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Yu D, Martin CB, Fryar CD, Hales CM, Eberhardt MS, Carroll MD, Zhao L, Ogden CL. Prevalence of Diabetes by BMI: China Nutrition and Health Surveillance (2015-2017) and U.S. National Health and Nutrition Examination Survey (2015-2018). AJPM Focus 2024; 3:100215. [PMID: 38638940 PMCID: PMC11024921 DOI: 10.1016/j.focus.2024.100215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Introduction The risk of diabetes begins at a lower BMI among Asian adults. This study compares the prevalence of diabetes between the U.S. and China by BMI. Methods Data from the 2015-2017 China Nutrition and Health Surveillance (n=176,223) and the 2015-2018 U.S. National Health and Nutrition Examination Survey (n=4,464) were used. Diagnosed diabetes was self-reported. Undiagnosed diabetes was no report of diagnosed diabetes and fasting plasma glucose ≥126 mg/dL or HbA1c ≥6.5%. Predicted age-adjusted prevalence estimates by BMI were produced using sex- and country-specific logistic regression models. Results In China, the age-adjusted prevalence of total diabetes was 7.8% (95% CI=7.4%, 8.3%), lower than the 14.6% (95% CI=13.1%, 16.3%) in the U.S. The prevalence of diagnosed diabetes was also lower in China than in the U.S. There were no statistically significant differences in the prevalence of undiagnosed diabetes between China and the U.S. The distribution of BMI in China was lower than in the U.S., and the predicted prevalence of total diabetes was similar between China and the U.S. when comparing adults with the same BMI. The predicted prevalence of undiagnosed diabetes was higher in China than in the U.S. for both men and women, and this disparity increased with BMI. When comparing adults at the same BMI, there was little difference in the prevalence of total diabetes, but diagnosed diabetes was lower in China than in the U.S., and undiagnosed was higher. Conclusions Although differences in BMI appear to explain nearly all of the differences in total diabetes prevalence in the 2 countries, not all factors that are associated with diabetes risk have been investigated.
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Affiliation(s)
- Dongmei Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Crescent B. Martin
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Cheryl D. Fryar
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Craig M. Hales
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Mark S. Eberhardt
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Margaret D. Carroll
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Liyun Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cynthia L. Ogden
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
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Wambogo EA, Ansai N, Herrick KA, Reedy J, Hales CM, Ogden CL. Differences in Intakes of Select Nutrients by Urbanization Level in the United States Population 2 Years and Older, NHANES 2013-2018. J Nutr 2024; 154:617-625. [PMID: 38142922 PMCID: PMC10900191 DOI: 10.1016/j.tjnut.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/05/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Differences in nutrient intakes by urbanization level in the Unites States is not well understood. OBJECTIVE Describe, by urbanization level: 1) intake of protein, fiber, percent of energy from added sugars (AS) and saturated fat (SF), calcium, iron, potassium, sodium, and vitamin D; 2) the percent of the population meeting nutrient recommendations. METHODS Twenty-four-hour dietary recalls from 23,107 participants aged 2 y and over from the 2013-2018 National Health and Nutrition Examination Surveys were analyzed. Usual intakes were estimated, and linear regression models adjusted for age, sex, race and Hispanic origin, and whether family income met the 130% threshold examined intake differences by urbanization levels-large urban areas (LUA), small to medium metro areas (SMMA), and rural areas (RA). RESULTS A small percentage of the population met the nutrient recommendations, except for protein (92.8%) and iron (70.5%). A higher percentage of the population met recommendations than SMMA and RA for fiber (11.8% compared with 8.1% and 5.3%, P < 0.001), AS (40.2% compared with 33.4% and 31.3%, P < 0.001), SF (26.8% compared with 18.2% and 20.1%, P < 0.001), and potassium (31.5% compared with 25.5% and 22.0%, P < 0.001). Mean protein intake were also higher in LUA than RA (80.0 g compared with 77.7 g, P = 0.003) and fiber intake higher in LUA than SMMA (16.5 g compared with 15.9 g, P = 0.01) and RA (16.5 g compared with 15.2 g, P = 0.001). In addition, contributions to energy intake were lower in LUA than SMMA for AS (11.3% compared with 12.0%, P < 0.001) and SF (11.5% compared with 11.7%, P < 0.001), and for LUA than RA for AS (11.3% compared with 12.9%, P < 0.001) and SF (11.5% compared with 11.8%, P < 0.001). CONCLUSIONS RA had some markers of poorer diet quality-lower protein and fiber intake and higher AS intake-compared with LUA, and these differences persisted in adjusted regression models. These results may inform public health efforts to address health disparities by urbanization levels in the Unites States.
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Affiliation(s)
- Edwina A Wambogo
- Office of Dietary Supplements, National Institutes of Health, Rockville, MD, United States.
| | - Nicholas Ansai
- Division of National Health and Nutrition Examination Survey, National Center for Health Statistics, Hyattsville, MD, United States
| | - Kirsten A Herrick
- Office of Dietary Supplements, National Institutes of Health, Rockville, MD, United States
| | - Jill Reedy
- Office of Dietary Supplements, National Institutes of Health, Rockville, MD, United States
| | - Craig M Hales
- Division of National Health and Nutrition Examination Survey, National Center for Health Statistics, Hyattsville, MD, United States
| | - Cynthia L Ogden
- Division of National Health and Nutrition Examination Survey, National Center for Health Statistics, Hyattsville, MD, United States
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Kim C, Rossen LM, Stierman B, Garrison V, Hales CM, Ogden CL. Federal Housing Assistance and Chronic Disease Among US Adults, 2005-2018. Prev Chronic Dis 2023; 20:E111. [PMID: 38033271 PMCID: PMC10723081 DOI: 10.5888/pcd20.230144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
Introduction Housing insecurity is associated with poor health outcomes. Characterization of chronic disease outcomes among adults with and without housing assistance would enable housing programs to better understand their population's health care needs. Methods We used National Health and Nutrition Examination Survey (NHANES) data from 2005 through 2018 linked to US Department of Housing and Urban Development (HUD) administrative records to estimate the prevalence of obesity, diabetes, and hypertension and to assess the independent associations between housing assistance and chronic conditions among adults receiving HUD assistance and HUD-assistance-eligible adults not receiving HUD assistance at the time of their NHANES examination. We estimated propensity scores to adjust for potential confounders among linkage-eligible adults who had an income-to-poverty ratio less than 2 and were not receiving HUD assistance. Sensitivity analysis used 2013-2018 NHANES cycles to account for disability status. Results Adults not receiving HUD assistance had a significantly lower adjusted prevalence of obesity (42.1%; 95% CI, 40.4%-43.8%) compared with adults receiving HUD assistance (47.5%; 95% CI, 44.8%-50.3%), but we found no differences for diabetes and hypertension. We found significant associations between housing assistance and obesity (adjusted odds ratio = 1.29; 95% CI, 1.12-1.47), but these were not significant in the sensitivity analysis with and without controlling for disability status. We found no significant associations between housing assistance and diabetes or hypertension. Conclusion Based on data from a cross-sectional survey, we observed a higher prevalence of obesity among adults with HUD assistance compared with HUD-assistance-eligible adults without HUD assistance. Results from this study can help inform research on understanding the prevalence of chronic disease among adults with HUD assistance.
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Affiliation(s)
- Christine Kim
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta GA 30329-4027
| | - Lauren M Rossen
- Division of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Bryan Stierman
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Veronica Garrison
- Office of Research, Evaluation, and Monitoring, Office of Policy Development and Research, US Department of Housing and Urban Development, Washington, DC
| | - Craig M Hales
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Cynthia L Ogden
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
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4
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Ogden CL, Freedman DS, Hales CM. CDC Extended BMI-for-Age Percentiles Versus Percent of the 95th Percentile. Pediatrics 2023; 152:e2023062285. [PMID: 37615069 PMCID: PMC11074997 DOI: 10.1542/peds.2023-062285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 08/25/2023] Open
Affiliation(s)
- Cynthia L. Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - David S. Freedman
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Craig M. Hales
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
- US Public Health Service, Rockville, Maryland
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Ansai N, Wambogo EA, Herrick KA, Zimmer M, Reedy J, Hales CM, Ogden CL. Dietary contributions of food outlets by urbanization level in the US population aged 2 years and older-NHANES 2013-2018. Am J Clin Nutr 2023; 117:946-954. [PMID: 36822405 PMCID: PMC10159996 DOI: 10.1016/j.ajcnut.2023.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Differences in food access, availability, affordability, and dietary intake are influenced by the food environment, which includes outlets where foods are obtained. These differences between food outlets within rural and urban food environments in the United States are not well understood. OBJECTIVES The aim of this analysis is to describe the contribution of foods and beverages from 6 outlets-grocery stores, convenience stores, full-service restaurants, quick-service restaurants, schools, and other outlets-to the total energy intake and Healthy Eating Index (HEI)-2015 scores in the United States population, by urbanization level (nonmetropolitan statistical areas [MSAs], small-to-medium MSAs, and large MSAs). METHODS Data from the National Health and Nutrition Examination Survey 2013-2018 were used. Dietary intake from one 24-h dietary recall was analyzed by the outlet where a food or beverage was obtained and by urbanization. Linear regression, adjusted for sex, age, race and Hispanic origin, and family income, was used to predict the contribution of each food outlet to the total energy intake and HEI-2015 total and component scores by urbanization level. RESULTS During 2013-2018, foods and beverages from grocery stores and quick-service and full-service restaurants contributed to 62.1%, 15.1%, and 8.5% of the energy intake, respectively. The percentage of energy intake from full- and quick-service restaurants increased with increasing urbanization level. HEI-2015 total scores increased with the increasing urbanization level overall (48.1 non-MSAs, 49.2 small-to-medium MSAs, and 51.3 large MSAs) for grocery stores (46.7 non-MSAs, 48.0 small-to-medium MSAs, and 50.6 large MSAs) and for quick-service restaurants (35.8 non-MSAs, 36.3 small-to-medium MSAs, and 37.5 large MSAs). CONCLUSIONS Grocery stores and restaurants were the largest contributors of energy intake in urban and rural areas. Diet quality improved with increasing urbanization overall and for grocery stores and quick-service restaurants.
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Affiliation(s)
- Nicholas Ansai
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
| | - Edwina A Wambogo
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | | | | | - Jill Reedy
- National Cancer Institute, Rockville, MD, USA
| | - Craig M Hales
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Cynthia L Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
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Affiliation(s)
- Allon N. Friedman
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana,Address for Correspondence: Allon Friedman, MD, 550 University Blvd, Suite 6100, Indianapolis, IN 46202.
| | - Cynthia L. Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Craig M. Hales
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
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Ogden CL, Martin CB, Freedman DS, Hales CM. Trends in Obesity Disparities During Childhood. Pediatrics 2022; 150:188479. [PMID: 35788862 PMCID: PMC9677549 DOI: 10.1542/peds.2022-056547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Cynthia L. Ogden
- National Center for Health Statistics, Centers for Disease
Control and Prevention, Hyattsville, Maryland
| | - Crescent B. Martin
- National Center for Health Statistics, Centers for Disease
Control and Prevention, Hyattsville, Maryland
| | - David S. Freedman
- Division of Nutrition, Physical Activity, and Obesity,
Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Craig M. Hales
- National Center for Health Statistics, Centers for Disease
Control and Prevention, Hyattsville, Maryland,United States Public Health Service, Rockville,
Maryland
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8
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Martin CB, Stierman B, Yanovski JA, Hales CM, Sarafrazi N, Ogden CL. Body fat differences among US youth aged 8-19 by race and Hispanic origin, 2011-2018. Pediatr Obes 2022; 17:e12898. [PMID: 35135038 PMCID: PMC9177747 DOI: 10.1111/ijpo.12898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/17/2021] [Accepted: 01/11/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The association between body mass index (BMI) and adiposity differs by race/ethnicity. OBJECTIVE To examine differences in adiposity by race/Hispanic origin among US youth and explore how those differences relate to differences in BMI using the most recent national data, including non-Hispanic Asian youth. METHODS Weight, height and DXA-derived fat mass index (FMI) and percentage body fat (%BF) from 6923 youth 8-19 years in the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were examined. Age-adjusted mean BMI, FMI and %BF were reported. Sex-specific linear regression models predicting %BF and FMI were adjusted for age, BMI category and BMI category*race/Hispanic origin interaction. RESULTS %BF was highest among Hispanic males (28.2%) and females (35.7%). %BF was lower among non-Hispanic Black (23.9%) compared with non-Hispanic White (26.0%) and non-Hispanic Asian (26.6%) males. There was no difference between non-Hispanic Black females (32.7%) and non-Hispanic White (33.2%) or non-Hispanic Asian (32.7%) females. FMI was higher among Hispanic youth compared with non-Hispanic White youth. Among youth with underweight/healthy weight, predicted %BF and FMI were lower among non-Hispanic Black males (-2.8%; -0.5) and females (-2.0%; -0.3), compared with non-Hispanic White youth, and higher among Hispanic males (0.9%; 0.2) and females (2.0%; 0.5), while %BF but not FMI was higher among non-Hispanic Asian males (1.3%) and females (1.4%). Among females with obesity, non-Hispanic Asian females had lower %BF (-2.3%) and FMI (-1.7) than non-Hispanic White females. CONCLUSIONS Differences in %BF and FMI by race/Hispanic origin were not consistent by BMI category among US youth in 2011-2018.
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Affiliation(s)
- Crescent B. Martin
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC
| | - Bryan Stierman
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC; Epidemic Intelligence Service, CDC
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH
| | - Craig M. Hales
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC; United States Public Health Service
| | - Neda Sarafrazi
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC
| | - Cynthia L. Ogden
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC
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Hales CM, Gu Q, Ogden CL, Yanovski SZ. Use of prescription medications associated with weight gain among US adults, 1999-2018: A nationally representative survey. Obesity (Silver Spring) 2022; 30:229-239. [PMID: 34907655 PMCID: PMC8842491 DOI: 10.1002/oby.23299] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/20/2021] [Accepted: 08/28/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aimed to evaluate trends in the use of obesogenic medications among adults. METHODS Cross-sectional data on adults aged ≥20 years are from the 1999 to 2018 National Health and Nutrition Examination Survey (n = 52,340). Obesogenic medications were defined according to the 2015 Endocrine Society guidelines on the pharmacological management of obesity. Weight status was categorized according to BMI. Trends in prior 30-day use were evaluated. RESULTS In NHANES 2017-2018, 20.3% of US adults used an obesogenic medication. Beta-blockers (9.8%) and antidiabetics (5.7%) were the most common; antipsychotics (1.0%) were the least common. Most common indications were disorders of glucose metabolism, hypertension, neuralgia or neuritis, heart disease, and musculoskeletal pain and/or inflammation. From 1999 to 2018, the proportional use of obesogenic medications increased for anticonvulsants (34.4% to 55.0%) but decreased for antidepressants (32.1% to 18.8%), antidiabetics (82.9% to 52.5%), and beta-blockers (83.9% to 80.7%). The proportional use of obesogenic medications was not associated with weight status, except for antipsychotics. CONCLUSIONS Use of obesogenic medications was common. Differences in the proportional use of obesogenic medication may reflect changing availability of obesogenic versus nonobesogenic medications over time. The decision to prescribe a nonobesogenic alternative, if one exists, is guided by weighing the risks and benefits of available treatments.
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Affiliation(s)
- Craig M Hales
- Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland, USA
| | - Qiuping Gu
- Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland, USA
| | - Cynthia L Ogden
- Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland, USA
| | - Susan Z Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Stierman B, Ogden CL, Yanovski JA, Martin CB, Sarafrazi N, Hales CM. Changes in adiposity among children and adolescents in the United States, 1999-2006 to 2011-2018. Am J Clin Nutr 2021; 114:1495-1504. [PMID: 34291279 PMCID: PMC8645193 DOI: 10.1093/ajcn/nqab237] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/22/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Data from the NHANES indicate that BMI has increased in some subgroups of children and adolescents in the United States over the past 20 y; however, BMI is an indirect measure of body fatness. OBJECTIVES We assessed changes in DXA-derived measures of adiposity in a nationally representative population of US children and adolescents aged 8-19 y from 1999-2006 to 2011-2018. METHODS Using data from the NHANES, we compared the means and distributions of DXA-derived percentage body fat (%BF) and fat mass index (FMI; fat mass/height2 in kg/m2) between 1999-2006 (n = 10,231) and 2011-2018 (n = 6923) among males and females by age group, race and Hispanic origin, and BMI categories. Estimates were standardized by age and race and Hispanic origin. RESULTS From 1999-2006 to 2011-2018, mean %BF increased from 25.6% to 26.3% (change in %BF: 0.7%; 95% CI: 0.2%, 1.2%; P < 0.01) among all males, whereas mean %BF increased from 33.0% to 33.7% (change in %BF: 0.7%; 95% CI: 0.2%, 1.2%; P = 0.01) and mean FMI increased from 7.7 to 8.0 fat mass kg/m2 (change in FMI: 0.3 fat mass kg/m2; 95% CI: 0.0, 0.6 fat mass kg/m2; P = 0.02) among all females. Changes were not consistent across all age, race and Hispanic origin, and BMI categories. Both %BF and FMI increased among Mexican-American children and adolescents, but not other race and Hispanic origin groups. CONCLUSIONS Among US children and adolescents, DXA-derived measures of adiposity increased from 1999-2006 to 2011-2018, albeit not consistently in every age, race and Hispanic origin, and BMI subgroup. These data reinforce the need to consider other measures, besides BMI categories, when studying adiposity in children and adolescents.
