Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-26 (of 26 Records) |
Query Trace: Osborne M[original query] |
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Sosuga virus detected in Egyptian rousette bats (Rousettus aegyptiacus) in Sierra Leone
Amman BR , Koroma AH , Schuh AJ , Conteh I , Sealy TK , Foday I , Johnny J , Bakarr IA , Whitmer SLM , Wright EA , Gbakima AA , Graziano J , Bangura C , Kamanda E , Osborne A , Saidu E , Musa JA , Bangura DF , Williams SMT , Fefegula GM , Sumaila C , Jabaty J , James FH , Jambai A , Garnett K , Kamara TF , Towner JS , Lebbie A . Viruses 2024 16 (4) Sosuga virus (SOSV), a rare human pathogenic paramyxovirus, was first discovered in 2012 when a person became ill after working in South Sudan and Uganda. During an ecological investigation, several species of bats were sampled and tested for SOSV RNA and only one species, the Egyptian rousette bat (ERBs; Rousettus aegyptiacus), tested positive. Since that time, multiple other species have been sampled and ERBs in Uganda have continued to be the only species of bat positive for SOSV infection. Subsequent studies of ERBs with SOSV demonstrated that ERBs are a competent host for SOSV and shed this infectious virus while exhibiting only minor infection-associated pathology. Following the 2014 Ebola outbreak in West Africa, surveillance efforts focused on discovering reservoirs for zoonotic pathogens resulted in the capture and testing of many bat species. Here, SOSV RNA was detected by qRT-PCR only in ERBs captured in the Moyamba District of Sierra Leone in the central region of the country. These findings represent a substantial range extension from East Africa to West Africa for SOSV, suggesting that this paramyxovirus may occur in ERB populations throughout its sub-Saharan African range. |
CDC recommendations for hepatitis C testing among perinatally exposed infants and children - United States, 2023
Panagiotakopoulos L , Sandul AL , Conners EE , Foster MA , Nelson NP , Wester C . MMWR Recomm Rep 2023 72 (4) 1-21 The elimination of hepatitis C is a national priority (https://www.hhs.gov/sites/default/files/Viral-Hepatitis-National-Strategic-Plan-2021-2025.pdf). During 2010-2021, hepatitis C virus (HCV) acute and chronic infections (hereinafter referred to as HCV infections) increased in the United States, consequences of which include cirrhosis, liver cancer, and death. Rates of acute infections more than tripled among reproductive-aged persons during this time (from 0.8 to 2.5 per 100,000 population among persons aged 20-29 years and from 0.6 to 3.5 among persons aged 30-39 years). Because acute HCV infection can lead to chronic infection, this has resulted in increasing rates of HCV infections during pregnancy. Approximately 6%-7% of perinatally exposed (i.e., exposed during pregnancy or delivery) infants and children will acquire HCV infection. Curative direct-acting antiviral therapy is approved by the Food and Drug Administration for persons aged ≥3 years. However, many perinatally infected children are not tested or linked to care. In 2020, because of continued increases in HCV infections in the United States, CDC released universal screening recommendations for adults, which included recommendations for screening for pregnant persons during each pregnancy (Schillie S, Wester C, Osborne M, Wesolowski L, Ryerson AB. CDC recommendations for hepatitis C screening among adults-United States, 2020. MMWR Recomm Rep 2020;69[No. RR-2]:1-17). This report introduces four new CDC recommendations: 1) HCV testing of all perinatally exposed infants with a nucleic acid test (NAT) for detection of HCV RNA at age 2-6 months; 2) consultation with a health care provider with expertise in pediatric hepatitis C management for all infants and children with detectable HCV RNA; 3) perinatally exposed infants and children with an undetectable HCV RNA result at or after age 2 months do not require further follow-up unless clinically warranted; and 4) a NAT for HCV RNA is recommended for perinatally exposed infants and children aged 7-17 months who previously have not been tested, and a hepatitis C virus antibody (anti-HCV) test followed by a reflex NAT for HCV RNA (when anti-HCV is reactive) is recommended for perinatally exposed children aged ≥18 months who previously have not been tested. Proper identification of perinatally infected children, referral to care, and curative treatment are critical to achieving the goal of hepatitis C elimination. |
Trends in heat related illness: Nationwide observational cohort at the US Department of Veteran Affairs
Osborne TF , Veigulis ZP , Vaidyanathan A , Arreola DM , Schramm PJ . J Clim Cha Health 2023 12 Introduction: Environmental heat can have a negative impact on health, leading to increased healthcare utilization, disability, and death. Specific clinical conditions, in combination with a global rise in temperature, may amplify the risk of heat related illnesses. Materials and Methods: We conducted a retrospective analysis of VA's national electronic health record database from January 1, 2002, through December 31, 2019. Heat related illness diagnoses were assessed for associations with patient demographics, comorbidities, and geographic residence at the time of a heat related illness diagnosis. Descriptive statistics, linear regression, and additive seasonal decomposition methods were utilized to assess risk factors and trends. Results: There were 33,114 documented cases of heat related illness, which impacted 28,039 unique patients, during our 18 year assessment period. Veterans were diagnosed with heat related illnesses in all 50 US states and there was an increase in the rate over time. The likelihood of heat related illnesses was greater for those with increased comorbidity burden. Rates increased for homeless Veterans in the first half of the assessment period, and then declined for the second half. Black, as well as American Indian/Alaska Native Veterans accounted for a greater proportion of heat related illnesses. Conclusion: There has been a statistically significant and clinically important increase in the incidence of heat related illnesses over time. There has also been an increased number of heat related diagnoses associated with existing health and demographic factors, and the increase over time did not strictly follow the expected geographic North-South climate trends. © 2023 |
Workplace supported recovery from substance use disorders: defining the construct, developing a model, and proposing an agenda for future research
Frone MR , Chosewood LC , Osborne JC , Howard JJ . Occup Health Sci 2022 6 (4) 475-511 Substance use disorders (SUDs) represent a critical public and occupational health issue. Therefore, understanding the process of SUD recovery has become an issue of growing importance among substance use and recovery professionals. Nonetheless, despite the acknowledged importance of employment for SUD recovery, little conceptual or empirical work exists on how the workplace might support or undermine SUD recovery. In this article, we address this limitation in several ways. First, to promote a better understanding of SUD recovery for occupational health researchers, we provide a brief overview of the nature of a SUD, prior definitions of SUD recovery, and general themes associated with the recovery process. Second, we develop a working definition of workplace supported recovery. Third, we present a heuristic conceptual model showing how the workplace might impact the SUD recovery process. Fourth, using this model and research from the substance use and occupational health literatures, we develop a series of general research propositions. These propositions highlight broad directions requiring more detailed conceptualization and empirical research to understand better how work conditions may support or undermine the process of employee SUD recovery. Our overarching goal is to motivate innovative conceptualization and research on workplace supported recovery from SUDs. Such research may inform the development and evaluation of workplace interventions and policies supporting SUD recovery and highlight the benefits of workplace supported SUD recovery for employees, employers, and communities. Research on this issue may allow occupational health researchers to impact a significant societal and occupational health issue. |
