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Daley MF, Reifler LM, Shoup JA, Glanz JM, Naleway AL, Nelson JC, Williams JTB, McLean HQ, Vazquez-Benitez G, Goddard K, Lewin BJ, Weintraub ES, McNeil MM, Razzaghi H, Singleton JA. Racial and ethnic disparities in influenza vaccination coverage among pregnant women in the United States: The contribution of vaccine-related attitudes. Prev Med 2023; 177:107751. [PMID: 37926397 PMCID: PMC10881081 DOI: 10.1016/j.ypmed.2023.107751] [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: 04/24/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Racial and ethnic disparities in influenza vaccination coverage among pregnant women in the United States have been documented. This study assessed the contribution of vaccine-related attitudes to coverage disparities. METHODS Surveys were conducted following the 2019-2020 and 2020-2021 influenza seasons in a US research network. Using electronic health record data to identify pregnant women, random samples were selected for surveying; non-Hispanic Black women and influenza-unvaccinated women were oversampled. Regression-based decomposition analyses were used to assess the contribution of vaccine-related attitudes to racial and ethnic differences in influenza vaccination. Data were combined across survey years, and analyses were weighted and accounted for survey design. RESULTS Survey response rate was 41.2% (721 of 1748) for 2019-2020 and 39.3% (706 of 1798) for 2020-2021. Self-reported influenza vaccination was higher among non-Hispanic White respondents (79.4% coverage, 95% CI 73.1%-85.7%) than Hispanic (66.2% coverage, 95% CI 52.5%-79.9%) and non-Hispanic Black (55.8% coverage, 95% CI 50.2%-61.4%) respondents. For all racial and ethnic groups, a high proportion (generally >80%) reported being seen for care, recommended for influenza vaccination, and offered vaccination. In decomposition analyses, vaccine-related attitudes (e.g., worry about vaccination causing influenza; concern about vaccine safety and effectiveness) explained a statistically significant portion of the observed racial and ethnic disparities in vaccination. Maternal age, education, and health status were not significant contributors after controlling for vaccine-related attitudes. CONCLUSIONS In a setting with relatively high influenza vaccination coverage among pregnant women, racial and ethnic disparities in coverage were identified. Vaccine-related attitudes were associated with the disparities observed.
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Affiliation(s)
- Matthew F Daley
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Liza M Reifler
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
| | - Jo Ann Shoup
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
| | - Jason M Glanz
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
| | | | - Jennifer C Nelson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
| | - Joshua T B Williams
- Department of General Pediatrics, Denver Health and Hospital Authority, Denver, CO, USA.
| | - Huong Q McLean
- Marshfield Clinic Research Institute, Marshfield, WI, USA.
| | | | | | - Bruno J Lewin
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
| | - Eric S Weintraub
- Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Michael M McNeil
- Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Hilda Razzaghi
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - James A Singleton
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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202
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O'Leary A, Willis LA, Henny KD, Madden M, Koenig LJ. Development of a Video-Delivered Serial Drama Designed to Reduce Community Homophobia and HIV Stigma, Decrease Sexual Risk Behavior, and Increase HIV Testing Among Black Youth. AIDS Educ Prev 2023; 35:439-451. [PMID: 38096457 PMCID: PMC10877481 DOI: 10.1521/aeap.2023.35.6.439] [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: 12/18/2023]
Abstract
This article describes the development of a video serial drama intervention that was designed to address factors that influence HIV in the United States among Black youth. These include HIV testing, sexual behaviors not protected by condoms, negative attitudes towards sexual minorities, and HIV stigma. Behavior-change principles (social learning theory and education-entertainment) and input from members of the priority audience formed the basis of this 27-episode (3 minutes each) drama for dissemination on multiple platforms, including in public spaces or privately online. The developmental process, specifically involving members of the population of interest and use of behavioral theory, enriched the narrative elements and likely ensured intervention acceptability, enhancing effectiveness. Public health practitioners and prevention programmers may want to consider using this intervention and/or the narrative communication approach when intervening to change behavior.
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Affiliation(s)
| | - Leigh A Willis
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kirk D Henny
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Linda J Koenig
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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203
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Williams AM, Brown KH, Allen LH, Dary O, Moorthy D, Suchdev PS. Improving Anemia Assessment in Clinical and Public Health Settings. J Nutr 2023; 153 Suppl 1:S29-S41. [PMID: 37778891 PMCID: PMC11002965 DOI: 10.1016/j.tjnut.2023.05.032] [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: 12/09/2022] [Revised: 03/28/2023] [Accepted: 05/10/2023] [Indexed: 10/03/2023] Open
Abstract
We aim to provide a practical approach to assess anemia and its primary causes, both in clinical settings and in the context of public health programs. Anemia remains a global challenge; thus, to achieve goals for anemia reduction and assess progress, standardized approaches are required for the assessment of anemia and its causes. We first provide a brief review of how to assess anemia, based on hemoglobin concentrations and cutoffs that correspond to age, sex, and physiologic status. Next, we discuss how to assess the likely causes of anemia in different settings. The causes of anemia are classified as non-nutritional (for example, because of infection, inflammation, blood loss, or genetic disorders) or nutrition-specific (for example, because of deficiencies of iron, vitamin A, riboflavin, vitamin B12, or folate). There is an important overlap between these 2 categories, such as the increased likelihood of iron deficiency in the context of inflammation. Given the multifaceted nature of anemia etiology, we introduce a framework for anemia assessment based on the "ecology of anemia," which recognizes its many overlapping causes. This conceptual framework is meant to inform what data on anemia causes may need to be collected in population surveys. The framework has a supporting table with information on the diagnostic tests, biomarkers and proposed cutoffs, characteristics, and feasibility of collecting the myriad information that can help elucidate the anemia etiology. We also provide examples of how this framework can be applied to interpret the anemia risk factor data from population-based surveys that can inform decisions about context-specific interventions. Finally, we present research gaps and priorities related to anemia assessment.
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Affiliation(s)
- Anne M Williams
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand; Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States; Emory University, Atlanta, GA, United States.
| | - Kenneth H Brown
- Department of Nutrition and Institute for Global Nutrition, University of California, Davis, CA, United States
| | - Lindsay H Allen
- United States Department of Agriculture, Agricultural Research Service Western Human Nutrition Research Center, Davis, CA, United States
| | - Omar Dary
- Division of Nutrition and Environmental Health, Office of Maternal and Child Health and Nutrition, Bureau for Global Health, United States Agency for International Development, Washington, DC, United States
| | | | - Parminder S Suchdev
- Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States; Emory University, Atlanta, GA, United States
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204
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Selcen Kilinc-Balci F, Kahveci Z, Yorio PL. Impact of surface tension on the barrier performance of gowns and coveralls. Am J Infect Control 2023; 51:1392-1400. [PMID: 37121474 PMCID: PMC10680362 DOI: 10.1016/j.ajic.2023.04.171] [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: 02/23/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Health care workers and laboratory workers who are routinely exposed to potentially life-threatening infectious diseases should wear protective clothing when anticipating contact with infectious materials. The most critical property of protective clothing is its ability to prevent liquids and viruses from passing through the garment. There are a number of potentially infectious liquids that workers may be exposed to during routine tasks. Each liquid has different physical and chemical properties that affect penetration. However, the current test methods use a limited number of liquids for classifying the barrier performance. The impact of the surface tension of the challenge liquid on the penetration resistance of gowns and coveralls was investigated in this study. METHODS Eight isolation gowns and 2 coveralls were tested in accordance with American Association of Textile Chemists and Colorists 42 and American Association of Textile Chemists and Colorists 127 test methods, which were modified to incorporate the substitute challenge liquids. RESULTS Although current standard test methods only use water to categorize the liquid penetration resistance of minimal to moderate barrier performance gowns, a significant difference in the penetration was found when simulated body fluids were used. CONCLUSIONS The results suggest that safety professionals and wearers should consider the varying barrier performance of personal protective equipment with different liquids and the use limitations when selecting them for the required tasks. Furthermore, standard development organizations should consider multiple challenge liquids when classifying protective clothing for health care settings.
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Affiliation(s)
- F Selcen Kilinc-Balci
- US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA.
| | - Zafer Kahveci
- US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA
| | - Patrick L Yorio
- US Centers for Disease Control and Prevention, Office of the Director (OD), Human Resources Office (HRO), Office of the Chief Operating Officer (OCOO), Atlanta, GA
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205
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Hall K, Geary N, Warnock AL, Dooyema C. Supporting Healthy Weight in Statewide Quality Rating and Improvement Systems: A Review of 2020 Standards and Comparison to 2015 Standards. Child Obes 2023; 19:541-551. [PMID: 36472466 PMCID: PMC10235206 DOI: 10.1089/chi.2022.0165] [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: 12/12/2022]
Abstract
Background: Quality Rating and Improvement Systems (QRISs) are used to assess, improve, and communicate quality in early care and education (ECE) programs. One strategy for supporting healthy growth in early childhood is embedding nutrition, physical activity, infant feeding, and screen time content into state QRIS standards, using the Caring for Our Children high-impact obesity prevention standards (HIOPS) and the CDC Spectrum of Opportunities framework (CDC Spectrum). We assessed the number of obesity prevention standards in QRISs in 2020 and compared results to an analysis published in 2015. Methods: We collected state QRIS standards for ECE centers from March to April 2020. Two analysts coded documents for standards related to 47 HIOPS and 6 Spectrum areas. Results: Thirty-nine states and the District of Columbia had statewide QRISs in early 2020. Of these, 21 QRISs (53%) embedded 1 or more HIOPS, and 26 (65%) embedded 1 or more Spectrum components. On average, 6.9% of HIOPS were embedded in QRIS standards in 2020, an increase from 4.6% in 2015. Nine QRISs included more HIOPS in 2020 than in 2015. Five QRISs added 10% or more of the 47 HIOPS between 2015 and 2020. Physical activity and screen time standards continued to be most often included; infant feeding standards were least included. Conclusion: Obesity prevention components were embedded in three-quarters of state QRISs, and more were embedded in 2020 than in 2015, suggesting that QRISs can be levers for supporting healthy weight in ECE settings.
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Affiliation(s)
- Kelly Hall
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education (ORISE) Research Participation Program, Oak Ridge, TN, USA
| | - Nora Geary
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- McKing Consulting Corporation, Atlanta, GA, USA
| | - Amy Lowry Warnock
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carrie Dooyema
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
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206
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Baur R, Kashon M, Lukomska E, Weatherly LM, Shane HL, Anderson SE. Exposure to the anti-microbial chemical triclosan disrupts keratinocyte function and skin integrity in a model of reconstructed human epidermis. J Immunotoxicol 2023; 20:1-11. [PMID: 36524471 PMCID: PMC10364087 DOI: 10.1080/1547691x.2022.2148781] [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: 07/20/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022] Open
Abstract
Triclosan is an anti-microbial chemical incorporated into products that are applied to the skin of healthcare workers. Exposure to triclosan has previously been shown to be associated with allergic disease in humans and impact the immune responses in animal models. Additionally, studies have shown that exposure to triclosan dermally activates the NLRP3 inflammasome and disrupts the skin barrier integrity in mice. The skin is the largest organ of the body and plays an important role as a physical barrier and regulator of the immune system. Alterations in the barrier and immune regulatory functions of the skin have been demonstrated to increase the risk of sensitization and development of allergic disease. In this study, the impact of triclosan exposure on the skin barrier and keratinocyte function was investigated using a model of reconstructed human epidermis. The apical surface of reconstructed human epidermis was exposed to triclosan (0.05-0.2%) once for 6, 24, or 48 h or daily for 5 consecutive days. Exposure to triclosan increased epidermal permeability and altered the expression of genes involved in formation of the skin barrier. Additionally, exposure to triclosan altered the expression patterns of several cytokines and growth factors. Together, these results suggest that exposure to triclosan impacts skin barrier integrity and function of human keratinocytes and suggests that these alterations may impact immune regulation.
