Public space initiatives (PSIs) in African cities can significantly promote health and social well-being, yet their implementation and impact are unknown across the continent. There is a substantial gap in literature on PSIs in African countries, with most studies concentrated in wealthier cities and lacking comprehensive assessments of long-term health impacts. The objective of this study was to synthesise evidence on the typology, location, features, and outcomes of these initiatives as well as the guiding principles that underlie their design and implementation. Employing a mixed-methods model, the study systematically reviews peer-reviewed and grey literature articles, focusing on the types, settings, and outcomes of PSIs. Data is analyzed using the CASP appraisal tool and thematic analysis. We analysed 47 studies, 15 of which were mixed methods, 22 qualitative and 10 quantitative. Sports accounted for 50% of initiatives. 30 of the 47 papers originated from South Africa. Communities viewed initiatives' wellbeing impacts through social, economic, and ecological lenses, with health being but one dimension. The sustainability of initiatives was often limited by funding, historical marginalization, and competing land uses. Findings underscore the need for more comprehensive, long-term evaluations and cross-sector collaborations to sustain and enhance health-promoting public spaces in African cities.

The COVID-19 pandemic has highlighted how infodemics (defined as an overabundance of information, including misinformation and disinformation) pose a threat to public health and could hinder individuals from making informed health decisions. Although public health authorities and other stakeholders have implemented measures for managing infodemics, existing frameworks for infodemic management have been primarily focused on responding to acute health emergencies rather than integrated in routine service delivery. We review the evidence and propose a framework for infodemic management that encompasses upstream strategies and provides guidance on identifying different interventions, informed by the four levels of prevention in public health: primary, secondary, tertiary, and primordial prevention. On the basis of a narrative review of 54 documents (peer-reviewed and grey literature published from 1961 to 2023), we present examples of interventions that belong to each level of prevention. Adopting this framework requires proactive prevention and response through managing information ecosystems, beyond reacting to misinformation or disinformation.

BACKGROUND: Humans are likely exposed to microplastics (MPs) in a variety of places including indoor and outdoor air. Research to better understand how exposure to MPs correlates to health is growing. To fully understand the possible impacts of MPs on human health, it is necessary to quantify MP exposure and identify what critical data gaps exist. OBJECTIVES: The current paper provides a human exposure assessment of microplastics in the air using systematically reviewed literature that provided concentration of MPs in air as well as doses used in toxicology studies to calculate inhalation exposure dose. METHODS: All published peer-reviewed journal articles, non-published papers, and grey literature that focused on micro- or nano-plastics in indoor and outdoor air were systematically searched using PRISMA guidelines. Literature that defined specific concentrations and size of MPs in air or exposed to human lung cells, animals, or humans with measurable health impacts were included in data extraction. Inhalational exposures were calculated for different age groups using published MP concentrations from the included literature using exposure dose equations and values from U.S. ATSDR and EPA. RESULTS: Calculated mean indoor inhalational exposures from passive sampling methods were higher than those calculated from active sampling methods. When comparing indoor and outdoor sampling, calculated inhalation exposures from indoor samples were greater than those from outdoor samples. Inhalation exposures of MPs differed between age groups with infants having the highest calculated dose values for all locations followed by preschool age children, middle-school aged children, pregnant women, adolescents, and non-pregnant adults. MP doses used in toxicology studies produced higher calculated mean inhalational exposures than those from environmental samples. IMPACT: This study is the first known systematic review of inhalational MP exposure from indoor and outdoor air. It also provides inhalational exposures calculated from previously published environmental samples of MPs as well as from toxicology studies.

BACKGROUND: Recent estimates show progress toward malaria elimination is slowing in many settings, underscoring the need for tailored approaches to fight the disease. In addition to essential structural changes, human behaviour plays an important role in elimination. Engagement in malaria behaviours depends in part on psychosocial determinants such as knowledge, perceived risk, and community norms. Understanding the state of research on psychosocial determinants in low malaria transmission settings is important to augment social and behaviour change practice. This review synthesizes research on psychosocial factors and malaria behaviours in low-transmission settings. METHODS: A systematic search of peer-reviewed literature and supplemental manual search of grey literature was conducted using key terms and eligibility criteria defined a priori. Publications from 2000-2020 in the English language were identified, screened, and analysed using inductive methods to determine the relationship between the measured psychosocial factors and malaria behaviours. RESULTS: Screening of 961 publications yielded 96 for inclusion. Nineteen articles collected data among subpopulations that are at increased risk of malaria exposure in low-transmission settings. Purposive and cluster randomized sampling were common sampling approaches. Quantitative, qualitative, and mixed-methods study designs were used. Knowledge, attitudes, and perceived risk were commonly measured psychosocial factors. Perceived response-efficacy, perceived self-efficacy, and community norms were rarely measured. Results indicate positive associations between malaria knowledge and attitudes, and preventive and care-seeking behaviour. Studies generally report high rates of correct knowledge, although it is comparatively lower among studies of high-risk groups. There does not appear to be sufficient extant evidence to determine the relationship between other psychosocial variables and behaviour. CONCLUSIONS: The review highlights the need to deploy more consistent, comprehensive measures of psychosocial factors and the importance of reaching subpopulations at higher risk of transmission in low transmission contexts. Malaria-related knowledge is generally high, even in settings of low transmission. Programmes and research should work to better understand the psychosocial factors that have been positively associated with prevention and care-seeking behaviours, such as norms, perceived response efficacy, perceived self-efficacy, and interpersonal communication. These factors are not necessarily distinct from that which research has shown are important in settings of high malaria transmission. However, the importance of each factor and application to malaria behaviour change programming in low-transmission settings is an area in need of further research. Existing instruments and approaches are available to support more systematic collection of psychosocial determinants and improved sampling approaches and should be applied more widely. Finally, while human behaviour is critical, health systems strengthening, and structural interventions are essential to achieve malaria elimination goals.

