Last data update: Jun 03, 2024. (Total: 46935 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Cadet J [original query] |
---|
Outbreak of Acute Respiratory Illness Associated with Human Adenovirus Type 4 at the U.S. Coast Guard Academy, 2019.
Chu VT , Simon E , Lu X , Rockwell P , Abedi GR , Gardner C , Kujawski SA , Schneider E , Gentile M , Ramsey LA , Liu R , Jones S , Janik C , Siniscalchi A , Landry ML , Christopher J , Lindstrom S , Steiner S , Thomas D , Gerber SI , Biggs HM . J Infect Dis 2021 225 (1) 55-64 BACKGROUND: Although a human adenovirus (HAdV) vaccine is available for military use, officers-in-training are not routinely vaccinated. We describe an HAdV-associated respiratory outbreak among unvaccinated cadets at the U.S. Coast Guard Academy and its impact on cadet training. METHODS: We defined a case as a cadet with new onset cough or sore throat during August 1-October 4, 2019. We reviewed medical records and distributed a questionnaire to identify cases and to estimate impact on cadet training. We performed real-time PCR testing on patient and environmental samples and whole genome sequencing on a subset of positive patient samples. RESULTS: Among the 1,072 cadets, 378 (35%) cases were identified by medical records (n=230) or additionally by the questionnaire (n=148). Of the 230 cases identified from medical records, 138 (60%) were male and 226 (98%) had no underlying conditions. From questionnaire responses, 113/228 (50%) cases reported duty restrictions. Of cases with respiratory specimens, 36/50 (72%) were HAdV positive; all 14 sequenced specimens were HAdV-4a1. Sixteen (89%) of 18 environmental specimens from the cadet dormitory were HAdV-positive. CONCLUSIONS: The HAdV-4-associated outbreak infected a substantial number of cadets and significantly impacted cadet training. Routine vaccination could prevent HAdV respiratory outbreaks in this population. |
Multi-site evaluation of the LN34 pan-lyssavirus real-time RT-PCR assay for post-mortem rabies diagnostics.
Gigante CM , Dettinger L , Powell JW , Seiders M , Condori REC , Griesser R , Okogi K , Carlos M , Pesko K , Breckenridge M , Simon EMM , Chu Myjv , Davis AD , Brunt SJ , Orciari L , Yager P , Carson WC , Hartloge C , Saliki JT , Sanchez S , Deldari M , Hsieh K , Wadhwa A , Wilkins K , Peredo VY , Rabideau P , Gruhn N , Cadet R , Isloor S , Nath SS , Joseph T , Gao J , Wallace R , Reynolds M , Olson VA , Li Y . PLoS One 2018 13 (5) e0197074 Rabies is a fatal zoonotic disease that requires fast, accurate diagnosis to prevent disease in an exposed individual. The current gold standard for post-mortem diagnosis of human and animal rabies is the direct fluorescent antibody (DFA) test. While the DFA test has proven sensitive and reliable, it requires high quality antibody conjugates, a skilled technician, a fluorescence microscope and diagnostic specimen of sufficient quality. The LN34 pan-lyssavirus real-time RT-PCR assay represents a strong candidate for rabies post-mortem diagnostics due to its ability to detect RNA across the diverse Lyssavirus genus, its high sensitivity, its potential for use with deteriorated tissues, and its simple, easy to implement design. Here, we present data from a multi-site evaluation of the LN34 assay in 14 laboratories. A total of 2,978 samples (1,049 DFA positive) from Africa, the Americas, Asia, Europe, and the Middle East were tested. The LN34 assay exhibited low variability in repeatability and reproducibility studies and was capable of detecting viral RNA in fresh, frozen, archived, deteriorated and formalin-fixed brain tissue. The LN34 assay displayed high diagnostic specificity (99.68%) and sensitivity (99.90%) when compared to the DFA test, and no DFA positive samples were negative by the LN34 assay. The LN34 assay produced definitive findings for 80 samples that were inconclusive or untestable by DFA; 29 were positive. Five samples were inconclusive by the LN34 assay, and only one sample was inconclusive by both tests. Furthermore, use of the LN34 assay led to the identification of one false negative and 11 false positive DFA results. Together, these results demonstrate the reliability and robustness of the LN34 assay and support a role for the LN34 assay in improving rabies diagnostics and surveillance. |
An assessment of data quality in a multi-site electronic medical record system in Haiti
Puttkammer N , Baseman JG , Devine EB , Valles JS , Hyppolite N , Garilus F , Honore JG , Matheson AI , Zeliadt S , Yuhas K , Sherr K , Cadet JR , Zamor G , Pierre E , Barnhart S . Int J Med Inform 2015 86 104-16 OBJECTIVES: Strong data quality (DQ) is a precursor to strong data use. In resource limited settings, routine DQ assessment (DQA) within electronic medical record (EMR) systems can be resource-intensive using manual methods such as audit and chart review; automated queries offer an efficient alternative. This DQA focused on Haiti's national EMR - iSante - and included longitudinal data for over 100,000 persons living with HIV (PLHIV) enrolled in HIV care and treatment services at 95 health care facilities (HCF). METHODS: This mixed-methods evaluation used a qualitative Delphi process to identify DQ priorities among local stakeholders, followed by a quantitative DQA on these priority areas. The quantitative DQA examined 13 indicators of completeness, accuracy, and timeliness of retrospective data collected from 2005 to 2013. We described levels of DQ for each indicator over time, and examined the consistency of within-HCF performance and associations between DQ and HCF and EMR system characteristics. RESULTS: Over all iSante data, age was incomplete in <1% of cases, while height, pregnancy status, TB status, and ART eligibility were more incomplete (approximately 20-40%). Suspicious data flags were present for <3% of cases of male sex, ART dispenses, CD4 values, and visit dates, but for 26% of cases of age. Discontinuation forms were available for about half of all patients without visits for 180 or more days, and >60% of encounter forms were entered late. For most indicators, DQ tended to improve over time. DQ was highly variable across HCF, and within HCFs DQ was variable across indicators. In adjusted analyses, HCF and system factors with generally favorable and statistically significant associations with DQ were University hospital category, private sector governance, presence of local iSante server, greater HCF experience with the EMR, greater maturity of the EMR itself, and having more system users but fewer new users. In qualitative feedback, local stakeholders emphasized lack of stable power supply as a key challenge to data quality and use of the iSante EMR. CONCLUSIONS: Variable performance on key DQ indicators across HCF suggests that excellent DQ is achievable in Haiti, but further effort is needed to systematize and routinize DQ approaches within HCFs. A dynamic, interactive "DQ dashboard" within iSante could bring transparency and motivate improvement. While the results of the study are specific to Haiti's iSante data system, the study's methods and thematic lessons learned holdgeneralized relevance for other large-scale EMR systems in resource-limited countries. |
Rapid monitoring in vaccination campaigns during emergencies: the post-earthquake campaign in Haiti
Rainey JJ , Sugerman D , Brennan M , Cadet JR , Ernsly J , Lacapere F , Danovaro-Holliday MC , Mubalama JC , Nandy R . Bull World Health Organ 2013 91 (12) 957-62 PROBLEM: The earthquake that struck Haiti in January 2010 caused 1.5 million people to be displaced to temporary camps. The Haitian Ministry of Public Health and Population and global immunization partners developed a plan to deliver vaccines to those residing in these camps. A strategy was needed to determine whether the immunization targets set for the campaign were achieved. APPROACH: Following the vaccination campaign, staff from the Ministry of Public Health and Population interviewed convenience samples of households - in specific predetermined locations in each of the camps - regarding receipt of the emergency vaccinations. A camp was targeted for "mop-up vaccination" - i.e. repeat mass vaccination - if more than 25% of the children aged 9 months to 7 years in the sample were found not to have received the emergency vaccinations. LOCAL SETTING: Rapid monitoring was implemented in camps located in the Port-au-Prince metropolitan area. Camps that housed more than 5000 people were monitored first. RELEVANT CHANGES: By the end of March 2010, 72 (23%) of the 310 vaccinated camps had been monitored. Although 32 (44%) of the monitored camps were targeted for mop-up vaccination, only six of them had received such repeat mass vaccination when checked several weeks after monitoring. LESSONS LEARNT: Rapid monitoring was only marginally beneficial in achieving immunization targets in the temporary camps in Port-au-Prince. More research is needed to evaluate the utility of conventional rapid monitoring, as well as other strategies, during post-disaster vaccination campaigns that involve mobile populations, particularly when there is little capacity to conduct repeat mass vaccination. |
Vaccination coverage in Haiti: results from the 2009 national survey
Rainey JJ , Lacapere F , Danovaro-Holliday MC , Mung K , Magloire R , Kananda G , Cadet JR , Lee CE , Chamouillet H , Luman E . Vaccine 2012 30 (9) 1746-51 INTRODUCTION: Since 1977, vaccinations to protect against tuberculosis, diphtheria, tetanus, pertussis, polio, and measles (and rubella since 2009) have been offered to children in Haiti through the routine immunization program. From April to July 2009, a national vaccination coverage survey was conducted to assess the success of the routine vaccination program at reaching children in Haiti. METHODS: A multi-stage cluster survey was conducted using a modified WHO methodology for household sampling. A standardized questionnaire was administered to collect vaccination histories, demographic information, and reasons for under-vaccination of children aged 12-23 months. A child who received the eight recommended routine vaccinations was considered fully vaccinated. The routine vaccination schedule was used to define valid doses and estimate the percent of children vaccinated on time. RESULTS: Among 1345 children surveyed, 40.4% (95% CI: 36.6-44.2) of the 840 children with vaccination cards had received all eight recommended vaccinations. Coverage was highest for the Bacille Calmette-Guerin vaccine (87.3%), the first doses of the diphtheria-tetanus-pertussis vaccine (92.0%) and oral poliovirus vaccine (93.4%) and lowest for measles vaccine (46.9%). Assuming similar coverage for the 505 children without cards, overall coverage with the complete vaccination series among all children was 31.9%. Timely vaccination rates were lower. Reasons for under-vaccination included not having enough time to reach the vaccination location (24.8%), having a child who was ill (13.8%), and not knowing when, or forgetting, to go for vaccination (12.8%). CONCLUSIONS AND RECOMMENDATIONS: Coverage for early-infant vaccines was high; however, most children did not complete their full vaccination series, and many children received vaccinations later than recommended. Efforts to improve the vaccination program should include increasing the frequency of outreach services, training for vaccination staff to minimize missed opportunities, and better communicating the timing of vaccinations to encourage caregivers to bring their children for vaccinations at the recommended age. Efforts to promote the benefits of vaccination and card retention are also needed. |
Cholera prevention training materials for community health workers, Haiti, 2010-2011
Rajasingham A , Bowen A , O'Reilly C , Sholtes K , Schilling K , Hough C , Brunkard J , Domercant JW , Lerebours G , Cadet J , Quick R , Person B . Emerg Infect Dis 2011 17 (11) 2162-2165 Stopping the spread of the cholera epidemic in Haiti required engaging community health workers (CHWs) in prevention and treatment activities. The Centers for Disease Control and Prevention collaborated with the Haitian Ministry of Public Health and Population to develop CHW educational materials, train >1,100 CHWs, and evaluate training efforts. |
Health in All Policies: addressing the legal and policy foundations of health impact assessment
Rajotte BR , Ross CL , Ekechi CO , Cadet VN . J Law Med Ethics 2011 39 Suppl 1 27-9 The concept of Health in All Policies aims to improve the health outcomes associated with policies in an attempt to mitigate health disparities and provide optimal environments for healthier living. This multidisciplinary framework seeks to improve health through effective assessment and reformation of policy for organizations of any level and stature. The importance of integrating health in policy assessment and decision making is a key concept in the growing field of Health Impact Assessment. | The World Health Organization defines Health Impact Assessment (HIA) as “a combination of procedures, methods, and tools by which a policy, program, or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population.” HIA provides a mechanism for collaboration between various sectors and disciplines bridging the gap between research, policymaking, and implementation of policies, programs, and projects affecting health outcomes. In the United States, while some HIA efforts have focused on proposed public policies, HIA has been used primarily to analyze the health effects of proposed development projects and plans related to community design and transportation. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Jun 03, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure