Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-11 (of 11 Records) |
Query Trace: Hastings D[original query] |
---|
US county-level estimation for maternal and infant health-related behavior indicators using pregnancy risk assessment monitoring system data, 2016-2018
Wang Y , Tevendale H , Lu H , Cox S , Carlson SA , Li R , Shulman H , Morrow B , Hastings PA , Barfield WD . Popul Health Metr 2022 20 (1) 14 BACKGROUND: There is a critical need for maternal and child health data at the local level (for example, county), yet most counties lack sustainable resources or capabilities to collect local-level data. In such case, model-based small area estimation (SAE) could be a feasible approach. SAE for maternal or infant health-related behaviors at small areas has never been conducted or evaluated. METHODS: We applied multilevel regression with post-stratification approach to produce county-level estimates using Pregnancy Risk Assessment Monitoring System (PRAMS) data, 2016-2018 (n = 65,803 from 23 states) for 2 key outcomes, breastfeeding at 8 weeks and infant non-supine sleeping position. RESULTS: Among the 1,471 counties, the median model estimate of breastfeeding at 8 weeks was 59.8% (ranged from 34.9 to 87.4%), and the median of infant non-supine sleeping position was 16.6% (ranged from 10.3 to 39.0%). Strong correlations were found between model estimates and direct estimates for both indicators at the state level. Model estimates for both indicators were close to direct estimates in magnitude for Philadelphia County, Pennsylvania. CONCLUSION: Our findings support this approach being potentially applied to other maternal and infant health and behavioral indicators in PRAMS to facilitate public health decision-making at the local level. |
Variation in Calculating and Reporting Antimalarial Efficacy against Plasmodium falciparum in Sub-Saharan Africa: A Systematic Review of Published Reports
Plucinski MM , Hastings IM , Moriarty LF , Venkatesan M , Felger I , Halsey ES . Am J Trop Med Hyg 2021 104 (5) 1820-1829 Antimalarials, in particular artemisinin-based combination therapies (ACTs), are critical tools in reducing the global burden of malaria, which is concentrated in sub-Saharan Africa. Performing and reporting antimalarial efficacy studies in a transparent and standardized fashion permit comparison of efficacy outcomes across countries and time periods. This systematic review summarizes study compliance with WHO laboratory and reporting guidance pertaining to antimalarial therapeutic efficacy studies and evaluates how well studies from sub-Saharan Africa adhered to these guidelines. We included all published studies (January 2020 or before) performed in sub-Saharan Africa where ACT efficacy for treatment of uncomplicated Plasmodium falciparum infection was reported. The primary outcome was a composite indicator for study methodology consistent with WHO guidelines for statistical analysis of corrected efficacy, defined as an article presenting a Kaplan-Meier survival analysis of corrected efficacy or reporting a per-protocol analysis where new infections were excluded from the numerator and denominator. Of 581 articles screened, we identified 279 for the review. Molecular correction was used in 83% (232/279) to distinguish new infections from recrudescences in subjects experiencing recurrent parasitemia. Only 45% (99/221) of articles with therapeutic efficacy as a primary outcome and performing molecular correction reported corrected efficacy outcomes calculated in a way consistent with WHO recommendations. These results indicate a widespread lack of compliance with WHO-recommended methods of analysis, which may result in biases in how antimalarial effectiveness is being measured and reported from sub-Saharan Africa. |
Women's awareness and healthcare provider discussions about Zika virus during pregnancy, United States, 2016-2017
Williams L , D'Angelo DV , Bauman B , Dieke AC , Ellington SR , Shapiro-Mendoza CK , Cox S , Hastings P , Shulman H , Harrison L , Kapaya M , Barfield WD , Warner L . Emerg Infect Dis 2020 26 (5) 998-1001 We surveyed women with a recent live birth who resided in 16 US states and 1 city during the 2016 Zika outbreak. We found high awareness about the risk of Zika virus infection during pregnancy and about advisories to avoid travel to affected areas but moderate levels of discussions with healthcare providers. |
Evaluating accuracy of microsatellite markers for classification of recurrent infections during routine monitoring of anti-malarial drug efficacy: A computer modelling approach.
Jones S , Plucinski M , Kay K , Hodel EM , Hastings IM . Antimicrob Agents Chemother 2020 64 (4) Anti-malarial drugs have long half-lives, so clinical trials to monitor their efficacy require long durations of follow-up to capture drug failure that may only become patent weeks after treatment. Reinfections often occur during follow-up so robust methods of distinguishing drug failures (recrudescence) from emerging new infections are needed to produce accurate failure rate estimates. "Molecular correction" aims to achieve this by comparing the genotypes between a patient's pre-treatment (initial) blood sample and any infection that occurs during follow-up, 'matching' genotypes indicating a drug failure. We use an in-silico approach to show that the widely used "match counting" method of molecular correction with microsatellite markers is likely to be highly unreliable and may lead to gross under- or over-estimates of true failure rates depending on the choice of matching criterion. A Bayesian algorithm for molecular correction has been previously developed and utilized for analysis of in vivo efficacy trials. We validated this algorithm using in silico data and showed it had high specificity and generated accurate failure rate estimates. This conclusion was robust for multiple drugs, different levels of drug failure rate, different levels of transmission intensity in the study sites, and microsatellite genetic diversity. The Bayesian algorithm was inherently unable to accurately identify low-density recrudescence that occurred in a small number of patients, but this did not appear to compromise its utility as a highly effective molecular correction method for analysing microsatellite genotypes. Strong consideration should be given to using Bayesian methodology for obtaining accurate failure rate estimates during routine monitoring trials of antimalarial efficacy that use microsatellite markers. |
Advancing the public's health by scaling innovations in clinical quality
Malcarney MB , Horton K , Seiler N , Hastings D . Public Health Rep 2017 132 (4) 512-517 Clinical care improvements that advance population health are important to public health policy and practice. Increasingly, evidence-based clinical care quality improvement efforts are reflected in the legally binding standards that govern the certification of health care entities and institutions, as well as private insurance coverage and payment. As clinical practice is reengineered to improve quality of care, these new practice standards can become embedded in the legal rules and norms governing health care in ways that spread innovation and create access to evidence-based services across the population. | This installment of Law and the Public’s Health provides a foundation for understanding the theory of innovation diffusion and opportunities for spreading innovations aimed at prevention in health care settings. Our research grows out of a project with the Division of Unintentional Injury Prevention at the Centers for Disease Control and Prevention (CDC) to examine how innovations in clinical practice related to falls prevention among community-dwelling older adults can more rapidly reach at-risk populations. Although this project focuses on falls prevention, it is relevant to public health policy and practice more generally. |
Early identification and prevention of the spread of Ebola in high-risk African countries
Breakwell L , Gerber AR , Greiner AL , Hastings DL , Mirkovic K , Paczkowski MM , Sidibe S , Banaski J , Walker CL , Brooks JC , Caceres VM , Arthur RR , Angulo FJ . MMWR Suppl 2016 65 (3) 21-7 In the late summer of 2014, it became apparent that improved preparedness was needed for Ebola virus disease (Ebola) in at-risk countries surrounding the three highly affected West African countries (Guinea, Sierra Leone, and Liberia). The World Health Organization (WHO) identified 14 nearby African countries as high priority to receive technical assistance for Ebola preparedness; two additional African countries were identified at high risk for Ebola introduction because of travel and trade connections. To enhance the capacity of these countries to rapidly detect and contain Ebola, CDC established the High-Risk Countries Team (HRCT) to work with ministries of health, CDC country offices, WHO, and other international organizations. From August 2014 until the team was deactivated in May 2015, a total of 128 team members supported 15 countries in Ebola response and preparedness. In four instances during 2014, Ebola was introduced from a heavily affected country to a previously unaffected country, and CDC rapidly deployed personnel to help contain Ebola. The first introduction, in Nigeria, resulted in 20 cases and was contained within three generations of transmission; the second and third introductions, in Senegal and Mali, respectively, resulted in no further transmission; the fourth, also in Mali, resulted in seven cases and was contained within two generations of transmission. Preparedness activities included training, developing guidelines, assessing Ebola preparedness, facilitating Emergency Operations Center establishment in seven countries, and developing a standardized protocol for contact tracing. CDC's Field Epidemiology Training Program Branch also partnered with the HRCT to provide surveillance training to 188 field epidemiologists in Cote d'Ivoire, Guinea-Bissau, Mali, and Senegal to support Ebola preparedness. Imported cases of Ebola were successfully contained, and all 15 priority countries now have a stronger capacity to rapidly detect and contain Ebola.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html). |
Outbreak of Middle East Respiratory Syndrome at Tertiary Care Hospital, Jeddah, Saudi Arabia, 2014
Hastings DL , Tokars JI , Abdel Aziz IZ , Alkhaldi KZ , Bensadek AT , Alraddadi BM , Jokhdar H , Jernigan JA , Garout MA , Tomczyk SM , Oboho IK , Geller AI , Arinaminpathy N , Swerdlow DL , Madani TA . Emerg Infect Dis 2016 22 (5) 794-801 During March-May 2014, a Middle East respiratory syndrome (MERS) outbreak occurred in Jeddah, Saudi Arabia, that included many persons who worked or received medical treatment at King Fahd General Hospital. We investigated 78 persons who had laboratory-confirmed MERS during March 2-May 10 and documented contact at this hospital. The 78 persons with MERS comprised 53 patients, 16 healthcare workers, and 9 visitors. Among the 53 patients, the most probable sites of acquisition were the emergency department (22 patients), inpatient areas (17), dialysis unit (11), and outpatient areas (3). Infection control deficiencies included limited separation of suspected MERS patients, patient crowding, and inconsistent use of infection control precautions; aggressive improvements in these deficiencies preceded a decline in cases. MERS coronavirus transmission probably was multifocal, occurring in multiple hospital settings. Continued vigilance and strict application of infection control precautions are necessary to prevent future MERS outbreaks. |
Ebola infection control in Sierra Leonean health clinics: a large cross-agency cooperative project
Levy B , Rao CY , Miller L , Kennedy N , Adams M , Davis R , Hastings L , Kabano A , Bennett SD , Sesay M . Am J Infect Control 2015 43 (7) 752-5 The Ebola virus disease outbreak occurring in West Africa has resulted in at least 199 cases of Ebola in Sierra Leonean health care workers, many as a result of transmission occurring in health facilities. The Ministry of Health and Sanitation of Sierra Leone recognized that improvements in infection prevention and control (IPC) were necessary at all levels of health care delivery. To this end, the U.S. Centers for Disease Control and Prevention, United Nations Children's Fund, and multiple nongovernmental organizations implemented a national IPC training program in 1,200 peripheral health units (PHUs) in Sierra Leone. A tiered training of trainers program was used. Trainers conducted multiday trainings at PHUs and coordinated the delivery of personal protective equipment (gloves, gowns, masks, boots) and infection control supplies (chlorine, buckets, disposable rags, etc) to all PHU staff. Under the ongoing project, 4,264 health workers have already been trained, and 98% of PHUs have received their first shipment of supplies. |
Mycoplasma pneumoniae outbreak in a long-term care facility - Nebraska, 2014
Hastings DL , Harrington KJ , Kutty PK , Rayman RJ , Spindola D , Diaz MH , Thurman KA , Winchell JM , Safranek TJ . MMWR Morb Mortal Wkly Rep 2015 64 (11) 296-299 On June 20, 2014, a Nebraska long-term care facility notified the East Central District Health Department (ECDHD) and Nebraska Department of Health and Human Services (NDHHS) of an outbreak of respiratory illness characterized by cough and fever in 22 residents and resulting in four deaths during the preceding 2 weeks. To determine the etiologic agent, identify additional cases, and implement control measures, Nebraska and CDC investigators evaluated the facility's infection prevention measures and collected nasopharyngeal (NP) and oropharyngeal (OP) swabs or autopsy specimens from patients for real-time polymerase chain reaction (PCR) testing at CDC. The facility was closed to new admissions until 1 month after the last case, droplet precautions were implemented, ill residents were isolated, and group activities were canceled. During the outbreak, a total of 55 persons experienced illnesses that met the case definition; 12 were hospitalized, and seven died. PCR detected Mycoplasma pneumoniae DNA in 40% of specimens. M. pneumoniae should be considered a possible cause of respiratory illness outbreaks in long-term care facilities. Morbidity and mortality from respiratory disease outbreaks at long-term care facilities might be minimized if facilities monitor for respiratory disease clusters, report outbreaks promptly, prioritize diagnostic testing in outbreak situations, and implement timely and strict infection control measures to halt transmission. |
Comprehensive laboratory evaluation of a highly specific lateral flow assay for the presumptive identification of ricin in suspicious white powders and environmental samples
Hodge DR , Prentice KW , Ramage JG , Prezioso S , Gauthier C , Swanson T , Hastings R , Basavanna U , Datta S , Sharma SK , Garber EA , Staab A , Pettit D , Drumgoole R , Swaney E , Estacio PL , Elder IA , Kovacs G , Morse BS , Kellogg RB , Stanker L , Morse SA , Pillai SP . Biosecur Bioterror 2013 11 (4) 237-50 Ricin, a heterodimeric toxin that is present in the seeds of the Ricinus communis plant, is the biothreat agent most frequently encountered by law enforcement agencies in the United States. Even in untrained hands, the easily obtainable seeds can yield a highly toxic product that has been used in various types of threats, including "white-powder" letters. Although the vast majority of these threats are hoaxes, an impediment to accurate hazard assessments by first responders is the unreliability of rapid detection assays for ricin, such as lateral flow assays (LFAs). One of the complicating factors associated with LFAs is the incorporation of antibodies of poor specificity that cross-react with near-neighbors or with plant lectins that are capable of nonspecifically cross-linking the capture and detector antibodies. Because of the compelling and critical need to promote the interests of public safety and public health, the Department of Homeland Security conducted a comprehensive laboratory evaluation study of a commercial LFA for the rapid detection of ricin. This study was conducted using comprehensive inclusivity and exclusivity panels of ricin and near-neighbor plant materials, along with panels of lectins and "white-powders," to determine the specificity, sensitivity, limits of detection, dynamic range, and repeatability of the assay for the specific intended use of evaluating suspicious white powders and environmental samples in the field. |
Referrals for suspected hematologic malignancy: a survey of primary care physicians
Abel GA , Friese CR , Neville BA , Wilson KM , Hastings BT , Earle CC , Keating NL , Richardson LC . Am J Hematol 2012 87 (6) 634-6 Little is known about referrals from primary care providers (PCPs) for suspected hematologic malignancies, including their clinical triggers and frequency. A random sample of 190 Massachusetts PCPs were presented with a vignette concerning a patient with a new finding of moderate anemia, asked how they would respond, and then asked what they would do if the patient returned with persistent anemia plus one additional sign or symptom. We also asked about referral behaviors for suspected hematologic malignancies during the prior year. A total of 134 (70.5%) PCPs responded. At first anemia presentation,only 3.8% reported referring to hematology. The development of a second sign or symptom yielded higher referral rates: pancytopenia 588.7%, leukopenia 5 63.9%, thrombocytopenia 5 63.9%, lymphadenopathy 5 42.9%, leukocytosis 5 37.6%, night sweats 5 25.6%, and weight loss 5 23.3%. The median yearly number (interquartile range) of patients PCPs reported suspecting of having hematologic malignancy was 5 (3, 10), and the median formally referred was 5 (3, 10). We conclude that anemia plus signs and symptoms suggestive of myelodysplasia or leukemia (compared with those suggestive of lymphoma) are more likely to prompt hematology referral. In addition, given their rarity,the numbe |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 13, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure