Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-23 (of 23 Records) |
Query Trace: Franks J [original query] |
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Pre-exposure prophylaxis uptake concerns in the Democratic Republic of the Congo: Key population and healthcare workers perspectives
Shen Y , Franks J , Reidy W , Olsen H , Wang C , Mushimbele N , Mazala RT , Tchissambou T , Malele F , Kilundu A , Bingham T , Djomand G , Mukinda E , Ewetola R , Abrams EJ , Teasdale CA . PLoS One 2023 18 (11) e0280977 Key populations (KP) in the Democratic Republic of the Congo (DRC), including female sex workers (SW), are disproportionally affected by HIV. Quantitative feedback surveys were conducted at seven health facilities in DRC with 70 KP clients enrolled in pre-exposure prophylaxis (PrEP) services to measure benefits and concerns. The surveys also assessed satisfaction with PrEP services and experiences of stigma at the health facilities. Thirty healthcare workers (HCW) were surveyed to measure attitudes, beliefs, and acceptability of providing services to KP. KP client survey participants were primarily female SW. KP clients reported that the primary concern about taking PrEP was fear of side effects (67%) although few KP reported having experienced side effect (14%). HCW concurred with clients that experienced and anticipated side effects were a primary PrEP uptake concern, along with costs of clinic visits. |
Pre-exposure Prophylaxis Uptake Concerns in the Democratic Republic of the Congo: Key Population and Healthcare Workers Perspectives (preprint)
Shen Y , Franks J , Reidy W , Olsen H , Wang C , Mushimbele N , Mazala RT , Tchissambou T , Malele F , Kilundu A , Bingham T , Djomand G , Mukinda E , Ewetola R , Abrams EJ , Teasdale CA . medRxiv 2023 17 Key populations (KP) in the Democratic Republic of the Congo (DRC), including female sex workers (FSW), are disproportionally affected by HIV. Quantitative feedback surveys were conducted at seven health facilities in DRC with 70 KP clients enrolled in services to measure pre-exposure prophylaxis (PrEP) benefits and concerns. The surveys also assessed satisfaction with PrEP services and experiences of stigma at the health facilities. Thirty healthcare workers (HCW) were surveyed to measure attitudes, beliefs, and acceptability of providing services to KP. KP client survey participants were primarily female SW. KP clients reported that the primary concern about taking PrEP was fear of side effects. HCW concurred with clients that experienced and anticipated side effects were a primary PrEP uptake concern, along with costs of clinic visits. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. This article is a US Government work. It is not subject to copyright under 17 USC 105 and is also made available for use under a CC0 license. |
Prevalence of influenza-specific vaccination hesitancy among adults in the United States, 2018
Srivastav A , Lu PJ , Amaya A , Dever JA , Stanley M , Franks JL , Scanlon PJ , Fisher AM , Greby SM , Nguyen KH , Black CL . Vaccine 2023 41 (15) 2572-2581 BACKGROUND: The role of vaccine hesitancy on influenza vaccination is not clearly understood. Low influenza vaccination coverage in U.S. adults suggests that a multitude of factors may be responsible for under-vaccination or non-vaccination including vaccine hesitancy. Understanding the role of influenza vaccination hesitancy is important for targeted messaging and intervention to increase influenza vaccine confidence and uptake. The objective of this study was to quantify the prevalence of adult influenza vaccination hesitancy (IVH) and examine association of IVH beliefs with sociodemographic factors and early-season influenza vaccination. METHODS: A four-question validated IVH module was included in the 2018 National Internet Flu Survey. Weighted proportions and multivariable logistic regression models were used to identify correlates of IVH beliefs. RESULTS: Overall, 36.9% of adults were hesitant to receive an influenza vaccination; 18.6% expressed concerns about vaccination side effects; 14.8% personally knew someone with serious side effects; and 35.6% reported that their healthcare provider was not the most trusted source of information about influenza vaccinations. Influenza vaccination ranged from 15.3 to 45.2 percentage points lower among adults self-reporting any of the four IVH beliefs. Being female, age 18-49 years, non-Hispanic Black, having high school or lower education, being employed, and not having primary care medical home were associated with hesitancy. CONCLUSIONS: Among the four IVH beliefs studied, being hesitant to receiving influenza vaccination followed by mistrust of healthcare providers were identified as the most influential hesitancy beliefs. Two in five adults in the United States were hesitant to receive an influenza vaccination, and hesitancy was negatively associated with vaccination. This information may assist with targeted interventions, personalized to the individual, to reduce hesitancy and thus improve influenza vaccination acceptance. |
Consensus statements on deployment-related respiratory disease, inclusive of constrictive bronchiolitis: A modified Delphi study
Falvo MJ , Sotolongo AM , Osterholzer JJ , Robertson MW , Kazerooni EA , Amorosa JK , Garshick E , Jones KD , Galvin JR , Kreiss K , Hines SE , Franks TJ , Miller RF , Rose CS , Arjomandi M , Krefft SD , Morris MJ , Polosukhin VV , Blanc PD , D'Armiento JM . Chest 2022 163 (3) 599-609 BACKGROUND: The diagnosis of constrictive bronchiolitis (CB) in previously deployed individuals, and evaluation of respiratory symptoms more broadly, presents considerable challenges, including utilizing consistent histopathologic criteria and clinical assessments. RESEARCH QUESTION: What is the recommended diagnostic workup, and associated terminology, of respiratory symptoms in previously deployed individuals STUDY DESIGN AND METHODS: Nineteen experts participated in a three-round modified Delphi study, ranking their level of agreement for each statement with a priori definition of consensus. Additionally, rank-order voting on the recommended diagnostic approach and terminology was performed. RESULTS: 25 of 28 statements reached consensus, including the definition of CB as a histological pattern of lung injury that occurs in some previously deployed individuals while recognizing the importance of considering alternative diagnoses. Consensus statements also identified a diagnostic approach for the previously deployed individual with respiratory symptoms distinguishing assessments best performed at a local or specialty referral center. Also, 'deployment-related respiratory disease' (DRRD) was proposed as a broad term to subsume a wide range of potential syndromes and conditions identified through non-invasive evaluation, or when surgical lung biopsy reveals evidence of multi-compartmental lung injury which may include CB. INTERPRETATION: Using a modified Delphi technique, consensus statements provide a clinical approach to possible CB in previously deployed individuals. Use of DRRD provides a broad descriptor encompassing a range of post-deployment respiratory findings. Additional follow-up of individuals with DRRD is needed to assess disease progression and define other features of its natural history, which could better inform and lead to evolution in this nosology. |
Defining the risk of SARS-CoV-2 variants on immune protection.
DeGrace MM , Ghedin E , Frieman MB , Krammer F , Grifoni A , Alisoltani A , Alter G , Amara RR , Baric RS , Barouch DH , Bloom JD , Bloyet LM , Bonenfant G , Boon ACM , Boritz EA , Bratt DL , Bricker TL , Brown L , Buchser WJ , Carreo JM , Cohen-Lavi L , Darling TL , Davis-Gardner ME , Dearlove BL , Di H , Dittmann M , Doria-Rose NA , Douek DC , Drosten C , Edara VV , Ellebedy A , Fabrizio TP , Ferrari G , Florence WC , Fouchier RAM , Franks J , Garca-Sastre A , Godzik A , Gonzalez-Reiche AS , Gordon A , Haagmans BL , Halfmann PJ , Ho DD , Holbrook MR , Huang Y , James SL , Jaroszewski L , Jeevan T , Johnson RM , Jones TC , Joshi A , Kawaoka Y , Kercher L , Koopmans MPG , Korber B , Koren E , Koup RA , LeGresley EB , Lemieux JE , Liebeskind MJ , Liu Z , Livingston B , Logue JP , Luo Y , McDermott AB , McElrath MJ , Meliopoulos VA , Menachery VD , Montefiori DC , Mhlemann B , Munster VJ , Munt JE , Nair MS , Netzl A , Niewiadomska AM , O'Dell S , Pekosz A , Perlman S , Pontelli MC , Rockx B , Rolland M , Rothlauf PW , Sacharen S , Scheuermann RH , Schmidt SD , Schotsaert M , Schultz-Cherry S , Seder RA , Sedova M , Sette A , Shabman RS , Shen X , Shi PY , Shukla M , Simon V , Stumpf S , Sullivan NJ , Thackray LB , Theiler J , Thomas PG , Trifkovic S , Treli S , Turner SA , Vakaki MA , vanBakel H , VanBlargan LA , Vincent LR , Wallace ZS , Wang L , Wang M , Wang P , Wang W , Weaver SC , Webby RJ , Weiss CD , Wentworth DE , Weston SM , Whelan SPJ , Whitener BM , Wilks SH , Xie X , Ying B , Yoon H , Zhou B , Hertz T , Smith DJ , Diamond MS , Post DJ , Suthar MS . Nature 2022 605 (7911) 640-652 The global emergence of many severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants jeopardizes the protective antiviral immunity induced following infection or vaccination. To address the public health threat caused by the increasing SARS-CoV-2 genomic diversity, the National Institute of Allergy and Infectious Diseases (NIAID) within the National Institutes of Health (NIH) established the SARS-CoV-2 Assessment of Viral Evolution (SAVE) program. This effort was designed to provide a real-time risk assessment of SARS-CoV-2 variants potentially impacting transmission, virulence, and resistance to convalescent and vaccine-induced immunity. The SAVE program serves as a critical data-generating component of the United States Government SARS-CoV-2 Interagency Group to assess implications of SARS-CoV-2 variants on diagnostics, vaccines, and therapeutics and for communicating public health risk. Here we describe the coordinated approach used to identify and curate data about emerging variants, their impact on immunity, and effects on vaccine protection using animal models. We report the development of reagents, methodologies, models, and pivotal findings facilitated by this collaborative approach and identify future challenges. This program serves as a template for the response against rapidly evolving pandemic pathogens by monitoring viral evolution in the human population to identify variants that could erode the effectiveness of countermeasures. |
PrEP for key populations: results from the first PrEP demonstration project in the Democratic Republic of the Congo
Franks J , Teasdale C , Olsen H , Wang C , Mushimebele N , Tenda Mazala R , Tchissambou T , Malele Bazola F , Bingham T , Djomand G , Mukinda E , Ewetola R , Abrams E , Reidy W . AIDS Care 2021 34 (3) 1-4 Oral pre-exposure prophylaxis (PrEP) is recommended for persons at substantial risk for HIV, including female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), and transgender women (TGW). We report on a PrEP demonstration project at seven clinics in the Democratic Republic of the Congo. Routinely collected data were abstracted to assess PrEP uptake, scheduled visit attendance, and self-reported adherence. Between February and May 2018, 469 eligible clients were offered daily oral PrEP; 75.1% accepted: 78.7% FSW, 20.5% MSM, and 0.9% TGW. Two percent also identified as PWID. Attendance was 64.5% at one-month visits; 82.1% at three-month visits; and among 47.7% of clients who initiated PrEP at least six months before data abstraction, 85.8% at six-month visits. Among 66.3% of clients with at least one adherence assessment, 39% self-reported low adherence. Results demonstrate the acceptability of PrEP delivered in healthcare settings serving FSW, MSM, PWID, and TGW. |
Bringing HIV services to key populations and their communities in Tanzania: from pilot to scale
Maruyama H , Franks J , Laki D , Msumi O , Makyao N , Rwabiyago OE , Rabkin M , Kagashe MJ , El-Sadr WM . J Int AIDS Soc 2021 24 Suppl 3 e25718 INTRODUCTION: Despite the global scale-up of HIV testing, prevention and treatment, these services remain inaccessible to groups most vulnerable to HIV. Globally, most new HIV infections are concentrated among members of key populations (KP), including female sex workers, men who have sex with men, transgender people, people who inject drugs and their sexual partners. These populations lag in access to HIV prevention and antiretroviral therapy (ART) and have less favourable HIV outcomes compared to the general population. Intersecting behavioural and structural factors contribute to these gaps in service access for at-risk KP and those living with HIV; corresponding comprehensive approaches to improving service delivery for KP are urgently needed. Differentiated service delivery (DSD) models tailor HIV programmes to the needs and preferences of specific groups but are rarely implemented at scale for KP. We describe the FIKIA Project, which implemented innovative approaches to scaling up DSD models to reach and engage KP in Tanzania. METHODS: The FIKIA Project worked with diverse KP communities in Tanzania to tailor HIV services to their needs and to pair healthcare workers with trained peer educators and expert client counsellors to expand uptake of community-based HIV testing and ART services. We analysed routine aggregate project data from 2016 to 2020 to describe project implementation, outcomes and best practices. RESULTS AND DISCUSSION: The FIKIA Project conducted 1,831,441 HIV tests in community settings; of the 98,349 (5.4%) individuals with new HIV diagnoses, 89,640 (91.1%) initiated ART. The project reached substantial numbers of KP: 203,233 received HIV tests, 28,830 (14.2%) received a new HIV diagnosis and 25,170 KP (87.3%) initiated ART at the point of diagnosis. Over time, HIV testing increased by 1.6 times overall (2.3 times among KP), HIV diagnoses increased by 8.7 times (10.9 times among KP) and ART initiation at the point of diagnosis increased from 80.0% to 95.9% overall (from 69.6% to 94.9% among KP). CONCLUSIONS: Over four years, the FIKIA Project scaled up HIV testing, diagnosis and treatment by using DSD principles to design services that meet the needs of KP and their communities. |
Tailored activation of middle-aged men to promote discussion of recent active suicide thoughts: A randomized controlled trial
Jerant A , Duberstein P , Kravitz RL , Stone DM , Cipri C , Franks P . J Gen Intern Med 2020 35 (7) 2050-2058 PURPOSE: Middle-aged men are at high risk of suicide. While about half of those who kill themselves visit a primary care clinician (PCC) shortly before death, in current practice, few spontaneously disclose their thoughts of suicide during the visits, and PCCs seldom inquire about such thoughts. In a randomized controlled trial, we examined the effect of a tailored interactive computer program designed to encourage middle-aged men's discussion of suicide with PCCs. METHODS: We recruited men 35-74 years old reporting recent (within 4 weeks) active suicide thoughts from the panels of 42 PCCs (the unit of randomization) in eight offices within a single California health system. In the office before a visit, men viewed the intervention corresponding to their PCC's random group assignment: Men and Providers Preventing Suicide (MAPS) (20 PCCs), providing tailored multimedia promoting discussion of suicide thoughts, or control (22 PCCs), composed of a sleep hygiene video plus brief non-tailored text encouraging discussion of suicide thoughts. Logistic regressions, adjusting for patient nesting within physicians, examined MAPS' effect on patient-reported suicide discussion in the subsequent office visit. RESULTS: Sixteen of the randomized PCCs had no patients enroll in the trial. From the panels of the remaining 26 PCCs (12 MAPS, 14 control), 48 men (MAPS 21, control 27) were enrolled (a mean of 1.8 (range 1-5) per PCC), with a mean age of 55.9 years (SD 11.4). Suicide discussion was more likely among MAPS patients (15/21 [65%]) than controls (8/27 [35%]). Logistic regression showed men viewing MAPS were more likely than controls to discuss suicide with their PCC (OR 5.91, 95% CI 1.59-21.94; P = 0.008; nesting-adjusted predicted effect 71% vs. 30%). CONCLUSIONS: In addressing barriers to discussing suicide, the tailored MAPS program activated middle-aged men with active suicide thoughts to engage with PCCs around this customarily taboo topic. |
Characteristics associated with presence of pediatric mental health care policies in emergency departments
Cree RA , So M , Franks J , Richards R , Leeb R , Hashikawa A , Krug S , Ludwig L , Olson LM . Pediatr Emerg Care 2019 37 (12) e1116-e1121 OBJECTIVES: The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy. METHODS: We analyzed data from the National Pediatric Readiness Project, a nationally representative cross-sectional survey of US EDs. Nurse managers reported whether their hospitals had a policy to care for children with social/mental health concerns (n = 3612). We calculated prevalence estimates, prevalence ratios (PRs), and confidence intervals (CIs) for regional and ED characteristics (eg, rurality and types of personnel) by whether EDs had a pediatric mental health care policy. RESULTS: Overall, 46.2% (n = 1668/3612) of EDs had a pediatric mental health care policy. Emergency departments located in remote areas were 60% less likely to have such a policy compared with EDs in urban areas (PR, 0.4; CI, 0.3-0.5). Emergency department characteristics associated with having a pediatric mental health care policy included having a policy to transfer children with social/mental health concerns (PR, 5.4; CI, 4.7-6.2), having a policy to address maltreatment (PR, 3.4; CI, 2.6-4.4), and having nurse and physician pediatric emergency care coordinators (PR, 1.6; CI, 1.5-1.8). CONCLUSIONS: Lower prevalence of pediatric mental health policies in rural EDs is concerning considering EDs are often the first point of contact for pediatric patients. This work highlights the importance of pediatric emergency care coordinators in fostering ED capacity to meet children's mental health needs. |
Building children's preparedness capacity at the Centers for Disease Control and Prevention one event at a time, 2009-2018
Leeb RT , Franks JL , Dziuban EJ , Ruben W , Bartenfeld M , Hinton CF , Chatham-Stephens K , Peacock G . Am J Public Health 2019 109 S260-s262 This issue of AJPH highlights the importance of community preparedness for public health emergencies. An essential component of community preparedness is the capacity to address the needs of children, who comprise nearly one quarter of the US population and are particularly vulnerable to disaster-related morbidity and mortality (Figure 1).1 However, communities may not be well equipped to address children’s needs. |
An evaluation of the literacy demands of online natural disaster preparedness materials for families
So M , Franks JL , Cree RA , Leeb RT . Disaster Med Public Health Prep 2019 14 (4) 1-10 OBJECTIVE: Natural disasters are becoming increasingly common, but it is unclear whether families can comprehend and use available resources to prepare for such emergencies. The objective of this study was to evaluate the literacy demands of risk communication materials on natural disasters for US families with children. METHODS: In January 2018, we assessed 386 online self-directed learning resources related to emergency preparedness for natural disasters using 5 literacy assessment tools. Assessment scores were compared by information source, audience type, and disaster type. RESULTS: One-in-three websites represented government institutions, and 3/4 were written for a general audience. Nearly 1-in-5 websites did not specify a disaster type. Assessment scores suggest a mismatch between the general population's literacy levels and literacy demands of materials in the areas of readability, complexity, suitability, web usability, and overall audience appropriateness. Materials required more years of education beyond the grade level recommended by prominent health organizations. Resources for caregivers of children generally and children with special health care needs possessed lower literacy demands than materials overall, for most assessment tools. CONCLUSIONS: Risk communication and public health agencies could better align the literacy demands of emergency preparedness materials with the literacy capabilities of the general public. |
Extending the reach of pediatric emergency preparedness: A virtual tabletop exercise targeting children's needs
So M , Dziuban EJ , Franks JL , Cobham-Owens K , Schonfeld DJ , Gardner AH , Krug SE , Peacock G , Chung S . Public Health Rep 2019 134 (4) 33354919849880 OBJECTIVES: Virtual tabletop exercises (VTTXs) simulate disaster scenarios to help participants improve their emergency-planning capacity. The objectives of our study were to (1) evaluate the effectiveness of a VTTX in improving preparedness capabilities specific to children's needs among pediatricians and public health practitioners, (2) document follow-up actions, and (3) identify exercise strengths and weaknesses. METHODS: In February 2017, we conducted and evaluated a VTTX facilitated via videoconferencing among 26 pediatricians and public health practitioners from 4 states. Using a mixed-methods design, we assessed participants' knowledge and confidence to fulfill targeted federal preparedness capabilities immediately before and after the exercise. We also evaluated the degree to which participants made progress on actions through surveys 1 month (n = 14) and 6 months (n = 14) after the exercise. RESULTS: Participants reported a greater ability to identify their state's pediatric emergency preparedness strengths and weaknesses after the exercise (16 of 18) compared with before the exercise (10 of 18). We also observed increases in (1) knowledge of and confidence in performing most pediatric emergency preparedness capabilities and (2) most dimensions of interprofessional collaboration. From 1 month to 6 months after the exercise, participants (n = 14) self-reported making progress in increasing awareness for potential preparedness partners and in conducting similar pediatric exercises (from 4-7 for both). CONCLUSIONS: Participants viewed the VTTX positively and indicated increased pediatric emergency preparedness knowledge and confidence. Addressing barriers to improving local pediatric emergency preparedness-particularly long term-is an important target for future tabletop exercises. |
Emergency preparedness is equally important as response in optimizing the health and well-being of the nation's children
Peacock G , So M , Franks J . Pediatrics 2018 142 (4) We commend the policy statement by Kuo et al1 in which they highlight the critical need for collaboration between pediatric and public health sectors in safeguarding the health of our nation’s children,1 and in particular, we commend the authors’ emphasis on emergency management and response efforts surrounding the 2016 Flint water contamination crisis, 2015 Zika virus emergency, and 2015 Disneyland measles outbreak. In addition, we agree that synergy between public health and pediatricians on emergency preparedness is a key opportunity for primary prevention and health promotion. In this letter, we highlight the crucial partnership between the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) and discuss ongoing preparedness activities used to address the call to action put forth by Kuo et al.1 |
The disaster information needs of families of children with special healthcare needs: A scoping review
Hipper TJ , Davis R , Massey PM , Turchi RM , Lubell KM , Pechta LE , Rose DA , Wolkin A , Briseno L , Franks JL , Chernak E . Health Secur 2018 16 (3) 178-192 Families with children who have access and mobility challenges, chronic illness, or intellectual or developmental disabilities require targeted messages before, during, and after disasters to ensure that they understand risks to their children's health and can take measures to avoid harm and build resilience. A scoping review was conducted to assess current evidence for optimal ways to address the disaster information needs and communication preferences of families with children and youth with special healthcare needs. The disaster information needs of such families remain understudied, with few published evidence-based practices. Much of the relevant research focuses on information content, specifically the preparedness needs of these families; disaster recovery information for them remains a major gap. The few studies that have been performed suggest that parents with children and youth with special healthcare needs require additional information, education, and training to develop an effective disaster preparedness plan for their children. They are also largely unaware of schools' disaster plans, and schools are often unable to meet parents' expectations for timely, accurate information during a disaster. Several guidance documents highlighted the importance of completing an emergency information form before an event. Several studies suggested that one-on-one education or counseling was a strategy for encouraging preparedness planning; others highlighted potential value in incorporating families directly into disaster risk reduction planning. Evidence about channel preferences and their effectiveness in this population was generally lacking. Future studies should expand the evidence basis for optimal communication during all disaster phases both with parents of children and youth with special healthcare needs and with children directly. |
Addressing children's needs in disasters: A regional pediatric tabletop exercise
Chung S , Gardner AH , Schonfeld DJ , Franks JL , So M , Dziuban EJ , Peacock G . Disaster Med Public Health Prep 2018 12 (5) 1-5 OBJECTIVE: Preparing and responding to the needs of children during public health emergencies continues to be challenging. The purpose of this study was to assess the usefulness of a tabletop exercise in initiating pediatric preparedness strategies and assessing the impact of the exercise on participants' understanding of and confidence in their roles during pediatric public health emergencies. METHODS: A tabletop exercise was developed to simulate a public health emergency scenario involving smallpox in a child, with subsequent spread to multiple states. During the exercise, participants discussed and developed communication, collaboration, and medical countermeasure strategies to enhance pediatric public health preparedness. Exercise evaluation was designed to assess participants' knowledge gained and level of confidence surrounding pediatric public health emergencies. RESULTS: In total, 22 participants identified over 100 communication and collaboration strategies to promote pediatric public health preparedness during the exercise and found that the most beneficial aspect during the exercise was the partnership between pediatricians and public health officials. Participants' knowledge and level of confidence surrounding a pediatric public health emergency increased after the exercise. CONCLUSION: The tabletop exercise was effective in identifying strategies to improve pediatric public health preparedness as well as enhancing participants' knowledge and confidence surrounding a potential pediatric public health emergency. (Disaster Med Public Health Preparedness. 2018;page 1 of 5). |
Elizabethkingia in children: A comprehensive review of symptomatic cases reported from 1944-2017
Dziuban EJ , Franks J , So M , Peacock G , Blaney DD . Clin Infect Dis 2017 67 (1) 144-149 Elizabethkingia species often exhibit extensive antibiotic resistance and result in high morbidity and mortality, yet no systematic reviews exist that thoroughly characterize and quantify concerns for infected infants and children. We performed a review of literature and identified an initial 902 articles; 96 articles reporting 283 pediatric cases met our inclusion criteria and were subsequently reviewed. Case reports spanned 28 countries and ranged from 1944 to 2017. Neonatal meningitis remains the most common presentation of this organism in children, along with a range of other clinical manifestations. The majority of reported cases occurred as isolated cases, rather than within outbreaks. Mortality was high but has decreased in recent years, although neurologic sequelae among survivors remains concerning. Child outcomes can be improved through effective prevention measures and early identification and treatment of infected patients. |
Differential activation of RAW 264.7 macrophages by size-segregated crystalline silica
Mischler SE , Cauda EG , Di Giuseppe M , McWilliams LJ , St Croix C , Sun M , Franks J , Ortiz LA . J Occup Med Toxicol 2016 11 57 BACKGROUND: Occupational exposure to crystalline silica is a well-established occupational hazard. Once in the lung, crystalline silica particles can result in the activation of alveolar macrophages (AM), potentially leading to silicosis, a fibrotic lung disease. Because the activation of alveolar macrophages is the beginning step in a complicated inflammatory cascade, it is necessary to define the particle characteristics resulting in this activation. The aim of this research was to determine the effect of the size of crystalline silica particles on the activation of macrophages. METHODS: RAW 264.7 macrophages were exposed to four different sizes of crystalline silica and their activation was measured using electron microscopy, reactive oxygen species (ROS) generation by mitochondria, and cytokine expression. RESULTS: These data identified differences in particle uptake and formation of subcellular organelles based on particle size. In addition, these data show that the smallest particles, with a geometric mean of 0.3 mum, significantly increase the generation of mitochondrial ROS and the expression of cytokines when compared to larger crystalline silica particles, with a geometric mean of 4.1 mum. CONCLUSION: In summary, this study presents novel data showing that crystalline silica particles with a geometric mean of 0.3 mum enhance the activation of AM when compared to larger silica particles usually represented in in vitro and in vivo research. |
Characteristics of children aged <18 years with Zika virus disease acquired postnatally - U.S. States, January 2015-July 2016
Goodman AB , Dziuban EJ , Powell K , Bitsko RH , Langley G , Lindsey N , Franks JL , Russell K , Dasgupta S , Barfield WD , Odom E , Kahn E , Martin S , Fischer M , Staples JE . MMWR Morb Mortal Wkly Rep 2016 65 (39) 1082-1085 Zika virus is an emerging mosquito-borne flavivirus that typically causes an asymptomatic infection or mild illness, although infection during pregnancy is a cause of microcephaly and other serious brain abnormalities. Guillain-Barre syndrome and other neurologic complications can occur in adults after Zika virus infection. However, there are few published reports describing postnatally acquired Zika virus disease among children. During January 2015-July 2016, a total of 158 cases of confirmed or probable postnatally acquired Zika virus disease among children aged <18 years were reported to CDC from U.S. states. The median age was 14 years (range = 1 month-17 years), and 88 (56%) were female. Two (1%) patients were hospitalized; none developed Guillain-Barre syndrome, and none died. All reported cases were travel-associated. Overall, 129 (82%) children had rash, 87 (55%) had fever, 45 (29%) had conjunctivitis, and 44 (28%) had arthralgia. Health care providers should consider a diagnosis of Zika virus disease in children who have an epidemiologic risk factor and clinically compatible illness, and should report cases to their state or local health department. |
Comparative effectiveness of high-dose versus standard-dose influenza vaccines in US residents aged 65 years and older from 2012 to 2013 using Medicare data: a retrospective cohort analysis
Izurieta HS , Thadani N , Shay DK , Lu Y , Maurer A , Foppa IM , Franks R , Pratt D , Forshee RA , MaCurdy T , Worrall C , Howery AE , Kelman J . Lancet Infect Dis 2015 15 (3) 293-300 BACKGROUND: A high-dose trivalent inactivated influenza vaccine was licensed in 2009 by the US Food and Drug Administration (FDA) on the basis of serological criteria. We sought to establish whether high-dose inactivated influenza vaccine was more effective for prevention of influenza-related visits and hospital admissions in US Medicare beneficiaries than was standard-dose inactivated influenza vaccine. METHODS: In this retrospective cohort study, we identified Medicare beneficiaries aged 65 years and older who received high-dose or standard-dose inactivated influenza vaccines from community pharmacies that offered both vaccines during the 2012-13 influenza season. Outcomes were defined with billing codes on Medicare claims. The primary outcome was probable influenza infection, defined by receipt of a rapid influenza test followed by dispensing of the neuraminidase inhibitor oseltamivir. The secondary outcome was a hospital or emergency department visit, listing a Medicare billing code for influenza. We estimated relative vaccine effectiveness by comparing outcome rates in Medicare beneficiaries during periods of high influenza circulation. Univariate and multivariate Poisson regression models were used for analyses. FINDINGS: Between Aug 1, 2012 and Jan 31, 2013, we studied 929 730 recipients of high-dose vaccine and 1 615 545 recipients of standard-dose vaccine. Participants enrolled in each cohort were well balanced with respect to age and presence of underlying medical disorders. The high-dose vaccine (1.30 outcomes per 10 000 person-weeks) was 22% (95% CI 15-29) more effective than the standard-dose vaccine (1.01 outcomes per 10 000 person-weeks) for prevention of probable influenza infections (rapid influenza test followed by oseltamivir treatment) and 22% (95% CI 16-27%) more effective for prevention of influenza hospital admissions (0.86 outcomes per 10 000 person-weeks in the high-dose cohort vs 1.10 outcomes per 10 000 person-weeks in the standard-dose cohort). INTERPRETATION: Our retrospective cohort study in US Medicare beneficiaries shows that, in people 65 years of age and older, high-dose inactivated influenza vaccine was significantly more effective than standard-dose vaccine in prevention of influenza-related medical encounters. Additionally, the large population in our study enabled us to show, for the first time, a significant reduction in influenza-related hospital admissions in high-dose compared to standard-dose vaccine recipients, an outcome not shown in randomised studies. These results provide important new information to be considered by policy makers recommending influenza vaccinations for elderly people. FUNDING: FDA and the office of the Assistant Secretary of Planning and Evaluation. |
Opportunities for tuberculosis diagnosis and prevention among persons living with HIV: a cross-sectional study of policies and practices at four large Ryan White Program-funded HIV clinics
Pascopella L , Franks J , Marks SM , Salcedo K , Schmitz K , Colson PW , Hirsch-Moverman Y , Flood J , Sayles J . PLoS One 2014 9 (7) e101313 OBJECTIVE: We describe the frequency and attributes of tuberculosis testing and treatment at four publicly-funded HIV clinics. METHODS: We abstracted medical records from a random sample of 600 HIV-infected patients having at least one clinic visit in 2009 at four clinics in New York and Los Angeles Metropolitan Statistical areas. We described testing and treatment for tuberculosis infection (TBI), 2008-2010, and estimated adjusted odds ratios (aORs). We interviewed key informants and described clinic policies and practices. RESULTS: Of 600 patients, 500 were eligible for testing, and 393 (79%) were tested 2008-2010; 107 (21%) did not receive at least one tuberculin skin test or interferon gamma release assay. Results were positive in 20 (5%) patients, negative in 357 (91%), and unknown in 16 (4%). Fourteen (70%) of 20 patients with TBI initiated treatment at the clinics; only three were documented to have completed treatment. Three hundred twenty three (54%) patients had chest radiography, 346 (58%) had tuberculosis symptom screening, and three had tuberculosis disease (117 per 100,000 person-years, 95% confidence interval (CI) = 101-165). Adjusting for site, non-Hispanic ethnicity (aOR = 4.9, 95% CI = 2.6-9.5), and employment (aOR = 1.9, 95% CI = 1.0-3.4) were associated with TBI testing; female gender (aOR = 2.0, 95% CI = 1.4-3.3), non-black race (aOR = 1.7, 95% CI = 1.3-2.5), and unemployment (aOR = 1.5, 95% CI = 1.1-2.1) were associated with chest radiography. Clinics evaluated TBI testing performance annually and identified challenges to TB prevention. CONCLUSIONS: Study clinics routinely tested patients for TBI, but did not always document treatment. In a population with a high TB rate, ensuring treatment of TBI may enhance TB prevention. |
No interactions between previously associated 2-hour glucose gene variants and physical activity or BMI on 2-hour glucose levels.
Scott RA , Chu AY , Grarup N , Manning AK , Hivert MF , Shungin D , Tonjes A , Yesupriya A , Barnes D , Bouatia-Naji N , Glazer NL , Jackson AU , Kutalik Z , Lagou V , Marek D , Rasmussen-Torvik LJ , Stringham HM , Tanaka T , Aadahl M , Arking DE , Bergmann S , Boerwinkle E , Bonnycastle LL , Bornstein SR , Brunner E , Bumpstead SJ , Brage S , Carlson OD , Chen H , Chen YD , Chines PS , Collins FS , Couper DJ , Dennison EM , Dowling NF , Egan JS , Ekelund U , Erdos MR , Forouhi NG , Fox CS , Goodarzi MO , Grässler J , Gustafsson S , Hallmans G , Hansen T , Hingorani A , Holloway JW , Hu FB , Isomaa B , Jameson KA , Johansson I , Jonsson A , Jørgensen T , Kivimaki M , Kovacs P , Kumari M , Kuusisto J , Laakso M , Lecoeur C , Lévy-Marchal C , Li G , Loos RJ , Lyssenko V , Marmot M , Marques-Vidal P , Morken MA , Müller G , North KE , Pankow JS , Payne F , Prokopenko I , Psaty BM , Renström F , Rice K , Rotter JI , Rybin D , Sandholt CH , Sayer AA , Shrader P , Schwarz PE , Siscovick DS , Stancáková A , Stumvoll M , Teslovich TM , Waeber G , Williams GH , Witte DR , Wood AR , Xie W , Boehnke M , Cooper C , Ferrucci L , Froguel P , Groop L , Kao WH , Vollenweider P , Walker M , Watanabe RM , Pedersen O , Meigs JB , Ingelsson E , Barroso I , Florez JC , Franks PW , Dupuis J , Wareham NJ , Langenberg C . Diabetes 2012 61 (5) 1291-6 Gene-lifestyle interactions have been suggested to contribute to the development of type 2 diabetes. Glucose levels 2 h after a standard 75-g glucose challenge are used to diagnose diabetes and are associated with both genetic and lifestyle factors. However, whether these factors interact to determine 2-h glucose levels is unknown. We meta-analyzed single nucleotide polymorphism (SNP) x BMI and SNP x physical activity (PA) interaction regression models for five SNPs previously associated with 2-h glucose levels from up to 22 studies comprising 54,884 individuals without diabetes. PA levels were dichotomized, with individuals below the first quintile classified as inactive (20%) and the remainder as active (80%). BMI was considered a continuous trait. Inactive individuals had higher 2-h glucose levels than active individuals (beta = 0.22 mmol/L [95% CI 0.13-0.31], P = 1.63 x 10(-6)). All SNPs were associated with 2-h glucose (beta = 0.06-0.12 mmol/allele, P ≤ 1.53 x 10(-7)), but no significant interactions were found with PA (P > 0.18) or BMI (P ≥ 0.04). In this large study of gene-lifestyle interaction, we observed no interactions between genetic and lifestyle factors, both of which were associated with 2-h glucose. It is perhaps unlikely that top loci from genome-wide association studies will exhibit strong subgroup-specific effects, and may not, therefore, make the best candidates for the study of interactions. |
Use of historical data and a novel metric in the evaluation of the effectiveness of hearing conservation program components
Heyer N , Morata TC , Pinkerton LE , Brueck SE , Stancescu D , Panaccio MP , Kim H , Sinclair JS , Waters MA , Estill CF , Franks JR . Occup Environ Med 2010 68 (7) 510-7 OBJECTIVES: To evaluate the effectiveness of hearing conservation programs (HCP) and their specific components in reducing noise-induced hearing loss (NIHL). METHODS: This retrospective cohort study was conducted at one food-processing plant and two automotive plants. Audiometric and work-history databases were combined with historical noise monitoring data to develop a time-dependent exposure matrix for each plant. Historical changes in production and HCP implementation were collected from company records, employee interviews and focus groups. These data were used to develop time-dependent quality assessments for various HCP components. 5478 male (30 427 observations) and 1005 female (5816 observations) subjects were included in the analysis. RESULTS: Analyses were conducted separately for males and females. Females tended to have less NIHL at given exposure levels than males. Duration of noise exposure stratified by intensity (dBA) was a better predictor of NIHL than the standard equivalent continuous noise level (L(eq)) based upon a 3-dBA exchange. Within this cohort, efficient dBA strata for males were <95 versus ≥95, and for females <90 versus ≥90. The reported enforced use of hearing protection devices (HPDs) significantly reduced NIHL. The data did not have sufficient within-plant variation to determine the effectiveness of noise monitoring or worker training. An association between increased audiometric testing and NIHL was believed to be an artifact of increased participation in screening. CONCLUSIONS: Historical audiometric data combined with noise monitoring data can be used to better understand the effectiveness of HCPs. Regular collection and maintenance of quality data should be encouraged and used to monitor the effectiveness of these interventions. |
Carbon nanotubes degraded by neutrophil myeloperoxidase induce less pulmonary inflammation
Kagan VE , Konduru NV , Feng W , Allen BL , Conroy J , Volkov Y , Vlasova II , Belikova NA , Yanamala N , Kapralov A , Tyurina YY , Shi J , Kisin ER , Murray AR , Franks J , Stolz D , Gou P , Klein-Seetharaman J , Fadeel B , Star A , Shvedova AA . Nat Nanotechnol 2010 5 (5) 354-9 We have shown previously that single-walled carbon nanotubes can be catalytically biodegraded over several weeks by the plant-derived enzyme, horseradish peroxidase. However, whether peroxidase intermediates generated inside human cells or biofluids are involved in the biodegradation of carbon nanotubes has not been explored. Here, we show that hypochlorite and reactive radical intermediates of the human neutrophil enzyme myeloperoxidase catalyse the biodegradation of single-walled carbon nanotubes in vitro, in neutrophils and to a lesser degree in macrophages. Molecular modelling suggests that interactions of basic amino acids of the enzyme with the carboxyls on the carbon nanotubes position the nanotubes near the catalytic site. Importantly, the biodegraded nanotubes do not generate an inflammatory response when aspirated into the lungs of mice. Our findings suggest that the extent to which carbon nanotubes are biodegraded may be a major determinant of the scale and severity of the associated inflammatory responses in exposed individuals. |
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