Improving water, sanitation, and hygiene (WASH), with a focus on hand hygiene, globally for community mitigation of COVID-19
Berendes D , Martinsen A , Lozier M , Rajasingham A , Medley A , Osborne T , Trinies V , Schweitzer R , Prentice-Mott G , Pratt C , Murphy J , Craig C , Lamorde M , Kesande M , Tusabe F , Mwaki A , Eleveld A , Odhiambo A , Ngere I , Kariuki Njenga M , Cordon-Rosales C , Contreras APG , Call D , Ramay BM , Ramm RES , Paulino CJT , Schnorr CD , Aubin M , Dumas D , Murray KO , Bivens N , Ly A , Hawes E , Maliga A , Morazan GH , Manzanero R , Morey F , Maes P , Diallo Y , Ilboudo M , Richemond D , Hattab OE , Oger PY , Matsuhashi A , Nsambi G , Antoine J , Ayebare R , Nakubulwa T , Vosburgh W , Boore A , Herman-Roloff A , Zielinski-Gutierrez E , Handzel T . PLOS Water 2022 1 (6) Continuity of key water, sanitation, and hygiene (WASH) infrastructure and WASH practices-for example, hand hygiene-are among several critical community preventive and mitigation measures to reduce transmission of infectious diseases, including COVID-19 and other respiratory diseases. WASH guidance for COVID-19 prevention may combine existing WASH standards and new COVID-19 guidance. Many existing WASH tools can also be modified for targeted WASH assessments during the COVID-19 pandemic. We partnered with local organizations to develop and deploy tools to assess WASH conditions and practices and subsequently implement, monitor, and evaluate WASH interventions to mitigate COVID-19 in low- and middle-income countries in Latin America and the Caribbean and Africa, focusing on healthcare, community institution, and household settings and hand hygiene specifically. Employing mixed-methods assessments, we observed gaps in access to hand hygiene materials specifically despite most of those settings having access to improved, often onsite, water supplies. Across countries, adherence to hand hygiene among healthcare providers was about twice as high after patient contact compared to before patient contact. Poor or non-existent management of handwashing stations and alcohol-based hand rub (ABHR) was common, especially in community institutions. Markets and points of entry (internal or external border crossings) represent congregation spaces, critical for COVID-19 mitigation, where globally-recognized WASH standards are needed. Development, evaluation, deployment, and refinement of new and existing standards can help ensure WASH aspects of community mitigation efforts that remain accessible and functional to enable inclusive preventive behaviors. |
Investigating Health Disparities Associated With Multisystem Inflammatory Syndrome in Children After SARS-CoV-2 Infection.
Zambrano LD , Ly KN , Link-Gelles R , Newhams MM , Akande M , Wu MJ , Feldstein LR , Tarquinio KM , Sahni LC , Riggs BJ , Singh AR , Fitzgerald JC , Schuster JE , Giuliano JSJr , Englund JA , Hume JR , Hall MW , Osborne CM , Doymaz S , Rowan CM , Babbitt CJ , Clouser KN , Horwitz SM , Chou J , Patel MM , Hobbs C , Randolph AG , Campbell AP . Pediatr Infect Dis J 2022 41 (11) 891-898 BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a postinfectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related complication that has disproportionately affected racial/ethnic minority children. We conducted a pilot study to investigate risk factors for MIS-C aiming to understand MIS-C disparities. METHODS: This case-control study included MIS-C cases and SARS-CoV-2-positive outpatient controls aged less than 18 years frequency-matched 4:1 to cases by age group and site. Patients hospitalized with MIS-C were admitted between March 16 and October 2, 2020, across 17 pediatric hospitals. We evaluated race, ethnicity, social vulnerability index (SVI), insurance status, weight-for-age and underlying medical conditions as risk factors using mixed effects multivariable logistic regression. RESULTS: We compared 241 MIS-C cases to 817 outpatient SARS-CoV-2-positive at-risk controls. Cases and controls had similar sex, age and U.S. census region distribution. MIS-C patients were more frequently previously healthy, non-Hispanic Black, residing in higher SVI areas, and in the 95th percentile or higher for weight-for-age. In the multivariable analysis, the likelihood of MIS-C was higher among non-Hispanic Black children [adjusted odds ratio (aOR): 2.07; 95% CI: 1.23-3.48]. Additionally, SVI in the 2nd and 3rd tertiles (aOR: 1.88; 95% CI: 1.18-2.97 and aOR: 2.03; 95% CI: 1.19-3.47, respectively) were independent factors along with being previously healthy (aOR: 1.64; 95% CI: 1.18-2.28). CONCLUSIONS: In this study, non-Hispanic Black children were more likely to develop MIS-C after adjustment for sociodemographic factors, underlying medical conditions, and weight-for-age. Investigation of the potential contribution of immunologic, environmental, and other factors is warranted. |
Violence against children: multifaceted approaches to a complex problem
Villaveces A , Viswanathan S . Int J Inj Contr Saf Promot 2022 29 (1) 1-2 In this issue of the Journal, we highlight the problem of violence against children globally. We conceptualized this process and the thematic focus and widely disseminated an invitation to submit manuscripts. Each of us took the lead editorial role in a group of manuscripts submitted for this issue. Dr. Viswanathan led the review process for manuscripts submitted by Moe et. al, Seff et. al., Couture et. al, Osborne et. al, Khan et. al., and Friedman et. al. Dr Villaveces led the reviews of Pendharkar et. al, Tang et. al, Ryan et. al, Bravo Sanzana et. al, Flynn O'Brien et. al., Silverman et. al., and Taliep et.al. We hope that readers will see the complexities related to violence against children and get a better sense of the global implications of this problem. |
Associations among age of first experience of violence, type of victimization, polyvictimization, and mental distress in Nigerian females
Lee N , Osborne M , Massetti G , Watson A , Self-Brown S . Violence Against Women 2021 28 2992-3012 This study explored associations of age of first victimization, sexual violence (SV), physical violence (PV), polyvictimization, and mental distress among females in Nigeria (n = 1,766, 13-24 years old) using the nationally representative 2014 Nigeria Violence Against Children Survey. Multinomial logistic regressions were performed. Nigerian females reporting SV victimization and polyvictimization were more likely to experience higher mental distress. The older the female was at the time of PV victimization, the greater the risk for mental distress. Violence is prevalent in Nigeria and its impact on youth's health is severe. However, evidence-based and data-driven policies and programs can reduce and prevent violence. |
Review of cannabis reimbursement by workers' compensation insurance in the U.S. and Canada
Howard J , Wurzelbacher S , Osborne J , Wolf J , Ruser J , Chadarevian R . Am J Ind Med 2021 64 (12) 989-1001 Changing public attitudes about cannabis consumption have currently led 36 U.S. states and the District of Columbia to approve laws that make cannabis available to consumers with qualifying medical conditions. This article reviews the 36 states and the District of Columbia with medical cannabis access laws to determine if the state or the District also allows reimbursement of the costs of cannabis for a work-related health condition under that state's or District's workers' compensation insurance (WCI) laws and administrative regulations. The legal basis for a state allowing or not allowing WCI reimbursement is described. The review found that only six of the 36 states expressly allow cannabis WCI reimbursement, six expressly prohibit it, 14 states do not require reimbursement, and 10 states, and the District of Columbia, are silent on the issue. The article describes the role of the insurer, treating physician, and worker in obtaining WCI reimbursement in the six states that expressly allow cannabis WCI reimbursement. Comparisons are made to how selected Canadian provinces and territories administer cannabis reimbursement under Canada's new national cannabis legalization law. The article discusses the future role of cannabis legalization in the United States and the evolving role of cannabis from an international perspective. |
NIOSH Responds to the U.S. Drug Overdose Epidemic.