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Affiliation(s)
- Rachel Baur
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
- Department of Microbiology, Immunology, and Cell Biology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Michael Kashon
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Ewa Lukomska
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Lisa M. Weatherly
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Hillary L. Shane
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Stacey E. Anderson
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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207
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Beer L, Williams D, Tie Y, McManus T, Yuan A(X, Crim SM, Demeke HB, Creel D, Blackwell AD, Craw JA, Weiser J. The Capacity of HIV Care Facilities to Implement Strategies Recommended by the Ending the HIV Epidemic Initiative: The Medical Monitoring Project Facility Survey. J Acquir Immune Defic Syndr 2023; 94:290-300. [PMID: 37643411 PMCID: PMC10615730 DOI: 10.1097/qai.0000000000003290] [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: 04/07/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Data are needed to assess the capacity of HIV care facilities to implement recommended Ending the HIV Epidemic activities. SETTING US HIV care facilities. METHODS We analyzed 2021 survey data from 514 facilities that were recruited from a census of facilities providing care to a national probability sample of US adults with HIV. We present weighted estimates of facility characteristics, services, and policies and estimates of the proportion of all US HIV patients attending these facilities. RESULTS Among HIV care facilities, 37% were private practices, 72% were in areas with population >1 million, and 21% had more than 1000 HIV patients. Most provided preexposure prophylaxis (83%) and postexposure prophylaxis (84%). More than 67% of facilities provided HIV-specific stigma or discrimination training for all staff (covering 70% of patients) and 66% provided training on cultural competency (covering 74% of patients). A majority of patients attended facilities that provided on-site access to HIV/sexually transmitted infection (STI) transmission risk reduction counseling (89%); fewer had on-site access to treatment for substance use disorders (35%). We found low provision of on-site assistance with food banks or meal delivery (14%) and housing (33%). Approximately 71% of facilities reported using data to systematically monitor patient retention in care. On-site access to adherence tools was available at 58% of facilities; 29% reported notifying patients of missed prescription pickups. CONCLUSION Results indicate some strengths that support Ending the HIV Epidemic-recommended strategies among HIV care facilities, such as high availability of preexposure prophylaxis/postexposure prophylaxis, as well as areas for improvement, such as provision of staff antistigma trainings and adherence supports.
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Affiliation(s)
- Linda Beer
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Yunfeng Tie
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy McManus
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Stacy M. Crim
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hanna B. Demeke
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Angela D. Blackwell
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jason A. Craw
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John Weiser
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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208
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Waltzman D, Sarmiento K, Zhang X, Miller GF. Estimated prevalence of helmet use while bicycling, rollerblading, and skateboarding among middle school students in selected U.S. States- Youth Behavior Risk Survey, 2013-2019. J Safety Res 2023; 87:367-374. [PMID: 38081708 PMCID: PMC10714050 DOI: 10.1016/j.jsr.2023.08.007] [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: 06/16/2022] [Revised: 10/04/2022] [Accepted: 08/09/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Helmet use helps prevent severe and fatal head and brain injuries from bicycle, rollerblade, and skateboard crashes. This study explores the prevalence of self-reported helmet use among middle school students while bicycling, skateboarding, and rollerblading. METHODS Data from the Middle School Youth Risk Behavior Survey (YRBS) for selected states were analyzed. Self-reported prevalence (frequency) of helmet use while bicycling, rollerblading, or skateboarding and other variables (sex, grade level, and race/ethnicity) are reported. RESULTS The overall prevalence of rarely or never wearing a helmet while bicycling among middle school students in selected states was 68.6%; decreasing from 71.7% in 2013 to 67.1% in 2019. The overall prevalence of rarely or never wearing a helmet while rollerblading or skateboarding in middle school students in selected states was 74.6%; decreasing from 76.4% in 2013 to 73.5% in 2019. Students in 7th and 8th grade and students of non-Hispanic race/ethnicity had significantly higher odds of rarely or never wearing a helmet while bicycling or while rollerblading and skateboarding than students in 6th grade and non-Hispanic White students. CONCLUSIONS While helmet use among middle school students improved over time, overall helmet use during bicycling, rollerblading, and skateboarding remained low. These estimates illustrate the continued call for universal implementation of helmet use efforts among kids using established strategies. PRACTICAL APPLICATIONS Future research on helmet use among youth who rollerblade and skateboard, as well as multi-pronged efforts to promote helmet use among middle schoolers who bicycle, skateboard, and rollerblade (inclusive of education, helmet distribution, and social marketing techniques, as well as the provision of helmets at no-cost) may be beneficial for addressing perceived risks for injury and other barriers.
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Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, United States.
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, United States
| | - Xinjian Zhang
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, United States
| | - Gabrielle F Miller
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, United States
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209
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Abstract
OBJECTIVE To assess factors that are associated with asthma prevalence and asthma attacks among children (0-17 years) and adults (18 years and over) in the United States of America. METHODS The 2019-2021 National Health Interview Survey data were analyzed using multivariable logistic regression models to determine associations between health outcomes (i.e. current asthma and asthma attacks) and demographic and socioeconomic factors. Each health outcome was regressed over each characteristic variable, adjusting for age, sex, and race/ethnicity for adults and sex and race/ethnicity for children. RESULTS Asthma was more common among children who were male, blacks, parental education less than bachelor's, or had public health insurance, and among adults who had less than a bachelor's degree, do not own a home, or not in the workforce. Persons in families facing difficulty paying medical bills were more likely to have current asthma (children: aPR = 1.62[1.40-1.88]; adults: aPR = 1.67[1.55-1.81]) and asthma attacks (children: aPR = 1.34[1.15-1.56]; adults: aPR = 1.31[1.20-1.43]). Persons with family income <100% federal poverty threshold (FPT) (children: aPR = 1.39[1.17-1.64]; adults: aPR = 1.64[1.50-1.80]) or adults 100-199% FPT (aPR = 1.28[1.19-1.39]) were more likely to have current asthma. Children and adults with family income <100% FPT and adults 100-199% FPT were also more likely to have asthma attacks. Having asthma attacks was common among adults not in the workforce as well (aPR = 1.17[1.07-1.27]). CONCLUSIONS Asthma affects certain groups disproportionately. The findings of this paper suggesting asthma disparities continue to persist may increase public health programs awareness to better deliver effective and evidence-based interventions.
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Affiliation(s)
- Cynthia A Pate
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xiaoting Qin
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carol Johnson
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hatice S Zahran
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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210
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Yu W, Drzymalla E, Gyorfy MF, Khoury MJ, Sun YV, Gwinn M. Navigating epigenetic epidemiology publications. Epigenetics Commun 2023; 3:8. [PMID: 38414576 PMCID: PMC10895989 DOI: 10.1186/s43682-023-00023-3] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/25/2023] [Indexed: 02/29/2024]
Affiliation(s)
- Wei Yu
- Office of Genomics and Precision Public Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily Drzymalla
- Office of Genomics and Precision Public Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Muin J Khoury
- Office of Genomics and Precision Public Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yan V Sun
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Irving SA, Groom HC, Belongia EA, Crane B, Daley MF, Goddard K, Jackson LA, Kauffman TL, Kenigsberg TA, Kuckler L, Naleway AL, Patel SA, Tseng HF, Williams JTB, Weintraub ES. Influenza vaccination coverage among persons ages six months and older in the Vaccine Safety Datalink in the 2017-18 through 2022-23 influenza seasons. Vaccine 2023; 41:7138-7146. [PMID: 37866991 PMCID: PMC10867768 DOI: 10.1016/j.vaccine.2023.10.023] [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: 08/10/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND In the United States, annual vaccination against seasonal influenza is recommended for all people ages ≥ 6 months. Vaccination coverage assessments can identify populations less protected from influenza morbidity and mortality and help to tailor vaccination efforts. Within the Vaccine Safety Datalink population ages ≥ 6 months, we report influenza vaccination coverage for the 2017-18 through 2022-23 seasons. METHODS Across eight health systems, we identified influenza vaccines administered from August 1 through March 31 for each season using electronic health records linked to immunization registries. Crude vaccination coverage was described for each season, overall and by self-reported sex; age group; self-reported race and ethnicity; and number of separate categories of diagnoses associated with increased risk of severe illness and complications from influenza (hereafter referred to as high-risk conditions). High-risk conditions were assessed using ICD-10-CM diagnosis codes assigned in the year preceding each influenza season. RESULTS Among individual cohorts of more than 12 million individuals each season, overall influenza vaccination coverage increased from 41.9 % in the 2017-18 season to a peak of 46.2 % in 2019-20, prior to declaration of the COVID-19 pandemic. Coverage declined over the next three seasons, coincident with widespread SARS-CoV-2 circulation, to a low of 40.3 % in the 2022-23 season. In each of the six seasons, coverage was lowest among males, 18-49-year-olds, non-Hispanic Black people, and those with no high-risk conditions. While decreases in coverage were present in all age groups, the declines were most substantial among children: 2022-23 season coverage for children ages six months through 8 years and 9-17 years was 24.5 % and 22.4 % (14 and 10 absolute percentage points), respectively, less than peak coverage achieved in the 2019-20 season. CONCLUSIONS Crude influenza vaccination coverage increased from 2017 to 18 through 2019-20, then decreased to the lowest level in the 2022-23 season. In this insured population, we identified persistent disparities in influenza vaccination coverage by sex, age, and race and ethnicity. The overall low coverage, disparities in coverage, and recent decreases in coverage are significant public health concerns.
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Affiliation(s)
| | - Holly C Groom
- Kaiser Permanente Center for Health Research, Portland OR, USA
| | | | - Bradley Crane
- Kaiser Permanente Center for Health Research, Portland OR, USA
| | - Matthew F Daley
- Institute for Health Research, Kaiser Permanente Colorado, Denver CO, USA
| | - Kristin Goddard
- Vaccine Study Center, Kaiser Permanente Northern California, Oakland CA, USA
| | - Lisa A Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle WA, USA
| | - Tia L Kauffman
- Kaiser Permanente Center for Health Research, Portland OR, USA
| | - Tat'Yana A Kenigsberg
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta GA, USA
| | | | | | - Suchita A Patel
- Immunization Services Division, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Hung Fu Tseng
- Kaiser Permanente Southern California, Pasadena CA, USA
| | | | - Eric S Weintraub
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta GA, USA
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212
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Burnett E, Riaz A, Anwari P, Myat TW, Chavers TP, Talat N, Safi N, Aung NNT, Cortese MM, Sultana S, Samsor A, Thu HM, Saddal NS, Safi S, Lin H, Qazi SH, Safi H, Ali A, Parashar UD, Tate JE. Intussusception risk following oral monovalent rotavirus vaccination in 3 Asian countries: A self-control case series evaluation. Vaccine 2023; 41:7220-7225. [PMID: 37884416 PMCID: PMC10929074 DOI: 10.1016/j.vaccine.2023.10.042] [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: 07/24/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023]
Abstract
Rotavirus vaccines have substantially decreased rotavirus hospitalizations in countries where they have been implemented. In some high- and middle-income countries, a low-level of increased risk of intussusception, a type of acute bowel obstruction, has been detected following rotavirus vaccination. However, no increased risk of intussusception was found in India, South Africa, or a network of 7 other African countries. We assessed the association between a 2-dose monovalent rotavirus vaccine (Rotarix) and intussusception in 3 early-adopter low-income Asian countries -- Afghanistan, Myanmar, and Pakistan. Children <12 months of age admitted to a sentinel surveillance hospital with Brighton level 1 intussusception were eligible for enrollment. We collected information about each child's vaccination status and used the self-controlled case series method to calculate the relative incidence of intussusception 1-7 days, 8-21 days, and 1-21 days following each dose of vaccine and derived confidence intervals with bootstrapping. Of the 585 children meeting the analytic criteria, the median age at intussusception symptom onset was 24 weeks (IQR: 19-29). Overall, 494 (84 %) children received the first Rotarix dose and 398 (68 %) received the second dose. There was no increased intussusception risk during any of the risk periods following the first (1-7 days: 1.01 (95 %CI: 0.39, 2.60); 8-21 days: 1.37 (95 %CI: 0.81, 2.32); 1-21 days: 1.28 (95 %CI: 0.78, 2.11)) or second (1-7 days: 0.81 (95 %CI: 0.42, 1.54); 8-21 days: 0.77 (95 %CI: 0.53, 1.16); 1-21 days: 0.78 (95 %CI: 0.53, 1.16)) rotavirus vaccine dose. Our findings are consistent with other data showing no increased intussusception risk with rotavirus vaccination in low-income countries and add to the growing body of evidence demonstrating safety of rotavirus vaccines.
