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Herron MS, Wang L, von Bartheld CS. Prevalence and Types of Strabismus in Cerebral Palsy: A Global and Historical Perspective Based on a Systematic Review and Meta-Analysis. Ophthalmic Epidemiol 2024:1-18. [PMID: 38635869 DOI: 10.1080/09286586.2024.2331537] [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] [Received: 01/25/2024] [Accepted: 03/08/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE Strabismus is more frequent in cerebral palsy (CP) than in the normal population, but reports differ how much it is increased. We here examined the global prevalence and types of strabismus in CP, whether esotropia or exotropia is more frequent, and whether the prevalence differs between ethnicities and/or country income levels, and between generations. METHODS We compiled in a systematic review and meta-analysis the results of 147 CP studies that report the prevalence of strabismus or the ratio of esotropia to exotropia, and we conducted subgroup analyses for region (income level) and ethnicity. We performed a pooled analysis for the CP strabismus prevalence, and estimated the global number of CP cases with strabismus. RESULTS The pooled prevalence of strabismus in CP is 49.8% in high-income countries and 39.8% in lower-income countries. We estimate the global number of strabismus cases in CP as 12.2 million, with 7.6 million males and 4.6 million females, based on current estimates of 29.6 million global CP cases. Esotropia is more frequent than exotropia in Caucasians, while exotropia is more frequent than esotropia in Hispanic and in some Asian and African populations. The strabismus prevalence in CP increases with increasing country income levels. CONCLUSION Generational changes in strabismus prevalence appear to reflect a transition of CP types and an increase in prevalence as countries attain higher income and more effective maternal health care. The distribution of esotropia and exotropia in CP patients largely reflects the horizontal strabismus type that is predominant in the subject's ethnicity.
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Affiliation(s)
- Michael S Herron
- Center of Biomedical Research Excellence in Cell Biology, School of Medicine, University of Nevada, Reno, Nevada, USA
| | - Lingchen Wang
- School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Christopher S von Bartheld
- Center of Biomedical Research Excellence in Cell Biology, School of Medicine, University of Nevada, Reno, Nevada, USA
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, Nevada, USA
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Rodríguez ECA, Rodríguez EYA, Marins FAS, da Silva AF, Nascimento LFC. Spatial patterns of prematurity and its determinants in the metropolitan region of São Paulo, Brazil, 2010-2019. Rev Bras Epidemiol 2024; 27:e240008. [PMID: 38422232 PMCID: PMC10896237 DOI: 10.1590/1980-549720240008] [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: 07/28/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE To analyze spatial distribution of preterm births and their association with maternal, social, and health services indicators in the metropolitan region of São Paulo, Brazil, 2010-2019. METHODS Ecological study using data on preterm newborns from 39 municipalities in the metropolitan region of São Paulo. Univariate global Moran's index (Im) was used to evaluate spatial association of prematurity, and univariate local Moran's index by using the cluster map (LISA) to identify spatial patterns and clusters. Bivariate global Moran's index was also used to analyze spatial autocorrelation with maternal, social, and health services indicators. RESULTS A total of 3,103,898 live births were registered in period 2010-2019, of which 331,174 (10.7%) were preterm. The global Moran's index showed spatial independence (Im=0.05; p-value=0.233) of the proportion of preterm births between municipalities. However, in the local spatial analysis it was possible to identify a statistically significant spatial cluster between the municipalities of Biritiba Mirim, Guararema and Salesópolis, with high proportions of preterm births. In the bivariate analysis, a significant positive spatial association was identified with proportions of mothers under 20 years old (Im=0.17; p-value=0.024) and mothers with low schooling (Im=0.17; p-value=0.020), and a significant negative spatial association with HDI (Im=-0.14; p-value=0.039). CONCLUSIONS The local spatial approach identified a spatial cluster located in the far east of the metropolitan region of São Paulo, where actions by health managers are needed to minimize occurrence of preterm births.
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Affiliation(s)
- Elias Carlos Aguirre Rodríguez
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Postgraduate Program in Engineering - Guaratinguetá (SP), Brazil
| | - Elen Yanina Aguirre Rodríguez
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Postgraduate Program in Engineering - Guaratinguetá (SP), Brazil
| | - Fernando Augusto Silva Marins
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Postgraduate Program in Engineering - Guaratinguetá (SP), Brazil
| | - Aneirson Francisco da Silva
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Postgraduate Program in Engineering - Guaratinguetá (SP), Brazil
| | - Luiz Fernando Costa Nascimento
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Postgraduate Program in Engineering - Guaratinguetá (SP), Brazil
- Universidade de Taubaté, Postgraduate Program in Environmental Sciences - Taubaté (SP), Brazil
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Herron MS, Wang L, von Bartheld CS. Prevalence and types of strabismus in cerebral palsy: A global and historical perspective based on a systematic review and meta-analysis. medRxiv 2024:2024.01.23.24301684. [PMID: 38343841 PMCID: PMC10854329 DOI: 10.1101/2024.01.23.24301684] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Purpose Strabismus is more frequent in cerebral palsy (CP) than in the normal population, but reports differ how much it is increased. We here examined the global prevalence and types of strabismus in CP, whether esotropia or exotropia is more frequent, and whether the prevalence differs between ethnicities and/or country income levels, and between generations. Methods We compiled in a systematic review and meta-analysis the results of 147 CP studies that report the prevalence of strabismus or the ratio of esotropia to exotropia, and we conducted subgroup analyses for region (income level) and ethnicity. We performed a pooled analysis for the CP strabismus prevalence, and estimated the global number of CP cases with strabismus. Results The pooled prevalence of strabismus in CP is 49.8% in high-income countries and 39.8% in lower-income countries. We estimate the global number of strabismus cases in CP as 12.2 million, with 7.6 million males and 4.6 million females, based on current estimates of 29.6 million global CP cases. Esotropia is more frequent than exotropia in Caucasians, while exotropia is more frequent than esotropia in Hispanic and in some Asian and African populations. The strabismus prevalence in CP increases with increasing country income levels. Conclusion Generational changes in strabismus prevalence appear to reflect a transition of CP types and an increase in prevalence as countries attain higher income and more effective maternal health care. The distribution of esotropia and exotropia in CP patients largely reflects the horizontal strabismus type that is predominant in the subject's ethnicity.
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Affiliation(s)
- Michael S. Herron
- Center of Biomedical Research Excellence in Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
| | - Lingchen Wang
- School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Christopher S. von Bartheld
- Center of Biomedical Research Excellence in Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
- Department of Physiology and Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
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Astolfo S, Andrade ACDS, Kehrig RT. Temporal analysis and spatial distribution of acquired syphilis in the state of Mato Grosso, Brazil, 2010-2021: an ecological study. Epidemiol Serv Saude 2024; 33:e2023398. [PMID: 38265335 PMCID: PMC10804916 DOI: 10.1590/s2237-96222024v33e2023398.en] [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: 05/12/2023] [Accepted: 10/20/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE To analyze the temporal trend and the spatial distribution of acquired syphilis in Mato Grosso, Brazil, between 2010 and 2021. METHODS This was an ecological study using notifications of acquired syphilis held on the Notifiable Health Conditions Information System. Detection rates were calculated by health macro-region and three-year periods (2010-2012, 2013-2015, 2016-2018, 2019-2021). The jointpoint method was used to calculate annual percentage change (APC). Thematic maps of Bayesian rates were built and distribution was analyzed using Local Moran. RESULTS The detection rate increased from 16.2 per 100,000 inhabitants in the first three-year period (2010-2012) to 70.0 in the last three-year period (2019-2021). The Central-North macro-region had the highest rate in the last three years (94.3/100,000 inhab.), while the highest upward trend occurred in the Central-Northwest macro-region, from 2013 to 2018 (APC = 50.2; 95%CI 26.3;78.6). There was an increase in Bayesian rates in most municipalities. CONCLUSION There was a trend towards an increase in acquired syphilis, especially in the last two three-year periods.
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Affiliation(s)
- Susi Astolfo
- Superintendência Estadual do Ministério da Saúde, Serviço de
Articulação Interfederativa e Participativa, Cuiabá, MT, Brazil
| | | | - Ruth Terezinha Kehrig
- Universidade Federal de Mato Grosso, Instituto de Saúde Coletiva,
Cuiabá, MT, Brazil
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Salvador CC, Lopes AADS, Resendes D, Demarco FF, Justina MDD, de Saboya RT, Rech CR, d’Orsi E. Geocoding processes in cohort studies: methods applied in the EpiFloripa Aging. Rev Saude Publica 2023; 57:88. [PMID: 37971072 PMCID: PMC10681526 DOI: 10.11606/s1518-8787.2023057004976] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/02/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To describe the process and epidemiological implications of georeferencing in EpiFloripa Aging samples (2009-2019). METHOD The EpiFloripa Aging Cohort Study sought to investigate and monitor the living and health conditions of the older adult population (≥ 60) of Florianópolis in three study waves (2009/2010, 2013/2014, 2017/2019). With an automatic geocoding tool, the residential addresses were spatialized, allowing to investigate the effect of the georeferencing sample losses regarding 19 variables, evaluated in the three waves. The influence of different neighborhood definitions (census tracts, Euclidean buffers, and buffers across the street network) was examined in the results of seven variables: area, income, residential density, mixed land use, connectivity, health unit count, and public open space count. Pearson's correlation coefficients were calculated to evaluate the differences between neighborhood definitions according to three variables: contextual income, residential density, and land use diversity. RESULT The losses imposed by geocoding (6%, n = 240) caused no statistically significant difference between the total sample and the geocoded sample. The analysis of the study variables suggests that the geocoding process may have included a higher proportion of participants with better income, education, and living conditions. The correlation coefficients showed little correspondence between measures calculated by the three neighborhood definitions (r = 0.37-0.54). The statistical difference between the variables calculated by buffers and census tracts highlights limitations in their use in the description of geospatial attributes. CONCLUSION Despite the challenges related to geocoding, such as inconsistencies in addresses, adequate correction and verification mechanisms provided a high rate of assignment of geographic coordinates, the findings suggest that adopting buffers, favored by geocoding, represents a potential for spatial epidemiological analyses by improving the representation of environmental attributes and the understanding of health outcomes.
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Affiliation(s)
- Catharina Cavasin Salvador
- Universidade Estadual de LondrinaPrograma Associado de Pós-Graduação em Arquitetura e UrbanismoLondrinaPRBrasilUniversidade Estadual de Londrina. Programa Associado de Pós-Graduação em Arquitetura e Urbanismo. Londrina, PR, Brasil
- Universidade Federal de Santa CatarinaPrograma de Pós-Graduação em Arquitetura e UrbanismoFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Programa de Pós-Graduação em Arquitetura e Urbanismo. Florianópolis, SC, Brasil
| | - Adalberto Aparecido dos Santos Lopes
- Universidade Federal de Minas GeraisObservatório de Saúde UrbanaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Observatório de Saúde Urbana. Belo Horizonte, MG, Brasil
- Universidade Federal de Santa CatarinaPrograma de Pós-Graduação em Educação FísicaFlorianópolisSCBrasil Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Educação Física. Florianópolis, SC, Brasil
| | - Danilo Resendes
- Universidade Federal de Santa CatarinaPrograma de Pós-Graduação em Arquitetura e UrbanismoFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Programa de Pós-Graduação em Arquitetura e Urbanismo. Florianópolis, SC, Brasil
| | - Fernanda Faccio Demarco
- Universidade Federal de Santa CatarinaPrograma de Pós-Graduação em Arquitetura e UrbanismoFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Programa de Pós-Graduação em Arquitetura e Urbanismo. Florianópolis, SC, Brasil
| | - Marcelo Dutra Della Justina
- Universidade Federal de Santa CatarinaPrograma de Pós-Graduação em Educação FísicaFlorianópolisSCBrasil Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Educação Física. Florianópolis, SC, Brasil
| | - Renato Tibiriçá de Saboya
- Universidade Federal de Santa CatarinaCentro TecnológicoDepartamento de Arquitetura e UrbanismoFlorianópolisSCBrasil Universidade Federal de Santa Catarina. Centro Tecnológico. Departamento de Arquitetura e Urbanismo. Florianópolis, SC, Brasil
| | - Cassiano Ricardo Rech
- Universidade Federal de Santa CatarinaCentro de DesportosDepartamento de Educação FísicaFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Desportos. Departamento de Educação Física. Florianópolis, SC, Brasil
| | - Eleonora d’Orsi
- Universidade Federal de Santa CatarinaCentro de Ciências da SaúdeDepartamento de Saúde PúblicaFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Ciências da Saúde. Departamento de Saúde Pública. Florianópolis, SC, Brasil
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Leite MA, Barata MF, Levy RB. Food environment near schools in the largest Brazilian metropolis: analyses and contributions based on census data. CAD SAUDE PUBLICA 2023; 39:e00030223. [PMID: 37820245 PMCID: PMC10566553 DOI: 10.1590/0102-311xen030223] [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: 02/24/2023] [Revised: 06/29/2023] [Accepted: 07/28/2023] [Indexed: 10/13/2023] Open
Abstract
We aimed to investigate and compare the distribution of establishments that sell food near municipal, state, and private schools in the municipality of São Paulo, Brazil. This cross-sectional, exploratory, and census study was conducted in 3,121 schools. Circular buffers were traced around schools and concentrations or dispersions of food stores (in absolute numbers and densities) were analyzed. A p-trend was calculated to analyze how food stores density behaved as the buffer radius distance increased. Stratified regression models were built to analyze the characteristics of the food environment. Snack bars and street vendors are the most common types of establishments surrounding schools. Some categories of food stores are concentrated (such as candy stores around municipal and private schools, mini markets around municipal schools, and snack bars around private schools), whereas others (such as super and hypermarkets and fruit and vegetable stores) are dispersed around public schools. The food environment around schools shows differences regarding the instance that administers them and private schools have more food stores around them. Poor-quality food environment around schools exposes students to risk factors regarding excessive unhealthy food consumption.
