Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-30 (of 1178 Records) |
Query Trace: Jones A [original query] |
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Efficacy of internet recruitment and HIV self-testing for diagnosing HIV infections among black and Hispanic/Latino MSM and transgender women in 11 US states, 2020-2021
MacGowan RJ , Chavez PR , Dana R , Hannah M , Raiford JL , Caldwell JA , Wall KM , Johnson JA , Sharma A , Hightow-Weidman L , Stephenson R , Sanchez T , Smith AJ , Sullivan S , Jones J , Sullivan PS . J Acquir Immune Defic Syndr 2024 97 (2) 133-141 INTRODUCTION: We evaluated internet platforms for distributing HIV self-tests (HIVSTs) to Black or African American (Black) and Hispanic or Latino men who have sex with men (MSM) and transgender women (TGW). METHODS: We recruited MSM and TGW from general interest, dating, and lesbian, gay, bisexual, and transgender platforms. Two HIVSTs were mailed to all MSM and TGW. Surveys (screening, baseline, 4-month, and results reporting) were completed online. After 4 months, participants were mailed another HIVST and a dried blood spot card. All HIVST interpretations and images of HIVST devices were reported online. RESULTS: Of 2093 MSM and 102 TGW, most were recruited through general interest and dating platforms. Over 50% were 18-29 years old, most identified as gay or bisexual. Overall, 45% had not tested for HIV in the past 12 months, and 9.1% of MSM reported a positive (reactive for HIV antibodies) HIVST result, with the highest percentage among Black MSM (11.5%). Dating platforms recruited higher percentages of MSM who recorded positive results compared with MSM from general interest platforms during the intervention period (11.9% vs 5.5% (P < 0.0001)), and MSM who had never tested for HIV reported a greater percentage of positive HIVST results compared with MSM who had been tested for HIV before enrollment (16.1% vs. 7.1%; P < 0.0001). MSM were able to correctly interpret and report HIVST results. Of TGW, 7% reported a positive HIVST result. CONCLUSIONS: Internet dating and general interest platforms can be key to increasing awareness of infection among BMSM, HMSM, and TGW persons, including those who do not use existing HIV services. TRIAL REGISTRATION: www.clinicaltrials.gov Identifier: NCT04219878. |
Leptospirosis outbreak in aftermath of Hurricane Fiona - Puerto Rico, 2022
Jones FK , Medina AG , Ryff KR , Irizarry-Ramos J , Wong JM , O'Neill E , Rodríguez IA , Cardona I , Hernández L , Hernandez-Romieu AC , Phillips MT , Johansson MA , Bayleyegn T , Atherstone C , DeBord KR , Negrón ME , Galloway R , Adams LE , Marzán-Rodríguez M . MMWR Morb Mortal Wkly Rep 2024 73 (35) 763-768 Leptospirosis, an acute bacterial zoonotic disease, is endemic in Puerto Rico. Infection in approximately 10%-15% of patients with clinical disease progresses to severe, potentially fatal illness. Increased incidence has been associated with flooding in endemic areas around the world. In 2022, Hurricane Fiona, a Category 1 hurricane, made landfall and inundated Puerto Rico with heavy rainfall and severe flooding, increasing the risk for a leptospirosis outbreak. In response, the Puerto Rico Department of Health (PRDH) changed guidelines to make leptospirosis cases reportable within 24 hours, centralized the case investigation management system, and provided training and messaging to health care providers. To evaluate changes in risk for leptospirosis after Hurricane Fiona to that before the storm, the increase in cases was quantified, and patient characteristics and geographic distribution were compared. During the 15 weeks after Hurricane Fiona, 156 patients experienced signs and symptoms of leptospirosis and had a specimen with a positive laboratory result reported to PRDH. The mean weekly number of cases during this period was 10.4, which is 3.6 as high as the weekly number of cases during the previous 37 weeks (2.9). After Hurricane Fiona, the proportion of cases indicating exposure to potentially contaminated water increased from 11% to 35%, and the number of persons receiving testing increased; these factors likely led to the resulting overall surge in reported cases. Robust surveillance combined with outreach to health care providers after flooding events can improve leptospirosis case identification, inform clinicians considering early initiation of treatment, and guide public messaging to avoid wading, swimming, or any contact with potentially contaminated floodwaters. |
Tracking the burden, distribution, and impact of Post-COVID conditions in diverse populations for children, adolescents, and adults (Track PCC): passive and active surveillance protocols
Jones RM , Andrews JG , Dalton AF , Dixon BE , Dzomba BJ , Fernando SI , Pogreba-Brown KM , Ortiz MR , Sharma V , Simmons N , Saydah SH . BMC Public Health 2024 24 (1) 2345 BACKGROUND: Track PCC includes five geographic surveillance sites to conduct standardized population-based surveillance to estimate and track Post-COVID Conditions (PCC) by age, sex, race/ethnicity, geographic area, severity of initial infection, and risk factors among persons with evidence of SARS-CoV-2 infection (based on the Council of State and Territorial Epidemiologist [CSTE] case definitions for confirmed cases or laboratory-confirmed evidence of infection). METHODS: The study will estimate the incidence, prevalence, including temporal trends, and duration and severity of PCC symptoms, among children, adolescents, and adults. PCCs include a broad range of symptoms and conditions that continue or develop after acute SARS-CoV-2 infection or COVID-19 illness. Surveillance includes both passive and active components for diverse populations in Arizona, Indiana, and Utah as well as the Bronx Borough, NY, and part of Philadelphia County, PA. Passive surveillance will utilize electronic health records and health information exchanges within each site catchment area to longitudinally follow persons with COVID-19 to estimate PCC occurring at least 30 days after acute COVID-19 illness. Active surveillance will utilize self-report of PCCs from detailed surveys of persons ages 7 years and older with evidence of SARS-CoV-2 infection in the past 3 months. Respondents will complete follow-up surveys at 6-, 12- and 18-months post-infection. DISCUSSION: These data can help identify which groups are most affected by PCC, and what health differences among demographic groups exist, as well as indicate potential barriers to care. These additional levels of granularity can inform public health action and help direct needed clinical care for patients. |
School mask policies and SARS-CoV-2 seroprevalence among school-age children-United States, September to December 2021