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Affiliation(s)
| | - Atif Riaz
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Theingi Win Myat
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | | | - Nabila Talat
- Pediatric Surgery Unit, University of Child Health Sciences and Children Hospital, Lahore, Pakistan
| | | | | | | | - Shazia Sultana
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Hlaing Myat Thu
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | | | | | - Htin Lin
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Saqib Hamid Qazi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Asad Ali
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
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213
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Lewis KC, Barker LK, Jiles RB, Gupta N. Estimated Prevalence and Awareness of Hepatitis C Virus Infection Among US Adults: National Health and Nutrition Examination Survey, January 2017-March 2020. Clin Infect Dis 2023; 77:1413-1415. [PMID: 37417196 PMCID: PMC11000503 DOI: 10.1093/cid/ciad411] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 03/13/2023] [Revised: 06/08/2023] [Accepted: 06/30/2023] [Indexed: 07/08/2023] Open
Abstract
During January 2017-March 2020, approximately 2.2 million noninstitutionalized civilian US adults had hepatitis C; one-third were unaware of their infection. Prevalence was substantially higher among persons who were uninsured or experiencing poverty. Unrestricted access to testing and curative treatment is needed to reduce disparities and achieve 2030 elimination goals.
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Affiliation(s)
- Karon C Lewis
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Laurie K Barker
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ruth B Jiles
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Neil Gupta
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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214
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O'Shea JG, Bonacci RA, Cholli P, Kimball A, Brooks JT. HIV and mpox: a rapid review. AIDS 2023; 37:2105-2114. [PMID: 37877274 PMCID: PMC10962215 DOI: 10.1097/qad.0000000000003684] [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: 10/26/2023]
Abstract
In this review, we discuss the history and epidemiology of mpox, prevention strategies, clinical characteristics and management, severity of mpox among persons with advanced HIV, and areas for future research relevant to persons with HIV.
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Affiliation(s)
- Jesse G O'Shea
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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215
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Davies KA, Welch SR, Jain S, Sorvillo TE, Coleman-McCray JD, Montgomery JM, Spiropoulou CF, Albariño C, Spengler JR. Fluorescent and Bioluminescent Reporter Mouse-Adapted Ebola Viruses Maintain Pathogenicity and Can Be Visualized in Vivo. J Infect Dis 2023; 228:S536-S547. [PMID: 37145895 PMCID: PMC11014640 DOI: 10.1093/infdis/jiad136] [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: 03/04/2023] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 05/07/2023] Open
Abstract
Ebola virus (EBOV) causes lethal disease in humans but not in mice. Here, we generated recombinant mouse-adapted (MA) EBOVs, including 1 based on the previously reported serially adapted strain (rMA-EBOV), along with single-reporter rMA-EBOVs expressing either fluorescent (ZsGreen1 [ZsG]) or bioluminescent (nano-luciferase [nLuc]) reporters, and dual-reporter rMA-EBOVs expressing both ZsG and nLuc. No detriment to viral growth in vitro was seen with inclusion of MA-associated mutations or reporter proteins. In CD-1 mice, infection with MA-EBOV, rMA-EBOV, and single-reporter rMA-EBOVs conferred 100% lethality; infection with dual-reporter rMA-EBOV resulted in 73% lethality. Bioluminescent signal from rMA-EBOV expressing nLuc was detected in vivo and ex vivo using the IVIS Spectrum CT. Fluorescent signal from rMA-EBOV expressing ZsG was detected in situ using handheld blue-light transillumination and ex vivo through epi-illumination with the IVIS Spectrum CT. These data support the use of reporter MA-EBOV for studies of Ebola virus in animal disease models.
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Affiliation(s)
- Katherine A Davies
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen R Welch
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shilpi Jain
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Teresa E Sorvillo
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - JoAnn D Coleman-McCray
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joel M Montgomery
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christina F Spiropoulou
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - César Albariño
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jessica R Spengler
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
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216
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He S, Park S, Kuklina E, Therrien NL, Lundeen EA, Wall HK, Lampley K, Kompaniyets L, Pierce SL, Sperling L, Jackson SL. Leveraging Electronic Health Records to Construct a Phenotype for Hypertension Surveillance in the United States. Am J Hypertens 2023; 36:677-685. [PMID: 37696605 PMCID: PMC10898654 DOI: 10.1093/ajh/hpad081] [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: 01/25/2023] [Revised: 05/10/2023] [Accepted: 09/06/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Hypertension is an important risk factor for cardiovascular diseases. Electronic health records (EHRs) may augment chronic disease surveillance. We aimed to develop an electronic phenotype (e-phenotype) for hypertension surveillance. METHODS We included 11,031,368 eligible adults from the 2019 IQVIA Ambulatory Electronic Medical Records-US (AEMR-US) dataset. We identified hypertension using three criteria, alone or in combination: diagnosis codes, blood pressure (BP) measurements, and antihypertensive medications. We compared AEMR-US estimates of hypertension prevalence and control against those from the National Health and Nutrition Examination Survey (NHANES) 2017-18, which defined hypertension as BP ≥130/80 mm Hg or ≥1 antihypertensive medication. RESULTS The study population had a mean (SD) age of 52.3 (6.7) years, and 56.7% were women. The selected three-criteria e-phenotype (≥1 diagnosis code, ≥2 BP measurements of ≥130/80 mm Hg, or ≥1 antihypertensive medication) yielded similar trends in hypertension prevalence as NHANES: 42.2% (AEMR-US) vs. 44.9% (NHANES) overall, 39.0% vs. 38.7% among women, and 46.5% vs. 50.9% among men. The pattern of age-related increase in hypertension prevalence was similar between AEMR-US and NHANES. The prevalence of hypertension control in AEMR-US was 31.5% using the three-criteria e-phenotype, which was higher than NHANES (14.5%). CONCLUSIONS Using an EHR dataset of 11 million adults, we constructed a hypertension e-phenotype using three criteria, which can be used for surveillance of hypertension prevalence and control.
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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, GA, USA
| | - Soyoun Park
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elena Kuklina
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - 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, GA, USA
| | - Elizabeth A Lundeen
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - 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, GA, USA
| | - Katrice Lampley
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- ASRT, INC, Smyrna, GA, USA
| | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - 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, GA, USA
| | - Laurence Sperling
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - 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, GA, USA
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217
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Kojima N, Peterson L, Hawkins R, Allen M, Flannery B, Uyeki TM. Influenza Antiviral Shortages Reported by State and Territorial Public Health Officials, 2022-2023. JAMA 2023; 330:1793-1795. [PMID: 37862007 PMCID: PMC10646723 DOI: 10.1001/jama.2023.17244] [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: 06/23/2023] [Accepted: 08/17/2023] [Indexed: 10/21/2023]
Abstract
This study provides survey results from state and territorial public health preparedness directors regarding antiviral shortages during the 2022-2023 respiratory viral season.
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Affiliation(s)
- Noah Kojima
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa Peterson
- The Association of State and Territorial Health Officials, Arlington, Virginia
| | - Regina Hawkins
- The Association of State and Territorial Health Officials, Arlington, Virginia
| | - Meredith Allen
- The Association of State and Territorial Health Officials, Arlington, Virginia
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218
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Rossen LM, Hoyert D, Branum AM. US Trends in Maternal Mortality by Racial and Ethnic Group. JAMA 2023; 330:1799-1800. [PMID: 37962660 PMCID: PMC10754215 DOI: 10.1001/jama.2023.17547] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Affiliation(s)
- Lauren M. Rossen
- National Center for Health Statistics, Centers for Disease
Control and Prevention, Hyattsville, Maryland
| | - Donna Hoyert
- National Center for Health Statistics, Centers for Disease
Control and Prevention, Hyattsville, Maryland
| | - Amy M. Branum
- National Center for Health Statistics, Centers for Disease
Control and Prevention, Hyattsville, Maryland
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219
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Suthar AB, Ouk V, Samreth S, Ngauv B, Bain R, Eng B, Hy C, Ernst A, Rutherford GW, Yang C, Ly V, Albalak R. Programmatic Implications of National Recent HIV Infection Surveillance in Cambodia. J Infect Dis 2023; 228:1347-1351. [PMID: 37002831 PMCID: PMC10950055 DOI: 10.1093/infdis/jiad082] [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: 12/13/2022] [Accepted: 03/30/2023] [Indexed: 11/14/2023] Open
Abstract
We compared characteristics of HIV diagnosis and recent HIV infection (ie, likely acquired within the last year) in Cambodia. We included individuals ≥ 15 years old accessing HIV testing. From August 2020 to August 2022, 53 031 people were tested for HIV, 6868 were newly diagnosed, and 192 were recently infected. We found differences in geographical burden and risk behaviors with diagnosis and recency (eg, men who have sex with men, transgender women, and entertainment workers had a nearly 2-fold increased odds of testing positive for recent infection compared to being diagnosed with HIV). Recent infection surveillance may provide unique insights into ongoing HIV acquisition to inform programs.
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Affiliation(s)
- Amitabh Bipin Suthar
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Vichea Ouk
- National Center for HIV/AIDS, Dermatology, and STDs, Cambodia Ministry of Health, Phnom Penh, Cambodia
| | - Sovannarith Samreth
- National Center for HIV/AIDS, Dermatology, and STDs, Cambodia Ministry of Health, Phnom Penh, Cambodia
| | - Bora Ngauv
- National Center for HIV/AIDS, Dermatology, and STDs, Cambodia Ministry of Health, Phnom Penh, Cambodia
| | - Rommel Bain
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bunthoeun Eng
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Phnom Penh, Cambodia
| | - Chhaily Hy
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Phnom Penh, Cambodia
| | - Alexandra Ernst
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - George W. Rutherford
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Chunfu Yang
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Vanthy Ly
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Phnom Penh, Cambodia
| | - Rachel Albalak
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Phnom Penh, Cambodia
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220
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Smith Z, Ryan V, Willson S. Using interpretive question evaluation methods to assess race and ethnicity items. Surv Pract 2023; 16:1-6. [PMID: 37994347 PMCID: PMC10660586 DOI: 10.29115/sp-2023-0026] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Recently, the Office of the Chief Statistician announced recommended revisions to the Office of Management and Budget’s (OMB) Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (SPD 15). In particular, the revisions recommend combining race and ethnicity into a single, select-all-that-apply question, including “Middle Eastern and North African” (MENA) as a new minimum category within the item, and collecting detailed race and ethnicity data in the same item (Office of Management and Budget 2023). This short piece addresses how existing interpretive approaches to question evaluation (Miller et al. 2014) assist in assessing construct validity in the context of the OMB recommended revisions. In so doing, these question evaluation methods can help answer how race and ethnicity, as constructs, can be effectively measured. While these changes present challenges, a focus on the meaning of race and ethnicity in respondents’ lives provides needed context to survey statistics, enhances survey question design, and improves the equity of data collected.
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221
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Siegel DA, King JB, Lupo PJ, Durbin EB, Tai E, Mills K, Van Dyne E, Lunsford NB, Henley SJ, Wilson RJ. Counts, incidence rates, and trends of pediatric cancer in the United States, 2003-2019. J Natl Cancer Inst 2023; 115:1337-1354. [PMID: 37433078 PMCID: PMC11018256 DOI: 10.1093/jnci/djad115] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 03/22/2023] [Revised: 06/02/2023] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Cancer is a leading cause of death by disease among children and adolescents in the United States. This study updates cancer incidence rates and trends using the most recent and comprehensive US cancer registry data available. METHODS We used data from US Cancer Statistics to evaluate counts, age-adjusted incidence rates, and trends among children and adolescents younger than 20 years of age diagnosed with malignant tumors between 2003 and 2019. We calculated the average annual percent change (APC) and APC using joinpoint regression. Rates and trends were stratified by demographic and geographic characteristics and by cancer type. RESULTS With 248 749 cases reported between 2003 and 2019, the overall cancer incidence rate was 178.3 per 1 million; incidence rates were highest for leukemia (46.6), central nervous system neoplasms (30.8), and lymphoma (27.3). Rates were highest for males, children 0 to 4 years of age, Non-Hispanic White children and adolescents, those in the Northeast census region, the top 25% of counties by economic status, and metropolitan counties with a population of 1 million people or more. Although the overall incidence rate of pediatric cancer increased 0.5% per year on average between 2003 and 2019, the rate increased between 2003 and 2016 (APC = 1.1%), and then decreased between 2016 and 2019 (APC = -2.1%). Between 2003 and 2019, rates of leukemia, lymphoma, hepatic tumors, bone tumors, and thyroid carcinomas increased, while melanoma rates decreased. Rates of central nervous system neoplasms increased until 2017, and then decreased. Rates of other cancer types remained stable. CONCLUSIONS Incidence of pediatric cancer increased overall, although increases were limited to certain cancer types. These findings may guide future public health and research priorities.
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Affiliation(s)
- 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, GA, USA
| | - Jessica B. King
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Philip J. Lupo
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Eric B. Durbin
- Kentucky Cancer Registry, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Eric Tai
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathi Mills
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth Van Dyne
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Natasha Buchanan Lunsford
- Office of the Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Reda J. Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
This Viewpoint discusses Hospital Sepsis Program Core Elements, a set of guidance provided by the Centers for Disease Control and Prevention to help hospitals develop multiprofessional programs that monitor and optimize management and outcomes of sepsis.
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Affiliation(s)
- Hallie C Prescott
- Department of Internal Medicine, University of Michigan, Ann Arbor
- VA Center for Clinical Management Research, Ann Arbor, Michigan
| | - Patricia J Posa
- Office of the Chief Nurse Officer, Adult Hospitals, University of Michigan, Ann Arbor
| | - Raymund Dantes
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
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223
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Zeleke ED, Yimer G, Lisanework L, Chen RT, Huang WT, Wang SH, Bennett SD, Makonnen E. System and facility readiness assessment for conducting active surveillance of adverse events following immunization in Addis Ababa, Ethiopia. Int Health 2023; 15:676-683. [PMID: 36622733 PMCID: PMC10472974 DOI: 10.1093/inthealth/ihac085] [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: 07/14/2022] [Revised: 09/02/2022] [Accepted: 12/17/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND To help distinguish vaccine-related adverse events following immunization (AEFI) from coincidental occurrences, active vaccine pharmacovigilance (VP) prospective surveillance programs are needed. From February to May 2021, we assessed the system and facility readiness for implementing active AEFI VP surveillance in Addis Ababa, Ethiopia. METHODS Selected hospitals were assessed using a readiness assessment tool with scoring measures. The site assessment was conducted via in-person interviews within the specific departments in each hospital. We evaluated the system readiness with a desk review of AEFI guidelines, Expanded Program for Immunization Guidelines and Ethiopian Food and Drug Administration and Ethiopian Public Health Institute websites. RESULTS Of the hospitals in Addis Ababa, 23.1% met the criteria for our site assessment. During the system readiness assessment, we found that essential components were in place. However, rules, regulations and proclamations pertaining to AEFI surveillance were absent. Based on the tool, the three hospitals (A, B and C) scored 60.6% (94/155), 48.3% (75/155) and 40% (62/155), respectively. CONCLUSIONS Only one of three hospitals assessed in our evaluation scored >50% for readiness to implement active AEFI surveillance. We also identified the following areas for improvement to ensure successful implementation: training, making guidelines and reporting forms available and ensuring a system that accommodates paper-based and electronic-based recording systems.
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Affiliation(s)
- Eden Dagnachew Zeleke
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Midwifery, College of Health Science, Bule Hora University, Bule-Hora, Ethiopia
| | - Getnet Yimer
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Ohio State University, Global One Health Initiative, Eastern Africa Regional Office, Addis Ababa, Ethiopia
| | - Leuel Lisanework
- Ohio State University, Global One Health Initiative, Eastern Africa Regional Office, Addis Ababa, Ethiopia
| | - Robert T Chen
- Brighton Collaboration, Task Force for Global Health, Decatur, GA, USA
| | - Wan-Ting Huang
- Brighton Collaboration, Task Force for Global Health, Decatur, GA, USA
| | - Shu-Hua Wang
- Department of Internal Medicine, Division of Infectious Diseases, Ohio State University, N-1120 Doan Hall, 410 West 10th Ave, Columbus, OH 43210, USA
- Ohio State University Global One Health Initiative, N-1120 Doan Hall, 410 West 10th Ave, Columbus, OH 43210, USA
| | - Sarah D Bennett
- Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop H24-2, Atlanta, GA 30333, USA
| | - Eyasu Makonnen
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmacology and Clinical Pharmacy, College of Health sciences, Addis Ababa University, Addis Ababa, Ethiopia
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224
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Lazaro G. When Positive is Negative: Health Literacy Barriers to Patient Access to Clinical Laboratory Test Results. J Appl Lab Med 2023; 8:1133-1147. [PMID: 37681277 PMCID: PMC10756206 DOI: 10.1093/jalm/jfad045] [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: 01/30/2023] [Accepted: 05/09/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Health literacy is a multidimensional set of skills (e.g., narrative, numeracy, digital, medication) that patients need to access and understand health information timely and accurately to make evidence-based informed decisions. CONTENT Multiple barriers prevent patients from effectively interacting with health information. The most salient barriers are poor overall health literacy skills and linguistic proficiency in English. As patients prefer direct access to laboratory test results, especially those of routine tests, contextualization and provider-directed interpretation of results are required to foster shared decision-making to address their healthcare issues and improve health outcomes. SUMMARY The use of systematic approaches that account for poor health literacy skills and include culturally and linguistically appropriate planning and availability of resources is warranted at individual and population health levels (e.g., human-centered design of patient portals).
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Affiliation(s)
- Gerardo Lazaro
- Division of Laboratory Systems, Centers for Disease Control and Prevention, Atlanta, GA, United States
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225
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Eisen L, Eisen RJ. Changes in the geographic distribution of the blacklegged tick, Ixodes scapularis, in the United States. Ticks Tick Borne Dis 2023; 14:102233. [PMID: 37494882 PMCID: PMC10862374 DOI: 10.1016/j.ttbdis.2023.102233] [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: 05/09/2023] [Revised: 06/29/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
Ixodes scapularis (the blacklegged tick) was considered a species of no medical concern until the mid-1970s. By that time, the tick's geographic distribution was thought to be mainly in the southeastern United States (US), with additional localized populations along the Eastern Seaboard north to southern Massachusetts and in the Upper Midwest. Since 1975, I. scapularis has been implicated as a vector of seven human pathogens and is now widely distributed across the eastern US up to the border with Canada. Geographic expansion of tick-borne diseases associated with I. scapularis (e.g., Lyme disease, anaplasmosis, and babesiosis) is attributed to an expanding range of the tick. However, due to changes in tick surveillance efforts over time, it is difficult to differentiate between range expansion and increased recognition of already established tick populations. We provide a history of the documented occurrence of I. scapularis in the US from its description in 1821 to present, emphasizing studies that provide evidence of expansion of the geographic distribution of the tick. Deforestation and decimation of the white-tailed deer (Odocoileus virginianus), the primary reproductive host for I. scapularis adults, during the 1800s presumably led to the tick disappearing from large areas of the eastern US where it previously had been established. Subsequent reforestation and deer population recovery, together with recent climate warming, contributed to I. scapularis proliferating in and spreading from refugia where it had persisted into the early 1900s. From documented tick collection records, it appears I. scapularis was present in numerous locations in the southern part of the eastern US in the early 1900s, whereas in the north it likely was limited to a small number of refugia sites during that time period. There is clear evidence for established populations of I. scapularis in coastal New York and Massachusetts by 1950, and in northwestern Wisconsin by the late 1960s. While recognizing that surveillance for I. scapularis increased dramatically from the 1980s onward, we describe multiple instances of clearly documented expansion of the tick's geographic distribution in the Northeast, Upper Midwest, and Ohio Valley regions from the 1980s to present. Spread and local population increase of I. scapularis, together with documentation of Borrelia burgdorferi sensu stricto in host-seeking ticks, was universally followed by increases in Lyme disease cases in these areas. Southward expansion of northern populations of I. scapularis, for which the host questing behavior of the nymphal stage leads to substantially higher risk of human bites compared with southern populations, into Virginia and North Carolina also was followed by rising numbers of Lyme disease cases. Ongoing surveillance of ticks and tick-borne pathogens is essential to provide the data needed for studies that seek to evaluate the relative roles of land cover, tick hosts, and climate in explaining and predicting geographic expansion of ticks and tick-borne diseases.
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Affiliation(s)
- Lars Eisen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, CO 80521, United States.
| | - Rebecca J Eisen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, CO 80521, United States
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226
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Munsey A, Kinyina A, Assenga M, Almeida A, Kitojo C, Reaves E, Simeo J, Aron S, Chacky F, Nhiga SL, Drake M, Lemwayi R, Lash R, Walker PGT, Gutman JR. Assessing the utility of pregnant women as a sentinel surveillance population for malaria in Geita, Tanzania, 2019 - 2021. Int J Infect Dis 2023; 136:57-63. [PMID: 37567552 PMCID: PMC10870194 DOI: 10.1016/j.ijid.2023.08.007] [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: 05/19/2023] [Revised: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVES Estimates of malaria burden and intervention uptake in Africa are primarily based on household surveys. However, their expense and infrequency limit their utility. We investigated whether data collected during antenatal care (ANC) can provide relevant information for decision-makers. METHODS Malaria test positivity rates and questionnaire data from ANC attendees at 39 health facilities were compared to questionnaire data and positivity rates among children from two cross-sectional surveys in the facilities' corresponding catchment areas. RESULTS Trends in parasitemia among ANC attendees were predictive of trends in parasitemia among children at the council level (mean absolute error 6.0%). Primigravid ANC attendees had the lowest rates of net ownership (modeled odds ratio [OR] 0.28, 95% CI 0.19-0.40) and use (OR 0.58, 95% CI 0.42-0.79). ANC attendees reported higher levels of care-seeking (OR 1.78, 95% CI 1.48-2.14), malaria testing (OR 4.16, 95% CI 3.44-5.04), and treatment for children with fever (OR 7.66, 95% CI 4.89-11.98) compared to women surveyed in households, raising concerns about social desirability bias disproportionately impacting ANC surveys. CONCLUSION ANC surveillance is an effective strategy for tracking trends in malaria burden. More work is required to elucidate the value of administering questionnaires to ANC attendees.
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Affiliation(s)
- Anna Munsey
- U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA.
| | | | | | | | - Chonge Kitojo
- U.S. President's Malaria Initiative, U.S. Agency for International Development (USAID), Dar es Salaam, Tanzania
| | - Erik Reaves
- U.S. President's Malaria Initiative, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | | | | | | | | | | | | | - Ryan Lash
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Patrick G T Walker
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College, London, UK
| | - Julie R Gutman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
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227
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Holcomb KM, Khalil N, Cozens DW, Cantoni JL, Brackney DE, Linske MA, Williams SC, Molaei G, Eisen RJ. Comparison of acarological risk metrics derived from active and passive surveillance and their concordance with tick-borne disease incidence. Ticks Tick Borne Dis 2023; 14:102243. [PMID: 37611506 PMCID: PMC10885130 DOI: 10.1016/j.ttbdis.2023.102243] [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: 04/05/2023] [Revised: 07/19/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023]
Abstract
Tick-borne diseases continue to threaten human health across the United States. Both active and passive tick surveillance can complement human case surveillance, providing spatio-temporal information on when and where humans are at risk for encounters with ticks and tick-borne pathogens. However, little work has been done to assess the concordance of the acarological risk metrics from each surveillance method. We used data on Ixodes scapularis and its associated human pathogens from Connecticut (2019-2021) collected through active collections (drag sampling) or passive submissions from the public to compare county estimates of tick and pathogen presence, infection prevalence, and tick abundance by life stage. Between the surveillance strategies, we found complete agreement in estimates of tick and pathogen presence, high concordance in infection prevalence estimates for Anaplasma phagocytophilum, Borrelia burgdorferi sensu stricto, and Babesia microti, but no consistent relationships between actively and passively derived estimates of tick abundance or abundance of infected ticks by life stage. We also compared nymphal metrics (i.e., pathogen prevalence in nymphs, nymphal abundance, and abundance of infected nymphs) with reported incidence of Lyme disease, anaplasmosis, and babesiosis, but did not find any consistent relationships with any of these metrics. The small spatial and temporal scale for which we had consistently collected active and passive data limited our ability to find significant relationships. Findings are likely to differ if examined across a broader spatial or temporal coverage with greater variation in acarological and epidemiological outcomes. Our results indicate similar outcomes between some actively and passively derived tick surveillance metrics (tick and pathogen presence, pathogen prevalence), but comparisons were variable for abundance estimates.
