was associated with asthma symptoms in this urban setting. Individual fungal species associated with asthma morbidity were not detected. Further research is warranted into building type, carpeting, and other environmental characteristics which influence fungal exposures in homes.
Collapse
Affiliation(s)
- Samuel J Cochran
- Division of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, Ohio State University, Columbus, OH, 43210, USA
| | - Luis Acosta
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Adnan Divjan
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Angela R Lemons
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 26505, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, 10032, NY, USA
| | - Rachel L Miller
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, 10029, NY, USA
| | - Edward Sobek
- Assured Bio Laboratories, Oak Ridge, TN, 37830, USA
| | - Brett J Green
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 26505, USA
| | - Matthew S Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
| | - Karen C Dannemiller
- Department of Civil, Environmental and Geodetic Engineering, College of Engineering, Ohio State University, Columbus, OH, 43210, USA; Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH, 43210, USA; Sustainability Institute, Ohio State University, Columbus, OH, 43210, USA
| |
Collapse
|
171
|
Hofmeister MG, Zhong Y, Moorman AC, Samuel CR, Teshale EH, Spradling PR. Temporal Trends in Hepatitis C-Related Hospitalizations, United States, 2000-2019. Clin Infect Dis 2023; 77:1668-1675. [PMID: 37463305 PMCID: PMC11017377 DOI: 10.1093/cid/ciad425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Hospitalization burden related to hepatitis C virus (HCV) infection is substantial. We sought to describe temporal trends in hospitalization rates before and after release of direct-acting antiviral (DAA) agents. METHODS We analyzed 2000-2019 data from adults aged ≥18 years in the National Inpatient Sample. Hospitalizations were HCV-related if (1) hepatitis C was the primary diagnosis, or (2) hepatitis C was any secondary diagnosis with a liver-related primary diagnosis. We analyzed characteristics of HCV-related hospitalizations nationally and examined trends in age-adjusted hospitalization rates. RESULTS During 2000-2019, there were an estimated 1 286 397 HCV-related hospitalizations in the United States. The annual age-adjusted hospitalization rate was lowest in 2019 (18.7/100 000 population) and highest in 2012 (29.6/100 000 population). Most hospitalizations occurred among persons aged 45-64 years (71.8%), males (67.1%), White non-Hispanic persons (60.5%), and Medicaid/Medicare recipients (64.0%). The national age-adjusted hospitalization rate increased during 2000-2003 (annual percentage change [APC], 9.4%; P < .001) and 2003-2013 (APC, 1.8%; P < .001) before decreasing during 2013-2019 (APC, -7.6%; P < .001). Comparing 2000 to 2019, the largest increases in hospitalization rates occurred among persons aged 55-64 years (132.9%), Medicaid recipients (41.6%), and Black non-Hispanic persons (22.3%). CONCLUSIONS Although multiple factors likely contributed, overall HCV-related hospitalization rates declined steadily after 2013, coinciding with the release of DAAs. However, the declines were not observed equally among age, race/ethnicity, or insurance categories. Expanded access to DAA treatment is needed, particularly among Medicaid and Medicare recipients, to reduce disparities and morbidity and eliminate hepatitis C as a public health threat.
Collapse
Affiliation(s)
- Megan G Hofmeister
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yuna Zhong
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anne C Moorman
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christina R Samuel
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eyasu H Teshale
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Philip R Spradling
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
172
|
DeGue S, Ray CM, Bontempo D, Niolon PH, Tracy AJ, Estefan LF, Le VD, Little TD. Prevalence of Violence Victimization and Perpetration During Middle and High School in Underresourced, Urban Communities. Violence Vict 2023; 38:839-857. [PMID: 37949460 PMCID: PMC10953482 DOI: 10.1891/vv-2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
This study describes rates of violence victimization, perpetration, and witnessing in 6th-11th grade for a multisite sample (N = 3,466) of predominantly Black and Hispanic middle- and high-school students from urban areas with high rates of crime and economic disadvantage. Students completed surveys in middle and high school assessing teen dating violence, stalking, sexual violence and harassment, bullying, cyberbullying, and physical violence perpetration and victimization, as well as witnessing violence. The highest prevalence rates are observed most often in 8th or 9th grade. Youth reported high rates of witnessing serious assault and severe community violence throughout adolescence. These findings suggest that efforts to prevent violence among youth living in under-resourced communities need to start early and address community-level socioeconomic disparities.
Collapse
Affiliation(s)
- Sarah DeGue
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Colleen M Ray
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniel Bontempo
- College of Education, Texas Tech University, Lubbock, TX, USA
| | - Phyllis Holditch Niolon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Allison J Tracy
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lianne Fuino Estefan
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vi D Le
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Todd D Little
- College of Education, Texas Tech University, Lubbock, TX, USA
- Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
| |
Collapse
|
173
|
Mark-Carew M, van Zyl A, Tatti KM, Chong M, Rose C, Sifre K, Jarris D, Still W, Aynalem G, Welton M, Thomas ES, Hall L, Samson ME. Understanding COVID-19 Vaccine Hesitancy Among K-12 Staff, Parents, and Students: District of Columbia, February to April, 2022. J Sch Health 2023; 93:1079-1090. [PMID: 37602945 PMCID: PMC10833106 DOI: 10.1111/josh.13382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE Despite widespread availability of COVID-19 vaccines, millions of Americans have not received the recommended vaccine doses. In the District of Columbia (DC), COVID-19 vaccination rates are lowest among residents who are Non-Hispanic (NH) Black and among school-aged children. We assessed COVID-19 vaccine hesitancy among staff and parents of students in DC K-12 public and public charter schools. METHODS We conducted a telephone-based survey from February 6 to April 16, 2022 to staff, students, and parents of students who participated in school-based COVID-19 screening testing. COVID-19-related survey items included: vaccination status, reasons for not getting vaccinated, perceived vaccine access, and trusted COVID-19 information sources. Utilizing time-to-event analyses, we evaluated differences across demographic groups. RESULTS The interview response rate was 25.8% (308/1193). Most unvaccinated participants were NH Black and ages 5 to 11 years. Median time from vaccine eligibility to uptake was 236 days for NH Black participants vs. 10 days for NH White participants. Vaccine safety was the top concern among unvaccinated participants. Government and healthcare providers were the most trusted COVID-19 information sources. CONCLUSIONS Differences in timing of vaccine uptake among respondents and greater vaccine hesitancy among NH Black participants compared to other racial/ethnic groups highlight a need for continued tailored outreach and communication using trusted sources to convey the importance, benefits, and safety of COVID-19 vaccination.
Collapse
Affiliation(s)
- Miguella Mark-Carew
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - André van Zyl
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Kathleen M. Tatti
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Muhling Chong
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Charles Rose
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Katlynn Sifre
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Daniel Jarris
- District of Columbia Department of Health, Washington, District of Columbia, USA
| | - Will Still
- District of Columbia Department of Health, Washington, District of Columbia, USA
| | - Getahun Aynalem
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Michael Welton
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Ebony S. Thomas
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - LaShonda Hall
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Marsha E. Samson
- District of Columbia Department of Health, Washington, District of Columbia, USA
| |
Collapse
|
174
|
Gondard M, Lane M, Barratt J, Talundzic E, Qvarnstrom Y. Simultaneous targeted amplicon deep sequencing and library preparation for a time and cost-effective universal parasite diagnostic sequencing approach. Parasitol Res 2023; 122:3243-3256. [PMID: 37940706 PMCID: PMC10772880 DOI: 10.1007/s00436-023-07991-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/26/2023] [Indexed: 11/10/2023]
Abstract
We recently described a targeted amplicon deep sequencing (TADS) strategy that utilizes a nested PCR targeting the 18S rDNA gene of blood-borne parasites. The assay facilitates selective digestion of host DNA by targeting enzyme restriction sites present in vertebrates but absent in parasites. This enriching of parasite-derived amplicon drastically reduces the proportion of host-derived reads during sequencing and results in the sensitive detection of several clinically important blood parasites including Plasmodium spp., Babesia spp., kinetoplastids, and filarial nematodes. Despite these promising results, high costs and the laborious nature of metagenomics sequencing are prohibitive to the routine use of this assay in most laboratories. We describe and evaluate a new metagenomic approach that utilizes a set of primers modified from our original assay that incorporates Illumina barcodes and adapters during the PCR steps. This modification makes amplicons immediately compatible with sequencing on the Illumina MiSeq platform, removing the need for a separate library preparation, which is expensive and time-consuming. We compared this modified assay to our previous nested TADS assay in terms of preparation speed, limit of detection (LOD), and cost. Our modifications reduced assay turnaround times from 7 to 5 days. The cost decreased from approximately $40 per sample to $11 per sample. The modified assay displayed comparable performance in the detection and differentiation of human-infecting Plasmodium spp., Babesia spp., kinetoplastids, and filarial nematodes in clinical samples. The LOD of this modified approach was determined for malaria parasites and remained similar to that previously reported for our earlier assay (0.58 Plasmodium falciparum parasites/µL of blood). These modifications markedly reduced costs and turnaround times, making the assay more amenable to routine diagnostic applications.
