Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-30 (of 141 Records) |
Query Trace: Morales J [original query] |
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Fatal meningoencephalitis associated with Ebola virus persistence in two survivors of Ebola virus disease in the Democratic Republic of the Congo: a case report study
Mukadi-Bamuleka D , Edidi-Atani F , Morales-Betoulle ME , Legand A , Nkuba-Ndaye A , Bulabula-Penge J , Mbala-Kingebeni P , Crozier I , Mambu-Mbika F , Whitmer S , Tshiani Mbaya O , Hensley LE , Kitenge-Omasumbu R , Davey R , Mulangu S , Fonjungo PN , Wiley MR , Klena JD , Peeters M , Delaporte E , van Griensven J , Ariën KK , Pratt C , Montgomery JM , Formenty P , Muyembe-Tamfum JJ , Ahuka-Mundeke S . Lancet Microbe 2024 100905 BACKGROUND: During the 2018-20 Ebola virus disease outbreak in the Democratic Republic of the Congo, thousands of patients received unprecedented vaccination, monoclonal antibody (mAb) therapy, or both, leading to a large number of survivors. We aimed to report the clinical, virological, viral genomic, and immunological features of two previously vaccinated and mAb-treated survivors of Ebola virus disease in the Democratic Republic of the Congo who developed second episodes of disease months after initial discharge, ultimately complicated by fatal meningoencephalitis associated with viral persistence. METHODS: In this case report study, we describe the presentation, management, and subsequent investigations of two patients who developed recrudescent Ebola virus disease and subsequent fatal meningoencephalitis. We obtained data from epidemiological databases, Ebola treatment units, survivor programme databases, laboratory datasets, and hospital records. Following national protocols established during the 2018-20 outbreak in the Democratic Republic of the Congo, blood, plasma, and cerebrospinal fluid (CSF) samples were collected during the first and second episodes of Ebola virus disease from both individuals and were analysed by molecular (quantitative RT-PCR and next-generation sequencing) and serological (IgG and IgM ELISA and Luminex assays) techniques. FINDINGS: The total time between the end of the first Ebola virus episode and the onset of the second episode was 342 days for patient 1 and 137 days for patient 2. In both patients, Ebola virus RNA was detected in blood and CSF samples during the second episode of disease. Complete genomes from CSF samples from this relapse episode showed phylogenetic relatedness to the genome sequenced from blood samples collected from the initial infection, confirming in-host persistence of Ebola virus. Serological analysis showed an antigen-specific humoral response with typical IgM and IgG kinetics in patient 1, but an absence of an endogenous adaptive immune response in patient 2. INTERPRETATION: We report the first two cases of fatal meningoencephalitis associated with Ebola virus persistence in two survivors of Ebola virus disease who had received vaccination and mAb-based treatment in the Democratic Republic of the Congo. Our findings highlight the importance of long-term monitoring of survivors, including continued clinical, virological, and immunological profiling, as well as the urgent need for novel therapeutic strategies to prevent and mitigate the individual and public health consequences of Ebola virus persistence. FUNDING: Ministry of Health of the Democratic Republic of the Congo, Institut National de Recherche Biomédicale, Infectious Disease Rapid Response Reserve Fund, US Centers for Disease Control and Prevention, French National Research Institute for Development, and WHO. |
Temporal trends of exposure to the herbicide glyphosate in the United States (2013-2018): Data from the National Health and Nutrition Examination Survey
Ospina M , Schütze A , Morales-Agudelo P , Vidal M , Wong LY , Calafat AM . Chemosphere 2024 142966 Glyphosate, the most widely used herbicide in the United States, is applied to control broadleaf weeds and grasses. Public concern is mounting over how pesticides affect human and environmental health. Glyphosate toxicity in animals is known, but human carcinogenicity is controversial, and limited epidemiologic evidence suggests associations between exposure and respiratory diseases (e.g., asthma) and adverse child neurodevelopment. Understanding the extent of the general U.S. population exposure to glyphosate is important. To examine temporal trends in exposure to glyphosate, we determined urinary concentrations of glyphosate among U.S. children and adults from three cycles of the National Health and Nutrition Examination Survey (NHANES) conducted 2013-2018. Most of the population (70.0%-81.7%, depending on cycle) was exposed, including children as young as 3 years of age. Concentrations decreased from 2013 to 2018 by 38%; the decline was smaller in younger age groups. The downward trend likely reflects changes in glyphosate use resulting, at least in part, from changes in agricultural practices, regulatory actions, and shifts in public awareness regarding glyphosate toxicity. Continuing glyphosate biomonitoring will help understand how changes in use and actions to restrict applications of this common pesticide affect human exposures. |
Diagnostic accuracy of the Abbott BinaxNOW COVID-19 antigen card test, Puerto Rico
Madewell ZJ , Major CG , Graff N , Adams C , Rodriguez DM , Morales T , Medina Lopes NA , Tosado R , Sánchez-González L , Perez-Padilla J , Volkman HR , Bertrán-Pasarell J , Sainz de la Peña D , Munoz-Jordan J , Santiago GA , Lorenzi O , Rivera-Amill V , Rolfes MA , Paz-Bailey G , Adams LE , Wong JM . Influenza Other Respir Viruses 2024 18 (7) e13305 BACKGROUND: The COVID-19 pandemic underscored the need for rapid and accurate diagnostic tools. In August 2020, the Abbott BinaxNOW COVID-19 Antigen Card test became available as a timely and affordable alternative for SARS-CoV-2 molecular testing, but its performance may vary due to factors including timing and symptomatology. This study evaluates BinaxNOW diagnostic performance in diverse epidemiological contexts. METHODS: Using RT-PCR as reference, we assessed performance of the BinaxNOW COVID-19 test for SARS-CoV-2 detection in anterior nasal swabs from participants of two studies in Puerto Rico from December 2020 to May 2023. Test performance was assessed by days post symptom onset, collection strategy, vaccination status, symptomatology, repeated testing, and RT-PCR cycle threshold (Ct) values. RESULTS: BinaxNOW demonstrated an overall sensitivity of 84.1% and specificity of 98.8%. Sensitivity peaked within 1-6 days after symptom onset (93.2%) and was higher for symptomatic (86.3%) than asymptomatic (67.3%) participants. Sensitivity declined over the course of infection, dropping from 96.3% in the initial test to 48.4% in testing performed 7-14 days later. BinaxNOW showed 99.5% sensitivity in participants with low Ct values (≤ 25) but lower sensitivity (18.2%) for participants with higher Cts (36-40). CONCLUSIONS: BinaxNOW demonstrated high sensitivity and specificity, particularly in early-stage infections and symptomatic participants. In situations where test sensitivity is crucial for clinical decision-making, nucleic acid amplification tests are preferred. These findings highlight the importance of considering clinical and epidemiological context when interpreting test results and emphasize the need for ongoing research to adapt testing strategies to emerging SARS-CoV-2 variants. |
Using the index of concentration at the extremes to evaluate associations of economic and Hispanic/Latino-White racial segregation with HIV outcomes among adults aged ≥ 18 years with diagnosed HIV - United States, 2021
Gant Sumner Z , Dailey A , Beer L , Dong X , Morales J , Johnson Lyons S , Satcher Johnson A . J Racial Ethn Health Disparities 2024 OBJECTIVE(S): To examine associations between Index of Concentration at the Extremes (ICE) measures (proxy for structural racism) for economic and Hispanic/Latino-White racial segregation and HIV outcomes among adults in the U.S. METHODS: Census tract-level HIV diagnoses, linkage to HIV medical care within 1 month of diagnosis (linkage), and viral suppression within 6 months of diagnosis (viral suppression) data for 2021 from the National HIV Surveillance System were used. Three ICE measures were obtained from the American Community Survey: ICEincome (income segregation), ICErace (Hispanic/Latino-White racial segregation), and ICEincome + race (Hispanic/Latino-White racialized economic segregation). Rate ratios (RRs) for HIV diagnosis and prevalence ratios (PRs) for linkage and viral suppression were used to examine differences in HIV outcomes across ICE quintiles with Quintile5 (Q5: most privileged) as reference group and adjusted by selected characteristics. RESULTS: Among the 32,529 adults, diagnosis rates were highest in Quintile1 (Q1: most deprived) for ICEincome (28.7) and ICEincome + race (28.4) and Q2 for ICErace (27.0). We also observed higher RRs in HIV diagnosis and lower PRs in linkage and viral suppression (except for ICErace for linkage) in Q1 compared to Q5. Higher RRs and lower PRs in ICE measures were observed among males (diagnosis), adults aged 18‒34 (diagnosis and linkage) and aged ≥ 45 (viral suppression), and among adults in the South (all 3 HIV outcomes). CONCLUSIONS: Barriers in access to care/treatment in more Hispanic/Latino-White racialized economic segregated communities perpetuate the disproportionate impact of HIV on the population. Removing barriers to HIV care/treatment created by systemic racism/segregation may improve HIV outcomes and reduce disparities. |