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Affiliation(s)
- Karen M Holcomb
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States.
| | - Noelle Khalil
- Center for Vector Biology and Zoonotic Diseases, The Connecticut Agricultural Experiment Station, New Haven, CT, United States
| | - Duncan W Cozens
- Center for Vector Biology and Zoonotic Diseases, The Connecticut Agricultural Experiment Station, New Haven, CT, United States
| | - Jamie L Cantoni
- Center for Vector Biology and Zoonotic Diseases, The Connecticut Agricultural Experiment Station, New Haven, CT, United States
| | - Doug E Brackney
- Center for Vector Biology and Zoonotic Diseases, The Connecticut Agricultural Experiment Station, New Haven, CT, United States
| | - Megan A Linske
- Center for Vector Biology and Zoonotic Diseases, The Connecticut Agricultural Experiment Station, New Haven, CT, United States
| | - Scott C Williams
- Center for Vector Biology and Zoonotic Diseases, The Connecticut Agricultural Experiment Station, New Haven, CT, United States
| | - Goudarz Molaei
- Center for Vector Biology and Zoonotic Diseases, The Connecticut Agricultural Experiment Station, New Haven, CT, United States; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
| | - Rebecca J Eisen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States
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228
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Velazquez-Kronen R, MacDonald LA, Akinyemiju TF, Cushman M, Howard VJ. Shiftwork, long working hours and markers of inflammation in a national US population-based sample of employed black and white men and women aged ≥45 years. Occup Environ Med 2023; 80:635-643. [PMID: 37813482 PMCID: PMC10936900 DOI: 10.1136/oemed-2023-108902] [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: 03/03/2023] [Accepted: 09/19/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES Work schedule demands contribute to circadian disruption and may influence health via an inflammatory response. We examined the impact of shiftwork and long work hours on inflammation in a national US sample. METHODS Participants included 12 487 employed black and white men and women aged ≥45 years enrolled in the REasons for Geographic and Racial Differences in Stroke Study who completed an occupational questionnaire (2011-2013) and clinical examination (2013-2016). Cross-sectional associations between shiftwork and work hours with log-transformed high-sensitivity C reactive protein (CRP) and white blood cell (WBC) count were examined by multiple linear regression analysis, overall and by race-sex subgroups. RESULTS Overall, rotating shift workers had higher log-CRP concentration compared with day workers (β=0.09, 95% CI:0.02 to 0.16) and findings for WBC were null. Black women had the highest geometric mean CRP (2.82 mg/L), while white men had the highest WBC (6.35×109/L). White men who worked afternoons had higher log-CRP compared with those who worked days (β=0.20, 95% CI: 0.08 to 0.33). Black men engaged in shiftwork <10 years working ≥55 hours/week had higher log-CRP and log-WBC compared with those working days <55 hours/week (β=0.33, 95% CI: 0.02 to 0.64 and β=0.10, 95% CI: 0.003 to 0.19). Among shift workers, non-retired white women working forward and backward shift rotations had higher log-CRP compared with those working forward only (β=0.49, 95% CI: 0.02 to 0.96). CONCLUSIONS Shift workers had higher inflammatory markers compared with day workers and race-sex disparities should be examined further. These findings highlight a potential biological pathway linking work schedule demands and chronic disease.
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Affiliation(s)
- Raquel Velazquez-Kronen
- Field Research Branch, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Leslie A MacDonald
- Field Research Branch, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Tomi F Akinyemiju
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Abstract
BACKGROUND Little is known about the role of air quality in fatal asthma exacerbations among children. METHODS We collected information about 80 deaths that occurred in North Carolina from 2001 through 2016, among children aged 5-17 years, with asthma identified as the primary cause of death. We linked information about each death with county-level estimates of particulate matter ≤2.5 µm (PM2.5) and ozone (O3). Using the linked data, we conducted a case-crossover analysis of associations between PM2.5 and O3 lagged by 3-5 days with the odds of fatal asthma exacerbations. RESULTS In the highest tertile of PM2.5 lag(3-5), the odds of a fatal exacerbation of asthma were more than twice the odds in the lowest tertile (odds ratio = 2.2; 95% confidence interval = 1.1, 4.6). CONCLUSION These findings from North Carolina provide evidence to support the hypothesis that ambient air pollution increases the risk of fatal exacerbations of asthma among children.
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Affiliation(s)
- Maria C. Mirabelli
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - W. Dana Flanders
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Ambarish Vaidyanathan
- Climate and Health Program, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Daniel P. Beavers
- Department of Statistical Sciences, Wake Forest University, Winston-Salem, NC
| | - W. Adam Gower
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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230
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Kaur G, Perry RT. Preventing measles in children and adolescents with HIV. AIDS 2023; 37:2087-2089. [PMID: 37755425 PMCID: PMC10683796 DOI: 10.1097/qad.0000000000003649] [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: 09/28/2023]
Affiliation(s)
- Gurpreet Kaur
- Global Immunization Division, Center for Global Health, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert T. Perry
- Global Immunization Division, Center for Global Health, Atlanta, Georgia, USA
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231
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Chan PA, Le Brazidec DL, Becasen JS, Martin H, Kapadia J, Reno H, Bachmann L, Barbee LA. Safety of Longer-Term Doxycycline Use: A Systematic Review and Meta-Analysis With Implications for Bacterial Sexually Transmitted Infection Chemoprophylaxis. Sex Transm Dis 2023; 50:701-712. [PMID: 37732844 PMCID: PMC10592014 DOI: 10.1097/olq.0000000000001865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
BACKGROUND Sexually transmitted infections (STIs) such as syphilis, gonorrhea, and chlamydia have significantly increased over the past decade in the United States. Doxycycline as chemoprophylaxis (i.e., postexposure prophylaxis) offers promise for addressing bacterial STIs. The goal of the current study was to evaluate the safety of longer-term doxycycline use (defined as 8 or more weeks) in the context of potential use as STI chemoprophylaxis through a systematic literature review and meta-analysis. METHODS This review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to search MEDLINE/PubMed for clinical studies published from August 2003 to January 2023 that reported on adverse events with doxycycline use with a focus on side effects and metabolic effects of long-term use. RESULTS A total of 67 studies were included in the systematic review. Overall, studies on longer-term doxycycline use reported 0% to greater than 50% adverse events ranging from mild to severe. Most common adverse events included gastrointestinal symptoms (i.e., nausea, vomiting, and abdominal pain), dermatologic (i.e., rash), and neurological (i.e., headache and dizziness) symptoms. Discontinuation of doxycycline due to adverse events was relatively uncommon in most studies. A meta-analysis of placebo controlled clinical trials (N = 18) revealed that gastrointestinal and dermatological adverse events were more likely to occur in the doxycycline group. CONCLUSIONS Longer-term (8+ weeks) doxycycline use is generally safe and may be associated with minor side effects. Further research is needed on the potential metabolic impact of longer-term doxycycline use.
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Affiliation(s)
- Philip A. Chan
- Department of Medicine, Brown University, Providence, Rhode Island, USA
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Jeffrey S. Becasen
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Harrison Martin
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Jhanavi Kapadia
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Hilary Reno
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Laura Bachmann
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindley A. Barbee
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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232
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Bohm MK, Esser MB. Associations Between Parental Drinking and Alcohol Use Among Their Adolescent Children: Findings From a National Survey of United States Parent-Child Dyads. J Adolesc Health 2023; 73:961-964. [PMID: 37715766 PMCID: PMC10592189 DOI: 10.1016/j.jadohealth.2023.05.028] [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: 02/02/2023] [Revised: 05/17/2023] [Accepted: 05/27/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE Underage drinking is common and costly. This study examined associations between parent and child drinking using recent United States national survey data. METHODS We analyzed responses of 740 parent-child dyads from 2020 SummerStyles and YouthStyles surveys. Parents and their adolescent children answered questions about past 30-day alcohol use. We estimated prevalence of adolescent drinking and explored differences by sociodemographics. A multivariable logistic regression model assessed whether parents' drinking behaviors were associated with drinking among their children. RESULTS Overall, 6.6% of adolescents drank alcohol, with no significant differences by sociodemographics. Adolescents whose parents drank frequently (≥5 days/month), or binge drank, had significantly higher odds of drinking than adolescents whose parents did not drink or did not binge drink, respectively. DISCUSSION Parents could drink less to reduce the likelihood of drinking among their children. Implementation of effective population-level strategies (e.g., increasing alcohol taxes, regulating alcohol sales) can reduce excessive drinking among both adults and adolescents.
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Affiliation(s)
- Michele K. Bohm
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS-S107-6, Atlanta, GA 30341 USA
| | - Marissa B. Esser
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS-S107-6, Atlanta, GA 30341 USA
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233
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Rikard SM, Strahan AE, Schmit KM, Guy GP. Prevalence of Pharmacologic and Nonpharmacologic Pain Management Therapies Among Adults With Chronic Pain-United States, 2020. Ann Intern Med 2023; 176:1571-1575. [PMID: 37983788 PMCID: PMC10711739 DOI: 10.7326/m23-2004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Affiliation(s)
- S Michaela Rikard
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrea E Strahan
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristine M Schmit
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gery P Guy
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Bartels CM, Jorge A, Feldman CH, Zell J, Bermas B, Barber CEH, Duarte-García A, Garg S, Haseley L, Jatwani S, Johansson T, Limanni A, Rodgers W, Rovin BH, Santiago-Casas Y, Suter LG, Barnado A, Ude J, Aguirre A, Li J, Schmajuk G, Yazdany J. Development of American College of Rheumatology Quality Measures for Systemic Lupus Erythematosus: A Modified Delphi Process With Rheumatology Informatics System for Effectiveness (RISE) Registry Data Review. Arthritis Care Res (Hoboken) 2023; 75:2295-2305. [PMID: 37165898 PMCID: PMC10615706 DOI: 10.1002/acr.25143] [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: 01/04/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE We aimed to develop readily measurable digital quality measure statements for clinical care in systemic lupus erythematosus (SLE) using a multistep process guided by consensus methods. METHODS Using a modified Delphi process, an American College of Rheumatology (ACR) workgroup of SLE experts reviewed all North American and European guidelines from 2000 to 2020 on treatment, monitoring, and phenotyping of patients with lupus. Workgroup members extracted quality constructs from guidelines, rated these by importance and feasibility, and generated evidence-based quality measure statements. The ACR Rheumatology Informatics System for Effectiveness (RISE) Registry was queried for measurement data availability. In 3 consecutive Delphi sessions, a multidisciplinary Delphi panel voted on the importance and feasibility of each statement. Proposed measures with consensus on feasibility and importance were ranked to identify the top 3 measures. RESULTS Review of guidelines and distillation of 57 quality constructs resulted in 15 quality measure statements. Among these, 5 met high consensus for importance and feasibility, including 2 on treatment and 3 on laboratory monitoring measures. The 3 highest-ranked statements were recommended for further measure specification as SLE digital quality measures: 1) hydroxychloroquine use, 2) limiting glucocorticoid use >7.5 mg/day to <6 months, and 3) end-organ monitoring of kidney function and urine protein excretion at least every 6 months. CONCLUSION The Delphi process selected 3 quality measures for SLE care on hydroxychloroquine, glucocorticoid reduction, and kidney monitoring. Next, measures will undergo specification and validity testing in RISE and US rheumatology practices as the foundation for national implementation and use in quality improvement programs.
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Affiliation(s)
| | | | | | | | | | | | | | - Shivani Garg
- University of Wisconsin School of Medicine and Public Health, Madison
| | | | | | | | | | - Wendy Rodgers
- Lupus Foundation Care and Support Services, Los Angeles, California
| | - Brad H Rovin
- Ohio State University Wexner Medical Center, Columbus
| | | | - Lisa G Suter
- Yale School of Medicine, New Haven, and Veterans Administration Medical Center, West Haven, Connecticut
| | - April Barnado
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jennifer Ude
- American College of Rheumatology, Atlanta, Georgia
| | | | - Jing Li
- University of California San Francisco
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Krajewski AK, Patel A, Gray CL, Messer LC, Keeler CY, Langlois PH, Reefhuis J, Gilboa SM, Werler MM, Shaw GM, Carmichael SL, Nembhard WN, Insaf TZ, Feldkamp ML, Conway KM, Lobdell DT, Desrosiers TA. Is gastroschisis associated with county-level socio-environmental quality during pregnancy? Birth Defects Res 2023; 115:1758-1769. [PMID: 37772934 PMCID: PMC10878499 DOI: 10.1002/bdr2.2250] [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: 07/17/2023] [Accepted: 08/31/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Gastroschisis prevalence more than doubled between 1995 and 2012. While there are individual-level risk factors (e.g., young maternal age, low body mass index), the impact of environmental exposures is not well understood. METHODS We used the U.S. Environmental Protection Agency's Environmental Quality Index (EQI) as a county-level estimate of cumulative environmental exposures for five domains (air, water, land, sociodemographic, and built) and overall from 2006 to 2010. Adjusted odds ratios (aOR) and 95% confidence interval (CI) were estimated from logistic regression models between EQI tertiles (better environmental quality (reference); mid; poorer) and gastroschisis in the National Birth Defects Prevention Study from births delivered between 2006 and 2011. Our analysis included 594 cases with gastroschisis and 4105 infants without a birth defect (controls). RESULTS Overall EQI was modestly associated with gastroschisis (aOR [95% CI]: 1.29 [0.98, 1.71]) for maternal residence in counties with poorer environmental quality, compared to the reference (better environmental quality). Within domain-specific indices, only the sociodemographic domain (aOR: 1.51 [0.99, 2.29]) was modestly associated with gastroschisis, when comparing poorer to better environmental quality. CONCLUSIONS Future work could elucidate pathway(s) by which components of the sociodemographic domain or possibly related psychosocial factors like chronic stress potentially contribute to risk of gastroschisis.
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Affiliation(s)
- Alison K. Krajewski
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, Center for Public Health & Environmental Assessment, Research Triangle Park, North Carolina, USA
| | - Achal Patel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | | | - Corinna Y. Keeler
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Peter H. Langlois
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health—Austin Regional Campus, Austin, Texas, USA
| | - Jennita Reefhuis
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Infant Disorders, Atlanta, Georgia, USA
| | - Suzanne M. Gilboa
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Infant Disorders, Atlanta, Georgia, USA
| | - Martha M. Werler
- Department of Epidemiology, Boston University, School of Public Health, Boston, Massachusetts, USA
| | - Gary M. Shaw
- Stanford University, School of Medicine, Stanford, California, USA
| | | | - Wendy N. Nembhard
- Department of Epidemiology, University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, Little Rock, Arkansas, USA
| | - Tabassum Z. Insaf
- New York State Department of Health, Center for Environmental Health, Bureau of Environmental and Occupational Epidemiology, Albany, New York, USA
- Department of Epidemiology and Biostatistics, University at Albany, Albany, New York, USA
| | - Marcia L. Feldkamp
- Department of Pediatrics, Division of Medical Genetics, University of Utah, Salt Lake City, Utah, USA
| | - Kristin M. Conway
- Department of Epidemiology, The University of Iowa, College of Public Health, Iowa City, Iowa, USA
| | - Danelle T. Lobdell
- United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, Center for Public Health & Environmental Assessment, Research Triangle Park, North Carolina, USA
| | - Tania A. Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Nawrocki CC, Piedmonte N, Niesobecki SA, Rowe A, Hansen AP, Kaufman A, Foster E, Meek JI, Niccolai L, White J, Backenson B, Eisen L, Hook SA, Connally NP, Hornbostel VL, Hinckley AF. Acceptability of 4-poster deer treatment devices for community-wide tick control among residents of high Lyme disease incidence counties in Connecticut and New York, USA. Ticks Tick Borne Dis 2023; 14:102231. [PMID: 37531890 PMCID: PMC10883357 DOI: 10.1016/j.ttbdis.2023.102231] [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: 04/27/2023] [Revised: 06/12/2023] [Accepted: 07/14/2023] [Indexed: 08/04/2023]
Abstract
The 4-Poster Tick Control Deer Feeder (4-poster) device applies acaricide to white-tailed deer (Odocoileus virginianus) and can reduce populations of the blacklegged tick (Ixodes scapularis), which transmits the agents of Lyme disease, anaplasmosis, babesiosis, and Powassan virus disease in the Northeastern United States. While 4-poster devices have the potential to provide community-wide management of blacklegged ticks in Lyme disease endemic areas, no recent study has assessed their acceptability among residents. We conducted a survey of residents from 16 counties with high annual average Lyme disease incidence (≥ 10 cases per 100,000 persons between 2013 and 2017) in Connecticut and New York to understand perceptions and experiences related to tickborne diseases, support or concerns for placement of 4-poster devices in their community, and opinions on which entities should be responsible for tick control on private properties. Overall, 37% of 1652 respondents (5.5% response rate) would support placement of a 4-poster device on their own property, 71% would support placement on other private land in their community, and 90% would support placement on public land. Respondents who were male, rented their property, resided on larger properties, or were very or extremely concerned about encountering ticks on their property were each more likely to support placement of 4-poster devices on their own property. The primary reason for not supporting placement of a 4-poster device on one's own property was the need for weekly service visits from pest control professionals, whereas the top reason for not supporting placement on other land (private or public) was safety concerns. Most respondents (61%) felt property owners should be responsible for tick control on private properties. Communities considering 4-poster devices as part of a tick management strategy should consider targeting owners of larger properties and placing devices on public lands.
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Affiliation(s)
- Courtney C Nawrocki
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA.
| | - Nicholas Piedmonte
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Sara A Niesobecki
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Adam Rowe
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - AmberJean P Hansen
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Alison Kaufman
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Erik Foster
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - James I Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Linda Niccolai
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Jennifer White
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Bryon Backenson
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Lars Eisen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Sarah A Hook
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Neeta P Connally
- Department of Biology, Western Connecticut State University, Danbury, CT, USA
| | | | - Alison F Hinckley
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
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237
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Chun HM, Milligan K, Boyd MA, Abutu A, Bachanas P, Dirlikov E. Reaching HIV epidemic control in Nigeria using a lower HIV viral load suppression cut-off. AIDS 2023; 37:2081-2085. [PMID: 37503650 PMCID: PMC10990556 DOI: 10.1097/qad.0000000000003672] [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: 07/29/2023]
Abstract
BACKGROUND Virologic suppression has been defined using a HIV viral load of less than 1000 copies/ml. Low-level viremia (51-999 copies/ml) is associated with an increased risk of virologic failure and HIV drug resistance. METHODS Retrospective data from persons with HIV (PWH) who initiated ART between January 2016 and September 2022 in Nigeria were analyzed for virologic suppression at cut-off values less than 1000 copies/ml. RESULTS In 2022, virologic suppression at less than 1000 copies/ml was 95.7%. Using cut-off values of less than 400, less than 200 and less than 50 copies/ml, virologic suppression was 94.2%, 92.5%, and 87%, respectively. DISCUSSION Monitoring virologic suppression using lower cut-off values, alongside differentiated management of low-level viremia, may help Nigeria achieve HIV epidemic control targets.
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Affiliation(s)
- Helen M. Chun
- Division of Global HIV/TB, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kyle Milligan
- Division of Global HIV/TB, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA
- Peraton, Herndon, VA, USA
| | - Mary Adetinuke Boyd
- Division of Global HIV/TB, Global Health Center, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Andrew Abutu
- Division of Global HIV/TB, Global Health Center, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Pamela Bachanas
- Division of Global HIV/TB, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA
| | - Emilio Dirlikov
- Division of Global HIV/TB, Global Health Center, Centers for Disease Control and Prevention, Kampala, Uganda
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238
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Ware JL, Li R, Chen A, Nelson JM, Kmet JM, Parks SE, Morrow AL, Chen J, Perrine CG. Associations Between Breastfeeding and Post-perinatal Infant Deaths in the U.S. Am J Prev Med 2023; 65:763-774. [PMID: 37220859 PMCID: PMC10897060 DOI: 10.1016/j.amepre.2023.05.015] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/15/2023] [Accepted: 05/15/2023] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Initiation of breastfeeding has been associated with reduced post-perinatal infant mortality. Although most states have initiatives to protect, promote, and support breastfeeding, no analysis of the association between breastfeeding and infant mortality has been conducted at the state and regional levels. To understand the associations between breastfeeding and post-perinatal infant mortality, the initiation of breastfeeding with post-perinatal infant mortality was analyzed by geographic region and individual states within each region. METHODS This study was a prospective cohort analysis linking U.S. national birth and post-perinatal infant death data for nearly 10 million infants born in 2016-2018, who were then followed for one year after birth and analyzed in 2021-2022. RESULTS A total of 9,711,567 live births and 20,632 post-perinatal infant deaths from 48 states and the District of Columbia were included in the analysis. The overall AOR and 95% CIs for breastfeeding initiation with post-perinatal infant mortality was 0.67 (0.65, 0.69, p<0.0001) for days 7-364. All seven U.S. geographic regions had significant reductions in postperinatal infant deaths associated with breastfeeding initiation; Mid-Atlantic and Northeast regions had the largest reductions with AOR of 0.56 (95% CI=0.51, 0.61, p<0.001 and 0.50, 0.63, p<0.001, respectively), whereas the Southeast had the smallest reduction with AOR of 0.79 (95% CI=0.75, 0.84, p<0.001). Statistically significant results were noted for 35 individual states for reduction in total post-perinatal infant deaths. CONCLUSIONS Although regional and state variation in the magnitude of the association between breastfeeding and infant mortality exists, the consistency of reduced risk, together with existing literature, suggests that breastfeeding promotion and support may be a strategy to reduce infant mortality in the U.S.
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Affiliation(s)
- Julie L Ware
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
| | - Ruowei Li
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aimin Chen
- Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Center of Excellence in Environmental Toxicology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jennifer M Nelson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service, Rockville, Maryland
| | - Jennifer M Kmet
- Bureau of Epidemiology, Informatics, and Emergency Preparedness, Shelby County Health Department, Memphis, Tennessee
| | - Sharyn E Parks
- U.S. Public Health Service, Rockville, Maryland; Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ardythe L Morrow
- Division of Epidemiology, Department of Environmental & Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jian Chen
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - 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; U.S. Public Health Service, Rockville, Maryland
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239
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Fliss MD, Cox ME, Proescholdbell S, Patel A, Smith M. Tying Overdose Data to Action: North Carolina's Opioid and Substance Use Action Plan Data Dashboard. J Public Health Manag Pract 2023; 29:831-834. [PMID: 37498535 PMCID: PMC10526884 DOI: 10.1097/phh.0000000000001796] [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: 07/28/2023]
Abstract
From 2000 to 2020, more than 28 000 North Carolina (NC) residents died of drug overdose. In response, NC Department of Health and Human Services worked with community partners to develop an Opioid and Substance Use Action Plan (OSUAP), now in its third iteration. The NC OSUAP data dashboard brings together data on 15 public health indicators and 16 local actions across 8 strategies. We share innovations in design, data structures, user tasks, and visual elements over 5 years of dashboard development and maintenance, with a special focus and supplemental material covering the technical details and techniques that dashboard design and implementation teams may benefit from.
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Affiliation(s)
- Mike Dolan Fliss
- University of North Carolina Injury Prevention Research Center, Chapel Hill, North Carolina (Dr Fliss); and Injury & Violence Prevention Branch, NC Division of Public Health, Raleigh, North Carolina (Dr Fliss, Mss Cox, Patel, and Smith, and Mr Proescholdbell)
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240
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Evans SP, Ailes EC, Kramer MR, Shumate CJ, Reefhuis J, Insaf TZ, Yazdy MM, Carmichael SL, Romitti PA, Feldkamp ML, Neo DT, Nembhard WN, Shaw GM, Palmi E, Gilboa SM. Neighborhood Deprivation and Neural Tube Defects. Epidemiology 2023; 34:774-785. [PMID: 37757869 PMCID: PMC10928547 DOI: 10.1097/ede.0000000000001655] [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: 09/29/2023]
Abstract
BACKGROUND Individual measures of socioeconomic status (SES) have been associated with an increased risk of neural tube defects (NTDs); however, the association between neighborhood SES and NTD risk is unknown. Using data from the National Birth Defects Prevention Study (NBDPS) from 1997 to 2011, we investigated the association between measures of census tract SES and NTD risk. METHODS The study population included 10,028 controls and 1829 NTD cases. We linked maternal addresses to census tract SES measures and used these measures to calculate the neighborhood deprivation index. We used generalized estimating equations to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) estimating the impact of quartiles of census tract deprivation on NTDs adjusting for maternal race-ethnicity, maternal education, and maternal age at delivery. RESULTS Quartiles of higher neighborhood deprivation were associated with NTDs when compared with the least deprived quartile (Q2: aOR = 1.2; 95% CI = 1.0, 1.4; Q3: aOR = 1.3, 95% CI = 1.1, 1.5; Q4 (highest): aOR = 1.2; 95% CI = 1.0, 1.4). Results for spina bifida were similar; however, estimates for anencephaly and encephalocele were attenuated. Associations differed by maternal race-ethnicity. CONCLUSIONS Our findings suggest that residing in a census tract with more socioeconomic deprivation is associated with an increased risk for NTDs, specifically spina bifida.