Collapse
Affiliation(s)
- Mathilde Gondard
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Meredith Lane
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Synergy America Inc., Duluth, GA, USA
| | - Joel Barratt
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eldin Talundzic
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yvonne Qvarnstrom
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| |
Collapse
|
175
|
Kincl L, Syron L, Lucas D, Vaughan A, Bovbjerg V. Relationship of personal, situational, and environmental factors to injury experience in commercial fishing. J Safety Res 2023; 87:375-381. [PMID: 38081709 PMCID: PMC10807482 DOI: 10.1016/j.jsr.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/17/2023] [Accepted: 08/10/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Commercial fishing work involves a variety of activities and is hazardous. While much is understood to mitigate fatalities in this industry, research must further explore nonfatal injury characteristics, factors related to injury, and potential injury prevention strategies. This paper determines if fishing experience is associated with injury risk and explores common work activities associated with injury. METHOD Key informant interviews and a survey of fishermen were conducted to refine work activity codes and collect injury experiences. Independent sample t-tests compared the means of the years fishing by injury incident for all crab fishermen then stratified by position. Descriptive statistics explored the nature of injury in relation to work activity. RESULTS The level of experience was significantly lower for injured fishermen compared to fishermen who reported no injuries, but when stratified by position at the time of the injury, the association of injury to experience was only significant for owners. This stratified result demonstrates that the work activity, rather than experience, drives the apparent relationship of experience to injury. Being tired (24%) and weather (26%) were indicated as contributing factors at the time of injury. CONCLUSION Modifying the work environment to better control hazards would benefit all fishermen, regardless of their experience, age, or position. Further work into effective interventions that fishermen would adopt is needed to reduce injury risk. Any formal or informal training of new fishermen should focus on the most hazardous activities, but more experienced fishermen would also benefit. Additionally, effective training or interventions for fatigue management, and decision support tools for weather- and navigation-related decisions would further reduce risk of at sea injuries. PRACTICAL APPLICATIONS Injury prevention training, for all fishermen, regardless of their position and years of experience, should cover the most hazardous tasks, fatigue risk management strategies, and weather decisions.
Collapse
Affiliation(s)
- Laurel Kincl
- College of Public Health and Human Sciences, Oregon State University, USA.
| | - Laura Syron
- National Institute for Occupational Safety and Health, Western States Division, USA
| | - Devin Lucas
- National Institute for Occupational Safety and Health, Western States Division, USA
| | - Amelia Vaughan
- College of Public Health and Human Sciences, Oregon State University, USA
| | - Viktor Bovbjerg
- College of Public Health and Human Sciences, Oregon State University, USA
| |
Collapse
|
176
|
Chiasakul T, Lam BD, McNichol M, Robertson W, Rosovsky RP, Lake L, Vlachos IS, Adamski A, Reyes N, Abe K, Zwicker JI, Patell R. Artificial intelligence in the prediction of venous thromboembolism: A systematic review and pooled analysis. Eur J Haematol 2023; 111:951-962. [PMID: 37794526 PMCID: PMC10900245 DOI: 10.1111/ejh.14110] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Accurate diagnostic and prognostic predictions of venous thromboembolism (VTE) are crucial for VTE management. Artificial intelligence (AI) enables autonomous identification of the most predictive patterns from large complex data. Although evidence regarding its performance in VTE prediction is emerging, a comprehensive analysis of performance is lacking. AIMS To systematically review the performance of AI in the diagnosis and prediction of VTE and compare it to clinical risk assessment models (RAMs) or logistic regression models. METHODS A systematic literature search was performed using PubMed, MEDLINE, EMBASE, and Web of Science from inception to April 20, 2021. Search terms included "artificial intelligence" and "venous thromboembolism." Eligible criteria were original studies evaluating AI in the prediction of VTE in adults and reporting one of the following outcomes: sensitivity, specificity, positive predictive value, negative predictive value, or area under receiver operating curve (AUC). Risks of bias were assessed using the PROBAST tool. Unpaired t-test was performed to compare the mean AUC from AI versus conventional methods (RAMs or logistic regression models). RESULTS A total of 20 studies were included. Number of participants ranged from 31 to 111 888. The AI-based models included artificial neural network (six studies), support vector machines (four studies), Bayesian methods (one study), super learner ensemble (one study), genetic programming (one study), unspecified machine learning models (two studies), and multiple machine learning models (five studies). Twelve studies (60%) had both training and testing cohorts. Among 14 studies (70%) where AUCs were reported, the mean AUC for AI versus conventional methods were 0.79 (95% CI: 0.74-0.85) versus 0.61 (95% CI: 0.54-0.68), respectively (p < .001). However, the good to excellent discriminative performance of AI methods is unlikely to be replicated when used in clinical practice, because most studies had high risk of bias due to missing data handling and outcome determination. CONCLUSION The use of AI appears to improve the accuracy of diagnostic and prognostic prediction of VTE over conventional risk models; however, there was a high risk of bias observed across studies. Future studies should focus on transparent reporting, external validation, and clinical application of these models.
Collapse
Affiliation(s)
- Thita Chiasakul
- Division of Hematology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Division of Hemostasis and Thrombosis, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Division of Hematology, Faculty of Medicine, Department of Medicine, Center of Excellence in Translational Hematology, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Barbara D Lam
- Division of Hematology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Division of Hemostasis and Thrombosis, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Megan McNichol
- Division of Knowledge Services, Department of Information Services (M.M.), Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - William Robertson
- National Blood Clot Alliance, Philadelphia, Pennsylvania, USA
- Department of Emergency Healthcare, College of Health Professions, Weber State University, Ogden, Utah, USA
| | - Rachel P Rosovsky
- Division of Hematology/Oncology, Department of Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Leslie Lake
- National Blood Clot Alliance, Philadelphia, Pennsylvania, USA
| | - Ioannis S Vlachos
- Department of Pathology, Cancer Research Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Alys Adamski
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nimia Reyes
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Karon Abe
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeffrey I Zwicker
- Division of Hematology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Division of Hemostasis and Thrombosis, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Hematology Service, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Rushad Patell
- Division of Hematology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Division of Hemostasis and Thrombosis, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
177
|
Judge AS, Downing KF, Nembhard WN, Oster ME, Farr SL. Racial and ethnic disparities in socio-economic status, access to care, and healthcare utilisation among children with heart conditions, National Survey of Children's Health 2016-2019. Cardiol Young 2023; 33:2539-2547. [PMID: 36999847 PMCID: PMC10680441 DOI: 10.1017/s1047951122004097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Among children with and without heart conditions of different race/ethnicities, upstream social determinants of health, such as socio-economic status, access to care, and healthcare utilisation, may vary. Using caregiver-reported data from the 2016-19 National Survey of Children's Health, we calculated the prevalence of caregiver employment and education, child's health insurance, usual place of medical care in the past 12 months, problems paying for child's care, ≥2 emergency room visits, and unmet healthcare needs by heart condition status and race/ethnicity (Hispanic, non-Hispanic Black, and non-Hispanic White). For each outcome, we used multivariable logistic regression to generate adjusted prevalence ratios controlling for child's age and sex. Of 2632 children with heart conditions and 104,841 without, 65.4% and 58.0% were non-Hispanic White and 52.0% and 51.1% were male, respectively. Children with heart conditions, compared to those without, were 1.7-2.6 times more likely to have problems paying for healthcare, have ≥2 emergency room visits, and have unmet healthcare needs. Hispanic and non-Hispanic Black children with heart conditions, compared to non-Hispanic White, were 1.5-3.2 times as likely to have caregivers employed <50 weeks in the past year and caregivers with ≤ high school education, public or no health insurance, no usual place of care, and ≥2 emergency room visits. Children with heart conditions, compared to those without, may have greater healthcare needs that more commonly go unmet. Among children with heart conditions, Hispanic and non-Hispanic Black children may experience lower socio-economic status and greater barriers to healthcare than non-Hispanic White children.
Collapse
Affiliation(s)
- Ashley S. Judge
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Karrie F. Downing
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| | - Wendy N. Nembhard
- Department of Epidemiology, Fay W Boozman College of Public Health and the Arkansas Center for Birth Defects Research and Prevention, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Matthew E. Oster
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
- Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, USA
| | - Sherry L. Farr
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| |
Collapse
|
178
|
Metcalf BJ, Waldetoft KW, Beall BW, Brown SP. Variation in pneumococcal invasiveness metrics is driven by serotype carriage duration and initial risk of disease. Epidemics 2023; 45:100731. [PMID: 38039595 PMCID: PMC10786323 DOI: 10.1016/j.epidem.2023.100731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/24/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023] Open
Abstract
Streptococcus pneumoniae is an opportunistic pathogen that, while usually carried asymptomatically, can cause severe invasive diseases like meningitis and bacteremic pneumonia. A central goal in S. pneumoniae public health management is to identify which serotypes (immunologically distinct strains) pose the most risk of invasive disease. The most common invasiveness metrics use cross-sectional data (i.e., invasive odds ratios (IOR)), or longitudinal data (i.e., attack rates (AR)). To assess the reliability of these metrics we developed an epidemiological model of carriage and invasive disease. Our mathematical analyses illustrate qualitative failures with the IOR metric (e.g., IOR can decline with increasing invasiveness parameters). Fitting the model to both longitudinal and cross-sectional data, our analysis supports previous work indicating that invasion risk is maximal at or near time of colonization. This pattern of early invasive disease risk leads to substantial (up to 5-fold) biases when estimating underlying differences in invasiveness from IOR metrics, due to the impact of carriage duration on IOR. Together, these results raise serious concerns with the IOR metric as a basis for public health decision-making and lend support for multiple alternate metrics including AR.
Collapse
Affiliation(s)
- Benjamin J Metcalf
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia; Center for Microbial Dynamics and Infection, Georgia Institute of Technology, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Kristofer Wollein Waldetoft
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia; Center for Microbial Dynamics and Infection, Georgia Institute of Technology, Atlanta, Georgia; Torsby Hospital, Torsby, Sweden
| | - Bernard W Beall
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sam P Brown
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia; Center for Microbial Dynamics and Infection, Georgia Institute of Technology, Atlanta, Georgia.
| |
Collapse
|
179
|
Gilbertson KE, Liu T, Wiener JS, Walker WO, Smith K, Castillo J, Castillo H, Wilson P, Peterson P, Clayton GH, Valdez R. Age-Specific Probability of 4 Major Health Outcomes in Children with Spina Bifida. J Dev Behav Pediatr 2023; 44:e633-e641. [PMID: 37816172 PMCID: PMC10926062 DOI: 10.1097/dbp.0000000000001218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/28/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVE This study aimed to estimate the age-specific probability of 4 health outcomes in a large registry of individuals with spina bifida (SB). METHODS The association between age and 4 health outcomes was examined in individuals with myelomeningocele (MMC, n = 5627) and non-myelomeningocele (NMMC, n = 1442) from the National Spina Bifida Patient Registry. Sixteen age categories were created, 1 for each year between the ages of 5 and 19 years and 1 for those aged 20 years or older. Generalized linear models were used to calculate the adjusted probability and 95% prediction intervals of each outcome for each age category, adjusting for sex and race/ethnicity. RESULTS For the MMC and NMMC groups, the adjusted coefficients for the correlation between age and the probability of each outcome were -0.933 and -0.657 for bladder incontinence, -0.922 and -0.773 for bowel incontinence, 0.942 and 0.382 for skin breakdown, and 0.809 and 0.619 for lack of ambulation, respectively. CONCLUSION In individuals with SB, age is inversely associated with the probability of bladder and bowel incontinence and directly associated with the probability of skin breakdown and lack of ambulation. The estimated age-specific probabilities of each outcome can help SB clinicians estimate the expected proportion of patients with the outcome at specific ages and explain the probability of the occurrence of these outcomes to patients and their families.
Collapse
Grants
- U01DD001279 ACL HHS
- U01 DD001268 NCBDD CDC HHS
- U01 DD001279 NCBDD CDC HHS
- U01DD001093 ACL HHS
- U01DD001062 ACL HHS
- U01 DD001057 NCBDD CDC HHS
- U01 DD001275 NCBDD CDC HHS
- DD000738, DD000740, DD000743, DD000774, DD001057, DD001062, DD001065, DD001093, DD001235, DD001237, DD001240, DD001262, DD001265, DD001266, DD001268, DD001270, DD001272, DD001274, DD001275, DD001278, DD001279, and DD001280. CDC HHS
- U01 DD001237 NCBDD CDC HHS
- U01DD001057 ACL HHS
- U01 DD000738 NCBDD CDC HHS
- U01DD001065 ACL HHS
- U01 DD001280 NCBDD CDC HHS
- U01DD001235 ACL HHS
- U01 DD001235 NCBDD CDC HHS
- U01DD001268 ACL HHS
- U01DD001275 ACL HHS
- U01 DD001093 NCBDD CDC HHS
- U01DD001240 ACL HHS
- U01DD001262 ACL HHS
- U01 DD001278 NCBDD CDC HHS
- U01DD001270 ACL HHS
- U01DD001274 ACL HHS
- U01 DD000740 NCBDD CDC HHS
- U01DD001266 ACL HHS
- U01 DD000774 NCBDD CDC HHS
- CC999999 Intramural CDC HHS
- U01 DD001265 NCBDD CDC HHS
- U01 DD001062 NCBDD CDC HHS
- U01 DD001240 NCBDD CDC HHS
- U01 DD001274 NCBDD CDC HHS
- U01DD001280 ACL HHS
- U01 DD001262 NCBDD CDC HHS
- U01 DD001270 NCBDD CDC HHS
- U01 DD001065 NCBDD CDC HHS
- U01 DD000743 NCBDD CDC HHS
- U01DD001237 ACL HHS
- U01DD001272 ACL HHS
- U01DD001265 ACL HHS
- U01 DD001266 NCBDD CDC HHS
- U01 DD001272 NCBDD CDC HHS
- U01DD001278 ACL HHS
Collapse
Affiliation(s)
- Kendra E. Gilbertson
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Chamblee, GA
| | - Tiebin Liu
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Chamblee, GA
| | - John S. Wiener
- Division of Pediatric Urology, Department of Urology, Duke University School of Medicine, Durham, NC
| | - William O. Walker
- Department of Pediatrics, Division of Developmental Medicine, University of Washington School of Medicine, Seattle Children’s Hospital, Seattle, WA
| | - Kathryn Smith
- Children’s Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jonathan Castillo
- Developmental Pediatrics, Department of Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX
| | - Heidi Castillo
- Developmental Pediatrics, Department of Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX
| | - Pamela Wilson
- Department of Rehabilitation and Therapy, Children’s Hospital Colorado, Aurora, CO
| | - Paula Peterson
- Brain and Spine Center, Primary Children’s Hospital, Salt Lake City, UT
| | - Gerald H. Clayton
- Department of Rehabilitation and Therapy, Children’s Hospital Colorado, Aurora, CO
| | - Rodolfo Valdez
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Chamblee, GA
| |
Collapse
|
180
|
Bookhart LH, Anstey EH, Kramer MR, Perrine CG, Ramakrishnan U, Young MF. A dose-response relationship found between the Ten Steps to Successful Breastfeeding indicators and in-hospital exclusive breastfeeding in US hospitals. Birth 2023; 50:916-922. [PMID: 37435951 PMCID: PMC11022270 DOI: 10.1111/birt.12742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 04/11/2023] [Accepted: 06/09/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND In-hospital exclusive breastfeeding (EBF) is associated with longer breastfeeding durations, yet only 64% of US newborns are EBF for 7 days. The Ten Steps to Successful Breastfeeding (Ten Steps) are a set of evidenced-based maternity practices shown to improve breastfeeding outcomes; these were updated in 2018. METHODS Using hospital-level data from the 2018 Maternity Practices in Infant Nutrition and Care Survey (n = 2045 hospitals), we examined the prevalence of implementation of Ten Steps indicators (each step and total number of steps implemented). Using linear regression, we also examined the association between the steps and EBF prevalence adjusted for hospital characteristics and all other steps. Discharge support was not included in the models since it primarily occurs after hospital discharge. RESULTS The most frequently implemented step was the provision of prenatal breastfeeding education (95.6%). Steps with low implementation included rooming-in (18.9%), facility policies supportive of breastfeeding (23.4%), and limited formula supplementation (28.2%). After adjusting for hospital characteristics and all other steps, limited formula supplementation (difference = 14.4: 95% confidence interval [CI]: 12.6, 16.1), prenatal breastfeeding education (difference = 7.0; 95% CI: 3.3, 10.8), responsive feeding (difference = 6.3; 95% CI: 3.7, 9.0), care right after birth (skin-to-skin; difference = 5.8; 95% CI: 4.2, 7.4), and rooming-in (difference = 2.4; 95% CI: 0.4, 4.6) were associated with higher in-hospital EBF prevalence. We found a dose-response relationship between the number of steps implemented and in-hospital EBF prevalence. CONCLUSION Increased implementation of the updated Ten Steps may improve EBF and infant and maternal health outcomes.
Collapse
Affiliation(s)
- Larelle H. Bookhart
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA
- Center of Excellence in Maternal and Child Health, Community Health, Sciences School of Public Health, University of Illinois, Chicago, Illinois, USA
| | - Erica H. Anstey
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael R. Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Cria G. Perrine
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Usha Ramakrishnan
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Melissa F. Young
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
181
|
Saelee R, Hora IA, Pavkov ME, Imperatore G, Chen Y, Benoit SR, Holliday CS, Bullard KM. Diabetes Prevalence and Incidence Inequality Trends Among U.S. Adults, 2008-2021. Am J Prev Med 2023; 65:973-982. [PMID: 37467866 PMCID: PMC10792096 DOI: 10.1016/j.amepre.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION This study examined national trends in age, sex, racial and ethnic, and socioeconomic inequalities for diagnosed diabetes prevalence and incidence among U.S. adults from 2008 to 2021. METHODS Adults (aged ≥18 years) were from the National Health Interview Survey (2008-2021). The annual between-group variance (BGV) for sex, race, and ethnicity; and the slope index of inequality (SII) for age, education, and poverty-to-income ratio along with the average annual percentage change (AAPC) were estimated in 2023 to assess trends in inequalities over time in diabetes prevalence and incidence. For BGV and SII, a value of 0 represents no inequality, whereas a value further from 0 represents greater inequality. RESULTS On average over time, poverty-to-income ratio inequalities in diabetes prevalence worsened (SII= -8.24 in 2008 and -9.80 in 2021; AAPC for SII= -1.90%, p=0.003), whereas inequalities in incidence for age (SII=17.60 in 2008 and 8.85 in 2021; AAPC for SII= -6.47%, p<0.001), sex (BGV=0.09 in 2008, 2.05 in 2009, 1.24 in 2010, and 0.27 in 2021; AAPC for BGV= -12.34%, p=0.002), racial and ethnic (BGV=4.80 in 2008 and 2.17 in 2021; AAPC for BGV= -10.59%, p=0.010), and education (SII= -9.89 in 2008 and -2.20 in 2021; AAPC for SII=8.27%, p=0.001) groups improved. CONCLUSIONS From 2008 to 2021, age, sex, racial and ethnic, and education inequalities in the incidence of diagnosed diabetes improved but persisted. Income-related diabetes prevalence inequalities worsened over time. To close these gaps, future research could focus on identifying the factors driving these trends, including the contribution of morbidity and mortality.
Collapse
Affiliation(s)
- Ryan Saelee
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Israel A Hora
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meda E Pavkov
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yu Chen
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen R Benoit
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher S Holliday
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kai McKeever Bullard
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
182
|
Prentice-Mott G, Odhiambo A, Conners EE, Mwaki A, Blackstock AJ, Oremo J, Akelo O, Eleveld A, Quick R, Murphy J, Berendes DM. Evaluation of SaTo pans as a new latrine technology in Kisumu County healthcare facilities, Kenya. Trop Med Int Health 2023; 28:881-889. [PMID: 37940633 PMCID: PMC10886420 DOI: 10.1111/tmi.13939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVES Innovations to improve public sanitation facilities, especially in healthcare facilities (HCFs) in low-income countries, are limited. SaTo pans represent novel, largely untested, modifications to reduce odour and flies and improve acceptability of HCF sanitation facilities. We conducted a pilot project to evaluate acceptability, cleanliness, flies and odour within latrines in 37 HCFs in Kisumu, Kenya, randomised into intervention (SaTo pan modifications) and control arms by sub-county and HCF level. METHODS At baseline (pre-intervention) and endline (>3 months after completion of SaTo pan installations in latrines in intervention HCFs), we surveyed users, cleaners and in-charges, observed odour and cleanliness, and assessed flies using fly tape. Unadjusted difference-in-difference analysis compared changes from baseline to endline in patient-reported acceptability and observed latrine conditions between intervention and control HCFs. A secondary assessment compared patient-reported acceptability following use of SaTo pan versus non-SaTo pan latrines within intervention HCFs. RESULTS Patient-reported acceptability of latrines was higher following the intervention (baseline: 87%, endline: 96%, p = 0.05). However, patient-reported acceptability was also high in the control arm (79%, 86%, p = 0.34), and the between-arm difference-in-difference was not significant. Enumerator-observed odour declined in intervention latrines (32%-14%) compared with controls (36%-51%, difference-in-difference ratio: 0.32, 95% confidence interval: 0.12-0.84), but changes in flies, puddling of urine and visible faeces did not differ between arms. In the secondary assessment, fewer intervention than control latrines had patient-reported flies (0% vs. 26%) and odour (18% vs. 50%), and reported satisfaction was greater. Most cleaners reported dropholes and floors were easier to clean in intervention versus controls; limited challenges with water for flushing were reported. CONCLUSIONS Our results suggest SaTo pans may be acceptable by cleaners and users and reduce odour in HCF sanitation facilities, though challenges exist and further evaluation with larger sample sizes is needed.
Collapse
Affiliation(s)
- Graeme Prentice-Mott
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Erin E Conners
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alex Mwaki
- EIS Service, Safe Water and AIDS Project, Kisumu, Kenya
| | - Anna J Blackstock
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jared Oremo
- EIS Service, Safe Water and AIDS Project, Kisumu, Kenya
| | - Oscar Akelo
- EIS Service, Safe Water and AIDS Project, Kisumu, Kenya
| | - Alie Eleveld
- EIS Service, Safe Water and AIDS Project, Kisumu, Kenya
| | - Robert Quick
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Murphy
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David M Berendes
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
183
|
Carmichael AE, Lennon NH, Qualters JR. Analysis of social determinants of health and individual factors found in health equity frameworks: Applications to injury research. J Safety Res 2023; 87:508-518. [PMID: 38081722 PMCID: PMC10775896 DOI: 10.1016/j.jsr.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION This research evaluated existing health equity frameworks as they relate to social determinants of health (SDOHs) and individual factors that may impact injury outcomes and identify gaps in coverage using the Healthy People (HP) 2030 key domains. METHODS The study used a list of health equity frameworks sourced from previous literature. SDOHs and individual factors from each framework were identified and categorized into the Healthy People 2030 domains. Five injury topic areas were used as examples for how SDOHs and individual factors can be compared to injury topic-specific health disparities to identify health equity frameworks to apply to injury research. RESULTS The study identified 59 SDOHs and individual factors from the list of 33 health equity frameworks. The number of SDOHs and individual factors identified varied by Healthy People 2030 domain: Neighborhood and Built Environment contained 16 (27.1%) SDOHs and individual actors, Social and Community Context contained 22 (37.3%), Economic Stability contained 10 (16.9%), Healthcare Access and Quality contained 10 (16.9%), and Education Access and Quality contained one (1.7%). Twenty-three (39.0%) SDOHs/individual factors related to traumatic brain injury, thirteen (22.0%) related to motor vehicle crashes and suicide, 11 (18.6%) related to drowning and older adult falls. Eight frameworks (24.2%) covered all HP 2030 key domains and may be applicable to injury topics. CONCLUSIONS Incorporating health equity into research is critical. Health equity frameworks can provide a way to systematically incorporate health equity into research. The findings from this study may be useful to health equity research by providing a resource to injury and other public health fields. PRACTICAL APPLICATIONS Health equity frameworks are a practical tool to guide injury research, translation, evaluation, and program implementation. The findings from this study can be used to guide the application of health equity frameworks in injury research for specific topic areas.
Collapse
Affiliation(s)
- Andrea E Carmichael
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Natalie H Lennon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Judith R Qualters
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
184
|
DeSisto CL, Terplan M, Kacha-Ochana A, Green JL, Mueller T, Cox S, Ko JY. Buprenorphine use and setting type among reproductive-aged women self-reporting nonmedical prescription opioid use. J Subst Use Addict Treat 2023; 155:209083. [PMID: 37245854 PMCID: PMC10676438 DOI: 10.1016/j.josat.2023.209083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 04/11/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Screening for opioid misuse and treatment for opioid use disorder are critical for reducing morbidity and mortality. We sought to understand the extent of self-reported past 30-day buprenorphine use in various settings among women of reproductive age with self-reported nonmedical prescription opioid use being assessed for substance use problems. METHODS The study collected data from individuals being assessed for substance use problems using the Addiction Severity Index-Multimedia Version in 2018-2020. We stratified the sample of 10,196 women ages 12-55 self-reporting past 30-day nonmedical prescription opioid use by buprenorphine use and setting type. We categorized setting types as: buprenorphine in specialty addiction treatment, buprenorphine in office-based opioid treatment, and diverted buprenorphine. We included each woman's first intake assessment during the study period. The study assessed number of buprenorphine products, reasons for using buprenorphine, and sources of buprenorphine procurement. The study calculated frequency of reasons for using buprenorphine to treat opioid use disorder outside of a doctor-managed treatment, overall and by race/ethnicity. RESULTS Overall, 25.5 % of the sample used buprenorphine in specialty addiction treatment, 6.1 % used buprenorphine prescribed in office-based treatment, 21.7 % used diverted buprenorphine, and 46.7 % reported no buprenorphine use during the past 30 days. Among women who reported using buprenorphine to treat opioid use disorder, but not as part of a doctor-managed treatment, 72.3 % could not find a provider or get into a treatment program, 21.8 % did not want to be part of a program or see a provider, and 6.0 % reported both; a higher proportion of American Indian/Alaska Native women (92.1 %) reported that they could not find a provider or get into a treatment program versus non-Hispanic White (78.0 %), non-Hispanic Black (76.0 %), and Hispanic (75.0 %) women. CONCLUSIONS Appropriate screening for nonmedical prescription opioid use to assess need for treatment with medication for opioid use disorder is important for all women of reproductive age. Our data highlight opportunities to improve treatment program accessibility and availability and support the need to increase equitable access for all women.
Collapse
Affiliation(s)
- Carla L DeSisto
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Chamblee, GA 30341, United States of America.
| | - Mishka Terplan
- Friends Research Institute, 1040 Park Ave, Baltimore, MD 21201, United States of America
| | - Akadia Kacha-Ochana
- Office of Strategy and Innovation, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Chamblee, GA 30341, United States of America
| | - Jody L Green
- Integrated Behavioral Health, Inflexxion, 2 Park Plaza, Suite 1200, Irvine, CA 92614, United States of America
| | - Trisha Mueller
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Chamblee, GA 30341, United States of America
| | - Shanna Cox
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Chamblee, GA 30341, United States of America
| | - Jean Y Ko
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Chamblee, GA 30341, United States of America
| |
Collapse
|
185
|
Aljaroudi AM, Bhattacharya A, Strauch A, Quinn TD, Williams WJ. Effect of cooling on static postural balance while wearing firefighter's protective clothing in a hot environment. Int J Occup Saf Ergon 2023; 29:1460-1466. [PMID: 36259654 PMCID: PMC10182180 DOI: 10.1080/10803548.2022.2138142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives. Postural imbalance can result from hyperthermia-mediated muscular fatigue and is a major factor contributing to injuries from falling. The objective of this study was to investigate the effect of exercise-induced hyperthermia and the impact of cooling on postural balance while wearing firefighters' protective clothing (FPC) in a hot environment. Methods. A portable force platform measured postural balance characterized by postural sway patterns using center of pressure metrics. Twelve healthy, physically fit males were recruited to stand on the force platform once with eyes open and once with eyes closed before and after treadmill exercise (40% V ˙ O 2 max ) inside an environmental chamber under hot and humid conditions (30 °C and 70% relative humidity) while wearing FPC. Subjects participated in two randomly assigned experimental phases: control and cooling intervention. Results. A significant increase in physiological responses and postural balance metrics was observed after exercising in the heat chamber while wearing FPC. Cooling resulted in a significant effect only on postural sway speed after exercise-induced hyperthermia. Conclusions. Hyperthermia can negatively alter postural balance metrics, which may lead to an increased likelihood of falling. The utilization of body cooling reduced the thermal strain but had limited impact on postural balance stability.
Collapse
Affiliation(s)
- Ali M. Aljaroudi
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), USA
- Department of Engineering Technology, Sam Houston State University, USA
- Current address: College of Aviation, Embry-Riddle Aeronautical University, USA
| | - Amit Bhattacharya
- Department of Environmental & Public Health Sciences, University of Cincinnati, USA
| | - Amanda Strauch
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), USA
- Environmental Science Center, Environmental Protection Agency (EPA), USA
| | - Tyler D. Quinn
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), USA
| | - W. Jon Williams
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), USA
| |
Collapse
|
186
|
Yuan K, Haddad Y, Law R, Shakya I, Haileyesus T, Navon L, Zhang L, Liu Y, Bergen G. Emergency Department Visits for Alcohol-Associated Falls Among Older Adults in the United States, 2011 to 2020. Ann Emerg Med 2023; 82:666-677. [PMID: 37204348 PMCID: PMC10950308 DOI: 10.1016/j.annemergmed.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/30/2023] [Accepted: 04/11/2023] [Indexed: 05/20/2023]
Abstract
STUDY OBJECTIVE The aim of this study was to examine the epidemiology of alcohol-associated fall injuries among older adults aged ≥65 years in the United States. METHODS We included emergency department (ED) visits for unintentional fall injuries by adults from the National Electronic Injury Surveillance System-All Injury Program during 2011 to 2020. We estimated the annual national rate of ED visits for alcohol-associated falls and the proportion of these falls among older adults' fall-related ED visits using demographic and clinical characteristics. Joinpoint regression was performed to examine trends in alcohol-associated ED fall visits between 2011 and 2019 among older adult age subgroups and to compare these trends with those of younger adults. RESULTS There were 9,657 (weighted national estimate: 618,099) ED visits for alcohol-associated falls, representing 2.2% of ED fall visits during 2011 to 2020 among older adults. The proportion of fall-related ED visits that were alcohol-associated was higher among men than among women (adjusted prevalence ratio [aPR]=3.6, 95% confidence interval [CI] 2.9 to 4.5). The head and face were the most commonly injured body parts, and internal injury was the most common diagnosis for alcohol-associated falls. From 2011 to 2019, the annual rate of ED visits for alcohol-associated falls increased (annual percent change 7.5, 95% CI 6.1 to 8.9) among older adults. Adults aged 55 to 64 years had a similar increase; a sustained increase was not detected in younger age groups. CONCLUSION Our findings highlight the rising rates of ED visits for alcohol-associated falls among older adults during the study period. Health care providers in the ED can screen older adults for fall risk and assess for modifiable risk factors such as alcohol use to help identify those who could benefit from interventions to reduce their risk.
Collapse
Affiliation(s)
- Keming Yuan
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA.
| | - Yara Haddad
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Royal Law
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Iju Shakya
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Tadesse Haileyesus
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Livia Navon
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lei Zhang
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Yang Liu
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gwen Bergen
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| |
Collapse
|
187
|
Park J, Tang S, Mendez I, Barrett C, Danielson ML, Bitsko RH, Holliday C, Bullard KM. Prevalence of diagnosed depression, anxiety, and ADHD among youth with type 1 or type 2 diabetes mellitus. Prim Care Diabetes 2023; 17:658-660. [PMID: 37743208 PMCID: PMC11000495 DOI: 10.1016/j.pcd.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 09/26/2023]
Abstract
We examined the prevalence of diagnosed depression, anxiety, and ADHD among youth by diabetes type, insurance type, and race/ethnicity. These mental disorders were more prevalent among youth with diabetes, particularly those with type 2 diabetes, with non-Hispanic White youth with Medicaid and diabetes having a higher prevalence than other races/ethnicities.
Collapse
Affiliation(s)
- Joohyun Park
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Shichao Tang
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Isabel Mendez
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Catherine Barrett
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Melissa L Danielson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Rebecca H Bitsko
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Christopher Holliday
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kai McKeever Bullard
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| |
Collapse
|
188
|
Meeker JR, Strid P, Simeone R, D'Angelo DV, Dieke A, von Essen BS, Galang RR, Zapata LB, Ellington S. Pandemic-related stressors and mental health among women with a live birth in 2020. Arch Womens Ment Health 2023; 26:767-776. [PMID: 37608095 PMCID: PMC11025528 DOI: 10.1007/s00737-023-01364-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/12/2023] [Indexed: 08/24/2023]
Abstract
The objective of this analysis was to assess the associations between pandemic-related stressors and feeling more anxious/depressed, among women with a live birth. We analyzed data from the Pregnancy Risk Assessment Monitoring System (PRAMS) COVID-19 maternal experiences supplement, implemented in 29 U.S. jurisdictions from October 2020-June 2021, among women with a live birth during April-December 2020. We examined stressors by type (economic, housing, childcare, food insecurity, partner, COVID-19 illness) and score (number of stressor types experienced [none, 1-2, 3-4, or 5-6]). Outcomes were feeling 1) more anxious and 2) more depressed than usual due to the pandemic. We calculated adjusted prevalence ratios estimating associations between stressors and outcomes. Among 12,525 respondents, half reported feeling more anxious and 28% more depressed than usual. The prevalence of stressor types was 50% economic, 41% childcare, 18% partner, 17% food insecurity, 12% housing, and 10% COVID-19 illness. Respondents who experienced partner stressors (anxious aPR: 1.81, 95% CI: 1.73-1.90; depressed aPR: 3.01, 95% CI: 2.78-3.25) and food insecurity (anxious aPR: 1.79, 95% CI: 1.71-1.88; depressed aPR: 2.32, 95% CI: 2.13-2.53) had the largest associations with feeling more anxious and depressed than usual. As stressor scores increased, so did the aPRs for feeling more anxious and more depressed due to the pandemic. COVID-19 stressors, not COVID-19 illness, were found to be significantly associated with feeling more anxious and depressed. Pregnant and postpartum women might benefit from access to supports and services to address pandemic-related stressors/social-determinants and feelings of anxiety and depression.
Collapse
Affiliation(s)
- Jessica R Meeker
- USA Centers for Disease Control and Prevention, 4770 Buford Highway, MS 107-2, Atlanta, GA, 30341, USA.
| | - Penelope Strid
- USA Centers for Disease Control and Prevention, 4770 Buford Highway, MS 107-2, Atlanta, GA, 30341, USA
| | - Regina Simeone
- USA Centers for Disease Control and Prevention, 4770 Buford Highway, MS 107-2, Atlanta, GA, 30341, USA
| | - Denise V D'Angelo
- USA Centers for Disease Control and Prevention, 4770 Buford Highway, MS 107-2, Atlanta, GA, 30341, USA
| | - Ada Dieke
- USA Centers for Disease Control and Prevention, 4770 Buford Highway, MS 107-2, Atlanta, GA, 30341, USA
| | | | - Romeo R Galang
- USA Centers for Disease Control and Prevention, 4770 Buford Highway, MS 107-2, Atlanta, GA, 30341, USA
| | - Lauren B Zapata
- USA Centers for Disease Control and Prevention, 4770 Buford Highway, MS 107-2, Atlanta, GA, 30341, USA
| | - Sascha Ellington
- USA Centers for Disease Control and Prevention, 4770 Buford Highway, MS 107-2, Atlanta, GA, 30341, USA
| |
Collapse
|
189
|
Gaugler JE, Borson S, Epps F, Shih RA, Parker LJ, McGuire LC. The intersection of social determinants of health and family care of people living with Alzheimer's disease and related dementias: A public health opportunity. Alzheimers Dement 2023; 19:5837-5846. [PMID: 37698187 PMCID: PMC10840787 DOI: 10.1002/alz.13437] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 09/13/2023]
Abstract
In this Perspective article, we highlight current research to illustrate the intersection of social determinants of health (SDOHs) and Alzheimer's disease and related dementia (ADRD) caregiving. We then outline how public health can support ADRD family caregivers in the United States. Emerging research suggests that family care for persons with ADRD is influenced by SDOHs. Public health actions that address these intersections such as improved surveillance and identification of ADRD caregivers; building and enhancing community partnerships; advancing dementia-capable health care and related payment incentives; and reducing the stigma of dementia and ADRD caregiving can potentially enhance the health and well-being of dementia caregivers. By engaging in one or all of these actions, public health practitioners could more effectively address the myriad of challenges facing ADRD caregivers most at risk for emotional, social, financial, psychological, and health disruption.
Collapse
Affiliation(s)
- Joseph E. Gaugler
- Building Our Largest Dementia Infrastructure (BOLD) Public Health Center of Excellence on Dementia Caregiving, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Soo Borson
- BOLD Public Health Center of Excellence on Early Detection, NYU Grossman School of Medicine, New York, New York, USA
| | - Fayron Epps
- BOLD Public Health Center of Excellence on Dementia Caregiving, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Regina A. Shih
- BOLD Public Health Center of Excellence on Dementia Caregiving, RAND Social and Behavioral Policy Program, RAND Corporation, Santa Monica, California, USA
| | - Lauren J. Parker
- BOLD Public Health Center of Excellence on Dementia Caregiving, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lisa C. McGuire
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
190
|
Pampati S, Verlenden JV, Cree RA, Hertz M, Bitsko RH, Spencer P, Moore S, Michael SL, Dittus PJ. Children's mental health during the COVID-19 pandemic: a population-based cohort study in the United States. Ann Epidemiol 2023; 88:7-14. [PMID: 37858782 PMCID: PMC10843774 DOI: 10.1016/j.annepidem.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/30/2023] [Accepted: 10/13/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Examine children's mental health symptoms, including changes during the COVID-19 pandemic. METHODS The COVID Experiences Surveys, designed to be representative of the U.S. household population, were administered online to parents of children aged 5-12 years (wave 1 (W1), October-November 2020, n = 1561; wave 2 (W2), March-May 2021, n = 1287). We modeled changes in children's symptoms of anxiety, depression, and psychological stress and examined associations between demographic characteristics, COVID-19 related experiences, and protective factors with symptoms across both waves using generalized estimating equations. RESULTS Based on parent-report, children's symptoms of anxiety and depression decreased from W1 to W2 (Δ t-score anxiety = -1.8 [95% confidence intervals (CI): -2.5, -1.0]; Δ t-score depression = -1.0 [CI: -1.7, -0.3]). Psychological stress remained consistent. Across waves, older children and children with an emotional, mental, developmental, behavioral, physical, or medical condition were more likely to have specific poor mental health symptoms. Poor mental health symptoms were more likely among children with several contextual stressors (e.g., economic stress, parental emotional strain) and less likely among children with protective factors (e.g., daily routines, neighborhood cohesion). CONCLUSIONS Establishing programs that support mental health, improving access to mental health services, and fostering collaborations to advance children's mental health is important.
Collapse
Affiliation(s)
- Sanjana Pampati
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA.
| | - Jorge V Verlenden
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA
| | - Robyn A Cree
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Atlanta, GA
| | - Marci Hertz
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA
| | - Rebecca H Bitsko
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Atlanta, GA
| | - Patricia Spencer
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Shamia Moore
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Shannon L Michael
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Atlanta, GA
| | - Patricia J Dittus
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA
| |
Collapse
|
191
|
Antonini JM, Kodali V, Meighan TG, McKinney W, Cumpston JL, Leonard HD, Cumpston JB, Friend S, Leonard SS, Andrews R, Zeidler-Erdely PC, Erdely A, Lee EG, Afshari AA. Lung toxicity, deposition, and clearance of thermal spray coating particles with different metal profiles after inhalation in rats. Nanotoxicology 2023; 17:669-686. [PMID: 38116948 PMCID: PMC10872229 DOI: 10.1080/17435390.2023.2297048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Thermal spray coating is a process in which molten metal is sprayed onto a surface. Little is known about the health effects associated with these aerosols. Sprague-Dawley rats were exposed to aerosols (25 mg/m3 × 4 hr/d × 4 d) generated during thermal spray coating using different consumables [i.e. stainless-steel wire (PMET731), Ni-based wire (PMET885), Zn-based wire (PMET540)]. Control animals received air. Bronchoalveolar lavage was performed at 4 and 30 d post-exposure to assess lung toxicity. The particles were chain-like agglomerates and similar in size (310-378 nm). Inhalation of PMET885 aerosol caused a significant increase in lung injury and inflammation at both time points. Inhalation of PMET540 aerosol caused a slight but significant increase in lung toxicity at 4 but not 30 d. Exposure to PMET731 aerosol had no effect on lung toxicity. Overall, the lung responses were in the order: PMET885≫PMET540 >PMT731. Following a shorter exposure (25 mg/m3 × 4 h/d × 1d), lung burdens of metals from the different aerosols were determined by ICP-AES at 0, 1, 4 and 30 d post-exposure. Zn was cleared from the lungs at the fastest rate with complete clearance by 4 d post-exposure. Ni, Cr, and Mn had similar rates of clearance as nearly half of the deposited metal was cleared by 4 d. A small but significant percentage of each of these metals persisted in the lungs at 30 d. The pulmonary clearance of Fe was difficult to assess because of inherently high levels of Fe in control lungs.
Collapse
Affiliation(s)
- James M Antonini
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Vamsi Kodali
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Terence G Meighan
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Walter McKinney
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Jared L Cumpston
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Howard D Leonard
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - James B Cumpston
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Sherri Friend
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Stephen S Leonard
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Ronnee Andrews
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Patti C Zeidler-Erdely
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Aaron Erdely
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Eun Gyung Lee
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Aliakbar A Afshari
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| |
Collapse
|
192
|
Koyama AK, Nee R, Yu W, Choudhury D, Heng F, Cheung AK, Norris KC, Cho ME, Yan G. Role of Anemia in Dementia Risk Among Veterans With Incident CKD. Am J Kidney Dis 2023; 82:706-714. [PMID: 37516301 PMCID: PMC10822015 DOI: 10.1053/j.ajkd.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/30/2023] [Accepted: 04/30/2023] [Indexed: 07/31/2023]
Abstract
RATIONALE & OBJECTIVE Although some evidence exists of increased dementia risk from anemia, it is unclear whether this association persists among adults with CKD. Anemia may be a key marker for dementia among adults with CKD, so we evaluated whether anemia is associated with an increased risk of dementia among adults with CKD. STUDY DESIGN Retrospective cohort study. SETTING & PARTICIPANTS The study included 620,095 veterans aged≥45 years with incident stage 3 CKD (estimated glomerular filtration rate [eGFR]<60mL/min/1.73m2) between January 2005 and December 2016 in the US Veterans Health Administration system and followed through December 31, 2018, for incident dementia, kidney failure, or death. EXPOSURE Anemia was assessed based on the average of hemoglobin levels (g/L) during the 2 years before the date of incident CKD and categorized as normal, mild, or moderate/severe anemia (≥12.0, 11.0-11.9,<11.0g/dL, respectively, for women, and≥13.0, 11.0-12.9,<11.0g/dL for men). OUTCOME Dementia and the composite outcome of kidney failure or death. ANALYTICAL APPROACH Adjusted cause-specific hazard ratios were estimated for each outcome. RESULTS At the time of incident CKD, the mean age of the participants was 72 years, 97% were male, and their mean eGFR was 51mL/min per 1.73m2. Over a median 4.1 years of follow-up, 92,306 veterans (15%) developed dementia before kidney failure or death. Compared with the veterans with CKD without anemia, the multivariable-adjusted models showed a 16% (95% CI, 14%-17%) significantly higher risk of dementia for those with mild anemia and a 27% (95% CI, 23%-31%) higher risk with moderate/severe anemia. Combined risk of kidney failure or death was higher at 39% (95% CI, 37%-40%) and 115% (95% CI, 112%-119%) for mild and moderate/severe anemia, respectively, compared with no anemia. LIMITATIONS Residual confounding from the observational study design. Findings may not be generalizable to the broader US population. CONCLUSIONS Anemia was significantly associated with an increased risk of dementia among veterans with incident CKD, underscoring the role of anemia as a predictor of dementia risk. PLAIN-LANGUAGE SUMMARY Adults with chronic kidney disease (CKD) often have anemia. Prior studies among adults in the general population suggest anemia is a risk factor for dementia, though it is unclear whether this association persists among adults with CKD. In this large study of veterans in the United States, we studied the association between anemia and the risk of 2 important outcomes in this population: (1) dementia and (2) kidney failure or death. We found that anemia was associated with a greater risk of dementia as well as risk of kidney failure or death. The study findings therefore emphasize the role of anemia as a key predictor of dementia risk among adults with CKD.
Collapse
Affiliation(s)
- Alain K Koyama
- Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Robert Nee
- Walter Reed National Military Medical Center; Uniformed Services University, Bethesda, Maryland
| | - Wei Yu
- University of Virginia, Charlottesville, Virginia
| | - Devasmita Choudhury
- University of Virginia, Charlottesville, Virginia; Virginia-Tech Carilion School of Medicine Medical Center, Roanoke, Virginia; Salem Veterans Affairs Healthcare System, Salem, Virginia
| | - Fei Heng
- University of North Florida, Jacksonville, Florida
| | - Alfred K Cheung
- VA Salt Lake City Healthcare System, Salt Lake City, Utah; University of Utah, Salt Lake City, Utah
| | - Keith C Norris
- University of California-Los Angeles, Los Angeles, California
| | | | - Guofen Yan
- University of Virginia, Charlottesville, Virginia.
| |
Collapse
|
193
|
Naimi TS, Sherk A, Esser MB, Zhao J. Estimating alcohol-attributable injury deaths: A comparison of epidemiological methods. Addiction 2023; 118:2466-2476. [PMID: 37466014 PMCID: PMC10926872 DOI: 10.1111/add.16299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/18/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND AND AIMS Injuries often involve alcohol, but determining the proportion caused by alcohol is difficult. Several approaches have been used to determine the causal role of alcohol, but these methods have not been compared directly with one another. Such a comparison would be useful for understanding the strengths and comparability of different approaches. This study compared estimates of average annual alcohol-attributable deaths in the United States from injuries during 2015-19 using a blood alcohol concentration (BAC) method compared with a population attributable fraction (PAF) approach. METHODS For the BAC method, we used a direct method involving the proportion of decedents with a high blood alcohol concentration (BAC; e.g. ≥ 0.10%). For the PAF approach, we compared the use of unadjusted survey data with average consumption data adjusted using alcohol sales data to account for underreporting and also accounting for the underreporting of binge drinking. Survey data were from the Behavioral Risk Factor Surveillance System and mortality data were from the National Vital Statistics System. RESULTS The number of alcohol-attributable injury deaths using the direct method (48 516 deaths annually) was similar to that using PAF methods (47 879 deaths annually), but only when alcohol use measures were adjusted using alcohol sales data. Furthermore, estimates were similar for cause-specific categories of deaths, including non-motor vehicle unintentional injuries and motor vehicle crashes. Among PAF methods, excessive drinking accounted for 38.3% of injury deaths using unadjusted survey data, but 64.8% of injury deaths using adjusted data. CONCLUSIONS Estimates of alcohol-attributable injury deaths from a direct method and from a population attributable fraction method that adjusts for alcohol use based on alcohol sales data appear to be comparable.
Collapse
Affiliation(s)
- Timothy S Naimi
- Canadian Institute for Substance Use Research, Victoria, BC, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, Victoria, BC, Canada
| | - Marissa B Esser
- Alcohol Program, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jinhui Zhao
- Canadian Institute for Substance Use Research, Victoria, BC, Canada
| |
Collapse
|
194
|
Hennessee IP, Benedict K, Dulski TM, Lipner SR, Gold JAW. Racial disparities, risk factors, and clinical management practices for tinea capitis: An observational cohort study among US children with Medicaid. J Am Acad Dermatol 2023; 89:1261-1264. [PMID: 37549790 PMCID: PMC10683529 DOI: 10.1016/j.jaad.2023.07.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/22/2023] [Accepted: 07/05/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Ian P Hennessee
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Kaitlin Benedict
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Theresa M Dulski
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Jeremy A W Gold
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
195
|
Rikard SM, Nataraj N, Zhang K, Strahan AE, Mikosz CA, Guy GP. Longitudinal dose patterns among patients newly initiated on long-term opioid therapy in the United States, 2018 to 2019: an observational cohort study and time-series cluster analysis. Pain 2023; 164:2675-2683. [PMID: 37498751 PMCID: PMC10694996 DOI: 10.1097/j.pain.0000000000002994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/05/2023] [Indexed: 07/29/2023]
Abstract
ABSTRACT Opioid prescribing varies widely, and prescribed opioid dosages for an individual can fluctuate over time. Patterns in daily opioid dosage among patients prescribed long-term opioid therapy have not been previously examined. This study uses a novel application of time-series cluster analysis to characterize and visualize daily opioid dosage trajectories and associated demographic characteristics of patients newly initiated on long-term opioid therapy. We used 2018 to 2019 data from the IQVIA Longitudinal Prescription (LRx) all-payer pharmacy database, which covers 92% of retail pharmacy prescriptions dispensed in the United States. We identified a cohort of 277,967 patients newly initiated on long-term opioid therapy during 2018. Patients were stratified into 4 categories based on their mean daily dosage during a 90-day baseline period (<50, 50-89, 90-149, and ≥150 morphine milligram equivalent [MME]) and followed for a 270-day follow-up period. Time-series cluster analysis identified 2 clusters for each of the 3 baseline dosage categories <150 MME and 3 clusters for the baseline dosage category ≥150 MME. One cluster in each baseline dosage category comprised opioid dosage trajectories with decreases in dosage at the end of the follow-up period (80.7%, 98.7%, 98.7%, and 99.0%, respectively), discontinuation (58.5%, 80.0%, 79.3%, and 81.7%, respectively), and rapid tapering (50.8%, 85.8%, 87.5%, and 92.9%, respectively). These findings indicate multiple clusters of patients newly initiated on long-term opioid therapy who experience discontinuation and rapid tapering and highlight potential areas for clinician training to advance evidence-based guideline-concordant opioid prescribing, including strategies to minimize sudden dosage changes, discontinuation, or rapid tapering, and the importance of shared decision-making.
Collapse
Affiliation(s)
- S. Michaela Rikard
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nisha Nataraj
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kun Zhang
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Andrea E. Strahan
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Christina A. Mikosz
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gery P. Guy
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| |
Collapse
|
196
|
Zarus GM, Muianga C, Brenner S, Stallings K, Casillas G, Pohl HR, Mumtaz MM, Gehle K. Worker studies suggest unique liver carcinogenicity potential of polyvinyl chloride microplastics. Am J Ind Med 2023; 66:1033-1047. [PMID: 37742097 PMCID: PMC10841875 DOI: 10.1002/ajim.23540] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Plastic debris pervades our environment. Some breaks down into microplastics (MPs) that can enter and distribute in living organisms causing effects in multiple target organs. MPs have been demonstrated to harm animals through environmental exposure. Laboratory animal studies are still insufficient to evaluate human impact. And while MPs have been found in human tissues, the health effects at environmental exposure levels are unclear. AIM We reviewed and summarized existing evidence on health effects from occupational exposure to MPs. Additionally, the diverse effects documented for workers were organized by MP type and associated co-contaminants. Evidence of the unique effects of polyvinyl chloride (PVC) on liver was then highlighted. METHODS We conducted two stepwise online literature reviews of publications focused on the health risks associated with occupational MP exposures. This information was supplemented with findings from animal studies. RESULTS Our analysis focused on 34 published studies on occupational health effects from MP exposure with half involving exposure to PVC and the other half a variety of other MPs to compare. Liver effects following PVC exposure were reported for workers. While PVC exposure causes liver toxicity and increases the risk of liver cancers, including angiosarcomas and hepatocellular carcinomas, the carcinogenic effects of work-related exposure to other MPs, such as polystyrene and polyethylene, are not well understood. CONCLUSION The data supporting liver toxicity are strongest for PVC exposure. Overall, the evidence of liver toxicity from occupational exposure to MPs other than PVC is lacking. The PVC worker data summarized here can be useful in assisting clinicians evaluating exposure histories from PVC exposure and designing future cell, animal, and population exposure-effect research studies.
Collapse
Affiliation(s)
- Gregory M Zarus
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, Georgia, USA
| | - Custodio Muianga
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, Georgia, USA
| | - Stephan Brenner
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, Georgia, USA
| | - Katie Stallings
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, Georgia, USA
| | - Gaston Casillas
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, Georgia, USA
| | - Hana R Pohl
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, Georgia, USA
| | - M Moiz Mumtaz
- Agency for Toxic Substances and Disease Registry, Office of the Associate Director of Science, Atlanta, Georgia, USA
| | - Kimberly Gehle
- Agency for Toxic Substances and Disease Registry, Office of the Associate Director of Science, Atlanta, Georgia, USA
| |
Collapse
|
197
|
Nemechek K, Sean Stapleton G, Waltenburg MA, Low M, Gollarza L, Adams J, Peralta V, Lopez K, Morrison A, Schnitzler H, Kline KE, McGinnis S, Nichols M. Multistate outbreak of turtle-associated salmonellosis highlights ongoing challenges with the illegal sale and distribution of small turtles. Zoonoses Public Health 2023; 70:684-691. [PMID: 37772367 PMCID: PMC10878351 DOI: 10.1111/zph.13080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/07/2023] [Accepted: 09/17/2023] [Indexed: 09/30/2023]
Abstract
The sale and distribution of small turtles (shell length <4 inches) as pets has been banned in the United States since 1975 because of the risk of Salmonella transmission, especially to children. Despite this 48-year-old ban, salmonellosis outbreaks continue to be linked to contact with small turtles. During investigations of turtle-associated outbreaks, information regarding the turtle farm of origin is difficult to obtain because turtles are commonly sold by transient vendors. During 2020-2021, public health officials investigated a multistate illness outbreak caused by Salmonella enterica serotype Typhimurium linked to pet small turtles. Cases were defined as a laboratory-confirmed Salmonella Typhimurium infection highly related (within 0-6 allele differences) to the outbreak strain based on whole-genome sequencing analysis by core-genome multilocus sequence typing with illness onset occurring during 27 August 2020-14 May 2021. Forty-three patients were identified from 12 states; of these, 35% (15/43) were children <5 years old. Among patients with available information, 37% (14/38) were hospitalized, and one death was reported. Seventy-four percent (25/34) of patients reported turtle exposure in the week before illness onset, and 84% (16/19) specified exposure to small turtles. The outbreak strain was isolated from samples collected from a Pennsylvania patient's small turtle tank. Two patients reported purchasing their small turtles from pet stores. Salmonella Braenderup was isolated from samples collected from small turtles and their habitat at one of these stores; however, at that time, this strain was not associated with any human illnesses. This investigation was notable because of the documented sale of small turtles from several pet stores combined with the identification of a single small turtle supplier to these pet stores. The high proportion of children involved in this outbreak highlights the continued need to educate the pet industry as well as parents and caregivers about the risk of turtle-associated salmonellosis especially in children. Understanding and addressing the persisting challenges related to the illegal sale and distribution of small turtles could reduce the burden of turtle-associated salmonellosis.
Collapse
Affiliation(s)
- Kaylea Nemechek
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - G. Sean Stapleton
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Michelle A. Waltenburg
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mabel Low
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lauren Gollarza
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Adams
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Association of Public Health Laboratories, Silver Spring, Maryland, USA
| | - Vi Peralta
- California Department of Public Health, Richmond, California, USA
| | - Karen Lopez
- Delaware Department of Agriculture, Dover, Delaware, USA
| | - Atisha Morrison
- Texas Department of State Health Services, Austin, Texas, USA
| | | | - Kelly E. Kline
- Pennsylvania Department of Health, Bureau of Epidemiology, Harrisburg, Pennsylvania, USA
| | - Shannon McGinnis
- Pennsylvania Department of Health, Bureau of Epidemiology, Harrisburg, Pennsylvania, USA
| | - Megin Nichols
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
198
|
O’Shea JG, Cholli P, Heil EL, Buchacz K. Considerations for long-acting antiretroviral therapy in older persons with HIV. AIDS 2023; 37:2271-2286. [PMID: 37965737 PMCID: PMC10993170 DOI: 10.1097/qad.0000000000003704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
People with HIV (PWH) can now enjoy longer, healthier lives due to safe and highly effective antiretroviral therapy (ART), and improved care and prevention strategies. New drug formulations such as long-acting injectables (LAI) may overcome some limitations and issues with oral antiretroviral therapy and strengthen medication adherence. However, challenges and questions remain regarding their use in aging populations. Here, we review unique considerations for LAI-ART for the treatment of HIV in older PWH, including benefits, risks, pharmacological considerations, implementation challenges, knowledge gaps, and identify factors that may facilitate uptake of LA-ART in this population.
Collapse
Affiliation(s)
- Jesse G. O’Shea
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Preetam Cholli
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily L. Heil
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Kate Buchacz
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
199
|
Parker-Collins W, Njie F, Goodman DA, Cox S, Chang J, Petersen EE, Beauregard JL. Pregnancy-Related Deaths by Hispanic Origin, United States, 2009-2018. J Womens Health (Larchmt) 2023; 32:1320-1327. [PMID: 37672570 PMCID: PMC11002520 DOI: 10.1089/jwh.2023.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
Objective: To describe pregnancy-related mortality among Hispanic people by place of origin (country or region of Hispanic ancestry), 2009-2018. Materials and Methods: We conducted a cross-sectional descriptive study of pregnancy-related deaths among Hispanic people, stratified by place of origin (Central or South America, Cuba, Dominican Republic, Mexico, Puerto Rico, Other and Unknown Hispanic), using Pregnancy Mortality Surveillance System data, 2009-2018. We describe distributions of pregnancy-related deaths and pregnancy-related mortality ratios (number of pregnancy-related deaths per 100,000 live births) overall and by place of origin for select demographic and clinical characteristics. Results: For 2009-2018, the overall pregnancy-related mortality ratio among Hispanic people was 11.5 pregnancy-related deaths per 100,000 live births (95% confidence intervals [CI]: 10.8-12.2). In general, pregnancy-related mortality ratios were higher among older age groups (i.e., 35 years and older) and lower among those with higher educational attainment (i.e., college degree or higher). Approximately two in five pregnancy-related deaths among Hispanic people occurred on the day of delivery through 6 days postpartum. Place of origin-specific pregnancy-related mortality ratios ranged from 9.6 (95% CI: 5.8-15.0) among people of Cuban origin to 15.3 (95% CI: 12.4-18.3) among people of Puerto Rican origin. Hemorrhage and infection were the most frequent causes of pregnancy-related deaths overall among Hispanic people. People of Puerto Rican origin had a higher proportion of deaths because of cardiomyopathy. Conclusions: We identified differences in pregnancy-related mortality by place of origin among Hispanic people that can help inform prevention of pregnancy-related deaths.
Collapse
Affiliation(s)
- Wilda Parker-Collins
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Fanny Njie
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - David A. Goodman
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shanna Cox
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeani Chang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Emily E. Petersen
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- U.S. Public Health Service, Commissioned Corps, Rockville, Maryland, USA
| | - Jennifer L. Beauregard
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- U.S. Public Health Service, Commissioned Corps, Rockville, Maryland, USA
| |
Collapse
|
200
|
Sumner SA, Alic A, Law RK, Idaikkadar N, Patel N. Estimating national and state-level suicide deaths using a novel online symptom search data source. J Affect Disord 2023; 342:63-68. [PMID: 37704053 PMCID: PMC10958391 DOI: 10.1016/j.jad.2023.08.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/21/2023] [Accepted: 08/11/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Suicide mortality data are a critical source of information for understanding suicide-related trends in the United States. However, official suicide mortality data experience significant delays. The Google Symptom Search Dataset (SSD), a novel population-level data source derived from online search behavior, has not been evaluated for its utility in predicting suicide mortality trends. METHODS We identified five mental health related variables (suicidal ideation, self-harm, depression, major depressive disorder, and pain) from the SSD. Daily search trends for these symptoms were utilized to estimate national and state suicide counts in 2020, the most recent year for which data was available, via a linear regression model. We compared the performance of this model to a baseline autoregressive integrated moving average (ARIMA) model and a model including all 422 symptoms (All Symptoms) in the SSD. RESULTS Our Mental Health Model estimated the national number of suicide deaths with an error of -3.86 %, compared to an error of 7.17 % and 28.49 % for the ARIMA baseline and All Symptoms models. At the state level, 70 % (N = 35) of states had a prediction error of <10 % with the Mental Health Model, with accuracy generally favoring larger population states with higher number of suicide deaths. CONCLUSION The Google SSD is a new real-time data source that can be used to make accurate predictions of suicide mortality monthly trends at the national level. Additional research is needed to optimize state level predictions for states with low suicide counts.
Collapse
Affiliation(s)
- Steven A Sumner
- National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Alen Alic
- National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Royal K Law
- National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nimi Idaikkadar
- National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nimesh Patel
- Center for Forecasting and Outbreak Analytics, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|