Human Orthohantavirus disease prevalence and genotype distribution in the U.S., 2008–2020: a retrospective observational study
Whitmer SLM , Whitesell A , Mobley M , Talundzic E , Shedroff E , Cossaboom CM , Messenger S , Deldari M , Bhatnagar J , Estetter L , Zufan S , Cannon D , Chiang CF , Gibbons A , Krapiunaya I , Morales-Betoulle M , Choi M , Knust B , Amman B , Montgomery JM , Shoemaker T , Klena JD . Lancet Reg Health - Am 2024 37 Background: In the United States (U.S.), hantavirus pulmonary syndrome (HPS) and non-HPS hantavirus infection are nationally notifiable diseases. Criteria for identifying human cases are based on clinical symptoms (HPS or non-HPS) and acute diagnostic results (IgM+, rising IgG+ titers, RT-PCR+, or immunohistochemistry (IHC)+). Here we provide an overview of diagnostic testing and summarize human Hantavirus disease occurrence and genotype distribution in the U.S. from 2008 to 2020. Methods: Epidemiological data from the national hantavirus registry was merged with laboratory diagnostic testing results performed at the CDC. Residual hantavirus-positive specimens were sequenced, and the available epidemiological and genetic data sets were linked to conduct a genomic epidemiological study of hantavirus disease in the U.S. Findings: From 1993 to 2020, 833 human hantavirus cases have been identified, and from 2008 to 2020, 335 human cases have occurred. Among New World (NW) hantavirus cases detected at the CDC diagnostic laboratory (representing 29.2% of total cases), most (85.0%) were detected during acute disease, however, some convalescent cases were detected in states not traditionally associated with hantavirus infections (Connecticut, Missouri, New Jersey, Pennsylvania, Tennessee, and Vermont). From 1993 to 2020, 94.9% (745/785) of U.S. hantaviruses cases were detected west of the Mississippi with 45.7% (359/785) in the Four Corners region of the U.S. From 2008 to 2020, 67.7% of NW hantavirus cases were detected between the months of March and August. Sequencing of RT-PCR-positive cases demonstrates a geographic separation of Orthohantavirus sinnombreense species [Sin Nombre virus (SNV), New York virus, and Monongahela virus]; however, there is a large gap in viral sequence data from the Northwestern and Central U.S. Finally, these data indicate that commercial IgM assays are not concordant with CDC-developed assays, and that “concordant positive” (i.e., commercial IgM+ and CDC IgM+ results) specimens exhibit clinical characteristics of hantavirus disease. Interpretation: Hantaviral disease is broadly distributed in the contiguous U.S, viral variants are localised to specific geographic regions, and hantaviral disease infrequently detected in most Southeastern states. Discordant results between two diagnostic detection methods highlight the need for an improved standardised testing plan in the U.S. Hantavirus surveillance and detection will continue to improve with clearly defined, systematic reporting methods, as well as explicit guidelines for clinical characterization and diagnostic criteria. Funding: This work was funded by core funds provided to the Viral Special Pathogens Branch at CDC. © 2024 |
Rocky Mountain spotted fever mimicking multisystem inflammatory syndrome in hospitalized children, Sonora, Mexico
Álvarez-Hernández G , Rivera-Rosas CN , Calleja-López JRT , McCormick DW , Paddock CD , Álvarez-Meza JB , Correa-Morales F . Emerg Infect Dis 2024 30 (7) We describe 5 children who had Rocky Mountain spotted fever (RMSF) and manifested clinical symptoms similar to multisystem inflammatory syndrome in Sonora, Mexico, where RMSF is hyperendemic. Physicians should consider RMSF in differential diagnoses of hospitalized patients with multisystem inflammatory syndrome to prevent illness and death caused by rickettsial disease. |
Insecticide susceptibility status of Anopheles albimanus populations in historical malaria foci in Quintana Roo, Mexico
Escobar D , González-Olvera G , Gómez-Rivera Á S , Navarrete-Carballo J , Mis-Ávila P , Baack-Valle R , Escalante G , Reyes-Cabrera G , Correa-Morales F , Che-Mendoza A , Vazquez-Prokopec G , Lenhart A , Manrique-Saide P . Malar J 2024 23 (1) 165 BACKGROUND: Mexico has experienced a significant reduction in malaria cases over the past two decades. Certification of localities as malaria-free areas (MFAs) has been proposed as a steppingstone before elimination is achieved throughout the country. The Mexican state of Quintana Roo is a candidate for MFA certification. Monitoring the status of insecticide susceptibility of major vectors is crucial for MFA certification. This study describes the susceptibility status of Anopheles albimanus, main malaria vector, from historically important malaria foci in Quintana Roo, using both phenotypic and genotypic approaches. METHODS: Adult mosquito collections were carried out at three localities: Palmar (Municipality of Othon P. Blanco), Buenavista (Bacalar) and Puerto Morelos (Puerto Morelos). Outdoor human-landing catches were performed by pairs of trained staff from 18:00 to 22:00 during 3-night periods at each locality during the rainy season of 2022. Wild-caught female mosquitoes were exposed to diagnostic doses of deltamethrin, permethrin, malathion, pirimiphos-methyl or bendiocarb using CDC bottle bioassays. Mortality was registered at the diagnostic time and recovery was assessed 24 h after exposure. Molecular analyses targeting the Voltage-Gated Sodium Channel (vgsc) gene and acetylcholinesterase (ace-1) gene were used to screen for target site polymorphisms. An SNP analysis was carried out to identify mutations at position 995 in the vgsc gene and at position 280 in the ace-1 gene. RESULTS: A total of 2828 anophelines were collected. The main species identified were Anopheles albimanus (82%) and Anopheles vestitipennis (16%). Mortalities in the CDC bottle bioassay ranged from 99% to 100% for all the insecticides and mosquito species. Sequence analysis was performed on 35 An. albimanus across the three localities; of those, 25 were analysed for vgsc and 10 for ace-1 mutations. All individuals showed wild type alleles. CONCLUSION: The results demonstrated that An. albimanus populations from historical malaria foci in Quintana Roo are susceptible to the main insecticides used by the Ministry of Health. |
Clinical course, antifungal susceptibility, and genomic sequencing of trichophyton indotineae
Caplan AS , Todd GC , Zhu Y , Sikora M , Akoh CC , Jakus J , Lipner SR , Babbush K , Acker KP , Morales AE , Rolón RMM , Westblade LF , Fonseca M , Cline A , Gold JAW , Lockhart SR , Smith DJ , Chiller T , Greendyke WG , Manjari SR , Banavali NK , Chaturvedi S . JAMA Dermatol 2024 IMPORTANCE: Trichophyton indotineae is an emerging dermatophyte causing outbreaks of extensive tinea infections often unresponsive to terbinafine. This species has been detected worldwide and in multiple US states, yet detailed US data on infections with T indotineae are sparse and could improve treatment practices and medical understanding of transmission. OBJECTIVE: To correlate clinical features of T indotineae infections with in vitro antifungal susceptibility testing results, squalene epoxidase gene sequence variations, and isolate relatedness using whole-genome sequencing. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study of patients with T indotineae infections in New York City spanned May 2022 to May 2023. Patients with confirmed T indotineae infections were recruited from 6 New York City medical centers. MAIN OUTCOME AND MEASURE: Improvement or resolution at the last follow-up assessment. RESULTS: Among 11 patients with T indotineae (6 male and 5 female patients; median [range] age, 39 [10-65] years), 2 were pregnant; 1 had lymphoma; and the remainder were immunocompetent. Nine patients reported previous travel to Bangladesh. All had widespread lesions with variable scale and inflammation, topical antifungal monotherapy failure, and diagnostic delays (range, 3-42 months). Terbinafine treatment failed in 7 patients at standard doses (250 mg daily) for prolonged duration; these patients also had isolates with amino acid substitutions at positions 393 (L393S) or 397 (F397L) in squalene epoxidase that correlated with elevated terbinafine minimum inhibitory concentrations of 0.5 μg/mL or higher. Patients who were treated with fluconazole and griseofulvin improved in 2 of 4 and 2 of 5 instances, respectively, without correlation between outcomes and antifungal minimum inhibitory concentrations. Furthermore, 5 of 7 patients treated with itraconazole cleared or had improvement at the last follow-up, and 2 of 7 were lost to follow-up or stopped treatment. Based on whole-genome sequencing analysis, US isolates formed a cluster distinct from Indian isolates. CONCLUSION AND RELEVANCE: The results of this case series suggest that disease severity, diagnostic delays, and lack of response to typically used doses and durations of antifungals for tinea were common in this primarily immunocompetent patient cohort with T indotineae, consistent with published data. Itraconazole was generally effective, and the acquisition of infection was likely in Bangladesh. |