Osborne JC , Chosewood LC . New Solut 2021 31 (3) 307-314 The United States is experiencing an evolving and worsening drug overdose epidemic. Although the rate of drug use among workers has remained relatively stable, the risk of overdose and death among drug users has not, as illicit drugs have increased in potency and lethality. The cumulative impacts of COVID-19 and the opioid crisis increase the likelihood of illness and death among workers with opioid use disorder. Workplaces represent a critical point of contact for people living in the United States who are struggling with or recovering from a substance use disorder, and employment is a vital source of recovery "capital." The benefits of addressing substance use in the workplace, supporting treatment, and employing workers in recovery are evident. The National Institute for Occupational Safety and Health has published research to inform policy and practice toward prevention efforts and has developed accessible resources and toolkits to support workers, employers, and workplaces in combatting the opioid overdose crisis and creating safer, healthier communities. |
Substance use and deaths by suicide: A latent class analysis of the National Violent Death Reporting System
Culbreth R , Swahn MH , Osborne M , Brandenberger K , Kota K . Prev Med 2021 150 106682 Substance use is strongly associated with suicide completions. However, little is known about the patterns of substances used in suicide deaths. The purpose of this analysis is to determine latent classes of toxicology-reported substances among individuals who completed suicide. The sample consists of suicide victims in the National Violent Death Reporting System (NVDRS) during years 2003-2017 (n = 202,838). Toxicology reports were used to construct latent class analyses of substance use among suicide victims. Correlates for latent class membership included sex, race/ethnicity, previous experiences of child abuse, homelessness, and intimate partner violence (IPV) victimization. The majority of suicide victims were male (77.7%), straight/heterosexual (99.5%) and white (88.3%). The final unconditional model yielded a four-class model, including a "No substance/single substance use" class, an "Alcohol and other substance" class, a "Marijuana and other substance" class, and an "Opiate use" class. Compared to the reference class of "No substance/single substance," females were more likely than males to be classified in the "Alcohol and other substance" class, the "Multi-substance use" class, and the "Opiate use" class. Homelessness was associated with classification in the "Marijuana and other substance" class and the "Opiate use" class compared to the "No substance/single substance" class. IPV was associated with both polysubstance use classes ("Alcohol plus other substance" and "Marijuana plus other substance") along with the "Opiate use" class compared to the "No substance/single substance" class. These classes highlight profiles of suicide descendants and emphasize the importance of polysubstance use prevention among females, homeless individuals, and those who experience IPV. |
Case Series of Laboratory-Associated Zika Virus Disease, United States, 2016-2019
Hills SL , Morrison A , Stuck S , Sandhu K , Mason KL , Stanek D , Gabel J , Osborne MA , Schroeder BA , Rico E , Drenzek CL , Gallagher GR , Fiddner J , Heberlein-Larson LA , Brown CM , Fischer M . Emerg Infect Dis 2021 27 (5) 1296-1300 Zika virus diagnostic testing and laboratory research increased considerably when Zika virus began spreading through the Americas in 2015, increasing the risk for potential Zika virus exposure of laboratory workers and biomedical researchers. We report 4 cases of laboratory-associated Zika virus disease in the United States during 2016-2019. Of these, 2 were associated with needlestick injuries; for the other 2 cases, the route of transmission was undetermined. In laboratories in which work with Zika virus is performed, good laboratory biosafety practices must be implemented and practiced to reduce the risk for infection among laboratory personnel. |
Cannabis and work: Need for more research
Howard J , Osborne J . Am J Ind Med 2020 63 (11) 963-972 Cannabis sativa is one of the oldest and most widely used plants in the world with a variety of industrial, medical, and nonmedical applications. Despite its long history, cannabis-derived products remain a source of controversy across the fields of medicine, law, and occupational safety and health. More favorable public attitudes about cannabis in the US have resulted in greater access to cannabis through legalization by states, leading to more consumption by workers. As more states adopt cannabis access laws, and as more workers choose to consume cannabis products, the implications for existing workplace policies, programs, and practices become more salient. Past workplace practices were grounded in a time when cannabis consumption was always viewed as problematic, considered a moral failing, and was universally illegal. Shifting cultural views and the changing legal status of cannabis indicate a need for research into the implications and challenges relating to cannabis and work. This commentary suggests research needs in the following areas: (a) data about industries and occupations where cannabis consumption among workers is most prevalent; (b) adverse health consequences of cannabis consumption among workers; (c) workplace supported recovery programs; (d) hazards to workers in the emerging cannabis industry; (e) relationship between cannabis consumption and occupational injuries; (f) ways to assess performance deficits and impairment from cannabis consumption; (g) consumption of synthetic cannabinoids to evade detection by drug testing; (h) cannabis consumption and its effect on occupational driving; and (i) ways to craft workplace policies and practices that take into consideration conflicting state and federal laws pertaining to cannabis. |
Violence victimization and negative health correlates of youth in post-earthquake Haiti: Findings from the cross-sectional violence against children survey
Lai BS , Osborne MC , De Veauuse-Brown N , Swedo EA , Self-Brown S , Massetti GM . J Affect Disord 2020 270 59-64 BACKGROUND: We examined the prevalence of and relationships between violence victimization and negative health correlates of Haitian youth exposed to the 2010 earthquake. METHODS: Participants were randomly selected 13-24 year-old youth (1457 females; 1459 males) living in Haiti following the 2010 earthquake. Data collected via Haiti's 2012 Violence against Children Survey (VACS) were analyzed. RESULTS: Participants reported violence victimization in the past 12 months (females: 49.93%; males: 41.68%), moderate-to-severe mental distress (females: 76.56%; males: 66.41%), and suicidal ideation (females: 26.79%; males: 8.05%). Compared to participants without experiences of violence, victims of violence had significantly higher mean number of sexual partners (females: 1.99, 95% CI: 1.81-2.16, p = .02; males: 4.33, 95% CI: 3.50-5.16, p = .03), mental distress (females: 80.39%, p = .01; males: 72.95%, p = .002), and suicidal ideation (females: 36.09%, p < .0001; males: 12.02%, p < .0001). Male victims of violence were more likely to have sex without a condom (26.02%, p = .01) and female victims of violence were more likely to report histories of STIs (28.04%, p = .01), when compared to participants without history of violence. LIMITATIONS: Data were collected via self-report. Disaster exposure experiences were not assessed. Analysis was correlational and did not control for potential confounding variables. CONCLUSIONS: Disaster-exposed youth endorsed high levels of violence victimization and negative health correlates. Earthquake survivors who experienced violence were more likely to report negative health correlates. Greater attention to downstream sequelae of natural disasters is needed. |