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Affiliation(s)
| | - Cynthia L Ogden
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD, USA
| | - Crescent B Martin
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - Neda Sarafrazi
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - Craig M Hales
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA,United States Public Health Service, Rockville, MD, USA
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11
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Servais J, Ramage-Morin PL, Gal J, Hales CM. Prescription medication use among Canadian children and youth, 2012 to 2017. Health Rep 2021; 32:3-16. [PMID: 33728887 PMCID: PMC8647816 DOI: 10.25318/82-003-x202100300001-eng] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
BACKGROUND Prescription medications are used throughout the life course, including among children and youth. Prescribing practices may be influenced by emerging medical conditions, the availability of new medications, changing clinical practices, and evolving knowledge of the safety and effectiveness of medications. The Canadian Health Measures Survey (CHMS) provides national-level information to help monitor the use of prescribed medications in the population. DATA AND METHODS Based on data from the CHMS (2012 to 2017), this article describes prescription medication use in the past month among those aged 3 to 19 years. Information on up to 45 prescription medications was recorded and classified according to Health Canada's Anatomical Therapeutic Chemical classification. Frequencies and bivariate analyses examined medication use by sociodemographic and health-related factors. The most common medication classes were identified for each age group. RESULTS An estimated 23% of Canadian children and youth (1.5 million) had used at least one prescription medication in the past month and 9% had used two or more prescription medications.Prescription medication use was more common among those who reported lower levels of general and mental health, as well as among those with asthma (51%), a mood disorder (71%), attention deficit disorder (60%) or a learning disability (43%). Medications for the respiratory and nervous systems were among those most commonly prescribed. Of youth aged 14 years or older, 4% had misused prescription medications for non-medicinal purposes, for the experience, for the feeling they cause or to get high. DISCUSSION Prescription medication use among children and youth is common in Canada. It is associated with lower levels of self-reported health and the presence of chronic conditions. The estimates provide a benchmark to help monitor prescription drug use in Canada.
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Affiliation(s)
- Jennifer Servais
- Centre for Population Health Data, Statistics Canada, Ottawa, Ontario
| | | | - Julia Gal
- Centre for Population Health Data, Statistics Canada, Ottawa, Ontario
| | - Craig M Hales
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA
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Stierman B, Ansai N, Mishra S, Hales CM. Special Diets Among Adults: United States, 2015-2018. NCHS Data Brief 2020:1-8. [PMID: 33151144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease, the 2015-2020 Dietary Guidelines for Americans recommend following a healthy eating pattern across the lifespan (1). Some people adhere to specific eating patterns, otherwise known as special diets, for the purposes of weight loss or other health-related reasons. This report shows the percentage of U.S. adults who, on a given day, were on any special diet and specific types of special diets in 2015-2018 and trends from 2007-2008 through 2017-2018.
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Stierman B, Mishra S, Gahche JJ, Potischman N, Hales CM. Dietary Supplement Use in Children and Adolescents Aged ≤19 Years - United States, 2017-2018. MMWR Morb Mortal Wkly Rep 2020; 69:1557-1562. [PMID: 33119556 PMCID: PMC7641005 DOI: 10.15585/mmwr.mm6943a1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Abstract
This study uses NHANES data to assess trends in obesity and severe obesity stratified by race and Hispanic origin among US residents from 1999 to 2018.
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Affiliation(s)
- Cynthia L. Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Cheryl D. Fryar
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Crescent B. Martin
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - David S. Freedman
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Margaret D. Carroll
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Qiuping Gu
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Craig M. Hales
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
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15
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Wei R, Ogden CL, Parsons VL, Freedman DS, Hales CM. A method for calculating BMI z-scores and percentiles above the 95 th percentile of the CDC growth charts. Ann Hum Biol 2020; 47:514-521. [PMID: 32901504 DOI: 10.1080/03014460.2020.1808065] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The 2000 CDC growth charts are based on national data collected between 1963 and 1994 and include a set of selected percentiles between the 3rd and 97th and LMS parameters that can be used to obtain other percentiles and associated z-scores. Obesity is defined as a sex- and age-specific body mass index (BMI) at or above the 95th percentile. Extrapolating beyond the 97th percentile is not recommended and leads to compressed z-score values. AIM This study attempts to overcome this limitation by constructing a new method for calculating BMI distributions above the 95th percentile using an extended reference population. SUBJECTS AND METHODS Data from youth at or above the 95th percentile of BMI-for-age in national surveys between 1963 and 2016 were modelled as half-normal distributions. Scale parameters for these distributions were estimated at each sex-specific 6-month age-interval, from 24 to 239 months, and then smoothed as a function of age using regression procedures. RESULTS The modelled distributions above the 95th percentile can be used to calculate percentiles and non-compressed z-scores for extreme BMI values among youth. CONCLUSION This method can be used, in conjunction with the current CDC BMI-for-age growth charts, to track extreme values of BMI among youth.
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Affiliation(s)
- Rong Wei
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Cynthia L Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Van L Parsons
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - David S Freedman
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Craig M Hales
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
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16
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Hales CM, Martin CB, Gu Q. Prevalence of Prescription Pain Medication Use Among Adults: United States, 2015-2018. NCHS Data Brief 2020:1-8. [PMID: 32600518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Prescription pain medications are used to treat pain due to injury, surgery, and health conditions, such as arthritis and cancer. While opioids may be prescribed together with nonopioid pain medications, nonpharmacologic and nonopioid-containing pharmacologic therapies are preferred for management of chronic pain, where appropriate (1). This report shows the percentage of U.S. adults who, in the past 30 days, used one or more prescription pain medications, used prescription opioid medications, or used nonopioid prescription pain medications (without prescription opioids) in 2015-2018.
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17
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Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. NCHS Data Brief 2020:1-8. [PMID: 32487284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Obesity is associated with serious health risks (1). Severe obesity further increases the risk of obesity-related complications, such as coronary heart disease and end-stage renal disease (2,3). From 1999-2000 through 2015-2016, a significantly increasing trend in obesity was observed (4). This report provides the most recent national data for 2017-2018 on obesity and severe obesity prevalence among adults by sex, age, and race and Hispanic origin. Trends from 1999-2000 through 2017-2018 for adults aged 20 and over are also presented.
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18
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Santo L, Rui P, Hales CM, Arem H, Ogden CL. Trends in Preventive Visits Among U.S. Youth Where Weight and Height Were Recorded: 2005-2016. Am J Prev Med 2019; 57:716-717. [PMID: 31630763 PMCID: PMC6919545 DOI: 10.1016/j.amepre.2019.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Loredana Santo
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland.
| | - Pinyao Rui
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Craig M Hales
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Hannah Arem
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Cynthia L Ogden
- National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland
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19
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Hales CM, Servais J, Martin CB, Kohen D. Prescription Drug Use Among Adults Aged 40-79 in the United States and Canada. NCHS Data Brief 2019:1-8. [PMID: 31442200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Patterns of prescription drug use may reflect underlying patterns of health conditions and health care access in the population. Polypharmacy, often defined as the simultaneous use of five or more prescription drugs, is more common in an aging population where multiple coexisting chronic conditions often occur; however, safety concerns may arise (1). The United States and Canada share many cultural and historical ties, but with different models for health care delivery (2). This report describes the use of one or more and five or more prescription drugs among adults aged 40-79 in the United States and Canada.
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20
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Martin CB, Hales CM, Gu Q, Ogden CL. Prescription Drug Use in the United States, 2015-2016. NCHS Data Brief 2019:1-8. [PMID: 31112126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Monitoring prescription drug use patterns at the population level (1) can inform research and clinical practice. These patterns may shift over time in response to changing health needs, updated clinical guidelines (2), policy changes, and other factors (1,3). The percentage of the U.S. population that used one or more prescription drugs increased from 1999-2000 through 2007-2008 (4). This report describes prescription drug use by age, sex, and race and Hispanic origin in 2015-2016 and trends over the preceding decade.
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21
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Hales CM, Carroll MD, Kuo T, Simon PA. Diabetes and Prediabetes Among Adults in Los Angeles County and the United States, 1999-2006 and 2007-2014. Natl Health Stat Report 2019:1-8. [PMID: 31112125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective-This report presents the prevalence of diagnosed diabetes, undiagnosed diabetes, total diabetes, and prediabetes among adults aged 20 and over in Los Angeles County and the United States in 1999-2006 and 2007-2014. The prevalence of diagnosed diabetes, total diabetes, and prediabetes in 2007-2014 are presented by age, sex, and race and Hispanic origin. Methods-Data are from in-home interviews and laboratory testing conducted as part of the National Health and Nutrition Examination Survey (NHANES). Los Angeles County has been selected with certainty in every NHANES cycle since 1999. Sample persons in Los Angeles County were selected and sample weights constructed so that estimates represent the county. Prevalence and 95% confidence intervals for diagnosed, undiagnosed, total diabetes, and prediabetes were estimated using self-reported diagnosis of diabetes, plasma fasting glucose, and hemoglobin A1c. Differences in prevalence were tested between Los Angeles County and the United States, between 1999-2006 and 2007-2014, and among demographic subgroups. Results-The age-adjusted prevalence of total diabetes among adults in Los Angeles County increased from 10.5% in 1999-2006 to 14.4% in 2007-2014. In 2007-2014, 40.2% of adults in Los Angeles County had prediabetes. There were no significant differences in the overall prevalence of diagnosed diabetes, undiagnosed diabetes, total diabetes, or prediabetes between Los Angeles County and the United States in 1999-2006 or 2007-2014. The prevalence of diagnosed diabetes, total diabetes, and prediabetes increased with age in both Los Angeles County and the United States. The prevalence of total diabetes was higher in non-Hispanic black adults, Hispanic adults, and Mexican-American adults than in non-Hispanic white adults in both Los Angeles County and the United States.
