301
|
Anenberg SC, Bindl M, Brauer M, Castillo JJ, Cavalieri S, Duncan BN, Fiore AM, Fuller R, Goldberg DL, Henze DK, Hess J, Holloway T, James P, Jin X, Kheirbek I, Kinney PL, Liu Y, Mohegh A, Patz J, Jimenez MP, Roy A, Tong D, Walker K, Watts N, West JJ. Using Satellites to Track Indicators of Global Air Pollution and Climate Change Impacts: Lessons Learned From a NASA-Supported Science-Stakeholder Collaborative. Geohealth 2020; 4:e2020GH000270. [PMID: 32642628 PMCID: PMC7334378 DOI: 10.1029/2020gh000270] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 05/18/2023]
Abstract
The 2018 NASA Health and Air Quality Applied Science Team (HAQAST) "Indicators" Tiger Team collaboration between NASA-supported scientists and civil society stakeholders aimed to develop satellite-derived global air pollution and climate indicators. This Commentary shares our experience and lessons learned. Together, the team developed methods to track wildfires, dust storms, pollen counts, urban green space, nitrogen dioxide concentrations and asthma burdens, tropospheric ozone concentrations, and urban particulate matter mortality. Participatory knowledge production can lead to more actionable information but requires time, flexibility, and continuous engagement. Ground measurements are still needed for ground truthing, and sustained collaboration over time remains a challenge.
Collapse
Affiliation(s)
- Susan C. Anenberg
- Milken Institute School of Public HealthGeorge Washington UniversityWashingtonDCUSA
| | - Matilyn Bindl
- Nelson Institute Center for Sustainability and the Global EnvironmentUniversity of WisconsinMadisonWIUSA
| | - Michael Brauer
- School of Population and Public HealthThe University of British ColumbiaVancouverBritish ColumbiaCanada
- Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleWAUSA
| | - Juan J. Castillo
- Clean Air InstituteWashingtonDCUSA
- Now at Pan‐American Health OrganizationWashingtonDCUSA
| | - Sandra Cavalieri
- Climate and Clean Air Coalition to Reduce Short‐Lived Climate PollutantsWashingtonDCUSA
| | | | - Arlene M. Fiore
- Lamont‐Doherty Earth ObservatoryColumbia UniversityPalisadesNYUSA
| | | | - Daniel L. Goldberg
- Milken Institute School of Public HealthGeorge Washington UniversityWashingtonDCUSA
| | - Daven K. Henze
- College of Engineering and Applied ScienceUniversity of Colorado BoulderBoulderCOUSA
| | - Jeremy Hess
- Department of Environmental and Occupational Health SciencesUniversity of WashingtonSeattleWAUSA
| | - Tracey Holloway
- Nelson Institute Center for Sustainability and the Global EnvironmentUniversity of WisconsinMadisonWIUSA
| | - Peter James
- James T.H. Chan School of Public HealthHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - Xiaomeng Jin
- Lamont‐Doherty Earth ObservatoryColumbia UniversityPalisadesNYUSA
| | | | - Patrick L. Kinney
- School of Public HealthBoston University School of Public HealthBostonMAUSA
| | - Yang Liu
- Rollins School of Public HealthEmory UniversityAtlantaGAUSA
| | - Arash Mohegh
- Milken Institute School of Public HealthGeorge Washington UniversityWashingtonDCUSA
| | - Jonathan Patz
- Nelson Institute Center for Sustainability and the Global EnvironmentUniversity of WisconsinMadisonWIUSA
| | - Marcia P. Jimenez
- James T.H. Chan School of Public HealthHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - Ananya Roy
- Environmental Defense FundWashingtonDCUSA
| | - Daniel Tong
- Center for Spatial Science and SystemsGeorge Mason UniversityFairfaxVAUSA
| | | | - Nick Watts
- Lancet CountdownUniversity College LondonLondonUK
| | - J. Jason West
- Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| |
Collapse
|
302
|
Technical Contributors To The June Who Meeting. A definition for community-based surveillance and a way forward: results of the WHO global technical meeting, France, 26 to 28 June 2018. ACTA ACUST UNITED AC 2020; 24. [PMID: 30646977 PMCID: PMC6337056 DOI: 10.2807/1560-7917.es.2019.24.2.1800681] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
303
|
Nguyen L, Stoové M, Boyle D, Callander D, McManus H, Asselin J, Guy R, Donovan B, Hellard M, El-Hayek C. Privacy-Preserving Record Linkage of Deidentified Records Within a Public Health Surveillance System: Evaluation Study. J Med Internet Res 2020; 22:e16757. [PMID: 32579128 PMCID: PMC7381059 DOI: 10.2196/16757] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/25/2020] [Accepted: 02/21/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) was established to monitor national testing and test outcomes for blood-borne viruses (BBVs) and sexually transmissible infections (STIs) in key populations. ACCESS extracts deidentified data from sentinel health services that include general practice, sexual health, and infectious disease clinics, as well as public and private laboratories that conduct a large volume of BBV/STI testing. An important attribute of ACCESS is the ability to accurately link individual-level records within and between the participating sites, as this enables the system to produce reliable epidemiological measures. OBJECTIVE The aim of this study was to evaluate the use of GRHANITE software in ACCESS to extract and link deidentified data from participating clinics and laboratories. GRHANITE generates irreversible hashed linkage keys based on patient-identifying data captured in the patient electronic medical records (EMRs) at the site. The algorithms to produce the data linkage keys use probabilistic linkage principles to account for variability and completeness of the underlying patient identifiers, producing up to four linkage key types per EMR. Errors in the linkage process can arise from imperfect or missing identifiers, impacting the system's integrity. Therefore, it is important to evaluate the quality of the linkages created and evaluate the outcome of the linkage for ongoing public health surveillance. METHODS Although ACCESS data are deidentified, we created two gold-standard datasets where the true match status could be confirmed in order to compare against record linkage results arising from different approaches of the GRHANITE Linkage Tool. We reported sensitivity, specificity, and positive and negative predictive values where possible and estimated specificity by comparing a history of HIV and hepatitis C antibody results for linked EMRs. RESULTS Sensitivity ranged from 96% to 100%, and specificity was 100% when applying the GRHANITE Linkage Tool to a small gold-standard dataset of 3700 clinical medical records. Medical records in this dataset contained a very high level of data completeness by having the name, date of birth, post code, and Medicare number available for use in record linkage. In a larger gold-standard dataset containing 86,538 medical records across clinics and pathology services, with a lower level of data completeness, sensitivity ranged from 94% to 95% and estimated specificity ranged from 91% to 99% in 4 of the 6 different record linkage approaches. CONCLUSIONS This study's findings suggest that the GRHANITE Linkage Tool can be used to link deidentified patient records accurately and can be confidently used for public health surveillance in systems such as ACCESS.
Collapse
Affiliation(s)
| | - Mark Stoové
- Burnet Institute, Melbourne, Australia
- School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Douglas Boyle
- Department of General Practice, HaBIC Research Technology Unit, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Denton Callander
- Kirby Institute, University of New South Wales, Sydney, Australia
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Hamish McManus
- Kirby Institute, University of New South Wales, Sydney, Australia
| | | | - Rebecca Guy
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Basil Donovan
- Kirby Institute, University of New South Wales, Sydney, Australia
- Sydney Sexual Health Centre, Sydney, Australia
| | - Margaret Hellard
- Burnet Institute, Melbourne, Australia
- School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Australia
- Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Carol El-Hayek
- Burnet Institute, Melbourne, Australia
- School of Population Health and Preventive Medicine, Monash University, Melbourne, Australia
| |
Collapse
|
304
|
Anderson C, Pooley JA, Mills B, Anderson E, Smith EC. Do Paramedics Have a Professional Obligation to Work During a Pandemic? A Qualitative Exploration of Community Member Expectations. Disaster Med Public Health Prep 2020; 14:406-12. [PMID: 32576316 DOI: 10.1017/dmp.2020.212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives: Previous research has identified a lack of clarification regarding paramedic professional obligation to work. Understanding community expectations of paramedics will provide some clarity around this issue. The objective of this research was to explore the expectations of a sample of Australian community members regarding the professional obligation of paramedics to respond during pandemics. Methods: The authors used qualitative methods to gather Australian community member perspectives immediately before the onset of the coronavirus disease 2019 (COVID-19) pandemic. Focus groups were used for data collection, and a thematic analysis was conducted. Results: The findings revealed 9 key themes: context of obligation (normal operations versus crisis situation), hierarchy of obligation (individual versus organizational obligation), risk acceptability, acceptable occupational risk (it’s part of the job), access to personal protective equipment, legal and ethical guidelines, education and training, safety, and acceptable limitations to obligation. The factors identified as being acceptable limitations to professional obligation are presented as further sub-themes: physical health, mental health, and competing personal obligations. Conclusions: The issue of professional obligation must be addressed by ambulance services as a matter of urgency, especially in light of the COVID-19 coronavirus pandemic. Further research is recommended to understand how community member expectations evolve during and after the COVID-19 coronavirus pandemic.
Collapse
|
305
|
Sonekar HB, Ponnaiah M. Emergence of Coronavirus (COVID-19) Outbreak: Anthropological and Social Science Perspectives. Disaster Med Public Health Prep 2020; 14:759-61. [PMID: 32576324 DOI: 10.1017/dmp.2020.203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
With the ongoing coronavirus (severe acute respiratory syndrome coronavirus-2, SARS-CoV-2), the entire community of health professionals is working to control disease and investing crores in vaccine development. The present discussion is to bring the focus on various social issues that emerge during outbreak and calls for equal attention as that of other health-care interventions. These issues are summarized in three categories: first, stigmatization due to lack of knowledge about the source of infection; second, speculations and their consequences around lack of knowledge about transmission; and finally, the concern regarding miscommunication during such a crisis. Most of these concerns emerge from press and social media coverage of the episode. The Ebola outbreak response is an example of how social scientists and anthropologists can work with other experts to solve questions of public health importance. Their approach toward the community with the objective to understand the sources, reasons, and circumstances of the infection will help to manage the current outbreak. In this context, we suggest collaboration of diverse scientific community to control and sensitize the people to tackle the misinformation in the affected and non-affected community during the outbreaks.
Collapse
|
306
|
Martinez D, Landon KA, McDermott W, Roth J Jr, Schnall AH, Talbert TP, Mainzer HM. The 2017 Hurricane Public Health Responses: Case Studies Illustrating the Role of Centers for Disease Control and Prevention's Public Health Emergency Preparedness Program - Erratum. Disaster Med Public Health Prep 2020; 17:e8. [PMID: 32571443 DOI: 10.1017/dmp.2020.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
307
|
Turk PJ, Chou SH, Kowalkowski MA, Palmer PP, Priem JS, Spencer MD, Taylor YJ, McWilliams AD. Modeling COVID-19 Latent Prevalence to Assess a Public Health Intervention at a State and Regional Scale: Retrospective Cohort Study. JMIR Public Health Surveill 2020; 6:e19353. [PMID: 32427104 PMCID: PMC7307325 DOI: 10.2196/19353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Emergence of the coronavirus disease (COVID-19) caught the world off guard and unprepared, initiating a global pandemic. In the absence of evidence, individual communities had to take timely action to reduce the rate of disease spread and avoid overburdening their health care systems. Although a few predictive models have been published to guide these decisions, most have not taken into account spatial differences and have included assumptions that do not match the local realities. Access to reliable information that is adapted to local context is critical for policy makers to make informed decisions during a rapidly evolving pandemic. OBJECTIVE The goal of this study was to develop an adapted susceptible-infected-removed (SIR) model to predict the trajectory of the COVID-19 pandemic in North Carolina and the Charlotte Metropolitan Region, and to incorporate the effect of a public health intervention to reduce disease spread while accounting for unique regional features and imperfect detection. METHODS Three SIR models were fit to infection prevalence data from North Carolina and the greater Charlotte Region and then rigorously compared. One of these models (SIR-int) accounted for a stay-at-home intervention and imperfect detection of COVID-19 cases. We computed longitudinal total estimates of the susceptible, infected, and removed compartments of both populations, along with other pandemic characteristics such as the basic reproduction number. RESULTS Prior to March 26, disease spread was rapid at the pandemic onset with the Charlotte Region doubling time of 2.56 days (95% CI 2.11-3.25) and in North Carolina 2.94 days (95% CI 2.33-4.00). Subsequently, disease spread significantly slowed with doubling times increased in the Charlotte Region to 4.70 days (95% CI 3.77-6.22) and in North Carolina to 4.01 days (95% CI 3.43-4.83). Reflecting spatial differences, this deceleration favored the greater Charlotte Region compared to North Carolina as a whole. A comparison of the efficacy of intervention, defined as 1 - the hazard ratio of infection, gave 0.25 for North Carolina and 0.43 for the Charlotte Region. In addition, early in the pandemic, the initial basic SIR model had good fit to the data; however, as the pandemic and local conditions evolved, the SIR-int model emerged as the model with better fit. CONCLUSIONS Using local data and continuous attention to model adaptation, our findings have enabled policy makers, public health officials, and health systems to proactively plan capacity and evaluate the impact of a public health intervention. Our SIR-int model for estimated latent prevalence was reasonably flexible, highly accurate, and demonstrated efficacy of a stay-at-home order at both the state and regional level. Our results highlight the importance of incorporating local context into pandemic forecast modeling, as well as the need to remain vigilant and informed by the data as we enter into a critical period of the outbreak.
Collapse
Affiliation(s)
- Philip J Turk
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, United States
| | - Shih-Hsiung Chou
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, United States
| | - Marc A Kowalkowski
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, United States
| | - Pooja P Palmer
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, United States
| | - Jennifer S Priem
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, United States
| | - Melanie D Spencer
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, United States
| | - Yhenneko J Taylor
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, United States
| | - Andrew D McWilliams
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, United States
| |
Collapse
|
308
|
Rha B, Lively JY, Englund JA, Staat MA, Weinberg GA, Selvarangan R, Halasa NB, Williams JV, Boom JA, Sahni LC, Michaels MG, Stewart LS, Harrison CJ, Szilagyi PG, McNeal MM, Klein EJ, Strelitz B, Lacombe K, Schlaudecker E, Moffatt ME, Schuster JE, Pahud BA, Weddle G, Hickey RW, Avadhanula V, Wikswo ME, Hall AJ, Curns AT, Gerber SI, Langley G. Severe Acute Respiratory Syndrome Coronavirus 2 Infections in Children: Multicenter Surveillance, United States, January-March 2020. J Pediatric Infect Dis Soc 2020; 9:609-612. [PMID: 32556327 PMCID: PMC7337823 DOI: 10.1093/jpids/piaa075] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 12/30/2022]
Abstract
Previous reports of coronavirus disease 2019 among children in the United States have been based on health jurisdiction reporting. We performed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing on children enrolled in active, prospective, multicenter surveillance during January-March 2020. Among 3187 children, only 4 (0.1%) SARS-CoV-2-positive cases were identified March 20-31 despite evidence of rising community circulation.
Collapse
Affiliation(s)
- Brian Rha
- CDC COVID-19 Response Team,Corresponding author: Brian Rha, MD, MSPH, for the CDC COVID-19 Response Team, [], 404-639-3972
| | - Joana Y Lively
- CDC COVID-19 Response Team,IHRC Inc., contracting agency to the Division of Viral Diseases, Atlanta, Georgia
| | | | - Mary A Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Geoffrey A Weinberg
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | | | | | - John V Williams
- UPMC Children's Hospital of Pittsburgh, UPSOM, Pittsburgh, Pennsylvania
| | - Julie A Boom
- Texas Children's Hospital, Houston, Texas,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Leila C Sahni
- Texas Children's Hospital, Houston, Texas,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Marian G Michaels
- UPMC Children's Hospital of Pittsburgh, UPSOM, Pittsburgh, Pennsylvania
| | | | | | - Peter G Szilagyi
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, CA
| | - Monica M McNeal
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | | | | | - Elizabeth Schlaudecker
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | | | | | - Gina Weddle
- UMKC-SOM, Children's Mercy, Kansas City, Missouri
| | - Robert W Hickey
- UPMC Children's Hospital of Pittsburgh, UPSOM, Pittsburgh, Pennsylvania
| | - Vasanthi Avadhanula
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | | | | | | | | | - Gayle Langley
- CDC COVID-19 Response Team,Alternate corresponding author: Gayle Langley, MD, MPH, for the CDC COVID-19 Response Team, [], 404.639.8092
| |
Collapse
|
309
|
Lane CR, Seemann T, Worth LJ, Easton M, Pitchers W, Wong J, Cameron D, Azzato F, Bartolo R, Mateevici C, Marshall C, Slavin MA, Howden BP, Williamson DA. Incursions of Candida auris into Australia, 2018. Emerg Infect Dis 2020; 26:1326-1328. [PMID: 32213261 PMCID: PMC7258446 DOI: 10.3201/eid2606.190936] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Candida auris is an emerging global healthcare-associated pathogen. During July–December 2018, four patients with C. auris were identified in Victoria, Australia, all with previous overseas hospitalization. Phylogenetic analysis revealed putative transmission between 2 patients and suspected overseas acquisition in the others. Vigilant screening of at-risk patients is required.
Collapse
|
310
|
Fernandez K, Lingani C, Aderinola OM, Goumbi K, Bicaba B, Edea ZA, Glèlè C, Sarkodie B, Tamekloe A, Ngomba A, Djingarey M, Bwaka A, Perea W, Ronveaux O. Meningococcal Meningitis Outbreaks in the African Meningitis Belt After Meningococcal Serogroup A Conjugate Vaccine Introduction, 2011-2017. J Infect Dis 2020; 220:S225-S232. [PMID: 31671449 PMCID: PMC6822966 DOI: 10.1093/infdis/jiz355] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In 2010-2017, meningococcal serogroup A conjugate vaccine (MACV) was introduced in 21 African meningitis belt countries. Neisseria meningitidis A epidemics have been eliminated here; however, non-A serogroup epidemics continue. METHODS We reviewed epidemiological and laboratory World Health Organization data after MACV introduction in 20 countries. Information from the International Coordinating Group documented reactive vaccination. RESULTS In 2011-2017, 17 outbreaks were reported (31 786 suspected cases from 8 countries, 1-6 outbreaks/year). Outbreaks were of 18-14 542 cases in 113 districts (median 3 districts/outbreak). The most affected countries were Nigeria (17 375 cases) and Niger (9343 cases). Cumulative average attack rates per outbreak were 37-203 cases/100 000 population (median 112). Serogroup C accounted for 11 outbreaks and W for 6. The median proportion of laboratory confirmed cases was 20%. Reactive vaccination was conducted during 14 outbreaks (5.7 million people vaccinated, median response time 36 days). CONCLUSION Outbreaks due to non-A serogroup meningococci continue to be a significant burden in this region. Until an affordable multivalent conjugate vaccine becomes available, the need for timely reactive vaccination and an emergency vaccine stockpile remains high. Countries must continue to strengthen detection, confirmation, and timeliness of outbreak control measures.
Collapse
Affiliation(s)
| | - Clément Lingani
- World Health Organization, AFRO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
| | | | - Kadadé Goumbi
- Ministère de la Santé Publique du Niger, Niamey, Niger
| | - Brice Bicaba
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | | | | | | | | | - Armelle Ngomba
- Ministère de la Santé Publique du Cameroun, Yaoundé, Cameroon
| | - Mamoudou Djingarey
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Ado Bwaka
- World Health Organization, AFRO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
| | | | | |
Collapse
|
311
|
Batey DS, Dong X, Rogers RP, Merriweather A, Elopre L, Rana AI, Hall HI, Mugavero MJ. Time From HIV Diagnosis to Viral Suppression: Survival Analysis of Statewide Surveillance Data in Alabama, 2012 to 2014. JMIR Public Health Surveill 2020; 6:e17217. [PMID: 32045344 PMCID: PMC7275256 DOI: 10.2196/17217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/06/2020] [Accepted: 02/10/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Evaluation of the time from HIV diagnosis to viral suppression (VS) captures the collective effectiveness of HIV prevention and treatment activities in a given locale and provides a more global estimate of how effectively the larger HIV care system is working in a given geographic area or jurisdiction. OBJECTIVE This study aimed to evaluate temporal and geographic variability in VS among persons with newly diagnosed HIV infection in Alabama between 2012 and 2014. METHODS With data from the National HIV Surveillance System, we evaluated median time from HIV diagnosis to VS (<200 c/mL) overall and stratified by Alabama public health area (PHA) among persons with HIV diagnosed during 2012 to 2014 using the Kaplan-Meier approach. RESULTS Among 1979 newly diagnosed persons, 1181 (59.67%) achieved VS within 12 months of diagnosis; 52.6% (353/671) in 2012, 59.5% (377/634) in 2013, and 66.9% (451/674) in 2014. Median time from HIV diagnosis to VS was 8 months: 10 months in 2012, 8 months in 2013, and 6 months in 2014. Across 11 PHAs in Alabama, 12-month VS ranged from 45.8% (130/284) to 84% (26/31), and median time from diagnosis to VS ranged from 5 to 13 months. CONCLUSIONS Temporal improvement in persons achieving VS following HIV diagnosis statewide in Alabama is encouraging. However, considerable geographic variability warrants further evaluation to inform public health action. Time from HIV diagnosis to VS represents a meaningful indicator that can be incorporated into public health surveillance and programming.
Collapse
Affiliation(s)
- D Scott Batey
- Department of Social Work, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Richard P Rogers
- Division of STD Prevention and Control, Alabama Department of Public Health, Montgomery, AL, United States
| | - Anthony Merriweather
- Division of STD Prevention and Control, Alabama Department of Public Health, Montgomery, AL, United States
| | - Latesha Elopre
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Aadia I Rana
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - H Irene Hall
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Michael J Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| |
Collapse
|
312
|
Cavazzotto TG, Ronque ERV, Vieira ER, Queiroga MR, Serassuelo Junior H. Social-Ecological Correlates of Regular Leisure-Time Physical Activity Practice among Adults. Int J Environ Res Public Health 2020; 17:E3619. [PMID: 32455832 DOI: 10.3390/ijerph17103619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/07/2020] [Accepted: 05/12/2020] [Indexed: 02/06/2023]
Abstract
This study calculated the exposure-response rates of social-ecological correlates of practicing regular (>150 min/week) leisure-time physical activity (PA) in 393,648 adults from the 27 Brazilian state capitals who participated in a national survey between 2006 and 2016. Regular PA encouraging factors were inputted into an exposure-response model. Growth rates for the odds ratio and prevalence of regular PA were calculated for each increase of one encouraging factor. Regular PA was reported by 22% of the participants (25% of men and 20% of women). More than 40% of men and 30% of women with higher intra-personal encouraging conditions reported practicing regular PA. There was a 3% (ages 18–32 years) to 5% (ages 46–60 years) increase in regular PA practice in men for each increase in an encouraging climate factor (temperature from 21 °C to 31 °C, humidity from 65% to 85%, 2430 to 3250 h of sun/year, and from 1560 to 1910 mm of rain/year). Encouraging intra-personal factors and favorable climate conditions had larger effects on regular PA practice than the built environment and socio-political conditions; the latter two had independent effects, but did not have a cumulative effect on PA.
Collapse
|
313
|
Ahweyevu JO, Chukwudebe NP, Buchanan BM, Yin J, Adhikari BB, Zhou X, Tse ZTH, Chowell G, Meltzer MI, Fung IC. Using Twitter to Track Unplanned School Closures: Georgia Public Schools, 2015-17. Disaster Med Public Health Prep 2020;:1-5. [PMID: 32406359 DOI: 10.1017/dmp.2020.65] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To aid emergency response, Centers for Disease Control and Prevention (CDC) researchers monitor unplanned school closures (USCs) by conducting online systematic searches (OSS) to identify relevant publicly available reports. We examined the added utility of analyzing Twitter data to improve USC monitoring. METHODS Georgia public school data were obtained from the National Center for Education Statistics. We identified school and district Twitter accounts with 1 or more tweets ever posted ("active"), and their USC-related tweets in the 2015-16 and 2016-17 school years. CDC researchers provided OSS-identified USC reports. Descriptive statistics, univariate, and multivariable logistic regression were computed. RESULTS A majority (1,864/2,299) of Georgia public schools had, or were in a district with, active Twitter accounts in 2017. Among these schools, 638 were identified with USCs in 2015-16 (Twitter only, 222; OSS only, 2015; both, 201) and 981 in 2016-17 (Twitter only, 178; OSS only, 107; both, 696). The marginal benefit of adding Twitter as a data source was an increase in the number of schools identified with USCs by 53% (222/416) in 2015-16 and 22% (178/803) in 2016-17. CONCLUSIONS Policy-makers may wish to consider the potential value of incorporating Twitter into existing USC monitoring systems.
Collapse
|
314
|
Avoundjian T, Dombrowski JC, Golden MR, Hughes JP, Guthrie BL, Baseman J, Sadinle M. Comparing Methods for Record Linkage for Public Health Action: Matching Algorithm Validation Study. JMIR Public Health Surveill 2020; 6:e15917. [PMID: 32352389 PMCID: PMC7226047 DOI: 10.2196/15917] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/20/2019] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
Background Many public health departments use record linkage between surveillance data and external data sources to inform public health interventions. However, little guidance is available to inform these activities, and many health departments rely on deterministic algorithms that may miss many true matches. In the context of public health action, these missed matches lead to missed opportunities to deliver interventions and may exacerbate existing health inequities. Objective This study aimed to compare the performance of record linkage algorithms commonly used in public health practice. Methods We compared five deterministic (exact, Stenger, Ocampo 1, Ocampo 2, and Bosh) and two probabilistic record linkage algorithms (fastLink and beta record linkage [BRL]) using simulations and a real-world scenario. We simulated pairs of datasets with varying numbers of errors per record and the number of matching records between the two datasets (ie, overlap). We matched the datasets using each algorithm and calculated their recall (ie, sensitivity, the proportion of true matches identified by the algorithm) and precision (ie, positive predictive value, the proportion of matches identified by the algorithm that were true matches). We estimated the average computation time by performing a match with each algorithm 20 times while varying the size of the datasets being matched. In a real-world scenario, HIV and sexually transmitted disease surveillance data from King County, Washington, were matched to identify people living with HIV who had a syphilis diagnosis in 2017. We calculated the recall and precision of each algorithm compared with a composite standard based on the agreement in matching decisions across all the algorithms and manual review. Results In simulations, BRL and fastLink maintained a high recall at nearly all data quality levels, while being comparable with deterministic algorithms in terms of precision. Deterministic algorithms typically failed to identify matches in scenarios with low data quality. All the deterministic algorithms had a shorter average computation time than the probabilistic algorithms. BRL had the slowest overall computation time (14 min when both datasets contained 2000 records). In the real-world scenario, BRL had the lowest trade-off between recall (309/309, 100.0%) and precision (309/312, 99.0%). Conclusions Probabilistic record linkage algorithms maximize the number of true matches identified, reducing gaps in the coverage of interventions and maximizing the reach of public health action.
Collapse
Affiliation(s)
- Tigran Avoundjian
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States.,HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, United States
| | - Julia C Dombrowski
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States.,HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, United States.,Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, United States
| | - Matthew R Golden
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States.,HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, United States.,Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, United States
| | - James P Hughes
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, United States
| | - Brandon L Guthrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States.,Department of Global Health, School of Public Health, University of Washington, Seattle, WA, United States
| | - Janet Baseman
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States
| | - Mauricio Sadinle
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, United States
| |
Collapse
|
315
|
Baker J, Kohlhoff J, Onobrakpor SI, Woolfenden S, Smith R, Knebel C, Eapen V. The Acceptability and Effectiveness of Web-Based Developmental Surveillance Programs: Rapid Review. JMIR Mhealth Uhealth 2020; 8:e16085. [PMID: 32324149 PMCID: PMC7206511 DOI: 10.2196/16085] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/05/2020] [Accepted: 02/10/2020] [Indexed: 12/05/2022] Open
Abstract
Background Web-based developmental surveillance programs may be an innovative solution to improving the early detection of childhood developmental difficulties, especially within disadvantaged populations. Objective This review aimed to identify the acceptability and effectiveness of web-based developmental surveillance programs for children aged 0 to 6 years. Methods A total of 6 databases and gray literature were searched using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses–informed protocol. Data extraction included variables related to health equity. Results In total, 20 studies were identified. Most papers implemented web-based versions of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up screener for autism spectrum disorder or Parent Evaluation of Developmental Status screeners for broad developmental delay. Caregivers and practitioners indicated a preference for web-based screeners, primarily for user-friendliness, improved follow-up accuracy, time, and training efficiencies. Conclusions Although evidence is limited as to the necessity of web- versus face-to-face–based developmental screening, there are clear efficiencies in its use. Trial Registration PROSPERO CRD42019127894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=127894
Collapse
Affiliation(s)
- Jess Baker
- The University of New South Wales, Liverpool, Australia
| | - Jane Kohlhoff
- The University of New South Wales, Carramarr, Australia
| | | | | | - Rebecca Smith
- South Eastern Sydney Local Health District, Sydney, Australia
| | | | | |
Collapse
|
316
|
Martinez R, Soliz P, Caixeta R, Ordunez P. Reflection on modern methods: years of life lost due to premature mortality-a versatile and comprehensive measure for monitoring non-communicable disease mortality. Int J Epidemiol 2020; 48:1367-1376. [PMID: 30629192 PMCID: PMC6693813 DOI: 10.1093/ije/dyy254] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2018] [Indexed: 11/12/2022] Open
Abstract
The analysis of causes impacting on premature mortality is an essential function of public health surveillance. Diverse methods have been used for accurately assessing and reporting the level and trends of premature mortality; however, many have important limitations, particularly in capturing actual early deaths. We argue that the framework of years of life lost (YLL), as conceptualized in disability-adjusted life-years (DALYs), is a robust and comprehensive measure of premature mortality. Global Burden of Disease study is systematically providing estimates of YLL; however, it is not widely adopted at country level, among other reasons because its conceptual and methodological bases seem to be not sufficiently known and understood. In this paper, we provide the concepts and the methodology of the YLL framework, including the selection of the loss of function that defines the time lost due to premature deaths, and detailed methods for calculating YLL metrics. We also illustrate how to use YLL to quantify the level and trends of premature non-communicable disease (NCD) mortality in the Americas. The tutorial style of the illustrative example is intended to educate the public health community and stimulate the use of YLL in disease prevention and control programmes at different levels.
Collapse
Affiliation(s)
- Ramon Martinez
- Department of Non-Communicable Diseases and Mental Health
| | - Patricia Soliz
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization, Washington, DC, USA
| | | | - Pedro Ordunez
- Department of Non-Communicable Diseases and Mental Health
| |
Collapse
|
317
|
Argumedo G, Taylor JRL, Gaytán-González A, González-Casanova I, Villalobos MFG, Jáuregui A, Ulloa EJ, Medina C, Miranda YSP, Rodríguez MP, Resendiz E, Pelayo RAR, Martínez MDPR, Galaviz KI. Mexico's 2018 Report Card on Physical Activity for Children and Youth: Full report. Rev Panam Salud Publica 2020; 44:e26. [PMID: 32341689 PMCID: PMC7178555 DOI: 10.26633/rpsp.2020.26] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/15/2019] [Indexed: 12/21/2022] Open
Abstract
Objectives. Mexico’s 2018 Report Card evaluates the opportunities available for Mexican children and youth to reach healthy levels of physical activity, sleep, and sedentary behavior. Methods. The Report Card is a surveillance system that gathers data from national surveys, censuses, government documents, websites, grey literature, and published studies to evaluate 16 indicators in four categories: Daily Behaviors; Physical Fitness; Settings and Sources of Influence; and Strategies and Investments. Data were compared to established benchmarks. Each indicator was assigned a grade from 1 – 10 (< 6 is a failing grade) or “incomplete” if data was insufficient/unavailable. Results. Daily Behavior grades were: Overall Physical Activity, 4; Organized Sport Participation, 5; Active Play, 3; Active Transportation, 5; Sleep, 7; and Sedentary Behavior, 3. Physical Fitness, received a 7. Settings and Sources of Influence grades were: Family and Peers, incomplete; School, 3; and Community and Environment, 4. Strategies and Investments were: Government Strategies, 6; and Non-Government Organizations, 2. Conclusion. Low grades in 11 of the 16 indicators indicate that schools, families, communities, and government need to work together to improve physical activity opportunities for children and youth in Mexico.
Collapse
Affiliation(s)
- Gabriela Argumedo
- Department for Health University of Bath BathSomerset United Kingdom Department for Health, University of Bath, Bath, Somerset, United Kingdom
| | - Juan Ricardo López Taylor
- Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano Centro Universitario de Ciencias de la Salud Universidad de Guadalajara GuadalajaraJalisco México Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Alejandro Gaytán-González
- Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano Centro Universitario de Ciencias de la Salud Universidad de Guadalajara GuadalajaraJalisco México Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Inés González-Casanova
- Hubert Department of Global Health Rollins School of Public Health Emory University AtlantaGeorgia United States of America Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Martín Francisco González Villalobos
- Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano Centro Universitario de Ciencias de la Salud Universidad de Guadalajara GuadalajaraJalisco México Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Alejandra Jáuregui
- Departamento de Actividad Física y Estilos de Vida Saludables Centro de Investigación en Nutrición y Salud Instituto Nacional de Salud Pública Cuernavaca México Departamento de Actividad Física y Estilos de Vida Saludables, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Edtna Jáuregui Ulloa
- Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano Centro Universitario de Ciencias de la Salud Universidad de Guadalajara GuadalajaraJalisco México Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Catalina Medina
- Departamento de Actividad Física y Estilos de Vida Saludables Centro de Investigación en Nutrición y Salud Instituto Nacional de Salud Pública Cuernavaca México Departamento de Actividad Física y Estilos de Vida Saludables, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Yoali Selene Pacheco Miranda
- Departamento de Alimentación, Cultura y Ambiente Instituto Nacional de Salud Pública Cuernavaca México Departamento de Alimentación, Cultura y Ambiente, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Marcela Pérez Rodríguez
- Centro de Adiestramiento en Investigación Clínica División de Desarrollo de la Investigación Instituto Mexicano del Seguro Social Ciudad de México México Centro de Adiestramiento en Investigación Clínica, División de Desarrollo de la Investigación Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Eugen Resendiz
- Departamento de Actividad Física y Estilos de Vida Saludables Centro de Investigación en Nutrición y Salud Instituto Nacional de Salud Pública Cuernavaca México Departamento de Actividad Física y Estilos de Vida Saludables, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Ricardo Alejandro Retano Pelayo
- Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano Centro Universitario de Ciencias de la Salud Universidad de Guadalajara GuadalajaraJalisco México Instituto de Ciencias Aplicadas a la Actividad Física y al Deporte, Departamento de Ciencias del Movimiento Humano, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - María Del Pilar Rodríguez Martínez
- Centro de Educación Física y Salud Integral Instituto Tecnológico y de Estudios Superiores de Occidente TlaquepaqueJalisco México Centro de Educación Física y Salud Integral, Instituto Tecnológico y de Estudios Superiores de Occidente, Tlaquepaque, Jalisco, México
| | - Karla I Galaviz
- Hubert Department of Global Health Rollins School of Public Health Emory University AtlantaGeorgia United States of America Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| |
Collapse
|
318
|
Dixon BE, Zhang Z, Arno JN, Revere D, Joseph Gibson P, Grannis SJ. Improving Notifiable Disease Case Reporting Through Electronic Information Exchange-Facilitated Decision Support: A Controlled Before-and-After Trial. Public Health Rep 2020; 135:401-410. [PMID: 32250707 DOI: 10.1177/0033354920914318] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Outbreak detection and disease control may be improved by simplified, semi-automated reporting of notifiable diseases to public health authorities. The objective of this study was to determine the effect of an electronic, prepopulated notifiable disease report form on case reporting rates by ambulatory care clinics to public health authorities. METHODS We conducted a 2-year (2012-2014) controlled before-and-after trial of a health information exchange (HIE) intervention in Indiana designed to prepopulate notifiable disease reporting forms to providers. We analyzed data collected from electronic prepopulated reports and "usual care" (paper, fax) reports submitted to a local health department for 7 conditions by using a difference-in-differences model. Primary outcomes were changes in reporting rates, completeness, and timeliness between intervention and control clinics. RESULTS Provider reporting rates for chlamydia and gonorrhea in intervention clinics increased significantly from 56.9% and 55.6%, respectively, during the baseline period (2012) to 66.4% and 58.3%, respectively, during the intervention period (2013-2014); they decreased from 28.8% and 27.5%, respectively, to 21.7% and 20.6%, respectively, in control clinics (P < .001). Completeness improved from baseline to intervention for 4 of 15 fields in reports from intervention clinics (P < .001), although mean completeness improved for 11 fields in both intervention and control clinics. Timeliness improved for both intervention and control clinics; however, reports from control clinics were timelier (mean, 7.9 days) than reports from intervention clinics (mean, 9.7 days). CONCLUSIONS Electronic, prepopulated case reporting forms integrated into providers' workflow, enabled by an HIE network, can be effective in increasing notifiable disease reporting rates and completeness of information. However, it was difficult to assess the effect of using the forms for diseases with low prevalence (eg, salmonellosis, histoplasmosis).
Collapse
Affiliation(s)
- Brian E Dixon
- 10668 Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.,50826 Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, USA.,12250 Center for Health Information and Communication, Health Services Research & Development Service, Department of Veterans Affairs, Indianapolis, IN, USA
| | - Zuoyi Zhang
- 50826 Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, USA
| | - Janet N Arno
- 12250 School of Medicine, Indiana University, Indianapolis, IN, USA.,4059 Marion County Public Health Department, Indianapolis, IN, USA
| | - Debra Revere
- 7284 School of Public Health, University of Washington, Seattle, WA, USA
| | - P Joseph Gibson
- 4059 Marion County Public Health Department, Indianapolis, IN, USA
| | - Shaun J Grannis
- 50826 Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, USA.,12250 School of Medicine, Indiana University, Indianapolis, IN, USA
| |
Collapse
|
319
|
Needle S, Rucks AC, Wallace LA, Ginter PM, Katholi CR, Xie R. Pediatric Practice Readiness for Disaster Response. Disaster Med Public Health Prep 2021; 15:277-81. [PMID: 32238203 DOI: 10.1017/dmp.2020.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The American Academy of Pediatrics (AAP) calls for the inclusion of office-based pediatricians in disaster preparedness and response efforts. However, there is little research about disaster preparedness and response on the part of pediatric practices. This study describes the readiness of pediatric practices to respond to disaster and delineates factors associated with increased preparedness. METHODS An AAP survey was distributed to members to assess the state of pediatric offices in readiness for disaster. Potential predictor variables used in chi-square analysis included community setting, primary employment setting, area of practice, and previous disaster experience. RESULTS Three-quarters (74%) of respondents reported some degree of disaster preparedness (measured by 6 indicators including written plans and maintaining stocks of supplies), and approximately half (54%) reported response experience (measured by 3 indicators, including volunteering to serve in disaster areas). Respondents who reported disaster preparation efforts were more likely to have signed up for disaster response efforts, and vice versa. CONCLUSIONS These results contribute information about the state of pediatric physician offices and can aid in developing strategies for augmenting the inclusion of office-based pediatricians in community preparedness and response efforts.
Collapse
|
320
|
Foxlee ND, Townell N, Tosul MAL, McIver L, Lau CL. Bacteriology and Antimicrobial Resistance in Vanuatu: January 2017 to December 2019. Antibiotics (Basel) 2020; 9:E151. [PMID: 32244420 PMCID: PMC7235848 DOI: 10.3390/antibiotics9040151] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 11/16/2022] Open
Abstract
Keywords: drug resistance; antimicrobial; public health surveillance; Pacific Islands; bacteriology; epidemiology.
Collapse
Affiliation(s)
- Nicola D. Foxlee
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT 2600, Australian
| | - Nicola Townell
- Diagnostic Microbiology Development Program, Phnom Penh 12000, Cambodia;
| | - Mary Ann L. Tosul
- Microbiology Department Laboratory, Vila Central Hospital, Port Vila, Vanuatu;
| | - Lachlan McIver
- Rocketship Pacific Ltd, Port Melbourne, Melbourne 3207, Australia;
| | - Colleen L. Lau
- Department of Global Health, Research School of Population Health, Australian National University, Canberra 2600, Australian;
| |
Collapse
|
321
|
de Oliveira SIM, de Oliveira Saraiva COP, de França DF, Ferreira Júnior MA, de Melo Lima LH, de Souza NL. Syphilis Notifications and the Triggering Processes for Vertical Transmission: A Cross-Sectional Study. Int J Environ Res Public Health 2020; 17:ijerph17030984. [PMID: 32033272 PMCID: PMC7037822 DOI: 10.3390/ijerph17030984] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/20/2019] [Accepted: 12/04/2019] [Indexed: 12/14/2022]
Abstract
Syphilis is a disease that is found all over the world that causes damaging effects to the fetus through vertical transmission. This study aimed to analyze the processes that trigger the vertical transmission of syphilis through gestational and congenital syphilis notifications. It is a cross-sectional study. The sample totaled 129 notifications of syphilis in pregnant women and 132 notifications of congenital syphilis in the city of Natal, from 2011 to 2015. Data were obtained from the Information System for Disease Notification. The Chi-square, Student's and Fisher's tests were used to verify associations of interest. Diagnosis of maternal syphilis was predominant in the third trimester of pregnancy. Only 1.6% of the pregnant women were registered with an adequate treatment regimen, of these 16.3% had the concomitant treatment with their partners. Of the affected children, 78.8% were registered as asymptomatic. The factors that trigger vertical transmission are related to the late diagnosis of the pregnant woman and sexual partner(s) and the deficiencies in clinical/therapeutic management in relation to the phase of the disease. Strategies of professional training should be adopted to notify and expand the provision of information for epidemiological surveillance, aiming to strengthen care, reduce vertical transmission and enable the continuous analysis of this problem.
Collapse
Affiliation(s)
- Samara Isabela Maia de Oliveira
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
- Correspondence: ; Tel.: +55-084-3215-3615
| | - Cecília Olívia Paraguai de Oliveira Saraiva
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
| | - Débora Feitosa de França
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
| | - Marcos Antônio Ferreira Júnior
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
- Department of Nursing, Integrated Institute of Health of Federal University of Mato Grosso do Sul, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Libna Helen de Melo Lima
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
- Department of Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil
| | - Nilba Lima de Souza
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
| |
Collapse
|
322
|
Jesus JGD, Sacchi C, Candido DDS, Claro IM, Sales FCS, Manuli ER, Silva DBBD, Paiva TMD, Pinho MAB, Santos KCDO, Hill SC, Aguiar RS, Romero F, Santos FCPD, Gonçalves CR, Timenetsky MDC, Quick J, Croda JHR, Oliveira WD, Rambaut A, Pybus OG, Loman NJ, Sabino EC, Faria NR. Importation and early local transmission of COVID-19 in Brazil, 2020. Rev Inst Med Trop Sao Paulo 2020; 62:e30. [PMID: 32401959 PMCID: PMC7232955 DOI: 10.1590/s1678-9946202062030] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/26/2022] Open
Abstract
We conducted the genome sequencing and analysis of the first confirmed COVID-19 infections in Brazil. Rapid sequencing coupled with phylogenetic analyses in the context of travel history corroborate multiple independent importations from Italy and local spread during the initial stage of COVID-19 transmission in Brazil.
Collapse
Affiliation(s)
- Jaqueline Goes de Jesus
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Claudio Sacchi
- Laboratório Estratégico, Instituto Adolfo Lutz, São Paulo, São Paulo, Brazil
| | | | - Ingra Morales Claro
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Erika Regina Manuli
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | | - Filipe Romero
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro,, Brazil
| | | | | | | | - Joshua Quick
- University of Birmingham, Birmingham, United Kingdom
| | - Julio Henrique Rosa Croda
- Coordenação Geral de Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil.,Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, Mato Grosso do Sul, Brazil,Fundação Osvaldo Cruz Campo Grande, Mato Grosso do Sul, Brazil
| | - Wanderson de Oliveira
- Coordenação Geral de Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil
| | - Andrew Rambaut
- University of Edinburgh, Institute of Evolutionary Biology, Edinburgh, United Kingdom
| | - Oliver G. Pybus
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | | | - Ester Cerdeira Sabino
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Nuno Rodrigues Faria
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, São Paulo, Brazil.,Department of Zoology, University of Oxford, Oxford, United Kingdom.,Imperial College, School of Public Health, Department of Infectious Disease Epidemiology, London, United Kingdom
| |
Collapse
|
323
|
Lo Presti A, Neri A, Fazio C, Vacca P, Ambrosio L, Grazian C, Liseo B, Rezza G, Maiden MCJ, Stefanelli P. Reconstruction of Dispersal Patterns of Hypervirulent Meningococcal Strains of Serogroup C:cc11 by Phylogenomic Time Trees. J Clin Microbiol 2019; 58:e01351-19. [PMID: 31666361 DOI: 10.1128/JCM.01351-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/15/2019] [Indexed: 01/01/2023] Open
Abstract
Neisseria meningitidis is one of the few commensal bacteria that can even cause large epidemics of invasive meningococcal disease (IMD). N. meningitis serogroup C belonging to the hypervirulent clonal complex 11 (cc11) represents an important public health threat worldwide. We reconstructed the dispersal patterns of hypervirulent meningococcal strains of serogroup C:cc11 by phylogenomic time trees. Neisseria meningitidis is one of the few commensal bacteria that can even cause large epidemics of invasive meningococcal disease (IMD). N. meningitis serogroup C belonging to the hypervirulent clonal complex 11 (cc11) represents an important public health threat worldwide. We reconstructed the dispersal patterns of hypervirulent meningococcal strains of serogroup C:cc11 by phylogenomic time trees. In particular, we focused the attention on the epidemic dynamics of C:P1.5.1,10-8:F3-6;ST-11(cc11) meningococci causing outbreaks, as occurred in the Tuscany region, Italy, in 2015 to 2016. A phylogeographic analysis was performed through a Bayesian method on 103 Italian and 208 foreign meningococcal genomes. The C:P1.5.1,10-8:F3-6;ST-11(cc11) genotype dated back to 1995 (1992 to 1998) in the United Kingdom. Two main clades of the hypervirulent genotype were identified in Italy. The Tuscany outbreak isolates were included in different clusters in a specific subclade which originated in the United Kingdom around 2011 and was introduced in Tuscany in 2013 to 2014. In this work, phylogeographic analysis allowed the identification of multiple introductions of these strains in several European countries and connections with extra-European areas. Whole-genome sequencing (WGS) combined with phylogeography enables us to track the dissemination of meningococci and their transmission. The C:P1.5.1,10-8:F3-6;ST-11(cc11) genotype analysis revealed how a hypervirulent strain may be introduced in previously naïve areas, causing a large and long-lasting outbreak.
Collapse
|
324
|
Nduaguba SO, Ford KH, Wilson JP, Lawson KA. Gender and ethnic differences in rates of immune reconstitution, AIDS diagnosis, and survival. AIDS Care 2019; 33:285-289. [PMID: 31838894 DOI: 10.1080/09540121.2019.1703890] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this work, we use 2011-2013 Texas HIV surveillance data (N=2,175) and apply hierarchical linear and Cox regression modeling to characterize the association of gender and race/ethnicity with rate of immune recovery and determine whether immune recovery contributes to gender and racial/ethnic disparities in AIDS diagnosis and survival. The associations between gender and rate of immune recovery and between race/ethnicity and rate of immune recovery were not statistically significant (p > 0.05). In the multivariate survival analyses, there was no statistically significant association between gender and AIDS diagnosis (Adjusted Hazard Ratio (AHR) = 1.06, p = 0.61, 95%=0.85-1.32) and between race/ethnicity and AIDS diagnosis (Blacks vs Whites: AHR = 1.10, p = 0.24, 95% CI = 0.94-1.30; Hispanics vs Whites: AHR = 1.06, p = 0.46, 95% CI = 0.91-1.24). Similarly, there were no statistically significant associations with death (males vs females: AHR = 0.88, p = 0.73, 95% CI = 0.43-1.81; Blacks vs Whites: AHR = 0.68 p = 0.25, 95% CI = 0.36-1.30; Hispanics vs Whites: AHR = 0.96, p = 0.88, 95% CI = 0.55-1.67). However, the direction of the point estimates were in the reverse direction when compared to the rate of immune recovery or the AIDS diagnosis models. Our findings suggest that differences in rate of immune recovery may better explain disparities in AIDS diagnosis than disparities in survival. Future studies with longer follow-up may potentially generate statistically significant results.
Collapse
Affiliation(s)
- Sabina O Nduaguba
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA.,Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Kentya H Ford
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - James P Wilson
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - Kenneth A Lawson
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| |
Collapse
|
325
|
Hilarión-Gaitán L, Díaz-Jiménez D, Cotes-Cantillo K, Castañeda-Orjuela C. Inequalities in health by regime of affiliation to the health system in events of obligatory notification, Colombia, 2015. ACTA ACUST UNITED AC 2019; 39:737-47. [PMID: 31860184 DOI: 10.7705/biomedica.4453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Indexed: 11/21/2022]
Abstract
Introduction: Inequalities in the health field are caused by the differences in the social and economic conditions, that influence the disease risk and the measures taken to treat the disease.
Objective: We aimed to estimate the social inequalities in health in Colombia, according to the type of affiliation to the health system as a proxy of socioeconomic status.
Materials and methods: We conducted a retrospective descriptive analysis calculating incidence rates age and sex adjusted for all mandatory reporting events using the affiliation regime (subsidized and contributory) as a socioeconomic proxy. Estimates were made at departmental level for 2015. Social inequalities were calculated in terms of absolute and relative gaps.
Results: We found social inequalities in the occurrence of mandatory reporting events in population affiliated to the Colombian subsidized regime (poor population).
In this population, 82.31 cases of Plasmodium falciparum malaria per 100,000 affiliates were reported more than those reported in the contributory regime. Regarding the relative gap, belonging to the subsidized regime increased by 31.74 times the risk of dying from malnutrition in children under 5 years of age.
Other events such as those related to sexual and reproductive health (maternal mortality, gestational syphilis and congenital syphilis); neglected diseases and communicable diseases related to poverty (leprosy and tuberculosis), also showed profound inequalities.
Conclusion: In Colombia there are inequalities by regime of affiliation to the health system. Measured socioeconomic status was a predictor of increased morbidity and premature mortality.
Collapse
|
326
|
Bahardoust M, Rajabi A, Barakati SH, Naserbakht M, Ghadami S, Talachian E, Motevalian SA. Evaluation of Timeliness, Simplicity, Acceptability, and Flexibility in Child Mortality Surveillance System for Children Aged 1-59 Months in Iran. Int J Prev Med 2019; 10:205. [PMID: 31879554 PMCID: PMC6921285 DOI: 10.4103/ijpvm.ijpvm_452_18] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 10/05/2019] [Indexed: 11/09/2022] Open
Abstract
Background: Child mortality surveillance system (CMSS) for children aged 1–59 months is a critical issue in the prevention of mortality. This surveillance system like other health programs needs to be evaluated. Therefore, this study aims to evaluate CMSS in Iran. Methods: This evaluation was performed from March 2015 to March 2016 based on selected criteria for assessing the public health surveillance system proposed by the Centers for Disease Control and Prevention. Selected criteria examined in this study included timeliness, simplicity, acceptability, and flexibility. These criteria were evaluated in two ways. First, it included the use of a researcher-made questionnaire. The questionnaires were completed by 100 experts on CMSS. Second, to perform a more exact evaluation of these criteria, 24 of these experts were selected for the focus group. Results: In this study, the response rate was 91% (42% hospital-based and 49% primary care-based). In the timeliness section, 49% of the experts believed that approvals of the child mortality committees have not been sent within the designated time frame; hardware, software, and questionnaires were reported as effective factors in this respect. The structural and administrative problems were effective in simplicity domain and the experts of mortality registration and mood of relatives were effective in acceptability domain. The flexibility of the system was high and appropriate. Conclusions: The findings of the present study reveal that CMSS has some limitations and problems in the timeliness, simplicity, and acceptability criteria, which can be resolved. But this program has an appropriate situation in terms of flexibility.
Collapse
Affiliation(s)
- Mansour Bahardoust
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolhalim Rajabi
- Department of Biostatistics and Epidemiology, School of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Morteza Naserbakht
- Mental Health Research Center, Tehran Institute of Psychiatry- School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Shila Ghadami
- Family and Population Health Office, Ministry of Health and Medical Education, Tehran, Iran
| | - Elham Talachian
- Pediatric Gastroenterology Division, Ali-Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Abbas Motevalian
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences (IUMS), Tehran, Iran
| |
Collapse
|
327
|
Cheng AC, Holmes M, Dwyer DE, Senanayake S, Cooley L, Irving LB, Simpson G, Korman T, Macartney K, Friedman ND, Wark P, Howell A, Blyth CC, Crawford N, Buttery J, Bowler S, Upham JW, Waterer GW, Kotsimbos T, Kelly PM. Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2018: the Influenza Complications Alert Network (FluCAN). ACTA ACUST UNITED AC 2019; 43. [PMID: 31738866 DOI: 10.33321/cdi.2019.43.48] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza during the 2018 influenza season. In this observational surveillance system, cases were defined as patients admitted to any of the 17 sentinel hospitals with influenza confirmed by nucleic acid detection. Data were also collected on a frequency-matched control group of influenza-negative patients admitted with acute respiratory infection. During the period 3 April to 31 October 2018 (the 2018 influenza season), 769 patients were admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 30% were elderly (≥65 years), 28% were children (<16 years), 6.4% were Aboriginal and Torres Strait Islander peoples, 2.2% were pregnant and 66% had chronic comorbidities. A small proportion of FluCAN admissions were due to influenza B (13%). Estimated vaccine coverage was 77% in the elderly (≥65 years), 45% in non-elderly adults with medical comorbidities and 26% in children (<16 years) with medical comorbidities. The estimated vaccine effectiveness (VE) in the target population was 52% (95% CI: 37%, 63%). There were a smaller number of hospital admissions detected with confirmed influenza in this national observational surveillance system in 2018 than in 2017, with the demographic profile reflecting the change in circulating subtype from A/H3N2 to A/H1N1.
Collapse
Affiliation(s)
| | - Mark Holmes
- University of Adelaide, Royal Adelaide Hospital
| | - Dominic E Dwyer
- NSW Health Pathology-ICPMR, University of Sydney, Westmead Hospital
| | | | | | | | | | | | | | | | - Peter Wark
- University of Newcastle, John Hunter Hospital
| | | | - Christopher C Blyth
- Perth Children's Hospital, University of Western Australia, Telethon Kids Institute
| | - Nigel Crawford
- Royal Children's Hospital Melbourne, Murdoch Children's Research Institute
| | - Jim Buttery
- Monash Children's Hospital, Monash University
| | | | - John W Upham
- Princess Alexandra Hospital, University of Queensland
| | | | | | - Paul M Kelly
- Therapeutic Goods Administration, Australian Department of Health
| |
Collapse
|
328
|
Beer L, Johnson CH, Fagan JL, Frazier EL, Nyaku M, Craw JA, Sanders CC, Luna-Gierke RE, Shouse RL. A National Behavioral and Clinical Surveillance System of Adults With Diagnosed HIV (The Medical Monitoring Project): Protocol for an Annual Cross-Sectional Interview and Medical Record Abstraction Survey. JMIR Res Protoc 2019; 8:e15453. [PMID: 31738178 PMCID: PMC6887828 DOI: 10.2196/15453] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/23/2019] [Accepted: 08/27/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The Medical Monitoring Project (MMP) is a national population-based behavioral and clinical surveillance system of adults with diagnosed HIV in the United States, and it is sponsored by the Centers for Disease Control and Prevention (CDC). Its purpose is to provide locally and nationally representative estimates of factors affecting HIV transmission risk and clinical outcomes. OBJECTIVE This study aimed to describe the rationale for and methodology of the MMP, in addition to its contribution to evaluating and monitoring HIV prevention, care, and treatment efforts in the United States. METHODS MMP employs a stratified 2-stage sample design to select annual samples of persons living with diagnosed HIV from the National HIV Surveillance System and conducts interviews and medical record abstractions with participating persons. RESULTS MMP data are published routinely via annual reports, conference presentations, and scientific publications. Data may be accessed upon request from the CDC, contingent on the guidelines established for the security and confidentiality of HIV surveillance data. CONCLUSIONS MMP is the only source of annual population-based data on the behaviors and clinical care of persons with diagnosed HIV in the United States. It provides essential information for monitoring progress toward national treatment and prevention goals and guiding efforts to improve the health of persons with diagnosed HIV and prevent HIV transmission. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/15453.
Collapse
Affiliation(s)
- Linda Beer
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Jennifer L Fagan
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Emma L Frazier
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Margaret Nyaku
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jason A Craw
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | - R Luke Shouse
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| |
Collapse
|
329
|
Pratt RH, Manangan LP, Cummings CN, Langer AJ. Noncountable Tuberculosis Case Reporting, National Tuberculosis Surveillance System, United States, 2010-2014. Public Health Rep 2019; 135:18-24. [PMID: 31722186 DOI: 10.1177/0033354919884302] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Supplemental federal funding is allocated to state and local tuberculosis (TB) programs using a formula that considers only countable cases reported to the National Tuberculosis Surveillance System (NTSS). Health departments submit reports of cases, which are countable unless another (US or international) jurisdiction has already counted the case or the case represents a recurrence of TB diagnosed ≤12 months after completion of treatment for a previous TB episode. Noncountable cases are a resource burden, so in 2009, NTSS began accepting noncountable case reports as an indicator of program burden. We sought to describe the volume and completeness of noncountable case reports. METHODS We analyzed 2010-2014 NTSS data to determine the number and distribution of noncountable cases reported. We also surveyed jurisdictions to determine the completeness of noncountable case reporting and obtain information on jurisdictions' experience in reporting noncountable cases. In addition, we prepared a hypothetical recalculation of the funding formula to evaluate the effect of including noncountable cases on funding allocations. RESULTS Of 54 067 TB case reports analyzed, 1720 (3.2%) were noncountable; 47 of 60 (78.3%) jurisdictions reported ≥1 noncountable case. Of 60 programs surveyed, 34 (56.7%) responded. Of the 34 programs that responded, 24 (70.6%) had not reported all their noncountable cases to NTSS, and 11 (32.4%) stated that reporting noncountable cases was overly burdensome, considering the cases were not funded. CONCLUSIONS Complete data on noncountable TB cases help support estimates of programmatic burden. Ongoing training and a streamlined reporting system to NTSS can facilitate noncountable case reporting.
Collapse
Affiliation(s)
- Robert H Pratt
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lilia P Manangan
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Charisse Nitura Cummings
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adam J Langer
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
330
|
Hermann T, Gleckner W, Wasfi RA, Thierry B, Kestens Y, Ross NA. A pan-Canadian measure of active living environments using open data. Health Rep 2019; 30:16-25. [PMID: 31091332 DOI: 10.25318/82-003-x201900500002-eng] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
BACKGROUND Neighbourhood environments that support active living, such as walking or cycling for transportation, may decrease the burden of chronic conditions related to sedentary behaviour. Many measures exist to summarize features of communities that support active living, but few are pan-Canadian and none use open data sources that can be widely shared. This study reports the development and validation of a novel set of indicators of active living environments using open data that can be linked to national health surveys and can be used by local, regional or national governments for public health surveillance. DATA AND METHODS A Geographic Information System (GIS) was used to calculate a variety of measures of the connectivity, density and proximity to destinations for 56,589 dissemination areas (DAs) across Canada (2016 data). Pearson correlation coefficients were calculated to assess the association between each measure and the rates of walking to work and taking active transportation to work (a combination of walking, cycling and using public transportation) from census data. The active living environment measures selected for the final database were used to classify the DAs by the favourability of their active living environment into groups by k-medians clustering. RESULTS All measures were correlated with walking-to-work and active-transportation-to-work rates at the DA level, whether they were derived using proprietary or open data sources. Coverage of open data was consistent across Canadian regions. Three measures were selected for the Canadian Active Living Environments (Can-ALE) dataset based on the correlation analysis, but also on the principles of suitability for a variety of community sizes and openly available data: (1) three-way intersection density of roads and footpaths derived from OpenStreetMap (OSM), (2) weighted dwelling density derived from Statistics Canada dwelling counts and (3) points of interest derived from OSM. A measure of access to public transportation was added for the subset of DAs in larger urban areas and was strongly related to active-transportation-to-work rates. Active-transportation-to-work rates were graded, in steps, by the five Can-ALE groups derived from the cluster analysis, although walking-to-work rates exceeded the national average only in the most favourable active living environments. DISCUSSION Open data may be used to derive measures that characterize the active living environments of Canadian communities.
Collapse
Affiliation(s)
- Thomas Hermann
- Department of Geography, McGill University, Montreal, Quebec
| | | | - Rania A Wasfi
- Department of Geography, McGill University, Département de médecine sociale et préventive at the Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and the École de santé publique at the Université de Montréal (ESPUM)
| | - Benoît Thierry
- Département de médecine sociale et préventive at the Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and the École de santé publique at the Université de Montréal (ESPUM)
| | - Yan Kestens
- Département de médecine sociale et préventive at the Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and the École de santé publique at the Université de Montréal (ESPUM)
| | - Nancy A Ross
- Department of Geography, McGill University, Montreal, Quebec
| |
Collapse
|
331
|
Hosseini S, Karami M, Farhadian M, Mohammadi Y. Seasonal Activity of Influenza in Iran: Application of Influenza-like Illness Data from Sentinel Sites of Healthcare Centers during 2010 to 2015. J Epidemiol Glob Health 2019; 8:29-33. [PMID: 30859784 PMCID: PMC7325813 DOI: 10.2991/j.jegh.2018.08.100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 06/21/2018] [Indexed: 11/26/2022] Open
Abstract
This study aimed to predict seasonal influenza activity and detection of influenza outbreaks. Data of all registered cases (n = 53,526) of influenza-like illnesses (ILIs) from sentinel sites of healthcare centers in Iran were obtained from the FluNet web-based tool, World Health Organization (WHO), from 2010 to 2015. The status of the ILI activity was obtained from the FluNet and considered as the gold standard of the seasonal activity of influenza during the study period. The cumulative sum (CUSUM) as an outbreak detection method was used to predict the seasonal activity of influenza. Also, time series similarity between the ILI trend and CUSUM was assessed using the cross-correlogram. Of 7684 (14%) positive cases of influenza, about 71% were type A virus and 28% were type B virus. The majority of the outbreaks occurred in winter and autumn. Results of the cross-correlogram showed that there was a considerable similarity between time series graphs of the ILI cases and CUSUM values. However, the CUSUM algorithm did not have a good performance in the timely detection of influenza activity. Despite a considerable similarity between time series of the ILI cases and CUSUM algorithm in weekly lag, the seasonal activity of influenza in Iran could not be predicted by the CUSUM algorithm.
Collapse
Affiliation(s)
- Seyedhadi Hosseini
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Manoochehr Karami
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Modeling of Non-communicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Younes Mohammadi
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
332
|
Lafond KE, Praptiningsih CY, Mangiri A, Syarif M, Triada R, Mulyadi E, Septiawati C, Setiawaty V, Samaan G, Storms AD, Uyeki TM, Iuliano AD. Seasonal Influenza and Avian Influenza A(H5N1) Virus Surveillance among Inpatients and Outpatients, East Jakarta, Indonesia, 2011-2014. Emerg Infect Dis 2019; 25:2031-2039. [PMID: 31625837 PMCID: PMC6810195 DOI: 10.3201/eid2511.181844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During October 2011-September 2014, we screened respiratory specimens for seasonal and avian influenza A(H5N1) virus infections among outpatients with influenza-like illness and inpatients with severe acute respiratory infection (SARI) in East Jakarta, an Indonesia district with high incidence of H5N1 virus infection among poultry. In total, 31% (1,875/6,008) of influenza-like illness case-patients and 15% (571/3,811) of SARI case-patients tested positive for influenza virus. Influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B virus infections were detected in all 3 years, and the epidemic season extended from November through May. Although 28% (2,810/10,135) of case-patients reported exposure to poultry, only 1 SARI case-patient with an H5N1 virus infection was detected. Therefore, targeted screening among case-patients with high-risk poultry exposures (e.g., a recent visit to a live bird market or close proximity to sick or dead poultry) may be a more efficient routine surveillance strategy for H5N1 virus in these types of settings.
Collapse
|
333
|
Polling C, Bakolis I, Hotopf M, Hatch SL. Differences in hospital admissions practices following self-harm and their influence on population-level comparisons of self-harm rates in South London: an observational study. BMJ Open 2019; 9:e032906. [PMID: 31628133 PMCID: PMC6803107 DOI: 10.1136/bmjopen-2019-032906] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To compare the proportions of emergency department (ED) attendances following self-harm that result in admission between hospitals, examine whether differences are explained by severity of harm and examine the impact on spatial variation in self-harm rates of using ED attendance data versus admissions data. SETTING A dataset of ED attendances and admissions with self-harm to four hospitals in South East London, 2009-2016 was created using linked electronic patient record data and administrative Hospital Episode Statistics. DESIGN Proportions admitted following ED attendance and length of stay were compared. Variation and spatial patterning of age and sex standardised, spatially smoothed, self-harm rates by small area using attendance and admission data were compared and the association with distance travelled to hospital tested. RESULTS There were 20 750 ED attendances with self-harm, 7614 (37%) resulted in admission. Proportion admitted varied substantially between hospitals with a risk ratio of 2.45 (95% CI 2.30 to 2.61) comparing most and least likely to admit. This was not altered by adjustment for patient demographics, deprivation and type of self-harm. Hospitals which admitted more had a higher proportion of admissions lasting less than 24 hours (54% of all admissions at highest admitting hospital vs 35% at lowest). A previously demonstrated pattern of lower rates of self-harm admission closer to the city centre was reduced when ED attendance rates were used to represent self-harm. This was not altered when distance travelled to hospital was adjusted for. CONCLUSIONS Hospitals vary substantially in likelihood of admission after ED presentation with self-harm and this is likely due to the differences in hospital practices rather than in the patient population or severity of self-harm seen. Public health policy that directs resources based on self-harm admissions data could exacerbate existing health inequalities in inner-city areas where these data may underestimate rates relative to other areas.
Collapse
Affiliation(s)
- C Polling
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthew Hotopf
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Stephani L Hatch
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
334
|
Riblet NB, Shiner B, Watts BV, Britton P. Comparison of National and Local Approaches to Detecting Suicides in Healthcare Settings. Mil Med 2019; 184:e555-e560. [PMID: 30877803 PMCID: PMC8801297 DOI: 10.1093/milmed/usz045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/06/2019] [Accepted: 02/23/2019] [Indexed: 12/05/2022] Open
Abstract
Introduction: In order to address the problem of suicide, healthcare providers and researchers must be able to accurately identify suicide deaths. Common approaches to detecting suicide in the healthcare setting include the National Death Index (NDI) and Root-Cause Analysis (RCA) methodology. No study has directly compared these two methods. Materials and Methods: Suicide reporting was evaluated within the Veterans Affairs (VA) healthcare system. All suicides were included that occurred within 7 days of discharge from an inpatient mental health unit and were reported to the VA through the NDI record linkage and/or RCA database between 2002 and 2014. The proportion of suicide deaths that were identified by NDI and found in the RCA database were calculated. Potential misclassification by the NDI was evaluated, whereby the RCA database identified a suicide case, but the NDI classified the death as a non-suicide. Results: In the study period, the NDI identified 222 patients who died by suicide within 7 days of discharge, while the RCA database only detected 95 reports of suicide. A comparison of cases across the two methods indicated that the RCA database identified only 35% (N = 78) of NDI detected suicides (N = 222). Conversely, the RCA database detected 13 suicide cases that the NDI had coded as deaths due to accidental poisoning or other causes. Importantly, RCA accounted for 13% (N = 7) of overdose suicides identified in all databases (N = 52). Conclusions: Combining national and local approaches to detect suicide may help to improve the classification of suicide deaths in the healthcare setting.
Collapse
Affiliation(s)
- Natalie B Riblet
- Veterans Affairs Medical Center, White River Junction, VT.,Geisel School of Medicine at Dartmouth College, Hanover, NH.,The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
| | - Brian Shiner
- Veterans Affairs Medical Center, White River Junction, VT.,Geisel School of Medicine at Dartmouth College, Hanover, NH.,The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
| | - Bradley V Watts
- Geisel School of Medicine at Dartmouth College, Hanover, NH.,National Center for Patient Safety, Ann Arbor, MI
| | - Peter Britton
- VISN 2, Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua Medical Center, Canandaigua, NY.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY
| |
Collapse
|
335
|
Felton D, Hoffman K, Priddy D, Heu P. Insights in Public Health: The State of Childhood Lead Poisoning Prevention in Hawai'i. Hawaii J Health Soc Welf 2019; 78:320-323. [PMID: 31633114 PMCID: PMC6787395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Diana Felton
- Hawai'i Department of Health, Hazard Evaluation and Emergency Response Office, Pearl City, HI (DF, KH)
- Hawai'i Childhood Lead Poisoning Prevention Program, Honolulu, HI (KH, DP, PH)
- Hawai'i Department of Health, Children with Special Health Needs Branch, Honolulu, HI (DP, PH)
| | - Kelly Hoffman
- Hawai'i Department of Health, Hazard Evaluation and Emergency Response Office, Pearl City, HI (DF, KH)
- Hawai'i Childhood Lead Poisoning Prevention Program, Honolulu, HI (KH, DP, PH)
- Hawai'i Department of Health, Children with Special Health Needs Branch, Honolulu, HI (DP, PH)
| | - Derek Priddy
- Hawai'i Department of Health, Hazard Evaluation and Emergency Response Office, Pearl City, HI (DF, KH)
- Hawai'i Childhood Lead Poisoning Prevention Program, Honolulu, HI (KH, DP, PH)
- Hawai'i Department of Health, Children with Special Health Needs Branch, Honolulu, HI (DP, PH)
| | - Patricia Heu
- Hawai'i Department of Health, Hazard Evaluation and Emergency Response Office, Pearl City, HI (DF, KH)
- Hawai'i Childhood Lead Poisoning Prevention Program, Honolulu, HI (KH, DP, PH)
- Hawai'i Department of Health, Children with Special Health Needs Branch, Honolulu, HI (DP, PH)
| |
Collapse
|
336
|
Lang C, Hiller M, Konrad R, Fruth A, Flieger A. Whole-Genome-Based Public Health Surveillance of Less Common Shiga Toxin-Producing Escherichia coli Serovars and Untypeable Strains Identifies Four Novel O Genotypes. J Clin Microbiol 2019; 57:e00768-19. [PMID: 31366691 DOI: 10.1128/JCM.00768-19] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022] Open
Abstract
Shiga toxin-producing Escherichia coli (STEC) and the STEC subgroup enterohemorrhagic E. coli cause intestinal infections with symptoms ranging from watery diarrhea to hemolytic-uremic syndrome (HUS). A key tool for the epidemiological differentiation of STEC is serotyping. The serotype in combination with the main virulence determinants gives important insight into the virulence potential of a strain. Shiga toxin-producing Escherichia coli (STEC) and the STEC subgroup enterohemorrhagic E. coli cause intestinal infections with symptoms ranging from watery diarrhea to hemolytic-uremic syndrome (HUS). A key tool for the epidemiological differentiation of STEC is serotyping. The serotype in combination with the main virulence determinants gives important insight into the virulence potential of a strain. However, a large fraction of STEC strains found in human disease, including strains causing HUS, belongs to less frequently detected STEC serovars or their O/H antigens are unknown or even untypeable. Recent implementation of whole-genome sequence (WGS) analysis, in principle, allows the deduction of serovar and virulence gene information. Therefore, here we compared classical serovar and PCR-based virulence marker detection with WGS-based methods for 232 STEC strains, focusing on less frequently detected STEC serovars and nontypeable strains. We found that the results of WGS-based extraction showed a very high degree of overlap with those of the more classical methods. Specifically, the rate of concordance was 97% for O antigens (OAGs) and 99% for H antigens (HAGs) of typeable strains and >99% for stx1, stx2, or eaeA for all strains. Ninety-eight percent of nontypeable OAGs and 100% of nontypeable HAGs were defined by WGS analysis. In addition, the novel methods enabled a more complete analysis of strains causing severe clinical symptoms and the description of four novel STEC OAG loci. In conclusion, WGS is a promising tool for gaining serovar and virulence gene information, especially from a public health perspective.
Collapse
|
337
|
Cheng AC, Holmes M, Dwyer DE, Senanayake S, Cooley L, Irving LB, Simpson G, Korman T, Macartney K, Friedman ND, Wark P, Howell A, Blyth CC, Bowler S, Upham J, Waterer GW, Kotsimbos T, Kelly PM. Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2017: the Influenza Complications Alert Network (FluCAN). ACTA ACUST UNITED AC 2019; 43. [PMID: 31522661 DOI: 10.33321/cdi.2019.43.39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The Influenza Complications Alert Network (FluCAN) is a sentinel-hospital-based surveillance program that operates at sites in all jurisdictions in Australia. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza during the 2017 influenza season. In this observational surveillance system, cases were defined as patients admitted to any of the 17 sentinel hospitals with influenza confirmed by nucleic acid detection. Data are also collected on a frequency-matched control group of influenza-negative patients admitted with acute respiratory infection. During the period 3 April to 31 October 2017 (the 2017 influenza season), 4,359 patients were admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 52% were elderly (≥65 years), 14% were children (<16 years), 6.5% were Aboriginal and Torres Strait Islander peoples, 1.6% were pregnant and 78% had chronic comorbidities. A significant proportion were due to influenza B (31%). Estimated vaccine coverage was 72% in the elderly (≥65 years), 50% in non-elderly adults with medical comorbidities and 24% in children (<16 years) with medical comorbidities. The estimated vaccine effectiveness (VE) in the target population was 23% (95% CI: 7%, 36%). There were a large number of hospital admissions detected with confirmed influenza in this national observational surveillance system in 2017, with case numbers more than twice that reported in 2016.
Collapse
Affiliation(s)
| | - Mark Holmes
- University of Adelaide, Royal Adelaide Hospital
| | | | | | | | | | | | | | | | | | - Peter Wark
- University of Newcastle, John Hunter Hospital
| | | | - Christopher C Blyth
- Princess Margaret Hospital, University of Western Australia, Telethon Kids Institute
| | | | - John Upham
- Princess Alexandra Hospital, University of Queensland
| | | | | | - Paul M Kelly
- ACT Government Health Directorate; Australian National University Medical School
| |
Collapse
|
338
|
Mountcastle SB, Joyce AR, Sasinowski M, Costello N, Doshi S, Zedler BK. Validation of an administrative claims coding algorithm for serious opioid overdose: A medical chart review. Pharmacoepidemiol Drug Saf 2019; 28:1422-1428. [PMID: 31483548 DOI: 10.1002/pds.4886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE A standardized definition for serious opioid overdose has not been clearly established for disease surveillance or assessing the impact of risk mitigation strategies. The purpose of this study was to use medical chart review to clinically validate a claims-based algorithm to identify serious opioid overdose events. METHODS The algorithm for serious opioid overdose required an opioid poisoning or external cause ICD-9-CM code occurring within 1 day of (a) an adverse effect code for serious central nervous system or respiratory depression or (b) a mechanical ventilation or critical care CPT code. The claims coding algorithm identified a sample of 145 individuals 18 years or older among patients that presented to the emergency department of two large hospitals in metropolitan Atlanta, Georgia from January 2014 to August 2015. Claims-defined cases were evaluated against rigorous clinical definitions for serious opioid overdose using (a) literature-based criteria for typical clinical manifestations of opioid overdose and/or (b) clinical response to the opioid-specific reversal agent naloxone. The positive predictive value (PPV) for a serious opioid overdose was calculated as the percentage of clinically confirmed cases (definite or probable). RESULTS Among 140 evaluable claims-defined cases, 107 fulfilled clinical criteria for a serious opioid overdose [95 definite and 12 probable; PPV of 76.4% (95% CI 69.4%, 83.5%)]. Among 30 nonconfirmed cases, 20 were polyintoxications involving one or more nonopioid psychoactive agents. CONCLUSIONS An administrative claims coding algorithm for serious opioid overdose had high clinical predictive performance in a medical chart review.
Collapse
|
339
|
Abstract
The decline in child mortality over the past two decades has been described as the greatest story in global public health. Indeed, using modern tools and interventions, there has been remarkable progress, reducing deaths in children <5 y of age by nearly half from 2000 to 2017. However, as a consequence of persistent geographic inequalities, we fall short of the United Nations Sustainable Development Goal to end all preventable child deaths by 2030, with an estimated 44.6 million preventable deaths expected to occur by the target year. This article discusses how we might further improve the downward trend in child mortality over the next decade to end preventable child deaths.
Collapse
Affiliation(s)
- Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600 Seattle, WA, USA
| |
Collapse
|
340
|
Mamiya H, Schmidt AM, Moodie EEM, Ma Y, Buckeridge DL. An Area-Level Indicator of Latent Soda Demand: Spatial Statistical Modeling of Grocery Store Transaction Data to Characterize the Nutritional Landscape in Montreal, Canada. Am J Epidemiol 2019; 188:1713-1722. [PMID: 31063186 DOI: 10.1093/aje/kwz115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 04/24/2019] [Accepted: 04/29/2019] [Indexed: 12/26/2022] Open
Abstract
Measurement of neighborhood dietary patterns at high spatial resolution allows public health agencies to identify and monitor communities with an elevated risk of nutrition-related chronic diseases. Currently, data on diet are obtained primarily through nutrition surveys, which produce measurements at low spatial resolutions. The availability of store-level grocery transaction data provides an opportunity to refine the measurement of neighborhood dietary patterns. We used these data to develop an indicator of area-level latent demand for soda in the Census Metropolitan Area of Montreal in 2012 by applying a hierarchical Bayesian spatial model to data on soda sales from 1,097 chain retail food outlets. The utility of the indicator of latent soda demand was evaluated by assessing its association with the neighborhood relative risk of prevalent type 2 diabetes mellitus. The indicator improved the fit of the disease-mapping model (deviance information criterion: 2,140 with the indicator and 2,148 without) and enables a novel approach to nutrition surveillance.
Collapse
Affiliation(s)
- Hiroshi Mamiya
- Surveillance Lab, McGill Clinical and Health Informatics, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Alexandra M Schmidt
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Erica E M Moodie
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Yu Ma
- Desautels Faculty of Management, McGill University, Montreal, Quebec, Canada
| | - David L Buckeridge
- Surveillance Lab, McGill Clinical and Health Informatics, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
341
|
Wansaula Z, Wortham JM, Mindra G, Haddad MB, Salinas JL, Ashkin D, Morris SB, Grant GB, Ghosh S, Langer AJ. Bacillus Calmette-Guérin Cases Reported to the National Tuberculosis Surveillance System, United States, 2004-2015. Emerg Infect Dis 2019; 25:451-456. [PMID: 30789145 PMCID: PMC6390767 DOI: 10.3201/eid2503.180686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mycobacterium bovis bacillus Calmette-Guérin (BCG) is used as a vaccine to protect against disseminated tuberculosis (TB) and as a treatment for bladder cancer. We describe characteristics of US TB patients reported to the National Tuberculosis Surveillance System (NTSS) whose disease was attributed to BCG. We identified 118 BCG cases and 91,065 TB cases reported to NTSS during 2004-2015. Most patients with BCG were US-born (86%), older (median age 75 years), and non-Hispanic white (81%). Only 17% of BCG cases had pulmonary involvement, in contrast with 84% of TB cases. Epidemiologic features of BCG cases differed from TB cases. Clinicians can use clinical history to discern probable BCG cases from TB cases, enabling optimal clinical management. Public health agencies can use this information to quickly identify probable BCG cases to avoid inappropriately reporting BCG cases to NTSS or expending resources on unnecessary public health interventions.
Collapse
|
342
|
Lepuschitz S, Ruppitsch W, Pekard-Amenitsch S, Forsythe SJ, Cormican M, Mach RL, Piérard D, Allerberger F. Multicenter Study of Cronobacter sakazakii Infections in Humans, Europe, 2017. Emerg Infect Dis 2019; 25:515-522. [PMID: 30789137 PMCID: PMC6390735 DOI: 10.3201/eid2503.181652] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Cronobacter sakazakii has been documented as a cause of life-threating infections, predominantly in neonates. We conducted a multicenter study to assess the occurrence of C. sakazakii across Europe and the extent of clonality for outbreak detection. National coordinators representing 24 countries in Europe were requested to submit all human C. sakazakii isolates collected during 2017 to a study center in Austria. Testing at the center included species identification by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, subtyping by whole-genome sequencing (WGS), and determination of antimicrobial resistance. Eleven countries sent 77 isolates, including 36 isolates from 2017 and 41 historical isolates. Fifty-nine isolates were confirmed as C. sakazakii by WGS, highlighting the challenge of correctly identifying Cronobacter spp. WGS-based typing revealed high strain diversity, indicating absence of multinational outbreaks in 2017, but identified 4 previously unpublished historical outbreaks. WGS is the recommended method for accurate identification, typing, and detection of this pathogen.
Collapse
|
343
|
Nelson CK, Franklin LJ, Gibney KB. Infectious Disease Notification Practices in Victoria, 2016-17. ACTA ACUST UNITED AC 2019; 43. [PMID: 31426732 DOI: 10.33321/cdi.2019.43.34] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction Infectious disease surveillance in Victoria, Australia is based upon a legislated requirement for doctors and laboratories to notify suspected or diagnosed cases of specific conditions to the Department of Health and Human Services (DHHS). The department undertakes regular audits of notification practices in Victoria typically every two years. The objective of this particular audit was to describe notification practices in 2016 and 2017, assess the effect of enhanced surveillance programs (ESPs) on Indigenous status data completeness and provide a baseline assessment that can be used to monitor the impact of a recent legislative change to notification requirements for several of the notifiable diseases which came into effect on 1 September 2018. Methods Notified cases reported to DHHS between 1 January 2016 and 31 December 2017 which met the confirmed and probable national case definitions were analysed by year, notifier type (doctor-only, laboratory-only, or both) and condition category (urgent versus routine). For three notifiable conditions (gonococcal infection and hepatitis B and hepatitis C of unspecified duration) Indigenous status completeness was compared pre- and post ESP commencement. Results The number of notified cases in Victoria increased 50% from 76,904 in 2016 to 115,318 in 2017 with a 277% increase in notified influenza alone. Almost half of cases were notified by both laboratory and doctor. Indigenous status was more likely to be complete following the introduction of ESPs (relative risk, RR 1.36 (95%CI: 1.33 - 1.40) p>0 .001). Discussion DHHS Victoria experienced a 1.5-fold increase in notified cases in 2017 compared with 2016, which was almost entirely attributable to influenza. For three notifiable conditions which had ESPs introduced during this period, Indigenous status reporting significantly improved. Indigenous identifiers on pathology request forms and data linkage are both interventions which are being considered to improve Indigenous status reporting in Victoria.
Collapse
Affiliation(s)
- Cassidy K Nelson
- Public Health Medicine (Communicable Disease)
- Health Protection Branch Regulation, Health Protection and Emergency Management Division Department of Health and Human Services
| | - Lucinda J Franklin
- Communicable Disease Epidemiology and Surveillance
- Health Protection Branch Regulation, Health Protection and Emergency Management Division Department of Health and Human Services
| | - Katherine B Gibney
- Communicable Disease Epidemiology and Surveillance
- Health Protection Branch Regulation, Health Protection and Emergency Management Division Department of Health and Human Services
| |
Collapse
|
344
|
Law RKY, Kisselburgh H, Roblin D, Choudhary E, Schier J, Fraser M, Taylor E. Noninfectious Foodborne Exposures Reported to 2 National Reporting Systems, United States, 2000-2010. Public Health Rep 2019; 134:552-558. [PMID: 31386820 DOI: 10.1177/0033354919862690] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Foodborne disease is a pervasive problem caused by consuming food or drink contaminated by infectious or noninfectious agents. The 55 US poison centers receive telephone calls for advice on foodborne disease cases that may be related to a foodborne disease outbreak (FBDO). Our objective was to assess whether poison center call records uploaded to the National Poison Data System (NPDS) can be used for surveillance of noninfectious FBDOs in the United States. METHODS We matched NPDS records on noninfectious FBDO agents in the United States with records in the Foodborne Disease Outbreak Surveillance System (FDOSS) for 2000-2010. We conducted multivariable logistic regression analysis comparing NPDS matched and unmatched records to assess features of NPDS records that may indicate a confirmed noninfectious FBDO. RESULTS During 2000-2010, FDOSS recorded 491 noninfectious FBDOs of known etiology and NPDS recorded 8773 calls for noninfectious foodborne disease exposures. Of 8773 NPDS calls, 469 (5.3%) were matched to a noninfectious FBDO reported to FDOSS. Multivariable logistic regression indicated severity of medical outcome, whether the call was made by a health care professional, and etiology as significant predictors of NPDS records matching an FDOSS noninfectious FBDO. CONCLUSIONS NPDS may complement existing surveillance systems and response activities by providing timely information about single cases of foodborne diseases or about a known or emerging FBDO. Prioritizing NPDS records by certain call features could help guide public health departments in the types of noninfectious foodborne records that most warrant public health follow-up.
Collapse
Affiliation(s)
- Royal Kai Yee Law
- 1 National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hannah Kisselburgh
- 2 National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Douglas Roblin
- 3 Georgia State University School of Public Health, Atlanta, GA, USA
| | - Ekta Choudhary
- 1 National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joshua Schier
- 1 National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michael Fraser
- 4 American Association of Poison Control Centers, Alexandria, VA, USA
| | - Ethel Taylor
- 1 National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
345
|
Abstract
Child maltreatment identified by medical professionals is poorly represented in records of child protection. International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes may better represent the burden of maltreatment treated in clinical settings. Using emergency department (ED) discharge data from 2011 to 2014, we enumerated presentations of maltreatment treated in Connecticut EDs for children under 10 years. Of 790 080 discharges, child maltreatment was explicitly documented in 265 (0.03%) unique ED visits, consistent with prior studies. Sexual maltreatment was most prevalent. A total of 3634 visits included an ICD-9-CM code suggestive of maltreatment. Children with these codes were significantly younger, more likely to be of white race, and use private insurance. Use of ICD codes in child maltreatment surveillance may elucidate characteristics of maltreatment not captured by child welfare data. Combining ICD codes for explicit and suggestive maltreatment will aid in understanding the extent of this problem.
Collapse
Affiliation(s)
- Amy A Hunter
- 1 Injury Prevention Center, Connecticut Children's Medical Center, Hartford, CT, USA.,2 Department of Pediatrics, School of Medicine, University of Connecticut, Farmington, CT, USA.,3 Department of Community Medicine and Health Care, School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Bruce Bernstein
- 4 Department of Pediatics, Drexel University College of Medicine, Philadelphia, PA, USA
| |
Collapse
|
346
|
Cocoros NM, Ochoa A, Eberhardt K, Zambarano B, Klompas M. Denominators Matter: Understanding Medical Encounter Frequency and Its Impact on Surveillance Estimates Using EHR Data. EGEMS (Wash DC) 2019; 7:31. [PMID: 31367648 DOI: 10.5334/egems.292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: There is scant guidance for defining what denominator to use when estimating disease prevalence via electronic health record (EHR) data. Objectives: Describe the intervals between medical encounters to inform the selection of denominators for population-level disease rates, and evaluate the impact of different denominators on the prevalence of chronic conditions. Methods: We analyzed the EHRs of three practices in Massachusetts using the Electronic medical record Support for Public Health (ESP) system. We identified adult patients’ first medical encounter per year (2011–2016) and counted days to next encounter. We estimated the prevalence of asthma, hypertension, obesity, and smoking using different denominators in 2016: ≥1 encounter in the past one year or two years and ≥2 encounters in the past one year or two years. Results: In 2011–2016, 1,824,011 patients had 28,181,334 medical encounters. The median interval between encounters was 46, 56, and 66 days, depending on practice. Among patients with one visit in 2014, 82–84 percent had their next encounter within 1 year; 87–91 percent had their next encounter within two years. Increasing the encounter interval from one to two years increased the denominator by 23 percent. The prevalence of asthma, hypertension, and obesity increased with successively stricter denominators – e.g., the prevalence of obesity was 24.1 percent among those with ≥1 encounter in the past two years, 26.3 percent among those with ≥1 encounter in the last one year, and 28.5 percent among those with ≥2 encounters in the past one year. Conclusions: Prevalence estimates for chronic conditions can vary by >20 percent depending upon denominator. Understanding such differences will inform which denominator definition is best to be used for the need at hand.
Collapse
|
347
|
Schar D, Padungtod P, Tung N, O'Leary M, Kalpravidh W, Claes F. New frontiers in applied veterinary point-of-capture diagnostics: Toward early detection and control of zoonotic influenza. Influenza Other Respir Viruses 2019; 13:618-621. [PMID: 31334612 PMCID: PMC6800308 DOI: 10.1111/irv.12648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/25/2019] [Indexed: 12/18/2022] Open
Abstract
Among the chief limitations in achieving early detection and control of animal‐origin influenza of pandemic potential in high‐risk livestock populations is the existing lag time between sample collection and diagnostic result. Advances in molecular diagnostics are permitting deployment of affordable, rapid, highly sensitive, and specific point‐of‐capture assays, providing opportunities for targeted surveillance driving containment strategies with potentially compelling returns on investment. Interrupting disease transmission at source holds promise of disrupting cycles of animal‐origin influenza incursion to endemicity and limiting impact on animal production, food security, and public health. Adoption of new point‐of‐capture diagnostics should be undertaken in the context of promoting robust veterinary services systems and parallel support for operationalizing pre‐authorized plans and communication strategies that will ensure that the full potential of these new platforms is realized.
Collapse
Affiliation(s)
- Daniel Schar
- U.S. Agency for International Development, Bangkok, Thailand.,Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, Brussels, Belgium
| | - Pawin Padungtod
- Country Office for Viet Nam, Food and Agriculture Organization of the United Nations, Hanoi, Viet Nam
| | - Nguyen Tung
- Department of Animal Health, Ministry of Agriculture and Rural Development, Hanoi, Viet Nam
| | | | - Wantanee Kalpravidh
- Regional Office for Asia and the Pacific, Food and Agriculture Organization of the United Nations, Bangkok, Thailand
| | - Filip Claes
- Regional Office for Asia and the Pacific, Food and Agriculture Organization of the United Nations, Bangkok, Thailand
| |
Collapse
|
348
|
Cardenas VM, Paternina-Caicedo AJ, Salvatierra EB. Underreporting of Fatal Congenital Zika Syndrome, Mexico, 2016-2017. Emerg Infect Dis 2019; 25:1560-1562. [PMID: 31310228 PMCID: PMC6649343 DOI: 10.3201/eid2508.190106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To determine completeness of fatal congenital Zika syndrome reporting in Mexico, we examined data from the Mexican National Institute of Statistics and Geography. We found that an estimated 50% more infants died from microcephaly attributable to congenital Zika syndrome during 2016–2017 than were reported by the existing surveillance system.
Collapse
|
349
|
Lin FC, Huang ST, Shang RJ, Wang CC, Hsiao FY, Lin FJ, Lin MS, Hung KY, Wang J, Shen LJ, Lai F, Huang CF. A Web-Based Clinical System for Cohort Surveillance of Specific Clinical Effectiveness and Safety Outcomes: A Cohort Study of Non-Vitamin K Antagonist Oral Anticoagulants and Warfarin. JMIR Med Inform 2019; 7:e13329. [PMID: 31271151 PMCID: PMC6636345 DOI: 10.2196/13329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 12/14/2022] Open
Abstract
Background Conventional systems of drug surveillance lack a seamless workflow, which makes it crucial to have an active drug surveillance system that proactively assesses adverse drug events. Objective The aim of this study was to develop a seamless, Web-based workflow for comparing the safety and effectiveness of drugs in a database of electronic medical records. Methods We proposed a comprehensive integration process for cohort surveillance using the National Taiwan University Hospital Clinical Surveillance System (NCSS). We studied a practical application of the NCSS that evaluates the drug safety and effectiveness of novel oral anticoagulants (NOACs) and warfarin by cohort tree analysis in an efficient and interoperable platform. Results We demonstrated a practical example of investigating the differences in effectiveness and safety between NOACs and warfarin in patients with nonvalvular atrial fibrillation (AF) using the NCSS. We efficiently identified 2357 patients with nonvalvular AF with newly prescribed oral anticoagulants between 2010 and 2015 and further developed 1 main cohort and 2 subcohorts for separately measuring ischemic stroke as the clinical effectiveness outcome and intracranial hemorrhage (ICH) as the safety outcome. In the subcohort of ischemic stroke, NOAC users exhibited a significantly lower risk of ischemic stroke than warfarin users after adjusting for age, sex, comorbidity, and comedication in an intention-to-treat (ITT) analysis (P=.01) but did not exhibit a significantly distinct risk in an as-treated (AT) analysis (P=.12) after the 2-year follow-up. In the subcohort of ICH, NOAC users did not exhibit a different risk of ICH both in ITT (P=.68) and AT analyses (P=.15). Conclusions With a seamless and Web-based workflow, the NCSS can serve the critical role of forming associations between evidence and the real world at a medical center in Taiwan.
Collapse
Affiliation(s)
- Fong-Ci Lin
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.,Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Tsung Huang
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Rung Ji Shang
- Information Technology Office, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Chuan Wang
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fang-Ju Lin
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mei-Shu Lin
- Department of Development and Planning, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Yu Hung
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, Hsinchu, Taiwan
| | - Jui Wang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Li-Jiuan Shen
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Feipei Lai
- Department of Computer Science & Information Engineering, National Taiwan University, Taipei, Taiwan.,Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Chih-Fen Huang
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
350
|
Dougas G, Mellou K, Kostoulas P, Billinis C, Georgakopoulou T, Tsiodras S. Brucellosis underreporting in Greece: assessment based on aggregated laborato-ry data of culture-confirmed cases from public hospitals. Hippokratia 2019; 23:106-110. [PMID: 32581495 PMCID: PMC7307503] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Brucella spp. isolation is one of the mainstays of brucellosis diagnosis. Simultaneously, the true brucellosis disease rate may be underrepresented in notification systems. This study aims at assessing the nosocomial capacity for Brucella spp. isolation and the underreporting rate of brucellosis cases in Greece. METHODS Data for Brucella spp. culture capacity and the number of isolations were collected annually from public hospitals nationwide, during 2015-2018. The number of unreported cases was estimated after subtracting the National Mandatory Notification System cases from the survey-captured isolations, matched by hospital and year. RESULTS Feedback was provided by 112 public hospitals (response rate: 97.4 %). Brucella spp. isolation capacity was completely absent in 27.7 % of hospitals; during the four years of the study, 11.3 %, 13.9 %, 20.0 %, and 25.2 % of the hospitals had isolation competence for one, two, three, or four years, respectively. Underreporting assessment was possible in hospitals that declared at least one Brucella spp. isolation (n =35) and unreported cases were identified in 19 (54 %). Α mean underreporting of 28.9 % of total cases was estimated for the whole period of the study ranging annually from 24.1 % to 35.0 %. The number of unreported cases per hospital ranged from one to 12 per year (median: 2, IQR: 5). CONCLUSIONS Interventions for improving diagnosis and reporting of the disease are recommended. Assessment of brucellosis underreporting by comparing raw numerical data of survey-captured isolations and officially notified cases lacks the case by case specificity, however, keeping required data to a minimum achieves high feedback rate from hospitals and provides a tentative estimation of the notification deficit. HIPPOKRATIA 2019, 23(3): 106-110.
Collapse
Affiliation(s)
- G Dougas
- Zoonoses Unit, Hellenic National Public Health Organization, Athens, Greece
| | - K Mellou
- Zoonoses Unit, Hellenic National Public Health Organization, Athens, Greece
| | - P Kostoulas
- Department of Veterinary Epidemiology, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece
| | - C Billinis
- Department of Microbiology & Parasitology, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece
| | - T Georgakopoulou
- Zoonoses Unit, Hellenic National Public Health Organization, Athens, Greece
| | - S Tsiodras
- Zoonoses Unit, Hellenic National Public Health Organization, Athens, Greece
- 4th Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|