CDC recommendations for hepatitis C screening among adults - United States, 2020
Schillie S , Wester C , Osborne M , Wesolowski L , Ryerson AB . MMWR Recomm Rep 2020 69 (2) 1-17 Hepatitis C virus (HCV) infection is a major source of morbidity and mortality in the United States. HCV is transmitted primarily through parenteral exposures to infectious blood or body fluids that contain blood, most commonly through injection drug use. No vaccine against hepatitis C exists and no effective pre- or postexposure prophylaxis is available. More than half of persons who become infected with HCV will develop chronic infection. Direct-acting antiviral treatment can result in a virologic cure in most persons with 8-12 weeks of all-oral medication regimens. This report augments (i.e., updates and summarizes) previously published recommendations from CDC regarding testing for HCV infection in the United States (Smith BD, Morgan RL, Beckett GA, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR Recomm Rec 2012;61[No. RR-4]). CDC is augmenting previous guidance with two new recommendations: 1) hepatitis C screening at least once in a lifetime for all adults aged >/=18 years, except in settings where the prevalence of HCV infection is <0.1% and 2) hepatitis C screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection is <0.1%. The recommendation for HCV testing that remains unchanged is regardless of age or setting prevalence, all persons with risk factors should be tested for hepatitis C, with periodic testing while risk factors persist. Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks. |
Isolation of Angola-like Marburg virus from Egyptian rousette bats from West Africa
Amman BR , Bird BH , Bakarr IA , Bangura J , Schuh AJ , Johnny J , Sealy TK , Conteh I , Koroma AH , Foday I , Amara E , Bangura AA , Gbakima AA , Tremeau-Bravard A , Belaganahalli M , Dhanota J , Chow A , Ontiveros V , Gibson A , Turay J , Patel K , Graziano J , Bangura C , Kamanda ES , Osborne A , Saidu E , Musa J , Bangura D , Williams SMT , Wadsworth R , Turay M , Edwin L , Mereweather-Thompson V , Kargbo D , Bairoh FV , Kanu M , Robert W , Lungai V , Guetiya Wadoum RE , Coomber M , Kanu O , Jambai A , Kamara SM , Taboy CH , Singh T , Mazet JAK , Nichol ST , Goldstein T , Towner JS , Lebbie A . Nat Commun 2020 11 (1) 510 Marburg virus (MARV) causes sporadic outbreaks of severe Marburg virus disease (MVD). Most MVD outbreaks originated in East Africa and field studies in East Africa, South Africa, Zambia, and Gabon identified the Egyptian rousette bat (ERB; Rousettus aegyptiacus) as a natural reservoir. However, the largest recorded MVD outbreak with the highest case-fatality ratio happened in 2005 in Angola, where direct spillover from bats was not shown. Here, collaborative studies by the Centers for Disease Control and Prevention, Njala University, University of California, Davis USAID-PREDICT, and the University of Makeni identify MARV circulating in ERBs in Sierra Leone. PCR, antibody and virus isolation data from 1755 bats of 42 species shows active MARV infection in approximately 2.5% of ERBs. Phylogenetic analysis identifies MARVs that are similar to the Angola strain. These results provide evidence of MARV circulation in West Africa and demonstrate the value of pathogen surveillance to identify previously undetected threats. |
Clinical characteristics of enterovirus A71 neurological disease during an outbreak in children in Colorado, USA, in 2018: an observational cohort study
Messacar K , Spence-Davizon E , Osborne C , Press C , Schreiner TL , Martin J , Messer R , Maloney J , Burakoff A , Barnes M , Rogers S , Lopez AS , Routh J , Gerber SI , Oberste MS , Nix WA , Abzug MJ , Tyler KL , Herlihy R , Dominguez SR . Lancet Infect Dis 2019 20 (2) 230-239 BACKGROUND: In May, 2018, Children's Hospital Colorado noted an outbreak of enterovirus A71 (EV-A71) neurological disease. We aimed to characterise the clinical features of EV-A71 neurological disease during this outbreak. METHODS: In this retrospective observational cohort study, children (younger than 18 years) who presented to Children's Hospital Colorado (Aurora, CO, USA) between March 1 and November 30, 2018, with neurological disease (defined by non-mutually exclusive criteria, including meningitis, encephalitis, acute flaccid myelitis, and seizures) and enterovirus detected from any biological specimen were eligible for study inclusion. The clinical characteristics of children with neurological disease associated with EV-A71 were compared with those of children with neurological disease associated with other enteroviruses during the same period. To explore the differences in clinical presentation of acute flaccid myelitis, we also used a subgroup analysis to compare clinical findings in children with EV-A71-associated acute flaccid myelitis during the study period with these findings in those with enterovirus D68 (EV-D68)-associated acute flaccid myelitis at the same hospital between 2013 and 2018. FINDINGS: Between March 10 and Nov 10, 2018, 74 children presenting to Children's Hospital Colorado were found to have enterovirus neurological disease; EV-A71 was identified in 43 (58%) of these children. The median age of the children with EV-A71 neurological disease was 22.7 months (IQR 4.0-31.9), and most of these children were male (34 [79%] children). 40 (93%) children with EV-A71 neurological disease had findings suggestive of meningitis, 31 (72%) children showed evidence of encephalitis, and ten (23%) children met our case definition of acute flaccid myelitis. All children with EV-A71 disease had fever and 18 (42%) children had hand, foot, or mouth lesions at or before neurological onset. Children with EV-A71 disease were best differentiated from those with other enteroviruses (n=31) by the neurological findings of myoclonus, ataxia, weakness, and autonomic instability. Of the specimens collected from children with EV-A71, this enterovirus was detected in 94% of rectal, 79% of oropharyngeal, 56% of nasopharyngeal, and 20% of cerebrospinal fluid specimens. 39 (93%) of 42 children with EV-A71 neurological disease who could be followed up showed complete recovery by 1-2 months. Compared with children with EV-D68-associated acute flaccid myelitis, children with EV-A71-associated acute flaccid myelitis were younger, showed neurological onset earlier after prodromal symptom onset, had milder weakness, showed more rapid improvement, and were more likely to completely recover. INTERPRETATION: This outbreak of EV-A71 neurological disease, the largest reported in the Americas, was characterised by fever, myoclonus, ataxia, weakness, autonomic instability, and full recovery in most patients. Because EV-A71 epidemiology outside of Asia remains difficult to predict, identification of future outbreaks will be aided by prompt recognition of these distinct clinical findings, testing of non-sterile and sterile site specimens, and enhanced enterovirus surveillance. FUNDING: None. |
An open challenge to advance probabilistic forecasting for dengue epidemics.
