Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Amado C[original query] |
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Cervical cancer screening positivity among women living with HIV in CDC-PEPFAR programs 2018-2022
McCormick LJ , Gutreuter S , Adeoye O , Alger SX , Amado C , Bay Z , Chirwa CM , Chituwo O , Correia D , Deus M , Dirlikov E , Efuntoye T , Gunde L , Kabaghe A , Kalamya JN , Lorenzoni C , Magesa D , Mate C , Mulokoshi T , Ninsiima JC , Nyangasi M , Nyika P , Pasipamire M , Ssali M , Tefera F , Torre LA , Urso M , Wandira R , Zemburuka B , Montandon M . J Acquir Immune Defic Syndr 2023 94 (4) 301-307 BACKGROUND: The US President's Emergency Plan for AIDS Relief (PEPFAR) aims to address the higher risk of cervical cancer among women living with HIV (WLHIV) by offering high quality screening services in the highest burden regions of the world. METHODS: We analyzed PEPFAR Monitoring, Evaluation, and Reporting data from CDC-supported sites in 13 countries in sub-Saharan Africa for WHLIV aged 15+ years who accessed cervical cancer screening services (mostly visual inspection, with ablative or excisional treatment offered for precancerous lesions), April 2018-March 2022. We calculated the positivity by age, country, and clinical visit type (first lifetime screen, or routine rescreening). We fitted negative binomial random-coefficient models of log-linear trends in time to estimate the probabilities of testing positive, and any temporal trends in positivity. RESULTS: Among the 2.8 million completed cancer screens, 5.4% identified precancerous lesions, and 0.8% were positive for suspected invasive cervical cancers (6.1% overall). The positivity rates declined over the study period among those women screening for cervical cancer for the first time, and among those women presenting to antiretroviral therapy (ART) clinics for routine rescreening. CONCLUSIONS: These positivity rates are lower than expectations set by the published literature. Further research is needed to determine if these lower rates are attributable to the high level of consistent ART use among these populations, and systematic program monitoring and quality assurance activities are essential to ensure WLHIV have access to the highest possible quality prevention services. |
Comparison of the sensitivity of laboratory diagnostic methods from a well-characterized outbreak of mumps in New York city in 2009.
Rota JS , Rosen JB , Doll MK , McNall RJ , McGrew M , Williams N , Lopareva EN , Barskey AE , Punsalang A Jr , Rota PA , Oleszko WR , Hickman CJ , Zimmerman CM , Bellini WJ . Clin Vaccine Immunol 2013 20 (3) 391-6 A mumps outbreak in upstate New York in 2009 at a summer camp for Orthodox Jewish boys spread into Orthodox Jewish communities in the Northeast including New York City. The availability of epidemiologic information including vaccination records and parotitis onset dates allowed an enhanced analysis of laboratory methods for mumps testing. Serum and buccal swab samples were collected from 296 confirmed cases with onsets from September through December, 2009. All samples were tested using the CDC capture IgM EIA and a real-time RT-PCR (rRT-PCR) that targets the short hydrophobic gene. A subset of the samples (n=205) was used to evaluate 3 commercial mumps IgM assays and to assess the sensitivity of using an alternative target gene (nucleoprotein) in the rRT-PCR protocol. Among 115 cases of mumps with 2 documented doses of measles, mumps, and rubella (MMR) vaccine, the CDC capture IgM EIA detected IgM in 51% of serum samples compared to 9%-24% using three commercial IgM assays. The rRT-PCR that targeted the nucleoprotein gene increased RNA detection by 14% compared to that obtained with the original protocol. The ability to detect IgM improved when serum was collected 3 days or more after onset whereas sensitivity of RNA detection by rRT-PCR declined when buccal swabs were collected later than 2 days after onset. Selection of testing methods and timing of sample collection are important factors in the ability to confirm infection among vaccinated persons. These results reinforce the need to use virus detection assays in addition to serologic tests. |
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