INTRODUCTION: Congenital syphilis cases in the United States increased 755% during 2012-2021. Syphilis during pregnancy can lead to stillbirth, miscarriage, infant death, and maternal and infant morbidity; these outcomes can be prevented through appropriate screening and treatment. METHODS: A cascading framework was used to identify and classify missed opportunities to prevent congenital syphilis among cases reported to CDC in 2022 through the National Notifiable Diseases Surveillance System. Data on testing and treatment during pregnancy and clinical manifestations present in the newborn were used to identify missed opportunities to prevent congenital syphilis. RESULTS: In 2022, a total of 3,761 cases of congenital syphilis in the United States were reported to CDC, including 231 (6%) stillbirths and 51 (1%) infant deaths. Lack of timely testing and adequate treatment during pregnancy contributed to 88% of cases of congenital syphilis. Testing and treatment gaps were present in the majority of cases across all races, ethnicities, and U.S. Census Bureau regions. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Addressing missed opportunities for prevention, primarily timely testing and appropriate treatment of syphilis during pregnancy, is important for reversing congenital syphilis trends in the United States. Implementing tailored strategies addressing missed opportunities at the local and national levels could substantially reduce congenital syphilis.

Congenital syphilis (CS) rates have risen in the U.S. since 2013. Prevention of CS requires testing and treatment of pregnant and pregnancy-capable persons at high risk for syphilis. We developed a CS Prevention Cascade to assess how effectively testing and treatment interventions reached pregnant persons with a CS outcome.

Several invasive mosquito species that are nuisances or of medical and veterinary importance have been introduced into the Southeastern region of the USA, posing a threat to other species and the local ecosystems and/or increasing the risk of pathogen transmission to people, livestock, and domestic pets. Prompt and effective monitoring and control of invasive species is essential to prevent them from spreading and causing harmful effects. However, the capacity for invasive mosquito species surveillance is highly variable among mosquito control programs in the Southeast, depending on a combination of factors such as regional geography and climate, access to resources, and the ability to interact with other programs. To facilitate the development of invasive mosquito surveillance in the region, we, the Mosquito BEACONS (Biodiversity Enhancement and Control of Non-native Species) working group, conducted a survey on the capacities of various public health agencies and pest control agencies engaged in mosquito surveillance and control in seven Southeastern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina). Ninety control programs completed the survey, representing an overall response rate of 25.8%. We report key findings from our survey, emphasizing the training and resource needs, and discuss their implications for future invasive mosquito surveillance and control capacity building. By increasing communication and collaboration opportunities (e.g., real-time sharing of collection records, coordinated multistate programs), the establishment of Mosquito BEACONS and the implementation of this survey can accelerate knowledge transfer and improve decision support capacity in response to or in preparation for invasive mosquito surveillance and can establish infrastructure that can be used to inform programs around the world.

INTRODUCTION Epidemic forecasting and prediction tools have the potential to provide actionable information in the midst of emerging epidemics. While numerous predictive studies were published during the 2016-2017 Zika Virus (ZIKV) pandemic, it remains unknown how timely, reproducible and actionable the information produced by these studies was.METHODS To improve the functional use of mathematical modeling in support of future infectious disease outbreaks, we conducted a systematic review of all ZIKV prediction studies published during the recent ZIKV pandemic using the PRISMA guidelines. Using MEDLINE, EMBASE and grey literature review, we identified studies that forecasted, predicted or simulated ecological or epidemiological phenomenon related to the Zika pandemic that were published as of March 01, 2017. Eligible studies underwent evaluation of objectives, data sources, methods, timeliness, reproducibility, accessibility and clarity by independent reviewers.RESULTS 2034 studies were identified, of which n = 73 met eligibility criteria. Spatial spread, R0 (basic reproductive number) and epidemic dynamics were most commonly predicted, with few studies predicting Guillain-Barré Syndrome burden (4%), sexual transmission risk (4%) and intervention impact (4%). Most studies specifically examined populations in the Americas (52%), with few African-specific studies (4%). Case count (67%), vector (41%) and demographic data (37%) were the most common data sources. Real-time internet data and pathogen genomic information were used in 7% and 0% of studies, respectively, and social science and behavioral data were typically absent in modeling efforts. Deterministic models were favored over stochastic approaches. Forty percent of studies made model data entirely available, 29% provided all relevant model code, 43% presented uncertainty in all predictions and 54% provided sufficient methodological detail allowing complete reproducibility. Fifty-one percent of predictions were published after the epidemic peak in the Americas. While the use of preprints improved the accessibility of ZIKV predictions by a median 119 days sooner than journal publication dates, they were used in only 30% of studies.CONCLUSIONS Many ZIKV predictions were published during the 2016-2017 pandemic. The accessibility, reproducibility, timeliness, and incorporation of uncertainty in these published predictions varied and indicates that there is substantial room for improvement. To enhance the utility of analytical tools for outbreak response, it is essential to improve the sharing of model data, code, and preprints for future outbreaks, epidemics and pandemics.Author summary Researchers published many studies which sought to predict and forecast important features of Zika virus (ZIKV) infections and their spread during the 2016-2017 ZIKV pandemic. We conducted a comprehensive review of such ZIKV prediction studies and evaluated their aims, the data sources they used, which methods were used, how timely they were published, and whether they provided sufficient information to be used or reproduced by others. Of the 73 studies evaluated, we found that the accessibility, reproducibility, timeliness, and incorporation of uncertainty in these published predictions varied and indicates that there is substantial room for improvement. We identified that the release of study findings before formal journal publication (‘pre-prints’) increased the timeliness of Zika prediction studies, but note they were infrequently used during this public health emergency. Addressing these areas can improve our understanding of Zika and other outbreaks and ensure that forecasts can inform preparedness and response to future outbreaks, epidemics and pandemics.

BACKGROUND: Chancroid has been a nationally notifiable condition in the United States since 1944, with cases reported to Centers Disease Control and Prevention through the National Notifiable Diseases Surveillance System. Although frequently reported during the 1940s, <20 cases have been reported annually since 2011. We assessed the performance and utility of national case-based chancroid surveillance. METHODS: We reviewed the literature to contextualize chancroid surveillance through National Notifiable Diseases Surveillance System. We then assessed 4 system attributes, including data quality, sensitivity, usefulness, and representativeness: we reviewed chancroid cases reported during 2011-2020, conducted interviews with (a) sexually transmitted disease programs reporting ≥1 case in 2019 or 2020 (n = 9) and (b) Centers Disease Control and Prevention subject matter experts (n = 10), and reviewed published communicable disease reporting laws. RESULTS: Chancroid diagnostic testing is limited, which affects the surveillance case definition. National case-based surveillance has poor data quality; of the 2019 and preliminary 2020 cases (n = 14), only 3 were verified by jurisdictions as chancroid cases. Sexually transmitted disease programs report the system has low sensitivity given limited clinician knowledge and resources; experts report the system is not useful in guiding national control efforts. Review of reporting laws revealed it is not representative, as chancroid is not a reportable condition nationwide. CONCLUSIONS: Critical review of system attributes suggest that national case-based chancroid surveillance data have limited ability to help describe and monitor national trends, and chancroid's inclusion on the national notifiable list might need to be reconsidered. Alternative strategies might be needed to monitor national chancroid burden.

Considering the hazardous effects of particulate matter (PM) exposure on students and teachers and the high PM concentration issue in South Korea, air purifiers have recently been installed in most classrooms to improve air quality. However, some on-site challenges, such as operational costs and noise, have been issues with the continuous operation of air purifiers. Therefore, a guideline is needed to dynamically predict the indoor PM concentration based on the changes in outdoor PM concentration and activate the air purifiers only when necessary. This study develops a grey-box model that uses measured data and physical differential equations to perform the given objective and verifies its accuracy using ASTM D5157. Modeling and analysis results have obtained information that can form the basis for developing guidelines to address PM issues in schools: The air purifier should be operated during periods where the predicted values exceed the limit in closed windows and the air purifier is not operating. It was also confirmed that the need for the operation of the air purifier varies between schools and classrooms under the same outdoor PM concentration. Indoor PM concentration increased significantly after students' simultaneous mass movement, necessitating air purifiers' operation before and after the events. The pre-filter of the heater also aided in the removal of coarse PM. Additionally, the limitations and future development directions of the model were discussed.

Recent investments in built environment infrastructure to create healthy communities have highlighted the need for equity and environmental justice. Although the benefits of healthy community design (e.g., connecting transportation systems and land use changes) are well established, some reports suggest that these changes may increase property values. These increases can raise the risk of displacement for people with low incomes and/or who are from racial and ethnic minority groups, who would then miss out on benefits from changes in community design. This review scanned the literature for displacement mitigation and prevention measures, with the goal of providing a compilation of available strategies for a wide range of audiences including public health practitioners. A CDC librarian searched the Medline, EbscoHost, Scopus, and ProQuest Central databases, and we identified grey literature using Google and Google Scholar searches. The indexed literature search identified 6 articles, and the grey literature scan added 18 articles. From these 24 total articles, we identified 141 mitigation and prevention strategies for displacement and thematically characterized each by domain using an adapted existing typology. This work provides a well-categorized inventory for practitioners and sets the stage for future evaluation research on the implementation of strategies and practices to reduce displacement.

To identify research and gaps in literature about FGM/C-related attitudes and experiences among individuals from FGM/C-practicing countries living in the United States,we conducted a scoping review guided by Arksey and O'Malley's framework. We searched Medline (OVID), Embase (OVID), PubMed, and SCOPUS and conducted a grey literature search for studies assessing attitudes or experiences related to FGM/C with data collected directly from individuals from FGM/C-practicing countries living in the United States. The search yielded 417 studies, and 40 met the inclusion criteria. Findings suggest that women and men from FGM/C-practicing countries living in the United States generally oppose FGM/C, and that women with FGM/C have significant physical and mental health needs and have found US healthcare providers to lack understanding of FGM/C. Future research can improve measurement of FGM/C by taking into account the sociocultural influences on FGM/C-related attitudes and experiences.

Evidence-based treatments for tobacco use and dependence can increase cessation success but remain underutilized. Health professional societies and voluntary health organizations (advising organizations) are uniquely positioned to influence the delivery of cessation treatments by providing clinical guidance for healthcare providers. This study aimed to review the guidance produced by these organizations for content and consistency with current evidence. Documents discussing healthcare providers' role in treatment of tobacco use and dependence produced by US-based advising organizations between 2000 and 2019 were identified in both peer-reviewed and grey (i.e., informally or non-commercially published) literature. Extraction of variables, defined in terms of healthcare provider role and endorsement of specific treatment(s), was completed by two independent reviewers. Review of 38 identified documents sponsored by 57 unique advising organizations revealed deficits in the direction of comprehensive care and incorporation of the most recent evidence for treatment of tobacco use and dependence. Documents endorsed: screening (74%), pharmacotherapy (68%), counseling (89%), or follow-up (37%). Few documents endorsed more recent evidence-based treatments including combination nicotine replacement therapy (18%), and text- (11%) and web-based (11%) interventions. Advising organizations have opportunities to address identified gaps and enhance clinical guidance to contribute toward expanding the provision of comprehensive tobacco cessation support.

INTRODUCTION: Antimicrobial stewardship (AMS) is an important strategy to control antimicrobial resistance. Resources are available to provide guidance for design and implementation of AMS programmes, however these may have limited applicability in resource-limited settings including those in Asia. This scoping review aims to identify context-specific domains and items for the development of a healthcare facility (HCF)-level tool to guide AMS implementation in Asia. METHODS AND ANALYSIS: This review is the first step in a larger project to assess AMS implementation, needs and gaps in Asia. We will employ a deductive qualitative approach to identify locally appropriate domains and items of AMS implementation guided by Nilsen and Bernhardsson's contextual dimensions. This process is also informed by discussions from a technical advisory group coordinated by the US Centers for Disease Control and Prevention to develop an AMS HCF-level assessment tool for low-income and middle-income countries. We will review English-language documents that discuss HCF-level implementation, including those describing frameworks, components/elements or recommendations for design, implementation or assessment globally and specific to Asia. We have performed the search in August-September 2021 including general electronic databases (MEDLINE, Embase, Web of Science and Google Scholar), region-specific databases, national action plans, grey literature sources and reference lists to identify eligible documents. Country-specific documents will be restricted to countries in three subregions: South Asia, East Asia and Southeast Asia. Codes and themes will be derived through a content analysis, classified following the predefined context dimensions and used for developing domains and items of the assessment tool. ETHICS AND DISSEMINATION: Results from this review will feed into our stepwise process for developing a context-specific HCF-level assessment tool for AMS programmes to assess the implementation status, identify intervention opportunities and monitor progress over time. The process will be done in consultation with local stakeholders, the end-users of the generated knowledge.

Racial and ethnic disparities exist in physical activity (PA) among youth. Trail use can help children and youth get PA and confer additional health benefits. US Forest Service data shows disparities in trail use by race/ethnicity. The National Collaborative on Childhood Obesity Research set out to address disparities in trail use (and thereby related disparities in PA and obesity). | | PURPOSE: Originally, this project was twofold: to review the scientific published peer reviewed literature (findings published previously), and non-published “grey” literature (findings reported here) to identify effective programs to increase use of trails among youth from under-resourced communities. Youth trails use programs that were evaluated using experimental methods were not located. | | METHODS: A review of grey literature for youth trail use programs was conducted searching websites, government/organizational reports, success stories, conference proceedings, and leads from subject matter experts. Internet search terms included trails, programs, youth, low income, under-resourced, race/ethnic groups). Inclusion criteria were that a program must 1. be US based and ongoing ≥3 yrs., 2. focused on youth ≤18 yrs., 3. designed to reach youth from diverse racial/ethnic groups or whose families are low-income, 4. include trail use (walking, hiking, or biking), and 5. have evaluation data (e.g., participation rates by demographic characteristics, program satisfaction, psychosocial outcomes (e.g., self-esteem)). | | RESULTS: Of 39 programs located, 9 met inclusion criteria. These 9 programs were implemented in diverse communities (low income, under-resourced, some with no parks). Two of the 9 programs were school based (predominantly Title 1) programs. However, 2 are 1-week programs only, 1 was offered during the summer only and 2 during the school year only. Although, all programs included some type of evaluation data, only 1 program that estimated calories burned per bike miles ridden, evaluated health outcomes directly relevant to childhood obesity. | | CONCLUSIONS: Programs exist for increasing trail use among youth from diverse and under-resourced communities. Research is needed to document program effectiveness, so health professionals can more effectively advance trail use as a health enhancing behavior among youth.

BACKGROUND: The global critical shortage of health workers prevents expansion of healthcare services and universal health coverage. Like most countries in sub-Saharan Africa, Kenya's healthcare workforce density of 13.8 health workers per 10,000 population falls below the World Health Organization (WHO) recommendation of at least 44.5 doctors, nurses, and midwives per 10,000 population. In response to the health worker shortage, the WHO recommends task sharing, a strategy that can increase access to quality health services. To improve the utilization of human and financial health resources in Kenya for HIV and other essential health services, the Kenya Ministry of Health (MOH) in collaboration with various institutions developed national task sharing policy and guidelines (TSP). To advance task sharing, this article describes the process of developing, adopting, and implementing the Kenya TSP. CASE PRESENTATION: The development and approval of Kenya's TSP occurred from February 2015 to May 2017. The U.S. Centers for Disease Control and Prevention (CDC) allocated funding to Emory University through the United States President's Emergency Plan for AIDS Relief (PEPFAR) Advancing Children's Treatment initiative. After obtaining support from leadership in Kenya's MOH and health professional institutions, the TSP team conducted a desk review of policies, guidelines, scopes of practice, task analyses, grey literature, and peer-reviewed research. Subsequently, a Policy Advisory Committee was established to guide the process and worked collaboratively to form technical working groups that arrived at consensus and drafted the policy. The collaborative, multidisciplinary process led to the identification of gaps in service delivery resulting from health workforce shortages. This facilitated the development of the Kenya TSP, which provides a general orientation of task sharing in Kenya. The guidelines list priority tasks for sharing by various cadres as informed by evidence, such as HIV testing and counseling tasks. The TSP documents were disseminated to all county healthcare facilities in Kenya, yet implementation was stopped by order of the judiciary in 2019 after a legal challenge from an association of medical laboratorians. CONCLUSIONS: Task sharing may increase access to healthcare services in resource-limited settings. To advance task sharing, TSP and clinical practice could be harmonized, and necessary adjustments made to other policies that regulate practice (e.g., scopes of practice). Revisions to pre-service training curricula could be conducted to ensure health professionals have the requisite competencies to perform shared tasks. Monitoring and evaluation can help ensure that task sharing is implemented appropriately to ensure quality outcomes.

INTRODUCTION: The CDC Worksite Health ScoreCard (ScoreCard) is a free, publicly available survey tool designed to help employers assess the extent to which they have implemented evidence-based interventions or strategies at their worksites to improve the health and well-being of employees. We examined how, how broadly, and to what effect the ScoreCard has been applied. METHODS: We analyzed peer-reviewed and grey literature along with the ScoreCard database of online submissions from January 2012 through January 2021. Our inclusion criteria were workplace settings, adult working populations, and explicit use of the ScoreCard. RESULTS: We found that the ScoreCard had been used in 1) surveillance efforts by states, 2) health promotion training and technical assistance, 3) research on workplace health promotion program effectiveness, and 4) employer efforts to improve program design, implementation, and evaluation. CONCLUSION: The ScoreCard has been used as intended to support the development, planning, monitoring, and continuous improvement of workplace health promotion programs. Our review revealed gaps in the tool and opportunities to improve it by 1) enhancing surveillance efforts, 2) engaging employers in low-wage industries, 3) adding new questions or topic areas, and 4) conducting quantitative studies on the relationship between improvements in the ScoreCard and employee health and well-being outcomes.

The relative proportion of cases of P&S syphilis among men who have sex with men and women reported through national case report data from 2010 through 2019 appeared stable overall and stratified by race/ethnicity, region, and age group, but case counts increased.

Modifying the built environment to make communities more walkable remains one strategy to promote physical activity. These modifications may have the added benefit of reducing the risk of pedestrian injury; however, there is a gap in the physical activity literature regarding how best to measure pedestrian injury. Examining the measures that have been used and related data sources can help inform the use of pedestrian injury data to evaluate whether safety is optimized as walking increases. We conducted a systematic review of the literature to identify studies that evaluated changes to the built environment that support walking and measures impacts on pedestrian injury as a measure of safety. We searched PubMed, PsycInfo, and Web of Science to identify peer-review studies and websites of fifteen organizations to document studies from the grey literature published in English between January 1, 2010 and December 31, 2018. Our search identified twelve studies that met the inclusion criteria. The few studies that measured changes in pedestrian injury used crash data from police reports. Injury frequency was often reported, but not injury severity, and no studies reported injury risk based on walking exposure. We conclude that few studies have measured pedestrian injury in the context of creating more walkable communities. Future research would benefit from using well-characterized measures from existing studies to support consistency in measurement, and from more longitudinal and evaluation research to strengthen the evidence on additional benefits of walkability. Increased collaborations with injury prevention professionals could bolster use of valid and reliable measures.

BACKGROUND: Dried plasma spot specimens may be a viable alternative to traditional liquid plasma in field settings, but the diagnostic accuracy is not well understood. METHODS: Standard databases (PubMed and Medline), conferences, and grey literature were searched until January 2019. The quality of evidence was evaluated using STARD and QUADAS-2 criteria. We used univariate and bivariate random effects models to determine misclassification, sensitivity, and specificity across multiple thresholds, overall and for each viral load technology and to account for between-study variation. RESULTS: We identified 23 studies for inclusion in the systematic review that compared the diagnostic accuracy of dried plasma spots to plasma. Primary data from 16 of the 23 studies were shared and included in the meta-analysis, representing 18 countries, totaling 1,847 paired dried plasma spot:plasma data points. The mean bias of dried plasma spot specimens compared to plasma was 0.28 log10 copies/ml, while the difference in median viral load was 2.25 log10 copies/ml. More dried plasma spot values were undetectable compared to plasma values (43.6% vs. 29.8%). Analyzing all technologies together, the sensitivity and specificity of dried plasma spot specimens was >92% across all treatment failure thresholds compared and total misclassification <5.4% across all treatment failure thresholds compared. Some technologies had lower sensitivity or specificity; however, the results were typically consistent across treatment failure thresholds. DISCUSSION: Overall, dried plasma spot specimens performed relatively well compared to plasma with sensitivity and specificity values greater than 90% and misclassification rates less than 10% across all treatment failure thresholds reviewed.

OBJECTIVE: Fatigue Risk Management Systems (FRMS) are a data-driven set of management practices for identifying and managing fatigue-related safety risks. This approach also considers sleep and work time, and is based on ongoing risk assessment and monitoring. This narrative review addresses the effectiveness of FRMS, as well as barriers and enablers in the implementation of FRMS. Furthermore, this review draws on the literature to provide evidence-based policy guidance regarding FRMS implementation. METHODS: Seven databases were drawn on to identify relevant peer-reviewed literature. Relevant grey literature was also reviewed based on the authors' experience in the area. In total, 2129 records were screened based on the search strategy, with 231 included in the final review. RESULTS: Few studies provide an evidence-base for the effectiveness of FRMS as a whole. However, FRMS components (e.g., bio-mathematical models, self-report measures, performance monitoring) have improved key safety and fatigue metrics. This suggests FRMS as a whole are likely to have positive safety outcomes. Key enablers of successful implementation of FRMS include organisational and worker commitment, workplace culture, and training. CONCLUSIONS: While FRMS are likely to be effective, in organisations where safety cultures are insufficiently mature and resources are less available, these systems may be challenging to implement successfully. We propose regulatory bodies consider a hybrid model of FRMS, where organisations could choose to align with tight hours of work (compliance) controls. Alternatively, where organisational flexibility is desired, a risk-based approach to fatigue management could be implemented.

BACKGROUND: Syphilis, a sexually transmitted infection that can cause severe congenital disease when not treated during pregnancy, is on the rise in the United States. Our objective was to identify U.S. counties with elevated risk for emergence of primary and secondary (P&S) syphilis among reproductive-aged women. METHODS: Using syphilis case reports, we identified counties with no cases of P&S syphilis among reproductive-aged women in 2017 and ≥ 1 case in 2018. Using county-level syphilis and sociodemographic data, we developed a model to predict counties with emergence of P&S syphilis among women and a risk score to identify counties at elevated risk. RESULTS: Of 2,451 counties with no cases of P&S syphilis among reproductive-aged women in 2017, 345 counties (14.1%) had documented emergence of syphilis in 2018. Emergence was predicted by the county's P&S syphilis rate among men; violent crime rate; proportions of Black, White, Asian, and Hawaiian/Pacific Islander persons; urbanicity; presence of a metropolitan area; population size; and having a neighboring county with P&S syphilis among women. A risk score of ≥20 identified 75% of counties with emergence. CONCLUSIONS: Jurisdictions can identify counties at elevated risk for emergence of syphilis in women and tailor prevention efforts. Prevention of syphilis requires multidisciplinary collaboration to address underlying social factors.

Congenital syphilis, a life-threatening infection caused by the transmission of Treponema pallidum from a woman to her fetus during pregnancy, can result in miscarriage, stillbirth, preterm birth, low birth weight, and infant death.1 Whereas many infants with congenital syphilis are asymptomatic at birth,2 classic signs can appear in the first 2 years of life, including rash, copious nasal discharge (“snuffles”), hepatosplenomegaly, jaundice related to syphilitic hepatitis, bone deformities, and neurologic involvement. Although these sequelae can be prevented when maternal syphilis is diagnosed and treated 30 days or more before delivery,3 the incidence of congenital syphilis in the United States is increasing.2

BACKGROUND: To describe changes in reported sexually transmitted diseases (STDs) during the U.S. coronavirus disease 2019 pandemic, we compared the weekly number of reported nationally notifiable STDs in 2020 to 2019. METHODS: We reviewed cases of chlamydia, gonorrhea, and primary & secondary (P&S) syphilis reported to the U.S. National Notifiable Disease Surveillance System in 2020. For each STD, we compare the number of 2020 cases reported for a given Morbidity and Mortality Weekly Report (MMWR) week to the number of 2019 cases reported in the same week, expressing 2020 cases as a percentage of 2019 cases. We also calculated the percent difference between 2020 and 2019 cumulative case totals as of MMWR week 50 (week of December 9). RESULTS: During MMWR weeks 1-11 (week of December 29, 2019-March 11, 2020), the weekly number of cases of STDs reported in 2020 as a percentage of the cases in the same week in 2019 were similar. However, 2020 numbers were much lower than 2019 numbers in week 15 (week of April 8; chlamydia, 49.8%; gonorrhea, 71.2%; and P&S syphilis, 63.7%). As of week 50, the 2020 cumulative totals compared to 2019 were 14.0% lower for chlamydia, 7.1% higher for gonorrhea, and 0.9% lower for P&S syphilis. CONCLUSION: During March-April 2020, national case reporting for STDs dramatically decreased compared to 2019. However, resurgence in reported gonorrhea and syphilis cases later in the year suggest STD reporting may have increased during 2020, underscoring the importance of continued STD prevention and care activities.

A body of psychological and social scientific evidence suggests that the experience of technological disaster or long-term exposure to environmental contamination can be psychologically stressful. Addressing the psychosocial impact in communities living with chronic contamination is therefore a vital part of improving their resilience. Guided by a synthetic theoretical model of the unique psychosocial impact of chronic environmental contamination (in contrast to natural and technological disasters, and background pollution), we undertook a narrative review to assess the current research on this important social problem. Relevant qualitative peer-reviewed studies and grey literature were examined to derive a model identifying likely factors increasing risk for distress in chronic contamination experience and actions that may be taken by public health professionals and local leaders to enhance community resilience and take health-protective actions. Based on our initial theoretical model and the literature reviewed, we emphasize the importance of considering both the material and social dimensions of chronic environmental contamination experience. For instance, our review of the qualitative literature suggests that individuals who attribute material health impacts to contamination, and who have the social experience of their concerns being delegitimized by responsible institutions, are most at risk for psychological stress. Psychological stress in the context of chronic contamination is an important potential public health burden and a key area for additional research.

INTRODUCTION: High quality epidemic forecasting and prediction are critical to support response to local, regional and global infectious disease threats. Other fields of biomedical research use consensus reporting guidelines to ensure standardization and quality of research practice among researchers, and to provide a framework for end-users to interpret the validity of study results. The purpose of this study was to determine whether guidelines exist specifically for epidemic forecast and prediction publications. METHODS: We undertook a formal systematic review to identify and evaluate any published infectious disease epidemic forecasting and prediction reporting guidelines. This review leveraged a team of 18 investigators from US Government and academic sectors. RESULTS: A literature database search through May 26, 2019, identified 1467 publications (MEDLINE n = 584, EMBASE n = 883), and a grey-literature review identified a further 407 publications, yielding a total 1777 unique publications. A paired-reviewer system screened in 25 potentially eligible publications, of which two were ultimately deemed eligible. A qualitative review of these two published reporting guidelines indicated that neither were specific for epidemic forecasting and prediction, although they described reporting items which may be relevant to epidemic forecasting and prediction studies. CONCLUSIONS: This systematic review confirms that no specific guidelines have been published to standardize the reporting of epidemic forecasting and prediction studies. These findings underscore the need to develop such reporting guidelines in order to improve the transparency, quality and implementation of epidemic forecasting and prediction research in operational public health.

Despite high pregnancy rates and HIV incidence among adolescents, their uptake of prevention of mother-to-child HIV transmission (PMTCT) services is not well characterized. This paper describes current PMTCT program coverage among adolescents <20 years. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed/MEDLINE (NCBI), SCOPUS (Elsevier), Grey literature and EMBASE and websites of international organizations and conferences were searched for eligible studies published from 2000 to 2017. Adolescents had lower rates of planned pregnancies, were less likely to know their HIV infection status before their first ANC visit, lower use of ARV, higher rates of loss to follow-up and higher rates of MTCT compared to adults. This study identified differential uptake of PMTCT services for adolescents compared to adults. Age-disaggregated data are urgently needed to understand the sub-optimal uptake of HIV services for adolescents in PMTCT and support the design of effective interventions to close these gaps.

BACKGROUND: Disaster citizen science, or the use of scientific principles and methods by "non-professional" scientists or volunteers, may be a promising way to enhance public health emergency preparedness (PHEP) and build community resilience. However, little research has focused on understanding this emerging field and its implications for PHEP. To address research gaps, this paper: (1) assesses the state of disaster citizen science by developing an inventory of disaster citizen science projects; (2) identifies different models of disaster citizen science; and (3) assesses their relevance for PHEP. METHODS: We searched the English-language peer-reviewed and grey literature for disaster citizen science projects with no time period specified. Following searches, a team of three reviewers applied inclusion/exclusion criteria that defined eligible disasters and citizen science activities. Reviewers extracted the following elements from each project: project name and description; lead and partner entities; geographic setting; start and end dates; type of disaster; disaster phase; citizen science model; and technologies used. RESULTS: A final set of 209 projects, covering the time period 1953-2017, were included in the inventory. Projects were classified across five citizen science models: distributed or volunteer sensing (n = 19; 9%); contributory (n = 98; 47%); distributed intelligence (n = 52; 25%); collaborative research (n = 32; 15%); and collegial research (n = 8; 4%). Overall, projects were conducted across all disaster phases and most frequently for earthquakes, floods, and hurricanes. Although activities occurred globally, 40% of projects were set in the U.S. Academic, government, technology, and advocacy organizations were the most prevalent lead entities. Although a range of technologies were used, 77% of projects (n = 161) required an internet-connected device. These characteristics varied across citizen science models revealing important implications for applications of disaster citizen science, enhancement of disaster response capabilities, and sustainability of activities over time. CONCLUSIONS: By increasing engagement in research, disaster citizen science may empower communities to take collective action, improve system response capabilities, and generate relevant data to mitigate adverse health impacts. The project inventory established a baseline for future research to capitalize on opportunities, address limitations, and help disaster citizen science achieve its potential.

Human immunodeficiency virus (HIV) preexposure prophylaxis (HIV PrEP)1 provides substantial individual-level HIV risk reduction and may confer a population-level decrease in HIV incidence among gay, bisexual, and other men who have sex with men (MSM) when high HIV PrEP coverage is obtained.2 Unfortunately, the effect of HIV PrEP on sexually transmitted infection (STI) epidemics among MSM is less clear. We review recent trends in reported STIs among MSM in the United States, discuss the mechanisms by which HIV PrEP may impact STI rates, and consider the resulting population and individual-level effects of HIV PrEP on STI epidemics.

INTRODUCTION: Epidemic forecasting and prediction tools have the potential to provide actionable information in the midst of emerging epidemics. While numerous predictive studies were published during the 2016-2017 Zika Virus (ZIKV) pandemic, it remains unknown how timely, reproducible, and actionable the information produced by these studies was. METHODS: To improve the functional use of mathematical modeling in support of future infectious disease outbreaks, we conducted a systematic review of all ZIKV prediction studies published during the recent ZIKV pandemic using the PRISMA guidelines. Using MEDLINE, EMBASE, and grey literature review, we identified studies that forecasted, predicted, or simulated ecological or epidemiological phenomena related to the Zika pandemic that were published as of March 01, 2017. Eligible studies underwent evaluation of objectives, data sources, methods, timeliness, reproducibility, accessibility, and clarity by independent reviewers. RESULTS: 2034 studies were identified, of which n = 73 met the eligibility criteria. Spatial spread, R0 (basic reproductive number), and epidemic dynamics were most commonly predicted, with few studies predicting Guillain-Barre Syndrome burden (4%), sexual transmission risk (4%), and intervention impact (4%). Most studies specifically examined populations in the Americas (52%), with few African-specific studies (4%). Case count (67%), vector (41%), and demographic data (37%) were the most common data sources. Real-time internet data and pathogen genomic information were used in 7% and 0% of studies, respectively, and social science and behavioral data were typically absent in modeling efforts. Deterministic models were favored over stochastic approaches. Forty percent of studies made model data entirely available, 29% provided all relevant model code, 43% presented uncertainty in all predictions, and 54% provided sufficient methodological detail to allow complete reproducibility. Fifty-one percent of predictions were published after the epidemic peak in the Americas. While the use of preprints improved the accessibility of ZIKV predictions by a median of 119 days sooner than journal publication dates, they were used in only 30% of studies. CONCLUSIONS: Many ZIKV predictions were published during the 2016-2017 pandemic. The accessibility, reproducibility, timeliness, and incorporation of uncertainty in these published predictions varied and indicates there is substantial room for improvement. To enhance the utility of analytical tools for outbreak response it is essential to improve the sharing of model data, code, and preprints for future outbreaks, epidemics, and pandemics.