Johansson MA , Apfeldorf KM , Dobson S , Devita J , Buczak AL , Baugher B , Moniz LJ , Bagley T , Babin SM , Guven E , Yamana TK , Shaman J , Moschou T , Lothian N , Lane A , Osborne G , Jiang G , Brooks LC , Farrow DC , Hyun S , Tibshirani RJ , Rosenfeld R , Lessler J , Reich NG , Cummings DAT , Lauer SA , Moore SM , Clapham HE , Lowe R , Bailey TC , Garcia-Diez M , Carvalho MS , Rodo X , Sardar T , Paul R , Ray EL , Sakrejda K , Brown AC , Meng X , Osoba O , Vardavas R , Manheim D , Moore M , Rao DM , Porco TC , Ackley S , Liu F , Worden L , Convertino M , Liu Y , Reddy A , Ortiz E , Rivero J , Brito H , Juarrero A , Johnson LR , Gramacy RB , Cohen JM , Mordecai EA , Murdock CC , Rohr JR , Ryan SJ , Stewart-Ibarra AM , Weikel DP , Jutla A , Khan R , Poultney M , Colwell RR , Rivera-Garcia B , Barker CM , Bell JE , Biggerstaff M , Swerdlow D , Mier YTeran-Romero L , Forshey BM , Trtanj J , Asher J , Clay M , Margolis HS , Hebbeler AM , George D , Chretien JP . Proc Natl Acad Sci U S A 2019 116 (48) 24268-24274 A wide range of research has promised new tools for forecasting infectious disease dynamics, but little of that research is currently being applied in practice, because tools do not address key public health needs, do not produce probabilistic forecasts, have not been evaluated on external data, or do not provide sufficient forecast skill to be useful. We developed an open collaborative forecasting challenge to assess probabilistic forecasts for seasonal epidemics of dengue, a major global public health problem. Sixteen teams used a variety of methods and data to generate forecasts for 3 epidemiological targets (peak incidence, the week of the peak, and total incidence) over 8 dengue seasons in Iquitos, Peru and San Juan, Puerto Rico. Forecast skill was highly variable across teams and targets. While numerous forecasts showed high skill for midseason situational awareness, early season skill was low, and skill was generally lowest for high incidence seasons, those for which forecasts would be most valuable. A comparison of modeling approaches revealed that average forecast skill was lower for models including biologically meaningful data and mechanisms and that both multimodel and multiteam ensemble forecasts consistently outperformed individual model forecasts. Leveraging these insights, data, and the forecasting framework will be critical to improve forecast skill and the application of forecasts in real time for epidemic preparedness and response. Moreover, key components of this project-integration with public health needs, a common forecasting framework, shared and standardized data, and open participation-can help advance infectious disease forecasting beyond dengue. |
Type F infant botulism: Investigation of recent clusters and overview of this exceedingly rare disease
Halpin AL , Khouri JM , Payne JR , Nakao JH , Cronquist A , Kalas N , Mohr M , Osborne M , O'Dell S , Luquez C , Klontz KC , Sobel J , Rao AK . Clin Infect Dis 2017 66 S92-s94 From 1976 to 2016, neurotoxigenic Clostridium baratii type F caused 18 (<0.5%) reported US infant botulism cases. Six cases occurred during 2012-2013; no common source was identified. Type F infant botulism mostly occurs in very young infants and typically presents more rapidly and severely than illness caused by types A and B botulinum neurotoxin. |
Exploration of factors predictive of at-risk fathers' participation in a pilot study of an augmented evidence-based parent training program: A mixed methods approach
Rostad WL , Self-Brown S , Boyd C Jr , Osborne M , Patterson A . Child Youth Serv Rev 2017 79 485-494 There has been burgeoning parenting intervention research specifically addressing fathers in recent decades. Corresponding research examining their participation and engagement in evidence-based parent training programs, which have almost exclusively targeted mothers, is just emerging. The current study used mixed methods to examine factors that influenced completion of an augmented version of an evidence-based child maltreatment prevention program developed for male caregivers called SafeCare Dad to Kids (Dad2K) in a pilot study. The current sample comprised 50 male caregivers (Mage = 29.42 years, SD = 8.18) of a child between the ages of 2 and 5 years. Fathers participated in a baseline assessment and were considered program completers (n = 27) if they participated in the program's six home visiting sessions. A subsample of completers (n = 11) was recruited to participate in qualitative interviews that provided in-depth information about fathers' experiences in Dad2K. Logistic regression indicated that, in the context of other demographic predictors, fathers with an education beyond high school were over 5 times more likely to complete Dad2K program compared to fathers with a high school education or less. Qualitative analyses revealed that interviewed father completers were motivated to enroll and participate in a fathering program because of an interest to learn and obtain skills to make them a better parent. Fathers with a high school education or less may require additional engagement strategies to help proactively encourage their enrollment and completion of parent training programs. |
Specimen Referral Network to Rapidly Scale-Up CD4 Testing: The Hub and Spoke Model for Haiti
Louis FJ , Osborne AJ , Elias VJ , Buteau J , Boncy J , Elong A , Dismer A , Sasi V , Domercant JW , Lauture D , Balajee SA , Marston BJ . J AIDS Clin Res 2015 6 (8) OBJECTIVES: Regular and quality CD4 testing is essential to monitor disease progression in people living with HIV. In Haiti, most laboratories have limited infrastructure and financial resources and have relied on manual laboratory techniques. We report the successful implementation of a national specimen referral network to rapidly increase patient coverage with quality CD4 testing while at the same time building infrastructure for referral of additional sample types over time. METHOD: Following a thorough baseline analysis of facilities, expected workload, patient volumes, cost of technology and infrastructure constraints at health institutions providing care to HIV patients, the Haitian National Public Health Laboratory designed and implemented a national specimen referral network. The specimen referral network was scaled up in a step-wise manner from July 2011 to July 2014. RESULTS: Fourteen hubs serving a total of 67 healthcare facilities have been launched; in addition, 10 healthcare facilities operate FACSCount machines, 21 laboratories operate PIMA machines, and 11 healthcare facilities are still using manual CD4 tests. The number of health institutions able to access automated CD4 testing has increased from 27 to 113 (315%). Testing volume increased 76% on average. The number of patients enrolled on ART at the first healthcare facilities to join the network increased 182% within 6 months following linkage to the network. Performance on external quality assessment was acceptable at all 14 hubs. CONCLUSION: A specimen referral network has enabled rapid uptake of quality CD4 testing, and served as a backbone to allow for other future tests to be scaled-up in a similar way. |
Epidemiologic Investigation of a Cluster of Neuroinvasive Bacillus cereus Infections in 5 Patients With Acute Myelogenous Leukemia.
