Last data update: May 20, 2024. (Total: 46824 publications since 2009)
Records 1-14 (of 14 Records) |
Query Trace: Jahan F[original query] |
---|
School closures due to seasonal influenza: a prospective data collection-based study of eleven influenza seasons-United States, 2011-2022
Zviedrite N , Jahan F , Zheteyeva Y , Gao H , Uzicanin A . Lancet Reg Health Am 2024 34 100741 BACKGROUND: While numerous studies explore pandemic-associated school closures, literature is scant regarding seasonal influenza-associated closures. We previously reported summaries on COVID-19 pandemic-related school closures in the United States (US), which affected virtually all schools in the nation. The current prospective study aims to address the knowledge gap for seasonal influenza-related closures in the United States. METHODS: We conducted systematic daily online searches from August 1, 2011 to June 30, 2022, to identify public announcements of unplanned school closures in the US lasting ≥1 day, selecting those that mentioned influenza and influenza-like illness (ILI) as reason for school closure (ILI-SCs). We studied ILI-SC temporal patterns and compared them with reported outpatient ILI-related healthcare visits. FINDINGS: We documented that ILI-SCs occurred annually, with yearly totals ranging from 11 ILI-SCs in both the 2013-2014 and 2020-2021 school years to 2886 ILI-SCs in the 2019-2020 school year among more than 100,000 kindergarten through twelfth grade schools in the US. ILI-SCs occurred concurrently with widespread illness and the strongest correlations were observed during influenza A (H3N2)-dominant seasons, most notably in the 2016-2017 (Spearman rank correlation (r(s)) = 0.83) and the 2017-2018 (r(s) = 0.84) school years. ILI-SCs were heavily centered in U.S. Department of Health and Human Services Region 4 (states of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee) [60% (6040/9166, Region 4/Total school closures)] and disproportionately impacted rural and lower-income communities. INTERPRETATION: Outside of a pandemic, disease-related school closures are extreme and generally rare events for US schools and communities. Timely compilation of publicly available ILI-SC announcements could enhance influenza surveillance, particularly in severe influenza seasons or pandemics when ILI-SCs are prevalent. FUNDING: This work was supported by the U.S. Centers for Disease Control and Prevention. Co-authors (NZ, YZ, HG, AU) were or are US CDC employees, and FJ was a contractor through Cherokee Nation Operational Solutions, LLC, which supported FJ's salary, but had no additional role in the study. |
COVID-19-related school closures, United States, July 27, 2020-June 30, 2022
Zviedrite N , Jahan F , Moreland S , Ahmed F , Uzicanin A . Emerg Infect Dis 2024 30 (1) 58-69 As part of a multiyear project that monitored illness-related school closures, we conducted systematic daily online searches during July 27, 2020-June 30, 2022, to identify public announcements of COVID-19-related school closures (COVID-SCs) in the United States lasting >1 day. We explored the temporospatial patterns of COVID-SCs and analyzed associations between COVID-SCs and national COVID-19 surveillance data. COVID-SCs reflected national surveillance data: correlation was highest between COVID-SCs and both new PCR test positivity (correlation coefficient [r] = 0.73, 95% CI 0.56-0.84) and new cases (r = 0.72, 95% CI 0.54-0.83) during 2020-21 and with hospitalization rates among all ages (r = 0.81, 95% CI 0.67-0.89) during 2021-22. The numbers of reactive COVID-SCs during 2020-21 and 2021-22 greatly exceeded previously observed numbers of illness-related reactive school closures in the United States, notably being nearly 5-fold greater than reactive closures observed during the 2009 influenza (H1N1) pandemic. |
COVID-19-associated school closures and related efforts to sustain education and subsidized meal programs, United States, February 18–June 30, 2020 (preprint)
Zviedrite N , Hodis JD , Jahan F , Gao H , Uzicanin A . medRxiv 2021 2021.03.05.21252848 Pre-emptive school closures are frontline community mitigation measures recommended by CDC for implementation during severe pandemics. This study describes the spatiotemporal patterns of publicly announced school closures implemented in response to the coronavirus disease 2019 (COVID-19) pandemic and assesses how public K-12 districts adjusted their methods of education delivery and provision of subsidized meals. During February 18–June 30, 2020, we used daily systematic media searches to identify publicly announced coronavirus disease 2019 (COVID-19)–related school closures lasting ≥1 day in the United States (US). We also collected statewide school closure policies from state government websites. Data on distance learning and subsidized meal programs were collected from a stratified sample of 600 school districts. The first COVID-19–associated school closure occurred on February 27, 2020 in Washington state. By March 30, 2020, all but one US public school districts were closed, representing the first-ever nearly synchronous nationwide closure of public K-12 schools in the US. Approximately 100,000 public schools were closed for ≥8 weeks because of COVID-19, affecting >50 million K-12 students. Of 600 districts sampled, the vast majority offered distance learning (91.0%) and continued provision of subsidized meal programs (78.8%) during the closures. Despite the sudden and prolonged nature of COVID-19–associated school closures, schools demonstrated flexibility by implementing distance learning and alternate methods to continue subsidized meal programs.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis study was supported by the United States Centers for Disease Control and Prevention (http://www.cdc.gov/). Several co-authors are or were employees (NZ HG AU) or contractors (FJ) of the US CDC at the time of the study. During the study period, JH was a fellow appointed through the Research Participation Program at the US CDC administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and the US CDC.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:The project underwent ethical review at the Centers for Disease Control and Prevention and was determined not to involve human subjects; it was therefore not subject to institutional review board review requirements.All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesThe authors confirm that all data underlying the findings are fully available without restriction. Data are available from Google (www.google.com), Google News (news.google.com), and the National Center for Education Statistics (nces.ed.gov). The search and linking strategy used for these data sources is detailed within the paper. |
Causes, characteristics, and patterns of prolonged unplanned school closures prior to the COVID-19 pandemic - United States, 2011 - 2019 (preprint)
Jahan FA , Zviedrite N , Gao H , Ahmed F , Uzicanin A . medRxiv 2021 08 Introduction Outside of pandemics, there is little information about occurrence of prolonged unplanned K-12 school closures (PUSC). We describe here the reasons, characteristics, and patterns of PUSC in the United States during 8 consecutive inter-pandemic academic years, 2011-2019. Methods From August 1, 2011 through June 30, 2019, daily systematic online searches were conducted to collect data on publicly announced unplanned school closures lasting >=1 school days in the United States. Closures were categorized as prolonged when schools were closed for >=5 unplanned days (approximating one full workweek), excluding weekends and scheduled days off per school calendars. Results During the eight academic years, a total of 22,112 PUSCs were identified, affecting over 800,000 teachers and 13 million students that resulted in 91.5 million student-days lost. A median of 62.9% of students in PUSC-affected schools were eligible for subsidized school meals. Most affected schools were in cities (35%) and suburban areas (33%). Natural disasters (47%), adverse weather conditions (35%), and budget/teacher strikes (15%) were the most frequently cited reasons for PUSC; illness accounted for 1%, and building/facility issues, environmental issues and violence together accounted for the remaining 2%. The highest number of PUSCs occurred in Health and Human Services Regions 2, 3, 4, and 6 encompassing areas that are frequently in the path of hurricanes and tropical storms. The majority of PUSCs in these regions were attributed to a handful of hurricanes during the fall season, including hurricanes Sandy, Irma, Harvey, Florence, and Matthew. Conclusions PUSCs occur annually in the United States due to a variety of causes and are associated with a substantive loss of student-days for in-school learning. Both these prior experiences with PUSCs and those during the current COVID-19 pandemic illustrate a need for creating sustainable solutions for high-quality distance learning and innovative supplemental feeding programs nationwide, especially in disaster-prone areas. 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. |
Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study
Pneumonia Etiology Research for Child Health Study Group , O'Brien Katherine L , Levine Orin S , Knoll Maria Deloria , Feikin Daniel R , DeLuca Andrea N , Driscoll Amanda J , Fancourt Nicholas , Fu Wei , Haddix Meredith , Hammitt Laura L , Higdon Melissa M , Kagucia E Wangeci , Karron Ruth A , Li Mengying , Park Daniel E , Prosperi Christine , Shi Qiyuan , Wu Zhenke , Zeger Scott L , Watson Nora L , Crawley Jane , Murdoch David R , Brooks W Abdullah , Endtz Hubert P , Zaman Khalequ , Goswami Doli , Hossain Lokman , Jahan Yasmin , Chisti Mohammod Jobayer , Howie Stephen R C , Ebruke Bernard E , Antonio Martin , McLellan Jessica L , Machuka Eunice M , Shamsul Arifin , Zaman Syed M A , Mackenzie Grant , Scott J Anthony G , Awori Juliet O , Morpeth Susan C , Kamau Alice , Kazungu Sidi , Ominde Micah Silaba , Kotloff Karen L , Tapia Milagritos D , Sow Samba O , Sylla Mamadou , Tamboura Boubou , Onwuchekwa Uma , Kourouma Nana , Toure Aliou , Sissoko Seydou , Madhi Shabir A , Moore David P , Adrian Peter V , Baillie Vicky L , Kuwanda Locadiah , Mudau Azwifarwi , Groome Michelle J , Mahomed Nasreen , Simões Eric A F , Baggett Henry C , Thamthitiwat Somsak , Maloney Susan A , Bunthi Charatdao , Rhodes Julia , Sawatwong Pongpun , Akarasewi Pasakorn , Thea Donald M , Mwananyanda Lawrence , Chipeta James , Seidenberg Phil , Mwansa James , Somwe Somwe Wa , Kwenda Geoffrey , Anderson Trevor P , Mitchell Joanne L . Lancet 2019 394 (10200) 757-779 BACKGROUND: Pneumonia is the leading cause of death among children younger than 5 years. In this study, we estimated causes of pneumonia in young African and Asian children, using novel analytical methods applied to clinical and microbiological findings. METHODS: We did a multi-site, international case-control study in nine study sites in seven countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. All sites enrolled in the study for 24 months. Cases were children aged 1-59 months admitted to hospital with severe pneumonia. Controls were age-group-matched children randomly selected from communities surrounding study sites. Nasopharyngeal and oropharyngeal (NP-OP), urine, blood, induced sputum, lung aspirate, pleural fluid, and gastric aspirates were tested with cultures, multiplex PCR, or both. Primary analyses were restricted to cases without HIV infection and with abnormal chest x-rays and to controls without HIV infection. We applied a Bayesian, partial latent class analysis to estimate probabilities of aetiological agents at the individual and population level, incorporating case and control data. FINDINGS: Between Aug 15, 2011, and Jan 30, 2014, we enrolled 4232 cases and 5119 community controls. The primary analysis group was comprised of 1769 (41·8% of 4232) cases without HIV infection and with positive chest x-rays and 5102 (99·7% of 5119) community controls without HIV infection. Wheezing was present in 555 (31·7%) of 1752 cases (range by site 10·6-97·3%). 30-day case-fatality ratio was 6·4% (114 of 1769 cases). Blood cultures were positive in 56 (3·2%) of 1749 cases, and Streptococcus pneumoniae was the most common bacteria isolated (19 [33·9%] of 56). Almost all cases (98·9%) and controls (98·0%) had at least one pathogen detected by PCR in the NP-OP specimen. The detection of respiratory syncytial virus (RSV), parainfluenza virus, human metapneumovirus, influenza virus, S pneumoniae, Haemophilus influenzae type b (Hib), H influenzae non-type b, and Pneumocystis jirovecii in NP-OP specimens was associated with case status. The aetiology analysis estimated that viruses accounted for 61·4% (95% credible interval [CrI] 57·3-65·6) of causes, whereas bacteria accounted for 27·3% (23·3-31·6) and Mycobacterium tuberculosis for 5·9% (3·9-8·3). Viruses were less common (54·5%, 95% CrI 47·4-61·5 vs 68·0%, 62·7-72·7) and bacteria more common (33·7%, 27·2-40·8 vs 22·8%, 18·3-27·6) in very severe pneumonia cases than in severe cases. RSV had the greatest aetiological fraction (31·1%, 95% CrI 28·4-34·2) of all pathogens. Human rhinovirus, human metapneumovirus A or B, human parainfluenza virus, S pneumoniae, M tuberculosis, and H influenzae each accounted for 5% or more of the aetiological distribution. We observed differences in aetiological fraction by age for Bordetella pertussis, parainfluenza types 1 and 3, parechovirus-enterovirus, P jirovecii, RSV, rhinovirus, Staphylococcus aureus, and S pneumoniae, and differences by severity for RSV, S aureus, S pneumoniae, and parainfluenza type 3. The leading ten pathogens of each site accounted for 79% or more of the site's aetiological fraction. INTERPRETATION: In our study, a small set of pathogens accounted for most cases of pneumonia requiring hospital admission. Preventing and treating a subset of pathogens could substantially affect childhood pneumonia outcomes. FUNDING: Bill & Melinda Gates Foundation. |