Nycz E , Deng Y , Van Dyke ME , Bratcher A , Shi J , Iachan R , Berney K , Jones JM , Clarke KEN . Microbiol Spectr 2024 e0069124 During September to December 2021, school mask policies to mitigate SARS-CoV-2 transmission varied throughout the US. We compared infection-induced seroprevalence estimates and estimated seroconversion among children residing in areas with and without school mask requirements. We estimated infection-induced seroprevalence among children in three age groups (5-17, 5-11, and 12-17 years) in areas with and without school district mask requirements for two time points: September 1-30, 2021 and December 15, 2021 to January 14, 2022. Robust Poisson regression models estimated population seroconversion over the semester among initially seronegative children. Permutation tests assessed for significant differences in the estimated population seroconversion due to incident infections by school district mask policy. Residing in an area with no school mask requirement was associated with higher infection-induced seroprevalence among children aged 5-17 years (adjusted prevalence ratio [aPR] = 1.18, 95% confidence interval [CI]: 1.10, 1.26), and those aged 5-11 years (aPR) = 1.21, 95% CI: 1.10, 1.32) and those aged 12-17 years (aPR = 1.16, 95% CI: 1.07, 1.26), compared with areas requiring masks in school. Estimated population seroconversion during the semester was also significantly higher among children in districts without mask policies than those with school mask requirements among all age groups (5-17 years: 23.7% vs 18.1%, P < 0.001; 5-11 years: 6.4% vs 4.5%, P = 0.002;12-17 years: 27.2% vs 21.0%, P < 0.001). During the U.S. Fall 2021 semester, areas with school mask requirements had lower infection-induced seroprevalence and an estimated lower proportion of seroconversion due to incident infection among school-aged children compared with areas without school mask requirements; causality cannot necessarily be inferred from these associations. IMPORTANCE: During the U.S. Fall 2021 school semester, the estimated proportion of previously uninfected school-aged children who experienced a first infection with SARS-CoV-2 was lower in areas where public school district policies required masks for all staff and students compared with areas where the school districts had no mask requirements. Because children are more likely than adults to experience asymptomatic or mild SARS-CoV-2 infections, the presence of infection-induced antibodies is a more accurate measure of infection history than clinical testing. The proportion of children with these antibodies (i.e., seroprevalence) can improve our understanding of SARS-CoV-2 by detecting more infections and eliminating potential bias due to local testing and reporting practices. Enhanced robustness of surveillance for respiratory infections in children, including records of mitigation policies in communities and schools, as well as seroprevalence data, would establish a better evidence base for policy decisions and response measures during future respiratory outbreaks. |
Evaluating immunologic and illness outcomes of SARS-CoV-2 infection in vaccinated and unvaccinated children aged ≥ 5 years, in a multisite longitudinal cohort
Porter C , Lyski ZL , Uhrlaub JL , Ellingson KD , Jeddy Z , Gwynn L , Rivers P , Sprissler R , Hegmann KT , Coughlin MM , Fowlkes AL , Hollister J , LeClair L , Mak J , Beitel SC , Fuller S , Zheng PQ , Vaughan M , Rai RP , Grant L , Newes-Adeyi G , Yoo YM , Olsho L , Burgess JL , Caban-Martinez AJ , Yoon SK , Britton A , Gaglani M , Phillips AL , Thiese MS , Hagen MB , Jones JM , Lutrick K . Diseases 2024 12 (8) Hybrid immunity, as a result of infection and vaccination to SARS-CoV-2, has been well studied in adults but limited evidence is available in children. We evaluated the antibody responses to primary SARS-CoV-2 infection among vaccinated and unvaccinated children aged ≥ 5 years. METHODS: A longitudinal cohort study of children aged ≥ 5 was conducted during August 2021-August 2022, at sites in Arizona, Texas, Utah, and Florida. Children submitted weekly nasal swabs for PCR testing and provided sera 14-59 days after PCR-confirmed SARS-CoV-2 infection. Antibodies were measured by ELISA against the receptor-binding domain (RBD) and S2 domain of ancestral Spike (WA1), in addition to Omicron (BA.2) RBD, following infection in children, with and without prior monovalent ancestral mRNA COVID-19 vaccination. RESULTS: Among the 257 participants aged 5 to 18 years, 166 (65%) had received at least two mRNA COVID-19 vaccine doses ≥ 14 days prior to infection. Of these, 53 occurred during Delta predominance, with 37 (70%) unvaccinated at the time of infection. The remaining 204 infections occurred during Omicron predominance, with 53 (26%) participants unvaccinated. After adjusting for weight, age, symptomatic infection, and gender, significantly higher mean RBD AUC values were observed among the vaccinated group compared to the unvaccinated group for both WA1 and Omicron (p < 0.0001). A smaller percentage of vaccinated children reported fever during illness, with 55 (33%) reporting fever compared to 44 (48%) unvaccinated children reporting fever (p = 0.021). CONCLUSIONS: Children with vaccine-induced immunity at the time of SARS-CoV-2 infection had higher antibody levels during convalescence and experienced less fever compared to unvaccinated children during infection. |
Notes from the field: Prevalence of previous dengue virus infection among children and adolescents aged 7-16 years - American Samoa, September-October 2023
Kiplagat S , Tavale N , Konrote A , Johansson AM , Papu A , Perez-Padilla J , Jones FK , Desale H , Ilimaleota AF , Tulafono JM , Delorey M , Jones E , Chutaro E , Camacho J , Medina F , Tosado-Acevedo R , Munoz-Jordan JL , Paz-Bailey G , Adams LE , Nua MT , Wong JM , Anesi S . MMWR Morb Mortal Wkly Rep 2024 73 (31) 686-688 |
Progress toward elimination of mother-to-child transmission of hepatitis B virus - region of the Americas, 2012-2022
Alleman MM , Sereno LS , Whittembury A , Li X , Contreras M , Pacis-Tirso C , Gonzalez MV , Broome K , Jones S , Salas D , Alonso M , Tohme RA , Wasley A . MMWR Morb Mortal Wkly Rep 2024 73 (29) 648-655 In 2022, an estimated 5 million persons in the World Health Organization Region of the Americas (AMR) were living with chronic hepatitis B virus (HBV) infection, the leading cause of hepatocellular carcinoma and cirrhosis worldwide. Most chronic infections are acquired through mother-to-child transmission (MTCT) or horizontal transmission during childhood and are preventable with hepatitis B vaccination, including a birth dose (HepB-BD), followed by 2-3 additional doses (HepB3) in infancy. The Pan American Health Organization (PAHO) Elimination of MTCT of HBV infection strategy is intended to reduce chronic HBV infection (measured by hepatitis B surface antigen [HBsAg] seroprevalence) to ≤0.1% among children by achieving 1) ≥95% coverage with HepB-BD and HepB3; and 2) ≥80% of pregnant women received testing for HBsAg, and provision of hepatitis B immunoglobulin to HBV-exposed neonates. By 2012, all 51 AMR countries and territories (countries) provided HepB3 nationwide, and by 2021, 34 (67%) provided HepB-BD nationwide. Mathematical models estimate that HBsAg seroprevalence in children is ≤0.1% in 14 (28%) of 51 countries and at the regional level. Three (6%) of 51 countries met the 95% coverage targets for both HepB3 and HepB-BD during both 2021 and 2022. Of these, two have likely met criteria for the elimination of MTCT of HBV infection. However, in 2022, HepB3 coverage had declined by ≥10 percentage points in 15 (37%) of 41 countries with 2012 coverage data for comparison. These declines in HepB3 coverage, as well as the absence of HepB-BD in the routine immunization schedules in 17 countries, threaten PAHO's progress toward the elimination of MTCT of HBV infection. Efforts to introduce HepB-BD and maintain high HepB3 and HepB-BD coverage are needed. |
Progress toward achieving and sustaining maternal and neonatal tetanus elimination - Worldwide, 2000-2022
Jones CE , Yusuf N , Ahmed B , Kassogue M , Wasley A , Kanu FA . MMWR Morb Mortal Wkly Rep 2024 73 (28) 614-621 Tetanus remains a considerable cause of mortality among undervaccinated mothers and their infants following unhygienic deliveries, especially in low-income countries. Strategies of the maternal and neonatal tetanus elimination (MNTE) initiative, which targets 59 priority countries, include strengthening antenatal immunization of pregnant women with tetanus toxoid-containing vaccines (TTCVs); conducting TTCV supplementary immunization activities among women of reproductive age in high-risk districts; optimizing access to skilled birth attendants to ensure clean deliveries and umbilical cord care practices; and identifying and investigating suspected neonatal tetanus cases. This report updates a previous report and describes progress toward MNTE during 2000-2022. By December 2022, 47 (80%) of 59 priority countries were validated to have achieved MNTE. In 2022, among the 50 countries that reported coverage with ≥2 doses of TTCV among pregnant women, 16 (32%) reported coverage of ≥80%. In 2022, among 47 validated countries, 26 (55%) reported that ≥70% of births were assisted by skilled birth attendants. Reported neonatal tetanus cases worldwide decreased 89%, from 17,935 in 2000 to 1,995 in 2021; estimated neonatal tetanus deaths decreased 84%, from 46,898 to 7,719. However, the global disruption of routine immunization caused by the COVID-19 pandemic impeded MNTE progress. Since 2020, reported neonatal tetanus cases have increased in 18 (31%) priority countries. Integration of MNTE strategies into priority countries' national postpandemic immunization recovery activities is needed to achieve and sustain global elimination. |
Prescription opioid use disorder among adults reporting prescription opioid use with or without misuse in the United States
Han B , Jones CM , Einstein EB , Dowell D , Compton WM . J Clin Psychiatry 2024 85 (3) Objective: We examined prescription related opioid use disorder (POUD) prevalence, individual symptoms, severity, characteristics, and treatment by prescription opioid misuse status among adults with prescription opioid use. Methods: Cross-sectional study using nationally representative data from 47,291 adults aged ≥18 years who participated in the 2021 National Survey on Drug Use and Health. Past-year POUD used DSM-5 criteria. Results: Among US adults with past-year prescription opioid use, 12.1% (95% CI, 11.1%-13.1%) misused prescription opioids, and 7.0% (95% CI, 6.2%-8.9%) had POUD. Among adults with POUD, 62.0% (95% CI, 56.7%-67.2%) reported no prescription opioid misuse, including 49.1% (95% CI, 43.5%-54.7%) with mild POUD, 11.0% (95% CI, 6.5%-15.4%) with moderate POUD, and 1.9% (95% CI, 0.6%-3.2%) with severe POUD. Prevalence of POUD was 4.5 times higher (prevalence ratio = 4.5, 95% CI, 3.6-5.6) among those reporting prescription opioid misuse (22.0%, 95% CI, 18.6%-25.8%) than those reporting use without misuse (4.9%, 95% CI, 4.2%-5.7%). Among adults reporting prescription opioid use without misuse, high POUD prevalence was found for those with ≥3 emergency department visits (16.4%, 95% CI, 11.5%-23.0%), heroin use/use disorder (17.1%, 95% CI, 5.2%-43.8%), prescription sedative/ tranquilizer use disorder (36.2%, 95% CI, 23.6%-51.1%), and prescription stimulant use disorder (21.8%, 95% CI, 11.0%-38.7%). Conclusions: Moderate-to-severe POUD is more frequent among adults who report misusing prescription opioids. However, 62% of adults with POUD do not report prescription opioid misuse, suggesting that adults who are treated with prescription opioids and report no misuse could be at risk for developing POUD. Results highlight the need to screen for and treat POUD among adults taking prescription opioids regardless of whether they report prescription opioid misuse. |
Notes from the field: Illnesses after administration of presumed counterfeit botulinum toxin in nonmedical settings - Tennessee and New York City, March 2024
Thomas CM , McElroy R , Yackley J , Fill MA , Goonewardene D , Mackley C , Roth E , Ackelsberg J , Slavinski S , Habrun C , Hodge B , Rush C , Brown CM , Waltenburg MA , Bertling LH , McGorty M , Johnson R , Schaffner W , Jones TF , Dunn JR . MMWR Morb Mortal Wkly Rep 2024 73 (27) 609-611 |
Universal smoking machine adaptor for tobacco product testing
El-Hellani A , Watson CH , Huang M , Wilson CW , Fleshman CC , Petitti R , Pancake M , Bennett C , Keller-Hamilton BL , Jones J , Tran H , Bravo Cardenas R , Mays D , Ye W , Borthwick RP , Schaff J , Williamson RL , Wagener TL , Brinkman MC . Tob Control 2024 SIGNIFICANCE: Historically, tobacco product emissions testing using smoking machines has largely focused on combustible products, such as cigarettes and cigars. However, the popularity of newer products, such as electronic cigarettes (e-cigarettes), has complicated emissions testing because the products' mouth-end geometries do not readily seal with existing smoking and vaping machines. The demand for emissions data on popularly used products has led to inefficient and non-standardised solutions, such as laboratories making their geometry-specific custom adaptors and/or employing flexible tubing, for each unique mouth-end geometry tested. A user-friendly, validated, universal smoking machine adaptor (USMA) is needed for testing the variety of tobacco products reflecting consumer use, including e-cigarettes, heated tobacco products, cigarettes, plastic-tipped cigarillos and cigars. METHODS: A prototype USMA that is compatible with existing smoking/vaping machines was designed and fabricated. The quality of the seal between the USMA and different tobacco products, including e-cigarettes, cigars and cigarillos, was evaluated by examining the leak rate. RESULTS: Unlike commercial, product-specific adaptors, the USMA seals well with a wide range of tobacco product mouth-end geometries and masses. This includes e-cigarettes with non-cylindrical mouth ends and cigarillos with cuboid-like plastic tips. USMA leak rates were lower than or equivalent to commercial, product-specific adaptors. CONCLUSION: This report provides initial evidence that the USMA seals reliably with a variety of tobacco product mouth-end geometries and can be used with existing linear smoking/vaping machines to potentially improve the precision, repeatability and reproducibility of machine smoke yield data. Accurate and reproducible emissions testing is critical for regulating tobacco products. |
Benchmarking a universal smoking machine adaptor for tobacco product testing
El-Hellani A , Watson CH , Huang M , Wilson CW , Fleshman CC , Tran H , Chafin D , McGuigan M , Bravo Cardenas R , Petitti R , Pancake M , Bennett C , Mays D , Keller-Hamilton BL , Jones J , Ye W , Schaff J , Borthwick RP , Williamson RL , Wagener TL , Brinkman MC . Tob Control 2024 SIGNIFICANCE: Characterisation of tobacco product emissions is an important step in assessing their impact on public health. Accurate and repeatable emissions data require that a leak-tight seal be made between the smoking or vaping machine and the mouth-end of the tobacco product being tested. This requirement is challenging because of the variety of tobacco product mouth-end geometries being puffed on by consumers today. We developed and tested a prototype universal smoking machine adaptor (USMA) that interfaces with existing machines and reliably seals with a variety of tobacco product masses and geometries. METHODS: Emissions were machine-generated using the USMA and other available adaptors for a variety of electronic cigarettes (n=7 brands), cigars (n=4), cigarillos (n=2), a heated tobacco product, and a reference cigarette (1R6F), and mainstream total particulate matter (TPM) and nicotine were quantified. Data variability (precision, n≥10 replicates/brand) for all products and error (accuracy) from certified values (1R6F) were compared across adaptors. RESULTS: TPM and nicotine emissions generated using the USMA were accurate, precise and agreed with certified values for the 1R6F reference cigarette. Replicate data indicate that USMA repeatability across all tobacco products tested generally meets or exceeds that from the comparison adaptors and extant data. CONCLUSION: The USMA seals well with a variety of combustible tobacco products, e-cigarettes with differing geometries and plastic-tipped cigarillos. Variability for all measures was similar or smaller for the USMA compared with other adaptors. |
Development, evaluation, and long-term outcomes of environmental health and land reuse training-part 1: Developing environmental health and land reuse trainings for the environmental health workforce and their community partners
Berman L , Unkart S , Lewin M , Labbo R , Bare G , Wooden A , Erdal S , Bing L , Casteel S , Amar O , Jones T , Begay L . J Environ Health 2024 86 (10) 16-22 This article is the first in a series of three that describes the development and delivery of the Environmental Health and Land Reuse (EHLR) Basic Training and the first pilot of the EHLR Immersion Training. The EHLR Basic Training is based on the 5-step Land Reuse Model from the Agency for Toxic Substances and Disease Registry (ATSDR). Through a collaboration with the National Environmental Health Association (NEHA), we developed the EHLR Basic Training in two modalities: virtual/live (maintained by ATSDR) and online/asynchronous (maintained by NEHA). The modules include: 1) Engaging With Your Community, 2) Evaluating Environmental and Health Risks, 3) Communicating Environmental and Health Risks, 4) Redesigning With Health in Mind, and 5) Measuring Success: Evaluating Environmental and Health Change. From June 2019-August 2022, ATSDR and NEHA delivered 10 EHLR Classroom Basic Trainings, launched the EHLR Online Basic Training, and developed the EHLR Immersion Training. We piloted the EHLR Immersion Training in July 2022, March 2023, and July 2023. Our participants included science, technology, engineering, and mathematics (STEM) students from Dine College who were in a Summer Intern Program; tribal environmental professionals; NEHA members in environmental health careers; and environmental professionals, students, and community members who were engaged in environmental work or environmental justice. We have learned that individual training modules can be used for specific learning needs among our participants. Perhaps more importantly, we have learned that undergraduate students and community members can and should be engaged in EHLR Training. The results of the evaluation and longterm follow-up of the EHLR Training will be presented in the second and third articles in this series. © 2024, National Environmental Health Association. All rights reserved. |
Detection of nucleocapsid antibodies associated with primary SARS-CoV-2 infection in unvaccinated and vaccinated blood donors
Grebe E , Stone M , Spencer BR , Akinseye A , Wright D , Di Germanio C , Bruhn R , Zurita KG , Contestable P , Green V , Lanteri MC , Saa P , Biggerstaff BJ , Coughlin MM , Kleinman S , Custer B , Jones JM , Busch MP . Emerg Infect Dis 2024 30 (8) Nucleocapsid antibody assays can be used to estimate SARS-CoV-2 infection prevalence in regions implementing spike-based COVID-19 vaccines. However, poor sensitivity of nucleocapsid antibody assays in detecting infection after vaccination has been reported. We derived a lower cutoff for identifying previous infections in a large blood donor cohort (N = 142,599) by using the Ortho VITROS Anti-SARS-CoV-2 Total-N Antibody assay, improving sensitivity while maintaining specificity >98%. We validated sensitivity in samples donated after self-reported swab-confirmed infections diagnoses. Sensitivity for first infections in unvaccinated donors was 98.1% (95% CI 98.0-98.2) and for infection after vaccination was 95.6% (95% CI 95.6-95.7) based on the standard cutoff. Regression analysis showed sensitivity was reduced in the Delta compared with Omicron period, in older donors, in asymptomatic infections, <30 days after infection, and for infection after vaccination. The standard Ortho N antibody threshold demonstrated good sensitivity, which was modestly improved with the revised cutoff. |
Breaking down silos in the workplace: A framework to foster collaboration
Jones AA , Uhd J , Kabore CD , Cornett KA . J Public Health Manag Pract 2024 INTRODUCTION: Employees are often placed within an organization based on their respective roles or duties, which can lead to vertical and horizontal organizational silos. Organizational silos may restrict information, resources, and stymie progress and innovation. This analysis presents a framework to mitigate silos and overcome communication barriers within an organization by increasing collaboration. METHODS: The project team examined results from the Centers for Disease Control and Prevention (CDC), the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) 2020 Employee Viewpoint Survey Results and conducted 19 key informant discussions with NCCDPHP employees. Participants were asked to provide feedback on (1) understanding silos in the workplace and (2) best practices for reducing silos and fostering collaboration. A thematic analysis was conducted to understand organizational silos, the motivation to reduce silos, and identify best practices and strategies. RESULTS: Respondents felt that siloing exists at the division and branch levels; however, 95% of respondents were motivated to reduce silos. Fifty-eight percent of respondents identified that institutional factors such as the organizational structure (n = 8) and red tape/bureaucracy (n = 3) contribute to siloing. Additional behaviors and actions that perpetuate silos were identified, and efforts to reduce silos were categorized to propose a model: Framework to Foster Collaboration for improving organizational collaborative efforts. DISCUSSION AND CONCLUSION: Key themes included inclusion, shared goals and vision, bi-directional communication, and relationship building and developing trust as critical elements for improving collaboration and creating synergy across teams in efforts to reduce silos in the workplace. |
Treatment for opioid use disorder: Population estimates - United States, 2022
Dowell D , Brown S , Gyawali S , Hoenig J , Ko J , Mikosz C , Ussery E , Baldwin G , Jones CM , Olsen Y , Tomoyasu N , Han B , Compton WM , Volkow ND . MMWR Morb Mortal Wkly Rep 2024 73 (25) 567-574 In 2022, 81,806 opioid-involved overdose deaths were reported in the United States, more than in any previous year. Medications for opioid use disorder (OUD), particularly buprenorphine and methadone, substantially reduce overdose-related and overall mortality. However, only a small proportion of persons with OUD receive these medications. Data from the 2022 National Survey on Drug Use and Health were applied to a cascade of care framework to estimate and characterize U.S. adult populations who need OUD treatment, receive any OUD treatment, and receive medications for OUD. In 2022, 3.7% of U.S. adults aged ≥18 years needed OUD treatment. Among these, only 25.1% received medications for OUD. Most adults who needed OUD treatment either did not perceive that they needed it (42.7%) or received OUD treatment without medications for OUD (30.0%). Compared with non-Hispanic Black or African American and Hispanic or Latino adults, higher percentages of non-Hispanic White adults received any OUD treatment. Higher percentages of men and adults aged 35-49 years received medications for OUD than did women and younger or older adults. Expanded communication about the effectiveness of medications for OUD is needed. Increased efforts to engage persons with OUD in treatment that includes medications are essential. Clinicians and other treatment providers should offer or arrange evidence-based treatment, including medications, for patients with OUD. Pharmacists and payors can work to make these medications available without delays. |
Changes in illicit drug use among high school students in southeastern U.S. States-2009 to 2019
Kilmer G , Jones SE , Rico A , Houston A , Lim C , Leon-Nguyen M , Asher AK . J Prev (2022) 2024 To determine if decreasing lifetime use of methamphetamines, cocaine, ecstasy, and inhalants among high school students occurring from 2009 to 2019 in the U.S. also occurred in five southeastern states, Youth Risk Behavior Survey data representative of high school students in grades 9-12 in 2009 and 2019 were analyzed. In a classroom setting, lifetime use of methamphetamines, cocaine, ecstasy, and inhalants were self-reported. Students nationwide (n = 30,087) were compared to students in Alabama, Georgia, Louisiana, Mississippi, and South Carolina (n = 18,237). Lifetime methamphetamine use significantly increased from 4.8% in 2009 to 6.2% in 2019 in the southeast but decreased from 4.1 to 2.2% nationwide. Use of cocaine, ecstasy, and inhalants remained stable in the southeast while decreasing significantly nationwide from 2009 to 2019. During a period when use of methamphetamines, cocaine, ecstasy, and inhalants among high school students in the U.S. decreased, use in southeastern states did not change. Culturally specific programs and interventions may be needed to prevent illicit drug use in communities of southeastern states where youth remain at risk. |
Effectiveness and implementation of an EnhanceFitness physical activity intervention specifically in adults with arthritis: A RE-AIM Evaluation
Jones DL , Eicher JL , Fang W , Hootman JM . Gerontologist 2024 64 (7) BACKGROUND AND OBJECTIVES: This study evaluated the effectiveness of the evidence-based, EnhanceFitness (EF) physical activity (PA) intervention in improving arthritis symptoms, physical and mental function, and PA in adults with arthritis. RESEARCH DESIGN AND METHODS: This was a community-based, randomized, controlled effectiveness trial that switched to a nonrandomized controlled trial. Participants were sedentary/low-active adults, aged ≥18 years, with self-reported physician-diagnosed arthritis, who were assigned to an immediate or delayed group (12-week, wait-list control group). Classes were held thrice weekly for 12 weeks at 17 community sites in 4 urban and 5 rural West Virginia counties. Data were collected at baseline, 12 weeks, and 24 weeks. The RE-AIM Framework evaluated EF's: (1) reach (enrollment); (2) effectiveness (outcomes); (3) adoption (proportion of sites/instructors that delivered EF); (4) implementation (attendance, fidelity, adverse events, and satisfaction); and (5) maintenance (EF continuation). Outcomes were analyzed using linear mixed-effects regression. RESULTS: There were 323 adults with a mean age of 68.3 years (range 27-95). Reach was 74%; site and instructor adoption rates were 100% and 55%, respectively; attendance (1.8 sessions per week) and fidelity were good; injury rate was low (3.8%); participants were highly satisfied and experienced improvements in arthritis symptoms and physical function; and 27% of instructors and 18% of sites continued EF. DISCUSSION AND IMPLICATIONS: EnhanceFitness was safe and effective in improving arthritis symptoms and physical function in sedentary/low-active adults with arthritis, across the adult age spectrum, under real-world conditions, in both urban and rural communities.Clinical Trial Registration: NCT00526201. |
Serum dioxin levels in a subset of participants of the East Palestine, Ohio train derailment health tracking study
Haynes EN , Eskenazi B , Hilbert TJ , Brancato C , Holland N , Kim C , Calafat AM , Jones R , Davis M , Birnbaum LS , Sjodin A . Environ Sci Techno Lett 2024 A February 3, 2023 train derailment and subsequent burn released hazardous chemicals into East Palestine, Ohio. One potential exposure was polychlorinated dibenzo-p-dioxins, dibenzofurans, and coplanar polychlorinated biphenyls (cPCBs), collectively referred to as dioxins. Many studies have linked dioxins to numerous health effects. A pilot study was conducted July 17-18, 2023 to assess residents’ serum dioxin levels. Eighteen persons who were White, nonsmokers with a mean age of 55, and 56% female, provided serum for analysis. Measurement of 20 dioxins, furans, and cPCBs congeners was conducted using gas chromatography, isotope dilution, and high-resolution mass spectrometry. A toxic equivalency (TEQ) value for each participant was calculated by multiplying the reported concentration of each congener by its toxic equivalency factor and summing the results. TEQs were compared to 2011-2012 National Health and Nutrition Examination Survey (NHANES) data by race/ethnicity, sex, and age group. All participants had serum TEQ values either below or within the range of NHANES values. Mean TEQ values were lower in younger age groups; we observed no sex-specific differences. These pilot data demonstrate that although dioxins may have formed during the derailment, exposures to participants did not increase their TEQ values compared with 2011-2012 NHANES. © 2024 American Chemical Society. |
Comparison of SARS-CoV-2 seroprevalence estimates between commercial lab serum specimens and blood donor specimens, United States, September-December 2021
Kao SZ , Nycz E , Benoit TJ , Clarke KEN , Jones JM . Microbiol Spectr 2024 e0012324 We estimated monthly cross-sectional seroprevalence rates of anti-nucleocapsid (anti-N) and anti-spike (anti-S) antibodies to severe acute respiratory syndrome coronavirus 2 in two U.S. nationwide studies. The nationwide blood donor seroprevalence (NBDS) study included specimens from blood donors, while the nationwide commercial laboratory seroprevalence (NCLS) study included residual serum specimens tested in commercial laboratories for reasons unrelated to the assessment of coronavirus disease 2019 infection. In September-December 2021, specimens collected from both nationwide studies were tested for anti-N antibodies. In September-October 2021, specimens from both studies within a five-state area were tested for anti-S antibodies. We used raking methods to adjust all seroprevalence estimates by the population distribution of key demographics in included states. Seroprevalence estimates of each antibody type were compared across the two studies for specimens drawn in the same U.S. states during the same time period. Our analysis revealed that over a 4-month period, national NCLS monthly anti-N estimates were 0.5-1.9 percentage points higher than NBDS estimates. In contrast, across five states during a 2-month period, NBDS anti-S estimates were 7.6 and 8.2 percentage points higher than NCLS estimates. The observed differences in seroprevalence estimates between the NBDS and NCLS studies may be attributed to variations in the characteristics of the study sample populations, particularly with respect to health status, health behaviors, and vaccination status. These differences should be considered in the interpretation of seroprevalence study results based on blood donors or commercial lab residual specimens. IMPORTANCE: This study was the first systematic comparison between two nationwide severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) studies which estimated seroprevalence, or the proportion of the population with antibodies to the virus, using differing convenience sample populations. One study tested blood donor specimens; the other study tested specimens left over from clinical blood tests. The seroprevalence of anti-nucleocapsid and anti-spike antibodies was compared in the same states during the same months with statistical adjustments based on state demographics. Similar anti-nucleocapsid antibody seroprevalence estimates produced by two independent studies using differing convenience samples build confidence in the generalizability of their anti-nucleocapsid findings. Due to high blood donor vaccine rates, blood donor SARS-CoV-2 anti-spike antibody estimates might overestimate general population seroprevalence, an important consideration for interpreting national seroprevalence study results. Furthermore, because laboratory residuals and blood donations are two common sources of specimens for seroprevalence studies, study findings may be informative for other respiratory virus seroepidemiology studies. |
Overdose, behavioral health services, and medications for opioid use disorder after a nonfatal overdose
Jones CM , Shoff C , Blanco C , Losby JL , Ling SM , Compton WM . JAMA Intern Med 2024 IMPORTANCE: Recognizing and providing services to individuals at highest risk for drug overdose are paramount to addressing the drug overdose crisis. OBJECTIVE: To examine receipt of medications for opioid use disorder (MOUD), naloxone, and behavioral health services in the 12 months after an index nonfatal drug overdose and the association between receipt of these interventions and fatal drug overdose. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted in the US from January 2020 to December 2021 using claims, demographic, mortality, and other data from the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and other sources. The cohort comprised Medicare fee-for-service beneficiaries aged 18 years or older with International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes for a nonfatal drug overdose. Data analysis was performed from February to November 2023. EXPOSURES: Demographic and clinical characteristics, substance use disorder, and psychiatric comorbidities. MAIN OUTCOMES AND MEASURES: Receipt of MOUD, naloxone, and behavioral health services as well as subsequent nonfatal and fatal drug overdoses. RESULTS: The cohort consisted of 136 762 Medicare beneficiaries (80 140 females [58.6%]; mean (SD) age of 68.2 [15.0] years) who experienced an index nonfatal drug overdose in 2020. The majority of individuals had Hispanic (5.8%), non-Hispanic Black (10.9%), and non-Hispanic White (78.8%) race and ethnicity and lived in metropolitan areas (78.9%). In the 12 months after their index nonfatal drug overdose, 23 815 beneficiaries (17.4%) experienced at least 1 subsequent nonfatal drug overdose and 1323 (1.0%) died of a fatal drug overdose. Opioids were involved in 72.2% of fatal drug overdoses. Among the cohort, 5556 (4.1%) received any MOUD and 8530 (6.2%) filled a naloxone prescription in the 12 months after the index nonfatal drug overdose. Filling a naloxone prescription (adjusted odds ratio [AOR], 0.70; 95% CI, 0.56-0.89), each percentage of days receiving methadone (AOR, 0.98; 95% CI, 0.98-0.99) or buprenorphine (AOR, 0.99; 95% CI, 0.98-0.99), and receiving behavioral health assessment or crisis services (AOR, 0.25; 95% CI, 0.22-0.28) were all associated with reduced adjusted odds of fatal drug overdose in the 12 months after the index nonfatal drug overdose. CONCLUSIONS AND RELEVANCE: This cohort study found that, despite their known association with reduced risk of a fatal drug overdose, only a small percentage of Medicare beneficiaries received MOUD or filled a naloxone prescription in the 12 months after a nonfatal drug overdose. Efforts to improve access to behavioral health services; MOUD; and overdose-prevention strategies, such as prescribing naloxone and linking individuals to community-based health care settings for ongoing care, are needed. |
Shared vision for improving outcomes for serious fungal diseases: Report of a patient, caregiver, and clinician summit
Purdie R , Tushla LA , Ferretti J , Castro GK , Watson R , Davis T , Raborg B , Mazi PB , Stroman A , Thomas Jones C , Walsh TJ , Chiller TM , Pappas PG , Meyer J , Spec A . Open Forum Infect Dis 2024 11 (6) ofae226 BACKGROUND: Recently, increasing focus on patient input into research and healthcare improvements has fostered expanded patient-centered advocacy efforts. This first pan-fungal disease summit, part of the MYCology Advocacy, Research, & Education effort, brought together patients, caregivers, and mycology experts to better document patient experiences with invasive fungal disease (IFD) and establish priorities for mycology education, advocacy, and research. METHODS: Patients who had suffered from IFD, their caregivers, clinicians, industry representatives, government officials, and patient advocacy professionals were invited. Patients and caregivers shared their stories and struggles with IFD. Breakout sessions separated mycology experts from patients and caregivers for further discussions to identify commonalities and perceived gaps and to formulate recommendations. The 2 groups then reconvened to develop consensus recommendations. RESULTS: IFD patients and their caregivers shared experiences reflecting the typically lengthy prediagnosis, acute treatment, long-term treatment, and posttreatment recovery stages of IFD. They reported substantial physical, psychological, and financial burdens associated with the IFD experience, particularly related to delayed diagnoses. They reaffirmed a need for coordinated patient-centered education, peer support, and advocacy to document the burden of serious fungal infections. Mycology experts discussed strategies to address gaps in the mycology field, such as insufficient training, inadequate workforce support, and a need to partner more with patient groups. CONCLUSIONS: A summit involving patients with IFD, family caregivers, and mycology experts identified a substantial nonclinical burden of disease associated with IFD. Patients and mycology experts prioritized several goals for education, advocacy, and research to raise awareness of IFD and improve outcomes. |
Distribution of COVID-19 mitigation measures by industry and work arrangement-US blood donors, May 2021-December 2021
Shi DS , Rinsky JL , McDonald E , Shah MM , Groenewold MR , de Perio MA , Feldstein LR , Saydah S , Haynes JM , Spencer BR , Stramer SL , McCullough M , Jones JM , Chiu SK . Am J Ind Med 2024 OBJECTIVE: To describe coronavirus disease 2019 (COVID-19) mitigation measures in workplaces of employed US blood donors by industry and work arrangement. METHODS: During May-December 2021, blood donors responded to a survey; we describe the distribution of reported workplace mitigation measures by industry and work arrangement, organized using the hierarchy of controls. RESULTS: Of 53,433 respondents representing 21 industries, ventilation upgrades were reported by 4%-38% of respondents (overall: 20%); telework access ranged from 14%-80% (53% overall). Requiring masks (overall: 84%; range: 40%-94%), physical distancing (77%; 51%-86%), paid leave for illness (70%; 38%-87%), and encouraging vaccination (61%; 33%-80%) were common. Independent workers reported fewer mitigation measures than those in traditional employment settings. CONCLUSIONS: Mitigation measures varied by industry and work arrangement. Some mitigation measures may be challenging to implement or irrelevant in certain industries, supporting the idea that mitigation is not a one-size-fits-all strategy. POLICY IMPLICATIONS: Tailored strategies to mitigate workplace risks of disease transmission are vital. Strategies should rely on effective methods for identifying workplace controls (e.g., through the hierarchy of controls) and account for industry-specific characteristics and workplace environments. |
Shiga toxin-producing Escherichia coli O157:H7 outbreak associated with school field trips at a farm animal exhibit-Tennessee, September-October 2023
Thomas CM , Foster A , Boop S , Kirschke D , Mooney H , Reid I , May AS , Mullins H , Garman KN , Golwalkar M , Marr JH , Orejuela K , Ripley D , Rasnic R , Terrell E , Durso LM , Schaffner W , Jones TF , Fill MA , Dunn JR . Zoonoses Public Health 2024 AIMS: In October 2023, the Tennessee Department of Health identified an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 infections among elementary school students who attended school field trips to the same farm animal exhibit. Our aim was to determine STEC source and prevent additional illnesses by initiating epidemiologic, laboratory and environmental investigations. METHODS AND RESULTS: We identified cases using laboratory-based surveillance and by surveying caregivers of children who attended the exhibit. Probable cases were defined as illness with abdominal cramps or diarrhoea after attendance; confirmed cases were laboratory-confirmed STEC infection in an attendee or household contact. A site visit was conducted, and event organizers were interviewed. Human stool, animal faeces and environmental samples were tested for STEC O157:H7 by real-time polymerase chain reaction (PCR), culture and whole-genome sequencing (WGS). Approximately 2300 elementary school students attended the animal exhibit during 2 days. Field trip activities included contact with different farm animal species, drinking pasteurized milk outside animal enclosures and eating lunch in a separate building onsite. We received survey responses from 399 caregivers for 443 (19%) animal exhibit attendees. We identified 9 confirmed and 55 probable cases with illness onset dates during 26 September to 12 October. Seven children aged 1-7 years were hospitalized. Four children aged 1-6 years experienced haemolytic uraemic syndrome; none died. Laboratory testing identified STEC O157:H7 by culture from eight human stool samples with 0-1 allele difference by WGS. Three environmental samples had Shiga toxin (stx 2) genes detected by PCR, but no STEC isolates were recovered by culture. CONCLUSIONS: This is the largest reported STEC O157:H7 outbreak associated with an animal exhibit in Tennessee. We identified opportunities for educating school staff, event organizers and families about zoonotic disease risks associated with animal contact and published prevention measures. |
Systematic screening and assessment of hospital-based youth violence prevention programs
Piervil E , Wong L , Marshall KJ , Earl T , Leonard S , Waajid M , Jones T , Katapodis N , Marbach A , Schneiderman S , Bartholow B . Health Promot Pract 2024 15248399241255375 Youth violence is a preventable public health issue. Few hospital-based programs intentionally focus on youth violence prevention. This project aimed to describe the Systematic Screening and Assessment (SSA) methodology used to identify existing hospital-based youth violence prevention (HBYVP) programs ready for future rigorous evaluation. To identify promising HBYVP programs currently in use and assess readiness for evaluation, data from the 2017 American Hospital Association (AHA) Annual Survey of Hospitals was used to identify hospitals with Level I-III trauma centers with reported HBYVP programs. Information for each program was gathered via environmental scan and key informant interviews. A total of 383 hospital-based violence prevention programs were identified. Two review panels were conducted with violence prevention experts to identify characteristics of programs suitable for an evaluability assessment (EA). Fifteen programs focused on youth (10-24 years old) and were identified to be promising and evaluable. Three of the 15 programs were determined to have the infrastructure and readiness necessary for rigorous evaluation. Lessons learned and best practices for SSA project success included use of streamlined outreach efforts that provide program staff with informative and culturally tailored project materials outlining information about the problem, project goals, proposed SSA activities, and altruistic benefit to the community at the initial point of contact. In addition, success of review panels was attributed to use of software to streamline panelist review processes and use of evaluation and data analysis subject matter experts to serve as panel facilitators. Communities experiencing high youth violence burden and hospitals serving these communities can improve health outcomes among youth by implementing and evaluating tailored HBYVP programs. |
Antigenic characterization of circulating and emerging SARS-CoV-2 variants in the U.S. Throughout the Delta to Omicron waves
Di H , Pusch EA , Jones J , Kovacs NA , Hassell N , Sheth M , Lynn KS , Keller MW , Wilson MM , Keong LM , Cui D , Park SH , Chau R , Lacek KA , Liddell JD , Kirby MK , Yang G , Johnson M , Thor S , Zanders N , Feng C , Surie D , DeCuir J , Lester SN , Atherton L , Hicks H , Tamin A , Harcourt JL , Coughlin MM , Self WH , Rhoads JP , Gibbs KW , Hager DN , Shapiro NI , Exline MC , Lauring AS , Rambo-Martin B , Paden CR , Kondor RJ , Lee JS , Barnes JR , Thornburg NJ , Zhou B , Wentworth DE , Davis CT . Vaccines (Basel) 2024 12 (5) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into numerous lineages with unique spike mutations and caused multiple epidemics domestically and globally. Although COVID-19 vaccines are available, new variants with the capacity for immune evasion continue to emerge. To understand and characterize the evolution of circulating SARS-CoV-2 variants in the U.S., the Centers for Disease Control and Prevention (CDC) initiated the National SARS-CoV-2 Strain Surveillance (NS3) program and has received thousands of SARS-CoV-2 clinical specimens from across the nation as part of a genotype to phenotype characterization process. Focus reduction neutralization with various antisera was used to antigenically characterize 143 SARS-CoV-2 Delta, Mu and Omicron subvariants from selected clinical specimens received between May 2021 and February 2023, representing a total of 59 unique spike protein sequences. BA.4/5 subvariants BU.1, BQ.1.1, CR.1.1, CQ.2 and BA.4/5 + D420N + K444T; BA.2.75 subvariants BM.4.1.1, BA.2.75.2, CV.1; and recombinant Omicron variants XBF, XBB.1, XBB.1.5 showed the greatest escape from neutralizing antibodies when analyzed against post third-dose original monovalent vaccinee sera. Post fourth-dose bivalent vaccinee sera provided better protection against those subvariants, but substantial reductions in neutralization titers were still observed, especially among BA.4/5 subvariants with both an N-terminal domain (NTD) deletion and receptor binding domain (RBD) substitutions K444M + N460K and recombinant Omicron variants. This analysis demonstrated a framework for long-term systematic genotype to antigenic characterization of circulating and emerging SARS-CoV-2 variants in the U.S., which is critical to assessing their potential impact on the effectiveness of current vaccines and antigen recommendations for future updates. |
Characterizing the etiology of recurrent tuberculosis using whole genome sequencing-Alaska, USA, 2008-2020
Springer YP , Tompkins ML , Newell K , Jones M , Burns S , Chandler B , Cowan LS , Kammerer JS , Posey JE , Raz KM , Rothoff M , Silk BJ , Vergnetti YL , McLaughlin JB , Talarico S . J Infect Dis 2024 BACKGROUND: Understanding the etiology of recurrent tuberculosis (rTB) is important for effective TB control. Prior to the advent of whole genome sequencing (WGS), attributing rTB to relapse or reinfection using genetic information was complicated by the limited resolution of conventional genotyping methods. METHODS: We applied a systematic method of evaluating whole genome single nucleotide polymorphism (wgSNP) distances and results of phylogenetic analyses to characterize the etiology of rTB in American Indian and Alaska Native (AIAN) persons in Alaska during 2008-2020. We contextualized our findings through descriptive analyses of surveillance data and results of a literature search for investigations that characterized rTB etiology using WGS. RESULTS: The percentage of TB cases in AIAN persons in Alaska classified as recurrent episodes (11.8%) was three times the national percentage (3.9%). Of 38 recurrent episodes included in genetic analyses, we attributed 25 (65.8%) to reinfection based on wgSNP distances and phylogenetic analyses; this proportion was the highest among 16 published point estimates identified through the literature search. By comparison, we attributed 11 of 38 (28.9%) and 6 of 38 (15.8%) recurrent episodes to reinfection based on wgSNP distances alone and on conventional genotyping methods, respectively. CONCLUSIONS: WGS and attribution criteria involving genetic distances and patterns of relatedness can provide an effective means of elucidating rTB etiology. Our findings indicate that rTB occurs at high proportions among AIAN persons in Alaska and is frequently attributable to reinfection, reinforcing the importance of active surveillance and control measures to limit the spread of TB disease in Alaskan AIAN communities. |
Impact of the COVID-19 pandemic on routine childhood vaccination in 9 U.S. jurisdictions
Treharne A , Patel Murthy B , Zell ER , Jones-Jack N , Loper O , Bakshi A , Nalla A , Kuramoto S , Cheng I , Dykstra A , Robison SG , Youngers EH , Schauer S , Gibbs Scharf L , Harris L . Vaccine 2024 IMPORTANCE: Routine vaccinations are key to prevent outbreaks of vaccine-preventable diseases. However, there have been documented declines in routine childhood vaccinations in the U.S. and worldwide during the COVID-19 pandemic. OBJECTIVE: Assess how the COVID-19 pandemic impacted routine childhood vaccinations by evaluating vaccination coverage for routine childhood vaccinations for children born in 2016-2021. METHODS: Data on routine childhood vaccinations reported to CDC by nine U.S. jurisdictions via the immunization information systems (IISs) by December 31, 2022, were available for analyses. Population size for each age group was obtained from the National Center for Health Statistics' Bridging Population Estimates. MAIN OUTCOMES AND MEASURES: Vaccination coverage for routine childhood vaccinations at age three months, five months, seven months, one year, and two years was calculated by vaccine type and overall, for 4:3:1:3:3:1:4 series (≥4 doses DTaP, ≥3 doses Polio, ≥1 dose MMR, ≥3 doses Hib, ≥3 doses Hepatitis B, ≥1 dose Varicella, and ≥ 4 doses pneumococcal conjugate), for each birth cohort year and by jurisdiction. RESULTS: Overall, there was a 10.4 percentage point decrease in the 4:3:1:3:3:1:4 series in those children born in 2020 compared to those children born in 2016. As of December 31, 2022, 71.0% and 71.3% of children born in 2016 and 2017, respectively, were up to date on their routine childhood vaccinations by two years of age compared to 69.1%, 64.7% and 60.6% for children born in 2018, 2019, and 2020, respectively. CONCLUSIONS AND RELEVANCE: The decline in vaccination coverage for routine childhood vaccines is concerning. In order to protect population health, strategic efforts are needed by health care providers, schools, parents, as well as state, local, and federal governments to work together to address these declines in vaccination coverage during the COVID-19 pandemic to prevent outbreaks of vaccine preventable diseases by maintaining high levels of population immunity. |
Who gets sick from COVID-19? Sociodemographic correlates of severe adult health outcomes during Alpha- and Delta-variant predominant periods, 9/2020-11/2021
Wei SC , Freeman D , Himschoot A , Clarke KEN , Van Dyke ME , Adjemian J , Ahmad FB , Benoit TJ , Berney K , Gundlapalli AV , Hall AJ , Havers F , Henley SJ , Hilton C , Johns D , Opsomer JD , Pham HT , Stuckey MJ , Taylor CA , Jones JM . J Infect Dis 2024 229 (1) 122-132 BACKGROUND: Because COVID-19 case data do not capture most SARS-CoV-2 infections, the actual risk of severe disease and death per infection is unknown. Integrating sociodemographic data into analysis can show consequential health disparities. METHODS: Data were merged from September 2020 to November 2021 from 6 national surveillance systems in matched geographic areas and analyzed to estimate numbers of COVID-19-associated cases, emergency department visits, and deaths per 100 000 infections. Relative risks of outcomes per infection were compared by sociodemographic factors in a data set including 1490 counties from 50 states and the District of Columbia, covering 71% of the US population. RESULTS: Per infection with SARS-CoV-2, COVID-19-related morbidity and mortality were higher among non-Hispanic American Indian and Alaska Native persons, non-Hispanic Black persons, and Hispanic or Latino persons vs non-Hispanic White persons; males vs females; older people vs younger; residents in more socially vulnerable counties vs less; those in large central metro areas vs rural; and people in the South vs the Northeast. DISCUSSION: Meaningful disparities in COVID-19 morbidity and mortality per infection were associated with sociodemography and geography. Addressing these disparities could have helped prevent the loss of tens of thousands of lives. |
Prevalence and associated factors of shisha smoking among students in Senegal: Global Youth Tobacco Survey 2020
Cham B , Weaver SR , Jones CK , Popova L , Jacques N . Tob Induc Dis 2024 22 INTRODUCTION: Although shisha smoking is banned in Senegal, it has become increasingly popular, especially among youth. Despite the health risks associated with shisha smoking, there are few studies on shisha smoking in West Africa and none in Senegal. Our study assessed the prevalence and factors associated with shisha smoking among students aged 13-15 years in Senegal. METHODS: We used the 2020 Global Youth Tobacco Survey (GYTS) Senegal data from 2524 students aged 13-15 years. We calculated the weighted prevalence of ever and current (past 30 days) shisha smoking. Multivariable logistic regression analyses identified factors associated with ever and current shisha smoking among students. RESULTS: The prevalences of ever and current shisha smoking were 9.8% (95% CI: 7.7-12.3) and 2.2% (95% CI: 1.5-3.1), respectively. Ever shisha smoking was significantly associated with being male (AOR=1.97; 95% CI: 1.33-2.92), current cigarette smoking (AOR=7.54; 95% CI: 2.95-19.29), higher class grade (AOR=2.27; 95% CI:1.10-4.67), more weekly pocket money (AOR=3.29; 95% CI:1.36-7.95), current use of smokeless tobacco (AOR=11.53; 95% CI: 4.98- 26.72), and exposure to secondhand cigarette smoke in public (AOR=1.55; 95% CI: 1.00-2.41). Current shisha smoking was significantly associated with current cigarette smoking (AOR=21.75; 95% CI: 6.08-77.78), more weekly pocket money (AOR=8.91; 95% CI: 1.75-45.40), current use of smokeless tobacco (AOR=8.26; 95% CI: 2.07-33.04), and fathers' smoking (AOR=3.34; 95% CI: 1.24-8.96). CONCLUSIONS: One in 10 students aged 13-15 years have ever smoked shisha and 2.2% were currently smoking it, suggesting that shisha smoking is a public health concern in Senegal. Senegal might consider offering students more education on the harms of shisha, both in schools and through comprehensive media campaigns that address all tobacco products. |
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