Rhee C , Klompas M , Tamburini FB , Fremin BJ , Chea N , Epstein L , Halpin AL , Guh A , Gallen R , Coulliette A , Gee J , Hsieh C , Desjardins CA , Pedamullu CS , DeAngelo DJ , Manzo VE , Folkerth RD , Milner DA Jr , Pecora N , Osborne M , Chalifoux-Judge D , Bhatt AS , Yokoe DS . Open Forum Infect Dis 2015 2 (3) ofv096 BACKGROUND: Five neuroinvasive Bacillus cereus infections (4 fatal) occurred in hospitalized patients with acute myelogenous leukemia (AML) during a 9-month period, prompting an investigation by infection control and public health officials. METHODS: Medical records of case-patients were reviewed and a matched case-control study was performed. Infection control practices were observed. Multiple environmental, food, and medication samples common to AML patients were cultured. Multilocus sequence typing was performed for case and environmental B cereus isolates. RESULTS: All 5 case-patients received chemotherapy and had early-onset neutropenic fevers that resolved with empiric antibiotics. Fever recurred at a median of 17 days (range, 9-20) with headaches and abrupt neurological deterioration. Case-patients had B cereus identified in central nervous system (CNS) samples by (1) polymerase chain reaction or culture or (2) bacilli seen on CNS pathology stains with high-grade B cereus bacteremia. Two case-patients also had colonic ulcers with abundant bacilli on autopsy. No infection control breaches were observed. On case-control analysis, bananas were the only significant exposure shared by all 5 case-patients (odds ratio, 9.3; P = .04). Five environmental or food isolates tested positive for B cereus, including a homogenized banana peel isolate and the shelf of a kitchen cart where bananas were stored. Multilocus sequence typing confirmed that all case and environmental strains were genetically distinct. Multilocus sequence typing-based phylogenetic analysis revealed that the organisms clustered in 2 separate clades. CONCLUSIONS: The investigation of this neuroinvasive B cereus cluster did not identify a single point source but was suggestive of a possible dietary exposure. Our experience underscores the potential virulence of B cereus in immunocompromised hosts. |
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
Vos Theo , Flaxman Abraham D , Naghavi Mohsen , Lozano Rafael , Michaud Catherine , Ezzati Majid , Shibuya Kenji , Salomon Joshua A , Abdalla Safa , Aboyans Victor , Abraham Jerry , Ackerman Ilana , Aggarwal Rakesh , Ahn Stephanie Y , Ali Mohammed K , Alvarado Miriam , Anderson H Ross , Anderson Laurie M , Andrews Kathryn G , Atkinson Charles , Baddour Larry M , Bahalim Adil N , Barker-Collo Suzanne , Barrero Lope H , Bartels David H , Basanez Maria-Gloria , Baxter Amanda , Bell Michelle L , Benjamin Emelia J , Bennett Derrick , Bernabe Eduardo , Bhalla Kavi , Bhandari Bishal , Bikbov Boris , Bin Abdulhak Aref , Birbeck Gretchen , Black James A , Blencowe Hannah , Blore Jed D , Blyth Fiona , Bolliger Ian , Bonaventure Audrey , Boufous Soufiane , Bourne Rupert , Boussinesq Michel , Braithwaite Tasanee , Brayne Carol , Bridgett Lisa , Brooker Simon , Brooks Peter , Brugha Traolach S , Bryan-Hancock Claire , Bucello Chiara , Buchbinder Rachelle , Buckle Geoffrey , Budke Christine M , Burch Michael , Burney Peter , Burstein Roy , Calabria Bianca , Campbell Benjamin , Canter Charles E , Carabin Helene , Carapetis Jonathan , Carmona Loreto , Cella Claudia , Charlson Fiona , Chen Honglei , Cheng Andrew Tai-Ann , Chou David , Chugh Sumeet S , Coffeng Luc E , Colan Steven D , Colquhoun Samantha , Colson K Ellicott , Condon John , Connor Myles D , Cooper Leslie T , Corriere Matthew , Cortinovis Monica , de Vaccaro Karen Courville , Couser William , Cowie Benjamin C , Criqui Michael H , Cross Marita , Dabhadkar Kaustubh C , Dahiya Manu , Dahodwala Nabila , Damsere-Derry James , Danaei Goodarz , Davis Adrian , De Leo Diego , Degenhardt Louisa , Dellavalle Robert , Delossantos Allyne , Denenberg Julie , Derrett Sarah , Des Jarlais Don C , Dharmaratne Samath D , Dherani Mukesh , Diaz-Torne Cesar , Dolk Helen , Dorsey E Ray , Driscoll Tim , Duber Herbert , Ebel Beth , Edmond Karen , Elbaz Alexis , Ali Suad Eltahir , Erskine Holly , Erwin Patricia J , Espindola Patricia , Ewoigbokhan Stalin E , Farzadfar Farshad , Feigin Valery , Felson David T , Ferrari Alize , Ferri Cleusa P , Fevre Eric M , Finucane Mariel M , Flaxman Seth , Flood Louise , Foreman Kyle , Forouzanfar Mohammad H , Fowkes Francis Gerry R , Franklin Richard , Fransen Marlene , Freeman Michael K , Gabbe Belinda J , Gabriel Sherine E , Gakidou Emmanuela , Ganatra Hammad A , Garcia Bianca , Gaspari Flavio , Gillum Richard F , Gmel Gerhard , Gosselin Richard , Grainger Rebecca , Groeger Justina , Guillemin Francis , Gunnell David , Gupta Ramyani , Haagsma Juanita , Hagan Holly , Halasa Yara A , Hall Wayne , Haring Diana , Haro Josep Maria , Harrison James E , Havmoeller Rasmus , Hay Roderick J , Higashi Hideki , Hill Catherine , Hoen Bruno , Hoffman Howard , Hotez Peter J , Hoy Damian , Huang John J , Ibeanusi Sydney E , Jacobsen Kathryn H , James Spencer L , Jarvis Deborah , Jasrasaria Rashmi , Jayaraman Sudha , Johns Nicole , Jonas Jost B , Karthikeyan Ganesan , Kassebaum Nicholas , Kawakami Norito , Keren Andre , Khoo Jon-Paul , King Charles H , Knowlton Lisa Marie , Kobusingye Olive , Koranteng Adofo , Krishnamurthi Rita , Lalloo Ratilal , Laslett Laura L , Lathlean Tim , Leasher Janet L , Lee Yong Yi , Leigh James , Lim Stephen S , Limb Elizabeth , Lin John Kent , Lipnick Michael , Lipshultz Steven E , Liu Wei , Loane Maria , Ohno Summer Lockett , Lyons Ronan , Ma Jixiang , Mabweijano Jacqueline , MacIntyre Michael F , Malekzadeh Reza , Mallinger Leslie , Manivannan Sivabalan , Marcenes Wagner , March Lyn , Margolis David J , Marks Guy B , Marks Robin , Matsumori Akira , Matzopoulos Richard , Mayosi Bongani M , McAnulty John H , McDermott Mary M , McGill Neil , McGrath John , Medina-Mora Maria Elena , Meltzer Michele , Mensah George A , Merriman Tony R , Meyer Ana-Claire , Miglioli Valeria , Miller Matthew , Miller Ted R , Mitchell Philip B , Mocumbi Ana Olga , Moffitt Terrie E , Mokdad Ali A , Monasta Lorenzo , Montico Marcella , Moradi-Lakeh Maziar , Moran Andrew , Morawska Lidia , Mori Rintaro , Murdoch Michele E , Mwaniki Michael K , Naidoo Kovin , Nair M Nathan , Naldi Luigi , Narayan K M Venkat , Nelson Paul K , Nelson Robert G , Nevitt Michael C , Newton Charles R , Nolte Sandra , Norman Paul , Norman Rosana , O'Donnell Martin , O'Hanlon Simon , Olives Casey , Omer Saad B , Ortblad Katrina , Osborne Richard , Ozgediz Doruk , Page Andrew , Pahari Bishnu , Pandian Jeyaraj Durai , Rivero Andrea Panozo , Patten Scott B , Pearce Neil , Padilla Rogelio Perez , Perez-Ruiz Fernando , Perico Norberto , Pesudovs Konrad , Phillips David , Phillips Michael R , Pierce Kelsey , Pion Sebastien , Polanczyk Guilherme V , Polinder Suzanne , Pope C Arden 3rd , Popova Svetlana , Porrini Esteban , Pourmalek Farshad , Prince Martin , Pullan Rachel L , Ramaiah Kapa D , Ranganathan Dharani , Razavi Homie , Regan Mathilda , Rehm Jurgen T , Rein David B , Remuzzi Guiseppe , Richardson Kathryn , Rivara Frederick P , Roberts Thomas , Robinson Carolyn , De Leon Felipe Rodriguez , Ronfani Luca , Room Robin , Rosenfeld Lisa C , Rushton Lesley , Sacco Ralph L , Saha Sukanta , Sampson Uchechukwu , Sanchez-Riera Lidia , Sanman Ella , Schwebel David C , Scott James Graham , Segui-Gomez Maria , Shahraz Saeid , Shepard Donald S , Shin Hwashin , Shivakoti Rupak , Singh David , Singh Gitanjali M , Singh Jasvinder A , Singleton Jessica , Sleet David A , Sliwa Karen , Smith Emma , Smith Jennifer L , Stapelberg Nicolas J C , Steer Andrew , Steiner Timothy , Stolk Wilma A , Stovner Lars Jacob , Sudfeld Christopher , Syed Sana , Tamburlini Giorgio , Tavakkoli Mohammad , Taylor Hugh R , Taylor Jennifer A , Taylor William J , Thomas Bernadette , Thomson W Murray , Thurston George D , Tleyjeh Imad M , Tonelli Marcello , Towbin Jeffrey A , Truelsen Thomas , Tsilimbaris Miltiadis K , Ubeda Clotilde , Undurraga Eduardo A , van der Werf Marieke J , van Os Jim , Vavilala Monica S , Venketasubramanian N , Wang Mengru , Wang Wenzhi , Watt Kerrianne , Weatherall David J , Weinstock Martin A , Weintraub Robert , Weisskopf Marc G , Weissman Myrna M , White Richard A , Whiteford Harvey , Wiersma Steven T , Wilkinson James D , Williams Hywel C , Williams Sean R M , Witt Emma , Wolfe Frederick , Woolf Anthony D , Wulf Sarah , Yeh Pon-Hsiu , Zaidi Anita K M , Zheng Zhi-Jie , Zonies David , Lopez Alan D , Murray Christopher J L , Global Burden of Disease Study 2010 . Lancet 2013 380 (9859) 2163-96 BACKGROUND: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs). METHODS: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. FINDINGS: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0.37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. INTERPRETATION: Rates of YLDs per 100,000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world. FUNDING: Bill & Melinda Gates Foundation. |
A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
Lim Stephen S , Vos Theo , Flaxman Abraham D , Danaei Goodarz , Shibuya Kenji , Adair-Rohani Heather , Amann Markus , Anderson H Ross , Andrews Kathryn G , Aryee Martin , Atkinson Charles , Bacchus Loraine J , Bahalim Adil N , Balakrishnan Kalpana , Balmes John , Barker-Collo Suzanne , Baxter Amanda , Bell Michelle L , Blore Jed D , Blyth Fiona , Bonner Carissa , Borges Guilherme , Bourne Rupert , Boussinesq Michel , Brauer Michael , Brooks Peter , Bruce Nigel G , Brunekreef Bert , Bryan-Hancock Claire , Bucello Chiara , Buchbinder Rachelle , Bull Fiona , Burnett Richard T , Byers Tim E , Calabria Bianca , Carapetis Jonathan , Carnahan Emily , Chafe Zoe , Charlson Fiona , Chen Honglei , Chen Jian Shen , Cheng Andrew Tai-Ann , Child Jennifer Christine , Cohen Aaron , Colson K Ellicott , Cowie Benjamin C , Darby Sarah , Darling Susan , Davis Adrian , Degenhardt Louisa , Dentener Frank , Des Jarlais Don C , Devries Karen , Dherani Mukesh , Ding Eric L , Dorsey E Ray , Driscoll Tim , Edmond Karen , Ali Suad Eltahir , Engell Rebecca E , Erwin Patricia J , Fahimi Saman , Falder Gail , Farzadfar Farshad , Ferrari Alize , Finucane Mariel M , Flaxman Seth , Fowkes Francis Gerry R , Freedman Greg , Freeman Michael K , Gakidou Emmanuela , Ghosh Santu , Giovannucci Edward , Gmel Gerhard , Graham Kathryn , Grainger Rebecca , Grant Bridget , Gunnell David , Gutierrez Hialy R , Hall Wayne , Hoek Hans W , Hogan Anthony , Hosgood H Dean 3rd , Hoy Damian , Hu Howard , Hubbell Bryan J , Hutchings Sally J , Ibeanusi Sydney E , Jacklyn Gemma L , Jasrasaria Rashmi , Jonas Jost B , Kan Haidong , Kanis John A , Kassebaum Nicholas , Kawakami Norito , Khang Young-Ho , Khatibzadeh Shahab , Khoo Jon-Paul , Kok Cindy , Laden Francine , Lalloo Ratilal , Lan Qing , Lathlean Tim , Leasher Janet L , Leigh James , Li Yang , Lin John Kent , Lipshultz Steven E , London Stephanie , Lozano Rafael , Lu Yuan , Mak Joelle , Malekzadeh Reza , Mallinger Leslie , Marcenes Wagner , March Lyn , Marks Robin , Martin Randall , McGale Paul , McGrath John , Mehta Sumi , Mensah George A , Merriman Tony R , Micha Renata , Michaud Catherine , Mishra Vinod , Hanafiah Khayriyyah Mohd , Mokdad Ali A , Morawska Lidia , Mozaffarian Dariush , Murphy Tasha , Naghavi Mohsen , Neal Bruce , Nelson Paul K , Nolla Joan Miquel , Norman