Knowledge, attitudes and perceptions of Latin American healthcare workers relating to antibiotic stewardship and antibiotic use: a cross-sectional multi-country study
Fabre V , Cosgrove SE , Lessa FC , Patel TS , Reyes-Morales G , Aleman WR , Alvarez AA , Aquiles B , Arauz AB , Arguello F , Barberis MF , Barcan L , Bernachea MP , Bernan ML , Buitrago C , Del Carmen Bangher M , Castañeda X , Colque AM , Canton A , Contreras R , Correa S , Campero GC , Espinola L , Esquivel C , Ezcurra C , Falleroni LA , Fernandez J , Ferrari S , Frassone N , Cruz CG , Garzón MI , Quintero CHG , Gonzalez JA , Guaymas L , Guerrero-Toapanta F , Lambert S , Laplume D , Lazarte PR , Lemir CG , Lopez A , Lopez IL , Maldonado H , Martinez G , Maurizi DM , Melgar M , Mesplet F , Pertuz CM , Moreno C , Moya GL , Nuccetelli Y , Núñez G , Osuna C , Palacio B , Pellice F , Raffo C , Choto FR , Ricoy G , Rodriguez V , Romero F , Romero JJ , Russo ME , Sadino G , Sandoval N , Silva MG , Urueña AM , Reyes LV , Videla H , Valle M , Perez SVA , Vergara-Samur H , Villamandos S , Villarreal O , Viteri A , Warley E , Quiros RE . Antimicrob Resist Infect Control 2024 13 (1) 47 BACKGROUND: The burden of antimicrobial resistance (AMR) in Latin America is high. Little is known about healthcare workers' (HCWs) knowledge, attitudes, and perceptions of antimicrobial stewardship (AS), AMR, and antibiotic use (AU) in the region. METHODS: HCWs from 42 hospitals from 5 Latin American countries were invited to take an electronic, voluntary, anonymous survey regarding knowledge, attitudes, and perceptions of AS, AMR, and AU between March-April 2023. FINDINGS: Overall, 996 HCWs completed the survey (52% physicians, 32% nurses, 11% pharmacists, 3% microbiologists, and 2% "other"). More than 90% of respondents indicated optimizing AU was a priority at their healthcare facility (HCF), 69% stated the importance of AS was communicated at their HCF, and 23% were unfamiliar with the term "antibiotic stewardship". Most (> 95%) respondents acknowledged that appropriate AU can reduce AMR; however, few thought AU (< 30%) or AMR (< 50%) were a problem in their HCF. Lack of access to antibiogram and to locally endorsed guidelines was reported by 51% and 34% of HCWs, respectively. Among prescribers, 53% did not consider non-physicians' opinions to make antibiotic-related decisions, 22% reported not receiving education on how to select antibiotics based on culture results and 60% stated patients and families influence their antibiotic decisions. CONCLUSIONS: Although HCWs perceived improving AU as a priority, they did not perceive AU or AMR as a problem in their HCF. AS opportunities include improved access to guidelines, access to AMR/AU data, teamwork, and education on AS for HCWs and patients and families. |
Seroprevalence of IgA and IgG against SARS-CoV-2 and risk factors in workers from public markets of Guatemala
Grajeda LM , Mendizábal-Cabrera R , Romero JC , López MR , Morales E , López B , Zielinski E , Cordón-Rosales C . COVID 2023 3 (9) 1416-1428 Public market workers may be disproportionally exposed to SARS-CoV-2 due to interactions with shoppers. We aimed to estimate the seroprevalence of SARS-CoV-2 and determine whether occupation or adherence to preventive practices were associated with exposure. From July to December 2021, we longitudinally surveyed two Guatemalan markets twice. We collected blood to detect anti-S IgA, anti-S IgG, and anti-N IgG using ELISA, and a nasopharyngeal swab to detect SARS-CoV-2 using rRT-PCR. We estimated seroprevalences and assessed associations using generalized estimating equations. Of 229 workers, 109 (48%) participated in the first survey and 87 (38%) in the second. At baseline, 77% were female, 64% were aged <40, and 81% were vendors. Overall, the seroprevalence increased between surveys (61% to 89% for anti-S IgA, 53% to 91% for anti-S IgG, and 22% to 29% for anti-N IgG), but the magnitude differed by vaccination status and antibody type. The prevalence of infections decreased from 13% to 1% and most were asymptomatic. Vendor occupation was associated with IgA and IgG anti-S in males but not females. Using a mask was a protective measure. Most market workers had been exposed to SARS-CoV-2, possibly through asymptomatic individuals. Masking is a protective measure to be prioritized during high transmission. © 2023 by the authors. |
Investigating SARS-CoV-2 incidence and morbidity in Ponce, Puerto Rico: Protocol and baseline results from a community cohort study
Major CG , Rodríguez DM , Sánchez-González L , Rodríguez-Estrada V , Morales-Ortíz T , Torres C , Pérez-Rodríguez NM , Medina-Lópes NA , Alexander N , Mabey D , Ryff K , Tosado-Acevedo R , Muñoz-Jordán J , Adams LE , Rivera-Amill V , Rolfes M , Paz-Bailey G . JMIR Res Protoc 2024 13 e53837 BACKGROUND: A better understanding of SARS-CoV-2 infection risk among Hispanic and Latino populations and in low-resource settings in the United States is needed to inform control efforts and strategies to improve health equity. Puerto Rico has a high poverty rate and other population characteristics associated with increased vulnerability to COVID-19, and there are limited data to date to determine community incidence. OBJECTIVE: This study describes the protocol and baseline seroprevalence of SARS-CoV-2 in a prospective community-based cohort study (COPA COVID-19 [COCOVID] study) to investigate SARS-CoV-2 infection incidence and morbidity in Ponce, Puerto Rico. METHODS: In June 2020, we implemented the COCOVID study within the Communities Organized to Prevent Arboviruses project platform among residents of 15 communities in Ponce, Puerto Rico, aged 1 year or older. Weekly, participants answered questionnaires on acute symptoms and preventive behaviors and provided anterior nasal swab samples for SARS-CoV-2 polymerase chain reaction testing; additional anterior nasal swabs were collected for expedited polymerase chain reaction testing from participants that reported 1 or more COVID-19-like symptoms. At enrollment and every 6 months during follow-up, participants answered more comprehensive questionnaires and provided venous blood samples for multiantigen SARS-CoV-2 immunoglobulin G antibody testing (an indicator of seroprevalence). Weekly follow-up activities concluded in April 2022 and 6-month follow-up visits concluded in August 2022. Primary study outcome measures include SARS-CoV-2 infection incidence and seroprevalence, relative risk of SARS-CoV-2 infection by participant characteristics, SARS-CoV-2 household attack rate, and COVID-19 illness characteristics and outcomes. In this study, we describe the characteristics of COCOVID participants overall and by SARS-CoV-2 seroprevalence status at baseline. RESULTS: We enrolled a total of 1030 participants from 388 households. Relative to the general populations of Ponce and Puerto Rico, our cohort overrepresented middle-income households, employed and middle-aged adults, and older children (P<.001). Almost all participants (1021/1025, 99.61%) identified as Latino/a, 17.07% (175/1025) had annual household incomes less than US $10,000, and 45.66% (463/1014) reported 1 or more chronic medical conditions. Baseline SARS-CoV-2 seroprevalence was low (16/1030, 1.55%) overall and increased significantly with later study enrollment time (P=.003). CONCLUSIONS: The COCOVID study will provide a valuable opportunity to better estimate the burden of SARS-CoV-2 and associated risk factors in a primarily Hispanic or Latino population, assess the limitations of surveillance, and inform mitigation measures in Puerto Rico and other similar populations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/53837. |
