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Schlenker NW, Irvin NA, Galetto GG, Dashler GM, Jones JL, Ricketts EP, Barrow GM, Saheed MO, Greenbaum AH, Rothman RE, Hsieh YH. Identifying Missed Opportunities in the Prevention of Acute HIV Infection: The Need to Provide Pre-exposure Prophylaxis Referrals to Emergency Department Patients With Increased Risk for Acquiring HIV. J Acquir Immune Defic Syndr 2021; 88:e22. [PMID: 34321413 DOI: 10.1097/qai.0000000000002773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | | | - Joyce L Jones
- Division of Infectious Diseases, Department of Medicine; School of Medicine, Johns Hopkins University, Baltimore, MD
| | | | | | | | | | - Richard E Rothman
- Department of Emergency Medicine
- Division of Infectious Diseases, Department of Medicine; School of Medicine, Johns Hopkins University, Baltimore, MD
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Rosecrans AM, Cheedalla A, Rives ST, Scotti LA, Harris RE, Greenbaum AH, Irvin RR, Ntiri-Reid BA, Brown HT, Alston KE, Smith JA, Page KR, Falade-Nwulia OO. Public Health Clinic-Based Hepatitis C Treatment. Am J Prev Med 2020; 59:420-427. [PMID: 32430222 DOI: 10.1016/j.amepre.2020.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/20/2020] [Accepted: 03/11/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The availability of safe, effective treatments for hepatitis C virus infection has led to a call for the elimination of hepatitis C, but barriers to care persist. METHODS In July 2015, the Baltimore City Health Department sexual health clinics began on-site hepatitis C virus treatment. Investigators conducted a retrospective evaluation of the first 2.5 years of this program. Data were extracted from the medical record through June 2019, and data analysis was completed in September 2019. RESULTS Between July 2015 and December 2017, a total of 560 patients infected with hepatitis C virus accessed care at the Baltimore City Health Department sexual health clinics. Of these patients, 423 (75.5%) were scheduled for hepatitis C virus evaluation at the clinics, 347 (62.0%) attended their evaluation appointment, 266 (47.5%) were prescribed treatment, 227 (40.5%) initiated treatment, and 199 (35.5%) achieved sustained virologic response. Older age was independently associated with hepatitis C virus evaluation appointment attendance (aged 40-59 years: AOR=3.64, 95% CI=1.88, 7.06; aged ≥60 years: AOR=5.61, 95% CI=2.58, 12.21) compared with those aged 20-39 years. Among those who attended hepatitis C virus evaluation appointments, advanced liver disease was independently and positively associated with treatment initiation (AOR=11.89, 95% CI=6.35, 22.25). Conversely, illicit substance use in the past 12 months was negatively associated with hepatitis C virus treatment initiation (AOR=0.49, 95% CI=0.25, 0.96). CONCLUSIONS The integration of hepatitis C virus testing and on-site treatment in public sexual health clinics is an innovative approach to improve access to hepatitis C virus treatment for medically underserved populations.
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Affiliation(s)
- Amanda M Rosecrans
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, Maryland.
| | - Aneesha Cheedalla
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sarah T Rives
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, Maryland
| | - Lisa A Scotti
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, Maryland
| | - Robert E Harris
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, Maryland
| | - Adena H Greenbaum
- Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, Maryland
| | - Risha R Irvin
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Boatemaa A Ntiri-Reid
- Prevention and Health Promotion Administration, Maryland Department of Health, Baltimore, Maryland
| | - Holly T Brown
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, Maryland
| | - Karen E Alston
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, Maryland
| | - Jaeson A Smith
- Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, Maryland
| | - Kathleen R Page
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, Maryland
| | - Oluwaseun O Falade-Nwulia
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Schnabel D, Esposito DH, Gaines J, Ridpath A, Barry MA, Feldman KA, Mullins J, Burns R, Ahmad N, Nyangoma EN, Nguyen DB, Perz JF, Moulton-Meissner HA, Jensen BJ, Lin Y, Posivak-Khouly L, Jani N, Morgan OW, Brunette GW, Pritchard PS, Greenbaum AH, Rhee SM, Blythe D, Sotir M. Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013-2014(1). Emerg Infect Dis 2018; 22:1340-1347. [PMID: 27434822 PMCID: PMC4982176 DOI: 10.3201/eid2208.151938] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Infections in 6 states were linked to persons traveling to undergo cosmetic surgical procedures. During 2013, the Maryland Department of Health and Mental Hygiene in Baltimore, MD, USA, received report of 2 Maryland residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic procedures at a clinic (clinic A) in the Dominican Republic. A multistate investigation was initiated; a probable case was defined as a surgical site infection unresponsive to therapy in a patient who had undergone cosmetic surgery in the Dominican Republic. We identified 21 case-patients in 6 states who had surgery in 1 of 5 Dominican Republic clinics; 13 (62%) had surgery at clinic A. Isolates from 12 (92%) of those patients were culture-positive for Mycobacterium abscessus complex. Of 9 clinic A case-patients with available data, all required therapeutic surgical intervention, 8 (92%) were hospitalized, and 7 (78%) required ≥3 months of antibacterial drug therapy. Healthcare providers should consider infection with rapidly growing mycobacteria in patients who have surgical site infections unresponsive to standard treatment.
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Abstract
BACKGROUND Hospitalization for lower respiratory tract infections (LRTIs) among children have been well characterized. We characterized hospitalizations for severe LRTI among children. METHODS We analyzed claims data from commercial and Medicaid insurance enrollees (MarketScan) ages 0 to 18 years from 2007 to 2011. LRTI hospitalizations were identified by the first 2 listed International Classification of Diseases, Ninth Revision discharge codes; those with ICU admission and/or receiving mechanical ventilation were defined as severe LRTI. Underlying conditions were determined from out- and inpatient discharge codes in the preceding year. We report insurance specific and combined rates that used both commercial and Medicaid rates and adjusted for age and insurance status. RESULTS During 2007-2011, we identified 16797 and 12053 severe LRTI hospitalizations among commercial and Medicaid enrollees, respectively. The rates of severe LRTI hospitalizations per 100000 person-years were highest in children aged <1 year (commercial: 244; Medicaid: 372, respectively), and decreased with age. Among commercial enrollees, ≥ 1 condition increased the risk for severe LRTI (1 condition: adjusted relative risk, 2.68; 95% confidence interval, 2.58-2.78; 3 conditions: adjusted relative risk, 4.85; 95% confidence interval, 4.65-5.07) compared with children with no medical conditions. Using commercial/Medicaid combined rates, an estimated 31289 hospitalizations for severe LRTI occurred each year in children in the United States. CONCLUSIONS Among children, the burden of hospitalization for severe LRTI is greatest among children aged <1 year. Children with underlying medical conditions are at greatest risk for severe LRTI hospitalization.
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Affiliation(s)
- Adena H Greenbaum
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Epidemic Intelligence Service assigned to the Influenza Division
| | - Jufu Chen
- Influenza Division, National Center for Immunizations and Respiratory Diseases
| | - Carrie Reed
- Influenza Division, National Center for Immunizations and Respiratory Diseases
| | - Suzanne Beavers
- Division of Environmental Hazards and Health Effects, National Center for Environmental Health
| | - David Callahan
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, and
| | - Deborah Christensen
- Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lyn Finelli
- Influenza Division, National Center for Immunizations and Respiratory Diseases
| | - Alicia M Fry
- Influenza Division, National Center for Immunizations and Respiratory Diseases,
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Greenbaum AH, Wong K, Nguyen D, Smith E, Torso L, Chen G, Wise M, Casey M, Ostroff S, Nambiar A, Nalluswami K, Miller J, Lute J, Klimov A, Emery S, Green M, Giampa P, Moll M, Finelli L, Jhung M. Assessment for possible healthcare-associated transmission of a new variant influenza virus--Pennsylvania, August 2011. Infect Control Hosp Epidemiol 2013; 34:1306-9. [PMID: 24225616 DOI: 10.1086/673980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In August 2011, one of the earliest cases of influenza A(H3N2) variant [A(H3N2)v] virus infection was hospitalized with severe illness. To investigate the potential for healthcare-associated transmission of influenza A(H3N2)v, we evaluated both healthcare providers and patient contacts of the case. We found that healthcare-associated transmission was unlikely.
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Affiliation(s)
- Adena H Greenbaum
- Epidemic Intelligence Service Assigned to Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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