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22
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Abstract
IMPORTANCE Differences in childhood obesity by demographics and urbanization have been reported. OBJECTIVE To present data on obesity and severe obesity among US youth by demographics and urbanization and to investigate trends by urbanization. DESIGN, SETTING, AND PARTICIPANTS Measured weight and height among youth aged 2 to 19 years in the 2001-2016 National Health and Nutrition Examination Surveys, which are serial, cross-sectional, nationally representative surveys of the civilian, noninstitutionalized population. EXPOSURES Sex, age, race and Hispanic origin, education of household head, and urbanization, as assessed by metropolitan statistical areas (MSAs; large: ≥ 1 million population). MAIN OUTCOMES AND MEASURES Prevalence of obesity (body mass index [BMI] ≥95th percentile of US Centers for Disease Control and Prevention [CDC] growth charts) and severe obesity (BMI ≥120% of 95th percentile) by subgroups in 2013-2016 and trends by urbanization between 2001-2004 and 2013-2016. RESULTS Complete data on weight, height, and urbanization were available for 6863 children and adolescents (mean age, 11 years; female, 49%). In 2013-2016, the prevalence among youth aged 2 to 19 years was 17.8% (95% CI, 16.1%-19.6%) for obesity and 5.8% (95% CI, 4.8%-6.9%) for severe obesity. Prevalence of obesity in large MSAs (17.1% [95% CI, 14.9%-19.5%]), medium or small MSAs (17.2% [95% CI, 14.5%-20.2%]) and non-MSAs (21.7% [95% CI, 16.1%-28.1%]) were not significantly different from each other (range of pairwise comparisons P = .09-.96). Severe obesity was significantly higher in non-MSAs (9.4% [95% CI, 5.7%-14.4%]) compared with large MSAs (5.1% [95% CI, 4.1%-6.2%]; P = .02). In adjusted analyses, obesity and severe obesity significantly increased with greater age and lower education of household head, and severe obesity increased with lower level of urbanization. Compared with non-Hispanic white youth, obesity and severe obesity prevalence were significantly higher among non-Hispanic black and Hispanic youth. Severe obesity, but not obesity, was significantly lower among non-Hispanic Asian youth than among non-Hispanic white youth. There were no significant linear or quadratic trends in obesity or severe obesity prevalence from 2001-2004 to 2013-2016 for any urbanization category (P range = .07-.83). CONCLUSIONS AND RELEVANCE In 2013-2016, there were differences in the prevalence of obesity and severe obesity by age, race and Hispanic origin, and household education, and severe obesity was inversely associated with urbanization. Demographics were not related to the urbanization findings.
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Affiliation(s)
- Cynthia L Ogden
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Cheryl D Fryar
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Craig M Hales
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
- US Public Health Service, Rockville, Maryland
| | - Margaret D Carroll
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Yutaka Aoki
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - David S Freedman
- National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia
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23
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Hales CM, Fryar CD, Carroll MD, Freedman DS, Aoki Y, Ogden CL. Differences in Obesity Prevalence by Demographic Characteristics and Urbanization Level Among Adults in the United States, 2013-2016. JAMA 2018; 319:2419-2429. [PMID: 29922829 PMCID: PMC6583043 DOI: 10.1001/jama.2018.7270] [Citation(s) in RCA: 288] [Impact Index Per Article: 48.0] [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] [Indexed: 12/25/2022]
Abstract
IMPORTANCE Differences in obesity by sex, age group, race and Hispanic origin among US adults have been reported, but differences by urbanization level have been less studied. OBJECTIVES To provide estimates of obesity by demographic characteristics and urbanization level and to examine trends in obesity prevalence by urbanization level. DESIGN, SETTING, AND PARTICIPANTS Serial cross-sectional analysis of measured height and weight among adults aged 20 years or older in the 2001-2016 National Health and Nutrition Examination Survey, a nationally representative survey of the civilian, noninstitutionalized US population. EXPOSURES Sex, age group, race and Hispanic origin, education level, smoking status, and urbanization level as assessed by metropolitan statistical areas (MSAs; large: ≥1 million population). MAIN OUTCOMES AND MEASURES Prevalence of obesity (body mass index [BMI] ≥30) and severe obesity (BMI ≥40) by subgroups in 2013-2016 and trends by urbanization level between 2001-2004 and 2013-2016. RESULTS Complete data on weight, height, and urbanization level were available for 10 792 adults (mean age, 48 years; 51% female [weighted]). During 2013-2016, 38.9% (95% CI, 37.0% to 40.7%) of US adults had obesity and 7.6% (95% CI, 6.8% to 8.6%) had severe obesity. Men living in medium or small MSAs had a higher age-adjusted prevalence of obesity compared with men living in large MSAs (42.4% vs 31.8%, respectively; adjusted difference, 9.8 percentage points [95% CI, 5.1 to 14.5 percentage points]); however, the age-adjusted prevalence among men living in non-MSAs was not significantly different compared with men living in large MSAs (38.9% vs 31.8%, respectively; adjusted difference, 4.8 percentage points [95% CI, -2.9 to 12.6 percentage points]). The age-adjusted prevalence of obesity was higher among women living in medium or small MSAs compared with women living in large MSAs (42.5% vs 38.1%, respectively; adjusted difference, 4.3 percentage points [95% CI, 0.2 to 8.5 percentage points]) and among women living in non-MSAs compared with women living in large MSAs (47.2% vs 38.1%, respectively; adjusted difference, 4.7 percentage points [95% CI, 0.2 to 9.3 percentage points]). Similar patterns were seen for severe obesity except that the difference between men living in large MSAs compared with non-MSAs was significant. The age-adjusted prevalence of obesity and severe obesity also varied significantly by age group, race and Hispanic origin, and education level, and these patterns of variation were often different by sex. Between 2001-2004 and 2013-2016, the age-adjusted prevalence of obesity and severe obesity significantly increased among all adults at all urbanization levels. CONCLUSIONS AND RELEVANCE In this nationally representative survey of adults in the United States, the age-adjusted prevalence of obesity and severe obesity in 2013-2016 varied by level of urbanization, with significantly greater prevalence of obesity and severe obesity among adults living in nonmetropolitan statistical areas compared with adults living in large metropolitan statistical areas.
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Affiliation(s)
- Craig M. Hales
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
- US Public Health Service, Rockville, Maryland
| | - Cheryl D. Fryar
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Margaret D. Carroll
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - David S. Freedman
- National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yutaka Aoki
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Cynthia L. Ogden
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
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24
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Abstract
IMPORTANCE Access to appropriate prescription medications, use of inappropriate or ineffective treatments, and adverse drug events are public health concerns among US children and adolescents. OBJECTIVE To evaluate trends in use of prescription medications among US children and adolescents. DESIGN, SETTING, AND PARTICIPANTS US children and adolescents aged 0 to 19 years in the 1999-2014 National Health and Nutrition Examination Survey (NHANES)-serial cross-sectional, nationally representative surveys of the civilian noninstitutionalized population. EXPOSURES Sex, age, race and Hispanic origin, household income and education, insurance status, current health status. MAIN OUTCOMES AND MEASURES Use of any prescription medications or 2 or more prescription medications taken in the past 30 days; use of medications by therapeutic class; trends in medication use across 4-year periods from 1999-2002 to 2011-2014. Data were collected though in-home interview and direct observation of the prescription container. RESULTS Data on prescription medication use were available for 38 277 children and adolescents (mean age, 10 years; 49% girls). Overall, use of any prescription medication in the past 30 days decreased from 24.6% (95% CI, 22.6% to 26.6%) in 1999-2002 to 21.9% (95% CI, 20.3% to 23.6%) in 2011-2014 (β = -0.41 percentage points every 2 years [95% CI, -0.79 to -0.03]; P = .04), but there was no linear trend in the use of 2 or more prescription medications (8.5% [95% CI, 7.6% to 9.4%] in 2011-2014). In 2011-2014, the most commonly used medication classes were asthma medications (6.1% [95% CI, 5.4% to 6.8%]), antibiotics (4.5% [95% CI, 3.7% to 5.5%]), attention-deficit/hyperactivity disorder (ADHD) medications (3.5% [95% CI, 2.9% to 4.2%]), topical agents (eg, dermatologic agents, nasal steroids) (3.5% [95% CI, 3.0% to 4.1%]), and antihistamines (2.0% [95% CI, 1.7% to 2.5%]). There were significant linear trends in 14 of 39 therapeutic classes or subclasses, or in individual medications, with 8 showing increases, including asthma and ADHD medications and contraceptives, and 6 showing decreases, including antibiotics, antihistamines, and upper respiratory combination medications. CONCLUSIONS AND RELEVANCE In this study of US children and adolescents based on a nationally representative survey, estimates of prescription medication use showed an overall decrease in use of any medication from 1999-2014. The prevalence of asthma medication, ADHD medication, and contraceptive use increased among certain age groups, whereas use of antibiotics, antihistamines, and upper respiratory combination medications decreased.
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Affiliation(s)
- Craig M. Hales
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Brian K. Kit
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
- Currently with the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Qiuping Gu
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Cynthia L. Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
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25
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Abstract
This study uses National Health and Nutrition Examination Survey data to characterize trends in obesity prevalence among US youth and adults between 2007-2008 and 2015-2016.
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Affiliation(s)
- Craig M. Hales
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Cheryl D. Fryar
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Margaret D. Carroll
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - David S. Freedman
- National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cynthia L. Ogden
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
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26
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Ogden CL, Carroll MD, Fakhouri TH, Hales CM, Fryar CD, Li X, Freedman DS. Prevalence of Obesity Among Youths by Household Income and Education Level of Head of Household - United States 2011-2014. MMWR Morb Mortal Wkly Rep 2018; 67:186-189. [PMID: 29447142 PMCID: PMC5815488 DOI: 10.15585/mmwr.mm6706a3] [Citation(s) in RCA: 283] [Impact Index Per Article: 47.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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27
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Affiliation(s)
- Cynthia L. Ogden
- National Center for Health Statistics, Centers for Disease
Control and Prevention, Hyattsville, Maryland
| | - David S. Freedman
- National Center for Chronic Disease Prevention and Health
Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Craig M. Hales
- National Center for Health Statistics, Centers for Disease
Control and Prevention, Hyattsville, Maryland;,United States Public Health Service, Rockville,
Maryland
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28
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Ogden CL, Fakhouri TH, Carroll MD, Hales CM, Fryar CD, Li X, Freedman DS. Prevalence of Obesity Among Adults, by Household Income and Education - United States, 2011-2014. MMWR Morb Mortal Wkly Rep 2017; 66:1369-1373. [PMID: 29267260 PMCID: PMC5751581 DOI: 10.15585/mmwr.mm6650a1] [Citation(s) in RCA: 255] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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29
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Lopez AS, Lanzieri TM, Claussen AH, Vinson SS, Turcich MR, Iovino IR, Voigt RG, Caviness AC, Miller JA, Williamson WD, Hales CM, Bialek SR, Demmler-Harrison G. Intelligence and Academic Achievement With Asymptomatic Congenital Cytomegalovirus Infection. Pediatrics 2017; 140:peds.2017-1517. [PMID: 29066580 PMCID: PMC5654402 DOI: 10.1542/peds.2017-1517] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine intelligence, language, and academic achievement through 18 years of age among children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected infants. METHODS We used growth curve modeling to analyze trends in IQ (full-scale, verbal, and nonverbal intelligence), receptive and expressive vocabulary, and academic achievement in math and reading. Separate models were fit for each outcome, modeling the change in overall scores with increasing age for patients with normal hearing (n = 78) or with sensorineural hearing loss (SNHL) diagnosed by 2 years of age (n = 11) and controls (n = 40). RESULTS Patients with SNHL had full-scale intelligence and receptive vocabulary scores that were 7.0 and 13.1 points lower, respectively, compared with controls, but no significant differences were noted in these scores among patients with normal hearing and controls. No significant differences were noted in scores for verbal and nonverbal intelligence, expressive vocabulary, and academic achievement in math and reading among patients with normal hearing or with SNHL and controls. CONCLUSIONS Infants with asymptomatic congenital cytomegalovirus infection identified through newborn screening with normal hearing by age 2 years do not appear to have differences in IQ, vocabulary or academic achievement scores during childhood, or adolescence compared with uninfected children.
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Affiliation(s)
| | | | - Angelika H. Claussen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sherry S. Vinson
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
| | - Marie R. Turcich
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
| | - Isabella R. Iovino
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
| | - Robert G. Voigt
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
| | | | - Jerry A. Miller
- Texas Children’s Hospital, Houston, Texas;,P3S Corporation, San Antonio, Texas
| | | | - Craig M. Hales
- National Center for Immunization and Respiratory Diseases, and
| | | | - Gail Demmler-Harrison
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
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30
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Fryar CD, Ostchega Y, Hales CM, Zhang G, Kruszon-Moran D. Hypertension Prevalence and Control Among Adults: United States, 2015-2016. NCHS Data Brief 2017:1-8. [PMID: 29155682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hypertension remains an important public health challenge in the United States because it increases the risk for cardiovascular disease. Effective blood pressure management has been shown to decrease the incidence of stroke, heart attack, and heart failure (1–3). This report presents updated estimates for the prevalence and control of hypertension in the United States for 2015–2016. Trends in hypertension prevalence and control from 1999–2000 through 2015–2016 are also presented.
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31
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Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity Among Adults and Youth: United States, 2015-2016. NCHS Data Brief 2017:1-8. [PMID: 29155689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Obesity is associated with serious health risks. Monitoring obesity prevalence is relevant for public health programs that focus on reducing or preventing obesity. Between 2003–2004 and 2013–2014, there were no significant changes in childhood obesity prevalence, but adults showed an increasing trend. This report provides the most recent national estimates from 2015–2016 on obesity prevalence by sex, age, and race and Hispanic origin, and overall estimates from 1999–2000 through 2015–2016.
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32
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Hales CM, Carroll MD, Simon PA, Kuo T, Ogden CL. Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Aged ≥18 Years - Los Angeles County, 1999-2006 and 2007-2014. MMWR Morb Mortal Wkly Rep 2017; 66:846-849. [PMID: 28817553 PMCID: PMC5657669 DOI: 10.15585/mmwr.mm6632a3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Hypertension is an important and common risk factor for heart disease and stroke, two of the leading causes of death in adults in the United States. Despite considerable improvement in increasing the awareness, treatment, and control of hypertension, undiagnosed and uncontrolled hypertension remain public health challenges (1). Data from the National Health and Nutrition Examination Survey (NHANES) were used to estimate the prevalence of hypertension, as well as awareness, treatment, and control of hypertension among adults aged ≥18 years in Los Angeles County compared with adults aged ≥18 years in the United States during 1999-2006 and 2007-2014. During 2007-2014, the prevalence of hypertension was 23.1% among adults in Los Angeles County, lower than the prevalence of 29.6% among all U.S. adults. Among adults with hypertension in Los Angeles County, substantial improvements from 1999-2006 to 2007-2014 were found in hypertension awareness (increase from 73.8% to 84.6%), treatment (61.3% to 77.2%), and control (28.5% to 48.3%). Similar improvements were also seen among all U.S. adults. Although the prevalence of hypertension among adults in Los Angeles County meets the Healthy People 2020 (https://www.healthypeople.gov/) goal of ≤26.9%, continued progress is needed to meet the Healthy People 2020 goal of ≥61.2% for control of hypertension.
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33
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Isenhour CJ, Hariri SH, Hales CM, Vellozzi CJ. Hepatitis C Antibody Testing in a Commercially Insured Population, 2005-2014. Am J Prev Med 2017; 52:625-631. [PMID: 28161033 DOI: 10.1016/j.amepre.2016.12.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 04/18/2016] [Revised: 11/14/2016] [Accepted: 12/01/2016] [Indexed: 01/23/2023]
Abstract
INTRODUCTION In the U.S., the burden of hepatitis C virus (HCV) infection and associated sequelae is substantial. HCV prevalence is highest among those born in 1945-1965 (Birth Cohort). Newly diagnosed infections are increasing in younger people concurrent with rising opioid/heroin use. The Centers for Disease Control and Prevention (2012) and U.S. Preventive Services Task Force (2013) recommend HCV testing for at-risk individuals and one-time testing for the Birth Cohort. This study describes national trends in HCV antibody testing from 2005 to 2014. METHODS Using commercial and Medicare supplemental insurance claims data, people were identified who were continuously enrolled for ≥2 years during the 10-year study period, without prior HCV diagnosis (N=190,926,299). Current Procedural Terminology codes identified 3,382,267 unique antibody tests. Temporal trends in annual testing were evaluated using the Cochran-Armitage test, and primary ICD-9-CM diagnosis codes used at the time of testing were described. Data were analyzed in 2015 and 2016. RESULTS Testing was highest among those aged 18-29 and 30-39 years, increasing by 123% (1.66% to 3.71%) and 108% (1.99% to 4.13%), respectively (p<0.0001). Among the Birth Cohort, there was a 136% increase in HCV antibody testing from 2005 to 2014, with a 91% increase from 1.71% in 2011 to 3.26% 2014 (p<0.0001). CONCLUSIONS Although the increased HCV antibody testing observed among the Birth Cohort from 2011 to 2014 likely reflects early adoption of updated national testing recommendations, overall testing remains low in this commercially insured population, indicating a clear need for improvement.
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Affiliation(s)
- Cheryl J Isenhour
- Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Susan H Hariri
- Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Craig M Hales
- Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Claudia J Vellozzi
- Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
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Hales CM, Johnson E, Helgenberger L, Papania MJ, Larzelere M, Gopalani SV, Lebo E, Wallace G, Moturi E, Hickman CJ, Rota PA, Alexander HS, Marin M. Measles Outbreak Associated With Low Vaccine Effectiveness Among Adults in Pohnpei State, Federated States of Micronesia, 2014. Open Forum Infect Dis 2016; 3:ofw064. [PMID: 27186587 PMCID: PMC4866552 DOI: 10.1093/ofid/ofw064] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/21/2016] [Indexed: 12/03/2022] Open
Abstract
Background. A measles outbreak in Pohnpei State, Federated States of Micronesia in 2014 affected many persons who had received ≥1 dose of measles-containing vaccine (MCV). A mass vaccination campaign targeted persons aged 6 months to 49 years, regardless of prior vaccination. Methods. We evaluated vaccine effectiveness (VE) of MCV by comparing secondary attack rates among vaccinated and unvaccinated contacts after household exposure to measles. Results. Among 318 contacts, VE for precampaign MCV was 23.1% (95% confidence interval [CI], −425 to 87.3) for 1 dose, 63.4% (95% CI, −103 to 90.6) for 2 doses, and 95.9% (95% CI, 45.0 to 100) for 3 doses. Vaccine effectiveness was 78.7% (95% CI, 10.1 to 97.7) for campaign doses received ≥5 days before rash onset in the primary case and 50.4% (95% CI, −52.1 to 87.9) for doses received 4 days before to 3 days after rash onset in the primary case. Vaccine effectiveness for most recent doses received before 2010 ranged from 51% to 57%, but it increased to 84% for second doses received in 2010 or later. Conclusions. Low VE was a major source of measles susceptibility in this outbreak; potential reasons include historical cold chain inadequacies or waning of immunity. Vaccine effectiveness of campaign doses supports rapid implementation of vaccination campaigns in outbreak settings.
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Affiliation(s)
- Craig M Hales
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Eliaser Johnson
- Division of Primary Health Care , Pohnpei State , Federated States of Micronesia
| | - Louisa Helgenberger
- Department of Health and Social Affairs , Government of the Federated States of Micronesia
| | - Mark J Papania
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Maribeth Larzelere
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Sameer V Gopalani
- Department of Health and Social Affairs , Government of the Federated States of Micronesia
| | - Emmaculate Lebo
- Center for Global Health , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Greg Wallace
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Edna Moturi
- Center for Global Health , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Carole J Hickman
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Paul A Rota
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Hinden S Alexander
- Division of Primary Health Care , Pohnpei State , Federated States of Micronesia
| | - Mona Marin
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
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Marin M, Yawn BP, Hales CM, Wollan PC, Bialek SR, Zhang J, Kurland MJ, Harpaz R. Herpes zoster vaccine effectiveness and manifestations of herpes zoster and associated pain by vaccination status. Hum Vaccin Immunother 2016; 11:1157-64. [PMID: 25806911 DOI: 10.1080/21645515.2015.1016681] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Options for managing herpes zoster (HZ)-related pain and complications have limited effectiveness, making HZ prevention through vaccination an important strategy. Limited data are available on HZ vaccine effectiveness against confirmed HZ and manifestations of HZ among vaccinated persons. We conducted a matched case-control study to assess HZ vaccine effectiveness for prevention of HZ and other HZ-related outcomes and a cohort study of persons with HZ to compare HZ-related outcomes by vaccination status. Cases were identified through active surveillance among persons age ≥ 60 years with HZ onset and health-care encounters during 2010-2011 in Southeastern Minnesota. Controls were age- and sex-matched to cases. Data were collected by medical record review and from participants via interviews and daily pain diaries. 266 HZ case-patients and 362 matched controls were enrolled in the vaccine effectiveness studies and 303 case-patients in the cohort study of HZ characteristics by vaccination status. Vaccination was associated with 54% (95% CI:32%-69%) reduction in HZ incidence, 58% (95% CI:31%-75%) reduction in HZ prodromal symptoms, and 70% (95% CI:33%-87%) reduction in medically-attended prodrome. HZ vaccine was statistically significant effective at preventing postherpetic neuralgia (PHN) measured at 30 d after rash onset, 61% (95% CI: 22%-80%). Among persons who developed HZ, no differences were found by vaccination status in severity or duration of HZ pain after rash onset. In this population-based study, HZ vaccination was associated with >50% reduction in HZ, HZ prodrome, and medically-attended prodrome.
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Affiliation(s)
- Mona Marin
- a National Center for Immunization and Respiratory Diseases; Centers for Disease Control and Prevention; , Atlanta , GA USA
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Tseng HF, Harpaz R, Luo Y, Hales CM, Sy LS, Tartof SY, Bialek S, Hechter RC, Jacobsen SJ. Declining Effectiveness of Herpes Zoster Vaccine in Adults Aged ≥60 Years. J Infect Dis 2016; 213:1872-5. [DOI: 10.1093/infdis/jiw047] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 01/26/2016] [Indexed: 11/12/2022] Open
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Tseng HF, Lewin B, Hales CM, Sy LS, Harpaz R, Bialek S, Luo Y, Jacobsen SJ, Reddy K, Huang PY, Zhang J, Anand S, Bauer EM, Chang J, Tartof SY. Zoster Vaccine and the Risk of Postherpetic Neuralgia in Patients Who Developed Herpes Zoster Despite Having Received the Zoster Vaccine. J Infect Dis 2015; 212:1222-31. [PMID: 26038400 DOI: 10.1093/infdis/jiv244] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 04/03/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although it is evident that zoster vaccination reduces postherpetic neuralgia (PHN) risk by reducing herpes zoster (HZ) occurrence, it is less clear whether the vaccine protects against PHN among patients who develop HZ despite previous vaccination. METHODS This cohort study included immunocompetent patients with HZ. The vaccinated cohort included 1155 individuals who were vaccinated against HZ at age ≥60 years and had an HZ episode after vaccination. Vaccinated patients were matched 1:1 by sex and age with unvaccinated patients. Trained medical residents reviewed the full medical record to determine the presence of HZ-related pain at 1, 2, 3, and 6 months after HZ diagnosis. The incidence of PHN was compared between vaccinated and unvaccinated -patients. RESULTS Thirty vaccinated women (4.2%) experienced PHN, compared with 75 unvaccinated women (10.4%), with an adjusted relative risk of 0.41 (95% confidence interval, .26-.64). PHN occurred in 26 vaccinated men (6.0%) versus 25 unvaccinated men (5.8%), with an adjusted relative risk of 1.06 (.58-1.94). These associations did not differ significantly by age. CONCLUSIONS Among persons experiencing HZ, prior HZ vaccination is associated with a lower risk of PHN in women but not in men. This sex-related difference may reflect differences in healthcare-seeking patterns and deserve further investigation.
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Affiliation(s)
- Hung Fu Tseng
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | | | - Craig M Hales
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lina S Sy
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Rafael Harpaz
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephanie Bialek
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yi Luo
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Steven J Jacobsen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Kavya Reddy
- Internal Medicine, Kaiser Permanente Southern California, Los Angeles Medical Center
| | | | - Jeff Zhang
- Internal Medicine, Kaiser Permanente Southern California, Los Angeles Medical Center
| | - Sean Anand
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Erin Mary Bauer
- Internal Medicine, Kaiser Permanente Southern California, Los Angeles Medical Center
| | | | - Sara Y Tartof
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
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Williams WW, Lu PJ, O’Halloran A, Bridges CB, Kim DK, Pilishvili T, Hales CM, Markowitz LE. Vaccination coverage among adults, excluding influenza vaccination - United States, 2013. MMWR Morb Mortal Wkly Rep 2015; 64:95-102. [PMID: 25654611 PMCID: PMC4584858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Vaccinations are recommended throughout life to prevent vaccine-preventable diseases and their sequelae. Adult vaccination coverage, however, remains low for most routinely recommended vaccines and below Healthy People 2020 targets. In October 2014, the Advisory Committee on Immunization Practices (ACIP) approved the adult immunization schedule for 2015. With the exception of influenza vaccination, which is recommended for all adults each year, other adult vaccinations are recommended for specific populations based on a person's age, health conditions, behavioral risk factors (e.g., injection drug use), occupation, travel, and other indications. To assess vaccination coverage among adults aged ≥19 years for selected vaccines, CDC analyzed data from the 2013 National Health Interview Survey (NHIS). This report highlights results of that analysis for pneumococcal, tetanus toxoid-containing (tetanus and diphtheria vaccine [Td] or tetanus and diphtheria with acellular pertussis vaccine [Tdap]), hepatitis A, hepatitis B, herpes zoster (shingles), and human papillomavirus (HPV) vaccines by selected characteristics (age, race/ethnicity,† and vaccination indication). Influenza vaccination coverage estimates for the 2013-14 influenza season have been published separately. Compared with 2012, only modest increases occurred in Tdap vaccination among adults aged ≥19 years (a 2.9 percentage point increase to 17.2%), herpes zoster vaccination among adults aged ≥60 years (a 4.1 percentage point increase to 24.2%), and HPV vaccination among males aged 19-26 years (a 3.6 percentage point increase to 5.9%); coverage among adults in the United States for the other vaccines did not improve. Racial/ethnic disparities in coverage persisted for all six vaccines and widened for Tdap and herpes zoster vaccination. Increases in vaccination coverage are needed to reduce the occurrence of vaccine-preventable diseases among adults. Awareness of the need for vaccines for adults is low among the general population, and adult patients largely rely on health care provider recommendations for vaccination. The Community Preventive Services Task Force and the National Vaccine Advisory Committee have recommended that health care providers incorporate vaccination needs assessment, recommendation, and offer of vaccination into every clinical encounter with adult patients to improve vaccination rates and to narrow the widening racial/ethnic disparities in vaccination coverage.
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Affiliation(s)
- Walter W. Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC,Corresponding author: Walter W. Williams, , 404-718-8734
| | - Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alissa O’Halloran
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Carolyn B. Bridges
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David K. Kim
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Tamara Pilishvili
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Craig M. Hales
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Lauri E. Markowitz
- Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; CDC
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Hales CM, Harpaz R, Ortega-Sanchez I, Bialek SR. Update on recommendations for use of herpes zoster vaccine. MMWR Morb Mortal Wkly Rep 2014; 63:729-31. [PMID: 25144544 PMCID: PMC5779434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
Herpes zoster vaccine (Zostavax [Merck & Co., Inc.]) was licensed in 2006 and recommended by the Advisory Committee on Immunization Practices (ACIP) in 2008 for prevention of herpes zoster (shingles) and its complications among adults aged ≥60 years. The Food and Drug Administration (FDA) approved the use of Zostavax in 2011 for adults aged 50 through 59 years based on a large study of safety and efficacy in this age group. ACIP initially considered the use of herpes zoster vaccine among adults aged 50 through 59 years in June 2011, but declined to recommend the vaccine in this age group, citing shortages of Zostavax and limited data on long-term protection afforded by herpes zoster vaccine. In October 2013, ACIP reviewed the epidemiology of herpes zoster and its complications, herpes zoster vaccine supply, short-term vaccine efficacy in adults aged 50 through 59 years, short- and long- term vaccine efficacy and effectiveness in adults aged ≥60 years, an updated cost-effectiveness analysis, and deliberations of the ACIP herpes zoster work group, all of which are summarized in this report. No vote was taken, and ACIP maintained its current recommendation that herpes zoster vaccine be routinely recommended for adults aged ≥60 years. Meeting minutes are available at http://www.cdc.gov/vaccines/acip/meetings/meetings-info.html.
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Affiliation(s)
- Craig M. Hales
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Rafael Harpaz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Ismael Ortega-Sanchez
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephanie R. Bialek
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
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Williams WW, Lu PJ, O’Halloran A, Bridges CB, Pilishvili T, Hales CM, Markowitz LE. Noninfluenza vaccination coverage among adults - United States, 2012. MMWR Morb Mortal Wkly Rep 2014; 63:95-102. [PMID: 24500288 PMCID: PMC4584647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Vaccinations are recommended throughout life to prevent vaccine-preventable diseases and their sequelae. Adult vaccination coverage, however, remains low for most routinely recommended vaccines and well below Healthy People 2020 targets. In October 2013, the Advisory Committee on Immunization Practices (ACIP) approved the adult immunization schedule for 2014. With the exception of influenza vaccination, which is recommended for all adults each year, vaccinations recommended for adults target different populations based on age, health conditions, behavioral risk factors (e.g., injection drug use), occupation, travel, and other indications. To assess vaccination coverage among adults aged ≥19 years for selected vaccines, CDC analyzed data from the 2012 National Health Interview Survey (NHIS). This report summarizes the results of that analysis for pneumococcal, tetanus toxoid-containing (tetanus and diphtheria vaccine [Td] or tetanus and diphtheria with acellular pertussis vaccine [Tdap]), hepatitis A, hepatitis B, herpes zoster (shingles), and human papillomavirus (HPV) vaccines by selected characteristics (age, race/ethnicity, and vaccination target criteria). Influenza vaccination coverage estimates for the 2012-13 influenza season have been published separately. Compared with 2011, only modest increases occurred in Tdap vaccination among adults aged 19-64 years, herpes zoster vaccination among adults aged ≥60 years, and HPV vaccination among women aged 19-26 years; coverage among adults in the United States for the other vaccines did not improve. Racial/ethnic gaps in coverage persisted for all six vaccines and widened for Tdap, herpes zoster, and HPV vaccination. Increases in vaccination coverage are needed to reduce the occurrence of vaccine-preventable diseases among adults. The Community Preventive Services Task Force and other authorities have recommended that health-care providers incorporate vaccination needs assessment, recommendation, and offer of vaccination into routine clinical practice for adult patients.
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Affiliation(s)
- Walter W. Williams
- Immunization Services Division,Corresponding author: Walter W. Williams, , 404-718-8734
| | | | | | | | | | - Craig M. Hales
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Lauri E. Markowitz
- Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
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Abstract
BACKGROUND Introduction of a universal varicella vaccine program for U.S. children in 1996 sparked concern that less-frequent exposure to varicella would decrease external boosting of immunity to varicella zoster virus and thereby increase incidence of herpes zoster (HZ). OBJECTIVE To determine whether the varicella vaccination program has influenced trends in HZ incidence in the U.S. population older than 65 years. DESIGN Retrospective study of Medicare claims. SETTING Medicare, 1992 through 2010. PARTICIPANTS 2 848 765 beneficiaries older than 65 years. MEASUREMENTS Annual HZ incidence from 1992 through 2010; rate ratios (RRs) for HZ incidence by age, sex, and race or ethnicity; and state-level varicella vaccination coverage. RESULTS 281 317 incident cases of HZ occurred. Age- and sex-standardized HZ incidence increased 39% from 10.0 per 1000 person-years in 1992 to 13.9 per 1000 person-years in 2010 with no evidence of a statistically significant change in the rate of increase after introduction of the varicella vaccination program. Before introduction of this program, HZ incidence was higher in women (RR, 1.21 [95% CI, 1.19 to 1.24]) than men and was lower in black persons (RR, 0.51 [CI, 0.48 to 0.53]) and Hispanic persons (RR, 0.76 [CI, 0.72 to 0.81]) than white persons. In a model adjusted for sex, age, and calendar year from 1997 to 2010, HZ incidence did not vary by state varicella vaccination coverage (RR, 0.9998 [CI, 0.9993 to 1.0003]). LIMITATION Uncertain level and consistency of health-seeking behavior and access and uncertain accuracy of disease coding. CONCLUSION Age-specific HZ incidence increased in the U.S. population older than 65 years even before implementation of the childhood varicella vaccination program. Introduction and widespread use of the vaccine did not seem to affect this increase. This information is reassuring for countries considering universal varicella vaccination. PRIMARY FUNDING SOURCE None.
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Winston CA, Navin TR, Becerra JE, Chen MP, Armstrong LR, Jeffries C, Yelk Woodruff RS, Wing J, Starks AM, Hales CM, Kammerer JS, Mac Kenzie WR, Mitruka K, Miner MC, Price S, Scavotto J, Cronin AM, Griffin P, LoBue PA, Castro KG. Unexpected decline in tuberculosis cases coincident with economic recession - United States, 2009. BMC Public Health 2011; 11:846. [PMID: 22059421 PMCID: PMC3235079 DOI: 10.1186/1471-2458-11-846] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 11/07/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since 1953, through the cooperation of state and local health departments, the U.S. Centers for Disease Control and Prevention (CDC) has collected information on incident cases of tuberculosis (TB) disease in the United States. In 2009, TB case rates declined -11.4%, compared to an average annual -3.8% decline since 2000. The unexpectedly large decline raised concerns that TB cases may have gone unreported. To address the unexpected decline, we examined trends from multiple sources on TB treatment initiation, medication sales, and laboratory and genotyping data on culture-positive TB. METHODS We analyzed 142,174 incident TB cases reported to the U. S. National Tuberculosis Surveillance System (NTSS) during January 1, 2000-December 31, 2009; TB control program data from 59 public health reporting areas; self-reported data from 50 CDC-funded public health laboratories; monthly electronic prescription claims for new TB therapy prescriptions; and complete genotyping results available for NTSS cases. Accounting for prior trends using regression and time-series analyses, we calculated the deviation between observed and expected TB cases in 2009 according to patient and clinical characteristics, and assessed at what point in time the deviation occurred. RESULTS The overall deviation in TB cases in 2009 was -7.9%, with -994 fewer cases reported than expected (P < .001). We ruled out evidence of surveillance underreporting since declines were seen in states that used new software for case reporting in 2009 as well as states that did not, and we found no cases unreported to CDC in our examination of over 5400 individual line-listed reports in 11 areas. TB cases decreased substantially among both foreign-born and U.S.-born persons. The unexpected decline began in late 2008 or early 2009, and may have begun to reverse in late 2009. The decline was greater in terms of case counts among foreign-born than U.S.-born persons; among the foreign-born, the declines were greatest in terms of percentage deviation from expected among persons who had been in the United States less than 2 years. Among U.S.-born persons, the declines in percentage deviation from expected were greatest among homeless persons and substance users. Independent information systems (NTSS, TB prescription claims, and public health laboratories) reported similar patterns of declines. Genotyping data did not suggest sudden decreases in recent transmission. CONCLUSIONS Our assessments show that the decline in reported TB was not an artifact of changes in surveillance methods; rather, similar declines were found through multiple data sources. While the steady decline of TB cases before 2009 suggests ongoing improvement in TB control, we were not able to identify any substantial change in TB control activities or TB transmission that would account for the abrupt decline in 2009. It is possible that other multiple causes coincident with economic recession in the United States, including decreased immigration and delayed access to medical care, could be related to TB declines. Our findings underscore important needs in addressing health disparities as we move towards TB elimination in the United States.
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Affiliation(s)
- Carla A Winston
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Thomas R Navin
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Jose E Becerra
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Michael P Chen
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Lori R Armstrong
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Carla Jeffries
- Northrop Grumman Information Systems, 3375 Northeast Expressway NE, Atlanta, GA, 30333, USA
| | - Rachel S Yelk Woodruff
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Jessie Wing
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Angela M Starks
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Craig M Hales
- Public Health Surveillance Program Office, Division of Health Information, Office of Surveillance Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333, USA
| | - J Steve Kammerer
- Northrop Grumman Information Systems, 3375 Northeast Expressway NE, Atlanta, GA, 30333, USA
| | - William R Mac Kenzie
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Kiren Mitruka
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Mark C Miner
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Sandy Price
- Northrop Grumman Information Systems, 3375 Northeast Expressway NE, Atlanta, GA, 30333, USA
| | - Joseph Scavotto
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Ann M Cronin
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Phillip Griffin
- Tuberculosis Control Program, Kansas Department of Health and Environment, 1000 SW Jackson Street, Topeka, KS, 66612, USA, and Immediate Past President, National Tuberculosis Controllers Association, 2452 Spring Rd SE, Smyrna, GA, 30080, USA
| | - Philip A LoBue
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
| | - Kenneth G Castro
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30333 USA
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Lovegrove MC, Shehab N, Hales CM, Poneleit K, Crane E, Budnitz DS. Emergency department visits for antiviral adverse events during the 2009 H1N1 influenza pandemic. Public Health Rep 2011; 126:312-7. [PMID: 21553658 DOI: 10.1177/003335491112600303] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The 2009 pandemic influenza A (H1N1) outbreak was associated with an increased use of antiviral agents and highlighted the role of population-based monitoring for related adverse drug events (ADEs). An ongoing, nationally representative emergency department-based surveillance system was used to identify and characterize ADEs during the pandemic. Active surveillance for ADEs successfully provided timely, population-based data during the pandemic. Increases in antiviral ADEs paralleled increases in prescribing. Type and severity of ADEs were similar across all seasons.
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Affiliation(s)
- Maribeth C Lovegrove
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion, Atlanta, GA 30333, USA
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Chapman WW, Dowling JN, Baer A, Buckeridge DL, Cochrane D, Conway MA, Elkin P, Espino J, Gunn JE, Hales CM, Hutwagner L, Keller M, Larson C, Noe R, Okhmatovskaia A, Olson K, Paladini M, Scholer M, Sniegoski C, Thompson D, Lober B. Developing syndrome definitions based on consensus and current use. J Am Med Inform Assoc 2010; 17:595-601. [PMID: 20819870 PMCID: PMC2995670 DOI: 10.1136/jamia.2010.003210] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Accepted: 06/25/2010] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Standardized surveillance syndromes do not exist but would facilitate sharing data among surveillance systems and comparing the accuracy of existing systems. The objective of this study was to create reference syndrome definitions from a consensus of investigators who currently have or are building syndromic surveillance systems. DESIGN Clinical condition-syndrome pairs were catalogued for 10 surveillance systems across the United States and the representatives of these systems were brought together for a workshop to discuss consensus syndrome definitions. RESULTS Consensus syndrome definitions were generated for the four syndromes monitored by the majority of the 10 participating surveillance systems: Respiratory, gastrointestinal, constitutional, and influenza-like illness (ILI). An important element in coming to consensus quickly was the development of a sensitive and specific definition for respiratory and gastrointestinal syndromes. After the workshop, the definitions were refined and supplemented with keywords and regular expressions, the keywords were mapped to standard vocabularies, and a web ontology language (OWL) ontology was created. LIMITATIONS The consensus definitions have not yet been validated through implementation. CONCLUSION The consensus definitions provide an explicit description of the current state-of-the-art syndromes used in automated surveillance, which can subsequently be systematically evaluated against real data to improve the definitions. The method for creating consensus definitions could be applied to other domains that have diverse existing definitions.
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Affiliation(s)
- Wendy W Chapman
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA.
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Guirguis-Blake J, Hales CM. Screening for thyroid disease. Am Fam Physician 2005; 71:1369-70. [PMID: 15832539] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Janelle Guirguis-Blake
- U S Preventive Services Task Force, Center for Primary Care, Prevention, and Clinical Partnerships, Agency for Healthcare Research and Quality, USA
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Guirguis-Blake J, Hales CM. Screening for suicide risk. Am Fam Physician 2004; 70:2193-4. [PMID: 15606067] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Janelle Guirguis-Blake
- U.S. Preventive Services Task Force, Center for Primary Care, Prevention and Clinical Partnerships, Agency for Healthcare Research and Quality, Rockville, Maryland, USA
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Hales CM, Randhawa G. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse. Am Fam Physician 2004; 70:1743-4. [PMID: 15554493] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Craig M Hales
- Johns Hopkins Bloomberg School of Public Health, USA
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Hales CM, Griner R, Hobdy-Henderson KC, Dorn MC, Hardy D, Kumar R, Navarre J, Chan EK, Lapierre LA, Goldenring JR. Identification and characterization of a family of Rab11-interacting proteins. J Biol Chem 2001; 276:39067-75. [PMID: 11495908 DOI: 10.1074/jbc.m104831200] [Citation(s) in RCA: 255] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Rab11a is a small GTP-binding protein enriched in the pericentriolar plasma membrane recycling systems. We hypothesized that Rab11a-binding proteins exist as downstream effectors of its action. Here we define a family of four Rab11-interacting proteins: Rab11-Family Interacting Protein 1 (Rab11-FIP1), Rab11-Family Interacting Protein 2 (Rab11-FIP2), Rab11-Family Interacting Protein 3 (Rab11-FIP3), and pp75/Rip11. All four interacting proteins associated with wild type Rab11a and dominant active Rab11a (Rab11aS20V) as well as Rab11b and Rab25. Rab11-FIP2 also interacted with dominant negative Rab11a (Rab11aS25N) and the tail of myosin Vb. The binding of Rab11-FIP1, Rab11-FIP2, and Rab11-FIP3 to Rab11a was dependent upon a conserved carboxyl-terminal amphipathic alpha-helix. Rab11-FIP1, Rab11-FIP2, and pp75/Rip11 colocalized with Rab11a in plasma membrane recycling systems in both non-polarized HeLa cells and polarized Madin-Darby canine kidney cells. GFP-Rab11-FIP3 also colocalized with Rab11a in HeLa cells. Rab11-FIP1, Rab11-FIP2, and pp75/Rip11 also coenriched with Rab11a and H(+)K(+)-ATPase on parietal cell tubulovesicles, and Rab11-FIP1 and Rab11-FIP2 translocated with Rab11a and the H(+)K(+)-ATPase upon stimulating parietal cells with histamine. The results suggest that the function of Rab11a in plasma membrane recycling systems is dependent upon a compendium of protein effectors.
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Affiliation(s)
- C M Hales
- Department of Medicine, Institute of Molecular Medicine and Genetics, Medical College of Georgia and the Augusta Veterans Affairs Medical Center, Augusta, Georgia 30912, USA
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Jones KW, Gorzynski K, Hales CM, Fischer U, Badbanchi F, Terns RM, Terns MP. Direct interaction of the spinal muscular atrophy disease protein SMN with the small nucleolar RNA-associated protein fibrillarin. J Biol Chem 2001; 276:38645-51. [PMID: 11509571 DOI: 10.1074/jbc.m106161200] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Disruption of the survival motor neuron (SMN) gene leads to selective loss of spinal motor neurons, resulting in the fatal human neurodegenerative disorder spinal muscular atrophy (SMA). SMN has been shown to function in spliceosomal small nuclear ribonucleoprotein (snRNP) biogenesis and pre-mRNA splicing. We have demonstrated that SMN also interacts with fibrillarin, a highly conserved nucleolar protein that is associated with all Box C/D small nucleolar RNAs and functions in processing and modification of rRNA. Fibrillarin and SMN co-immunoprecipitate from HeLa cell extracts indicating that the proteins exist as a complex in vivo. Furthermore, in vitro binding studies indicate that the interaction between SMN and fibrillarin is direct and salt-stable. We show that the glycine/arginine-rich domain of fibrillarin is necessary and sufficient for SMN binding and that the region of SMN encoded by exon 3, including the Tudor domain, mediates the binding of fibrillarin. Tudor domain missense mutations, including one found in an SMA patient, impair the interaction between SMN and fibrillarin (as well as the common snRNP protein SmB). Our results suggest a function for SMN in small nucleolar RNP biogenesis (akin to its known role as an snRNP assembly factor) and reveal a potential link between small nucleolar RNP biogenesis and SMA.
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Affiliation(s)
- K W Jones
- Department of Biochemistry, University of Georgia, Athens, Georgia 30602, USA
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