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Kapoor S, Cantrell EM, Peng K, Pham TH, Bail CA, Gundersen OE, Hofman JM, Hullman J, Lones MA, Malik MM, Nanayakkara P, Poldrack RA, Raji ID, Roberts M, Salganik MJ, Serra-Garcia M, Stewart BM, Vandewiele G, Narayanan A. REFORMS: Consensus-based Recommendations for Machine-learning-based Science. SCIENCE ADVANCES 2024; 10:eadk3452. [PMID: 38691601 PMCID: PMC11092361 DOI: 10.1126/sciadv.adk3452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 03/29/2024] [Indexed: 05/03/2024]
Abstract
Machine learning (ML) methods are proliferating in scientific research. However, the adoption of these methods has been accompanied by failures of validity, reproducibility, and generalizability. These failures can hinder scientific progress, lead to false consensus around invalid claims, and undermine the credibility of ML-based science. ML methods are often applied and fail in similar ways across disciplines. Motivated by this observation, our goal is to provide clear recommendations for conducting and reporting ML-based science. Drawing from an extensive review of past literature, we present the REFORMS checklist (recommendations for machine-learning-based science). It consists of 32 questions and a paired set of guidelines. REFORMS was developed on the basis of a consensus of 19 researchers across computer science, data science, mathematics, social sciences, and biomedical sciences. REFORMS can serve as a resource for researchers when designing and implementing a study, for referees when reviewing papers, and for journals when enforcing standards for transparency and reproducibility.
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Affiliation(s)
- Sayash Kapoor
- Department of Computer Science, Princeton University, Princeton, NJ 08544, USA
- Center for Information Technology Policy, Princeton University, Princeton, NJ 08544, USA
| | - Emily M. Cantrell
- Department of Sociology, Princeton University, Princeton, NJ 08544, USA
- School of Public and International Affairs, Princeton University, Princeton, NJ 08544, USA
| | - Kenny Peng
- Department of Computer Science, Cornell University, Ithaca, NY 14850, USA
| | - Thanh Hien Pham
- Department of Computer Science, Princeton University, Princeton, NJ 08544, USA
- Center for Information Technology Policy, Princeton University, Princeton, NJ 08544, USA
| | - Christopher A. Bail
- Department of Sociology, Duke University, Durham, NC 27708, USA
- Department of Political Science, Duke University, Durham, NC 27708, USA
- Sanford School of Public Policy, Duke University, Durham, NC 27708, USA
| | - Odd Erik Gundersen
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
- Aneo AS, Trondheim, Norway
| | | | - Jessica Hullman
- Department of Computer Science, Northwestern University, Evanston, IL 60208, USA
| | - Michael A. Lones
- School of Mathematical and Computer Sciences, Heriot-Watt University, Edinburgh, UK
| | - Momin M. Malik
- Center for Digital Health, Mayo Clinic, Rochester, MN 55905, USA
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA 19104, USA
- Institute in Critical Quantitative, Computational, & Mixed Methodologies, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Priyanka Nanayakkara
- Department of Computer Science, Northwestern University, Evanston, IL 60208, USA
- Department of Communication Studies, Northwestern University, Evanston, IL 60208, USA
| | | | - Inioluwa Deborah Raji
- Department of Computer Science, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Michael Roberts
- Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Matthew J. Salganik
- Center for Information Technology Policy, Princeton University, Princeton, NJ 08544, USA
- Department of Sociology, Princeton University, Princeton, NJ 08544, USA
- Office of Population Research, Princeton University, Princeton, NJ 08544, USA
| | - Marta Serra-Garcia
- Rady School of Management, University of California, San Diego, La Jolla, CA 92093, USA
| | - Brandon M. Stewart
- Center for Information Technology Policy, Princeton University, Princeton, NJ 08544, USA
- Department of Sociology, Princeton University, Princeton, NJ 08544, USA
- Office of Population Research, Princeton University, Princeton, NJ 08544, USA
- Department of Politics, Princeton University, Princeton, NJ 08544, USA
| | - Gilles Vandewiele
- Department of Information Technology, Ghent University, Ghent, Belgium
| | - Arvind Narayanan
- Department of Computer Science, Princeton University, Princeton, NJ 08544, USA
- Center for Information Technology Policy, Princeton University, Princeton, NJ 08544, USA
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Rudolph AE, Nance RM, Bobashev G, Brook D, Akhtar W, Cook R, Cooper HL, Friedmann PD, Frost SDW, Go VF, Jenkins WD, Korthuis PT, Miller WC, Pho MT, Ruderman SA, Seal DW, Stopka TJ, Westergaard RP, Young AM, Zule WA, Tsui JI, Crane HM, Whitney BM, Delaney JAC. Evaluation of respondent-driven sampling in seven studies of people who use drugs from rural populations: findings from the Rural Opioid Initiative. BMC Med Res Methodol 2024; 24:94. [PMID: 38654219 PMCID: PMC11036624 DOI: 10.1186/s12874-024-02206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/21/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Accurate prevalence estimates of drug use and its harms are important to characterize burden and develop interventions to reduce negative health outcomes and disparities. Lack of a sampling frame for marginalized/stigmatized populations, including persons who use drugs (PWUD) in rural settings, makes this challenging. Respondent-driven sampling (RDS) is frequently used to recruit PWUD. However, the validity of RDS-generated population-level prevalence estimates relies on assumptions that should be evaluated. METHODS RDS was used to recruit PWUD across seven Rural Opioid Initiative studies between 2018-2020. To evaluate RDS assumptions, we computed recruitment homophily and design effects, generated convergence and bottleneck plots, and tested for recruitment and degree differences. We compared sample proportions with three RDS-adjusted estimators (two variations of RDS-I and RDS-II) for five variables of interest (past 30-day use of heroin, fentanyl, and methamphetamine; past 6-month homelessness; and being positive for hepatitis C virus (HCV) antibody) using linear regression with robust confidence intervals. We compared regression estimates for the associations between HCV positive antibody status and (a) heroin use, (b) fentanyl use, and (c) age using RDS-1 and RDS-II probability weights and no weights using logistic and modified Poisson regression and random-effects meta-analyses. RESULTS Among 2,842 PWUD, median age was 34 years and 43% were female. Most participants (54%) reported opioids as their drug of choice, however regional differences were present (e.g., methamphetamine range: 4-52%). Many recruitment chains were not long enough to achieve sample equilibrium. Recruitment homophily was present for some variables. Differences with respect to recruitment and degree varied across studies. Prevalence estimates varied only slightly with different RDS weighting approaches, most confidence intervals overlapped. Variations in measures of association varied little based on weighting approach. CONCLUSIONS RDS was a useful recruitment tool for PWUD in rural settings. However, several violations of key RDS assumptions were observed which slightly impacts estimation of proportion although not associations.
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Affiliation(s)
- Abby E Rudolph
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, 1301 Cecil B Moore Avenue, Ritter Annex 905, Philadelphia, PA, USA
| | - Robin M Nance
- Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA
| | - Georgiy Bobashev
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Daniel Brook
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, 43210, USA
| | - Wajiha Akhtar
- University of Wisconsin-Madison, Population Health Institute, 610 Walnut Street, 575 WARF, Madison, WI, 53726, USA
| | - Ryan Cook
- General Internal Medicine and Geriatrics, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239-3098, USA
| | - Hannah L Cooper
- Rollins School of Public Health, Emory University, Grace Crum Rollins Building, 1518 Clifton Road, Atlanta, Georgia, 30322, USA
| | - Peter D Friedmann
- Baystate Medical Center-University of Massachusetts, Office of Research, UMass Chan Medical School - Baystate, 3601 Main Street, 3rd Floor, Springfield, MA, 01199, USA
| | - Simon D W Frost
- Microsoft Premonition, Microsoft Building 99, 14820 NE 36th St. Redmond, Seattle, WA, 98052, USA
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Vivian F Go
- University of North Carolina-Chapel Hill, 363 Rosenau Hall, CB# 7440, Chapel Hill, NC, 27599, USA
| | - Wiley D Jenkins
- Southern Illinois University, 201 E Madison Street, Springfield, IL, 62702, USA
| | - Philip T Korthuis
- Oregon Health & Science University, 3270 Southwest Pavilion Loop OHSU Physicians Pavilion, Suite 350, Portland, OR, 97239, USA
| | - William C Miller
- The Ohio State University, 302 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43210, USA
| | - Mai T Pho
- University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA
| | - Stephanie A Ruderman
- Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA
| | - David W Seal
- Tulane University, 1440 Canal Street, Suite 2210, New Orleans, LA, 70112, USA
| | - Thomas J Stopka
- Tufts University School of Medicine, Public Health and Community Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA
| | - Ryan P Westergaard
- University of Wisconsin-Madison, 1685 Highland Avenue, 5th Floor, Madison, WI, 53705-2281, USA
| | - April M Young
- University of Kentucky, 760 Press Avenue, Suite 280, Lexington, KY, 40536, USA
| | - William A Zule
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Judith I Tsui
- Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA
| | - Heidi M Crane
- Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA.
| | - Bridget M Whitney
- Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA
| | - Joseph A C Delaney
- Harborview Medical Center, University of Washington and University of Manitoba, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98106, USA
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McCartney DJ, Bassichetto KC, Leal AF, Knauth D, Dourado I, Magno L, Carvalho da Silva RJ, Mayaud P, Veras MA. Acceptability and Usability of Self-Sampling for the Detection of Sexually Transmitted Infections Among Transgender Women: The TransOdara Multicentric Study in Brazil. Sex Transm Dis 2024; 51:276-282. [PMID: 38534084 DOI: 10.1097/olq.0000000000001924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND The effective testing of sexually transmitted infections (STIs) requires sampling from potential infection sites. This study aimed to assess the choice, satisfaction, and performance of self-collected samples (SCS) from potential infection sites for STI testing among transgender women in Brazil. METHODS TransOdara was a multicentric, cross-sectional STI prevalence study conducted in 5 Brazilian cities. Using respondent-driven sampling, 1317 transgender women 18 years or older were recruited. Participants completed interviewer-led questionnaires and provided swab samples from multiple sites (anorectal, oropharyngeal, genital) for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and human papillomavirus (HPV) testing. Participants were given a choice of SCS or provider-collected samples (PCS) at each site. RESULTS Most participants selected SCS for anorectal (74.9%; 95% confidence interval [CI], 72.4-77.3) and genital (72.7%; 95% CI, 70.2-75.1) sites, whereas fewer chose for oropharyngeal samples (49.8%; 95% CI, 47.0-52.6). For future testing, most participants expressed a preference for SCS for genital (72.2%; 95% CI, 69.5-74.7) and anorectal (70.2%; 95% CI, 67.6-72.7) sites. There was no significant difference in the positive test results for CT and NG between SCS and PCS at anorectal and oropharyngeal sites, or for HPV at anorectal and genital (penile or neovaginal) sites. CONCLUSIONS This study demonstrated a high level of acceptability and usability of self-sampling for STI testing among transgender women. A preference for SCS was evident at the anorectal and genital sites, and the results of SCS were comparable to those of PCS. The findings suggest that multisite STI testing utilizing self-collection methods as a provided option can be effectively integrated into sexual health services for transgender women.
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Affiliation(s)
- Daniel Jason McCartney
- From the Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Daniela Knauth
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia
| | - Laio Magno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador
| | | | - Philippe Mayaud
- From the Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Amini H, Solaymani-Dodaran M, Ghanei M, Abolghasemi J, Salesi M, Vahedian Azimi A, Farjami M, Ghazale AH, Mousavi B, Sahebkar A. A 39 Year mortality study of survivors exposed to sulfur mustard agent: A survival analysis. Heliyon 2024; 10:e24535. [PMID: 38312548 PMCID: PMC10835181 DOI: 10.1016/j.heliyon.2024.e24535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024] Open
Abstract
Background The primary objective of this study was to analyze the long-term survival of 48,067 chemical warfare survivors who suffered from pulmonary, cutaneous, and ocular lesions in the decades following the Iran-Iraq war. Methods The data for this study were obtained from the Veterans and Martyr Affair Foundation (VMAF) database. The survivors were divided into two groups based on whether they were evacuated/admitted (EA) to a hospital or not evacuated/admitted (NEA) to a hospital. The proportional hazard (PH) assumption for age categories, gender, exposure statuses, and eye severity was not satisfied. Therefore, we used a Generalized Gamma (GG) distribution with an Accelerated Failure Time (AFT) model for analysis. Results The study included a total of 48,067 observations, and among them, 4342 (9.03 %) died during the study period. The mean (SD) age of the survivors was 55.99 (7.9) years. The mortality rate increased with age, and higher rates were observed in males. Survival probabilities differed significantly among age categories, provinces, lung severity, and eye severity based on log-rank tests (p-value<0.05 for all). The GG model results showed that higher age and being male were associated with a shorter time to death. The study also found that the mortality rate was significantly higher in the EA group compared to the NEA group. Conclusion The present study showed no significant difference in survival time between the EA and NEA groups. The findings suggest that pulmonary lesions caused by mustard gas are more likely to be fatal compared to skin and eye lesions. The results also indicate a potential association between survival time and the severity of lung damage.
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Affiliation(s)
- Hossein Amini
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Solaymani-Dodaran
- Minimally Invasive Surgery Research Center, Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran
- Division of Epidemiology and Public Health, The University of Nottingham, UK
| | - Mostafa Ghanei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Jamileh Abolghasemi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Salesi
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Farjami
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Hosein Ghazale
- Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Batool Mousavi
- Prevention Department, Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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McCartney DJ, Luppi CG, Silva RJC, de Araújo S, Bassichetto KC, Mayaud P, Veras MA. Anorectal gonorrhoea and chlamydia among transgender women in Brazil: prevalence and assessment of performance and cost of anorectal infection detection and management approaches. Sex Transm Infect 2024; 100:3-9. [PMID: 38050133 DOI: 10.1136/sextrans-2023-055788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/29/2023] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVES We aimed to determine the prevalence of anorectal Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) among transgender women in Brazil, and to assess the performance and costs of various approaches for the diagnosis and management of anorectal NG/CT. METHODS TransOdara was a multicentric, cross-sectional STI prevalence study among 1317 transgender women conducted in five capital cities representing all Brazilian regions. Participants aged >18 years were recruited using respondent-driven sampling (RDS), completed an interviewer-led questionnaire, offered an optional physical examination and given choice between self-collected or provider-collected samples for NG/CT testing. Performance and cost indicators of predetermined management algorithms based on the WHO recommendations for anorectal symptoms were calculated. RESULTS Screening uptake was high (94.3%) and the estimated prevalence of anorectal NG, CT and NG and/or CT was 9.1%, 8.9% and 15.2%, respectively. Most detected anorectal NG/CT infections were asymptomatic (NG: 87.6%, CT: 88.9%), with a limited number of participants reporting any anorectal symptoms (9.1%). Of those who permitted anal examination, few had clinical signs of infection (13.6%). Sensitivity of the tested algorithms ranged from 1.4% to 5.1% (highest for treatment based on the reported anorectal discharge or ulcer and receptive anal intercourse (RAI) in the past 6 months) and specificity from 98.0% to 99.3% (highest for treatment based on the reported anorectal discharge with clinical confirmation or report of RAI). The estimated cost-per-true case of anorectal NG/CT infection treated varied from lowest providing treatment for anorectal discharge syndrome based on the reported RAI ($2.70-4.28), with algorithms including clinical examinations decreasing cost-effectiveness. CONCLUSIONS High prevalence of mostly asymptomatic anorectal NG and CT was observed among Brazilian transgender women. Multi-site NG/CT screening should be offered to transgender women. Where diagnostic testing capacity is limited, syndromic management for those presenting with anorectal symptoms is recommended.
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Affiliation(s)
- Daniel Jason McCartney
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Carla Gianna Luppi
- Centro de Referência e Treinamento em DST/Aids, Secretaria da Saúde do Estado de São Paulo, Sao Paulo, Brazil
| | - Roberto José Carvalho Silva
- Centro de Referência e Treinamento em DST/Aids, Secretaria da Saúde do Estado de São Paulo, Sao Paulo, Brazil
| | - Sandra de Araújo
- Centro de Referência e Treinamento em DST/Aids, Secretaria da Saúde do Estado de São Paulo, Sao Paulo, Brazil
| | - Katia Cristina Bassichetto
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
- Núcleo de Pesquisa e Direitos Humanos em Saúde da População LGBT+ (NUDHES), São Paulo, Brazil
| | - Philippe Mayaud
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Maria Amélia Veras
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
- Núcleo de Pesquisa e Direitos Humanos em Saúde da População LGBT+ (NUDHES), São Paulo, Brazil
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Silva VCM, Kerr LRFS, Kendall C, Mota RS, Guimarães MDC, Leal AF, Merchan-Hamann E, Dourado I, Veras MA, de Brito AM, Pontes AK, Macena RHM, Knauth D, Lima LNGC, Cavalcante S, Camillo AC, Díaz-Bermudez XP, Oliveira LC, Magno L, Lemos MF, Compri AP, Motta-Castro ARC, Moreira RC. Hepatitis C virus prevalence among men who have sex with men: a cross-sectional study in 12 Brazilian cities. BMC Infect Dis 2023; 23:705. [PMID: 37858036 PMCID: PMC10588169 DOI: 10.1186/s12879-023-08690-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Despite the preventive policies adopted, reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) has been limited. The risk of hepatitis C virus (HCV) infection has increased among the most vulnerable population groups, including MSM. The aim of this study was to estimate the prevalence of HCV infection and to assess risky practices among MSM from 12 Brazilian cities. METHODS This study was carried out from June to December 2016 using respondent driven sampling (RDS). Participants completed a self-administered questionnaire to collect behavioral, socioeconomic, and demographic variables. In addition, the rapid diagnostic test (RDT) for HCV was offered. Positive results were sent to Instituto Adolfo Lutz for confirmation. RESULTS A total of 4,176 participants were recruited and 23 samples were sent for confirmation. Of these, 16 were confirmed, resulting in a prevalence of 0.7% (95% CI: 0.3%-1.7%). The Southeast region showed a prevalence of 0.9% (95% CI: 0.3-2.6), followed by the South region, with 0.6% (95% CI: 0.2-2.1). The Northeast region had a prevalence of 0.3% (95% CI: 0.1-1.0) and the Midwest 0.1% (95% CI: 0.0-0.7). No positive cases were found in the North. Single men aged 40 years or older were the majority of participants exposed to HCV. High levels of alcohol consumption, illicit drug use, irregular condom use, in addition to infection with other STIs, were associated with exposure to HCV. CONCLUSIONS STIs continue to be important health problems in Brazil and globally. Many STIs are inapparent for many years until they bring more serious consequences. Extra investment in HCV is also warranted, given that it can be eliminated. Relying solely on clinical data to provide information about inapparent infection, especially in stigmatized populations, will make that goal more difficult to achieve. Surveillance studies, such as the one reported here need to be repeated over time to demonstrate trends and to provide information for evaluation, program and policies. Investments in the most vulnerable populations are critical to achieve the World Health Organization global health goals including the elimination of viral hepatitis by 2030.
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Affiliation(s)
- Vanessa C M Silva
- Laboratório de Hepatites, Centro de Virologia, Instituto Adolfo Lutz, Av. Dr Arnaldo, 355 Pacaembu, São Paulo, SP, Brazil
| | - Lígia R F S Kerr
- Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Carl Kendall
- Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- Department of Social, Behavioral and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Rosa S Mota
- Departamento de Estatística e Matemática Aplicada, Universidade Federal Do Ceará, Fortaleza, CE, Brazil
| | - Mark Drew C Guimarães
- Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Andréa F Leal
- Departamento de Sociologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Edgar Merchan-Hamann
- Faculdade de Ciências da Saúde, Saúde Coletiva, Universidade de Brasília, Brasília, DF, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Maria Amélia Veras
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Ana Maria de Brito
- Departamento de Saúde Coletiva, Instituto Aggeu Magalhães, Fiocruz, Recife, PE, Brazil
| | - Alexandre K Pontes
- Instituto de Psicologia, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Daniela Knauth
- Departamento de Medicina Social, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | | | | - Laio Magno
- Departamento de Ciências da Vida, Universidade Do Estado da Bahia (UNEB), Salvador, BA, Brazil
| | - Marcílio F Lemos
- Laboratório de Hepatites, Centro de Virologia, Instituto Adolfo Lutz, Av. Dr Arnaldo, 355 Pacaembu, São Paulo, SP, Brazil
| | - Adriana P Compri
- Laboratório de Hepatites, Centro de Virologia, Instituto Adolfo Lutz, Av. Dr Arnaldo, 355 Pacaembu, São Paulo, SP, Brazil
| | - Ana Rita C Motta-Castro
- Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição, Universidade Federal de Mato Grosso Do Sul, Campo Grande, MS, Brazil
| | - Regina C Moreira
- Laboratório de Hepatites, Centro de Virologia, Instituto Adolfo Lutz, Av. Dr Arnaldo, 355 Pacaembu, São Paulo, SP, Brazil.
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7
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Cohen M, Cardoso RB, Kerr LRFS, Kendall C, Almeida RLF, Schneider NB, Viera CM, Zaduchliver JG, Castro AA, Pinheiro FML, Albuquerque MFPM, Lima LNGC, Veras MASM, Martelli CMT, Cruz LN, Camey SA. Mental health outcomes in frontline healthcare workers in Brazil during the COVID-19 epidemic: Results of an online survey in four regions using respondent-driven sampling (RDS). Compr Psychiatry 2023; 126:152402. [PMID: 37647781 DOI: 10.1016/j.comppsych.2023.152402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/16/2023] [Accepted: 07/11/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic overwhelmed health facilities and presented healthcare workers (HCWs) with a new infectious disease threat. In addition to a sanitary crisis, Brazil still had to face major political, economic, and social challenges. This study aimed to investigate mental health outcomes in frontline HCWs in different regions of the country and at different epidemic times. We also sought to identify the main risk factors associated with these outcomes. METHODS A cross-sectional online survey using respondent-driven sampling was conducted to recruit physicians (n = 584), nurses (n = 997), and nurse technicians (n = 524) in 4 regions of Brazil (North, Northeast, Southeast, and South) from August 2020 to July 2021. We used standardized instruments to screen for common mental disorders (CMD)(SRQ-20), alcohol misuse (AUDIT-C), depression (PHQ-9), anxiety (GAD-7), and post-traumatic stress disorder (PTSD)(PCL-5). Gile's successive sampling estimator was used to produce weighted estimates. We created a three-cluster data set for each HCW category and developed a hierarchical regression model with three levels: individual characteristics; workplace-related aspects; COVID-19 personal experience. The impact of the epidemic moment on the outcomes was also studied. RESULTS The prevalence of probable CMD was 26.8-36.9%, alcohol misuse 8.7-13.6%, depression 16.4-21.2%, anxiety 10.8-14.2%, and PTSD 5.9-8.0%. We found a stronger association between mental health outcomes and the following factors: history of psychiatric disorders, female gender, and clinical comorbidities (level 1); work overload and family isolation (level 2); sick leave (level 3). Epidemic variables, such as the number of deaths and trend of deaths by COVID-19, had almost no impact on the outcomes. CONCLUSION An alarmingly high prevalence of depression and anxiety was found in Brazilian frontline HCWs. Individual factors were the most strongly associated with mental health outcomes. These findings indicate the need to develop programs that provide emotional support, identify professionals at risk and refer them to specialized treatment when necessary.
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Affiliation(s)
- Mírian Cohen
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, Brazil; National Institute of Science and Technology for Health Technology Assessment (IATS), Ramiro Barcelos St, 2350, BLDG 21, Unit 507, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Ricardo B Cardoso
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, Brazil; National Institute of Science and Technology for Health Technology Assessment (IATS), Ramiro Barcelos St, 2350, BLDG 21, Unit 507, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ligia R F S Kerr
- Department of Community Health, Federal University of Ceará (UFC), Prof Costa Mendes St, 1608, 5(th) fl, Fortaleza, Ceará, Brazil
| | - Carl Kendall
- Department of Community Health, Federal University of Ceará (UFC), Prof Costa Mendes St, 1608, 5(th) fl, Fortaleza, Ceará, Brazil; Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, Louisiana, USA
| | - Rosa L F Almeida
- Graduate Program in Public Health, Fortaleza University (UNIFOR), Washington Soares Ave, 1321 Fortaleza, Ceará, Brazil
| | - Nayê B Schneider
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, Brazil; National Institute of Science and Technology for Health Technology Assessment (IATS), Ramiro Barcelos St, 2350, BLDG 21, Unit 507, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carolina M Viera
- Medical School, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Ipiranga Ave, 6681 Porto Alegre, Rio Grande do Sul, Brazil
| | - Jorge G Zaduchliver
- Hospital Moinhos de Vento (HMV), Ramiro Barcelos St, 910, Porto Alegre, Rio Grande do Sul, Brazil
| | - Andriele A Castro
- Hospital Moinhos de Vento (HMV), Ramiro Barcelos St, 910, Porto Alegre, Rio Grande do Sul, Brazil
| | - Francisco M L Pinheiro
- Department of Community Health, Federal University of Ceará (UFC), Prof Costa Mendes St, 1608, 5(th) fl, Fortaleza, Ceará, Brazil
| | - Maria F P M Albuquerque
- Insitute Aggeu Magalhães, FIOCRUZ-PE, Prof. Moraes Rego Ave, s/n, UFPE Campus, Recife, Pernambuco, Brazil
| | - Luana N G C Lima
- Evandro Chagas Institute, BR-316 Hwy, km 7, Ananindeua, Pará, Brazil
| | - Maria A S M Veras
- School of Medical Sciences, Santa Casa de São Paulo, Dr Cesário Mota Jr. St, 61, São Paulo, São Paulo, Brazil
| | - Celina M T Martelli
- Insitute Aggeu Magalhães, FIOCRUZ-PE, Prof. Moraes Rego Ave, s/n, UFPE Campus, Recife, Pernambuco, Brazil
| | - Luciane N Cruz
- National Institute of Science and Technology for Health Technology Assessment (IATS), Ramiro Barcelos St, 2350, BLDG 21, Unit 507, Porto Alegre, Rio Grande do Sul, Brazil; Hospital Moinhos de Vento (HMV), Ramiro Barcelos St, 910, Porto Alegre, Rio Grande do Sul, Brazil
| | - Suzi A Camey
- Statistics Department, Federal University of Rio Grande do Sul (UFRGS), Bento Gonçalves Ave, 9500 Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Ramiro Barcelos St, 2350 Porto Alegre, Rio Grande do Sul, Brazil
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Tucker JA, Cheong J, Stinson LA, Chandler SD. Relationship between drinking risk and preferences for helping resources among emerging adults living in disadvantaged communities in the Southeastern United States. Alcohol Alcohol 2023; 58:539-546. [PMID: 37565459 DOI: 10.1093/alcalc/agad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/23/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023] Open
Abstract
Compared to campus-based alcohol interventions for college students, services for emerging adult (EA) risky drinkers who reside off-campus in disadvantaged communities are not well established. This web survey assessed drinking practices, problems, and preferences for professional and lay helping resources spanning digital and in-person formats among community-dwelling EAs to guide services for them and determine whether drinking risk levels varied by preferences for help. Digital respondent-driven sampling recruited EA risky drinkers from disadvantaged communities (N = 356; M age = 23.6 years, 64.0% women, 77.4% employed, 64.9% residing in impoverished areas above the US average, 53.5% income < $20k/year). A web survey assessed participants' drinking practices and problems, including alcohol use disorder symptoms, and help-seeking preferences for smartphone apps; online help; in-person help from doctors, clinics, teachers, and school programs; mutual help groups; and help from friends and family. Preferences were related to participant drinking risks using generalized linear modeling. Modeling results showed that risk levels were related to help-seeking preferences. EAs reporting more negative consequences preferred smartphone apps and help from friends, whereas EAs reporting fewer negative consequences and drinking days preferred professional in-person help (Ps < 0.05). Although >90% fulfilled alcohol use disorder diagnostic criteria, <4% had received an alcohol-related intervention. EAs who are riskier drinkers appear less likely to use professional resources in favor of informal and online resources that allow greater anonymity. Findings can guide services for this underserved population that are responsive to drinker risk levels.
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Affiliation(s)
- Jalie A Tucker
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, United States
| | - JeeWon Cheong
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, United States
| | - Lesleigh A Stinson
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, United States
| | - Susan D Chandler
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, United States
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9
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Meccanici F, Thijssen CGE, Gökalp AL, Bom AW, de Bruin JL, Bekkers JA, van Kimmenade RRJ, Geuzebroek GSC, Poyck P, Woorst JJT, Peels K, Sjatskig J, Heijmen RH, Post MC, Mokhles MM, Verhagen HJM, Takkenberg JJM, Roos-Hesselink JW. Long Term Health Related Quality of Life After Acute Type B Aortic Dissection: a Cross Sectional Survey Study. Eur J Vasc Endovasc Surg 2023; 66:332-341. [PMID: 37245796 DOI: 10.1016/j.ejvs.2023.05.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/14/2023] [Accepted: 05/20/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Acute type B aortic dissection (ATBD) is a rare yet serious cardiovascular event that potentially has an impact on health related quality of life (HRQoL). However, long term follow up data on this topic are scarce. This study aimed to review the long term HRQoL among patients treated for ATBD. METHODS In this multicentre, cross sectional survey study, consecutive treated patients with ATBD between 2007 and 2017 in four referral centres in the Netherlands were retrospectively included and baseline data were collected. Between 2019 and 2021 the 36 Item Short Form Survey (SF-36) was sent to all surviving patients (n = 263) and was compared with validated SF-36 scores in the Dutch general population stratified by age and sex. RESULTS In total, 144 of 263 surviving patients completed the SF-36 (response rate 55%). Median (IQR) age was 68 (61, 76) years at completion of the questionnaire, and 40% (n = 58) were female. Initial treatment was medical in 55% (n = 79), endovascular in 41% (n = 59), and surgical in 4% (n = 6) of ATBD patients. Median follow up time was 6.1 (range 1.7-13.9; IQR 4.0, 9.0) years. Compared with the general population, patients scored significantly worse on six of eight SF-36 subdomains, particularly physical domains. Apart from bodily pain, there were no substantial differences in HRQoL between male and female ATBD patients. Compared with sex matched normative data, females scored significantly worse on five of eight subdomains, whereas males scored significantly lower on six subdomains. Younger patients aged 41-60 years seemed more severely impaired in HRQoL compared with the age matched general population. Treatment strategy did not influence HRQoL outcomes. Follow up time was associated with better Physical and Mental Component Summary scores. CONCLUSION Long term HRQoL was impaired in ATBD patients compared with the Dutch general population, especially regarding physical status. This warrants more attention for HRQoL during clinical follow up. Rehabilitation programmes including exercise and physical support might improve HRQoL and increase patients' health understanding.
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Affiliation(s)
- Frederike Meccanici
- Department of Cardiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Carlijn G E Thijssen
- Department of Cardiology, Erasmus University Medical Centre, Rotterdam, the Netherlands; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Arjen L Gökalp
- Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Annemijn W Bom
- Department of Cardiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Jorg L de Bruin
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Jos A Bekkers
- Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Roland R J van Kimmenade
- Department of Cardiology, Erasmus University Medical Centre, Rotterdam, the Netherlands; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Guillaume S C Geuzebroek
- Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Paul Poyck
- Department of Vascular Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Joost J Ter Woorst
- Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | - Kathinka Peels
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Jelena Sjatskig
- Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Robin H Heijmen
- Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Marco C Post
- Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands; Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Mostafa M Mokhles
- Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands; Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Hence J M Verhagen
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Johanna J M Takkenberg
- Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
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Donnadieu H, Quillet C, D'Ottavi M, Castellani J, Debellefontaine A, Guichard S, Baglioni R, Langendorfer N, Faucherre V, Hanslik B, Tuaillon E, Laureillard D, Nagot N. Community-based respondent-driven sampling as a strategy for drug use surveillance in a large French urban area. Harm Reduct J 2023; 20:82. [PMID: 37386636 DOI: 10.1186/s12954-023-00814-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/16/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Understanding drug use and behavior within the PWUD population is crucial to adapt harm reduction and prevention strategies, and provide improved addiction and medical treatment. However, in most countries such as France, the knowledge of drug use behaviors is likely biased as it originates from addiction centers which are attended by only an unknown proportion of PWUD. The objectives of this study were to describe drug use behavior in a population of active PWUD in the urban area of Montpellier, South of France. METHODS We implemented a community-based respondent-driven sampling survey (RDSS), a validated strategy to obtain a representative sample of a population, to recruit PWUD in the city. Adult individuals reporting frequent psychoactive drug use other than cannabis, with confirmation by urine test, were eligible. Beside HCV and HIV testing, trained peers interviewed participants on their drug consumption and behavior using standardized questionnaires. Fifteen seeds launched the RDSS. RESULTS During the 11 weeks of the RDSS, 554 actives PWUD were consecutively included. They were mostly men (78.8%), had a median age of 39 years, and only 25.6% had a stable living place. On average, participants consumed 4.7 (± 3.1) different drugs, and 42.6% smoked free-base cocaine. Unexpectedly, heroin and methamphetamine were consumed by 46.8% and 21.5% of participants, respectively. Among the 194 participants injecting drugs, 33% declared sharing their equipment. CONCLUSION This RDSS highlighted a high consumption of heroin, crack and methamphetamine in this PWUD population. These unexpected results can be explained by low attendance to addiction centers, the source of drug use reports. Despite free care and risk reduction equipment in the city, sharing was very frequent among injectors, challenging the current program of harm reduction.
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Affiliation(s)
- Hélène Donnadieu
- Department of Addiction Medicine, Montpellier University Hospital, 80 Rue Augustin Fliche, 34090, Montpellier, France.
- Pathogenesis and Control of Chronic and Emerging Infections, Etablissement Français du Sang, INSERM, University of Antilles-Guyane, University of Montpellier, 60 Rue de Navacelles, 34394, Montpellier, France.
| | - Catherine Quillet
- Pathogenesis and Control of Chronic and Emerging Infections, Etablissement Français du Sang, INSERM, University of Antilles-Guyane, University of Montpellier, 60 Rue de Navacelles, 34394, Montpellier, France
| | - Morgana D'Ottavi
- Pathogenesis and Control of Chronic and Emerging Infections, Etablissement Français du Sang, INSERM, University of Antilles-Guyane, University of Montpellier, 60 Rue de Navacelles, 34394, Montpellier, France
| | - Joëlle Castellani
- Pathogenesis and Control of Chronic and Emerging Infections, Etablissement Français du Sang, INSERM, University of Antilles-Guyane, University of Montpellier, 60 Rue de Navacelles, 34394, Montpellier, France
| | - Anne Debellefontaine
- Pathogenesis and Control of Chronic and Emerging Infections, Etablissement Français du Sang, INSERM, University of Antilles-Guyane, University of Montpellier, 60 Rue de Navacelles, 34394, Montpellier, France
- AXESS, Harm Reduction Center, SOS Solidarités, 66 Avenue Charles Flahaut, 34090, Montpellier, France
| | - Sylvain Guichard
- Association of Marginality and Drug Addiction (AMT), 10 Boulevard Victor Hugo, 34000, Montpellier, France
| | - René Baglioni
- Department of Addiction Medicine, Montpellier University Hospital, 80 Rue Augustin Fliche, 34090, Montpellier, France
| | - Nicolas Langendorfer
- Department of Addiction Medicine, Montpellier University Hospital, 80 Rue Augustin Fliche, 34090, Montpellier, France
| | - Vincent Faucherre
- Department of Addiction Medicine, Montpellier University Hospital, 80 Rue Augustin Fliche, 34090, Montpellier, France
| | - Bertrand Hanslik
- Department of Addiction Medicine, Montpellier University Hospital, 80 Rue Augustin Fliche, 34090, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging Infections, Etablissement Français du Sang, INSERM, University of Antilles-Guyane, University of Montpellier, 60 Rue de Navacelles, 34394, Montpellier, France
| | - Didier Laureillard
- Pathogenesis and Control of Chronic and Emerging Infections, Etablissement Français du Sang, INSERM, University of Antilles-Guyane, University of Montpellier, 60 Rue de Navacelles, 34394, Montpellier, France
- Department of Infectious Diseases, Caremeau University Hospital, Place du Professeur Robert Debré, 30029, Nîmes, France
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic and Emerging Infections, Etablissement Français du Sang, INSERM, University of Antilles-Guyane, University of Montpellier, 60 Rue de Navacelles, 34394, Montpellier, France
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Chambers C, Deeks SL, Sutradhar R, Cox J, de Pokomandy A, Grennan T, Hart TA, Lambert G, Moore DM, Grace D, Grewal R, Jollimore J, Lachowsky N, Nisenbaum R, Ogilvie G, Sauvageau C, Tan DHS, Coutlée F, Burchell AN. Vaccine Effectiveness Against 12-Month Incident and Persistent Anal Human Papillomavirus Infection Among Gay, Bisexual, and Other Men Who Have Sex With Men. J Infect Dis 2023; 228:89-100. [PMID: 36655513 PMCID: PMC10304758 DOI: 10.1093/infdis/jiad005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/29/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Real-world evidence of human papillomavirus (HPV) vaccine effectiveness (VE) against longitudinal outcomes is lacking among gay, bisexual, and other men who have sex with men (GBM). We compared 12-month incidence and persistence of anal HPV infection between vaccinated and unvaccinated GBM. METHODS We recruited GBM aged 16-30 years in Montreal, Toronto, and Vancouver, Canada, from 2017 to 2019. Participants were followed over a median of 12 months (interquartile range, 12-13 months). Participants self-reported HPV vaccination and self-collected anal specimens for HPV DNA testing. We calculated prevalence ratios (PR) for 12-month cumulative incidence and persistence with ≥1 quadrivalent vaccine type (HPV 6/11/16/18) between vaccinated (≥1 dose at baseline) and unvaccinated participants using a propensity score-weighted, modified Poisson regression. RESULTS Among 248 participants, 109 (44.0%) were vaccinated at baseline, of whom 62.6% received 3 doses. PRs for HPV 6/11/16/18 were 0.56 (95% confidence interval [CI], .24-1.31) for cumulative incidence and 0.53 (95% CI, .25-1.14) for persistence. PRs were 0.23 (95% CI, .05-1.03) and 0.08 (95% CI, .01-.59) for incidence and persistence, respectively, among participants who received their first dose at age ≤23 years and 0.15 (95% CI, .03-.68) and 0.12 (95% CI, .03-.54) among participants who were sexually active for ≤5 years before vaccination. CONCLUSIONS Findings support national recommendations for HPV vaccination at younger ages or soon after sexual debut.
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Affiliation(s)
- Catharine Chambers
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Shelley L Deeks
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Government of Nova Scotia, Halifax, Nova Scotia, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rinku Sutradhar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada
| | - Joseph Cox
- McGill University Health Centre - Research Institute, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada
| | - Alexandra de Pokomandy
- McGill University Health Centre - Research Institute, Montréal, Québec, Canada
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trevor A Hart
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Gilles Lambert
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Jody Jollimore
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Nathan Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Rosane Nisenbaum
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Gina Ogilvie
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantal Sauvageau
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | | | - François Coutlée
- Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Ann N Burchell
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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12
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Sardinha DM, Ferreira ALDS, Guimarães RJDPSE, Lima KVB, Lima LNGC. Clinical Characteristics and Outcomes among Vaccinated and Unvaccinated Patients with Cardiovascular Disease Who Were Hospitalized for COVID-19 in Brazil: Retrospective Cohort. Vaccines (Basel) 2023; 11:vaccines11040861. [PMID: 37112773 PMCID: PMC10146801 DOI: 10.3390/vaccines11040861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION COVID-19 in Brazil has already caused, and it still causes, several impacts on health, economy, and education. The risk factors for death involved those with cardiovascular diseases (CVD), which were prioritized for the vaccination of COVID-19. OBJECTIVE To investigate the clinical characteristics and outcomes between vaccinated and unvaccinated patients with cardiovascular diseases hospitalized for COVID-19 in Brazil in the year 2022. METHODS A retrospective cohort was analyzed from the year 2022, with cases being hospitalized by COVID-19 being drawn from SIVEP-GRIPE surveillance. We compared clinical characteristics, comorbidities, and outcomes between CVD carriers and non-carriers, and we also compared vaccinated with two doses vs. those that are unvaccinated in CVD carriers. We performed chi-square, odds ratio, logistic regression, and survival analysis. RESULTS We included, in the cohort, 112,459 hospital inpatients. An amount of 71,661 (63.72%) of the hospitalized patients had CVD. Regarding deaths, 37,888 (33.69%) died. Regarding vaccination against COVID-19, 20,855 (18.54%) people were not vaccinated with any dose among those with CVD. Death p- < 0.001 (OR 1.307-CI 1.235-1.383) and fever p- < 0.001 (OR 1.156-CI 1.098-1.218) were associated with the unvaccinated CVD carriers, and diarrhea p-0.015 (OR 1.116-CI 1.022-1.218), dyspnea p-0.022 (OR 1.074-CI 1.011-1.142), and respiratory distress p-0.021 (OR 1.070-CI 1.011-1.134) were also recorded. Those patients who possessed predictors of death, including invasive ventilation (p- < 0.001 (OR 8.816-CI 8.313-9.350)), were admitted to the ICU p- < 0.001 (OR 1.754-CI 1.684-1.827), and some had respiratory distress p- < 0.001 (OR 1.367-CI 1.312-1.423), dyspnea p < 0.001 (OR 1.341-CI 1.284-1.400), O2 saturation < 95% p- < 0. 001 (OR 1.307-CI 1.254-1.363), they were unvaccinated against COVID-19 p- < 0.001 (OR 1.258-CI 1.200-1.319), they were of male sex p- < 0.001 (OR 1.179-CI 1.138-1.221), they had diarrhea p-0.018 (OR 1.081-CI 1.013-1.154), and they may have been old p < 0.001 (OR 1.034-CI 1.033-1.035). Survival was shorter for the unvaccinated p-0.003, and p- <0.001. CONCLUSIONS We highlight the predictors of death for those unvaccinated against COVID-19 in this research, and we evidenced the benefits of the COVID-19 vaccine in reducing deaths in hospitalized CVD patients.
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Affiliation(s)
- Daniele Melo Sardinha
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará and Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém 66087-670, Pará, Brazil
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua 67030-000, Pará, Brazil
- Laboratório de Geoprocessamento do Instituto Evandro Chagas (LABGEO/IEC), Ananindeua 67030-000, Pará, Brazil
- Seção de Bacteriologia e Micologia, Laboratório de Biologia Molecular, Instituto Evandro Chagas (SABMI/LABMOL/IEC), Ananindeua 67030-000, Pará, Brazil
| | - Ana Lúcia da Silva Ferreira
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará and Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém 66087-670, Pará, Brazil
- Seção de Bacteriologia e Micologia, Laboratório de Biologia Molecular, Instituto Evandro Chagas (SABMI/LABMOL/IEC), Ananindeua 67030-000, Pará, Brazil
| | - Ricardo José de Paula Souza E Guimarães
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua 67030-000, Pará, Brazil
- Laboratório de Geoprocessamento do Instituto Evandro Chagas (LABGEO/IEC), Ananindeua 67030-000, Pará, Brazil
| | - Karla Valéria Batista Lima
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará and Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém 66087-670, Pará, Brazil
- Seção de Bacteriologia e Micologia, Laboratório de Biologia Molecular, Instituto Evandro Chagas (SABMI/LABMOL/IEC), Ananindeua 67030-000, Pará, Brazil
| | - Luana Nepomuceno Gondim Costa Lima
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará and Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém 66087-670, Pará, Brazil
- Seção de Bacteriologia e Micologia, Laboratório de Biologia Molecular, Instituto Evandro Chagas (SABMI/LABMOL/IEC), Ananindeua 67030-000, Pará, Brazil
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13
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Cohen M, Cruz LN, Cardoso RB, Albuquerque MDFPMD, Montarroyos UR, de Souza WV, Ludermir AB, de Carvalho MR, da Silva Vicente JD, Viegas Filho MP, Cortes FJM, de Siqueira Silva MT, Almeida CMC, Lima LNGC, Veras MADSM, Kendall C, Kerr LRFS, Martelli CMT, Camey SA. Impact of the COVID-19 pandemic on the mental health of frontline healthcare workers in a highly affected region in Brazil. BMC Psychiatry 2023; 23:255. [PMID: 37069533 PMCID: PMC10107551 DOI: 10.1186/s12888-023-04702-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/20/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic had a major impact on the mental health of healthcare workers (HCWs), especially in low and middle-income countries, which had to face additional political, social, and economic challenges. We thus aimed to assess the prevalence of mental health outcomes and the associated factors in HCWs treating COVID-19 patients in one of the most affected regions in Brazil. METHODS We used the Respondent-Driven Sampling method to assess the risks of COVID-19 infection and symptoms of mental disorders in nurses, nursing technicians, and physicians who worked on the frontline in the metropolitan region of Recife. 865 healthcare workers completed a survey regarding sociodemographic data, work-related risks, and symptoms of mental disorders - SRQ-20 for common mental disorders (CMD); AUDIT-C for problematic alcohol use; GAD-7 for anxiety; PHQ-9 for depression; PCL-5 for post-traumatic stress disorder (PTSD). Gile's successive sampling estimator was used to produce the weighted estimates by professional category. A Poisson regression model with robust variance was used to analyze factors associated with a positive screening for CMD. We will present the results of a cross-sectional analysis of the mental health outcomes after the first peak of COVID-19 - from August 2020 to February 2021. RESULTS The prevalence ratios for a positive screening for CMD were 34.9% (95% CI: 27.8-41.9) in nurses, 28.6% (95% CI: 21.3-36.0) in physicians, and 26.6% (95% CI: 16.8-36.5) in nursing technicians. Nurses presented a higher prevalence of depressive symptoms (23%). Positive screening for problematic alcohol use (10.5 to14.0%), anxiety (10.4 to 13.3%), and PTSD (3.3 to 4.4%) were similar between the professional categories. The main factors associated with CMD in nurses and physicians were related to an intrinsic susceptibility to mental illness, such as previous or family history of psychiatric disorder, and female sex. Among nurse technicians, work-related factors, such as accidents with biological material, presented the strongest association with CMD. CONCLUSION The mental health of HCWs fighting COVID-19 in Recife was severely affected. It is crucial that healthcare services provide adequate working conditions and psychological support, investing in programs to promote and protect HCWs mental health.
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Affiliation(s)
- Mírian Cohen
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil.
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Luciane Nascimento Cruz
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, Rio Grande do Sul, Brazil
- Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ricardo Bertoglio Cardoso
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | | | | | | | - Fanny Julia Mireille Cortes
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | - Carl Kendall
- Department of Community Health, Federal University of Ceará, Fortaleza, Ceará, Brazil
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | | | - Suzi Alves Camey
- Statistics Department, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
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14
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Carneiro AMF, Rodrigues YC, Dolabela MF, Lima LNGC, Guimarães RJDPS, Kendall C, Kerr LRFS, Lima KVB. Social Experiences, Discrimination, and Violence among Men Who Have Sex with Men in a Northern Brazilian Capital. Healthcare (Basel) 2023; 11:healthcare11070964. [PMID: 37046891 PMCID: PMC10094014 DOI: 10.3390/healthcare11070964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 03/30/2023] Open
Abstract
Men who have sex with men who suffer stigmatization and discrimination become more fragile in facing life’s problems, such as the search for treatment in health services. In the present study, the social aspects related to discrimination and violence among men who have sex with men in Belém, Pará, are evaluated. Data were obtained by applying the respondent-driven sampling method to recruit 349 participants aged 18 years or older and who reported having had at least one sexual relationship with a man in the last 12 months. Data were collected from June to December 2016 in a semi-structured interview. Five seeds were initially recruited who applied RDS. The vast majority were between 18 and 35 years old, had completed elementary school but not high school, and were of mixed race. Almost a third lived in peripheral neighborhoods and were employed/self-employed. Additionally, most participants reported having suffered aggression/discrimination, more often in religious contexts, with family or in health services. The findings reported here may contribute to the development of public policies aimed at this population and indicate the need for new strategies to combat sexually transmitted infections, stigma, and discrimination suffered by this population.
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15
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Campbell TR, Reilly N, Zamponi M, Leathers D, Mollica PA, Cavallario J, Martinez JC. Salivary microRNA as a prospective tool for concussion diagnosis and management: A scoping review. Brain Inj 2023; 37:588-595. [PMID: 36867013 DOI: 10.1080/02699052.2023.2184867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND Despite increased efforts directed toward research, concussions are a growing concern and can be a complex injury for healthcare professionals to manage. Current practices are largely dependent on patients self-reporting symptoms and a clinical assessment, which uses objective tools that lack effectiveness. With the demonstrated effects of concussions, it is imperative that a more valid or reliable objective tool, like a clinical biomarker, be identified to improve outcomes. One potential biomarker that has shown promise is salivary microRNA. However, there is no objective consensus as to which microRNA offers the most clinical value regarding concussions, hence this review. Therefore, the purpose of this scoping review was to identify salivary miRNAs associated with concussions. METHODS Two independent reviewers performed a literature search to identify research articles. Studies using human subjects, collected salivary miRNA, and were published in English were included. Data of interest were salivary miRNA, collection timing, and relation to concussion diagnosis or management. RESULTS This paper reviews nine studies that analyzed salivary miRNA for concussion diagnosis and management. CONCLUSIONS In total, the studies have identified 49 salivary miRNA that show promise in assisting with concussion practices. With continued research, the use of salivary miRNA may enhance clinicians' abilities to diagnose and manage concussions.
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Affiliation(s)
- Thomas R Campbell
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Nicholas Reilly
- The Geneva Foundation, Womack Army Medical Center, Fort Bragg, North Carolina, USA
| | - Martina Zamponi
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Delaney Leathers
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Peter A Mollica
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Julie Cavallario
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Jessica C Martinez
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
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16
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Landorf KB, Kaminski MR, Munteanu SE, Zammit GV, Menz HB. Activity and footwear characteristics in people with and without plantar heel pain: A matched cross-sectional observational study. Musculoskeletal Care 2023; 21:35-44. [PMID: 35678543 DOI: 10.1002/msc.1663] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Activity and footwear may be associated with plantar heel pain (PHP), however both factors have rarely been investigated. The aim of this study was to investigate activity and footwear characteristics in PHP while controlling for important confounders. METHOD This cross-sectional observational study compared 50 participants with PHP to 25 participants without PHP who were matched for age, sex and body mass index. Activity was measured using the Stanford Activity Questionnaire, as well as the number of hours per day participants stood for, and whether they stood on hard floors. Footwear characteristics were measured using the footwear domain of the Foot Health Status Questionnaire (FHSQ), as well as the style of shoe, heel height, and the Shore A hardness value of the heel of the shoe most used. RESULTS Participants with PHP stood for more than twice as long as participants without PHP (mean difference 3.4 hours, p < 0.001, large effect size). Participants with PHP also reported greater difficulty accessing suitable footwear (FHSQ footwear domain mean difference (MD) 22 points, p = 0.002, large effect size (ES), and they wore harder-heeled shoes (Shore A MD 6.9 units, p = 0.019, medium ES). There were no significant differences for physical activity, whether they stood on hard floors, the style of shoe they wore, or heel height. CONCLUSIONS Compared to people without PHP, people with PHP stand for more than twice the amount of time each day, have substantial difficulties accessing suitable footwear, and the primary shoes they wear are harder under the heel.
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Affiliation(s)
- Karl B Landorf
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, Australia
| | - Michelle R Kaminski
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, Australia
| | | | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, Australia
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17
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Chambers C, Deeks SL, Sutradhar R, Cox J, de Pokomandy A, Grennan T, Hart TA, Lambert G, Moore DM, Grace D, Grewal R, Jollimore J, Lachowsky NJ, Mah A, Nisenbaum R, Ogilvie G, Sauvageau C, Tan DH, Yeung A, Burchell AN. Self-reported Human Papillomavirus Vaccination and Vaccine Effectiveness Among Men Who Have Sex with Men: A Quantitative Bias Analysis. Epidemiology 2023; 34:225-229. [PMID: 36722804 PMCID: PMC9891269 DOI: 10.1097/ede.0000000000001580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/04/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Self-report of human papillomavirus (HPV) vaccination has ~80-90% sensitivity and ~75-85% specificity. We measured the effect of nondifferential exposure misclassification associated with self-reported vaccination on vaccine effectiveness (VE) estimates. METHODS Between 2017-2019, we recruited sexually active gay, bisexual, and other men who have sex with men aged 16-30 years in Canada. VE was derived as 1-prevalence ratio × 100% for prevalent anal HPV infection comparing vaccinated (≥1 dose) to unvaccinated men using a multivariable modified Poisson regression. We conducted a multidimensional and probabilistic quantitative bias analysis to correct VE estimates. RESULTS Bias-corrected VE estimates were relatively stable across sensitivity values but differed from the uncorrected estimate at lower values of specificity. The median adjusted VE was 27% (2.5-97.5th simulation interval = -5-49%) in the uncorrected analysis, increasing to 39% (2.5-97.5th simulation interval = 2-65%) in the bias-corrected analysis. CONCLUSION A large proportion of participants erroneously reporting HPV vaccination would be required to meaningfully change VE estimates.
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Affiliation(s)
- Catharine Chambers
- From the University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Shelley L. Deeks
- Government of Nova Scotia, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rinku Sutradhar
- From the University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Joseph Cox
- McGill University, Montréal, Québec, Canada
- Direction régionale de santé publique de Montréal, Montréal, Québec, Canada
| | | | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Trevor A. Hart
- From the University of Toronto, Toronto, Ontario, Canada
- Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Gilles Lambert
- Direction régionale de santé publique de Montréal, Montréal, Québec, Canada
| | - David M. Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver British Columbia, Canada
| | - Daniel Grace
- From the University of Toronto, Toronto, Ontario, Canada
| | | | - Jody Jollimore
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | | | - Ashley Mah
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Rosane Nisenbaum
- From the University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Gina Ogilvie
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantal Sauvageau
- Institut national de santé publique du Québec, Québec, Québec, Canada
| | | | - Anna Yeung
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Ann N. Burchell
- From the University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
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18
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D’Onofrio R, Alashram AR, Annino G, Masucci M, Romagnoli C, Padua E, Manzi V. Prevention of Secondary Injury after Anterior Cruciate Ligament Reconstruction: Relationship between Pelvic-Drop and Dynamic Knee Valgus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3063. [PMID: 36833752 PMCID: PMC9958946 DOI: 10.3390/ijerph20043063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Optimal neuromuscular, Lumbo-Pelvic-Hip Complex, and lower extremity control are associated with decreased risk factors for secondary anterior cruciate ligament (ACL) injury. This study aimed to analyze any asymmetries and malalignments in the Lumbo-Pelvic-Hip Complex and the lower limbs at 6 months after ACL reconstruction (ACLR). (2) Methods: We conducted an exploratory retrospective observational single-center study in patients during the outpatient postoperative rehabilitation program at ICOT (Latina, Italy). From January 2014 to June 2020, 181 patients were recruited, but only 100 patients (86 male 28 ± 0.6 years, 178 ± 0.5 height; 14 female 24 ± 2.0 years, 178 ± 3.0 height) were eligible for the inclusion criteria and studied 6 months after ACL reconstruction surgery. (3) Statistical analysis: Student's t-tests and Pearson's product-moment correlation coefficient were used to determine significant differences between affected and non-affected limbs and variables' association. (4) Results: The study shows a decrease in neuromuscular control of the Lumbo-Pelvic-Hip Complex and dynamic adaptive valgus of the knee at 6 months after ACLR (mean difference between pathological and healthy limb of dynamic adaptive valgus was -10.11 ± 8.19° 95% CI -14.84 to -9.34; mean value was 16.3 ± 6.8° 95% CI 14.04 to 18.55 for healthy limb and 4.2 ± 3.1° 95% CI 3.15 to 5.21 for pathological limb, p < 0.0001). The results also showed a relationship between dynamic adaptive valgus and contralateral pelvic drop (r = 0.78, 95% CI 0.62 to 0.88, magnitude of correlation very large). (5) Conclusions: The analysis showed an associative correlation between decreased postural control of the pelvic girdle and dynamic adaptive valgus of the knee in 38% of patients; this study highlights the usefulness of the Single-Leg Squat Test (SLST) as a clinical/functional assessment to evaluate the rehabilitation process and as a preventive tool to reduce the risk of second ACL injuries during the return to sport.
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Affiliation(s)
- Rosario D’Onofrio
- Member of the Medical-Scientific Multidisciplinary Commission, Italian Football Doctors Association-L.A.M.I.CA., 04023 Formia, Italy
| | - Anas Radi Alashram
- Department of Physiotherapy, Faculty of Allied Medical Science, Middle East University, Amman 11622, Jordan
| | - Giuseppe Annino
- Centre of Space Bio-Medicine, Department of Medicine Systems, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Matteo Masucci
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Cristian Romagnoli
- Sport Engineering Lab, Department Industrial Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy
| | - Vincenzo Manzi
- Department of Humanities Science, Pegaso Open University, 80143 Naples, Italy
- Hellas Verona Football Club, Via Olanda 11, 37135 Verona, Italy
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19
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Dehghani A, Ghomian Z, Rakhshanderou S, Khankeh H, Kavousi A. Process and components of disaster risk communication in health systems: A thematic analysis. JAMBA (POTCHEFSTROOM, SOUTH AFRICA) 2022; 14:1367. [PMID: 36569774 PMCID: PMC9772705 DOI: 10.4102/jamba.v14i1.1367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/30/2022] [Indexed: 12/23/2022]
Abstract
Risk communication (RC) is one of the necessary functions in disaster management. Establishing communication processes such as planning, transparency of policies and guidelines, RC expert training, providing communication infrastructure and evaluation in the shortest period reduces confusion and management inconsistency. One of the existing challenges is not knowing the exact dimensions of risk communication and its components in disasters. The aim was to identify the components of disaster risk communication in the health system. This research was conducted by systematic review and searching of the databases of PubMed, Scopus, Web of Science, ProQuest, Google Scholar and ScienceOpen 2000-2021 to identify the components of disaster risk communication in the health system. Thematic content analysis was used for data analysis. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 chart was used for systematic search, and a modified Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used for quality determination. Out of 12 342 articles extracted, 25 studies were included for analysis. The components of disaster risk communication were analysed in 6 categories and 19 subcategories. These categories include communication (communication processes, communication features and infrastructure), information (content production, content characteristics and publishing), risk communication management (risk perception assessment, planning, coordination and logistics), monitoring and control (monitoring and evaluation, accreditation, documentation), education and training (public and organisational) and ethics and values (culture and social beliefs, ethics and trust). According to this research, the establishment of communication infrastructure and advanced equipment such as various structured formats for communication and artificial intelligence; online and offline communication support systems; and timely and accurate notice can help achieve goals such as coordination and organisation in the health system and increase social participation. Contribution This study has clarified and explained all the main components and measures of risk communication that can be used for planning scientifically.
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Affiliation(s)
- Arezoo Dehghani
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Zohreh Ghomian
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Sakineh Rakhshanderou
- Department of Health Education and Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Hamidreza Khankeh
- Department of Health in Emergency and Disaster, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran,Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
| | - Amir Kavousi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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20
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Marques-Sule E, Arnal-Gómez A, Monzani L, Deka P, López-Bueno JP, Saavedra-Hernández M, Suso-Martí L, Espí-López GV. Canoe polo Athletes' Anthropometric, Physical, Nutritional, and Functional Characteristics and Performance in a Rowing Task: Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13518. [PMID: 36294099 PMCID: PMC9602600 DOI: 10.3390/ijerph192013518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Understanding the physical, functional, mental, and nutritional attributes of canoe polo athletes is essential for training and development. Forty-three canoe polo athletes (mean age: 21.54 ± 6.03) participated in the study and were assessed for: anthropometric measurements, exercise motivation, eating habits, adherence to the Mediterranean Diet, and physical and functional abilities. Correlation and multivariate analysis were conducted. Individual performance in a rowing task showed body mass index (β = 0.41) and female gender (β = 0.34) to be the strongest anthropometric predictors, whereas body fat (β = -0.35) and triceps brachii skinfold fatty tissue (β = -0.35) were the strongest negative predictors. Pushing strength (β = 0.37) and range of motion with internal rotation (β = 0.30) were the strongest physical predictors. The physical dimension of the Exercise Motivation Index was a significant psychosocial predictor (β = 0.27). Senior participants had a higher waist-hip ratio (p = 0.04, d = 0.66), arm circumference (p = 0.03, d = 0.68), handgrip strength (p < 0.01, d = 1.27), and push strength (p < 0.01, d = 1.42) than under 21-year-olds. Understanding the highlighted sport-specific characteristics of canoe polo athletes can help trainers to design programs at all levels to optimize performance.
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Affiliation(s)
- Elena Marques-Sule
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
- Physiotherapy in Motion, Multispecialty Research Group (PTinMOTION), C/Gascó Oliag, 5, 46010 Valencia, Spain
| | - Anna Arnal-Gómez
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
- Physiotherapy in Motion, Multispecialty Research Group (PTinMOTION), C/Gascó Oliag, 5, 46010 Valencia, Spain
| | - Lucas Monzani
- Ivey Business School, Western University, 1255 Western Rd, London, ON N6G 0N1, Canada
| | - Pallav Deka
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
| | - Jairo P. López-Bueno
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
| | - Manuel Saavedra-Hernández
- Department of Physical Therapy, University of Almeria, Carretera Sacramento s/n, 04120 Almería, Spain
| | - Luis Suso-Martí
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
- Exercise Intervention for Health (EXINH), C/Gascó Oliag, 5, 46010 Valencia, Spain
| | - Gemma V. Espí-López
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5, 46010 Valencia, Spain
- Exercise Intervention for Health (EXINH), C/Gascó Oliag, 5, 46010 Valencia, Spain
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21
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Duong HT, Moles JP, Pham KM, Vallo R, Hoang GT, Vu VH, Khuat OTH, Nham TTT, Nguyen DQ, Quillet C, Rapoud D, Van de Perre P, Castellani J, Feelemyer J, Michel L, Laureillard D, Jarlais DD, Nagot N. A community-based intervention to decrease the prevalence of HIV viremia among people who inject drugs in Vietnam. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 27:100538. [PMID: 35856068 PMCID: PMC9287471 DOI: 10.1016/j.lanwpc.2022.100538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND In most low-to-middle-income countries, HIV control at the population level among people who inject drugs (PWID) remains a major challenge. We aimed to demonstrate that an innovative intervention can identify HIV-positive PWID in the community who are not treated efficiently, and get them treated efficiently. METHODS Between 2016 and 2020, we implemented an intervention consisting of mass HIV screening of PWID using three annual respondent-driven sampling surveys (RDSS) and a post-intervention evaluation RDSS in community-based organisation (CBO) sites, coupled with peer support to facilitate/improve access to antiretroviral and methadone therapy in Haiphong, Vietnam. The primary outcome was the proportion of identified uncontrolled HIV-positive PWID who achieved viral control. We also estimated the potential effect of the intervention on the proportion of PWID with HIV RNA >1000 copies/mL among all PWID during the study period. FINDINGS Over the three RDSS, 3150 different PWID were screened, i.e. two-thirds of the estimated population size. They all injected heroin, their median age was of 39 years, 95% were male, 26.5% were HIV-infected, and 78.6% of the latter had HIV RNA ≤1000 copies/mL. Among the 177 PWID identified with an unsuppressed viral load, 73 (41.2%) achieved viral suppression at the final visit. HIV viremia decreased from 7.2% at baseline to 2.9% at the final RDSS (p<0.001). Up to 42% of this observed reduction may be explained by the intervention, in the absence of any external intervention targeting PWID during the study period. INTERPRETATION Mass community-based screening using RDSS coupled with CBO support is a powerful tool to rapidly identify untreated HIV-positive PWID and (re)link them to care. FUNDING NIDA (USA) and ANRS (France).
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Affiliation(s)
- Huong Thi Duong
- Department of Public Health, Haiphong University of Medicine and Pharmacy, Số 72A Nguyễn Bỉnh Khiêm, Ngô Quyền, Haiphong, Vietnam
| | - Jean-Pierre Moles
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles, Montpellier, 60 Rue de Navacelles, 34394 Montpellier, France
| | - Khue Minh Pham
- Department of Public Health, Haiphong University of Medicine and Pharmacy, Số 72A Nguyễn Bỉnh Khiêm, Ngô Quyền, Haiphong, Vietnam
| | - Roselyne Vallo
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles, Montpellier, 60 Rue de Navacelles, 34394 Montpellier, France
| | - Giang Thi Hoang
- Department of Public Health, Haiphong University of Medicine and Pharmacy, Số 72A Nguyễn Bỉnh Khiêm, Ngô Quyền, Haiphong, Vietnam
| | - Vinh Hai Vu
- Infectious and Tropical Diseases Department, Viet Tiep Hospital, 1 Nha Thuong Street, Le Chan Dis, Hai Phong City, Haiphong, Vietnam
| | - Oanh Thi Hai Khuat
- Supporting Community Development Initiatives, No.9 165/30 Alley, Thai Ha Street, Lang Ha Ward, Dong Da District, Hanoi, Vietnam
| | - Thanh Tuyet Thi Nham
- Supporting Community Development Initiatives, No.9 165/30 Alley, Thai Ha Street, Lang Ha Ward, Dong Da District, Hanoi, Vietnam
| | - Duc Quang Nguyen
- Department of Public Health, Haiphong University of Medicine and Pharmacy, Số 72A Nguyễn Bỉnh Khiêm, Ngô Quyền, Haiphong, Vietnam
| | - Catherine Quillet
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles, Montpellier, 60 Rue de Navacelles, 34394 Montpellier, France
| | - Delphine Rapoud
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles, Montpellier, 60 Rue de Navacelles, 34394 Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles, Montpellier, 60 Rue de Navacelles, 34394 Montpellier, France
| | - Joëlle Castellani
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles, Montpellier, 60 Rue de Navacelles, 34394 Montpellier, France
| | - Jonathan Feelemyer
- School of Global Public Health, New York University, 708 Broadway, New York, NY 10003, USA
| | - Laurent Michel
- Paris Saclay University, Pierre Nicole Center, French Red Cross, CESP Inserm UMRS 1018, Paris, France
| | - Didier Laureillard
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles, Montpellier, 60 Rue de Navacelles, 34394 Montpellier, France
- Infectious Diseases Department, Caremeau University Hospital, Place du Professeur Robert Debré, 30029 Nîmes, France
| | - Don Des Jarlais
- School of Global Public Health, New York University, 708 Broadway, New York, NY 10003, USA
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles, Montpellier, 60 Rue de Navacelles, 34394 Montpellier, France
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Avery L, Maddox R, Abtan R, Wong O, Rotondi NK, McConkey S, Bourgeois C, McKnight C, Wolfe S, Flicker S, Macpherson A, Smylie J, Rotondi M. Modelling prevalent cardiovascular disease in an urban Indigenous population. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022:10.17269/s41997-022-00669-x. [PMID: 35945472 DOI: 10.17269/s41997-022-00669-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Studies have highlighted the inequities between the Indigenous and non-Indigenous populations with respect to the burden of cardiovascular disease and prevalence of predisposing risks resulting from historical and ongoing impacts of colonization. The objective of this study was to investigate factors associated with cardiovascular disease (CVD) within and specific to the Indigenous peoples living in Toronto, Ontario, and to evaluate the reliability and validity of the resulting model in a similar population. METHODS The Our Health Counts Toronto study measured the baseline health of Indigenous community members living in Toronto, Canada, using respondent-driven sampling. An iterative approach, valuing information from the literature, clinical insight and Indigenous lived experiences, as well as statistical measures was used to evaluate candidate predictors of CVD (self-reported experience of discrimination, ethnic identity, health conditions, income, education, age, gender and body size) prior to multivariable modelling. The resulting model was then validated using a distinct, geographically similar sample of Indigenous people living in Hamilton, Ontario, Canada. RESULTS The multivariable model of risk factors associated with prevalent CVD included age, diabetes, hypertension, body mass index and exposure to discrimination. The combined presence of diabetes and hypertension was associated with a greater risk of CVD relative to those with either condition and was the strongest predictor of CVD. Those who reported previous experiences of discrimination were also more likely to have CVD. Further study is needed to determine the effect of body size on risk of CVD in the urban Indigenous population. The final model had good discriminative ability and adequate calibration when applied to the Hamilton sample. CONCLUSION Our modelling identified hypertension, diabetes and exposure to discrimination as factors associated with cardiovascular disease. Discrimination is a modifiable exposure that must be addressed to improve cardiovascular health among Indigenous populations.
