Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Mindra G[original query] |
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Bacillus Calmette-Guerin cases reported to the National Tuberculosis Surveillance System, United States, 2004-2015
Wansaula Z , Wortham JM , Mindra G , Haddad MB , Salinas JL , Ashkin D , Morris SB , Grant GB , Ghosh S , Langer AJ . Emerg Infect Dis 2019 25 (3) 451-456 Mycobacterium bovis bacillus Calmette-Guerin (BCG) is used as a vaccine to protect against disseminated tuberculosis (TB) and as a treatment for bladder cancer. We describe characteristics of US TB patients reported to the National Tuberculosis Surveillance System (NTSS) whose disease was attributed to BCG. We identified 118 BCG cases and 91,065 TB cases reported to NTSS during 2004-2015. Most patients with BCG were US-born (86%), older (median age 75 years), and non-Hispanic white (81%). Only 17% of BCG cases had pulmonary involvement, in contrast with 84% of TB cases. Epidemiologic features of BCG cases differed from TB cases. Clinicians can use clinical history to discern probable BCG cases from TB cases, enabling optimal clinical management. Public health agencies can use this information to quickly identify probable BCG cases to avoid inappropriately reporting BCG cases to NTSS or expending resources on unnecessary public health interventions. |
Tuberculosis outbreaks in the United States, 2009-2015
Mindra G , Wortham JM , Haddad MB , Powell KM . Public Health Rep 2017 132 (2) 33354916688270 OBJECTIVES: The Centers for Disease Control and Prevention provides on-site epidemiologic assistance for outbreak response when the health capacity of state, tribal, local, and territorial health departments has been exceeded. We examined recent outbreaks of tuberculosis (TB) for which health departments needed assistance. METHODS: We defined a TB outbreak as detection of ≥3 TB cases related by transmission, as suggested by routine genotyping and epidemiologic linkages. We conducted retrospective reviews of documentation from all 21 TB outbreak investigations in the United States for which the Centers for Disease Control and Prevention provided on-site assistance during 2009-2015. We abstracted data on patients' demographic characteristics and TB risk factors, as well as factors contributing to the outbreak from trip reports written by on-site investigators, and we compared these with outbreaks investigated during 2002-2008. RESULTS: The 21 TB outbreaks during 2009-2015 involved 457 outbreak patients (range, 3-99 patients per outbreak). Of the 21 outbreaks, 16 were first identified through genotype data. In sum, 118 (26%) patients were identified through contact investigations of other patients in the outbreak. Most outbreak patients (n = 363, 79%) were US born. Ninety-two (26%) patients had a mental illness, 204 (45%) had been homeless in the year before diagnosis, and 379 (83%) used alcohol excessively or used illicit substances. The proportion of patients experiencing homelessness doubled between 2002-2008 and 2009-2015; other characteristics were similar between the 2 periods. Delayed TB diagnosis contributed to unmitigated transmission in all but 1 outbreak. CONCLUSIONS: TB outbreaks challenge frontline public health resources. Genotyping and contact investigations are important strategies for detecting and controlling TB outbreaks, particularly among people experiencing homelessness or those with mental illness. |
Tuberculosis among incarcerated Hispanic persons in the United States, 1993-2014
Mindra G , Wortham JM , Haddad MB , Salinas JL , Powell KM , Armstrong LR . J Immigr Minor Health 2016 19 (4) 982-986 We examined the National tuberculosis surveillance system to describe Hispanic persons who were incarcerated at time of tuberculosis (TB) diagnosis and to compare their characteristics with those of non-Hispanic incarcerated TB patients. After declines between 1993 and 2002, the annual proportion of Hispanic TB patients who were incarcerated grew from 4.9% in 2003 to 8.4% in 2014. During 2003-2014, 19% of incarcerated US-born TB patients were Hispanic, and 86% of the foreign-born were Hispanic. Most incarcerated TB patients were in local jails, but about a third of all foreign-born Hispanics were in the facility category that includes Immigration and Customs Enforcement detention centers. Foreign birth and recent U.S. arrival characterized many Hispanic persons receiving a TB diagnosis while incarcerated. Hispanic patients had twice the odds of being in federal prisons. Systematic efforts to identify TB infection and disease might lead to early diagnoses and prevention of future cases. |
Leveling of tuberculosis incidence - United States, 2013-2015
Salinas JL , Mindra G , Haddad MB , Pratt R , Price SF , Langer AJ . MMWR Morb Mortal Wkly Rep 2016 65 (11) 273-278 After 2 decades of progress toward tuberculosis (TB) elimination with annual decreases of ≥0.2 cases per 100,000 persons (1), TB incidence in the United States remained approximately 3.0 cases per 100,000 persons during 2013-2015. Preliminary data reported to the National Tuberculosis Surveillance System indicate that TB incidence among foreign-born persons in the United States (15.1 cases per 100,000) has remained approximately 13 times the incidence among U.S.-born persons (1.2 cases per 100,000). Resuming progress toward TB elimination in the United States will require intensification of efforts both in the United States and globally, including increasing U.S. efforts to detect and treat latent TB infection, strengthening systems to interrupt TB transmission in the United States and globally, accelerating reductions in TB globally, particularly in the countries of origin for most U.S. CASES: |
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