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Affiliation(s)
- Shannon Pruitt Evans
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
- Eagle Global Scientific LLC, San Antonio, TX
| | - Elizabeth C. Ailes
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael R. Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Charles J. Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX
| | - Jennita Reefhuis
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Tabassum Z. Insaf
- New York State Department of Health, Albany, NY
- School of Public Health, University at Albany, Rensselaer, NY
| | - Mahsa M. Yazdy
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA
| | - Suzan L. Carmichael
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Paul A. Romitti
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Marcia L. Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - Dayna T. Neo
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Wendy N. Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Gary M. Shaw
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Elizabeth Palmi
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Suzanne M. Gilboa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
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241
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Zervaki O, Dionysiou DD, Kulkarni P. Characterization of a multi-stage focusing nozzle for collection of spot samples for aerosol chemical analysis. J Aerosol Sci 2023; 174:10.1016/j.jaerosci.2023.106235. [PMID: 37799132 PMCID: PMC10548431 DOI: 10.1016/j.jaerosci.2023.106235] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Concentrated collection of aerosol particles on a substrate is essential for their chemical analysis using various microscopy and laser spectroscopic techniques. An impaction-based aerosol concentration system was developed for focused collection of particles using a multi-stage nozzle that consists of a succession of multiple smooth converging stages. Converging sections of the nozzle were designed to focus and concentrate a particle diameter range of 900-2500 nm into a relatively narrower particle beam to obtain particulate deposits with spot diameters of 0.5-1.56 mm. A slightly diverging section before the last contractions was included to allow for better focusing of particles at the lower end of the collectable diameter range. The characterization of this multi-stage nozzle and the impaction-based aerosol concentration system was accomplished both numerically and experimentally. The numerical and experimental trends in collection efficiency and spot diameters agreed well qualitatively; however, the quantitative agreement between numerical and experimental results for wall losses was poor, particularly for larger particle diameters. The resulting concentrated particulate deposit, a spot sample, was analysed using Raman spectroscopy to probe the effect of spot size on analytical sensitivity of measurement. The method's sensitivity was compared against other conventional techniques, such as filtration and aerosol focused impaction, implementing condensational growth. Impaction encompassing the multi-stage focusing nozzle is the only method that can ensure high sensitivity at Reynolds numbers greater than 2000, that can be supported by small pumps which renders such method suitable for portable instrumentation.
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Affiliation(s)
- Orthodoxia Zervaki
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, OH, 45226, United States
- Environmental Engineering and Science Program, Department of Chemical and Environmental Engineering (ChEE), University of Cincinnati, Cincinnati, OH, 45221, United States
| | - Dionysios D. Dionysiou
- Environmental Engineering and Science Program, Department of Chemical and Environmental Engineering (ChEE), University of Cincinnati, Cincinnati, OH, 45221, United States
| | - Pramod Kulkarni
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, OH, 45226, United States
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242
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Wambua D, Roman W, Vidanage I, Vidal M, Calafat AM, Ospina M. Online solid phase extraction high-performance liquid chromatography - Isotope dilution - Tandem mass spectrometry quantification of organophosphate pesticides, synthetic pyrethroids, and selected herbicide metabolites in human urine. Chemosphere 2023; 340:139863. [PMID: 37598954 PMCID: PMC10530585 DOI: 10.1016/j.chemosphere.2023.139863] [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: 06/02/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/22/2023]
Abstract
Analytical methods to quantify pesticide biomarkers in human population studies are critical for exposure assessment given the widespread use of pesticides for pest and weed control and their potential for affecting human health. We developed a method to quantify, in 0.2 mL of urine, concentrations of 10 pesticide biomarkers: four organophosphate insecticide metabolites (3,5,6-trichloro-2-pyridinol (TCPy), 2-isopropyl-6-methyl-4-pyrimidinol, para-nitrophenol, malathion dicarboxylic acid); five synthetic pyrethroid insecticide metabolites (4-fluoro-3-phenoxybenzoic acid, 3-phenoxybenzoic acid, cis and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (DCCA), cis-3-(2,2-dibromovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid); and the herbicide 2,4-dichlorophenoxyacetic acid. he method is based on enzymatic hydrolysis of conjugated urinary metabolites, extraction and pre-concentration of the deconjugated metabolites using automated online solid-phase extraction, and separation and quantification using liquid chromatography-isotope dilution tandem mass spectrometry. Depending on the analyte, method detection limits were 0.1-0.6 ng/mL; mean accuracy, calculated as spike recoveries, was 91-102%, and total precision, given as percent variation coefficient, was 5.9-11.5%. Percent differences associated with three freeze-thaw cycles, 24-h benchtop storage, and short-term processed sample stability were <14%. Method suitability was assessed by recurring successful participation in external quality assessment schemes and by analyzing samples from subjects with suspected exposure to pesticides (n = 40) or who self-reported consuming an organic diet (n = 50). Interquartile ranges were considerably lower for people consuming an organic diet than for those potentially exposed for cis-DCCA (0.37 ng/mL vs 0.75 ng/mL), trans-DCCA (0.88 ng/mL vs 1.78 ng/mL) and TCPy (1.81 ng/mL vs 2.48 ng/mL). This method requires one-fifth of the sample used in our previous method and is suitable for assessing background exposures to select pesticides in large human populations and for studies with limited sample volumes.
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Affiliation(s)
- Dickson Wambua
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S103-2, Atlanta, GA, 30341, USA.
| | - William Roman
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S103-2, Atlanta, GA, 30341, USA
| | - Isuru Vidanage
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S103-2, Atlanta, GA, 30341, USA
| | - Meghan Vidal
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S103-2, Atlanta, GA, 30341, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S103-2, Atlanta, GA, 30341, USA
| | - Maria Ospina
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S103-2, Atlanta, GA, 30341, USA
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243
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Schappert SM, Santo L, Ward BW, Ashman JJ, DeFrances CJ. NHAMCS has been a trusted source of data for healthcare disparities research since 1992. Public Health Nurs 2023; 40:811-812. [PMID: 37495542 PMCID: PMC10811283 DOI: 10.1111/phn.13231] [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: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Affiliation(s)
- Susan M Schappert
- Division of Health Care Statistics, National Center for Health Statistics, Hyattsville, Maryland
| | - Loredana Santo
- Division of Health Care Statistics, National Center for Health Statistics, Hyattsville, Maryland
| | - Brian W Ward
- Division of Health Care Statistics, National Center for Health Statistics, Hyattsville, Maryland
| | - Jill J Ashman
- Division of Health Care Statistics, National Center for Health Statistics, Hyattsville, Maryland
| | - Carol J DeFrances
- Division of Health Care Statistics, National Center for Health Statistics, Hyattsville, Maryland
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244
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Shi H, Book W, Raskind-Hood C, Downing KF, Farr SL, Bell MN, Sameni R, Rodriguez FH, Kamaleswaran R. A machine learning model for predicting congenital heart defects from administrative data. Birth Defects Res 2023; 115:1693-1707. [PMID: 37681293 PMCID: PMC10841295 DOI: 10.1002/bdr2.2245] [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: 07/08/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION International Classification of Diseases (ICD) codes recorded in administrative data are often used to identify congenital heart defects (CHD). However, these codes may inaccurately identify true positive (TP) CHD individuals. CHD surveillance could be strengthened by accurate CHD identification in administrative records using machine learning (ML) algorithms. METHODS To identify features relevant to accurate CHD identification, traditional ML models were applied to a validated dataset of 779 patients; encounter level data, including ICD-9-CM and CPT codes, from 2011 to 2013 at four US sites were utilized. Five-fold cross-validation determined overlapping important features that best predicted TP CHD individuals. Median values and 95% confidence intervals (CIs) of area under the receiver operating curve, positive predictive value (PPV), negative predictive value, sensitivity, specificity, and F1-score were compared across four ML models: Logistic Regression, Gaussian Naive Bayes, Random Forest, and eXtreme Gradient Boosting (XGBoost). RESULTS Baseline PPV was 76.5% from expert clinician validation of ICD-9-CM CHD-related codes. Feature selection for ML decreased 7138 features to 10 that best predicted TP CHD cases. During training and testing, XGBoost performed the best in median accuracy (F1-score) and PPV, 0.84 (95% CI: 0.76, 0.91) and 0.94 (95% CI: 0.91, 0.96), respectively. When applied to the entire dataset, XGBoost revealed a median PPV of 0.94 (95% CI: 0.94, 0.95). CONCLUSIONS Applying ML algorithms improved the accuracy of identifying TP CHD cases in comparison to ICD codes alone. Use of this technique to identify CHD cases would improve generalizability of results obtained from large datasets to the CHD patient population, enhancing public health surveillance efforts.
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Affiliation(s)
- Haoming Shi
- Department of Biomedical Engineering, Georgia Institute Technology, Atlanta, Georgia, USA
| | - Wendy Book
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, Georgia, USA
| | - Cheryl Raskind-Hood
- Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, Georgia, USA
| | - Karrie F. Downing
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sherry L. Farr
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary N. Bell
- Department of Biomedical Engineering, Georgia Institute Technology, Atlanta, Georgia, USA
| | - Reza Sameni
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Fred H. Rodriguez
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Rishikesan Kamaleswaran
- Department of Biomedical Engineering, Georgia Institute Technology, Atlanta, Georgia, USA
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA
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Bohrerova Z, Brinkman NE, Chakravarti R, Chattopadhyay S, Faith SA, Garland J, Herrin J, Hull N, Jahne M, Kang DW, Keely SP, Lee J, Lemeshow S, Lenhart J, Lytmer E, Malgave D, Miao L, Minard-Smith A, Mou X, Nagarkar M, Quintero A, Savona FDR, Senko J, Slonczewski JL, Spurbeck RR, Sovic MG, Taylor RT, Weavers LK, Weir M. Ohio Coronavirus Wastewater Monitoring Network: Implementation of Statewide Monitoring for Protecting Public Health. J Public Health Manag Pract 2023; 29:845-853. [PMID: 37738597 PMCID: PMC10539008 DOI: 10.1097/phh.0000000000001783] [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: 09/24/2023]
Abstract
CONTEXT Prior to the COVID-19 pandemic, wastewater influent monitoring for tracking disease burden in sewered communities was not performed in Ohio, and this field was only on the periphery of the state academic research community. PROGRAM Because of the urgency of the pandemic and extensive state-level support for this new technology to detect levels of community infection to aid in public health response, the Ohio Water Resources Center established relationships and support of various stakeholders. This enabled Ohio to develop a statewide wastewater SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) monitoring network in 2 months starting in July 2020. IMPLEMENTATION The current Ohio Coronavirus Wastewater Monitoring Network (OCWMN) monitors more than 70 unique locations twice per week, and publicly available data are updated weekly on the public dashboard. EVALUATION This article describes the process and decisions that were made during network initiation, the network progression, and data applications, which can inform ongoing and future pandemic response and wastewater monitoring. DISCUSSION Overall, the OCWMN established wastewater monitoring infrastructure and provided a useful tool for public health professionals responding to the pandemic.
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Affiliation(s)
- Zuzana Bohrerova
- Ohio Water Resources Center (Drs Bohrerova, Lenhart, and Weavers), Civil, Environmental and Geodetic Engineering (Drs Bohrerova, Hull, Lenhart, and Weavers), Infectious Diseases Institute (Drs Faith and Lee and Ms Savona), Sustainability Institute (Dr Hull), Department of Food Science & Technology (Dr Lee), and Center for Applied Plant Sciences (Dr Sovic), The Ohio State University, Columbus, Ohio; Office of Research and Development, US Environmental Protection Agency, Washington, District of Columbia (Drs Brinkman, Garland, Jahne, Keely, and Nagarkar); Departments of Physiology and Pharmacology (Dr Chakravarti) and Medical Microbiology and Immunology (Drs Chattopadhyay and Taylor), University of Toledo College of Medicine and Life Sciences, Toledo, Ohio; LuminUltra Technologies Inc, Hialeah, Florida (Mr Herrin and Dr Quintero); Department of Civil and Environmental Engineering, University of Toledo, Toledo, Ohio (Dr Kang); Divisions of Environmental Health Sciences (Drs Lee and Weir) and Biostatistics (Drs Lemeshow and Malgave and Ms Miao), The Ohio State University College of Public Health, Columbus, Ohio; Department of Biological Sciences, Bowling Green State University, Bowling Green, Ohio (Ms Lytmer); Health Outcomes and Biotechnology Solutions, Battelle Memorial Institute, Columbus, Ohio (Ms Minard-Smith and Dr Spurbeck); Department of Biological Sciences, Kent State University, Kent, Ohio (Dr Mou); Department of Geosciences and Department of Biology, The University of Akron, Akron, Ohio (Dr Senko); and Department of Biology, Kenyon College, Gambier, Ohio (Dr Slonczewski)
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246
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Hall LL, Thomas ES, Mahon G, Rose CE, Harwell OR. Observed Mask Use in Kindergarten Through Grade 12 Schools in Georgia-Fall, 2021. J Sch Health 2023; 93:1029-1035. [PMID: 37309093 PMCID: PMC10592516 DOI: 10.1111/josh.13347] [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: 10/13/2022] [Revised: 04/10/2023] [Accepted: 05/21/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Universal masking, with additional layered prevention strategies, was an essential tool for limiting the transmission of SARS-CoV-2 and ensuring a safe return to in-person learning for kindergarten through 12th grade (K-12) students and staff. Few studies have examined mask adherence in this setting and none have described types of masks worn or locations of mask adherence. This project sought to assess mask adherence, types worn, and location of mask adherence in K-12 settings. METHODS This study used direct in-person observations to measure the proportion of persons wearing masks correctly; type of masks worn; and location of mask adherence in 19 K-12 schools in Georgia. RESULTS A total of 16,222 observations were conducted. Among those observed, 85.2% wore masks, with 80.3% wearing the mask correctly. Persons in high school were less likely to wear masks correctly. Correct mask use was most often observed among persons wearing N95-type masks. The prevalence of persons wearing masks correctly in transitional spaces was 5% higher than in congregate spaces. CONCLUSION In K-12 schools with a universal masking policy, correct mask adherence was high among individuals. Examining adherence to recommended prevention measures can provide K-12 schools feedback to inform targeted messaging and policies during future disease outbreaks.
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247
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Foster E, Maes SA, Holcomb KM, Eisen RJ. Prevalence of five human pathogens in host-seeking Ixodes scapularis and Ixodes pacificus by region, state, and county in the contiguous United States generated through national tick surveillance. Ticks Tick Borne Dis 2023; 14:102250. [PMID: 37703795 PMCID: PMC10629455 DOI: 10.1016/j.ttbdis.2023.102250] [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: 06/05/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
The majority of vector-borne disease cases reported in the United States (U.S.) are caused by pathogens spread by the blacklegged tick, Ixodes scapularis. In recent decades, the geographic ranges of the tick and its associated human pathogens have expanded, putting an increasing number of communities at risk for tick-borne infections. In 2018, the U.S. Centers for Disease Control and Prevention (CDC) initiated a national tick surveillance program to monitor changes in the distribution and abundance of ticks and the presence and prevalence of human pathogens in them. We assessed the geographical representativeness of prevalence data submitted to CDC as part of the national tick surveillance effort. We describe county, state, and regional variation in the prevalence of five human pathogens (Borrelia burgdorferi sensu stricto (s.s.), Borrelia mayonii, Borrelia miyamotoi, Anaplasma phagocytophilum, and Babesia microti) in host-seeking I. scapularis and I. pacificus nymphs and adults. Although I. scapularis and I. pacificus are widely distributed in the eastern and western U.S., respectively, pathogen prevalence was estimated predominantly in ticks collected in the Northeast, Ohio Valley, and Upper Midwest regions, where human Lyme disease cases are most commonly reported. Within these regions, we found that state and regional estimates of pathogen prevalence generally reached predictable and stable levels, but variation in prevalence estimates at the sub-state level was considerable. Borrelia burgdorferi s.s. was the most prevalent and widespread pathogen detected. Borrelia miyamotoi and A. phagocytophilum shared a similarly broad geographic range, but were consistently detected at much lower prevalence compared with B. burgdorferi s.s. Babesia microti was detected at similar prevalence to A. phagocytophilum, where both pathogens co-occurred, but was reported over a much more limited geographic range compared with A. phagocytophilum or B. burgdorferi s.s. Borrelia mayonii was identified at very low prevalence with a focal distribution within the Upper Midwest. National assessments of risk for tick-borne diseases need to be improved through collection and testing of ticks in currently under-represented regions, including the West, South, Southeast, and eastern Plains states.
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Affiliation(s)
- Erik Foster
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA.
| | - Sarah A Maes
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA
| | - Karen M Holcomb
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA
| | - Rebecca J Eisen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA
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248
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Ratto J, Dobash D, Seya S, Trika B, Kamagate F, Chiang L. Prevalence of and factors associated with peer emotional and physical violence among youth ages 13-17 in Cote d'Ivoire. Child Abuse Negl 2023; 145:106380. [PMID: 37591047 PMCID: PMC10752422 DOI: 10.1016/j.chiabu.2023.106380] [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: 10/18/2022] [Revised: 07/11/2023] [Accepted: 07/23/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Peer violence during childhood is associated with negative outcomes. Data are limited on its associated factors in sub-Saharan Africa. OBJECTIVE This study assesses the prevalence and factors associated with peer emotional and physical violence among children and adolescents aged 13-17years in Côte d'Ivoire. PARTICIPANTS AND SETTING Data from the 2018 Côte d'Ivoire Violence Against Children and Youth Survey (VACS) were used to examine peer emotional and physical violence victimization. VACS is a national cross-sectional household survey of females and males aged 13-24years. METHODS Data included physical, emotional, and sexual violence and socioeconomic, demographic, and relationship factors. We computed the adjusted odds ratios (AOR) and confidence interval (CI) for associated factors adjusted for food insecurity and rural or urban setting. RESULTS Thirty-one percent of females and 46.7 % of males experienced lifetime peer physical violence and 36.8 % of females and 40.2 % of males experienced peer emotional violence in the past 12 months. Witnessing violence in the home towards the mother (female AOR 1.2, CI 1.0-1.3); male AOR 1.4, CI 1.2-1.6) and witnessing violence in the home towards a sibling (female AOR 1.2, CI 1.1-1.3; male AOR 1.3, CI 1.12-1.4) increased the odds of ever experiencing peer physical violence. In males, not living with their biological mother (AOR 1.2, CI 1.0, 1.4) or biological father (AOR 1.2, CI 1.1-1.3) was associated with ever experiencing peer physical violence. CONCLUSION Interventions for children and adolescents living without parents and programming focused on education and skills-building may help to reduce peer violence against children in Côte d'Ivoire.
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Affiliation(s)
- Jeffrey Ratto
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Dawson Dobash
- College of Public Health, University of Georgia, Athens, GA, United States
| | - Soletchi Seya
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Beugre Trika
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Abidjan, Côte d'Ivoire
| | - Fathim Kamagate
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Abidjan, Côte d'Ivoire
| | - Laura Chiang
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Chen J, Ouyang L, Goodman DA, Okoroh EM, Romero L, Ko JY, Cox S. Association of Medicaid Expansion Under the Affordable Care Act With Medicaid Coverage in the Prepregnancy, Prenatal, and Postpartum Periods. Womens Health Issues 2023; 33:582-591. [PMID: 37951662 PMCID: PMC11018307 DOI: 10.1016/j.whi.2023.08.002] [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: 11/06/2022] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION We evaluated how the Affordable Care Act (ACA) Medicaid eligibility expansion affected perinatal insurance coverage patterns for Medicaid-enrolled beneficiaries who gave birth overall and by race/ethnicity. We also examined state-level heterogeneous impacts. METHODS Using the 2011-2013 Medicaid Analytic eXtract and the 2016-2018 Transformed Medicaid Statistical Information System Analytic File databases, we identified 1.4 million beneficiaries giving birth in 2012 (pre-ACA expansion cohort) and 1.5 million in 2017 (post-ACA expansion cohort). We constructed monthly coverage rates for the two cohorts by state Medicaid expansion status and obtained difference-in-differences estimates of the association of Medicaid expansion with coverage overall and by race/ethnicity group (non-Hispanic White, non-Hispanic Black, and Hispanic). To explore state-level heterogeneous impacts, we divided the expansion and non-expansion states into groups based on the differences in the income eligibility limits for low-income parents in each state between 2012 and 2017. RESULTS Medicaid expansion was associated with 13 percentage points higher coverage in the 9 to 12 months before giving birth, and 11 percentage points higher coverage at 6 to 12 months postpartum. Hispanic birthing individuals had the greatest relative increases in coverage, followed by non-Hispanic White and non-Hispanic Black individuals. In Medicaid expansion states, those who experienced the greatest increases in income eligibility limits for low-income parents generally saw the greatest increases in coverage. In non-expansion states, there was less heterogeneity between state groupings. CONCLUSIONS Pregnancy-related Medicaid eligibility did not have major changes in the 2010s. However, states' adoption of ACA Medicaid expansion after 2012 was associated with increased Medicaid coverage before, during, and after pregnancy. The increases varied by race/ethnicity and across states.
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Affiliation(s)
- Jiajia Chen
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Mathematica, Atlanta, Georgia.
| | - Lijing Ouyang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - David A Goodman
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Ekwutosi M Okoroh
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Lisa Romero
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Jean Y Ko
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Shanna Cox
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Ahn C, Lee T, Shin JH, Lee JS, Upaassana VT, Ghosh S, Ku BK. Lab on a chip for detecting Clara cell protein 16 (CC16) for potential screening of the workers exposed to respirable silica aerosol. Microfluid Nanofluidics 2023; 27:1-10. [PMID: 38196842 PMCID: PMC10772934] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Early detection of pulmonary responses to silica aerosol exposure, such as lung inflammation as well as early identification of silicosis initiation, is of great importance in disease prevention of workers. In this study, to early screen the health condition of the workers who are exposed to respirable silica dusts, an immunoassay lab on a chip (LOC) was designed, developed and fully characterized for analyzing Clara cell protein 16 (CC16) in serum which has been considered as one of the potential biomarkers of lung inflammation or lung damage due to the respirable silica dusts. Sandwich immunoassay of CC16 was performed on the LOC developed with a custom-designed portable analyzer using artificial serums spiked with CC16 protein first and then human serums obtained from the coal mine workers exposed to the respirable silica-containing dusts. The dynamic range of CC16 assay performed on the LOC was in a range of 0.625-20 ng/mL, and the achieved limit of detection (LOD) was around 0.35 ng/mL. The assay results of CC16 achieved from both the developed LOC and the conventional 96 well plate showed a reasonable corelation. The correlation between the conventional reader and the developed portable analyzer was found to be reasonable, resulting in R2 ~ 0.93. This study shows that the LOC developed for the early detection of CC16 can be potentially applied for the development of a field-deployable point-of-care testing (POCT) for the early monitoring of the field workers who are exposed to silica aerosol.
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Affiliation(s)
- Chong Ahn
- Department of Electrical and Computer Engineering, Miscrosystems and BioMEMS Laboratory, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Taekhee Lee
- PMRD, Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Pittsburgh, PA 15236, USA
| | - Jae Hoon Shin
- Korea Workers’ Compensation & Welfare Service (COMWEL), Institute of Occupation and Environment (IOE), Incheon 21417, South Korea
| | - Jong Seong Lee
- Korea Workers’ Compensation & Welfare Service (COMWEL), Institute of Occupation and Environment (IOE), Incheon 21417, South Korea
| | - V. Thiyagarajan Upaassana
- Department of Electrical and Computer Engineering, Miscrosystems and BioMEMS Laboratory, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Sthitodhi Ghosh
- Department of Electrical and Computer Engineering, Miscrosystems and BioMEMS Laboratory, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Bon Ki Ku
- Health Effects Laboratory Division (HELD), Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, OH 45226, USA
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