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Affiliation(s)
- Maria Alvim Leite
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brasil
| | - Mayra Figueiredo Barata
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brasil
| | - Renata Bertazzi Levy
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, Brasil
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Guo K, McCoy AB, Reese TJ, Wright A, Rosenbloom ST, Liu S, Russo EM, Steitz BD. POINT: Pipeline for Offline Conversion and Integration of Geocodes and Neighborhood Data. Appl Clin Inform 2023; 14:833-842. [PMID: 37541656 PMCID: PMC10584391 DOI: 10.1055/a-2148-6414] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/03/2023] [Indexed: 08/06/2023] Open
Abstract
OBJECTIVES Geocoding, the process of converting addresses into precise geographic coordinates, allows researchers and health systems to obtain neighborhood-level estimates of social determinants of health. This information supports opportunities to personalize care and interventions for individual patients based on the environments where they live. We developed an integrated offline geocoding pipeline to streamline the process of obtaining address-based variables, which can be integrated into existing data processing pipelines. METHODS POINT is a web-based, containerized, application for geocoding addresses that can be deployed offline and made available to multiple users across an organization. Our application supports use through both a graphical user interface and application programming interface to query geographic variables, by census tract, without exposing sensitive patient data. We evaluated our application's performance using two datasets: one consisting of 1 million nationally representative addresses sampled from Open Addresses, and the other consisting of 3,096 previously geocoded patient addresses. RESULTS A total of 99.4 and 99.8% of addresses in the Open Addresses and patient addresses datasets, respectively, were geocoded successfully. Census tract assignment was concordant with reference in greater than 90% of addresses for both datasets. Among successful geocodes, median (interquartile range) distances from reference coordinates were 52.5 (26.5-119.4) and 14.5 (10.9-24.6) m for the two datasets. CONCLUSION POINT successfully geocodes more addresses and yields similar accuracy to existing solutions, including the U.S. Census Bureau's official geocoder. Addresses are considered protected health information and cannot be shared with common online geocoding services. POINT is an offline solution that enables scalability to multiple users and integrates downstream mapping to neighborhood-level variables with a pipeline that allows users to incorporate additional datasets as they become available. As health systems and researchers continue to explore and improve health equity, it is essential to quickly and accurately obtain neighborhood variables in a Health Insurance Portability and Accountability Act (HIPAA)-compliant way.
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Affiliation(s)
- Kevin Guo
- School of Medicine, Vanderbilt University, Nashville, Tennessee, United States
| | - Allison B. McCoy
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Thomas J. Reese
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Adam Wright
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Samuel Trent Rosenbloom
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Siru Liu
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Elise M. Russo
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Bryan D. Steitz
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
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Vital CL, Reis RB, Soares JFDS, Miranda DLP, Reis MG. Spatial distribution of congenital syphilis in the state of Bahia, Brazil from 2009 to 2018. Front Epidemiol 2023; 3:1234580. [PMID: 38516337 PMCID: PMC10956362 DOI: 10.3389/fepid.2023.1234580] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/31/2023] [Indexed: 03/23/2024]
Abstract
Objective To describe the temporal trend and spatial distribution of congenital syphilis (CS) cases in the state of Bahia, Brazil between 2009 and 2018. Method Mixed ecological study conducted through the analysis of data obtained from the Notifiable Diseases Information System and the Live Birth Information System. Global Moran Index I was performed in order to analyze spatial autocorrelation of CS cases in the municipalities of Bahia and the Local Spatial Association Indicator (LISA) was used to identify the formation of spatial regimes in the GeoDA software. Results 8,786 cases of CS were registered in the period. An increasing growth in CS incidence, with a 511% increase between 2009 and 2018. Spatial autocorrelation was observed between the municipalities (I Moran = 0.452; p < 0.001) and four clusters were identified. More frequently, mothers were aged 20-29 years (50.7%); had incomplete primary education (54.9%); were Black and multiracial (93.2%); received prenatal care (82.2%); 49.0% were diagnosed with syphilis during prenatal care; 68.8% were not adequately treated, and 81.1% of their partners were not treated. Conclusion The results showed that CS consolidates as a serious public health problem in Bahia, with an incidence 8.4 times higher in the period than the WHO target of 0.5/1,000 live births, predominantly related to inadequate prenatal care and social vulnerability indicators: young mothers with low education levels, as well as individuals identified as Black and multiracial. Thus, programs aimed at women of childbearing age and pregnant women need to be intensified.
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Affiliation(s)
- Caroline Luz Vital
- Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Department of Medicine of Bahia of Federal University of Bahia, Salvador, Bahia, Brazil
| | - Renato Barbosa Reis
- Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Post-Graduate Program in Regional and Urban Development, Salvador University, Salvador, Brazil
- National Industrial Learning Service University Center and Integrated Center for Manufacturing and Technology (SENAI CIMATEC), Salvador, Bahia, Brazil
| | - Jorgana Fernanda de Souza Soares
- Department of Preventive and Social Medicine of Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
- PhD in Public Health from the Post-Graduate Program of Collective Health at Federal University of Bahia, Salvador, Bahia, Brazil
| | - Diego Lopes Paim Miranda
- Post-Graduate Program in Medicine and Health at the Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mitermayer Galvão Reis
- Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Department of Medicine of Bahia of Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, United States
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Maciel NDS, Braga HMFG, de Moura FJN, Luzia FJM, Sousa IES, Rouberte ESC. Temporal and spatial distribution of polio vaccine coverage in Brazil between 1997 and 2021. Rev Bras Epidemiol 2023; 26:e230037. [PMID: 37646734 PMCID: PMC10470251 DOI: 10.1590/1980-549720230037] [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: 01/16/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE To analyze the temporal and spatial distribution of polio vaccine coverage in Brazilian states. METHODS An ecological time series study was conducted using data from the National Immunization Program Information System. The analyzed period was from 1997 to 2021. Joinpoint software was used to calculate the annual percentage change and average annual percentage change through regressions. QGIS 3.10.7 software was used to construct thematic maps. GeoDa 1.20.0.10 software was used to estimate spatial autocorrelation using the Global Moran's Index and Local Moran's Index. RESULTS National vaccine coverage in 1997 was 89.27%, decreasing to 61.32% in 2021. The trend analysis indicated an average annual decrease of 1.5% in polio vaccine coverage in Brazil. Across the country, 17 states showed a statistically significant reduction in the average annual percentage change rate. The highest average reduction rates in vaccine coverage among Brazilian states were observed in Amapá (-3.7%; 95%CI -6.0; -1.4) and Pernambuco (-3.3%; 95%CI -4.0; -2.5). In the spatial analysis, in Moran Global, a positive autocorrelation was identified in the years 2012 to 2021 (p<0.02), with an index value of 0.361, which means that geographically close areas tended to have similar levels of vaccination coverage. CONCLUSION There was significant heterogeneity in coverage among states and a strong decrease trend in vaccination rates, which could facilitate the circulation of the poliovirus and pose a threat to the susceptible population.
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Affiliation(s)
| | | | | | - Francisco Jardsom Moura Luzia
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Health Sciences Institute – Redenção (CE), Brazil
| | - Isabelle e Silva Sousa
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Health Sciences Institute – Redenção (CE), Brazil
| | - Emilia Soares Chaves Rouberte
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Health Sciences Institute – Redenção (CE), Brazil
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Carrel M, Clore GS, Goto M, Kim S, Perencevich EN, Vaughan-Sarrazin M. Impacts of Hurricane Matthew Exposure on Infections and Antimicrobial Prescribing in North Carolina Veterans. Disaster Med Public Health Prep 2023; 17:e357. [PMID: 36938923 DOI: 10.1017/dmp.2023.9] [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] [Indexed: 03/21/2023]
Abstract
The impact of hurricane-related flooding on infectious diseases in the US is not well understood. Using geocoded electronic health records for 62,762 veterans living in North Carolina counties impacted by Hurricane Matthew coupled with flood maps, we explore the impact of hurricane and flood exposure on infectious outcomes in outpatient settings and emergency departments as well as antimicrobial prescribing. Declines in outpatient visits and antimicrobial prescribing are observed in weeks 0-2 following the hurricane as compared with the baseline period and the year prior, while increases in antimicrobial prescribing are observed 3+ weeks following the hurricane. Taken together, hurricane and flood exposure appear to have had minor impacts on infectious outcomes in North Carolina veterans, not resulting in large increases in infections or antimicrobial prescribing.
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Affiliation(s)
- Margaret Carrel
- Department of Geographical and Sustainability Sciences, University of Iowa, Iowa, United States
| | - Gosia S Clore
- Department of Internal Medicine, University of Iowa, Iowa, United States
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, United States
| | - Michihiko Goto
- Department of Internal Medicine, University of Iowa, Iowa, United States
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, United States
| | - Seungwon Kim
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
| | - Eli N Perencevich
- Department of Internal Medicine, University of Iowa, Iowa, United States
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, United States
| | - Mary Vaughan-Sarrazin
- Department of Internal Medicine, University of Iowa, Iowa, United States
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, United States
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De Sousa Dos Santos S, Chachá SGF, da Rocha BC, Spiller KR, de Toledo CF, Aníbal FDF, de Avó LRDS, Luporini RL, Cereda Junior A, Melanda EA. Schistosomiasis mansoni and hydrographical conditions in São Carlos, São Paulo, Brazil. Trans R Soc Trop Med Hyg 2022; 117:391-400. [PMID: 36576498 DOI: 10.1093/trstmh/trac124] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In Brazil, schistosomiasis mansoni cases still occur, even in non-endemic areas. This study aimed to evaluate schistosomiasis mansoni cases and to delimit water collections investigated for infested planorbidae in São Carlos, São Paulo, Brazil. METHODS A cross-sectional descriptive study and spatial analysis of schistosomiasis mansoni cases notified in the city from January 2005 to December 2017 was conducted. The study used geographical information system software to map residential and leisure exposures to water courses and bodies and related them to planorbidae surveys of São Paulo state. RESULTS During the study period, 32 cases were notified. The main forms were intestinal and hepatosplenic. Twenty-eight cases were allochthonous, two autochthonous and two indeterminate. Eleven patients (33.3%) had contact with water collections in São Carlos, mainly the 29 and Broa reservoirs. Three of them had contact only with water collections in the region. A third of cases lived in the Água Fria and Água Quente microbasins, highly impacted by the presence of domestic sewage, and the whole region seems to be colonized by Biomphalaria tenagophila. CONCLUSIONS The resolution of anthropogenic contamination of water bodies is crucial for controlling schistosomiasis mansoni autochthony in São Carlos.
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Affiliation(s)
- Sigrid De Sousa Dos Santos
- Department of Medicine, Universidade Federal de São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Silvana Gama Florencio Chachá
- Department of Medicine, Universidade Federal de São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Beatriz Correia da Rocha
- Department of Medicine, Universidade Federal de São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Katia Regina Spiller
- Epidemiological Surveillance, São Carlos Municipal Health Department, Rua Conde do Pinhal, 2161, São Carlos, SP, CEP 13560-648, Brazil
| | - Carlos Fischer de Toledo
- São Carlos Chronic Infection Care Centre, São Carlos Municipal Health Department, Rua José de Alencar, 36, São Carlos, SP, CEP 13566-000, Brazil.,Department of Medicine, Gastroenterology Division, Universidade Federal de São Paulo, Rua Pedro de Toledo, 861, São Paulo, SP, CEP 04039-032, Brazil
| | - Fernanda de Freitas Aníbal
- Department of Morphology and Pathology, Universidade Federal de São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Lucimar Retto da Silva de Avó
- Department of Medicine, Universidade Federal de São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Rafael Luis Luporini
- Department of Medicine, Universidade Federal de São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, CEP 13565-905, Brazil
| | - Abimael Cereda Junior
- Department of Civil Engineering, Universidade Federal de São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, CEP 13565-905s, Brazil
| | - Edson Augusto Melanda
- Department of Civil Engineering, Universidade Federal de São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, CEP 13565-905s, Brazil
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Nicolato FV, Chaoubah A, van Keulen MDSL, dos Reis MF, Liebel G. Space-time distribution of urinary incontinence outpatient production in men, Brazil, 2010-2019. Epidemiol Serv Saude 2022; 31:e20211257. [PMID: 36134851 PMCID: PMC9887990 DOI: 10.1590/s2237-96222022000200025] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/25/2022] [Indexed: 02/02/2023] Open
Abstract
OBJETIVE To estimate the temporal trend and spatial distribution of urinary incontinence outpatient production in men in Brazil. METHODS This was an ecological time series study of Brazil and its regions, from 2010-2019, using data from the Brazilian National Health System Outpatient Information System. Prais-Winsten regression was used to analyze the temporal trend in Brazil as a whole and by region. The autoregressive integrated moving average model was used to forecast the trend until 2024. RESULTS In 2010, 3,457 outpatient appointments for urinary incontinence in men were registered, rising to 16,765 in 2019, revealing a rising temporal trend [annual percentage change = 50.37%; 95% confidence interval (95%IC) 37.54;63.62]; and a forecast of growth for the period 2020-2024 (final ARIMA model: 1, 1, 0). The spatial distribution of urinary incontinence rates varied between the country's macro-regions. CONCLUSION There was a rising temporal trend in urinary incontinence outpatient production in men in Brazil between 2010-2019 with growth forecast until 2024. The highest rates occurred in the Southeast region and the highest increase was found in the Southern region.
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Affiliation(s)
- Fernanda Vieira Nicolato
- Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em
Saúde Coletiva, Juiz de Fora, MG, Brazil
| | - Alfredo Chaoubah
- Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em
Saúde Coletiva, Juiz de Fora, MG, Brazil
| | | | - Marcio Fernandes dos Reis
- Universidade Federal de Juiz de Fora, Programa de Pós-Graduação em
Saúde Coletiva, Juiz de Fora, MG, Brazil
| | - Graziela Liebel
- Universidade do Vale do Itajaí, Programa de Pós-Graduação em Saúde e
Gestão do Trabalho, Itajaí, SC, Brazil
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Pathak PK, Singh Y, Mahapatro SR, Tripathi N, Jee J. Assessing Socioeconomic Vulnerabilities Related to COVID-19 Risk in India: A State-Level Analysis. Disaster Med Public Health Prep 2022; 16:590-603. [PMID: 32907661 PMCID: PMC7711356 DOI: 10.1017/dmp.2020.348] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/29/2020] [Accepted: 09/05/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE There is a paucity of scientific analysis that has examined spatial heterogeneities in the socioeconomic vulnerabilities related to coronavirus disease 2019 (COVID-19) risk and potential mitigation strategies at the sub-national level in India. The present study examined the demographic, socioeconomic, and health system-related vulnerabilities shaping COVID-19 risk across 36 states and union territories in India. METHODS Using secondary data from the Ministry of Health and Family Welfare (MoHFW), Government of India; Census of India, 2011; National Family Health Survey, 2015-16; and various rounds of the National Sample Survey, we examined socioeconomic vulnerabilities associated with COVID-19 risk at the sub-national level in India from March 16, 2020, to May 3, 2020. Descriptive statistics, principal component analysis, and the negative binomial regression model were used to examine the predictors of COVID-19 risk in India. RESULTS There persist substantial heterogeneities in the COVID-19 risk across states and union territories in India. The underlying demographic, socioeconomic, and health infrastructure characteristics drive the vulnerabilities related to COVID-19 in India. CONCLUSIONS This study emphasizes that concerted socially inclusive policy action and sustained livelihood/economic support for the most vulnerable population groups is critical to mitigate the impact of the COVID-19 pandemic in India.
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Affiliation(s)
- Praveen Kumar Pathak
- Department of Geography, Faculty of Natural Sciences, Jamia Millia Islamia (Central University), New Delhi, India
| | - Yadawendra Singh
- Department of Economics, Chandradhari Mithila College, Lalit Narayan Mithila University, Darbhanga, Bihar, India
| | | | - Niharika Tripathi
- ICMR-National Institute of Medical Statistics, New Delhi110029, India
| | - Jyoti Jee
- Post-Graduate Department of Geography, Veer Kunwar Singh University, Ara, Bihar, India
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Holcomb DS, Pengetnze Y, Steele A, Karam A, Spong C, Nelson DB. Geographic barriers to prenatal care access and their consequences. Am J Obstet Gynecol MFM 2021; 3:100442. [PMID: 34245930 DOI: 10.1016/j.ajogmf.2021.100442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/14/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although prenatal care has long been viewed as an important strategy toward improving maternal morbidity and mortality, limited data exist that support the premise that access to prenatal care impacts perinatal outcomes. Furthermore, little is known about geographic barriers that impact access to care in an underserved population and how this may influence perinatal outcomes. OBJECTIVE This study aimed to (1) evaluate perinatal outcomes among women with and without prenatal care and (2) examine barriers to receiving prenatal care according to block-level data of residence. We hypothesized that women without prenatal care would have worse outcomes and more barriers to receiving prenatal care services. STUDY DESIGN This was a retrospective cohort study of pregnant women delivering at ≥24 weeks' gestation in a large inner-city public hospital system. Maternal and neonatal data were abstracted from the electronic health record and a community-wide data initiative data set, which included socioeconomic and local geographic data from diverse sources. Maternal characteristics and perinatal outcomes were examined among women with and without prenatal care. Prenatal care was defined as at least 1 visit before delivery. Outcomes of interest were (1) preterm delivery at <37 weeks' gestation, (2) preeclampsia or eclampsia, and (3) days in the neonatal intensive care unit after delivery. Barriers to care were analyzed, including public transportation access and location of the nearest county-sponsored prenatal clinic according to block-level location of residence. Statistical analysis included chi-square test and analysis of variance with logistic regression performed for adjustment of demographic features. RESULTS Between January 1, 2019, and October 31, 2019, 9488 women received prenatal care and 326 women did not. Women without prenatal care differed by race and were noted to have higher rates of substance use (P=.004), preterm birth (P<.001), and longer lengths of newborn admission (P<.001). After adjustment for demographic features, higher rates of preterm birth in women without prenatal care persisted (adjusted odds ratio, 2.65; 95% confidence interval, 1.95-3.55). Women without prenatal care resided in areas that relied more on public transportation and required longer transit times (42 minutes vs 30 minutes; P=.005) with more bus stops (29 vs 17; P<.001) to the nearest county-sponsored prenatal clinic. CONCLUSION Women without prenatal care were at a significantly increased risk of adverse pregnancy outcomes. In a large inner city, women without prenatal care resided in areas with significantly higher demands for public transportation. Alternative resources, including telemedicine and ridesharing, should be explored to reduce barriers to prenatal care access.
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Affiliation(s)
- Denisse S Holcomb
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX (Drs Holcomb, Spong, and Nelson); Parkland Center for Clinical Innovation, Dallas, TX (Dr Pengetnze, Ms Steele, and Mr Karam).
| | - Yolande Pengetnze
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX (Drs Holcomb, Spong, and Nelson); Parkland Center for Clinical Innovation, Dallas, TX (Dr Pengetnze, Ms Steele, and Mr Karam)
| | - Ashley Steele
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX (Drs Holcomb, Spong, and Nelson); Parkland Center for Clinical Innovation, Dallas, TX (Dr Pengetnze, Ms Steele, and Mr Karam)
| | - Albert Karam
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX (Drs Holcomb, Spong, and Nelson); Parkland Center for Clinical Innovation, Dallas, TX (Dr Pengetnze, Ms Steele, and Mr Karam)
| | - Catherine Spong
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX (Drs Holcomb, Spong, and Nelson); Parkland Center for Clinical Innovation, Dallas, TX (Dr Pengetnze, Ms Steele, and Mr Karam)
| | - David B Nelson
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX (Drs Holcomb, Spong, and Nelson); Parkland Center for Clinical Innovation, Dallas, TX (Dr Pengetnze, Ms Steele, and Mr Karam)
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Greene SK, Peterson ER, Balan D, Jones L, Culp GM, Fine AD, Kulldorff M. Detecting COVID-19 Clusters at High Spatiotemporal Resolution, New York City, New York, USA, June-July 2020. Emerg Infect Dis 2021; 27. [PMID: 33900181 PMCID: PMC8084513 DOI: 10.3201/eid2705.203583] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
A surveillance system that uses census tract resolution and the SaTScan prospective space-time scan statistic detected clusters of increasing severe acute respiratory syndrome coronavirus 2 test percent positivity in New York City, NY, USA. Clusters included one in which patients attended the same social gathering and another that led to targeted testing and outreach.
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Valek A, Vitrai J, Erdei L, Branyiczkiné Géczy G, Pászthy B, Szabó A, Szabó M. Investigation of possible causes of increase in Hungarian infant mortality in 2019. Orv Hetil 2021; 162:830-838. [PMID: 34023815 DOI: 10.1556/650.2021.32092] [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: 10/22/2020] [Accepted: 01/08/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Bevezetés: Magyarországon a csecsemőhalandóság 2014 óta folyamatosan javult, azonban 2019-ben az előző évi adathoz képest 11%-kal magasabb érték mutatkozott. Célkitűzés: A vizsgálat célja a 2019. évi kedvezőtlenebb csecsemőhalálozási mutató lehetséges összetevőinek feltárása. Módszer: A 2018. és 2019. évi csecsemőhalálozási adatokat hasonlítottuk össze a csecsemő kora, a halál oka és a gyógyintézeti, illetve nem gyógyintézeti elhalálozás szerint. A vizsgálathoz a Központi Statisztikai Hivatal adatait használtuk. A trendvizsgálatnál 2010-től elemeztük az adatokat. A nem gyógyintézeti haláleseteket 10 évre összevonva járásonként térképesen ábrázoltuk. Eredmények: 2018-ban 304, 2019-ben 335 csecsemő halt meg Magyarországon, a csecsemőhalálozási arányszám 3,4 ezrelékről 3,8 ezrelékre emelkedett. A 2019. évi érték az előző évtizedek trendjére illesztett görbe alapján megfelelt a várható értéknek. 2019-ben a 0-27 napos csecsemőhalálozás alig változott a 2018. évihez képest, a 28-364 napos korban bekövetkezett halálesetek száma viszont növekedett. A vizsgált évben 59%-kal emelkedett a nem gyógyintézeti csecsemőhalálozás. A 2019. évi csecsemőhalálozás növekedéséért 74%-ban a nem gyógyintézeti esetek voltak felelősek. A nem gyógyintézeti halálozás döntő többsége késői csecsemőkorban következett be. A járásonkénti, 10 évre összevont, nem intézményben elhunyt csecsemők számában és 1000 élve születésre vonatkozó arányában ötszörös területi különbségek mutatkoztak. A halálokok közül a perinatalis szakban keletkező bizonyos állapotok miatt meghalt csecsemők száma emelkedett a leginkább, a nem gyógyintézeti halálozás esetében pedig a hirtelen csecsemőhalál szindrómában meghaltaké. Következtetés: 2019-ben kiugróan magas volt a nem gyógyintézeti, késői csecsemőhalálozás száma és részaránya, ezen esetek feltűnő regionális halmozódást mutattak. A csecsemőhalandóság csökkentésének hatásos eszköze lehetne a jövőben minden egyes csecsemőhalál részletes szakmai értékelése. Orv Hetil. 2021; 162(1): 830-838. SUMMARY INTRODUCTION In Hungary, infant mortality has been steadily declining since 2014, but in 2019 it increased by 11% compared to 2018. OBJECTIVE The aim of our study is to explore the possible components of the above increase. METHOD Ten-year trends of infant mortality were analized and compared by age, cause, place of deaths (hospital or non-hospital environment) and location, using Central Statistical Office data. RESULTS There were 304 infant deaths in Hungary in 2018 and 335 in 2019. Infant mortality rate rose from 3.4‰ to 3.8‰, however, it was in line with the expected value based on the curve fitted to the trend of previous decades. In 2019, 0-27-day infant mortality basically did not change compared to 2018, while the number of deaths at 28-364 days of age increased. Non-hospital infant mortality increased by 59% in 2019 and these cases accounted for 74% of the total increase in infant mortality; the vast majority of these deaths occurred in late infancy. There were fivefold regional differences in the number of non-hospital infant deaths. Among the causes of death, the conditions related to the perinatal period and sudden infant death syndrome increased the most. CONCLUSION In Hungary, the number and proportion of non-hospital infant mortality was remarkably high in 2019 compared to previous years. These cases showed a striking regional accumulation. An effective tool for reducing infant mortality could be an appropriate professional assessment of each infant death in the future. Orv Hetil. 2021; 162(21): 830-838.
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Affiliation(s)
- Andrea Valek
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Gyermekgyógyászati Klinika, Neonatológiai Tanszéki Csoport, Budapest, Bókay u. 53., 1083
| | | | - Lilla Erdei
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Gyermekgyógyászati Klinika, Neonatológiai Tanszéki Csoport, Budapest, Bókay u. 53., 1083
| | | | - Bea Pászthy
- 3 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Gyermekgyógyászati Klinika, Budapest
| | - Attila Szabó
- 3 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Gyermekgyógyászati Klinika, Budapest
| | - Miklós Szabó
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Gyermekgyógyászati Klinika, Neonatológiai Tanszéki Csoport, Budapest, Bókay u. 53., 1083
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Piltch-Loeb R, Bernard D, Quiñones Vallejo B, Harriman N, Savoia E. Engaging Community Leaders in Sharing Local Knowledge for Emergency Preparedness to Leverage Communication and Trusted Assets for Vulnerable Populations. Disaster Med Public Health Prep 2021;:1-7. [PMID: 34016210 DOI: 10.1017/dmp.2021.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Public health and emergency management agencies play a critical role in addressing the needs of vulnerable populations in preparation for and in response to emergencies. Identifying and leveraging community assets is a way to address such needs. This study focuses on the development of a process and tools to engage community leaders in sharing their knowledge about their community characteristics and assets useful for emergency planning. METHODS We conducted interviews with community leaders across five study sites with the goal of understanding what type of local knowledge community leaders are able to share in regard to emergency preparedness. Based on the interview results we developed and tested a mobile application as a mobile friendly directory of community assets. RESULTS We identified two main types of local knowledge about community assets for emergency preparedness: communication-based and trust-based local knowledge. We created an application to facilitate the sharing of such knowledge. Community leaders were able to share local knowledge across four areas: communication-based assets, trust-based assets, spatial-based assets and personal-preparedness assets. CONCLUSION Community leaders' engagement in preparedness efforts is important to identify community assets that can be leveraged to address the needs of the most vulnerable segments of a community.
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Reistetter TA, Eschbach K, Prochaska J, Jupiter DC, Hong I, Haas AM, Ottenbacher KJ. Understanding Variation in Postacute Care: Developing Rehabilitation Service Areas Through Geographic Mapping. Am J Phys Med Rehabil 2021; 100:465-472. [PMID: 32858537 PMCID: PMC8262929 DOI: 10.1097/phm.0000000000001577] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of the study were to demonstrate a method for developing rehabilitation service areas and to compare service areas based on postacute care rehabilitation admissions to service areas based on acute care hospital admissions. DESIGN We conducted a secondary analysis of 2013-2014 Medicare records for older patients in Texas (N = 469,172). Our analysis included admission records for inpatient rehabilitation facilities, skilled nursing facilities, long-term care hospitals, and home health agencies. We used Ward's algorithm to cluster patient ZIP Code Tabulation Areas based on which facilities patients were admitted to for rehabilitation. For comparison, we set the number of rehabilitation clusters to 22 to allow for comparison to the 22 hospital referral regions in Texas. Two methods were used to evaluate rehabilitation service areas: intraclass correlation coefficient and variance in the number of rehabilitation beds across areas. RESULTS Rehabilitation service areas had a higher intraclass correlation coefficient (0.081 vs. 0.076) and variance in beds (27.8 vs. 21.4). Our findings suggest that service areas based on rehabilitation admissions capture has more variation than those based on acute hospital admissions. CONCLUSIONS This study suggests that the use of rehabilitation service areas would lead to more accurate assessments of rehabilitation geographic variations and their use in understanding rehabilitation outcomes.
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Affiliation(s)
- Timothy A Reistetter
- From the Department of Occupational Therapy, University of Texas Health Science Center at San Antonio, School of Health Professions, San Antonio, Texas (TAR); Department of Preventive Medicine and Population Health, University of Texas Medical Branch, School of Medicine, Galveston, Texas (KE, JP, DCJ, AMH); Department of Occupational Therapy, Yonsei University, College of Health Sciences, Gangwon-do, Republic of Korea (IH); and Division of Rehabilitation Sciences, University of Texas Medical Branch, School of Health Professions, Galveston, Texas (KJO)
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Rickless DS, Wilt GE, Sharpe JD, Molinari N, Stephens W, LeBlanc TT. Social Vulnerability and Access of Local Medical Care During Hurricane Harvey: A Spatial Analysis. Disaster Med Public Health Prep 2021; 17:e12. [PMID: 33720000 DOI: 10.1017/dmp.2020.421] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES When Hurricane Harvey struck the coastline of Texas in 2017, it caused 88 fatalities and over US $125 billion in damage, along with increased emergency department visits in Houston and in cities receiving hurricane evacuees, such as the Dallas-Fort Worth metroplex (DFW).This study explored demographic indicators of vulnerability for patients from the Hurricane Harvey impact area who sought medical care in Houston and in DFW. The objectives were to characterize the vulnerability of affected populations presenting locally, as well as those presenting away from home, and to determine whether more vulnerable communities were more likely to seek medical care locally or elsewhere. METHODS We used syndromic surveillance data alongside the Centers for Disease Control and Prevention Social Vulnerability Index to calculate the percentage of patients seeking care locally by zip code tabulation area. We used this variable to fit a spatial lag regression model, controlling for population density and flood extent. RESULTS Communities with more patients presenting for medical care locally were significantly clustered and tended to have greater socioeconomic vulnerability, lower household composition vulnerability, and more extensive flooding. CONCLUSIONS These findings suggest that populations remaining in place during a natural disaster event may have needs related to income, education, and employment, while evacuees may have more needs related to age, disability, and single-parent household status.
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Benton B, Watson D, Ablah E, Lightwine K, Lusk R, Okut H, Bui T, Haan JM. Demographics and Incident Location of Gunshot Wounds at a Single Level I Trauma Center. Kans J Med 2021; 14:31-37. [PMID: 33654540 PMCID: PMC7889073 DOI: 10.17161/kjm.vol1413772] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/23/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Kansas has seen a steady increase in the rate of firearm deaths and injuries. Little is known surrounding the demographic and geospatial factors of these firearm-related traumas. The purpose of this study was to describe the overall incidence of firearm-related traumas, identify high injury locations, and examine any racial/ethnic disparities that may exist. Methods A retrospective review was conducted of all patients 14 years or older who were admitted with a gunshot wound (GSW) to a Level I trauma center between 2016 and 2017. Results Forty-nine percent of patients were Caucasian, 26.5% African American, and 19.6% Hispanic/Latino. Hispanic/Latino patients were the youngest (25.8 ± 8.8 years) and Caucasians were the oldest (34.3 ± 14.1 years, p = 0.002). Compared to Caucasian patients, African American (42.0%) and Hispanic/Latino (54.1%) patients were more likely to be admitted to the intensive care unit (ICU; p = 0.034) and experienced longer ICU lengths of stay (2.5 ± 6.3 and 2.4 ± 4.7 days, p = 0.031, respectively). African American patients (96.0%) experienced more assaults, while Caucasians were more likely to receive gunshot wounds accidentally (26.9%, p = 0.001). More African American (86.0%) and Hispanic/Latino (89.2%) patients were injured with a handgun and Caucasians sustained the highest percentage of shotgun/rifle related injuries (16.1%, p = 0.012). Most GSWs occurred in zip codes 67202, 67203, 67213, 67211, and 67214. Geographical maps indicated that GSWs occur in neighborhoods with low-income and high minority residents and in the downtown and nightclub areas of the city. Conclusions Most GSW victims were older Caucasian males. Racial differences were noted and injury locations concentrated in certain locations.
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Affiliation(s)
- Blair Benton
- Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - David Watson
- Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Elizabeth Ablah
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Kelly Lightwine
- Ascension Via Christi Hospital on St. Francis, Department of Trauma Services, Wichita, KS
| | - Ronda Lusk
- Ascension Via Christi Hospital on St. Francis, Department of Trauma Services, Wichita, KS
| | - Hayrettin Okut
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Thuy Bui
- University of Kansas School of Medicine-Wichita, Department of Pediatrics, Wichita, KS
| | - James M Haan
- Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS.,Ascension Via Christi Hospital on St. Francis, Department of Trauma Services, Wichita, KS
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Watson D, Benton B, Ablah E, Lightwine K, Lusk R, Okut H, Bui T, Haan JM. Demographics and Incident Location of Traumatic Injuries at a Single Level I Trauma Center. Kans J Med 2021; 14:5-11. [PMID: 33643521 PMCID: PMC7833984 DOI: 10.17161/kjm.vol1413771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/29/2020] [Accepted: 10/21/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Traumatic injuries are preventable and understanding determinants of injury, such as socio-economic and environmental factors, is vital. This study evaluated traumatic injuries and identified areas of high trauma incidence. Methods A retrospective review was conducted of all patients 14 years or older who were admitted with a traumatic injury to a Level I trauma center between 2016 and 2017. Descriptive analyses were presented and maps of high injury areas were generated. Results The most frequent mechanisms of injury were falls (58.3%), motor vehicle crashes (22.3%), and motorcycle crashes (5.7%). Fall patients were more likely to be female (59.6%) and were the oldest age group (72.1 ± 17.2) compared to motor vehicle and motorcycle crash patients. Severe head (22.1%, p = 0.007) and extremity (35.7%, p = 0.001) injuries were most frequent among fall patients, however, more motorcycle crash patients required mechanical ventilation (16.1%, p < 0.001) and experienced the longest intensive care unit length of stay (5.3 ± 6.8 days, p < 0.001) and mechanical ventilation days (6.6 ± 8.5, p < 0.036). Motorcycle crash patients also had the greatest number of deaths (7.5%, p < 0.001). The generated maps of all traumas suggested that most injuries occur near our hospital and are located in several of the most population-dense zip codes. Conclusion Patient demographics, injury severity, and hospital outcomes varied by mechanisms of injury. Traumatic injuries occurred near our hospital and were located in several of the most populationdense zip codes. Injury prevention efforts should target high incident areas.
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Affiliation(s)
- David Watson
- Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Blair Benton
- Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Elizabeth Ablah
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Kelly Lightwine
- Ascension Via Christi Hospital on St. Francis, Department of Trauma Services, Wichita, KS
| | - Ronda Lusk
- Ascension Via Christi Hospital on St. Francis, Department of Trauma Services, Wichita, KS
| | - Hayrettin Okut
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Thuy Bui
- Department of Pediatrics, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - James M Haan
- Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS.,Ascension Via Christi Hospital on St. Francis, Department of Trauma Services, Wichita, KS
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Do Q, Marc D, Plotkin M, Pickering B, Herasevich V. Starter Kit for Geotagging and Geovisualization in Health Care: Resource Paper. JMIR Form Res 2020; 4:e23379. [PMID: 33361054 PMCID: PMC7790608 DOI: 10.2196/23379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/10/2020] [Revised: 10/08/2020] [Accepted: 11/07/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Geotagging is the process of attaching geospatial tags to various media data types. In health care, the goal of geotagging is to gain a better understanding of health-related questions applied to populations. Although there has been a prevalence of geographic information in public health, in order to effectively use and expand geotagging across health care there is a requirement to understand other factors such as the disposition, standardization, data sources, technologies, and limitations. OBJECTIVE The objective of this document is to serve as a resource for new researchers in the field. This report aims to be comprehensive but easy for beginners to understand and adopt in practice. The optimal geocodes, their sources, and a rationale for use are suggested. Geotagging's issues and limitations are also discussed. METHODS A comprehensive review of technical instructions and articles was conducted to evaluate guidelines for geotagging, and online resources were curated to support the implementation of geotagging practices. Summary tables were developed to describe the available geotagging resources (free and for fee) that can be leveraged by researchers and quality improvement personnel to effectively perform geospatial analyses primarily targeting US health care. RESULTS This paper demonstrated steps to develop an initial geotagging and geovisualization project with clear structure and instructions. The geotagging resources were summarized. These resources are essential for geotagging health care projects. The discussion section provides better understanding of geotagging's limitations and suggests suitable way to approach it. CONCLUSIONS We explain how geotagging can be leveraged in health care and offer the necessary initial resources to obtain geocodes, adjustment data, and health-related measures. The resources outlined in this paper can support an individual and/or organization in initiating a geotagging health care project.
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Affiliation(s)
- Quan Do
- Mayo Clinic, Rochester, MN, United States
| | - David Marc
- College of St Scholastica, Duluth, MN, United States
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Moodley Y, Moodley VM, Mashele SS, Kiran RP, Madiba TE. Geospatial distribution of severe paediatric intussusception in KwaZulu-Natal province, South Africa. Pan Afr Med J 2020; 36:320. [PMID: 33193974 PMCID: PMC7603819 DOI: 10.11604/pamj.2020.36.320.19814] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 12/12/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction intussusception in South African (SA) children is often severe. A proportion of cases require management at quaternary hospitals which are a scare resource in SA. A geospatial investigation of severe paediatric intussusception (SPI) in the KwaZulu-Natal (KZN) province of SA would assist with identifying regions which should be targeted for preventative interventions. This could reduce resource utilisation for this condition at quaternary hospitals. The objective of this study was to determine the geospatial distribution of SPI in KZN. Methods this was a retrospective analysis of data for patients with SPI who were admitted to a quaternary hospital in KZN over an 11-year period. Data related to patient demographics, duration of hospitalization, surgical intervention, inpatient mortality and residential postal code were extracted from the electronic hospital admissions system. Each residential postal code was linked to a corresponding KZN district municipality. Descriptive statistical methods were used to determine the distribution of various characteristics in the study sample. Semi-quantitative geospatial analysis was used to determine the distribution of patients with SPI in each KZN district municipality. Results the study sample consisted of 182 patients with SPI. Most patients were <1 year old (83.5%), male (51.1%) and black African (87.9%). All patients underwent surgical intervention. Inpatient mortality was 2.7%. The majority of patients in the study sample resided in the eThekwini and King Cetshwayo district municipalities (51.1% and 14.8%, respectively). Conclusion preventative interventions for SPI should be considered for rollout in the eThekwini and King Cetshwayo district municipalities of KZN, SA.
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Affiliation(s)
- Yoshan Moodley
- Faculty of Health and Environmental Sciences, Central University of Technology, Bloemfontein, South Africa
| | | | - Sitheni Samson Mashele
- Faculty of Health and Environmental Sciences, Central University of Technology, Bloemfontein, South Africa
| | - Ravi Pokala Kiran
- Columbia University Medical Center and Mailman School of Public Health, New York, USA
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Brasil-Barros-da-Silva D, Fachin-Martins E. Pain mapping and health-related conditions in relation to forearm crutch usage: A cross-sectional study. Assist Technol 2020; 34:334-340. [PMID: 32897845 DOI: 10.1080/10400435.2020.1819914] [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: 10/23/2022] Open
Abstract
To explore pain complaints and health-related conditions, verifying if permanent or temporary usage of forearm crutches could be associated with them. We designed a cross-sectional study from a sample who answered a five-month public call. We organized data into five domains: (1) diseases, signs and symptoms; (2) personal factors related to age, sex, marital status, and paid occupation; (3) body structure and functional components defined by body mass index, arterial pressure, mental state, and pain; (4) activities and participation assessed by satisfaction with Assistive Technology; (5) and environmental factors focused on medicines and forearm crutch usage. The sample was geo-referenced by address, and the frequency of the codified health conditions was distributed according to ICD-10's chapters. We recruited three times more permanent than temporary users dealing with chronic and external causes of diseases. Pain mapping suggested different pattern of complaints between permanent and temporary users. Women who were temporary users seemed more likely to be injured because of external causes. Moreover, both users reported intense (31%) and moderate (53%) levels of pain. In contrast, mild pains were only reported by permanent users (16%), suggesting a distinction between acute and chronic pain according to the kind of forearm crutch usage.
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Affiliation(s)
| | - Emerson Fachin-Martins
- NTAAI - Núcleo De Tecnologia Assistiva, Acessibilidade E Inovação, Universidade De Brasília, Brasília, Brazil
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de Oliveira SIM, de Oliveira Saraiva COP, de França DF, Ferreira Júnior MA, de Melo Lima LH, de Souza NL. Syphilis Notifications and the Triggering Processes for Vertical Transmission: A Cross-Sectional Study. Int J Environ Res Public Health 2020; 17:ijerph17030984. [PMID: 32033272 PMCID: PMC7037822 DOI: 10.3390/ijerph17030984] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/20/2019] [Accepted: 12/04/2019] [Indexed: 12/14/2022]
Abstract
Syphilis is a disease that is found all over the world that causes damaging effects to the fetus through vertical transmission. This study aimed to analyze the processes that trigger the vertical transmission of syphilis through gestational and congenital syphilis notifications. It is a cross-sectional study. The sample totaled 129 notifications of syphilis in pregnant women and 132 notifications of congenital syphilis in the city of Natal, from 2011 to 2015. Data were obtained from the Information System for Disease Notification. The Chi-square, Student's and Fisher's tests were used to verify associations of interest. Diagnosis of maternal syphilis was predominant in the third trimester of pregnancy. Only 1.6% of the pregnant women were registered with an adequate treatment regimen, of these 16.3% had the concomitant treatment with their partners. Of the affected children, 78.8% were registered as asymptomatic. The factors that trigger vertical transmission are related to the late diagnosis of the pregnant woman and sexual partner(s) and the deficiencies in clinical/therapeutic management in relation to the phase of the disease. Strategies of professional training should be adopted to notify and expand the provision of information for epidemiological surveillance, aiming to strengthen care, reduce vertical transmission and enable the continuous analysis of this problem.
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Affiliation(s)
- Samara Isabela Maia de Oliveira
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
- Correspondence: ; Tel.: +55-084-3215-3615
| | - Cecília Olívia Paraguai de Oliveira Saraiva
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
| | - Débora Feitosa de França
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
| | - Marcos Antônio Ferreira Júnior
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
- Department of Nursing, Integrated Institute of Health of Federal University of Mato Grosso do Sul, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Libna Helen de Melo Lima
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
- Department of Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil
| | - Nilba Lima de Souza
- Department of Nursing, Post-Graduate Program in Nursing, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; (C.O.P.d.O.S.); (D.F.d.F.); (M.A.F.J.); (L.H.d.M.L.); (N.L.d.S.)
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Abstract
A comprehensive understanding of the geographic distribution of the tick-borne encephalitis virus (TBEV) complex is necessary due to increasing transboundary movement and cross-reactivity of serological tests. This review was conducted to identify the geographic distribution of the TBEV complex, including TBE virus, Alkhurma haemorrhagic fever virus, Kyasanur forest disease virus, louping-ill virus, Omsk haemorrhagic fever virus, and Powassan virus. Published reports were identified using PubMed, EMBASE, and the Cochrane library. In addition to TBEV complex case-related studies, seroprevalence studies were also retrieved to assess the risk of TBEV complex infection. Among 1406 search results, 314 articles met the inclusion criteria. The following countries, which are known to TBEV epidemic region, had conducted national surveillance studies: Austria, China, Czech, Denmark, Estonia, Finland, Germany, Hungary, Italy, Latvia, Norway, Poland, Romania, Russia, Switzerland, Sweden, Slovenia, and Slovakia. There were also studies/reports on human TBEV infection from Belarus, Bulgaria, Croatia, France, Japan, Kyrgyzstan, Netherland, and Turkey. Seroprevalence studies were found in some areas far from the TBEV belt, specifically Malaysia, Comoros, Djibouti, and Kenya. Kyasanur forest disease virus was reported in southwestern India and Yunnan of China, the Powassan virus in the United States, Canada, and east Siberia, Alkhurma haemorrhagic fever virus in Saudi Arabia and east Egypt, and Louping-ill virus in the United Kingdom, Ireland, and east Siberia. In some areas, the distribution of the TBEV complex overlaps with that of other viruses, and caution is recommended during serologic diagnosis. The geographic distribution of the TBEV complex appears to be wide and overlap of the TBE virus complex with other viruses was observed in some areas. Knowledge of the geographical distribution of the TBEV complex could help avoid cross-reactivity during the serologic diagnosis of these viruses. Surveillance studies can implement effective control measures according to the distribution pattern of these viruses.
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Affiliation(s)
- Jae Hyoung Im
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Ji-Hyeon Baek
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Areum Durey
- Department of Emergency Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Hea Yoon Kwon
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Moon-Hyun Chung
- Department of Internal Medicine, Seogwipo Medical Center, Jeju-do, Republic of Korea
| | - Jin-Soo Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea
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Abstract
Purpose: In this cross-sectional study, we examined the distribution of physiotherapists at the health region level across Canada in relation to self-reported physiotherapy use across the provinces and territories. Method: We drew on two data sources: the physiotherapy use question from the 2014 Canadian Community Health Survey and physiotherapists' primary employment information, obtained from the Canadian Institute of Health Information's 2015 Physiotherapist Database. We then applied geospatial mapping and Pearson's correlation analysis to the resulting variables. Results: Physiotherapy use is moderately associated with the distribution of physiotherapists (Pearson's r 92 = 0.581, p < 0.001). The use and distribution variables were converted into three categories using SDs of 0.5 from national means as cut-off values. Cross-classification between the variables revealed that 15.2% of health regions have a high use-high distribution ratio; 18.5% have a low use-low distribution ratio; 4.3% have a high use-low distribution ratio; 2.2% have a low use-high distribution ratio; and 60.0% have medium use-medium distribution ratio. Conclusions: The distribution of physiotherapists and self-reported physiotherapy use varies across health regions, indicating a potential inequality in geographical access. Given that most provinces have a regionalized approach to health human resources and health service delivery, these findings may be helpful to managers and policy-makers and may allow them to make a more granular comparison of intra- and inter-provincial differences and potential gaps.
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Affiliation(s)
| | | | - Catherine Trask
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Sask
| | - Brenna Bath
- School of Rehabilitation Science.,Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Sask
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Polling C, Bakolis I, Hotopf M, Hatch SL. Differences in hospital admissions practices following self-harm and their influence on population-level comparisons of self-harm rates in South London: an observational study. BMJ Open 2019; 9:e032906. [PMID: 31628133 PMCID: PMC6803107 DOI: 10.1136/bmjopen-2019-032906] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To compare the proportions of emergency department (ED) attendances following self-harm that result in admission between hospitals, examine whether differences are explained by severity of harm and examine the impact on spatial variation in self-harm rates of using ED attendance data versus admissions data. SETTING A dataset of ED attendances and admissions with self-harm to four hospitals in South East London, 2009-2016 was created using linked electronic patient record data and administrative Hospital Episode Statistics. DESIGN Proportions admitted following ED attendance and length of stay were compared. Variation and spatial patterning of age and sex standardised, spatially smoothed, self-harm rates by small area using attendance and admission data were compared and the association with distance travelled to hospital tested. RESULTS There were 20 750 ED attendances with self-harm, 7614 (37%) resulted in admission. Proportion admitted varied substantially between hospitals with a risk ratio of 2.45 (95% CI 2.30 to 2.61) comparing most and least likely to admit. This was not altered by adjustment for patient demographics, deprivation and type of self-harm. Hospitals which admitted more had a higher proportion of admissions lasting less than 24 hours (54% of all admissions at highest admitting hospital vs 35% at lowest). A previously demonstrated pattern of lower rates of self-harm admission closer to the city centre was reduced when ED attendance rates were used to represent self-harm. This was not altered when distance travelled to hospital was adjusted for. CONCLUSIONS Hospitals vary substantially in likelihood of admission after ED presentation with self-harm and this is likely due to the differences in hospital practices rather than in the patient population or severity of self-harm seen. Public health policy that directs resources based on self-harm admissions data could exacerbate existing health inequalities in inner-city areas where these data may underestimate rates relative to other areas.
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Affiliation(s)
- C Polling
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthew Hotopf
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Stephani L Hatch
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Rijks JM, Montizaan MGE, Bakker N, de Vries A, Van Gucht S, Swaan C, van den Broek J, Gröne A, Sprong H. Tick-Borne Encephalitis Virus Antibodies in Roe Deer, the Netherlands. Emerg Infect Dis 2019; 25:342-345. [PMID: 30666954 PMCID: PMC6346459 DOI: 10.3201/eid2502.181386] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To increase knowledge of tick-borne encephalitis virus (TBEV) circulation in the Netherlands, we conducted serosurveillance in roe deer (Capreolus capreolus) during 2017 and compared results with those obtained during 2010. Results corroborate a more widespread occurrence of the virus in 2017. Additional precautionary public health measures have been taken.
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Lindholm D, James S, Lagerqvist B, Hlatky MA, Varenhorst C. New Method for Assessing the Effect of Driving Distance to Hospital Care: Using OpenStreetMap Routing in Cardiovascular Research. Circ Cardiovasc Qual Outcomes 2019; 10:CIRCOUTCOMES.117.003850. [PMID: 28844994 DOI: 10.1161/circoutcomes.117.003850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Daniel Lindholm
- From the Department of Medical Sciences, Cardiology (D.L., S.J., B.L., C.V.), and Uppsala Clinical Research Center (D.L., S.J., B.L., C.V.), Uppsala University, Sweden; and Department of Health Research and Policy, Stanford University School of Medicine, Stanford University, CA (D.L., M.A.H.).
| | - Stefan James
- From the Department of Medical Sciences, Cardiology (D.L., S.J., B.L., C.V.), and Uppsala Clinical Research Center (D.L., S.J., B.L., C.V.), Uppsala University, Sweden; and Department of Health Research and Policy, Stanford University School of Medicine, Stanford University, CA (D.L., M.A.H.)
| | - Bo Lagerqvist
- From the Department of Medical Sciences, Cardiology (D.L., S.J., B.L., C.V.), and Uppsala Clinical Research Center (D.L., S.J., B.L., C.V.), Uppsala University, Sweden; and Department of Health Research and Policy, Stanford University School of Medicine, Stanford University, CA (D.L., M.A.H.)
| | - Mark A Hlatky
- From the Department of Medical Sciences, Cardiology (D.L., S.J., B.L., C.V.), and Uppsala Clinical Research Center (D.L., S.J., B.L., C.V.), Uppsala University, Sweden; and Department of Health Research and Policy, Stanford University School of Medicine, Stanford University, CA (D.L., M.A.H.)
| | - Christoph Varenhorst
- From the Department of Medical Sciences, Cardiology (D.L., S.J., B.L., C.V.), and Uppsala Clinical Research Center (D.L., S.J., B.L., C.V.), Uppsala University, Sweden; and Department of Health Research and Policy, Stanford University School of Medicine, Stanford University, CA (D.L., M.A.H.)
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Gexha Bunjaku D, Deva E, Gashi L, Kaçaniku-Gunga P, Comins CA, Emmanuel F. Programmatic Mapping to Estimate Size, Distribution, and Dynamics of Key Populations in Kosovo. JMIR Public Health Surveill 2019; 5:e11194. [PMID: 30835241 PMCID: PMC6423465 DOI: 10.2196/11194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/23/2018] [Accepted: 11/09/2018] [Indexed: 02/03/2023] Open
Abstract
Background The burden of an HIV epidemic in Kosovo lies among the key populations (KPs) of female sex workers (FSWs), men who have sex with men (MSM), and people who inject drugs (PWIDs). The available interventions for KPs are fragmented and lack sufficient and appropriate granularity of information needed to develop large-scale outreach programs. Objective The aim of this study was to estimate the size and distribution of these populations to create evidence for developing action plans for HIV prevention. Methods The programmatic mapping approach was used to collect systematic information from key informants, including geographic and virtual locations in 26 municipalities of Kosovo between February to April 2016. In level 1, information was gathered about KPs’ numbers and locations through 1537 key informant interviews within each municipality. Level 2 involved validating these spots by conducting another 976 interviews with KPs congregating at those spots. Population size estimates were calculated for each spot, and finally a national-level estimate was developed, which was corrected for duplication and overlaps. Results Of the estimated 6814 MSM (range: 6445 to 7117), nearly 4940 operate through the internet owing to the large stigma and discrimination against same-sex relationships. Geo-based MSM (who operate through physical spots) congregate at a few spots with large spot sizes (13.3 MSM/spot). Three-fourths of the MSM are distributed in 5 major municipalities. Fridays and Saturdays are the peak days of operation; however, the number only increases by 5%. A significant number are involved in sex work, that is, provide sex to other men for money. PWIDs are largely geo-based; 4973 (range: 3932 to 6015) PWIDs of the total number of 5819 (range: 4777 to 6860) visit geographical spots, with an average spot size of 7.1. In smaller municipalities, they mostly inject in residential locations. The numbers stay stable during the entire week, and there are no peak days. Of the 5037 (range: 4213 to 5860) FSWs, 20% use cell phones, whereas 10% use websites to connect with clients. The number increases by 25% on weekends, especially in larger municipalities where sex work is mostly concentrated. Other than a few street-based spots, most spots are establishments run by pimps, which is reflective of the highly institutionalized, structured, and organized FSW network. Conclusions This study provides valuable information about the population size estimates as well as dynamics of each KP, which is the key to developing effective HIV prevention strategies. The information should be utilized to develop microplans and effectively provide HIV prevention services to various KPs.
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Affiliation(s)
- Dafina Gexha Bunjaku
- National Institute of Public Health, Department of Epidemiolo, Pristina, Kosovo, Albania
| | - Edona Deva
- Community Development Fund, Kosovo, Albania
| | - Luljeta Gashi
- National Institute of Public Health, Department of Epidemiolo, Pristina, Kosovo, Albania
| | | | - Carly A Comins
- Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Faran Emmanuel
- Centre for Global Public Health, University of Manitoba, Winnipeg, MB, Canada
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Paireau J, Pelat C, Caserio-Schönemann C, Pontais I, Le Strat Y, Lévy-Bruhl D, Cauchemez S. Mapping influenza activity in emergency departments in France using Bayesian model-based geostatistics. Influenza Other Respir Viruses 2018; 12:772-779. [PMID: 30055089 PMCID: PMC6185885 DOI: 10.1111/irv.12599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 04/17/2018] [Revised: 07/09/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Maps of influenza activity are important tools to monitor influenza epidemics and inform policymakers. In France, the availability of a high-quality data set from the Oscour® surveillance network, covering 92% of hospital emergency department (ED) visits, offers new opportunities for disease mapping. Traditional geostatistical mapping methods such as Kriging ignore underlying population sizes, are not suited to non-Gaussian data and do not account for uncertainty in parameter estimates. OBJECTIVE Our objective was to create reliable weekly interpolated maps of influenza activity in the ED setting, to inform Santé publique France (the French national public health agency) and local healthcare authorities. METHODS We used Oscour® data of ED visits covering the 2016-2017 influenza season. We developed a Bayesian model-based geostatistical approach, a class of generalized linear mixed models, with a multivariate normal random field as a spatially autocorrelated random effect. Using R-INLA, we developed an algorithm to create maps of the proportion of influenza-coded cases among all coded visits. We compared our results with maps obtained by Kriging. RESULTS Over the study period, 45 565 (0.82%) visits were coded as influenza cases. Maps resulting from the model are presented for each week, displaying the posterior mean of the influenza proportion and its associated uncertainty. Our model performed better than Kriging. CONCLUSIONS Our model allows producing smoothed maps where the random noise has been properly removed to reveal the spatial risk surface. The algorithm was incorporated into the national surveillance system to produce maps in real time and could be applied to other diseases.
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Affiliation(s)
- Juliette Paireau
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France.,Centre National de la Recherche Scientifique, UMR2000: Génomique évolutive, modélisation et santé (GEMS), Paris, France.,Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, Paris, France
| | - Camille Pelat
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | | | - Isabelle Pontais
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | - Yann Le Strat
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | - Daniel Lévy-Bruhl
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France.,Centre National de la Recherche Scientifique, UMR2000: Génomique évolutive, modélisation et santé (GEMS), Paris, France.,Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, Paris, France
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Stephens JM, Bensink M, Bowers C, Hollenbeak CS. Travel burden associated with granulocyte colony-stimulating factor administration in a Medicare aged population: a geospatial analysis. Curr Med Res Opin 2018; 34:1351-1360. [PMID: 28722536 DOI: 10.1080/03007995.2017.1358158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Prophylaxis with granulocyte colony-stimulating factors (G-CSFs) is recommended for patients receiving myelosuppressive chemotherapy regimens with a high risk of febrile neutropenia (FN). G-CSFs should be administered starting the day after chemotherapy, necessitating return trips to the oncology clinic at the end of each cycle. We examined the travel burden related to prophylactic G-CSF injections after chemotherapy in the US. METHODS We used 2012-2014 Medicare claims data to identify a national cohort of beneficiaries age 65+ with non-myeloid cancers who received both chemotherapy and prophylactic G-CSFs. Patient travel origin was based on residence ZIP code. Oncologist practice locations and hospital addresses were obtained from the Medicare Physician Compare and Hospital Compare websites and geocoded using the Google Maps Application Programming Interface (API). Driving distance and time to the care site from each patient ZIP code tabulation area (ZCTA) were calculated using Open Street Maps road networks. Geographic and socio-economic characteristics of each ZCTA from the US Census Bureau's American Community Survey were used to stratify and analyze travel estimates. RESULTS The mean one-way driving distance to the G-CSF provider was 23.8 (SD 30.1) miles and the mean one-way driving time was 33.3 (SD 37.8) minutes. When stratified by population density, the mean one-way travel time varied from 12.1 (SD 10.1) minutes in Very Dense Urban areas to 76.7 (SD 72.1) minutes in Super Rural areas. About 48% of patients had one-way travel times of <20 minutes, but 19% of patients traveled ≥50 minutes one way for G-CSF prophylaxis. Patients in areas with above average concentrations of aged, poor or disabled residents were more likely to experience longer travel. CONCLUSIONS Administration of G-CSF therapy after chemotherapy can present a significant travel burden for cancer patients. Technological improvements in the form and methods of drug delivery for G-CSFs might significantly reduce this travel burden.
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Artois J, Jiang H, Wang X, Qin Y, Pearcy M, Lai S, Shi Y, Zhang J, Peng Z, Zheng J, He Y, Dhingra MS, von Dobschuetz S, Guo F, Martin V, Kalpravidh W, Claes F, Robinson T, Hay SI, Xiao X, Feng L, Gilbert M, Yu H. Changing Geographic Patterns and Risk Factors for Avian Influenza A(H7N9) Infections in Humans, China. Emerg Infect Dis 2018; 24:87-94. [PMID: 29260681 PMCID: PMC5749478 DOI: 10.3201/eid2401.171393] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The fifth epidemic wave of avian influenza A(H7N9) virus in China during 2016–2017 demonstrated a geographic range expansion and caused more human cases than any previous wave. The factors that may explain the recent range expansion and surge in incidence remain unknown. We investigated the effect of anthropogenic, poultry, and wetland variables on all epidemic waves. Poultry predictor variables became much more important in the last 2 epidemic waves than they were previously, supporting the assumption of much wider H7N9 transmission in the chicken reservoir. We show that the future range expansion of H7N9 to northern China may increase the risk of H7N9 epidemic peaks coinciding in time and space with those of seasonal influenza, leading to a higher risk of reassortments than before, although the risk is still low so far.
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Matos AMF, Coelho ACO, Araújo LPT, Alves MJM, Baquero OS, Duthie MS, Teixeira HC. Assessing epidemiology of leprosy and socio-economic distribution of cases. Epidemiol Infect 2018; 146:1750-5. [PMID: 29976268 DOI: 10.1017/S0950268818001814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Leprosy still represents a serious health problem in a number of countries, including Brazil. Although leprosy has been associated with poverty for a long time, it is still difficult to accurately define this relationship. Here, we evaluated in an endemic municipality the progress from 1995 to 2015 of epidemiological indicators to establish if there were any strong associations between social indicators and the occurrence of leprosy. An ecological study was conducted using the SINAN database (Brazilian leprosy-national notifiable diseases information system) in combination with georeferencing of leprosy cases. The georeferencing used the ArcGis programme and occurrence of cases was evaluated in relation to the Health Vulnerability Index (HVI), an indicator that categorises socio-economic and sanitation factors. The data identified a marked decrease in the overall prevalence of leprosy, a reduction in the new case-detection rate and a reduction in the number of cases with grade 2 disabilities (albeit with transient peaks in 2007 and 2015). Logistic regression analysis showed association of detection rates with elevated HVI. Thus, while the epidemiological indicators point to the elimination of leprosy, there is evidence of hidden cases and an association between higher rates of leprosy detection and greater social vulnerability remain.
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Quinn E, Hsiao K, Truman G, Rose N, Broome R. Lessons Learnt From Exercise Celestial Navigation: The Application of a Geographic Information System to Inform Legionnaires' Disease Control Activity. Disaster Med Public Health Prep 2019; 13:372-4. [PMID: 29716666 DOI: 10.1017/dmp.2018.40] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Geographic information systems (GIS) have emerged in the past few decades as a technology capable of assisting in the control of infectious disease outbreaks. A Legionnaires' disease cluster investigation in May 2016 in Sydney, New South Wales (NSW), Australia, demonstrated the importance of using GIS to identify at-risk water sources in real-time for field investigation to help control any immediate environmental health risk, as well as the need for more staff trained in the use of this technology. Sydney Local Health District Public Health Unit (PHU) subsequently ran an exercise (based on this investigation) with 11 staff members from 4 PHUs across Sydney to further test staff capability to use GIS across NSW. At least 80% of exercise participants reported that the scenario progression was realistic, assigned tasks were clear, and sufficient data were provided to complete tasks. The exercise highlighted the multitude of geocoding applications and need for inter-operability of systems, as well as the need for trained staff with specific expertise in spatial analysis to help assist in outbreak control activity across NSW. Evaluation data demonstrated the need for a common GIS, regular education and training, and guidelines to support the collaborative use of GIS for infectious disease epidemiology in NSW. (Disaster Med Public Health Preparedness. 2019;13:372-374).
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King JM, Tiwari C, Mikler AR, O'Neill M. Challenges of Designing and Implementing High Consequence Infectious Disease Response. Disaster Med Public Health Prep 2018; 12:563-6. [PMID: 29552993 DOI: 10.1017/dmp.2017.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Ebola is a high consequence infectious disease-a disease with the potential to cause outbreaks, epidemics, or pandemics with deadly possibilities, highly infectious, pathogenic, and virulent. Ebola's first reported cases in the United States in September 2014 led to the development of preparedness capabilities for the mitigation of possible rapid outbreaks, with the Centers for Disease Control and Prevention (CDC) providing guidelines to assist public health officials in infectious disease response planning. These guidelines include broad goals for state and local agencies and detailed information concerning the types of resources needed at health care facilities. However, the spatial configuration of populations and existing health care facilities is neglected. An incomplete understanding of the demand landscape may result in an inefficient and inequitable allocation of resources to populations. Hence, this paper examines challenges in implementing CDC's guidance for Ebola preparedness and mitigation in the context of geospatial allocation of health resources and discusses possible strategies for addressing such challenges. (Disaster Med Public Health Preparedness. 2018;12:563-566).
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Rudolph A, Tobin K, Rudolph J, Latkin C. Web-Based Survey Application to Collect Contextually Relevant Geographic Data With Exposure Times: Application Development and Feasibility Testing. JMIR Public Health Surveill 2018; 4:e12. [PMID: 29351899 PMCID: PMC5797287 DOI: 10.2196/publichealth.8581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/03/2017] [Indexed: 11/16/2022] Open
Abstract
Background Although studies that characterize the risk environment by linking contextual factors with individual-level data have advanced infectious disease and substance use research, there are opportunities to refine how we define relevant neighborhood exposures; this can in turn reduce the potential for exposure misclassification. For example, for those who do not inject at home, injection risk behaviors may be more influenced by the environment where they inject than where they live. Similarly, among those who spend more time away from home, a measure that accounts for different neighborhood exposures by weighting each unique location proportional to the percentage of time spent there may be more correlated with health behaviors than one’s residential environment. Objective This study aimed to develop a Web-based application that interacts with Google Maps application program interfaces (APIs) to collect contextually relevant locations and the amount of time spent in each. Our analysis examined the extent of overlap across different location types and compared different approaches for classifying neighborhood exposure. Methods Between May 2014 and March 2017, 547 participants enrolled in a Baltimore HIV care and prevention study completed an interviewer-administered Web-based survey that collected information about where participants were recruited, worked, lived, socialized, injected drugs, and spent most of their time. For each location, participants gave an address or intersection which they confirmed using Google Map and Street views. Geographic coordinates (and hours spent in each location) were joined to neighborhood indicators by Community Statistical Area (CSA). We computed a weighted exposure based on the proportion of time spent in each unique location. We compared neighborhood exposures based on each of the different location types with one another and the weighted exposure using analysis of variance with Bonferroni corrections to account for multiple comparisons. Results Participants reported spending the most time at home, followed by the location where they injected drugs. Injection locations overlapped most frequently with locations where people reported socializing and living or sleeping. The least time was spent in the locations where participants reported earning money and being recruited for the study; these locations were also the least likely to overlap with other location types. We observed statistically significant differences in neighborhood exposures according to the approach used. Overall, people reported earning money in higher-income neighborhoods and being recruited for the study and injecting in neighborhoods with more violent crime, abandoned houses, and poverty. Conclusions This analysis revealed statistically significant differences in neighborhood exposures when defined by different locations or weighted based on exposure time. Future analyses are needed to determine which exposure measures are most strongly associated with health and risk behaviors and to explore whether associations between individual-level behaviors and neighborhood exposures are modified by exposure times.
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Affiliation(s)
- Abby Rudolph
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Karin Tobin
- Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | | | - Carl Latkin
- Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
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Bidinotto DNPB, Simonetti JP, Bocchi SCM. Men's health: non-communicable chronic diseases and social vulnerability. Rev Lat Am Enfermagem 2016; 24:e2756. [PMID: 27533266 PMCID: PMC4996085 DOI: 10.1590/1518-8345.0735.2756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 01/19/2016] [Indexed: 03/15/2023] Open
Abstract
OBJECTIVES to evaluate the relationship between absences in scheduled appointments and the number of non-communicable chronic diseases and to investigate the relationship between spatial distribution of these diseases and social vulnerability, using geoprocessing. METHOD a quantitative study of sequential mixed approach by analyzing 158 medical records of male users to relate the absences and 1250 medical records for geoprocessing. RESULTS the higher the number of absences in the scheduled medical appointments, the less were the number of non-communicable chronic diseases and the ones listed in the International Classification of Diseases in single men. There were 21 significant geostatistically cases of glucose intolerance in the urban area. Of these, 62% lived in a region with a social vulnerability rating of Very Low, Medium 19%, 14% Low and 5% High. CONCLUSION it was observed that the older the men, the greater is the number of chronic diseases and the less they miss scheduled appointments. Regarding the use of geoprocessing, we obtained a significant number of cases of glucose intolerance in urban areas, the majority classified as Very Low social vulnerability. It was possible to relate the spatial distribution of these diseases with the social vulnerability classification; however, it was not possible to perceive a relationship of them with the higher rates of social vulnerability. OBJETIVOS avaliar a relação entre as faltas em consultas agendadas e o número de doenças crônicas não transmissíveis e averiguar a relação entre distribuição espacial dessas doenças e vulnerabilidade social, utilizando-se o geoprocessamento. MÉTODO estudo quantitativo, de abordagem mista sequencial, sendo analisados 158 prontuários de usuários do sexo masculino para se relacionar as faltas e 1250 prontuários para o geoprocessamento. RESULTADOS quanto maior o número de faltas nas consultas médicas agendadas, menores foram a quantidade de doenças crônicas não transmissíveis e as listadas na Classificação Internacional de Doenças em homens solteiros. Obtiveram-se 21 casos geoestatisticamente significantes de intolerância à glicose na zona urbana. Desses, 62% moravam em região com a classificação de vulnerabilidade social Muito Baixa, 19% Média, 14% Baixa e 5% Alta. CONCLUSÃO observou-se que quanto mais velhos os homens, maior é o número de doenças crônicas instaladas e menos eles faltam em consultas agendadas. Quanto ao uso do geoprocessamento, obteve-se número de casos significantes de intolerância à glicose na zona urbana, sendo a maioria classificada como vulnerabilidade social Muito Baixa. Pôde-se relacionar a distribuição espacial dessas doenças com a classificação de vulnerabilidade social, porém, não foi possível perceber uma relação delas com índices mais elevados de vulnerabilidade social. OBJETIVOS evaluar la relación entre las faltas en las citas programadas y el número de enfermedades crónicas y para investigar la relación entre la distribución espacial de estas enfermedades y la vulnerabilidad social, utilizando geoprocesamiento. MÉTODO estudio cuantitativo de enfoque mixto secuencial y siendo analizadas 158 historias clínicas de los usuarios masculinos para relacionar las faltas y 1250 registros de geoprocesamiento. RESULTADOS cuanto mayor eran el número de ausencias en las citas médicas programadas, menores fueron el número, para los hombres solteiros, de enfermedades crónicas y de las incluídas en la Clasificación Internacional de Enfermedades. Se obtuvieron 21 casos de intolerancia a la glucosa geoestadísticamente significativos en el área urbana. De éstos, el 62% viven en una región con calificación de vulnerabilidad social muy baja 19%, media, 14% baja y 5% Alta. CONCLUSIÓN se observó que cuanta mayor la edad de los hombres, mayor es el número de enfermedades crónicas instaladas y menos faltas en las citas programadas. Respecto al uso de geoprocesamiento, obtuvimos número significativo de casos de intolerancia a la glucosa en las zonas urbanas, la mayoría clasificada como vulnerabilidad social Muy baja. Se podría relacionarse la distribución espacial de estas enfermedades con la clasificación de la vulnerabilidad social, sin embargo, no fue posible ver una relación de esto con mayores tasas de vulnerabilidad social.
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Affiliation(s)
| | - Janete Pessuto Simonetti
- PhD, Assistant Professor, Faculdade de Medicina de Botucatu,
Universidade Estadual Paulista "Julio de Mesquita Filho", Botucatu, SP, Brazil
| | - Silvia Cristina Mangini Bocchi
- PhD, Assistant Professor, Faculdade de Medicina de Botucatu,
Universidade Estadual Paulista "Julio de Mesquita Filho", Botucatu, SP, Brazil
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Affiliation(s)
- Linda J Schieb
- From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
| | - Michele L Casper
- From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mary G George
- From the Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Ramos Herrera IM, Gonzalez Castañeda M, Robles J, Fonseca León J. Development of the Health Atlas of Jalisco: A New Web-Based Service for the Ministry of Health and the Community in Mexico. JMIR Public Health Surveill 2016; 2:e11. [PMID: 27227146 PMCID: PMC4869215 DOI: 10.2196/publichealth.5255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 12/12/2015] [Accepted: 01/03/2016] [Indexed: 11/13/2022] Open
Abstract
Background Maps have been widely used to provide a visual representation of information of a geographic area. Health atlases are collections of maps related to conditions, infrastructure or services provided. Various countries have put resources towards producing health atlases that support health decision makers to enhance their services to the communities. Latin America, as well as Spain, have produced several atlases of importance such as the interactive mortality atlas of Andalucía, which is very similar to the one that is presented in this paper. In Mexico, the National Institute of Public Health produced the only health atlas found that is of relevance. It was published online in 2003 and is currently still active. Objective The objective of this work is to describe the methods used to develop the Health Atlas of Jalisco (HAJ), and show its characteristics and how it interactively works with the user as a Web-based service. Methods This work has an ecological design in which the analysis units are the 125 municipalities (counties) of the state of Jalisco, Mexico. We created and published online a geographic health atlas displaying a system based on input from official health database of the Health Ministry of Jalisco (HMJ), and some databases from the National Institute of Statistics and Geography (NISGI). The atlas displays 256 different variables as health-direct or health-related indicators. Instant Atlas software was used to generate the online application. The atlas was developed using these procedures: (1) datasheet processing and base maps generation, (2) software arrangements, and (3) website creation. Results The HAJ is a Web-based service that allows users to interact with health and general data, regions, and categories according to their information needs and generates thematic maps (eg, the total population of the state or of a single municipality grouped by age or sex). The atlas is capable of displaying more than 32,000 different maps by combining categories, indicators, municipalities, and regions. Users can select the entire province, one or several municipalities, and the indicator they require. The atlas then generates and displays the requested map. Conclusions This atlas is a Web-based service that interactively allows users to review health indicators such as structure, supplies, processes, and the impact on public health and related sectors in Jalisco, Mexico. One of the main interests is to reduce the number of information requests that the Ministry of Health receives every week from the general public, media reporters, and other government sectors. The atlas will support transparency, information diffusion, health decision-making, and the formulation of new public policies. Furthermore, the research team intends to promote research and education in public health.
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Affiliation(s)
- Igor Martin Ramos Herrera
- Center of Research on Geographic Information Systems and Management in HealthDepartment of Public HealthUniversity of GuadalajaraGuadalajaraMexico
| | - Miguel Gonzalez Castañeda
- Center of Social Sciences and HumanitiesDepartment of Geography and Territorial OrderingUniversity of GuadalajaraGuadalajaraMexico
| | - Juan Robles
- Center of Social Sciences and HumanitiesDepartment of Geography and Territorial OrderingUniversity of GuadalajaraGuadalajaraMexico
| | - Joel Fonseca León
- Statistics analysis areaStatistics DepartmentMexican Institute of Social SecurityGuadalajaraMexico
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Foroughi F, Lam AKY, Lim MSC, Saremi N, Ahmadvand A. "Googling" for Cancer: An Infodemiological Assessment of Online Search Interests in Australia, Canada, New Zealand, the United Kingdom, and the United States. JMIR Cancer 2016; 2:e5. [PMID: 28410185 PMCID: PMC5369660 DOI: 10.2196/cancer.5212] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 02/07/2016] [Accepted: 02/26/2016] [Indexed: 12/16/2022] Open
Abstract
Background The infodemiological analysis of queries from search engines to shed light on the status of various noncommunicable diseases has gained increasing popularity in recent years. Objective The aim of the study was to determine the international perspective on the distribution of information seeking in Google regarding “cancer” in major English-speaking countries. Methods We used Google Trends service to assess people’s interest in searching about “Cancer” classified as “Disease,” from January 2004 to December 2015 in Australia, Canada, New Zealand, the United Kingdom, and the United States. Then, we evaluated top cities and their relative search volumes (SVs) and country-specific “Top searches” and “Rising searches.” We also evaluated the cross-country correlations of SVs for cancer, as well as rank correlations of SVs from 2010 to 2014 with the incidence of cancer in 2012 in the abovementioned countries. Results From 2004 to 2015, the United States (relative SV [from 100]: 63), Canada (62), and Australia (61) were the top countries searching for cancer in Google, followed by New Zealand (54) and the United Kingdom (48). There was a consistent seasonality pattern in searching for cancer in the United States, Canada, Australia, and New Zealand. Baltimore (United States), St John’s (Canada), Sydney (Australia), Otaika (New Zealand), and Saint Albans (United Kingdom) had the highest search interest in their corresponding countries. “Breast cancer” was the cancer entity that consistently appeared high in the list of top searches in all 5 countries. The “Rising searches” were “pancreatic cancer” in Canada and “ovarian cancer” in New Zealand. Cross-correlation of SVs was strong between the United States, Canada, and Australia (>.70, P<.01). Conclusions Cancer maintained its popularity as a search term for people in the United States, Canada, and Australia, comparably higher than New Zealand and the United Kingdom. The increased interest in searching for keywords related to cancer shows the possible effectiveness of awareness campaigns in increasing societal demand for health information on the Web, to be met in community-wide communication or awareness interventions.
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Affiliation(s)
- Forough Foroughi
- Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic Of Iran
| | - Alfred K-Y Lam
- Cancer Molecular Pathology, School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Megan S C Lim
- Centre for Population Health, Burnet Institute, Melbourne, Australia
| | - Nassim Saremi
- Cancer Molecular Pathology, School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Alireza Ahmadvand
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Gruebner O, Lowe SR, Tracy M, Cerdá M, Joshi S, Norris FH, Galea S. The Geography of Mental Health and General Wellness in Galveston Bay After Hurricane Ike: A Spatial Epidemiologic Study With Longitudinal Data. Disaster Med Public Health Prep 2016; 10:261-73. [PMID: 26818684 DOI: 10.1017/dmp.2015.172] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To demonstrate a spatial epidemiologic approach that could be used in the aftermath of disasters to (1) detect spatial clusters and (2) explore geographic heterogeneity in predictors for mental health and general wellness. METHODS We used a cohort study of Hurricane Ike survivors (n=508) to assess the spatial distribution of postdisaster mental health wellness (most likely resilience trajectory for posttraumatic stress symptoms [PTSS] and depression) and general wellness (most likely resilience trajectory for PTSS, depression, functional impairment, and days of poor health) in Galveston, Texas. We applied the spatial scan statistic (SaTScan) and geographically weighted regression. RESULTS We found spatial clusters of high likelihood wellness in areas north of Texas City and spatial concentrations of low likelihood wellness in Galveston Island. Geographic variation was found in predictors of wellness, showing increasing associations with both forms of wellness the closer respondents were located to Galveston City in Galveston Island. CONCLUSIONS Predictors for postdisaster wellness may manifest differently across geographic space with concentrations of lower likelihood wellness and increased associations with predictors in areas of higher exposure. Our approach could be used to inform geographically targeted interventions to promote mental health and general wellness in disaster-affected communities.
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Abstract
OBJECTIVE To review the clinical data for people with diabetes mellitus with reference to their location and clinical care in a general practice in Australia. MATERIALS AND METHODS Patient data were extracted from a general practice in Western Australia. Iterative data-cleansing steps were taken. Data were grouped into Statistical Area level 1 (SA1), designated as the smallest geographical area associated with the Census of Population and Housing. The data were analysed to identify if SA1s with people aged 70 years and older, and with relatively high glycosylated haemoglobin (HbA1c) were significantly clustered, and whether this was associated with their medical consultation rate and treatment. The analysis included Cluster and Outlier Analysis using Moran's I test. RESULTS The overall median age of the population was 70 years with more males than females, 53% and 47%, respectively. Older people (>70 years) with relatively high HbA1c comprised 9.3% of all people with diabetes in the sample, and were clustered around two 'hotspot' locations. These 111 patients do not attend the practice more or less often than people with diabetes living elsewhere in the practice (p=0.098). There was some evidence that they were more likely to be recorded as having consulted with regard to other chronic diseases. The average number of prescribed medicines over a 13-month time period, per person in the hotspots, was 4.6 compared with 5.1 in other locations (p=0.26). Their prescribed therapy was deemed to be consistent with the management of people with diabetes in other locations with reference to the relevant diabetes guidelines. CONCLUSIONS Older patients with relatively high HbA1c are clustered in two locations within the practice area. Their hyperglycaemia and ongoing cardiovascular risk indicates causes other than therapeutic inertia. The causes may be related to the social determinants of health, which are influenced by geography.
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Affiliation(s)
- Moyez Jiwa
- Melbourne Clinical School, School of Medicine Sydney, The University of Notre Dame Australia, Melbourne, Victoria, Australia
| | - Ori Gudes
- Cooperative Research Centre for Spatial Information and Department of Spatial Sciences, Curtin University, Perth, Western Australia, Australia
| | - Richard Varhol
- Department of Health Policy and Management, Curtin University, Perth, Western Australia, Australia
| | - Narelle Mullan
- Cooperative Research Centre for Spatial Information, Carlton, Victoria, Australia
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McArdle PF. An aid to generating figures for the American Journal of Epidemiology using SAS/GRAPH. Am J Epidemiol 2015; 182:747-9. [PMID: 26476284 DOI: 10.1093/aje/kwv216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 08/14/2015] [Indexed: 11/13/2022] Open
Abstract
Data visualization is an important tool that epidemiologists use to communicate with others in the field. The American Journal of Epidemiology recently acknowledged the importance of data visualization by inaugurating an award for the "Figure of the Year." Yet, creating figures that adhere to the standards of the Journal is a challenge. The purpose of the present article was to provide helpful hints for creating figures in SAS/GRAPH that meet the requirements of the Journal. It stresses 3 techniques: properly sizing figures overall, sizing text within a figure, and creating acceptable file formats. This information will prove useful to authors who create data-driven figures intended to be published in the Journal.
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Thomas DSK, Anthamatten P, Root ED, Lucero M, Nohynek H, Tallo V, Williams GM, Simões EAF. Disease mapping for informing targeted health interventions: childhood pneumonia in Bohol, Philippines. Trop Med Int Health 2015; 20:1525-1533. [PMID: 26104587 DOI: 10.1111/tmi.12561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 11/28/2022]
Abstract
BACKGROUND Acute lower respiratory tract infections (ALRI) are the leading cause of childhood mortality worldwide. Currently, most developing countries assign resources at a district level, and yet District Medical Officers have few tools for directing targeted interventions to high mortality or morbidity areas. Mapping of ALRI at the local level can guide more efficient allocation of resources, coordination of efforts and targeted interventions, which are particularly relevant for health management in resource-scarce settings. METHODS An efficacy study of 11-valent pneumococcal vaccine was conducted in six municipalities in the Bohol Province of central Philippines from July 2000 to December 2004. Geocoded under-five pneumonia cases (using WHO classifications) were mapped to create spatial patterns of pneumonia at the local health unit (barangay) level. RESULTS There were 2951 children with WHO-defined clinical pneumonia, of whom 1074 were severe or very severely ill, 278 were radiographic, and 219 were hypoxaemic. While most children with pneumonia were from urban barangays, there was a disproportionately higher distribution of severe/very severe pneumonia in rural barangays and the most severe hypoxaemic children were concentrated in the northern barangays most distant from the regional hospital. CONCLUSIONS Mapping of ALRI at the local administrative health level can be performed relatively simply. If these principles are applied to routinely collected IMCI classification of disease at the district level in developing countries, such efforts can form the basis for directing public health and healthcare delivery efforts in a targeted manner.
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Affiliation(s)
- Deborah S K Thomas
- Department of Geography & Environmental Sciences, University of Colorado, Denver, CO, USA
| | - Peter Anthamatten
- Department of Geography & Environmental Sciences, University of Colorado, Denver, CO, USA
| | - Elisabeth Dowling Root
- Department of Geography and Institute of Behavioral Sciences, University of Colorado, Boulder, CO, USA
| | - Marilla Lucero
- Research Institute for Tropical Medicine, Metro Manila, Philippines
| | - Hanna Nohynek
- Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Metro Manila, Philippines
| | - Gail M Williams
- School of Population Health, University of Queensland, Brisbane, Qld, Australia
| | - Eric A F Simões
- Department of Pediatrics, Section of Infectious Diseases, University of Colorado, School of Medicine, Aurora, CO, USA.,Department of Epidemiology and Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
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Zhang Q, Neitz M, Neitz J, Wang RK. Geographic mapping of choroidal thickness in myopic eyes using 1050-nm spectral domain optical coherence tomography. J Innov Opt Health Sci 2015; 8:1550012. [PMID: 26346175 PMCID: PMC4558621 DOI: 10.1142/s1793545815500121] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE To provide a geographical map of choroidal thickness (CT) around the macular region among subjects with low, moderate and high myopia. METHODS 20 myopic subjects (n = 40 eyes) without other identified pathologies participated in this study: 20 eyes of ≤ 3 diopters (D) (low myopic), 10 eyes between -3 and -6D (moderate myopic), and 10 eyes of ≥ 6D (high myopic). The mean age of subjects was 30.2 years (± 7.6 years; range, 24 to 46 years). A 1050 nm spectral-domain optical coherence tomography (SD-OCT) system, operating at 120 kHz imaging rate, was used in this study to simultaneously capture 3D anatomical images of the choroid and measure intraocular length (IOL) in the subject. The 3D OCT images of the choroid were segmented into superior, inferior, nasal and temporal quadrants, from which the CT was measured, representing radial distance between the outer retinal pigment epithelium (RPE) layer and inner scleral border. Measurements were made within concentric regions centered at fovea centralis, extended to 5 mm away from fovea at 1 mm intervals in the nasal and temporal directions. The measured IOL was the distance from the anterior cornea surface to the RPE in alignment along the optical axis of the eye. Statistical analysis was performed to evaluate CT at each geographic region and observe the relationship between CT and the degree of myopia. RESULTS For low myopic eyes, the IOL was measured at 24.619 ± 0.016 mm. The CT (273.85 ± 49.01 µm) was greatest under fovea as is in the case of healthy eyes. Peripheral to the fovea, the mean CT decreased rapidly along the nasal direction, reaching a minimum of 180.65 ± 58.25 µm at 5 mm away from the fovea. There was less of a change in thickness from the fovea in the temporal direction reaching a minimum of 234.25 ± 42.27 µm. In contrast to the low myopic eyes, for moderate and high myopic eyes, CTs were thickest in temporal region (where CT = 194.94 ± 27.28 and 163 ± 34.89 µm, respectively). Like the low myopic eyes, moderate and high myopic eyes had thinnest CTs in the nasal region (where CT = 100.84 ± 16.75 and 86.64 ± 42.6 µm, respectively). High myopic eyes had the longest mean IOL (25.983 ± 0.021 mm), while the IOL of moderate myopia was 25.413 ± 0.022 mm (**p < 0.001). The CT reduction rate was calculated at 31.28 µm/D (diopter) from low to moderate myopia, whilst it is 13.49 µm/D from moderate to high myopia. The similar tendency was found for the IOL reduction rate in our study: 0.265 mm/D from low to moderate myopia, and 0.137 mm/D from moderate to high myopia. CONCLUSION The CT decreases and the IOL increases gradually with the increase of myopic condition. The current results support the theory that choroidal abnormality may play an important role in the pathogenesis of myopic degeneration.
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Affiliation(s)
- Qinqin Zhang
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
| | - Maureen Neitz
- Department of Ophthalmology, University of Washington, Seattle, WA 98104, USA
| | - Jay Neitz
- Department of Ophthalmology, University of Washington, Seattle, WA 98104, USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA
- Department of Ophthalmology, University of Washington, Seattle, WA 98104, USA
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Berkowitz SA, Traore CY, Singer DE, Atlas SJ. Evaluating area-based socioeconomic status indicators for monitoring disparities within health care systems: results from a primary care network. Health Serv Res 2015; 50:398-417. [PMID: 25219917 PMCID: PMC4369215 DOI: 10.1111/1475-6773.12229] [Citation(s) in RCA: 176] [Impact Index Per Article: 19.6] [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] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine which area-based socioeconomic status (SES) indicator is best suited to monitor health care disparities from a delivery system perspective. DATA SOURCES/STUDY SETTING 142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011. STUDY DESIGN Cross-sectional, comparing associations between area-based SES indicators and patient outcomes. DATA COLLECTION Address data were geocoded to construct area-based SES indicators at block group (BG), census tract (CT), and ZIP code (ZIP) levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (RIIs) were calculated to quantify disparities detected by area-based SES indicators and compared to RIIs from self-reported educational attainment. PRINCIPAL FINDINGS ZIP indicators had less missing data than BG or CT indicators (p < .0001). Area-based SES indicators were strongly associated with self-report educational attainment (p < .0001). ZIP, BG, and CT indicators all detected expected SES gradients in health outcomes similarly. Single-item, cut point defined indicators performed as well as multidimensional indices and quantile indicators. CONCLUSIONS Area-based SES indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP-level median household income or percent poverty, using cut points.
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Affiliation(s)
- Seth A Berkowitz
- Address correspondence to Seth A. Berkowitz, M.D., M.P.H., Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St., 9th Floor, Boston, MA 02114; e-mail:
| | - Carine Y Traore
- Seth A. Berkowitz, M.D., M.P.H., Division of General Internal Medicine, Massachusetts General HospitalBoston, MA
- Carine Y. Traore, M.P.H., Daniel E. Singer, M.D., and Steven J. Atlas, M.D., M.P.H., are with the Division of General InternalMedicine, Massachusetts General HospitalBoston, MA
- Daniel E. Singer, M.D., and Steven J. Atlas, M.D., M.P.H., are also with theHarvard Medical SchoolBoston, MA
| | - Daniel E Singer
- Seth A. Berkowitz, M.D., M.P.H., Division of General Internal Medicine, Massachusetts General HospitalBoston, MA
- Carine Y. Traore, M.P.H., Daniel E. Singer, M.D., and Steven J. Atlas, M.D., M.P.H., are with the Division of General InternalMedicine, Massachusetts General HospitalBoston, MA
- Daniel E. Singer, M.D., and Steven J. Atlas, M.D., M.P.H., are also with theHarvard Medical SchoolBoston, MA
| | - Steven J Atlas
- Seth A. Berkowitz, M.D., M.P.H., Division of General Internal Medicine, Massachusetts General HospitalBoston, MA
- Carine Y. Traore, M.P.H., Daniel E. Singer, M.D., and Steven J. Atlas, M.D., M.P.H., are with the Division of General InternalMedicine, Massachusetts General HospitalBoston, MA
- Daniel E. Singer, M.D., and Steven J. Atlas, M.D., M.P.H., are also with theHarvard Medical SchoolBoston, MA
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Abstract
BACKGROUND Learning in general practice is an essential component of undergraduate medical education; currently, on average, 13% of clinical placements in the UK are in general practice. However, whether general practice can sustainably deliver more undergraduate placements is uncertain. AIM To identify the geographical distribution of undergraduate teaching practices and their distance from the host medical school. DESIGN AND SETTING National survey of all medical schools in the UK. METHOD All 33 UK medical schools were invited to provide the postcodes of their undergraduate teaching practices. These were collated, de-duplicated, and mapped. The distance in kilometres and journey times by car and public transport between each medical school and its teaching practices was estimated using Transport Direct (www.transportdirect.info). The postcodes of every practice in the UK were obtained from the UK's health departments. RESULTS All 33 UK medical schools responded; 4392 practices contributed to teaching, with a median (minimum-maximum) of 142 (17-385) practices per school. The median (minimum-maximum) distance between a school and a teaching practice was 28 km (0-1421 km), 41 (0:00-23:26) minutes' travel by car and 1 hour 12 (0:00-17:29) minutes' travel by public transport. All teaching practices were accessible by public transport in one school and 90-99% were in a further four schools; 24 schools had >20% of practices that were inaccessible by public transport. CONCLUSION The 4392 undergraduate teaching general practices are widely distributed and potentially any practice, no matter how isolated, could contribute to undergraduate education. However, this is, at the price of a considerable travel burden.
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Dasgupta S, Vaughan AS, Kramer MR, Sanchez TH, Sullivan PS. Use of a Google Map Tool Embedded in an Internet Survey Instrument: Is it a Valid and Reliable Alternative to Geocoded Address Data? JMIR Res Protoc 2014; 3:e24. [PMID: 24726954 PMCID: PMC4004146 DOI: 10.2196/resprot.2946] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 12/02/2013] [Accepted: 01/18/2014] [Indexed: 11/13/2022] Open
Abstract
Background Men who have sex with men (MSM) in the United States are at high risk for human immunodeficiency virus (HIV) and poor HIV related outcomes. Maps can be used to identify, quantify, and address gaps in access to HIV care among HIV-positive MSM, and tailor intervention programs based on the needs of patients being served. Objective The objective of our study was to assess the usability of a Google map question embedded in a Web-based survey among Atlanta-based, HIV-positive MSM, and determine whether it is a valid and reliable alternative to collection of address-based data on residence and last HIV care provider. Methods Atlanta-based HIV-positive MSM were recruited through Facebook and from two ongoing studies recruiting primarily through venue-based sampling or peer referral (VBPR). Participants were asked to identify the locations of their residence and last attended HIV care provider using two methods: (1) by entering the street address (gold standard), and (2) “clicking” on the locations using an embedded Google map. Home and provider addresses were geocoded, mapped, and compared with home and provider locations from clicked map points to assess validity. Provider location error values were plotted against home location error values, and a kappa statistic was computed to assess agreement in degree of error in identifying residential location versus provider location. Results The median home location error across all participants was 0.65 miles (interquartile range, IQR, 0.10, 2.5 miles), and was lower among Facebook participants (P<.001), whites (P<.001), and those reporting higher annual household income (P=.04). Median home location error was lower, although not statistically significantly, among older men (P=.08) and those with higher educational attainment (P=.05). The median provider location error was 0.32 miles (IQR, 0.12, 1.2 miles), and did not vary significantly by age, recruitment method, race, income, or level of educational attainment.
Overall, the kappa was 0.20, indicating poor agreement between the two error measures. However, those recruited through Facebook had a greater level of agreement (κ=0.30) than those recruited through VBPR methods (κ=0.16), demonstrating a greater level of consistency in using the map question to identify home and provider locations for Facebook-recruited individuals. Conclusions Most participants were able to click within 1 mile of their home address and their provider’s office, and were not always able to identify the locations on a map consistently, although some differences were observed across recruitment methods. This map tool may serve as the basis of a valid and reliable tool to identify residence and HIV provider location in the absence of geocoded address data. Further work is needed to improve and compare map tool usability with the results from this study.
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Affiliation(s)
- Sharoda Dasgupta
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
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