Novel Oliveros-like Clade C mammarenaviruses from rodents in Argentina, 1990-2020
Shedroff E , Martin ML , Whitmer SLM , Brignone J , Garcia JB , Sen C , Nazar Y , Fabbri C , Morales-Betoulle M , Mendez J , Montgomery J , Morales MA , Klena JD . Viruses 2024 16 (3) Following an Argentine Hemorrhagic Fever (AHF) outbreak in the early 1990s, a rodent survey for Junín virus, a New World Clade B arenavirus, in endemic areas of Argentina was conducted. Since 1990, INEVH has been developing eco-epidemiological surveillance of rodents, inside and outside the Argentine Hemorrhagic Fever endemic area. Samples from rodents captured between 1993 and 2019 that were positive for Arenavirus infection underwent Sanger and unbiased, Illumina-based high-throughput sequencing, which yielded 5 complete and 88 partial Mammarenaviruses genomes. Previously, 11 genomes representing four species of New World arenavirus Clade C existed in public records. This work has generated 13 novel genomes, expanding the New World arenavirus Clade C to 24 total genomes. Additionally, two genomes exhibit sufficient genetic diversity to be considered a new species, as per ICTV guidelines (proposed name Mammarenavirus vellosense). The 13 novel genomes exhibited reassortment between the small and large segments in New World Mammarenaviruses. This work demonstrates that Clade C Mammarenavirus infections circulate broadly among Necromys species in the Argentine Hemorrhagic Fever endemic area; however, the risk for Clade C Mammarenavirus human infection is currently unknown. |
Changes in anti-OV-16 IgG4 responses to onchocerciasis after elimination of transmission in the central endemic zone of Guatemala
Cama VA , Mendizabal-Cabrera R , de Leon O , White M , McDonald C , Thiele E , Ogawa GM , Morales Z , Prince-Guerra J , Cantey P , Rizzo N . Am J Trop Med Hyg 2024 Current WHO guidelines for onchocerciasis elimination provide requirements for stopping mass drug administration of ivermectin and the verification of elimination of transmission. These guidelines also recommend post-elimination surveillance (PES) based on entomological surveys. Serological markers in humans could complement entomological PES once the longevity of anti-OV-16 antibody responses is better understood. In 2014-2015 we evaluated ELISA anti-OV-16 IgG4 antibody persistence among previously seropositive people from the central endemic zone of Guatemala. The country stopped all onchocerciasis program interventions in 2012 and was verified by WHO as having eliminated transmission of onchocerciasis in 2016. A total of 246 participants with prior OV-16 ELISA results from 2003, 2006, 2007, or 2009 were enrolled in a follow-up study. Of these, 77 people were previously OV-16 seropositive and 169 were previously seronegative. By 2014 and 2015, 56 (72.7%) previously seropositive individuals had sero-reverted, whereas all previous negatives remained seronegative. The progression of antibody responses over time was estimated using a mixed-effects linear regression model, using data from seropositive participants who had sero-reverted. The temporal variation showed a mean activity unit decay of 0.20 per year (95% credible interval [CrI]: 0.17, 0.23), corresponding to an estimated antibody response half-life of 3.3 years (95% CrI: 2.7, 4.1). These findings indicate that the majority of seropositive people will sero-revert over time. |
Severe work-related injuries in the oil and gas extraction industry - 32 federal occupational safety and health administration jurisdictions, United States, January 2015-July 2022
Parasram V , Socias-Morales C , Reichard A . MMWR Morb Mortal Wkly Rep 2024 73 (5) 104-109 The Occupational Safety and Health Administration (OSHA) severe injuries reports include work-related injuries from establishments under federal OSHA jurisdiction that result in an amputation, loss of an eye, or inpatient hospitalization. Data from 32 jurisdictions were examined to determine oil and gas extraction industry-specific severe industry trends during January 2015-July 2022, using the 2012 North American Industry Classification System (NAICS) codes for oil and gas extraction. During this period, a total of 2,101 severe work-related injuries were reported in this sector. Among these severe work-related injuries, well service contract workers' injuries included the highest number of amputations (417) and hospitalizations (1,194), accounting for 20% and 57%, respectively, of all severe injuries reported. Overall, 895 (43%) of all severe injuries reported involved upper extremities. Contract workers in the service and drilling subindustries (NAICS codes 213112 and 213111, respectively) experienced disproportionately more work-related injuries compared with those in the operation subindustry (NAICS code 211). These injuries could be preventable by including contractors in worksite safety plans that administer the hierarchy of controls, are within an effective safety management system, and provide consistent safety training on work equipment, personal protective equipment, and daily site safety meetings that increase safety culture. |
Tropical data: Approach and methodology as applied to trachoma prevalence surveys
Harding-Esch EM , Burgert-Brucker CR , Jimenez C , Bakhtiari A , Willis R , Bejiga MD , Mpyet C , Ngondi J , Boyd S , Abdala M , Abdou A , Adamu Y , Alemayehu A , Alemayehu W , Al-Khatib T , Apadinuwe SC , Awaca N , Awoussi MS , Baayendag G , Badiane MD , Bailey RL , Batcho W , Bay Z , Bella A , Beido N , Bol YY , Bougouma C , Brady CJ , Bucumi V , Butcher R , Cakacaka R , Cama A , Camara M , Cassama E , Chaora SG , Chebbi AC , Chisambi AB , Chu B , Conteh A , Coulibaly SM , Courtright P , Dalmar A , Dat TM , Davids T , Djaker MEA , de Fátima Costa Lopes M , Dézoumbé D , Dodson S , Downs P , Eckman S , Elshafie BE , Elmezoghi M , Elvis AA , Emerson P , Epée EE , Faktaufon D , Fall M , Fassinou A , Fleming F , Flueckiger R , Gamael KK , Garae M , Garap J , Gass K , Gebru G , Gichangi MM , Giorgi E , Goépogui A , Gómez DVF , Gómez Forero DP , Gower EW , Harte A , Henry R , Honorio-Morales HA , Ilako DR , Issifou AAB , Jones E , Kabona G , Kabore M , Kadri B , Kalua K , Kanyi SK , Kebede S , Kebede F , Keenan JD , Kello AB , Khan AA , Khelifi H , Kilangalanga J , Kim SH , Ko R , Lewallen S , Lietman T , Logora MSY , Lopez YA , MacArthur C , Macleod C , Makangila F , Mariko B , Martin DL , Masika M , Massae P , Massangaie M , Matendechero HS , Mathewos T , McCullagh S , Meite A , Mendes EP , Abdi HM , Miller H , Minnih A , Mishra SK , Molefi T , Mosher A , M'Po N , Mugume F , Mukwiza R , Mwale C , Mwatha S , Mwingira U , Nash SD , Nassa C , Negussu N , Nieba C , Noah Noah JC , Nwosu CO , Olobio N , Opon R , Pavluck A , Phiri I , Rainima-Qaniuci M , Renneker KK , Saboyá-Díaz MI , Sakho F , Sanha S , Sarah V , Sarr B , Szwarcwald CL , Shah Salam A , Sharma S , Seife F , Serrano Chavez GM , Sissoko M , Sitoe HM , Sokana O , Tadesse F , Taleo F , Talero SL , Tarfani Y , Tefera A , Tekeraoi R , Tesfazion A , Traina A , Traoré L , Trujillo-Trujillo J , Tukahebwa EM , Vashist P , Wanyama EB , Warusavithana SDP , Watitu TK , West S , Win Y , Woods G , Yajima A , Yaya G , Zecarias A , Zewengiel S , Zoumanigui A , Hooper PJ , Millar T , Rotondo L , Solomon AW . Ophthalmic Epidemiol 2023 30 (6) 544-560 PURPOSE: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys. METHODS: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported. RESULTS: Between 29(th) February 2016 and 24(th) April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma. CONCLUSION: This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets. |
The association between safety climate and noncombat injury events among United States Air Force workers
Socias-Morales CM , Haas EJ , Gwilliam M , Yorio PL , Delaney NB , Falcon RG , Stallings HA , Burnham BR , Stuever DM , Stouder SM , Ewing GL , Collins JW , Chaumont Menendez CK . J Saf Res null [Epub ahead of print] Introduction: Work-related injuries are a common lagging safety indicator whereas safety climate assessments can help identify constructs serving as leading indicators. The National Institute for Occupational Safety and Health (NIOSH) partnered with the U.S. Department of the Air Force (DAF) Safety Center to examine the association between perceptions of safety climate survey constructs and the number of injury events within the DAF workforce. Methods: The DAF administers voluntary, anonymous, occupation-specific safety climate surveys to DAF workers using the internal Air Force Combined Mishap Reduction System (AFCMRS). Survey responses from 2014 to 2018 provided by DAF workers and injury events in maintenance, support, and operations occupations were shared with NIOSH. Exploratory Factor Analysis revealed five constructs: Leadership and Communication; Organizational Safety Priority; Error Management; Resource Adequacy; and Deployment/Official Travel Impact. Squadron-level analysis included bivariate correlations and estimated Rate Ratios (RRs). Results: 1,547 squadrons administered the survey, averaging 144 workers and 15.8 reportable injuries per squadron. Higher (more favorable) squadron-level construct scores were consistently correlated with fewer reported injuries (p < 0.001). Controlling for the number of workers, RRs revealed significant reductions in injury rates with each one-unit increase in responses: Leadership and Communication RR = 0.40 (95 %CI: 0.32-0.48); Organizational Safety Priority RR = 0.50 (95 %CI: 0.40-0.64); Error Management RR = 0.37 (95 %CI: 0.30-0.47); Deployment/Official Travel Impact RR = 0.36 (95 %CI: 0.29-0.45). Resource Adequacy revealed a non-significant lower injury rate RR = 0.87 (95 %CI: 0.73-1.04). Conclusions: This unique study quantified safety climate and the association with injuries across a multi-year period. While safety climate measurements may be limited by frequent turnover and the self-reported, voluntary, anonymous nature of AFCMRS, the strength of this study is in the census of injuries. Practical Applications: Future research should include longitudinal analyses to examine the impact on injuries when squadron leaders are provided feedback on safety climate survey results. |
Progress toward measles and rubella elimination - Indonesia, 2013-2022
Chacko S , Kamal M , Hastuti EB , Mildya F , Kelyombar C , Voronika V , Yosephine P , Tandy G , Anisiska D , Karolina S , Dewi LA , Khanal S , Bahl S , Wijayanti F , Merrill RD , Hsu CH , Morales M . MMWR Morb Mortal Wkly Rep 2023 72 (42) 1134-1139 In 2019, Indonesia and the other countries in the World Health Organization South-East Asia Region adopted the goal of measles and rubella elimination by 2023. This report describes Indonesia's progress toward measles and rubella elimination during 2013-2022. During this period, coverage with a first dose of measles-containing vaccine (MCV) decreased from 87% to 84%, and coverage with a second MCV dose decreased from 76% to 67%. After rubella vaccine was introduced in 2017, coverage with the first dose of rubella-containing vaccine increased approximately fivefold, from 15% in 2017 to 84% in 2022. During 2013-2021, annual reported measles incidence decreased by 95%, from 33.2 to 1.4 cases per million population; reported rubella incidence decreased 89%, from 9.3 to 1.0 cases per million population. However, a large surge in measles and rubella cases occurred in 2022, with a reported measles incidence of 29 cases per million and a reported rubella incidence of 3 per million, primarily related to disruption in immunization services caused by the COVID-19 pandemic. In 2022, approximately 26 million children (an estimated 73% of the target population) received a combined measles- and rubella-containing vaccine during supplementary immunization activities completed in 32 provinces. Progress toward measles and rubella elimination in Indonesia has been made; however, continued and urgent efforts are needed to restore routine immunization services that were adversely affected by the COVID-19 pandemic and close immunity gaps to accelerate progress toward measles and rubella elimination. |
2022 National Occupational Injury Research Symposium (NOIRS): Preventing workplace injuries in a changing world
Castillo DN , Schuler CR , Socias-Morales CM , Sinelnikov S . J Safety Res 2023 86 2-4 About NOIRS: The National Occupational Injury Research Symposium (NOIRS) is the only conference solely dedicated to occupational injury research and prevention. The 8th NOIRS, sponsored by the National Institute for Occupational Safety and Health (NIOSH) and several partners, was held on May 10-12, 2022. NOIRS was held entirely virtually in response to concerns of the COVID-19 pandemic and honoring the symposium theme "Preventing Workplace Injuries in a Changing World." About this Special Issue: The intent of this issue is to highlight the breadth of high-quality presentations at NOIRS, and to make them available to those who did not participate in the conference. This issue includes three short communication articles and nine research articles. Featured research articles in this special issue span a wide variety of methods, data sources, and worker populations. They address leading and emerging causes and contributors to occupational injury in a range of industries and occupations. Concluding Remarks: We hope that this special issue provides readers with a view into some of the research presented at the 2022 NOIRS. We also hope the articles are useful for research and practice, and thinking toward the future. |
Rio Negro virus infection, Bolivia, 2021
Loayza Mafayle R , Morales-Betoulle ME , Whitmer S , Cossaboom C , Revollo J , Loayza NM , Méndez HA , Chuquimia Valdez JA , Subieta FA , Espinoza Morales MX , Canedo Sánchez MV , Romero MER , Brault AC , Hugues HR , Mendez-Rico J , Malenfant JH , Shoemaker T , Klena JD , Montgomery JM , Marquina Salas JD . Emerg Infect Dis 2023 29 (8) 1705-1708 In May 2021, an agricultural worker originally from Trementinal, Argentina, sought treatment for febrile illness in Tarija, Bolivia, where he resided at the time of illness onset. The patient tested negative for hantavirus RNA, but next-generation sequencing of a serum sample yielded a complete genome for Rio Negro virus. |
Non-linkage to care and non-viral suppression among Hispanic/Latino persons by birthplace and social vulnerability-United States, 2021
Morales JA , Gant Sumner Z , Hu X , Johnson Lyons S , Satcher Johnson A . J Racial Ethn Health Disparities 2024 BACKGROUND: Assessing individual- and community-level factors may help to explain differences among Hispanic/Latino adults with diagnosed HIV not linked to care and without viral suppression in the United States. METHODS: We analyzed CDC's National HIV Surveillance System data among Hispanic/Latino persons aged ≥ 18 years with HIV diagnosed during 2021 in 47 states and the District of Columbia and linked cases via census tracts to the CDC/ATSDR's Social Vulnerability Index (SVI). Adjusted prevalence ratios and 95% confidence intervals for non-linkage to care and non-viral suppression were estimated using Poisson regression model. RESULTS: Among 5,056 Hispanic/Latino adults with HIV diagnosed in 2021, 51.5% were born in the United States, 17.3% in Mexico, 9.2% in Central America, 11.1% in South America, 1.8% in Puerto Rico, 6.8% in Cuba, and 2.4% in the Caribbean. Compared with U.S.-born Hispanic/Latino adults, those born in Mexico and South America had a lower prevalence of non-linkage to care. Hispanic/Latino adults born in Mexico, South America, and the Caribbean (excluding Puerto Rico and Cuba) had a lower prevalence of non-viral suppression, compared with those born in the United States. No significant differences were observed among SVI quartiles for either care outcome. CONCLUSION: This study aimed to challenge the narrow perspective on HIV care outcomes by examining the impact of birthplace and social vulnerability among Hispanic/Latino adults. To increase HIV care and prevention among Hispanic/Latino persons, research must evaluate health disparities within the group, and efforts are needed to better understand and tailor interventions within the diverse Hispanic/Latino population. |
Construction industry workers compensation injury claims due to slips, trips, and falls Ohio, 20102017
Socias-Morales C , Konda S , Bell JL , Wurzelbacher SJ , Naber SJ , Scott Earnest G , Garza EP , Meyers AR , Scharf T . J Saf Res 2023 Problem: Compared to other industries, construction workers have higher risks for serious fall injuries. This study describes the burden and circumstances surrounding injuries related to compensable slip, trip, and fall (STF) claims from private construction industries covered by the Ohio Bureau of Workers Compensation. Methods: STF injury claims in the Ohio construction industry from 20102017 were manually reviewed. Claims were classified as: slips or trips without a fall (STWOF), falls on the same level (FSL), falls to a lower level (FLL), and other. Claim narratives were categorized by work-related risk and contributing factors. Demographic, employer, and injury characteristics were examined by fall type and claim type (medical-only (MO, 07 days away from work, DAFW) or lost-time (LT, 8 DAFW)). Claim rates per 10,000 estimated full-time equivalent employees (FTEs) were calculated. Results: 9,517 Ohio construction industry STF claims occurred during the 8-year period, with an average annual rate of 75 claims per 10,000 FTEs. The rate of STFs decreased by 37% from 2010 to 2017. About half of the claims were FLL (51%), 29% were FSL, 17% were STWOF, and 3% were other. Nearly 40% of all STF claims were LT; mostly among males (96%). The top three contributing factors for STWOF and FSL were: slip/trip hazards, floor irregularities, and ice/snow; and ladders, vehicles, and stairs/steps for FLL. FLL injury rates per 10,000 FTE were highest in these industries: Foundation, Structure, and Building Exterior Contractors (52); Building Finishing Contractors (45); and Residential Building Construction (45). The highest rate of FLL LT claims occurred in the smallest firms, and the FLL rate decreased as construction firm size increased. Discussion and Practical Applications: STF rates declined over time, yet remain common, requiring prevention activities. Safety professionals should focus on contributing factors when developing prevention strategies, especially high-risk subsectors and small firms. 2023 |
Seroprevalence of Antibodies to SARS-CoV-2 in Six Sites in the United States, March 23-May 3, 2020 (preprint)
Havers FP , Reed C , Lim T , Montgomery JM , Klena JD , Hall AJ , Fry AM , Cannon DL , Chiang CF , Gibbons A , Krapiunaya I , Morales-Betoulle M , Roguski K , Rasheed MAU , Freeman B , Lester S , Mills L , Carroll DS , Owen SM , Johnson JA , Semenova V , Schiffer J , Thornburg NJ , Blackmore C , Blog D , Dunn A , Lindquist S , Pritchard S , Sosa L , Turabelidze G , Wiesman J , Williams RW . medRxiv 2020 2020.06.25.20140384 Importance Reported cases of SARS-CoV-2 infection likely underestimate the prevalence of infection in affected communities. Large-scale seroprevalence studies provide better estimates of the proportion of the population previously infected.Objective To estimate prevalence of SARS-CoV-2 antibodies in convenience samples from several geographic sites in the United States.Design Serologic testing of convenience samples using residual sera obtained for routine clinical testing by two commercial laboratory companies.Setting Connecticut (CT), south Florida (FL), Missouri (MO), New York City metro region (NYC), Utah (UT), and Washington State’s (WA) Puget Sound region.Participants Persons of all ages with serum collected during intervals from March 23 through May 3, 2020.Exposure SARS-CoV-2 virus infection.Main outcomes and measures We estimated the presence of antibodies to SARS-CoV-2 spike protein using an ELISA assay. We standardized estimates to the site populations by age and sex. Estimates were adjusted for test performance characteristics (96.0% sensitivity and 99.3% specificity). We estimated the number of infections in each site by extrapolating seroprevalence to site populations. We compared estimated infections to number of reported COVID-19 cases as of last specimen collection date.Results We tested sera from 11,933 persons. Adjusted estimates of the proportion of persons seroreactive to the SARS-CoV-2 spike protein ranged from 1.13% (95% confidence interval [CI] 0.70-1.94) in WA to 6.93% (95% CI 5.02-8.92) in NYC (collected March 23-April 1). For sites with later collection dates, estimates ranged from 1.85% (95% CI 1.00-3.23, collected April 6-10) for FL to 4.94% (95% CI 3.61-6.52) for CT (April 26-May 3). The estimated number of infections ranged from 6 to 24 times the number of reported cases in each site.Conclusions and relevance Our seroprevalence estimates suggest that for five of six U.S. sites, from late March to early May 2020, >10 times more SARS-CoV-2 infections occurred than the number of reported cases. Seroprevalence and under-ascertainment varied by site and specimen collection period. Most specimens from each site had no evidence of antibody to SARS-CoV-2. Tracking population seroprevalence serially, in a variety of specific geographic sites, will inform models of transmission dynamics and guide future community-wide public health measures.Question What proportion of persons in six U.S. sites had detectable antibodies to SARS-CoV-2, March 23-May 3, 2020?Findings We tested 11,933 residual clinical specimens. We estimate that from 1.1% of persons in the Puget Sound to 6.9% in New York City (collected March 23-April 1) had detectable antibodies. Estimates ranged from 1.9% in south Florida to 4.9% in Connecticut with specimens collected during intervals from April 6-May 3. Six to 24 times more infections were estimated per site with seroprevalence than with case report data.Meaning For most sites, evidence suggests >10 times more SARS-CoV-2 infections occurred than reported cases. Most persons in each site likely had no detectable SARS-CoV-2 antibodies.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis study was funded by the Centers for Disease Control and Prevention.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:This protocol underwent review by CDC human subjects research officials, who determined that the testing represented non-research activity in the setting of a public health response to the COVID-19 pandemic.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 su h 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.YesA limited dataset will be made publicly available at a later time. |
Evaluation of the durability of long-lasting insecticidal nets in Guatemala (preprint)
Castellanos ME , Rodas S , Juárez JG , Lol JC , Chanquin S , Morales Z , Vizcaino L , Smith SC , Vanden Eng J , Woldu HG , Lenhart A , Padilla N . medRxiv 2020 2020.07.30.20165316 Background Insecticide-treated bednets (ITNs) are widely used for the prevention and control of malaria. In Guatemala, since 2006, ITNs have been distributed free of charge in the highest risk malaria-endemic areas and constitute one of the primary vector control measures in the country. Despite relying on ITNs for almost 15 years, there is a lack of data to inform the timely replacement of ITNs whose effectiveness becomes diminished by routine use.Methods We assessed the survivorship, physical integrity, insecticide content and bio-efficacy of ITNs through cross-sectional surveys conducted at 18, 24 and 32 months after a 2012 distribution of PermaNet® 2.0 in a malaria focus in Guatemala. A total of 988 ITNs were analyzed (290 at 18 months, 349 at 24 months and 349 at 32 months).Results The functional survivorship of bednets decreased over time, from 92% at 18 months, to 81% at 24 months and 69% at 32 months. Independent of the time of the survey, less than 80% of the bednets that were still present in the household were reported to have been used the night before. Most of the bednets had been washed at least once (88% at 18 months, 92% at 24 months and 96% at 32 months). The proportion of bednets categorized as “in good condition” per WHO guidelines of the total hole surface area, diminished from 77% at 18 months to 58% at 32 months. The portion of ITNs with deltamethrin concentration less than 10mg/m2 increased over time (14% at 18 months, 23% at 24 months, and 35% at 32 months). Among the bednets for which bioassays were conducted, the percentage that met WHO criteria for efficacy dropped from 90% at 18 months to 52% at 32 months.Conclusion While our assessment demonstrated that nets were in relatively good physical condition over time, the combination of declining bio-efficacy over time and low use rates limited the overall effectiveness of the LLINs. Efforts to encourage the community to retain, use, and properly care for the LLINs may improve their impact. Durability assessments should be included in future campaigns.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThe funding for this study was provided by the United States Agency for International Development (USAID) via the Amazon Malaria Initiative (AMI), Centers for Disease Control and Prevention (CDC) of the United States of America, Guatemalan Ministry of Public Health and Social Welfare and Center for Health Studies and Universidad del Valle de Guatemala. The funding bodies had no role in the design of the study and collection, analysis, and interpretation of the data and in writing the manuscript.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:Oral informed consent was obtained from all participants prior to study inclusion. This study was approved by the Ethics Committee of the Center for Health Studies at Universidad del Valle de Guatemala (Approval Number: 081-06-2013); CDC investigators were not considered to be engaged in human subjects research.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 data that support the findings of this study are availa le on request from the senior author, NP. The data are not publicly available due to containing information that could compromise the privacy of participants.GISgeographic information systemGISgeographic information systemGPSGlobal positioning systemIQRinterquartile rangeITNInsecticide-treated bednetLLINlong-lasting insecticide-treated bednetLOESSLocally Weighted Scatterplot SmoothingMoHMinistry of HealthPDApersonal digital assistantTHSAtotal hole surface areatmmedian survival timeWHOWorld Health OrganizationXRFx-ray fluorescence |