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Affiliation(s)
- Lisa Avery
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Raglan Maddox
- Well Living House, Li Ka Shing Knowledge Institute, Unity Health Toronto - St. Michaels Hospital, Toronto, ON, Canada
- Aboriginal and Torres Strait Islander Health Group, National Centre for Epidemiology and Public Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Robert Abtan
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Octavia Wong
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Nooshin Khobzi Rotondi
- Well Living House, Li Ka Shing Knowledge Institute, Unity Health Toronto - St. Michaels Hospital, Toronto, ON, Canada
- Ontario Tech University, Oshawa, ON, Canada
| | - Stephanie McConkey
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Well Living House, Li Ka Shing Knowledge Institute, Unity Health Toronto - St. Michaels Hospital, Toronto, ON, Canada
| | - Cheryllee Bourgeois
- Seventh Generation Midwives Toronto, Toronto, ON, Canada
- Metropolitan University, Toronto, ON, Canada
| | | | - Sara Wolfe
- Seventh Generation Midwives Toronto, Toronto, ON, Canada
| | - Sarah Flicker
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Alison Macpherson
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Janet Smylie
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Well Living House, Li Ka Shing Knowledge Institute, Unity Health Toronto - St. Michaels Hospital, Toronto, ON, Canada
| | - Michael Rotondi
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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Smylie J, McConkey S, Rachlis B, Avery L, Mecredy G, Brar R, Bourgeois C, Dokis B, Vandevenne S, Rotondi MA. Uncovering SARS-COV-2 vaccine uptake and COVID-19 impacts among First Nations, Inuit and Métis Peoples living in Toronto and London, Ontario. CMAJ 2022; 194:E1018-E1026. [PMID: 35918087 PMCID: PMC9481260 DOI: 10.1503/cmaj.212147] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 11/14/2022] Open
Abstract
Background: First Nations, Inuit and Métis Peoples across geographies are at higher risk of SARS-CoV-2 infection and COVID-19 because of high rates of chronic disease, inadequate housing and barriers to accessing health services. Most Indigenous Peoples in Canada live in cities, where SARS-CoV-2 infection is concentrated. To address gaps in SARS-CoV-2 information for these urban populations, we partnered with Indigenous agencies and sought to generate rates of SARS-CoV-2 testing and vaccination, and incidence of infection for First Nations, Inuit and Métis living in 2 Ontario cities. Methods: We drew on existing cohorts of First Nations, Inuit and Métis adults in Toronto (n = 723) and London (n = 364), Ontario, who were recruited using respondent-driven sampling. We linked to ICES SARS-CoV-2 databases and prospectively monitored rates of SARS-CoV-2 testing, diagnosis and vaccination for First Nations, Inuit and Métis, and comparator city and Ontario populations. Results: We found that SARS-CoV-2 testing rates among First Nations, Inuit and Métis were higher in Toronto (54.7%, 95% confidence interval [CI] 48.1% to 61.3%) and similar in London (44.5%, 95% CI 36.0% to 53.1%) compared with local and provincial rates. We determined that cumulative incidence of SARS-CoV-2 infection was not significantly different among First Nations, Inuit and Métis in Toronto (7364/100 000, 95% CI 2882 to 11 847) or London (7707/100 000, 95% CI 2215 to 13 200) compared with city rates. We found that rates of vaccination among First Nations, Inuit and Métis in Toronto (58.2%, 95% CI 51.4% to 64.9%) and London (61.5%, 95% CI 52.9% to 70.0%) were lower than the rates for the 2 cities and Ontario. Interpretation: Although Ontario government policies prioritized Indigenous populations for SARS-CoV-2 vaccination, vaccine uptake was lower than in the general population for First Nations, Inuit and Métis Peoples in Toronto and London. Ongoing access to culturally safe testing and vaccinations is urgently required to avoid disproportionate hospital admisson and mortality related to COVID-19 in these communities.
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Affiliation(s)
- Janet Smylie
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont.
| | - Stephanie McConkey
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont
| | - Beth Rachlis
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont
| | - Lisa Avery
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont
| | - Graham Mecredy
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont
| | - Raman Brar
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont
| | - Cheryllee Bourgeois
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont
| | - Brian Dokis
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont
| | - Stephanie Vandevenne
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont
| | - Michael A Rotondi
- Well Living House (Smylie, McConkey, Brar), St. Michael's Hospital; Dalla Lana School of Public Health (Smylie, McConkey, Rachlis, Avery), University of Toronto; ICES (Smylie, Rachlis, Mecredy); Princess Margaret Cancer Centre (Avery), University Health Network; Seventh Generations Midwives Toronto (Bourgeois); Call Auntie Clinic (Bourgeois); School of Kinesiology and Health Science (Rotondi), York University, Toronto, Ont.; Southwest Ontario Aboriginal Health Access Centre (Dokis, Vandevenne), London, Ont
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Moura LMVR, Karakis I, Zack MM, Tian N, Kobau R, Howard D. Drivers of US health care spending for persons with seizures and/or epilepsies, 2010-2018. Epilepsia 2022; 63:2144-2154. [PMID: 35583854 PMCID: PMC10969856 DOI: 10.1111/epi.17305] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study was undertaken to characterize spending for persons classified with seizure or epilepsy and to determine whether spending has increased over time. METHODS In this cross-sectional study, we pooled data from the Medical Expenditure Panel Survey (MEPS) household component files for 2010-2018. We matched cases to controls on age and sex of a population-based sample of MEPS respondents (community-dwelling persons of all ages) with records associated with a medical event (e.g., outpatient visit, hospital inpatient) for seizure, epilepsy, or both. Outcomes were weighted to be representative of the civilian, noninstitutionalized population. We estimated the treated prevalence of epilepsy and seizure, health care spending overall and by site of care, and trends in spending growth. RESULTS We identified 1078 epilepsy cases and 2344 seizure cases. Treated prevalence was .38% (95% confidence interval [CI] = .34-.41) for epilepsy, .76% (95% CI = .71-.81) for seizure, and 1.14% (95% CI = 1.08-1.20) for epilepsy or seizure. The difference in annual spending for cases compared to controls was $4580 (95% CI = $3362-$5798) for epilepsy, $7935 (95% CI, $6237-$9634) for seizure, and $6853 (95% CI = $5623-$8084) for epilepsy or seizure, translating into aggregate costs of $5.4 billion, $19.0 billion, and $24.5 billion. From 2010 to 2018, the annual growth rate in total spending incurred for seizures and/or epilepsies was 7.6% compared to 3.6% among controls. SIGNIFICANCE US economic burden of seizures and/or epilepsies is substantial and warrants interventions focused on their unique and overlapping causes.
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Affiliation(s)
- Lidia M. V. R. Moura
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Ioannis Karakis
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Matthew M. Zack
- Epilepsy Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Niu Tian
- Epilepsy Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rosemarie Kobau
- Epilepsy Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David Howard
- Department of Health Policy, Emory University School of Medicine, Atlanta, Georgia, USA
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The implications of diabetic foot health-related with quality of life: A retrospective case control investigation. J Tissue Viability 2022; 31:790-793. [PMID: 35853797 DOI: 10.1016/j.jtv.2022.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/02/2022] [Accepted: 07/11/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND The diabetes people show a significant presence of foot health problems are usually all over the world, causing in big economic effects for these persons, their families and world population OBJECTIVE: The purpose of this research is to evaluate and relate the impact of foot health associated with the quality of life (QoL) in a group of people with and without diabetes MATERIAL AND METHODS: A total of 150 persons of a mean age of 71.45 ± 11.93 years came to a foot and ankle specialist outpatient center. Self-reported data were medical records where persons'with and without diabetes was evaluated. All findings obtained was compared with scores quality of life using the tool Foot Health Status Questionnaire, spanish version RESULTS: The diabetes group revealed a reduction of QoL linked to overall health and to foot health in particular. Differences among both groups were analyzed by means of a independent Student's t-test samples, displaying a p-value lower than 0.05 statistically significant for the domains of foot pain, foot function footwear and social capacity CONCLUSIONS: Diabetes people recorded a negative influence on the QoL related with foot health, that seems to be linked with the presence of chronic disease in diabetes people.
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Essential Factors for a Healthy Microbiome: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148361. [PMID: 35886216 PMCID: PMC9315476 DOI: 10.3390/ijerph19148361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/19/2022]
Abstract
Recent discoveries of the purpose and potential of microbial interactions with humans have broad implications for our understanding of metabolism, immunity, the host−microbe genetic interactions. Bioavailability and bioaccessibility of phytonutrients in foods not only enrich microbial diversity in the lower human gastrointestinal tract (GIT) but also direct the functioning of the metagenome of the microbiota. Thus, healthy choices must include foods that contain nutrients that satisfy both the needs of humans and their microbes. Physical activity interventions at a moderate level of intensity have shown positive effects on metabolism and the microbiome, while intense training (>70% VO2max) reduces diversity in the short term. The microbiome of elite endurance athletes is a robust producer of short-chain fatty acids. A lifestyle lacking activity is associated with the development of chronic disease, and experimental conditions simulating weightlessness in humans demonstrate loss of muscle mass occurring in conjunction with a decline in gut short-chain fatty acid (SCFA) production and the microbes that produce them. This review summarizes evidence addressing the relationship between the intestinal microbiome, diet, and physical activity. Data from the studies reviewed suggest that food choices and physical fitness in developed countries promote a resource “curse” dilemma for the microbiome and our health.
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Rice B, Machingura F, Maringwa G, Magutshwa S, Kujeke T, Jamali G, Busza J, de Wit M, Fearon E, Hanisch D, Yekeye R, Mugurungi O, Hargreaves JR, Cowan FM. Brief Report: Adolescent Girls Who Sell Sex in Zimbabwe: HIV Risk, Behaviours, and Service Engagement. J Acquir Immune Defic Syndr 2022; 90:263-269. [PMID: 35262519 DOI: 10.1097/qai.0000000000002948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/22/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND To reduce HIV incidence among adolescent girls who sell sex (AGSS) in Zimbabwe, we need to better understand how vulnerabilities intersect with HIV infection and how those living with HIV engage in care. METHODS In 2017, we conducted social mapping in 4 locations in Zimbabwe and recruited girls aged 16-19 years who sell sex, using respondent-driven sampling or census sampling methods. Participants completed a questionnaire and provided finger prick blood samples for HIV antibody testing. RESULTS Of 605 AGSS recruited, 74.4% considered themselves sex workers, 24.4% reported experiencing violence in the past year, 91.7% were not in school, and 83.8% had less than a complete secondary education. Prevalence of HIV increased steeply from 2.1% among those aged 16 years to 26.9% among those aged 19 years; overall, 20.2% of AGSS were HIV-positive. In the multivariate analysis, age, education, marital status, and violence from a client were associated with HIV. Among the 605 AGSS, 86.3% had ever tested for HIV, with 64.1% having tested in the past 6 months. Among AGSS living with HIV, half (50.8%) were aware of their status, among whom 83.9% reported taking antiretroviral therapy. CONCLUSION The steep rise in HIV prevalence among those aged between 16 and 19 years suggests the window to engage with AGSS before HIV acquisition is short. To accelerate reductions in incidence among AGSS, intensified combination prevention strategies that address structural factors and tailor services to the needs of AGSS are required, particularly ensuring girls enroll and remain in school.
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Affiliation(s)
- Brian Rice
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fortunate Machingura
- Centre for Sexual Health and HIV/AIDS Research Zimbabwe (CeSHHAR), Harare, Zimbabwe
| | - Galven Maringwa
- Centre for Sexual Health and HIV/AIDS Research Zimbabwe (CeSHHAR), Harare, Zimbabwe
| | | | - Tatenda Kujeke
- Centre for Sexual Health and HIV/AIDS Research Zimbabwe (CeSHHAR), Harare, Zimbabwe
| | - Gracious Jamali
- Centre for Sexual Health and HIV/AIDS Research Zimbabwe (CeSHHAR), Harare, Zimbabwe
| | - Joanna Busza
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mariken de Wit
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Elizabeth Fearon
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Owen Mugurungi
- Ministry of Health and Child Care, Harare, Zimbabwe; and
| | | | - Frances M Cowan
- Centre for Sexual Health and HIV/AIDS Research Zimbabwe (CeSHHAR), Harare, Zimbabwe
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Factors associated with the diagnosis of COVID-19 among Brazilian health professionals COVID-19 and health professionals. PLoS One 2022; 17:e0267121. [PMID: 35749441 PMCID: PMC9231739 DOI: 10.1371/journal.pone.0267121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 04/03/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Health professionals are on the front lines against the Coronavirus 2019 (COVID-19) pandemic and are at high risk for acquiring the infection. Failures in precautionary measures, inadequacy/scarcity of Personal Protective Equipment (PPE), and lack of social and family distancing may be associated with increased exposure and contamination by the new coronavirus. This study investigated the prevalence of COVID-19 among Brazilian health professionals and associated factors according to demographic and occupational characteristics. Methods A cross-sectional, analytical study was conducted using an online survey with 12,086 health professionals from all regions of Brazil. Data were collected using an adaptation of the respondent-driven sampling method for the virtual environment. The outcome variable was the diagnosis of COVID-19. Bivariate and multiple logistic regression analyzes were used to identify an association between the diagnosis of COVID-19 and demographic and occupational variables. Variables were considered statistically significant based on p<0.05. Results Most participants were female, from the northeast region, and nursing professionals. A prevalence of 31.95% (95%CI: 31.0%, 32.9%) of COVID-19 was estimated. Following multiple regression analysis, the variables associated with the diagnosis of COVID-19 among health professionals were: male gender, married individuals, professionals who provide care to patients with COVID-19, who work in a field hospital, and those who work in institutions that did not offer enough quality PPE. Conclusions The study found a high prevalence of COVID-19 infection, with male professionals being those with greater chances. Inadequate supply or poor quality of PPE offered by health institutions compromises the health of professionals with an increase in positive diagnosis for COVID-19.
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Tribal Tobacco Use Project II: Planning, Implementation, and Dissemination Using Culturally Relevant Data Collection among American Indian Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137708. [PMID: 35805376 PMCID: PMC9265766 DOI: 10.3390/ijerph19137708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/13/2022] [Accepted: 06/21/2022] [Indexed: 01/13/2023]
Abstract
American Indians have substantially higher commercial tobacco-related cancer rates when compared to the general population. To effectively combat commercial tobacco-related cancer, it is important that tribal nations obtain current and accurate community-specific data on commercial tobacco use and exposure-related attitudes and behaviors. With the goal to collect, synthesize, and disseminate data on tobacco use, including the role traditional tobacco plays among American Indian people, the American Indian Cancer Foundation (AICAF) and various stakeholders developed and implemented the Tribal Tobacco Use Project II (TTUP II) during 2018-2021. Building upon its predecessor, the Tribal Tobacco Use Project I (TTUP I), TTUP II used principles of community-based participatory research and culturally appropriate methods, such as Reality-Based Research, in partnership with tribal nations. We describe the TTUP II rationale, methods for participant recruitment and data collection, emphasizing the importance of using culturally relevant survey items to disentangle commercial tobacco use from traditional tobacco use. American Indian traditional tobacco is viewed as medicine in these communities with a unique socio-cultural context that must be addressed when engaging in commercial tobacco control efforts in American Indian communities. This approach may be useful to other tribal nations who are interested in conducting culturally relevant tobacco surveillance efforts.
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Albuquerque MDFPMD, Souza WVD, Montarroyos UR, Pereira CR, Braga C, Araújo TVBD, Ximenes RADA, Miranda-Filho DDB, Szwarcwald CL, Souza-Junior PRBD, Xavier MN, Morais CNLD, Albuquerque GDMD, Bresani-Salvi C, Mariz CA, Siqueira-Filha NTD, Galindo JM, França-Neto CL, Barbosa JMV, Veras MASM, Lima LNGC, Cruz LN, Kendall C, Kerr LRFS, Martelli CMT. Risk of SARS-CoV-2 infection among front-line healthcare workers in Northeast Brazil: a respondent-driven sampling approach. BMJ Open 2022; 12:e058369. [PMID: 35667719 PMCID: PMC9170795 DOI: 10.1136/bmjopen-2021-058369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES We assessed the prevalence of SARS-CoV-2 infection, personal protective equipment (PPE) shortages and occurrence of biological accidents among front-line healthcare workers (HCW). DESIGN, SETTING AND PARTICIPANTS Using respondent-driven sampling, the study recruited distinct categories of HCW attending suspected or confirmed patients with COVID-19 from May 2020 to February 2021, in the Recife metropolitan area, Northeast Brazil. OUTCOME MEASURES The criterion to assess SARS-CoV-2 infection among HCW was a positive self-reported PCR test. RESULTS We analysed 1525 HCW: 527 physicians, 471 registered nurses, 263 nursing assistants and 264 physical therapists. Women predominated in all categories (81.1%; 95% CI: 77.8% to 84.1%). Nurses were older with more comorbidities (hypertension and overweight/obesity) than the other staff. The overall prevalence of SARS-CoV-2 infection was 61.8% (95% CI: 55.7% to 67.5%) after adjustment for the cluster random effect, weighted by network, and the reference population size. Risk factors for a positive RT-PCR test were being a nursing assistant (OR adjusted: 2.56; 95% CI: 1.42 to 4.61), not always using all recommended PPE while assisting patients with COVID-19 (OR adj: 2.15; 95% CI: 1.02 to 4.53) and reporting a splash of biological fluid/respiratory secretion in the eyes (OR adj: 3.37; 95% CI: 1.10 to 10.34). CONCLUSIONS This study shows the high frequency of SARS-CoV2 infection among HCW presumably due to workplace exposures. In our setting, nursing assistant comprised the most vulnerable category. Our findings highlight the need for improving healthcare facility environments, specific training and supervision to cope with public health emergencies.
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Affiliation(s)
| | - Wayner Vieira de Souza
- Department of Collective Health, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
| | | | | | - Cynthia Braga
- Department of Parasitology, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
| | | | | | | | - Celia Landmann Szwarcwald
- Institute of Scientific Communication and Information and Technological (ICIT), FIOCRUZ-RJ, Rio de Janeiro, Brazil
| | | | - Morgana Nascimento Xavier
- Department of Collective Health, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
- Department of Biology, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | | | | | - Carolline Araújo Mariz
- Department of Collective Health, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
- Olinda Medical School, Olinda, Pernambuco, Brazil
| | | | - Jadson Mendonça Galindo
- Department of Collective Health, Institute Aggeu Magalhaes, FIOCRUZ-PE, Recife, Pernambuco, Brazil
| | | | | | | | | | | | - Carl Kendall
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Community Health, Federal University of Ceara, Fortaleza, Ceara, Brazil
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Increases in human papillomavirus vaccine coverage over 12 months among a community-recruited cohort of gay, bisexual, and other men who have sex with men in Canada. Vaccine 2022; 40:3690-3700. [PMID: 35577633 DOI: 10.1016/j.vaccine.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/11/2022] [Accepted: 05/05/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Starting in 2015/16, most Canadian provinces introduced publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) aged ≤ 26 years. We estimated 12-month changes in HPV vaccine coverage among community-recruited GBM from 2017 to 2021 and identified baseline factors associated with vaccine initiation (≥1 dose) or series completion (3 doses) among participants who were unvaccinated or partially vaccinated at baseline. METHODS We recruited sexually-active GBM aged ≥ 16 years in Montreal, Toronto, and Vancouver, Canada, from 02/2017 to 08/2019 and followed them over a median of 12 months (interquartile range = 12-13 months). We calculated the proportion who initiated vaccination (≥1 dose) or completed the series (3 doses) by 12-month follow-up. Analyses were stratified by city and age-eligibility for the publicly-funded programs at baseline (≤26 years or > 26 years). We used multivariable logistic regression to identify baseline factors associated with self-reported incident vaccine initiation or series completion. RESULTS Among 165 unvaccinated participants aged ≤ 26 years at baseline, incident vaccine initiation (≥1 dose) during follow-up was 24.1% in Montreal, 33.3% in Toronto, and 38.9% in Vancouver. Among 1,059 unvaccinated participants aged > 26 years, incident vaccine initiation was 3.4%, 8.9%, and 10.9%, respectively. Higher education and trying to access pre-exposure prophylaxis for HIV were associated with incident vaccination among those aged ≤ 26 years, while younger age, residing in Vancouver (vs. Montreal), being diagnosed with anogenital warts, having both government and private extended medical insurance, and being vaccinated against influenza were associated with incident vaccination among those aged > 26 years. CONCLUSIONS We observed substantial gains in HPV vaccine coverage among young GBM within 5 + years of targeted program implementation, but gaps remain, particularly among older men who are ineligible for publicly-funded programs. Findings suggest the need for expanded public funding or insurance coverage for HPV vaccines.
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Posada-Borrero AM, Patiño-Lugo DF, Plata-Contreras JA, Velasquez-Correa JC, Lugo-Agudelo LH. Development of a Clinical Practice Guideline for Lower Limb Amputees. A Knowledge Translation Process in a Middle Income Country. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:873436. [PMID: 36188954 PMCID: PMC9397661 DOI: 10.3389/fresc.2022.873436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022]
Abstract
Background and Aim Knowledge translation processes are necessary for improving patients' and communities' health outcomes. The aim of this study was to systematically develop evidence-based recommendations for people over 16 years of age who are in risk for or have suffered a lower limb amputation for medical reasons (vascular, diabetes mellitus) or trauma (civilian or military trauma) in order to improve function, quality of life, decrease complications and morbidity. Methods Following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach we developed a Clinical Practice Guideline (CPG) for lower limb amputees with funding from the Ministry of Health in Colombia and participation of a multidisciplinary group. We included patients' preferences. Based on the scope, purposes and objectives the questions were elaborated with the PECOT strategy. The evidence search was performed for each question in the main databases: Cochrane Library, Embase and PubMed, without time limit or language restriction. Teams were formed with thematic experts and clinical epidemiologists to review the clinical studies, describe the evidence, and evaluate the quality of the body of evidence with the GRADE methodology. The recommendations were made according to the judgments proposed by the GRADE working group. We conducted a stakeholder's dialogue as a mechanism for the external validation of the guideline implementation. Results The CPG included 43 recommendations related to the diagnosis, surgical treatment, rehabilitation, prescription and adaptation of the prosthesis. They were strong in favor 37.2, weak in favor 53.5, strong against 2.3, Weak against 7.0%. Quality of evidence was high in 0, moderate in 11.6, low in 58.1, and very low 30.2%. Discussion In 93% of the recommendations, the quality of the evidence was between low and very low. This is why it was so important to validate and discuss each recommendation with an expanded multidisciplinary group. The research group identified 25 interventions and five milestones to be prioritized in the implementation and in the stakeholder's dialogue participants identified opportunities and barriers for implementation of recommendations. Conclusion It is necessary to develop a national policy for implementation strategies of CPG recommendations that promotes the necessary arrangements for the provision of services for diagnosis, treatment, and rehabilitation of individuals with amputations.
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Nagot N, D’Ottavi M, Quillet C, Debellefontaine A, Castellani J, Langendorfer N, Hanslik B, Guichard S, Baglioni R, Faucherre V, Tuaillon E, Pageaux GP, Laureillard D, Donnadieu-Rigole H. Reaching hardly reached people who use drugs: a community-based strategy for the elimination of hepatitis C. Open Forum Infect Dis 2022; 9:ofac181. [PMID: 35774932 PMCID: PMC9239554 DOI: 10.1093/ofid/ofac181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/11/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Elimination of HCV among people who use drugs (PWUD) remains a challenge even in countries in which HCV care is provided free of cost. We assessed whether an innovative community-based respondent-driven sampling (RDS) survey, coupled with HCV screening and immediate treatment, could be efficient to detect and cure active PWUD with chronic HCV in a large city of Southern France.
Methods
At a community site with peers, PWUD (cannabis not included) were enrolled after confirmation by a urine drug test. Participants were then screened for HBV/HCV/HIV and benefited from on-site HCV treatment evaluation and prescription. Peer support was provided during treatment, and a systematic visit was scheduled 12 weeks after the end of treatment. The cost of the intervention was estimated.
Results
554 participants were enrolled. Most were male (78.8%) with a median age of 39 years (IQR: 33-46). Cocaine (73.1%) and heroine (46.8%) were the main drugs consumed. Overall, 32.6% of PWUD (N = 181) were HCV seropositive, of which 49 (27.1%) had detectable HCV RNA and were thus eligible for treatment. Ten of these patients had severe fibrosis. HCV treatment was initiated for 37 (75.5%) patients among whom 30 (81.1%) completed their treatment and 27 (73.0%) achieved sustained viral response at week 12. The total cost was 161€ per screened patient and 1,816€ per patient needing treatment.
Conclusions
Community-based RDS survey approach, involving peers, proved efficient and cost-effective to reach and cure PWUD for HCV. This innovative strategy could be key for the final step of HCV elimination.
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Affiliation(s)
- Nicolas Nagot
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
| | - Morgana D’Ottavi
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
| | - Catherine Quillet
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
| | - Anne Debellefontaine
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
- Groupe SOS Solidarité, Montpellier, France
| | - Joëlle Castellani
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
| | - Nicolas Langendorfer
- Department of Addiction Medicine, Montpellier University Hospital, Montpellier, France
| | - Bertrand Hanslik
- Department of Addiction Medicine, Montpellier University Hospital, Montpellier, France
| | - Sylvain Guichard
- Association of Marginality and Drug Addiction (AMT), Montpellier, France
| | - René Baglioni
- Department of Addiction Medicine, Montpellier University Hospital, Montpellier, France
| | - Vincent Faucherre
- Department of Addiction Medicine, Montpellier University Hospital, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
| | - Georges-Philippe Pageaux
- Department of Hepatology and Gastroenterology, Montpellier University Hospital, Montpellier, France
| | - Didier Laureillard
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
- Department of Infectious Diseases, Caremeau University Hospital, Nimes, France
| | - Hélène Donnadieu-Rigole
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, INSERM, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
- Department of Addiction Medicine, Montpellier University Hospital, Montpellier, France
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Pinto AD, Hapsari AP, Ho J, Meaney C, Avery L, Hassen N, Jetha A, Lay AM, Rotondi M, Zuberi D. Precarious work among personal support workers in the Greater Toronto Area: a respondent-driven sampling study. CMAJ Open 2022; 10:E527-E538. [PMID: 35700996 PMCID: PMC9343122 DOI: 10.9778/cmajo.20210338] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has highlighted the role of personal support workers (PSWs) in health care, as well as their work conditions. Our study aimed to understand the characteristics of the PSW workforce, their work conditions and their job security, as well as to explore the health of PSWs and the impact of precarious employment on their health. METHODS Our community-based participatory action research focused on PSWs in the Greater Toronto Area. We administered an online, cross-sectional survey between June and December 2020 using respondent-driven sampling. Data on sociodemographics, employment precarity, worker empowerment and health status were collected. We assessed the association between precarious employment and health using multivariable logistic regression models. RESULTS We contacted 739 PSWs, and 664 consented to participate. Overall, 658 (99.1%) completed at least part of the survey. Using data adjusted for our sampling approach, the participants were predominantly Black (76.5%, 95% confidence interval [CI] 68.2%-84.9%), women (90.1%, 95% CI 85.1%-95.1%) and born outside of Canada (97.4%, 95% CI 94.9%-99.9%). Most worked in home care (43.9%, 95% CI 35.2%-52.5%) or long-term care (34.5%, 95% CI 27.4%-42.0%). Although most participants had at least some postsecondary education (unadjusted proportion = 83.4%, n = 529), more than half were considered low income (55.1%, 95% CI 46.3%-63.9%). Most participants were precariously employed (86.5%, 95% CI 80.7%-92.4%) and lacked paid sick days (89.5%, 95% CI 85.8%-93.3%) or extended health benefits (74.1%, 95% CI 66.8%-81.4%). Nearly half of the participants described their health as less than very good (46.7%, 95% CI 37.9%-55.5%). Employment precarity was significantly associated with higher risk of depression (odds ratio 1.02, 95% CI 1.01-1.03). INTERPRETATION Despite being key members of health care teams, most PSWs were precariously employed with low wages that keep them in poverty; the poor work conditions they faced could be detrimental to their physical and mental health. Equitable strategies are needed to provide decent work conditions for PSWs and to improve their health.
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Affiliation(s)
- Andrew D Pinto
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont.
| | - Ayu P Hapsari
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont
| | - Julia Ho
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont
| | - Christopher Meaney
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont
| | - Lisa Avery
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont
| | - Nadha Hassen
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont
| | - Arif Jetha
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont
| | - A Morgan Lay
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont
| | - Michael Rotondi
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont
| | - Daniyal Zuberi
- Upstream Lab (Pinto, Hapsari, Ho), MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto; Department of Family and Community Medicine (Pinto), St. Michael's Hospital; Department of Family and Community Medicine (Pinto, Meaney), Faculty of Medicine; Dalla Lana School of Public Health (Pinto, Avery, Jetha), University of Toronto; Department of Biostatistics (Avery), Princess Margaret Hospital, University Health Network; Faculty of Environmental and Urban Change (Hassen), York University; Institute for Work and Health (Jetha); Institute of Population and Public Health (Lay), Canadian Institutes for Health Research, Ottawa, Ont.; School of Kinesiology and Health Science (Rotondi), York University; Munk School of Global Affairs & Public Policy (Zuberi); Factor-Inwentash Faculty of Social Work (Zuberi), University of Toronto, Toronto, Ont
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Abstract
Abstract
Purpose of Review
We provided an overview of sampling methods for hard-to-reach populations and guidance on implementing one of the most popular approaches: respondent-driven sampling (RDS).
Recent Findings
Limitations related to generating a sampling frame for marginalized populations can make them “hard-to-reach” when conducting population health research. Data analyzed from non-probability-based or convenience samples may produce estimates that are biased or not generalizable to the target population. In RDS and time-location sampling (TLS), factors that influence inclusion can be estimated and accounted for in an effort to generate representative samples. RDS is particularly equipped to reach the most hidden members of hard-to-reach populations.
Summary
TLS, RDS, or a combination can provide a rigorous method to identify and recruit samples from hard-to-reach populations and more generalizable estimates of population characteristics. Researchers interested in sampling hard-to-reach populations should expand their toolkits to include these methods.
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Cowan FM, Machingura F, Chabata ST, Ali MS, Busza J, Steen R, Desmond N, Shahmanesh M, Revill P, Mpofu A, Yekeye R, Mugurungi O, Phillips AN, Hargreaves JR. Differentiated prevention and care to reduce the risk of HIV acquisition and transmission among female sex workers in Zimbabwe: study protocol for the ‘AMETHIST’ cluster randomised trial. Trials 2022; 23:209. [PMID: 35279215 PMCID: PMC8917622 DOI: 10.1186/s13063-022-06119-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background Female sex workers (FSW) in sub-Saharan Africa are disproportionately affected by HIV and are critical to engage in HIV prevention, testing and care services. We describe the design of our evaluation of the ‘AMETHIST’ intervention, nested within a nationally-scaled programme for FSW in Zimbabwe. We hypothesise that the implementation of this intervention will result in a reduction in the risk of HIV transmission within sex work. Methods The AMETHIST intervention (Adapted Microplanning to Eliminate Transmission of HIV in Sex Transactions) is a risk-differentiated intervention for FSW, centred around the implementation of microplanning and self-help groups. It is designed to support uptake of, and adherence to, HIV prevention, testing and treatment behaviours among FSW. Twenty-two towns in Zimbabwe were randomised to receive either the Sisters programme (usual care) or the Sisters programme plus AMETHIST. The composite primary outcome is defined as the proportion of all FSW who are at risk of either HIV acquisition (HIV-negative and not fully protected by prevention interventions) or of HIV transmission (HIV-positive, not virally suppressed and not practicing consistent condom use). The outcome will be assessed after 2 years of intervention delivery in a respondent-driven sampling survey (total n = 4400; n = 200 FSW recruited at each site). Primary analysis will use the ‘RDS-II’ method to estimate cluster summaries and will adapt Hayes and Moulton’s ‘2-step’ method produce adjusted effect estimates. An in-depth process evaluation guided by our project trajectory will be undertaken. Discussion Innovative pragmatic trials are needed to generate evidence on effectiveness of combination interventions in HIV prevention and treatment in different contexts. We describe the design and analysis of such a study. Trial registration Pan African Clinical Trials Registry PACTR202007818077777. Registered on 2 July 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06119-w.
