Update on trends in varicella mortality during the varicella vaccine era-United States, 1990-2016

We reported previously that the annual average mortality rate in the United States in 2008-2011 for varicella listed as the underlying cause declined 87% compared with the prevaccine period (1990-1994). Here, we update the analysis with five additional years of data. We used varicella death data from the 2012-2016 Mortality Multiple Cause-of Death records to calculate mortality rates during 2012-2016 and trends since the prevaccine period and end of 1-dose vaccination program (2005-2007). The annual average age-adjusted mortality rate for varicella as the underlying cause was 0.03 per million population during 2012-2016, a 94% reduction from prevaccine years and a 47% reduction from 2005-2007. Varicella deaths continue to decline due to the varicella vaccination program in the United States.

Trends in varicella mortality in the United States: Data from vital statistics and the national surveillance system

This manuscript describes trends in US varicella mortality using national vital statistics system data for 2008-2011, the first years of the routine 2-dose varicella vaccination program, and characteristics of varicella deaths reported to CDC during 1996-2013. We obtained data on deaths with varicella as underlying or contributing cause from the 2008-2011 Mortality Multiple Cause-of Death records and calculated rates to compare with the prevaccine and mature 1-dose varicella vaccination program eras. We also reviewed available records of varicella deaths reported to CDC through the national varicella death surveillance. The annual average age-adjusted mortality rate for varicella as the underlying cause was 0.05 per million population during 2008-2011, an 87% reduction from the prevaccine years. Varicella deaths among persons aged <20 y declined by 99% in 2008-2011 compared with prevaccine years. There was a 70% decline in varicella mortality rates among those <20 y in 2008-2011 compared to 2005-2007. Among the 83 deaths reported to CDC during 1996-2013 classified as likely due to varicella, 24 (29%) were among immunocompromised individuals. Five were among persons previously vaccinated with 1 dose of varicella vaccine. In conclusion, although the US varicella vaccination program has significantly reduced varicella disease burden, there are still opportunities to prevent varicella and its associated morbidity and mortality through routine varicella vaccination, catch-up vaccination, and ensuring that household contacts of immunocompromised persons have evidence of immunity.

Years of potential life lost for brain and CNS tumors relative to other cancers in adults in the United States, 2010

BACKGROUND

Years of potential life lost (YPLL) complement incidence and survival rates by measuring how much a patient's life is likely to be shortened by his or her cancer. In this study, we examine the impact of death due to brain and other central nervous system (CNS) tumors compared to other common cancers in adults by investigating the YPLL of adults in the United States.

METHODS

Mortality and life table data were obtained from the Centers for Disease Control and Prevention's National Center for Health Statistics Vital Statistics Data for 2010. The study population included individuals aged 20 years or older at death who died from one of the selected cancers. YPLL was calculated by taking an individual's age at death and finding the corresponding expected remaining years of life using life table data.

RESULTS

The cancers with the greatest mean YPLL were other malignant CNS tumors (20.65), malignant brain tumors (19.93), and pancreatic cancer (15.13) for males and malignant brain tumors (20.31), breast cancer (18.78), and other malignant CNS tumors (18.36) for females. For both sexes, non-Hispanic whites had the lowest YPLL, followed by non-Hispanic blacks, and Hispanics.

CONCLUSION

Malignant brain and other CNS tumors have the greatest mean YPLL, thereby reflecting their short survival time post diagnosis. These findings will hopefully motivate more research into mitigating the impact of these debilitating tumors.

Association between height and malignancy among children in the north of Iran

BACKGROUND

This study aim to determine the association between height and cancer in the children aged 14 years at the time of diagnosis in Rasht, Iran.

MATERIALS AND METHODS

In this cross-sectional study, height of patients with a malignancy (≤14) at the time of diagnosis measured in the standard charts of United States National Center for the Health Statistics (NCHS). Data were reported by descriptive statistics and analyzed by Regression tests in SPSS version 19.

RESULTS

Overall, 78 male (38.6%) and 124 female (61.4%) patients with various kinds of malignancies were evaluated for their heights. Leukemia was the most common type of cancer. The median height of the patients was more than 20(th) percentile and under 50(th) percentile of the NCHS. No significant association was found between height and leukemia.

CONCLUSION

Previously, the median height of Iranian girls and boys (≤15) reported under 20(th) percentile of the NCHS. In this study, the median height of the patients at the time of diagnosis was more than 20(th) percentile of the NCHS. There was a correlation between height and cancer among our patients, although, this correlation can be assessed by further cohort study.

Underestimation of liver-related mortality in the United States

BACKGROUND & AIMS

According to the National Center for Health Statistics (NCHS), chronic liver disease and cirrhosis is the 12(th) leading cause of death in the United States. However, this single descriptor might not adequately enumerate all deaths from liver disease. The aim of our study was to update data on liver mortality in the United States.

METHODS

Mortality data were obtained from the Rochester Epidemiology Project (1999-2008) and the National Death Registry (1979-2008). Liver-specific mortality values were calculated. In contrast to the narrow NCHS definition, updated liver-related causes of death included other specific liver diagnoses (eg, hepatorenal syndrome), viral hepatitis, and hepatobiliary cancers.

RESULTS

The Rochester Epidemiology Project database contained information on 261 liver-related deaths, with an age- and sex-adjusted death rate of 27.0/100,000 persons (95% confidence interval: 23.7-30.3). Of these, only 71 deaths (27.2%) would have been captured by the NCHS definition. Of cases for which viral hepatitis or hepatobiliary cancer was the cause of death, 96.9% and 94.3% had liver-related immediate causes of death, respectively. In analysis of data from the National Death registry (2008), use of the updated definition increased liver mortality by >2-fold (from 11.7 to 25.7 deaths/100,000, respectively). Using NCHS definitions, liver-related deaths decreased from 18.9/100,000 in 1979 to 11.7/100,000 in 2008-a reduction of 38%. However, using the updated estimate, liver-related deaths were essentially unchanged from 1979 (25.8/100,000) to 2008 (25.7/100,000). Mortality burden was systematically underestimated among non-whites and persons of Hispanic ethnicity.

CONCLUSIONS

Based on analyses of the Rochester Epidemiology Project and National Death databases, liver-related mortality has been underestimated during the past 2 decades in the United States.

Growth patterns of jordanian children: a national study

This study examined the growth patterns of Jordanian children below three years of age in comparison with the NCHS reference population. Weight and length measurements of 1224 boys, and 1120 girls were obtained from a national multipurpose study of Jordanian preschool children carried out in 1984. The study results showed that children of both sexes grew at Gentiles that were close and parallel to the NCHS in the first quarter of the first year. However, both weight and length Gentiles departed from the NCHS counterparts later on with length showing marked differences from the reference. The differences observed between the local and the NCHS reference population suggest that the NCHS should be used as a target for planning and evaluation of' intervention programs at a national level while the need for the local standards to assess individual cases remains a necessity.