Detection of coxsackievirus A6 in formalin-fixed, paraffin-embedded skin biopsy specimens using immunohistochemistry and real-time reverse-transcriptase PCR
Denison AM , Bhatnagar J , Jahan-Tigh RR , Fair P , Hale GL . J Clin Virol Plus 2021 1(1-2) (no pagination) Background: Hand, foot, and mouth disease (HFMD), classically a childhood viral infection, has an atypical and severe clinical presentation in adults. Coxsackievirus A6 is a leading cause of atypical HFMD, but current diagnostic methods utilizing formalin-fixed, paraffin-embedded skin biopsy specimens often lack sensitivity and specificity. Method(s): Formalin-fixed, paraffin-embedded skin biopsies from seven case patients with clinical and histopathological suspicion of atypical HFMD were evaluated by coxsackievirus A6 (CVA6) immunohistochemistry, enterovirus-specific conventional reverse transcriptase-PCR with subsequent Sanger sequencing targeting the 5'UTR, and CVA6-specific real-time PCR targeting the VP1 gene. Result(s): The CVA6-specific antibody demonstrated appropriate antigen distribution and staining intensity in keratinocytes in all cases. Conventional RT-PCR and sequencing also detected the presence of enterovirus, and CVA6-specific real-time RT-PCR analysis identified CVA6. Conclusion(s): Applying these immunohistochemistry and molecular techniques to formalin-fixed, paraffin-embedded tissues, CVA6 was determined to be the causative infectious agent in seven cases of atypical hand, foot, and mouth disease. Copyright © 2021 |
Causes, characteristics, and patterns of prolonged unplanned school closures prior to the COVID-19 pandemic-United States, 2011-2019.
Jahan FA , Zviedrite N , Gao H , Ahmed F , Uzicanin A . PLoS One 2022 17 (7) e0272088 INTRODUCTION: Outside of pandemics, there is little information about occurrence of prolonged unplanned K-12 school closures (PUSC). We describe here the reasons, characteristics, and patterns of PUSC in the United States during 8 consecutive inter-pandemic academic years, 2011-2019. METHODS: From August 1, 2011 through June 30, 2019, daily systematic online searches were conducted to collect data on publicly announced unplanned school closures lasting 1 school days in the United States. Closures were categorized as prolonged when schools were closed for 5 unplanned days (approximating one full workweek), excluding weekends and scheduled days off per school calendars. RESULTS: During the eight academic years, a total of 22,112 PUSCs were identified, affecting over 800,000 teachers and 13 million students that resulted in 91.5 million student-days lost. A median of 62.9% of students in PUSC-affected schools were eligible for subsidized school meals. Most affected schools were in cities (35%) and suburban areas (33%). Natural disasters (47%), adverse weather conditions (35%), and budget/teacher strikes (15%) were the most frequently cited reasons for PUSC; illness accounted for 1%, and building/facility issues, environmental issues and violence together accounted for the remaining 2%. The highest number of PUSCs occurred in Health and Human Services Regions 2, 3, 4, and 6 encompassing areas that are frequently in the path of hurricanes and tropical storms. The majority of PUSCs in these regions were attributed to a handful of hurricanes during the fall season, including hurricanes Sandy, Irma, Harvey, Florence, and Matthew. CONCLUSIONS: PUSCs occur annually in the United States due to a variety of causes and are associated with a substantive loss of student-days for in-school learning. Both these prior experiences with PUSCs and those during the current COVID-19 pandemic illustrate a need for creating sustainable solutions for high-quality distance learning and innovative supplemental feeding programs nationwide, especially in disaster-prone areas. |
COVID-19-associated school closures and related efforts to sustain education and subsidized meal programs, United States, February 18-June 30, 2020.
Zviedrite N , Hodis JD , Jahan F , Gao H , Uzicanin A . PLoS One 2021 16 (9) e0248925 Pre-emptive school closures are frontline community mitigation measures recommended by the US Centers for Disease Control and Prevention (CDC) for implementation during severe pandemics. This study describes the spatiotemporal patterns of publicly announced school closures implemented in response to the coronavirus disease 2019 (COVID-19) pandemic and assesses how public K-12 districts adjusted their methods of education delivery and provision of subsidized meals. During February 18-June 30, 2020, we used daily systematic media searches to identify publicly announced COVID-19-related school closures lasting ≥1 day in the United States (US). We also collected statewide school closure policies from state government websites. Data on distance learning and subsidized meal programs were collected from a stratified sample of 600 school districts. The first COVID-19-associated school closure occurred on February 27, 2020 in Washington state. By March 30, 2020, all but one US public school districts were closed, representing the first-ever nearly synchronous nationwide closure of public K-12 schools in the US. Approximately 100,000 public schools were closed for ≥8 weeks because of COVID-19, affecting >50 million K-12 students. Of 600 districts sampled, the vast majority offered distance learning (91.0%) and continued provision of subsidized meal programs (78.8%) during the closures. Despite the sudden and prolonged nature of COVID-19-associated school closures, schools demonstrated flexibility by implementing distance learning and alternate methods to continue subsidized meal programs. |
Coding-Complete Sequence of a SARS-CoV-2 B.1.1.25 Lineage Obtained from an 8-Day-Old Deceased Neonate.
Alam M , Jahan MI , Jahan S , Blau DM , Rahman A , Rahman MZ , Hossain MZ , Gurley ES , Arifeen SE , Rahman M . Microbiol Resour Announc 2021 10 (35) e0075621 We report the complete genome sequence of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain, hCoV-19/Bangladesh/icddrb-CHAMPS-BDAA02205/2021, obtained from a nasopharyngeal swab from a deceased neonate from Faridpur, Bangladesh. The strain belongs to lineage B.1.1.25 but contains some notable mutations similar to the B.1.1.7 lineage. |
Digital auscultation in PERCH: Associations with chest radiography and pneumonia mortality in children
McCollum ED , Park DE , Watson NL , Fancourt NSS , Focht C , Baggett HC , Abdullah Brooks W , Howie SRC , Kotloff KL , Levine OS , Madhi SA , Murdoch DR , Scott JAG , Thea DM , Awori JO , Chipeta J , Chuananon S , DeLuca AN , Driscoll AJ , Ebruke BE , Elhilal M , Emmanouilidou D , Githua LP , Higdon MM , Hossain L , Jahan Y , Karron RA , Kyalo J , Moore DP , Mulindwa JM , Naorat S , Prosperi C , Verwey C , West JE , Knoll MD , Brien KLO , Feikin DR , Hammitt LL . Pediatr Pulmonol 2020 55 (11) 3197-3208 BACKGROUND: Whether digitally recorded lung sounds are associated with radiographic pneumonia or clinical outcomes among children in low-income and middle-income countries is unknown. We sought to address these knowledge gaps. METHODS: We enrolled 1-59 month old children hospitalized with pneumonia at eight African and Asian Pneumonia Etiology Research for Child Health sites in six countries, recorded digital stethoscope lung sounds, obtained chest radiographs, and collected clinical outcomes. Recordings were processed and reclassified into binary categories positive or negative for adventitial lung sounds. Listening and reading panels classified recordings and radiographs. Recording classification associations with chest radiographs with World Health Organization (WHO)-defined primary endpoint pneumonia (radiographic pneumonia) or mortality were evaluated. We also examined case fatality among risk strata. RESULTS: Among children without WHO danger signs, wheezing (without crackles) had a lower adjusted odds ratio (aOR) for radiographic pneumonia (0.35, 95% confidence interval (CI) 0.15, 0.82), compared to children with normal recordings. Neither crackle only (no wheeze) (aOR 2.13, 95%CI 0.91, 4.96) or any wheeze (with or without crackle) (aOR 0.63, 95%CI 0.34, 1.15) were associated with radiographic pneumonia. Among children with WHO danger signs no lung recording classification was independently associated with radiographic pneumonia, although trends towards greater odds of radiographic pneumonia were observed among children classified with crackle only (no wheeze) or any wheeze (with or without crackle). Among children without WHO danger signs, those with recorded wheezing had a lower case fatality than those without wheezing (3.8% vs 9.1%, p=0.03). CONCLUSIONS: Among lower risk children without WHO danger signs digitally recorded wheezing is associated with a lower odds for radiographic pneumonia and with lower mortality. Although further research is needed, these data indicate that with further development digital auscultation may eventually contribute to child pneumonia care. This article is protected by copyright. All rights reserved. |
Limited Utility of Polymerase Chain Reaction in Induced Sputum Specimens for Determining the Causes of Childhood Pneumonia in Resource-Poor Settings: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study.
Thea DM , Seidenberg P , Park DE , Mwananyanda L , Fu W , Shi Q , Baggett HC , Brooks WA , Feikin DR , Howie SRC , Knoll MD , Kotloff KL , Levine OS , Madhi SA , O'Brien KL , Scott JAG , Antonio M , Awori JO , Baillie VL , DeLuca AN , Driscoll AJ , Higdon MM , Hossain L , Jahan Y , Karron RA , Kazungu S , Li M , Moore DP , Morpeth SC , Ofordile O , Prosperi C , Sangwichian O , Sawatwong P , Sylla M , Tapia MD , Zeger SL , Murdoch DR , Hammitt LL . Clin Infect Dis 2017 64 S289-s300 Background.: Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses and bacteria in induced sputum (IS) specimens from children hospitalized with severe or very severe pneumonia. Methods.: Among children aged 1-59 months, we compared organism detection by multiplex PCR in IS and nasopharyngeal/oropharyngeal (NP/OP) specimens. To assess whether organism presence or density in IS specimens was associated with chest radiographic evidence of pneumonia (radiographic pneumonia), we compared prevalence and density in IS specimens from children with radiographic pneumonia and children with suspected pneumonia but without chest radiographic changes or clinical or laboratory findings suggestive of pneumonia (nonpneumonia group). Results.: Among 4232 cases with World Health Organization-defined severe or very severe pneumonia, we identified 1935 (45.7%) with radiographic pneumonia and 573 (13.5%) with nonpneumonia. The organism detection yield was marginally improved with IS specimens (96.2% vs 92.4% for NP/OP specimens for all viruses combined [P = .41]; 96.9% vs 93.3% for all bacteria combined [P = .01]). After accounting for presence in NP/OP specimens, no organism was detected more frequently in the IS specimens from the radiographic pneumonia compared with the nonpneumonia cases. Among high-quality IS specimens, there were no statistically significant differences in organism density, except with cytomegalovirus, for which there was a higher quantity in the IS specimens from cases with radiographic pneumonia compared with the nonpneumonia cases (median cycle threshold value, 27.9 vs 28.5, respectively; P = .01). Conclusions.: Using advanced molecular methods with IS specimens provided little additional diagnostic information beyond that obtained with NP/OP swab specimens. |
Safety of induced sputum collection in children hospitalized with severe or very severe pneumonia
DeLuca AN , Hammitt LL , Kim J , Higdon MM , Baggett HC , Brooks WA , Howie SRC , Deloria Knoll M , Kotloff KL , Levine OS , Madhi SA , Murdoch DR , Scott JAG , Thea DM , Amornintapichet T , Awori JO , Chuananon S , Driscoll AJ , Ebruke BE , Hossain L , Jahan Y , Kagucia EW , Kazungu S , Moore DP , Mudau A , Mwananyanda L , Park DE , Prosperi C , Seidenberg P , Sylla M , Tapia MD , Zaman SMA , O'Brien KL . Clin Infect Dis 2017 64 S301-s308 Background.: Induced sputum (IS) may provide diagnostic information about the etiology of pneumonia. The safety of this procedure across a heterogeneous population with severe pneumonia in low- and middle-income countries has not been described. Methods.: IS specimens were obtained as part a 7-country study of the etiology of severe and very severe pneumonia in hospitalized children <5 years of age. Rigorous clinical monitoring was done before, during, and after the procedure to record oxygen requirement, oxygen saturation, respiratory rate, consciousness level, and other evidence of clinical deterioration. Criteria for IS contraindications were predefined and serious adverse events (SAEs) were reported to ethics committees and a central safety monitor. Results.: A total of 4653 IS procedures were done among 3802 children. Thirteen SAEs were reported in relation to collection of IS, or 0.34% of children with at least 1 IS specimen collected (95% confidence interval, 0.15%-0.53%). A drop in oxygen saturation that required supplemental oxygen was the most common SAE. One child died after feeding was reinitiated 2 hours after undergoing sputum induction; this death was categorized as "possibly related" to the procedure. Conclusions.: The overall frequency of SAEs was very low, and the nature of most SAEs was manageable, demonstrating a low-risk safety profile for IS collection even among severely ill children in low-income-country settings. Healthcare providers should monitor oxygen saturation and requirements during and after IS collection, and assess patients prior to reinitiating feeding after the IS procedure, to ensure patient safety. |
Chest radiograph findings in childhood pneumonia cases from the multisite PERCH Study
Fancourt N , Deloria Knoll M , Baggett HC , Brooks WA , Feikin DR , Hammitt LL , Howie SRC , Kotloff KL , Levine OS , Madhi SA , Murdoch DR , Scott JAG , Thea DM , Awori JO , Barger-Kamate B , Chipeta J , DeLuca AN , Diallo M , Driscoll AJ , Ebruke BE , Higdon MM , Jahan Y , Karron RA , Mahomed N , Moore DP , Nahar K , Naorat S , Ominde MS , Park DE , Prosperi C , Wa Somwe S , Thamthitiwat S , Zaman SMA , Zeger SL , O'Brien KL . Clin Infect Dis 2017 64 S262-s270 Background: Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented. Methods: The Pneumonia Etiology Research for Child Health project enrolled 4232 cases of hospitalized World Health Organization (WHO)-defined severe and very severe pneumonia from 9 sites in 7 countries (Bangladesh, the Gambia, Kenya, Mali, South Africa, Thailand, and Zambia). At admission, each case underwent a standardized assessment of clinical signs and pneumonia risk factors by trained health personnel, and a CXR was taken that was interpreted using the standardized WHO methodology. CXRs were categorized as abnormal (consolidation and/or other infiltrate), normal, or uninterpretable. Results: CXRs were interpretable in 3587 (85%) cases, of which 1935 (54%) were abnormal (site range, 35%-64%). Cases with abnormal CXRs were more likely than those with normal CXRs to have hypoxemia (45% vs 26%), crackles (69% vs 62%), tachypnea (85% vs 80%), or fever (20% vs 16%) and less likely to have wheeze (30% vs 38%; all P < .05). CXR consolidation was associated with a higher case fatality ratio at 30-day follow-up (13.5%) compared to other infiltrate (4.7%) or normal (4.9%) CXRs. Conclusions: Clinically diagnosed pneumonia cases with abnormal CXRs were more likely to have signs typically associated with pneumonia. However, CXR-normal cases were common, and clinical signs considered indicative of pneumonia were present in substantial proportions of these cases. CXR-consolidation cases represent a group with an increased likelihood of death at 30 days post-discharge. |
Outbreak of hepatitis E in urban Bangladesh resulting in maternal and perinatal mortality
Gurley ES , Hossain MJ , Paul RC , Sazzad HM , Islam MS , Parveen S , Faruque LI , Husain M , Ara K , Jahan Y , Rahman M , Luby SP . Clin Infect Dis 2014 59 (5) 658-65 BACKGROUND: Hepatitis E virus (HEV) causes outbreaks of jaundice associated with maternal mortality. Four deaths among pregnant women with jaundice occurred in an urban community near Dhaka in late 2008 and were reported to authorities in January 2009. We investigated the etiology and risk factors for jaundice and death. METHODS: Field workers identified suspect cases, defined as acute onset of yellow eyes or skin, through house-to-house visits. A sub-set of suspect cases was tested for IgM antibodies to HEV to confirm infection. We used logistic regression to identify risk factors for HEV disease and for death. We estimated the increased risk of perinatal mortality associated with jaundice during pregnancy. RESULTS: We identified 4,751 suspect HEV cases during August 2008 - January 2009, including 17 deaths. IgM antibodies to HEV were identified in 56 (77%) of 73 case-patients tested who were neighbors of the case-patients who died. HEV disease was significantly associated with drinking municipal supplied water. Death among persons with HEV disease was significantly associated with being female and taking paracetamol. Among women who were pregnant, miscarriage and perinatal mortality was 2.7 times higher (95% confidence interval 1.2-6.1) in pregnancies complicated by jaundice. CONCLUSIONS: This outbreak of HEV was likely caused by sewerage contamination of the municipal water system. Longer-term efforts to improve access to safe water and license HEV vaccines are needed. However, securing resources and support for intervention will rely upon convincing data about the endemic burden of HEV disease, particularly its role in maternal and perinatal mortality. |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 20, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure