Last data update: Jun 24, 2024. (Total: 47078 publications since 2009)
Records 1-5 (of 5 Records) |
Query Trace: Chew Ng R [original query] |
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Contact tracing outcomes among household contacts of fully vaccinated COVID-19 patients - San Francisco, California, January 29-July 2, 2021.
Sachdev DD , Chew Ng R , Sankaran M , Ernst A , Hernandez KT , Servellita V , Sotomayor-Gonzalez A , Stoltey J , Cohen SE , Nguyen TQ , Chiu C , Philip S . Clin Infect Dis 2021 75 (1) e267-e275 BACKGROUND: The extent to which vaccinated persons diagnosed with COVID-19 can transmit to other vaccinated and unvaccinated persons is unclear. METHODS: Using data from the San Francisco Department of Public Health (SFDPH), this report describes outcomes of household contact tracing during January 29-July 2, 2021, where fully vaccinated COVID-19 patients were the index case in the household. RESULTS: Among 248 fully vaccinated patients with breakthrough infections, 203 (82%) were symptomatic and 105 were identified as the index patient within their household. Among 179 named household contacts, 71 (40%) contacts tested, over half (56%) were fully vaccinated and the secondary attack rate was 28%. Overall transmission from a symptomatic fully vaccinated patient with breakthrough infection to household contacts was suspected in 14 of 105 (13%) of households. Viral genomic sequencing of samples from 44% of fully vaccinated patients showed that 82% of those sequenced were infected by a variant of concern or interest, and 77% by a variant carrying mutation(s) associated with resistance to neutralizing antibodies. CONCLUSIONS: Transmission from fully vaccinated symptomatic index patients to vaccinated and unvaccinated household contacts can occur. Indoor face masking and timely testing of all household contacts should be considered when a household member receives a positive test result in order to identify and interrupt transmission chains. |
Effectiveness of syphilis partner notification after adjusting for treatment dates, 7 jurisdictions
Cope AB , Bernstein KT , Matthias J , Rahman M , Diesel JC , Pugsley RA , Schillinger JA , Chew Ng RA , Klingler EJ , Mobley VL , Samoff E , Peterman TA . Sex Transm Dis 2021 49 (2) 160-165 INTRODUCTION: Disease intervention specialists (DIS) prevent syphilis by assuring treatment for patients' sex partners through partner notification (PN). Different interpretations of how to measure partners treated due to DIS efforts complicates PN evaluation. We measured PN impact by counting partners treated for syphilis after DIS interviewed the patient. METHODS: We reviewed data from early syphilis cases reported during 2015-2017 in seven jurisdictions. We compared infected partners brought to treatment using: 1) DIS-assigned disposition codes or 2) all infected partners treated 0-90 days after the patient's interview (adjusted treatment estimate). Stratified analyses assessed patient characteristics associated with the adjusted treatment estimate. RESULTS: DIS interviewed 23,613 patients who reported 20,890 partners with locating information. Many of the 3,569 (17.1%) partners classified by DIS as brought to treatment were treated before the patient was interviewed. There were 2,359 (11.3%) partners treated 0-90 days after the patient's interview. Treatment estimates were more consistent between programs when measured using our adjusted estimates (range 6.1%-14.8% per patient interviewed) compared to DIS-assigned disposition (range 6.1%-28.3%). Treatment of >1 partner occurred after 9.0% of interviews and was more likely if the patient was a woman (17.9%), aged <25 years (12.6%), interviewed ≤7 days from diagnosis (13.9%), HIV negative (12.6%), or had no reported history of syphilis (9.8%). CONCLUSIONS: Counting infected partners treated 0-90 days after interview reduced variability in reporting and facilitates quality assurance. Identifying programs and DIS who are particularly good at finding and treating partners could improve program impact. |
Unnamed partners from syphilis partner services interviews, 7 jurisdictions
Cope AB , Bernstein K , Matthias J , Rahman M , Diesel J , Pugsley RA , Schillinger JA , Chew Ng RA , Sachdev D , Shaw R , Nguyen TQ , Klingler EJ , Mobley VL , Samoff E , Peterman TA . Sex Transm Dis 2020 47 (12) 811-818 BACKGROUND: Reducing transmission depends on the percentage of infected partners treated; if many are missed, impact on transmission will be low. Traditional partner services metrics evaluate the number of partners found and treated. We estimated the proportion of partners of syphilis patients not locatable for intervention. METHODS: We reviewed records of early syphilis cases (primary, secondary, early latent) reported during 2015-2017 in seven jurisdictions (Florida, Louisiana, Michigan, North Carolina, Virginia, New York City, and San Francisco). Among interviewed syphilis patients, we determined the proportion who reported named partners (with locating information), reported unnamed partners (no locating information), and did not report partners. For patients with no reported partners, we estimated their range of unreported partners to be between one and the average number of partners for patients who reported partners. RESULTS: Among 29,719 syphilis patients, 23,613 (80%) were interviewed and 18,581 (63%) reported 84,224 sex partners (average=4.5; 20,853 (25%) named and 63,371 (75%) unnamed). An estimated 11,138 to 54,521 partners were unreported. Thus, 74,509 to 117,892 (of 95,362 to 138,745) partners were not reached by partner services (78-85%). Among interviewed patients, 71% reported ≥1 unnamed partner or reported no partners; this proportion was higher for men who reported sex with men [MSM] (75%), compared to men who reported sex with women only (65%), and women (44%). CONCLUSION: Approximately 80% of sex partners were either unnamed or unreported. Partner services may be less successful at interrupting transmission in MSM networks where a higher proportion of partners are unnamed or unreported. |
Characteristics associated with delivery of an infant with congenital syphilis and missed opportunities for prevention - California, 2012 to 2014
Biswas HH , Chew Ng RA , Murray EL , Chow JM , Stoltey JE , Watt JP , Bauer HM . Sex Transm Dis 2018 45 (7) 435-441 BACKGROUND: Congenital syphilis (CS), the transmission of Treponema pallidum from mother to fetus during pregnancy, can cause adverse birth outcomes. In 2012 to 2014, the CS rate in California increased more than 200% from 6.6 to 20.3 cases per 100,000 live births. Our objectives were to identify characteristics associated with delivering an infant with CS and missed opportunities for prevention among syphilis-infected pregnant women in California. METHODS: We linked California Department of Public Health syphilis surveillance records from women aged 15 to 45 years-diagnosed from March 13, 2012, to December 31, 2014-to birth records. We compared characteristics among mothers who delivered an infant with CS (CS mothers) with mothers who delivered an infant without CS (non-CS mothers) by using chi or Fisher exact tests. To visualize gaps in prevention among syphilis-infected pregnant women, we constructed a CS prevention cascade, a figure that shows steps to prevent CS. RESULTS: During the selected period, 2498 women were diagnosed as having syphilis, and 427 (17%) linked to birth records; 164 (38%) were defined as CS mothers and 263 (62%) as non-CS mothers. Mothers with CS were more likely than non-CS mothers to have their first prenatal care visit in the third trimester. High proportions of mothers in both groups reported high-risk sexual behaviors, methamphetamine use, or incarceration (13%-29%). The CS prevention cascade showed decrements of 5% to 11% in prenatal care receipt, testing, and treatment steps; only 62% of potential CS births were prevented. CONCLUSIONS: Multifaceted efforts are needed to address gaps in the CS prevention cascade and reduce CS cases in California. |
Historical and current trends in the epidemiology of early syphilis in San Francisco, 1955-2016
Nguyen TQ , Kohn RP , Chew Ng R , Philip SS , Cohen SE . Sex Transm Dis 2018 45 S55-S62 BACKGROUND: Seventeen years into a sustained epidemic, early syphilis (ES) rates in San Francisco (SF) are continuing to increase and the demographics of the affected population are changing. We provide a historical overview of ES in SF among men who have sex with men (MSM) and describe trends in the epidemiology and disease investigation outcomes. METHODS: We examined data from the SF Department of Public Health's patient-based registry of integrated STD surveillance, clinical, and field investigation data to describe demographic and behavioral characteristics of ES cases, as well as outcomes of syphilis partner services. Chi-square tests were performed to examine categorical differences across time periods. Analysis of variance was used to examine differences in continuous variables. RESULTS: In 2016, 1095 ES cases were reported among males in SF, a 219% increase from the 343 cases identified 10 years ago. Between 1996-99 and 2010-16, an increasing proportion of ES cases were among MSM younger than 25 years, non-white, and HIV-negative (P<.05). A decreasing proportion of ES cases were assigned for Partner Services (PS), among whom a smaller proportion of reported sex partners were identified by name, resulting in an overall decline in the proportion of cases who had at least one named partner treated as a result of PS (Disease Investigation Rate) from 30.5 in 2000-2004 to 14.8 in 2010-2016. CONCLUSIONS: Syphilis case rates continue to increase in SF and the epidemic is expanding beyond a core population. Additional resources and innovative prevention approaches are needed to reduce the burden of syphilis among MSM. |
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