Using the NCBI AMRFinder Tool to Determine Antimicrobial Resistance Genotype-Phenotype Correlations Within a Collection of NARMS Isolates (preprint)
Feldgarden M , Brover V , Haft DH , Prasad AB , Slotta DJ , Tolstoy I , Tyson GH , Zhao S , Hsu CH , McDermott PF , Tadesse DA , Morales C , Simmons M , Tillman G , Wasilenko J , Folster JP , Klimke W . bioRxiv 2019 550707 Antimicrobial resistance (AMR) is a major public health problem that requires publicly available tools for rapid analysis. To identify acquired AMR genes in whole genome sequences, the National Center for Biotechnology Information (NCBI) has produced a high-quality, curated, AMR gene reference database consisting of up-to-date protein and gene nomenclature, a set of hidden Markov models (HMMs), and a curated protein family hierarchy. Currently, the Bacterial Antimicrobial Resistance Reference Gene Database contains 4,579 antimicrobial resistance gene proteins and more than 560 HMMs.Here, we describe AMRFinder, a tool that uses this reference dataset to identify AMR genes. To assess the predictive ability of AMRFinder, we measured the consistency between predicted AMR genotypes from AMRFinder against resistance phenotypes of 6,242 isolates from the National Antimicrobial Resistance Monitoring System (NARMS). This included 5,425 Salmonella enterica, 770 Campylobacter spp., and 47 Escherichia coli phenotypically tested against various antimicrobial agents. Of 87,679 susceptibility tests performed, 98.4% were consistent with predictions.To assess the accuracy of AMRFinder, we compared its gene symbol output with that of a 2017 version of ResFinder, another publicly available resistance gene database. Most gene calls were identical, but there were 1,229 gene symbol differences between them, with differences due to both algorithmic differences and database composition. AMRFinder missed 16 loci that Resfinder found, while Resfinder missed 1,147 loci AMRFinder identified. Two missing drug classes from the 2017 version of ResFinder contributed 81% of missed loci. Based on these results, AMRFinder appears to be a highly accurate AMR gene detection system.Importance Antimicrobial resistance is a major public health problem. Traditionally, antimicrobial resistance has been identified using phenotypic assays. With the advent of genome sequencing, we now can identify resistance genes and deduce if an isolate could be resistant to antibiotics. We describe a database of 4,579 acquired antimicrobial resistance genes, the largest publicly available, and a software tool to identify genes in bacterial genomes, AMRFinder. Unlike other tools, AMRFinder uses a gene hierarchy to prevent overpredicting what the correct gene call should be, enabling more accurate assessment. To assess these resources, we determined the resistance gene content of over 6,200 bacterial isolates from the National Antimicrobial Resistance Monitoring System that have been assayed using traditional methods and that also have had their genomes sequenced. We also compared our gene assessments to those of a popularly used tool. We found that AMRFinder has a high overall consistency between genotypes and phenotypes. |
Construction industry workers' compensation injury claims due to slips, trips, and falls - Ohio, 2010-2017
Socias-Morales C , Konda S , Bell JL , Wurzelbacher SJ , Naber SJ , Earnest GS , Garza EP , Meyers AR , Scharf T . J Safety Res 2023 86 [Epub ahead of print] Problem: Compared to other industries, construction workers have higher risks for serious fall injuries. This study describes the burden and circumstances surrounding injuries related to compensable slip, trip, and fall (STF) claims from private construction industries covered by the Ohio Bureau of Workers' Compensation. Methods: STF injury claims in the Ohio construction industry from 2010-2017 were manually reviewed. Claims were classified as: slips or trips without a fall (STWOF), falls on the same level (FSL), falls to a lower level (FLL), and other. Claim narratives were categorized by work-related risk and contributing factors. Demographic, employer, and injury characteristics were examined by fall type and claim type (medical-only (MO, 0-7 days away from work, DAFW) or lost-time (LT, ≥8 DAFW)). Claim rates per 10,000 estimated full-time equivalent employees (FTEs) were calculated. Results: 9,517 Ohio construction industry STF claims occurred during the 8-year period, with an average annual rate of 75 claims per 10,000 FTEs. The rate of STFs decreased by 37% from 2010 to 2017. About half of the claims were FLL (51%), 29% were FSL, 17% were STWOF, and 3% were "other." Nearly 40% of all STF claims were LT; mostly among males (96%). The top three contributing factors for STWOF and FSL were: slip/trip hazards, floor irregularities, and ice/snow; and ladders, vehicles, and stairs/steps for FLL. FLL injury rates per 10,000 FTE were highest in these industries: Foundation, Structure, and Building Exterior Contractors (52); Building Finishing Contractors (45); and Residential Building Construction (45). The highest rate of FLL LT claims occurred in the smallest firms, and the FLL rate decreased as construction firm size increased. Discussion and Practical Applications: STF rates declined over time, yet remain common, requiring prevention activities. Safety professionals should focus on contributing factors when developing prevention strategies, especially high-risk subsectors and small firms. |
Effectiveness of 2 and 3 mRNA COVID-19 Vaccines Doses against Omicron and Delta-Related Outpatient Illness among Adults, October 2021 - February 2022 (preprint)
Kim SS , Chung JR , Talbot HK , Grijalva CG , Wernli KJ , Martin ET , Monto AS , Belongia EA , McLean HQ , Gaglani M , Mamawala M , Nowalk MP , Geffel KM , Tartof SY , Florea A , Lee JS , Tenforde MW , Patel MM , Flannery B , Bentz ML , Burgin A , Burroughs M , Davis ML , Howard D , Lacek K , Madden JC , Nobles S , Padilla J , Sheth M , Arroliga A , Beeram M , Dunnigan K , Ettlinger J , Graves A , Hoffman E , Jatla M , McKillop A , Murthy K , Mutnal M , Priest E , Raiyani C , Rao A , Requenez L , Settele N , Smith M , Stone K , Thomas J , Volz M , Walker K , Zayed M , Annan E , Daley P , Kniss K , Merced-Morales A , Ayala E , Amundsen B , Aragones M , Calderon R , Hong V , Jimenez G , Kim J , Ku J , Lewin B , McDaniel A , Reyes A , Shaw S , Takhar H , Torres A , Burganowski R , Kiniry E , Moser KA , Nguyen M , Park S , Wellwood S , Wickersham B , Alvarado-Batres J , Benz S , Berger H , Bissonnette A , Blake J , Boese K , Botten E , Boyer J , Braun M , Breu B , Burbey G , Cravillion C , Delgadillo C , Donnerbauer A , Dziedzic T , Eddy J , Edgren H , Ermeling A , Ewert K , Fehrenbach C , Fernandez R , Frome W , Guzinski S , Heeren L , Herda D , Hertel M , Heuer G , Higdon E , Ivacic L , Jepsen L , Kaiser S , Karl J , Keffer B , King J , Koepel TK , Kohl S , Kohn S , Kohnhorst D , Kronholm E , Le T , Lemieux A , Marcis C , Maronde M , McCready I , McGreevey K , Meece J , Mehta N , Miesbauer D , Moon V , Moran J , Nikolai C , Olson B , Olstadt J , Ott L , Pan N , Pike C , Polacek D , Presson M , Price N , Rayburn C , Reardon C , Rotar M , Rottscheit C , Salzwedel J , Saucedo J , Scheffen K , Schug C , Seyfert K , Shrestha R , Slenczka A , Stefanski E , Strupp M , Tichenor M , Watkins L , Zachow A , Zimmerman B , Bauer S , Beney K , Cheng CK , Faraj N , Getz A , Grissom M , Groesbeck M , Harrison S , Henson K , Jermanus K , Johnson E , Kaniclides A , Kimberly A , Lamerato LE , Lauring A , Lehmann-Wandell R , McSpadden EJ , Nabors L , Truscon R , Balasubramani GK , Bear T , Bobeck J , Bowser E , Clarke K , Clarke LG , Dauer K , Deluca C , Dierks B , Haynes L , Hickey R , Johnson M , Jonsson A , Luosang N , McKown L , Peterson A , Phaturos D , Rectenwald A , Sax TM , Stiegler M , Susick M , Suyama J , Taylor L , Walters S , Weissman A , Williams JV , Blair M , Carter J , Chappell J , Copen E , Denney M , Graes K , Halasa N , Lindsell C , Liu Z , Longmire S , McHenry R , Short L , Tan HN , Vargas D , Wrenn J , Wyatt D , Zhu Y . medRxiv 2022 10 Background: We estimated SARS-CoV-2 Delta and Omicron-specific effectiveness of 2 and 3 mRNA COVID-19 vaccine doses in adults against symptomatic illness in US outpatient settings. Method(s): Between October 1, 2021, and February 12, 2022, research staff consented and enrolled eligible participants who had fever, cough, or loss of taste or smell and sought outpatient medical care or clinical SARS-CoV-2 testing within 10 days of illness onset. Using the test-negative design, we compared the odds of receiving 2 or 3 mRNA COVID-19 vaccine doses among SARS-CoV-2 cases versus controls using logistic regression. Regression models were adjusted for study site, age, onset week, and prior SARS-CoV-2 infection. Vaccine effectiveness (VE) was calculated as (1 - adjusted odds ratio) x 100%. Result(s): Among 3847 participants included for analysis, 574 (32%) of 1775 tested positive for SARS-CoV-2 during the Delta predominant period and 1006 (56%) of 1794 participants tested positive during the Omicron predominant period. When Delta predominated, VE against symptomatic illness in outpatient settings was 63% (95% CI: 51% to 72%) among mRNA 2-dose recipients and 96% (95% CI: 93% to 98%) for 3-dose recipients. When Omicron predominated, VE was 21% (95% CI: -6% to 41%) among 2-dose recipients and 62% (95% CI: 48% to 72%) among 3-dose recipients. Conclusion(s): In this adult population, 3 mRNA COVID-19 vaccine doses provided substantial protection against symptomatic illness in outpatient settings when the Omicron variant became the predominant cause of COVID-19 in the U.S. These findings support the recommendation for a 3rd mRNA COVID-19 vaccine dose. 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. |
Progress toward rubella elimination - World Health Organization South-East Asia Region, 2013-2021
Khanal S , Bahl S , Sangal L , Dhongde D , O'Connor PM , Crowcroft NS , Morales M . MMWR Morb Mortal Wkly Rep 2023 72 (25) 678-682 During 2013, the 11 countries of the World Health Organization (WHO) South-East Asia Region* (SEAR) adopted the goals of measles elimination and rubella and congenital rubella syndrome (CRS) control(†) by 2020. During 2019, SEAR countries declared a broader goal for eliminating both measles and rubella(§) by 2023 (1). Before 2013, only five SEAR countries had introduced rubella-containing vaccine (RCV). This report updates a previous report and describes progress toward rubella elimination in SEAR during 2013-2021 (2). During 2013-2021, six SEAR countries introduced RCV; all countries in the Region now use RCV in routine immunization. Routine immunization coverage with the first dose of a rubella-containing vaccine (RCV1) increased >600%, from 12% during 2013 to 86% during 2021, and an estimated 515 million persons were vaccinated via RCV supplementary immunization activities (SIAs)(¶) during 2013-2021. During this time, annual reported rubella incidence declined by 80%, from 5.5 to 1.1 cases per million population. Maldives and Sri Lanka are verified as having achieved rubella elimination; Bhutan, North Korea, and Timor-Leste have halted endemic transmission of rubella virus for >36 months. SEAR has made substantial progress toward rubella elimination; however, intensified measures are needed to achieve elimination. |
Time series, seasonality and trend evaluation of 7years (20152021) of OSHA severe injury data
Gomes H , Parasram V , Collins J , Socias-Morales C . J Saf Res 2023 [Epub ahead of print] Problem: Employers are required to report severe work-related injuries (e.g., amputation, inpatient hospitalization, or loss of an eye), to the Occupational Safety and Health Administration (OSHA). This study examined the OSHA severe injury reports (SIRs) public microdata to understand time-related trends and patterns. Methods: This study included all SIRs from January 2015 to December 2021 (84 months). We employed time series decomposition models (classical additive and multiplicative, X-11, and X-13ARIMA-SEATS) to evaluate monthly seasonal effect and seasonally adjusted trend of SIRs. We developed data visuals to display trends from different models with the original data series. We compared number of daily SIRs by day of the week, and yearly trends by 2-digit NAICS and separately by 1-digit OIICS injury event. Results: There were a total of 70,241 SIRs in this 7 year period; ranging from 8,704 to 11,156 per year, and 600 to 1,100 per month. Seasonally adjusted trend indicated a gradual increase of SIRs over time until October 2018, then a steeper decrease until August 2020, and staying somewhat flat for the rest of the months. Seasonality indicated more SIRs were reported in the summer months (June, July, August). Daily SIRs indicated a weekday average of 34 (SD = 9) and weekend average of 11 (SD = 5). The Manufacturing and Construction industries reported the highest yearly SIRs. Contact with objects and equipment, and falls, slips, trips were the most numerous injury events associated with SIRs. Discussion: Although Federal OSHA SIR data do not include SIRs from state-plan jurisdictions, the data provide a timely national trend of SIR. This is the first known time series analysis of SIRs. Practical Applications: The findings of this study highlight the ability of researchers to use the SIRs as a timely indicator to understand occupational injury trends by specific industries and injury events. |
Time series, seasonality and trend evaluation of 7 years (2015–2021) of OSHA severe injury data
Gomes H , Parasram V , Collins J , Socias-Morales C . J Safety Res 2023 86 [Epub ahead of print] Problem: Employers are required to report severe work-related injuries (e.g., amputation, inpatient hospitalization, or loss of an eye), to the Occupational Safety and Health Administration (OSHA). This study examined the OSHA severe injury reports (SIRs) public microdata to understand time-related trends and patterns. Methods: This study included all SIRs from January 2015 to December 2021 (84 months). We employed time series decomposition models (classical additive and multiplicative, X-11, and X-13ARIMA-SEATS) to evaluate monthly seasonal effect and seasonally adjusted trend of SIRs. We developed data visuals to display trends from different models with the original data series. We compared number of daily SIRs by day of the week, and yearly trends by 2-digit NAICS and separately by 1-digit OIICS injury event. Results: There were a total of 70,241 SIRs in this 7 year period; ranging from 8,704 to 11,156 per year, and 600 to 1,100 per month. Seasonally adjusted trend indicated a gradual increase of SIRs over time until October 2018, then a steeper decrease until August 2020, and staying somewhat flat for the rest of the months. Seasonality indicated more SIRs were reported in the summer months (June, July, August). Daily SIRs indicated a weekday average of 34 (SD = 9) and weekend average of 11 (SD = 5). The Manufacturing and Construction industries reported the highest yearly SIRs. Contact with objects and equipment, and falls, slips, trips were the most numerous injury events associated with SIRs. Discussion: Although Federal OSHA SIR data do not include SIRs from state-plan jurisdictions, the data provide a timely national trend of SIR. This is the first known time series analysis of SIRs. Practical Applications: The findings of this study highlight the ability of researchers to use the SIRs as a timely indicator to understand occupational injury trends by specific industries and injury events. |
SARS-CoV-2 Delta variant genomic variation associated with breakthrough infection in Northern California: A retrospective cohort study
Skarbinski J , Nugent JR , Wood MS , Liu L , Bullick T , Schapiro JM , Arunleung P , Morales C , Amsden LB , Hsiao CA , Wadford DA , Chai SJ , Reingold A , Wyman SK . J Infect Dis 2023 228 (7) 878-888 BACKGROUND: The association between SARS-CoV-2 genomic variation and breakthrough infection is not well-defined among persons with Delta variant SARS-CoV-2 infection. METHODS: In a retrospective cohort we assessed whether individual non-lineage defining mutations and overall genomic variation (including low frequency alleles) were associated with breakthrough infection defined as SARS-CoV-2 infection after COVID-19 primary vaccine series. We identified all non-synonymous single nucleotide polymorphisms, insertions and deletions in SARS-CoV-2 genomes with ≥5% allelic frequency and population frequency of ≥5% and ≤95%. Using Poisson regression, we assessed the association with breakthrough infection for each individual mutation and a viral genomic risk score. RESULTS: Thirty-six mutations met our inclusion criteria. Among 12,744 persons infected with Delta variant SARS-CoV-2, 5,949 (47%) were vaccinated and 6,795 (53%) were unvaccinated. Viruses with a viral genomic risk score in the highest quintile were 9% more likely to be associated with breakthrough infection than viruses in the lowest quintile, but including the risk score improved overall predictive model performance (measured by c-statistic) by only +0.0006. CONCLUSIONS: Genomic variation within SARS-CoV-2 Delta variant was weakly associated with breakthrough infection, however several potential non-lineage defining mutations were identified that might contribute to immune evasion by SARS-CoV-2. |
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