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Hall GJ, Page EJ, Rhee M, Hay C, Krause A, Langenbacher E, Ruth A, Grenier S, Duran AP, Kamara I, Iskander JK, Alsayyid F, Thomas DL, Bock E, Porta N, Pharo J, Osterink BA, Zelmanowitz S, Fleischmann CM, Liyanage D, Gray JP. Wastewater Surveillance of US Coast Guard Installations and Seagoing Military Vessels to Mitigate the Risk of COVID-19 Outbreaks, March 2021-August 2022. Public Health Rep 2024:333549241236644. [PMID: 38561999 DOI: 10.1177/00333549241236644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVES Military training centers and seagoing vessels are often environments at high risk for the spread of COVID-19 and other contagious diseases, because military trainees and personnel arrive after traveling from many parts of the country and live in congregate settings. We examined whether levels of SARS-CoV-2 genetic material in wastewater correlated with SARS-CoV-2 infections among military personnel living in communal barracks and vessels at US Coast Guard training centers in the United States. METHODS The Coast Guard developed and established 3 laboratories with wastewater testing capability at Coast Guard training centers from March 2021 through August 2022. We analyzed wastewater from barracks housing trainees and from 4 Coast Guard vessels for the presence of SARS-CoV-2 genes N and E and quantified the results relative to levels of a fecal indicator virus, pepper mild mottle virus. We compared quantified data with the timing of medically diagnosed COVID-19 infection among (1) military personnel who had presented with symptoms or had been discovered through contact tracing and had medical tests and (2) military personnel who had been discovered through routine surveillance by positive SARS-CoV-2 antigen or polymerase chain reaction test results. RESULTS Levels of viral genes in wastewater at Coast Guard locations were best correlated with diagnosed COVID-19 cases when wastewater testing was performed twice weekly with passive samplers deployed for the entire week; such testing detected ≥1 COVID-19 case 69.8% of the time and ≥3 cases 88.3% of the time. Wastewater assessment in vessels did not continue because of logistical constraints. CONCLUSION Wastewater testing is an effective tool for measuring the presence and patterns of SARS-CoV-2 infections among military populations. Success with wastewater testing for SARS-CoV-2 infections suggests that other diseases may be assessed with similar approaches.
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Affiliation(s)
- Gregory J Hall
- Department of Chemical and Environmental Sciences, US Coast Guard Academy, New London, CT, USA
| | - Eric J Page
- Department of Physics, US Coast Guard Academy, New London, CT, USA
| | - Min Rhee
- Department of Chemical and Environmental Sciences, US Coast Guard Academy, New London, CT, USA
| | - Clara Hay
- Department of Chemical and Environmental Sciences, US Coast Guard Academy, New London, CT, USA
| | - Amelia Krause
- Department of Chemical and Environmental Sciences, US Coast Guard Academy, New London, CT, USA
| | - Emma Langenbacher
- Department of Chemical and Environmental Sciences, US Coast Guard Academy, New London, CT, USA
| | - Allison Ruth
- Department of Chemical and Environmental Sciences, US Coast Guard Academy, New London, CT, USA
| | - Steve Grenier
- Department of Civil and Environmental Engineering, US Coast Guard Academy, New London, CT, USA
| | - Alexander P Duran
- Office of Environmental Safety, US Coast Guard Academy, New London, CT, USA
| | - Ibrahim Kamara
- Occupational Medicine and Quality Improvement Division, US Coast Guard Headquarters, Washington, DC, USA
| | - John K Iskander
- Preventive Medicine and Population Health, US Coast Guard Headquarters, Washington, DC, USA
| | - Fahad Alsayyid
- Coast Guard Medical Directorate, US Coast Guard, Cape May, NJ, USA
| | - Dana L Thomas
- Assistant Commandant, Health, Safety, and Work-Life Service Center, US Coast Guard Headquarters, Washington, DC, USA
| | - Edward Bock
- Health, Safety, and Work-Life Service Center, US Coast Guard, Norfolk, VA, USA
| | - Nicholas Porta
- Health, Safety, and Work-Life Service Center, US Coast Guard, Norfolk, VA, USA
| | - Jessica Pharo
- Health, Safety, and Work-Life Service Center, US Coast Guard, Norfolk, VA, USA
| | - Beth A Osterink
- Health, Safety, and Work-Life Service Center, US Coast Guard, Norfolk, VA, USA
| | - Sharon Zelmanowitz
- Department of Civil and Environmental Engineering, US Coast Guard Academy, New London, CT, USA
| | - Corinna M Fleischmann
- Department of Civil and Environmental Engineering, US Coast Guard Academy, New London, CT, USA
| | - Dilhara Liyanage
- Department of Chemical and Environmental Sciences, US Coast Guard Academy, New London, CT, USA
| | - Joshua P Gray
- Department of Chemical and Environmental Sciences, US Coast Guard Academy, New London, CT, USA
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Koffi KG, Silué DA, Laurent C, Boidy K, Koui S, Compaci G, Adeba ZH, Kamara I, Botty RP, Bognini AS, Sanogo I, Despas F, Laurent G. AMAFRICA, a patient-navigator program for accompanying lymphoma patients during chemotherapy in Ivory Coast: a prospective randomized study. BMC Cancer 2019; 19:1247. [PMID: 31870438 PMCID: PMC6929302 DOI: 10.1186/s12885-019-6478-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/18/2019] [Accepted: 12/17/2019] [Indexed: 01/08/2023] Open
Abstract
Background Previous studies have indicated that accompanying socially underserved cancer patients through Patient Navigator (PN) or PN-derived procedures improves therapy management and reassurance. At the Cancer Institute of Toulouse-Oncopole (France), we have implemented AMA (Ambulatory Medical Assistance), a PN-based procedure adapted for malignant lymphoma (ML) patients under therapy. We found that AMA improves adherence to chemotherapy and safety. In low-middle income countries (LMIC), refusal and abandonment were documented as major adverse factors for cancer therapy. We reasoned that AMA could improve clinical management of ML patients in LMIC. Methods This study was set up in the Abidjan University Medical Center (Ivory Coast) in collaboration with Toulouse. One hundred African patients were randomly assigned to either an AMA or control group. Main criteria of judgment were refusal and abandonment of CHOP or ABVD chemotherapy. Results We found that AMA was feasible and had significant impact on refusal and abandonment. However, only one third of patients completed their therapy in both groups. No differences were noted in terms of complete response rate (CR) (16% based on intent-to-treat) and median overall survival (OS) (6 months). The main reason for refusal and abandonment was limitation of financial resources. Conclusion Altogether, this study showed that PN may reduce refusal and abandonment of treatment. However, due to insufficient health care coverage, its ultimate impact on OS remains limited.
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Affiliation(s)
- K G Koffi
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire.
| | - D A Silué
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - C Laurent
- Hematology Department of Toulouse University Medical Center, Toulouse, France
| | - K Boidy
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - S Koui
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - G Compaci
- Hematology Department of Toulouse University Medical Center, Toulouse, France
| | - Z H Adeba
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - I Kamara
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - R P Botty
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - A S Bognini
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - I Sanogo
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - F Despas
- Hematology Department of Toulouse University Medical Center, Toulouse, France
| | - G Laurent
- Hematology Department of Toulouse University Medical Center, Toulouse, France
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