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Harris TG, Wu Y, Parmley LE, Musuka G, Mapingure MP, Chingombe I, Mugurungi O, Hakim A, Gozhora P, Miller SS, Lamb MR, Samba C, Rogers JH. HIV care cascade and associated factors among men who have sex with men, transgender women, and genderqueer individuals in Zimbabwe: findings from a biobehavioural survey using respondent-driven sampling. Lancet HIV 2022; 9:e182-e201. [PMID: 35150606 PMCID: PMC10654134 DOI: 10.1016/s2352-3018(21)00297-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/28/2021] [Accepted: 11/10/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Globally, men who have sex with men (MSM), transgender women, and genderqueer individuals are at greater risk for HIV than the general population although little data are available from these groups in Zimbabwe, a country with a national adult HIV prevalence of 12·9%. We aimed to examine progress towards the UNAIDS 90-90-90 treatment targets and factors associated with meeting the targets among a sample of MSM, transgender women, and genderqueer individuals in Zimbabwe. METHODS In this cross-sectional survey in 2019, we used respondent-driven sampling to identify MSM, transgender women, and genderqueer individuals aged at least 18 years to participate in a biobehavioural survey in Harare and Bulawayo, Zimbabwe. Participants were eligible to participate if they were assigned male at birth; had engaged in anal or oral sex with a man in the past 12 months; resided in Harare or Bulawayo for at least 1 month; spoke English, Shona, or Ndebele; provided written informed consent; and were in possession of a valid recruitment coupon if applicable. Enrolled participants completed a questionnaire and underwent HIV testing, and off-site viral load testing was done on all HIV-positive samples. Unweighted bivariate analyses and multivariable logistic regression models were used to evaluate the association of sociodemographic, behavioural, and other factors with HIV-positive status awareness among MSM, transgender women, and genderqueer individuals, and with viral load suppression among MSM. Analyses were done firstly using self-reported information and then by classifying those with a viral load of less than 200 copies per mL as being aware of their status and on treatment (viral load recategorisation). FINDINGS Among MSM, 248 (21%; 95% CI 19-24) of 1176 tested positive for HIV. Of those who tested positive, based on self-report, 119 (48%; 95% CI 42-54) reported knowing their HIV status, of whom 112 (94%; 88-98) reported using antiretroviral therapy (ART), of whom 89 (79%; 71-87) had viral load suppression. Based on viral load recategorisation, 180 (73%; 67-78) of 248 MSM testing HIV positive reported knowing their HIV status, of whom 174 (97%; 93-99) reported using ART, of whom 151 (87%; 81-91) had viral load suppression. 92 (28%; 23-33) of 335 transgender women and genderqueer individuals tested positive for HIV. Based on self-reports from these individuals 34 (37%; 27-48) of 92 participants reported knowing their HIV status, of whom 31 (91%; 76-98) reported using ART, of whom 27 (87%; 70-96%) had viral load suppression. Based on viral load recategorisation of data from transgender women and genderqueer participants, 53 (58%; 47-58) of 92 reported awareness of their HIV status, of whom 50 (94%; 84-99) reported using ART, of whom 46 (92%; 81-98) had viral load suppression. HIV-positive MSM aged 18-24 years had lower odds of being aware of their status than those aged at least 35 years (adjusted odds ratio [aOR] 0·34; 95% CI 0·13-0·92), as did HIV-positive MSM aged 25-34 years (aOR 0·26; 0·12-0·56). HIV-positive MSM aged 18-24 years also had a lower odds of having viral load suppression than those aged 35 years and older (aOR 0·35; 0·16-0·78), as did those aged 25-34 years (aOR 0·36; 0·19-0·67). No factors were significantly associated with awareness among transgender women and genderqueer individuals in multivariable models. INTERPRETATION Our survey showed that HIV prevalence was high and the largest difference between our results and the 90-90-90 treatment targets was in HIV status awareness, indicating the need for improvements in engaging MSM (especially young MSM), transgender women, and genderqueer individuals in HIV testing services. FUNDING US President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention.
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Affiliation(s)
- Tiffany G Harris
- ICAP at Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Yingfeng Wu
- ICAP at Columbia University, New York, NY, USA
| | | | | | | | | | - Owen Mugurungi
- AIDS and TB Programme, Zimbabwe Ministry of Health and Child Care, Harare, Zimbabwe
| | - Avi Hakim
- Division of Global HIV and TB, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Matthew R Lamb
- ICAP at Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - John H Rogers
- Division of Global HIV and TB, Center for Global Health, US Centers for Disease Control and Prevention, Harare, Zimbabwe
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Estimation of HIV incidence from analysis of HIV prevalence patterns by age and years since starting sex work among female sex workers in Zimbabwe. AIDS 2022; 36:1141-1150. [PMID: 35170527 DOI: 10.1097/qad.0000000000003198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To estimate HIV incidence among female sex workers (FSW) in Zimbabwe: using HIV prevalence by age and number of years since started selling sex (YSSS). DESIGN We pooled data from FSW aged 18-39 participating in respondent-driven sampling surveys conducted in Zimbabwe between 2011-2017. METHODS For each year of age, we estimated: HIV prevalence (Pt) and the change in HIV prevalence from the previous age (Pt-Pt-1). We then estimated the rate of new HIV infections during that year of age: It = Pt-Pt-1/(1-Pt-1), and calculated HIV incidence for 18-24 and 25-39 year-olds separately as the weighted average of It. We estimated HIV incidence for FSW 1-5 years and 6-15 years since first selling sex using the same approach, and compared HIV prevalence among FSW first selling sex at their current age with the general population. RESULTS Among 9,906 women, 50.2% were HIV positive. Based on HIV prevalence increases by age, we estimated an HIV incidence of 6.3/100 person-years at risk (pyar) (95%CI 5.3,7.6) among 18-24 year-olds, and 3.3/100 pyar (95% CI 1.3,4.2) among 25-39 year-olds. Based on prevalence increases by YSSS, HIV incidence was 5.3/100 pyar (95% CI 4.3,8.5) between 1-5 years since first selling sex, and 2.1/100 pyar (95% CI -1.3, 7.2) between 6-15 years. CONCLUSIONS Our analysis is consistent with very high HIV incidence among FSW in Zimbabwe, especially among those who are young and recently started selling sex. There is a critical need to engage young entrants into sex work in interventions that reduce their HIV risk.
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Chambers C, Deeks SL, Sutradhar R, Cox J, de Pokomandy A, Grennan T, Hart TA, Lambert G, Moore DM, Coutlée F, Burchell AN. Anal Human Papillomavirus Prevalence Among Vaccinated and Unvaccinated Gay, Bisexual, and Other Men Who Have Sex With Men in Canada. Sex Transm Dis 2022; 49:123-132. [PMID: 34561370 PMCID: PMC8746886 DOI: 10.1097/olq.0000000000001560] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Starting in 2015, human papillomavirus (HPV) vaccine has been publicly funded for gay, bisexual, and other men who have sex with men (GBM) 26 years or younger in Canada. METHODS Self-identified GBM who reported having sex with another man within the past 6 months were enrolled using respondent-driven sampling (RDS) between February 2017 and August 2019 in Montreal, Toronto, and Vancouver, Canada. Men aged 16 to 30 years self-collected anal specimens for HPV-DNA testing. Prevalence was estimated using RDS-II weights. We compared the prevalence of quadrivalent (HPV-6/11/16/18) and 9-valent (HPV-6/11/16/18/31/33/45/52/58) vaccine types between GBM who self-reported HPV vaccination (≥1 dose) and those reporting no vaccination using a modified Poisson regression for binary outcomes. RESULTS Among 645 GBM who provided a valid anal specimen (median age, 26 years; 5.9% HIV positive), 40.3% reported receiving ≥1 dose of HPV vaccine, of whom 61.8% received 3 doses. One-quarter were infected with ≥1 quadrivalent type (crude, 25.7%; RDS weighted, 24.4%). After adjustment for potential confounders, vaccinated GBM had a 27% lower anal prevalence of quadrivalent types compared with unvaccinated GBM (adjusted prevalence ratio [aPR], 0.73; 95% confidence interval [CI], 0.54-1.00). Lower prevalence ratios were found among vaccinated participants who were vaccinated >2 years before enrollment (aPR, 0.47; 95% CI, 0.25-0.86) or received their first vaccine dose at age ≤23 years (aPR, 0.64; 95% CI, 0.42-0.99). Point estimates were similar for ≥2 or 3 doses and 9-valent types. CONCLUSIONS Human papillomavirus vaccination was associated with a lower anal prevalence of vaccine-preventable HPV types among young, sexually active GBM. Findings will help inform shared decision making around HPV vaccination for GBM and their healthcare providers.
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Affiliation(s)
- Catharine Chambers
- From the Dalla Lana School of Public Health, University of Toronto
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Unity Health Toronto, Toronto
| | - Shelley L. Deeks
- From the Dalla Lana School of Public Health, University of Toronto
- Department of Health and Wellness, Government of Nova Scotia, Halifax
| | - Rinku Sutradhar
- From the Dalla Lana School of Public Health, University of Toronto
- ICES, Sunnybrook Research Institute, Toronto
| | - Joseph Cox
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University
| | | | - Troy Grennan
- Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver
| | - Trevor A. Hart
- From the Dalla Lana School of Public Health, University of Toronto
- Department of Psychology, Ryerson University, Toronto
| | - Gilles Lambert
- Direction régionale de santé publique de Montréal, Montréal
| | - David M. Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver
| | - François Coutlée
- Département de microbiologie, infectiologie et immunologie, Université de Montréal
- Laboratoire de virologie moléculaire, Centre de recherche du Centre hospitalier de l’Université de Montréal, Montréal
| | - Ann N. Burchell
- From the Dalla Lana School of Public Health, University of Toronto
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Unity Health Toronto, Toronto
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
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Hakim AJ, Bolo A, Coy KC, Achut V, Katoro J, Caesar G, Lako R, Taban AI, Sleeman K, Wesson J, Okiria AG. Progress toward the UNAIDS 90–90-90 targets among female sex workers and sexually exploited female adolescents in Juba and Nimule, South Sudan. BMC Public Health 2022; 22:132. [PMID: 35045854 PMCID: PMC8767749 DOI: 10.1186/s12889-022-12533-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 01/05/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Little is known about HIV in South Sudan and even less about HIV among female sex workers (FSW). We characterized progress towards UNAIDS 90–90-90 targets among female sex workers (FSW) and sexually exploited female adolescents in Juba and Nimule, South Sudan.
Methods
We conducted a biobehavioral survey of FSW and sexually exploited female adolescents using respondent-driven sampling (RDS) in Juba (November 2015–March 2016) and in Nimule (January–March 2017) to estimate achievements toward the UNAIDS 90–90-90 targets (90% of HIV-positive individuals know their status; of these, 90% are receiving antiretroviral therapy [ART]; and of these, 90% are virally suppressed). Eligibility criteria were girls and women who were aged ≥15 years; spoke English, Juba Arabic, or Kiswahili; received money, goods, or services in exchange for sex in the past 6 months; and resided, worked, or socialized in the survey city for ≥1 month. Data were weighted for RDS methods.
Results
We sampled 838 FSW and sexually exploited female adolescents in Juba (HIV-positive, 333) and 409 in Nimule (HIV-positive, 108). Among HIV-positive FSW and sexually exploited female adolescents living in Juba, 74.8% self-reported being aware of their HIV status; of these, 73.3% self-reported being on ART; and of these, 62.2% were virally suppressed. In Nimule, 79.5% of FSW and sexually exploited female adolescents living with HIV self-reported being aware of their HIV status; of these, 62.9% self-reported being on ART; and of these, 75.7% were virally suppressed.
Conclusions
Although awareness of HIV status is the lowest of the 90–90-90 indicators in many countries, treatment uptake and viral suppression were lowest among FSW and sexually exploited female adolescents in South Sudan. Differentiated service delivery facilitate linkage to and retention on treatment in support of attainment of viral suppression.
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Social Network Drinking Feedback is Associated with Use of Protective Behavioral Strategies and Drinking-Related Outcomes in Emerging Adult Risky Drinkers. J Stud Alcohol Drugs 2022; 83:64-73. [PMID: 35040761 PMCID: PMC8819894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Although emerging adult risky drinkers are generally unmotivated to change their drinking, use of protective behavioral strategies (PBS) to minimize drinking risks is associated with decreased alcohol-related harms. However, research on social influences on PBS use and associations with drinking outcomes is limited and relevant to informing interventions for this priority population. This study investigated whether emerging adults' drinking-related behaviors were associated with social network encouragement, discouragement, or mixed messages about their drinking and with PBS use. METHOD Risky drinkers ages 21-29 years (N = 356; 228 women; mean age = 23.6 years) were recruited from the community using digitally implemented respondent-driven sampling. A web-based survey assessed social network drinking feedback, PBS use, drinking practices and problems, and behavioral allocation of time and money to drinking. RESULTS Negative binomial generalized linear models indicated that friend and spouse/ partner discouragement of drinking was associated with greater PBS use, whereas mixed messages were associated with lower use (ps < .05). Greater PBS use was associated with fewer alcohol-related negative consequences and lower behavioral allocation to drinking (ps < .05); the latter association was most consistent for serious harm reduction PBS (e.g., use of a designated driver). Mixed drinking messages from all relationship types had direct negative associations with drinking outcomes, particularly time and money allocated to drinking. CONCLUSIONS Assessing social network features may guide interventions to increase PBS use and reduce drinking-related harms among emerging adult risky drinkers.
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Napierala S, Chabata ST, Davey C, Fearon E, Busza J, Mushati P, Mugurungi O, Hatzold K, Cambiano V, Phillips A, Hargreaves JR, Cowan FM. Engagement in HIV services over time among young women who sell sex in Zimbabwe. PLoS One 2022; 17:e0270298. [PMID: 35763532 PMCID: PMC9239457 DOI: 10.1371/journal.pone.0270298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Young female sex workers (FSW) are disproportionately vulnerable to HIV. Zimbabwe data show higher HIV incidence and lower engagement in services compared to older FSW. Utilizing data from a combination HIV prevention and treatment intervention, we describe engagement in the HIV services over time among FSW 18-24 years, compared to those ≥25 years of age. MATERIALS AND METHODS Data were collected via respondent-driven sampling (RDS) surveys in 14 communities in 2013 and 2016, with >2500 FSW per survey. They included blood samples for HIV and viral load testing. As the intervention had no significant impact on HIV care cascade outcomes, data were aggregated across study arms. Analyses used RDS-II estimation. RESULTS Mean age in 2013 and 2016 was 31 and 33 years, with 27% and 17% aged 18-24 years. Overall HIV prevalence was 59% at each timepoint, and 35% and 36% among younger FSW. From 2013 to 2016 there was an increase in young HIV-positive FSW knowing their status (38% vs 60%, OR = 2.51, p<0.01). Outcomes for all FSW improved significantly over time at all steps of the cascade, and the relative change over time was similar among older versus younger FSW for most cascade variables. DISCUSSION Young FSW had improvements in care cascade outcomes, and proportionate improvements similar to older FSW, yet they remain less engaged in services overall. This implies that the dedicated FSW services in Zimbabwe are having a comparably positive impact across age groups, however more is likely required to address young FSW's unique vulnerabilities and needs.
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Affiliation(s)
- Sue Napierala
- Women’s Global Health Imperative, RTI International, Berkeley, California, United States of America
- * E-mail:
| | - Sungai T. Chabata
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Calum Davey
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Elizabeth Fearon
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Joanna Busza
- Centre for Evaluation, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Phillis Mushati
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
| | | | - Karin Hatzold
- Population Services International, Cape Town, South Africa
| | - Valentina Cambiano
- Institute for Global Health, University College London, London, United Kingdom
| | - Andrew Phillips
- Institute for Global Health, University College London, London, United Kingdom
| | - James R. Hargreaves
- Centre for Evaluation, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Frances M. Cowan
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Evaluating the quality of HIV epidemiologic evidence for populations in the absence of a reliable sampling frame: a modified quality assessment tool. Ann Epidemiol 2022; 65:78-83. [PMID: 34314845 PMCID: PMC8748278 DOI: 10.1016/j.annepidem.2021.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/16/2021] [Accepted: 07/18/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Sampling frames rarely exist for key populations at highest risk for HIV, such as sex workers, men who have sex with men, people who use drugs, and transgender populations. Without reliable sampling frames, most data collection relies on non-probability sampling approaches including network-based methods (e.g. respondent driven sampling) and venue-based methods (e.g. time-location sampling). Quality of implementation and reporting of these studies is highly variable, making wide-ranging estimates often difficult to compare. Here, a modified quality assessment tool, Global.HIV Quality Assessment Tool for Data Generated through Non-Probability Sampling (GHQAT), was developed to evaluate the quality of HIV epidemiologic evidence generated using non-probability methods. METHODS The GHQAT assesses three main domains: study design, study implementation, and indicator-specific criteria(prevalence, incidence, HIV continuum of care, and population size estimates). The study design domain focuses primarily on the specification of the target and study populations. The study implementation domain is concerned with sampling implementation. Each indicator-specific section contains items relevant to that specific indicator. A random subset of 50 studies from a larger systematic review on epidemiologic data related to HIV and key populations was generated and reviewed using the GHQAT by two independent reviewers. Inter-rater reliability was assessed by calculating intraclass correlation coefficients for the scores assigned to study design, study implementation and each of the indicator-specific criteria. Agreement was categorized as poor(0.00-0.50), fair(0.51-0.70), and good(0.71-1.00). The distribution of good, fair, and poor scores for each section was described. RESULTS Overall, agreement between the two independent reviewers was good(ICC >0.7). Agreement was best for the section evaluating the HIV continuum of care(ICC = 0.96). For HIV incidence, perfect agreement was observed, but this is likely due to the small number of studies reviewed that assessed incidence(n = 3). Of the studies reviewed, 2% (n = 1) received a score of "poor" for study design, while 50% (n = 25) received a score of "poor" for study implementation. CONCLUSIONS Addressing HIV prevention and treatment needs of key populations is increasingly understood to be central to HIV responses across HIV epidemic settings, though data characterizing specific needs remains highly variable with the least amount of information in the most stigmatizing settings. Here, we present an efficient tool to guide HIV prevention and treatment programs as well as epidemiological data collection by reliably synthesizing the quality of available non-probability based epidemiologic information for key populations. This tool may help shed light on how researchers may improve not only the implementation of, but also the reporting on their studies.
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Olivari CF, Gaete J, Rodriguez N, Pizarro E, Del Villar P, Calvo E, Castillo-Carniglia A. Polydrug Use and Co-occurring Substance Use Disorders in a Respondent Driven Sampling of Cocaine Base Paste Users in Santiago, Chile. J Psychoactive Drugs 2021; 54:348-357. [PMID: 34724873 DOI: 10.1080/02791072.2021.1976886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We characterized substance use patterns and co-occurring substance use disorders among active cocaine base paste (CBP) users in Santiago, Chile using data from respondent-driven sampling (RDS) in three areas of Metropolitan Santiago. Recruitment began with nine seeds, reaching 398 active CBP users (18% women; mean age 37.7 years), defined as persons consuming CBP at least twice per week in the last three months. Population proportions and uncertainty were estimated accounting for individuals' social network and homophily. The median CBP age of initiation was 21 years, and the median number of years using CBP was 7 for women and 15 for men. The median days of use in the past month was 25 days, with a median of 56 doses per week. The proportion of monthly income spent on CBP was 65%. The prevalence of substance use disorders (SUDs) were: 98% for CBP, 67% for alcohol, 60% for marijuana, and 41% for cocaine hydrochloride. Heavy polydrug use patterns and co-occurring SUDs are frequent among active CBP users in the metropolitan area of Santiago. Traditional surveillance strategies may have underestimated polysubstance use and co-occurring SUDs in active CBP users. RDS proved to be a feasible methodology that could be effectively used for substance use surveillance among hard-to-reach populations.
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Affiliation(s)
- Carla F Olivari
- Society and Health Research Center, Universidad Mayor, Santiago, Chile
| | - Jorge Gaete
- Faculty of Education, Universidad de los Andes, Santiago, Chile.,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, MI, USA
| | - Nicolás Rodriguez
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - Esteban Pizarro
- Research Department, National Service for Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA), Santiago, Chile
| | - Paloma Del Villar
- Centro de estudios Justicia y Sociedad, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Esteban Calvo
- Society and Health Research Center, Universidad Mayor, Santiago, Chile.,School of Public Health, Universidad Mayor, Santiago, Chile.,Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.,Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, Universidad Mayor, Santiago, Chile.,School of Public Health, Universidad Mayor, Santiago, Chile.,Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Sahebi A, Jahangiri K, Alibabaei A, Khorasani-Zavareh D. Factors Influencing Hospital Emergency Evacuation during Fire: A Systematic Literature Review. Int J Prev Med 2021; 12:147. [PMID: 34912523 PMCID: PMC8631117 DOI: 10.4103/ijpvm.ijpvm_653_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/08/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although the hospital is known as a safe place for treating patients, due to various reasons, it is prone to several internal hazards, including fire. This study aimed to identify the factors affecting hospital emergency evacuation during fire. METHODS This was a systematic review conducted according to the PRISMA guideline. Thematic Content analysis was utilized to analyze and extract results. We found the studies investigating the factors affecting hospital emergency evacuation during fire through a comprehensive search in various data resources (MEDLINE, Web of Science, Google Scholar, Embase, ProQuest, Scopus, IRANMEDEX, SID, ISC, and Magiran) and other sources from the beginning of January 2000 to the end of December 2019. Thematic Content analysis was also employed to analyze. RESULTS At first and based on the initial search, 4484 studies were identified, and 48 articles were finally included in the study. Based on the results; five main themes along with 10 sub-themes were identified. The themes included the incident's characteristics, response measures, hospital preparedness, hospital residents, and hospital building, and the sub-themes were emergency evacuation features, fire characteristics, command, operation, patients' and staff's characteristics, planning, logistics, and structure and design hospital. CONCLUSIONS Based on the results of the present study, hospital preparedness as one of the most important factors can reduce the hospital evacuation time. Therefore, hospitals can ensure a timely and more effective response in emergency evacuation during fire by improving their preparedness.
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Affiliation(s)
- Ali Sahebi
- Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Katayoun Jahangiri
- Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Alibabaei
- Department of E-Learning, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davoud Khorasani-Zavareh
- Workplace Health Promotion Research Center, Department of Health in Emergencies and Disasters, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Liao Y, Hong X, Wu A, Jiang Y, Liang Y, Gao J, Xue L, Kou X. Global prevalence of norovirus in cases of acute gastroenteritis from 1997 to 2021: An updated systematic review and meta-analysis. Microb Pathog 2021; 161:105259. [PMID: 34687838 DOI: 10.1016/j.micpath.2021.105259] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/10/2021] [Accepted: 10/15/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND The worldwide response towards the acute gastroenteritis epidemic was well known, but the absence of an updated systematic review of global norovirus epidemiology in cases of gastroenteritis existed. We aimed to conduct and update a systematic review and meta-analysis of studies assessing norovirus prevalence among gastroenteritis patients worldwide. METHODS Four databases (PubMed, EMBASE, Cochrane Library, and Web of Science) were searched for epidemiological papers from 2014 to 2021 which applied the PCR method to access the prevalence of norovirus in acute gastroenteritis patients more than a full year. Statistical analysis was conducted using R-4.0.0 software. RESULTS A total of 405 records with 842, 926 cases were included. The pooled prevalence of norovirus was 16% (95%CI 15, 17). Children under 5 years old were at a higher risk with norovirus. A higher prevalence was seen in South America (22%, 95% CI 18, 27), while other continents showed a similar result with the overall prevalence of norovirus. No association was found between national income level and norovirus prevalence. A gradient of decreasing prevalence was noticed from community (20%, 95% CI 16, 24) to outpatients (18%, 95% CI 16, 20) to hospital setting (included both in- and outpatients, 17%, 95% CI 16, 19) to inpatients (15%, 95% CI 13, 17). CONCLUSION Norovirus were associated with 16% acute gastroenteritis globally. To fully understand the prevalence of norovirus worldwide, the continual surveillance of norovirus epidemics was required.
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Affiliation(s)
- Yingyin Liao
- KingMed School of Laboratory Medicine of Guangzhou Medical University, Guangzhou, China
| | - Xiaojing Hong
- KingMed School of Laboratory Medicine of Guangzhou Medical University, Guangzhou, China
| | - Aiwu Wu
- KingMed School of Laboratory Medicine of Guangzhou Medical University, Guangzhou, China
| | - Yueting Jiang
- Department of Laboratory Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yanhui Liang
- Hubei Key Laboratory of Edible Wild Plants Conservation and Utilization, Hubei Normal University, Huangshi, China
| | - Junshan Gao
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, China
| | - Liang Xue
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, China.
| | - Xiaoxia Kou
- KingMed School of Laboratory Medicine of Guangzhou Medical University, Guangzhou, China.
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Barbaric J, Bozicevic I, Manathunge A, Gajaweera C, Beneragama S. HIV, syphilis and hepatitis B prevalence, related risk behaviours and correlates of condom use among transgender women in two cities in Sri Lanka: findings from respondent-driven sampling surveys. Sex Health 2021; 18:311-318. [PMID: 34446151 DOI: 10.1071/sh21061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/06/2021] [Indexed: 11/23/2022]
Abstract
Background Biobehavioural data on transgender women (TGW) are limited globally. METHODS We used data collected as part of the 2017-18 National Integrated HIV Biobehavioural Survey, which included 254 TGW in Colombo and 252 in Jaffna, for structured questionnaire interviews and biological testing. We performed multivariable logistic regression analysis to explore factors associated with condom use. RESULTS We found low HIV prevalence in Colombo (0.6%) and no HIV infections in Jaffna. TGW in Colombo had higher positivity on the Treponema pallidum-particle agglutination test (2.5%) compared with TGW in Jaffna (0.4%). We found no hepatitis B infections. In both cities, <25% of TGW have comprehensive knowledge about HIV prevention. In Colombo 54.4%, but only 21.4% of TGW in Jaffna, have ever been tested for HIV. Drug-injecting behaviours are uncommon in both cities (prevalence <1%), whereas 7.4% reported sharing equipment for injecting feminising hormones in Colombo. Greater proportions of TGW in Colombo compared with Jaffna used condom at last sex (82.3% vs 37.7%). Multivariable analysis showed lower odds of condom use at last sex in TGW aged >30 years and those who did not test for HIV in the past 12 months in Colombo, and for TGW with higher income in Jaffna, TGW not visiting outdoor sites to find partners, and TGW who sold sex. CONCLUSIONS Current burden of HIV, syphilis and hepatitis B among TGW in Sri Lanka is low. Although risk behavioural patterns vary between the cities, a substantial sexually transmitted infection vulnerability is a common denominator, calling for strengthening of the capacity to respond to specific TGW needs.
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Affiliation(s)
- Jelena Barbaric
- World Health Organization Collaborating Centre for HIV Strategic Information, University of Zagreb School of Medicine, Zagreb, Croatia; and Corresponding author.
| | - Ivana Bozicevic
- World Health Organization Collaborating Centre for HIV Strategic Information, University of Zagreb School of Medicine, Zagreb, Croatia
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Motter FR, Cantuaria NM, Lopes LC. Healthcare professionals' knowledge, attitudes and practices toward deprescribing: a protocol of cross-sectional study (Desmedica Study-Brazil). BMJ Open 2021; 11:e044312. [PMID: 34341031 PMCID: PMC8330586 DOI: 10.1136/bmjopen-2020-044312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Deprescribing is the planned and supervised process of dose reduction or stopping of medication that might be causing harm, or no longer be of benefit. It is an activity that should be a normal part of care/the prescribing cycle. Although now broadly recognised, there are still challenges in its effective implementation. OBJECTIVES To develop and validate an instrument to measure Brazilian healthcare professionals' knowledge, attitudes and practices towards deprescribing. METHODS This study will include the following steps: (1) development of the preliminary instrument; (2) content validation; (3) pilot study; (4) evaluation of psychometric characteristics. After the elaboration of items of the instrument through the literature review, we will use a hybrid Delphi method to develop and establish the content validity of the instrument. Further, a pilot survey will be performed with 30 healthcare professionals. Finally, for the evaluation of psychometric characteristics, a cross-sectional study will be accomplished with a representative sample of different healthcare professionals from different Brazilian states using respondent-driven sampling. Exploratory factor analysis and confirmatory factor analysis will be performed. For assessing the model fit, we will use the ratio of χ2 and df (χ2/df), comparative fit index, the goodness of fit index and root mean square error of approximation. In addition, the reliability of the instrument will be estimated by test-retest reproducibility and Cronbach's alpha coefficient (α). ETHICS AND DISSEMINATION The Ethics Committee for Research at the University of Sorocaba (ethics approval number: 3.848.916) approved the study. Study findings will be circulated to healthcare professionals and scientists in the field through publication in peer-reviewed journals and conference presentations.
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Affiliation(s)
- Fabiane Raquel Motter
- Graduate Program in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
| | | | - Luciane Cruz Lopes
- Graduate Program in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
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49
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Patel EU, Solomon SS, Lucas GM, McFall AM, Tomori C, Srikrishnan AK, Kumar MS, Laeyendecker O, Celentano DD, Thomas DL, Quinn TC, Mehta SH. Drug use stigma and its association with active hepatitis C virus infection and injection drug use behaviors among community-based people who inject drugs in India. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 96:103354. [PMID: 34247900 DOI: 10.1016/j.drugpo.2021.103354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/09/2021] [Accepted: 06/13/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although drug use stigma is globally pervasive, quantitative evidence of its role in hepatitis C virus (HCV) transmission is limited. We evaluated the psychometric properties of a drug use stigma scale and examined the association between drug use stigma and active HCV infection among a community-based sample of people who inject drugs (PWID) in India. METHODS Between 8/2016 and 5/2017, a cross-sectional sample of PWID was recruited from 12 Indian cities (~1000/city) using respondent-driven sampling. Participants were ≥18 years old and reported injection drug use (IDU) in the past 2 years. Multivariable logistic regression with a random-intercept for each city was used to estimate adjusted odds ratios (aOR) of active HCV infection (RNA>30 IU/mL). Analyses incorporated RDS-II weights. RESULTS Of 11,663 participants, 73.1% reported IDU in the past 6 months and 33.8% had active HCV infection. Exploratory factor analysis yielded a four-factor solution of enacted, vicarious, felt normative and internalized drug use stigma with high internal consistency (Cronbach's α: 0.85-0.92). In analyses adjusted for age, gender, northeast region, education, homelessness, incarceration, alcohol dependence, HIV status, frequency of IDU, and ever sharing needles/syringes, PWID reporting any enacted stigma had greater odds of active HCV infection (aOR = 1.27 [95% CI = 1.13-1.43]) as did PWID with internalized stigma scores in the highest quartile (vs. lowest quartile; aOR = 1.69 [95% CI = 1.11-2.56]). Among PWID who reported IDU in the past 6 months, multiple forms of stigma were associated with higher frequency of IDU, sharing needles/syringes, having multiple injection partners, and IDU in public spaces. CONCLUSION Using a multidimensional drug use stigma scale, various forms of stigma were significantly associated with active HCV infection and injection drug use-related risk behaviors. Collectively, these data suggest that drug use stigma may play a role in HCV transmission and impede efforts to achieve HCV elimination. Strategies to diminish drug use stigma are warranted.
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Affiliation(s)
- Eshan U Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sunil S Solomon
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; YR Gaitonde Centre for AIDS Research and Education, Chennai, India
| | - Gregory M Lucas
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Allison M McFall
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cecília Tomori
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Oliver Laeyendecker
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Baltimore MD, USA
| | - David D Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David L Thomas
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas C Quinn
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Baltimore MD, USA
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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50
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Li J, Wang H, Li D, Zhang Q, Liu N. Infection status and circulating strains of rotaviruses in Chinese children younger than 5-years old from 2011 to 2018: systematic review and meta-analysis. Hum Vaccin Immunother 2021; 17:1811-1817. [PMID: 33651653 PMCID: PMC8115617 DOI: 10.1080/21645515.2020.1849519] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/14/2020] [Accepted: 11/04/2020] [Indexed: 12/29/2022] Open
Abstract
To evaluate rotavirus (RV) disease burden and circulating strains of RV among Chinese children younger than 5-years old who had diarrhea from 2011 to 2018. PubMed, Web of Science, Embase, CNKI and WANFANG databases were systematically searched to identify studies that reported RV prevalence in mainland China. After data extraction, a fixed-effects model or a random-effects model was applied to estimate RV positivity and proportions of G and P types. Statistical analysis was conducted using R software. We initially reviewed 1323 studies, and identified 69 studies that were eligible. The overall proportion of RV gastroenteritis (RVGE) among children under 5-years old who presented with diarrhea and sought medical care was 34.0% (95% CI: 31.3, 36.8), and RV positivity was higher among inpatients (39.7%) than outpatients (23.9%). Western areas of China had the highest proportion of RVGE (42.7%), and RV positivity was highest for children who were 6 months-old to 2 years-old. The most prevalent G types were G3 (26.1%), G9 (17.5%), and G1 (12.8%), the most prevalent P type was P[8] (56.8%) and the most prevalent G-P combination was G9P[8] (20.9%). RV continues to be a main cause of acute gastroenteritis in Chinese children who are younger than 5 years old. Following the introduction of an RV vaccine in 2011, monitoring of the disease burden of RV diarrhea and circulating strains in China remain important for assessments of vaccine efficacy.
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Affiliation(s)
- Jingxin Li
- Department of Viral Diarrhea, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hong Wang
- Department of Viral Diarrhea, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dandi Li
- Department of Viral Diarrhea, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qing Zhang
- Department of Viral Diarrhea, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Na Liu
- Department of Viral Diarrhea, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- CONTACT Na Liu Department of Viral Diarrhea, National Institute for Viral Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing102206, China
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