Rosana , Olives Casey , Omer Saad B , Orchard Jessica , Osborne Richard , Ostro Bart , Page Andrew , Pandey Kiran D , Parry Charles D H , Passmore Erin , Patra Jayadeep , Pearce Neil , Pelizzari Pamela M , Petzold Max , Phillips Michael R , Pope Dan , Pope C Arden 3rd , Powles John , Rao Mayuree , Razavi Homie , Rehfuess Eva A , Rehm Jurgen T , Ritz Beate , Rivara Frederick P , Roberts Thomas , Robinson Carolyn , Rodriguez-Portales Jose A , Romieu Isabelle , Room Robin , Rosenfeld Lisa C , Roy Ananya , Rushton Lesley , Salomon Joshua A , Sampson Uchechukwu , Sanchez-Riera Lidia , Sanman Ella , Sapkota Amir , Seedat Soraya , Shi Peilin , Shield Kevin , Shivakoti Rupak , Singh Gitanjali M , Sleet David A , Smith Emma , Smith Kirk R , Stapelberg Nicolas J C , Steenland Kyle , Stockl Heidi , Stovner Lars Jacob , Straif Kurt , Straney Lahn , Thurston George D , Tran Jimmy H , Van Dingenen Rita , van Donkelaar Aaron , Veerman J Lennert , Vijayakumar Lakshmi , Weintraub Robert , Weissman Myrna M , White Richard A , Whiteford Harvey , Wiersma Steven T , Wilkinson James D , Williams Hywel C , Williams Warwick , Wilson Nicholas , Woolf Anthony D , Yip Paul , Zielinski Jan M , Lopez Alan D , Murray Christopher J L , Ezzati Majid , Global Burden of Disease Study 2010 . Lancet 2013 380 (9859) 2224-60 BACKGROUND: Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. METHODS: We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. FINDINGS: In 2010, the three leading risk factors for global disease burden were high blood pressure (7.0% [95% uncertainty interval 6.2-7.7] of global DALYs), tobacco smoking including second-hand smoke (6.3% [5.5-7.0]), and alcohol use (5.5% [5.0-5.9]). In 1990, the leading risks were childhood underweight (7.9% [6.8-9.4]), household air pollution from solid fuels (HAP; 7.0% [5.6-8.3]), and tobacco smoking including second-hand smoke (6.1% [5.4-6.8]). Dietary risk factors and physical inactivity collectively accounted for 10.0% (95% UI 9.2-10.8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0.9% (0.4-1.6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. INTERPRETATION: Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children. FUNDING: Bill & Melinda Gates Foundation. |
Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
Murray Christopher J L , Vos Theo , Lozano Rafael , Naghavi Mohsen , Flaxman Abraham D , Michaud Catherine , Ezzati Majid , Shibuya Kenji , Salomon Joshua A , Abdalla Safa , Aboyans Victor , Abraham Jerry , Ackerman Ilana , Aggarwal Rakesh , Ahn Stephanie Y , Ali Mohammed K , Alvarado Miriam , Anderson H Ross , Anderson Laurie M , Andrews Kathryn G , Atkinson Charles , Baddour Larry M , Bahalim Adil N , Barker-Collo Suzanne , Barrero Lope H , Bartels David H , Basanez Maria-Gloria , Baxter Amanda , Bell Michelle L , Benjamin Emelia J , Bennett Derrick , Bernabe Eduardo , Bhalla Kavi , Bhandari Bishal , Bikbov Boris , Bin Abdulhak Aref , Birbeck Gretchen , Black James A , Blencowe Hannah , Blore Jed D , Blyth Fiona , Bolliger Ian , Bonaventure Audrey , Boufous Soufiane , Bourne Rupert , Boussinesq Michel , Braithwaite Tasanee , Brayne Carol , Bridgett Lisa , Brooker Simon , Brooks Peter , Brugha Traolach S , Bryan-Hancock Claire , Bucello Chiara , Buchbinder Rachelle , Buckle Geoffrey , Budke Christine M , Burch Michael , Burney Peter , Burstein Roy , Calabria Bianca , Campbell Benjamin , Canter Charles E , Carabin Helene , Carapetis Jonathan , Carmona Loreto , Cella Claudia , Charlson Fiona , Chen Honglei , Cheng Andrew Tai-Ann , Chou David , Chugh Sumeet S , Coffeng Luc E , Colan Steven D , Colquhoun Samantha , Colson K Ellicott , Condon John , Connor Myles D , Cooper Leslie T , Corriere Matthew , Cortinovis Monica , de Vaccaro Karen Courville , Couser William , Cowie Benjamin C , Criqui Michael H , Cross Marita , Dabhadkar Kaustubh C , Dahiya Manu , Dahodwala Nabila , Damsere-Derry James , Danaei Goodarz , Davis Adrian , De Leo Diego , Degenhardt Louisa , Dellavalle Robert , Delossantos Allyne , Denenberg Julie , Derrett Sarah , Des Jarlais Don C , Dharmaratne Samath D , Dherani Mukesh , Diaz-Torne Cesar , Dolk Helen , Dorsey E Ray , Driscoll Tim , Duber Herbert , Ebel Beth , Edmond Karen , Elbaz Alexis , Ali Suad Eltahir , Erskine Holly , Erwin Patricia J , Espindola Patricia , Ewoigbokhan Stalin E , Farzadfar Farshad , Feigin Valery , Felson David T , Ferrari Alize , Ferri Cleusa P , Fevre Eric M , Finucane Mariel M , Flaxman Seth , Flood Louise , Foreman Kyle , Forouzanfar Mohammad H , Fowkes Francis Gerry R , Fransen Marlene , Freeman Michael K , Gabbe Belinda J , Gabriel Sherine E , Gakidou Emmanuela , Ganatra Hammad A , Garcia Bianca , Gaspari Flavio , Gillum Richard F , Gmel Gerhard , Gonzalez-Medina Diego , Gosselin Richard , Grainger Rebecca , Grant Bridget , Groeger Justina , Guillemin Francis , Gunnell David , Gupta Ramyani , Haagsma Juanita , Hagan Holly , Halasa Yara A , Hall Wayne , Haring Diana , Haro Josep Maria , Harrison James E , Havmoeller Rasmus , Hay Roderick J , Higashi Hideki , Hill Catherine , Hoen Bruno , Hoffman Howard , Hotez Peter J , Hoy Damian , Huang John J , Ibeanusi Sydney E , Jacobsen Kathryn H , James Spencer L , Jarvis Deborah , Jasrasaria Rashmi , Jayaraman Sudha , Johns Nicole , Jonas Jost B , Karthikeyan Ganesan , Kassebaum Nicholas , Kawakami Norito , Keren Andre , Khoo Jon-Paul , King Charles H , Knowlton Lisa Marie , Kobusingye Olive , Koranteng Adofo , Krishnamurthi Rita , Laden Francine , Lalloo Ratilal , Laslett Laura L , Lathlean Tim , Leasher Janet L , Lee Yong Yi , Leigh James , Levinson Daphna , Lim Stephen S , Limb Elizabeth , Lin John Kent , Lipnick Michael , Lipshultz Steven E , Liu Wei , Loane Maria , Ohno Summer Lockett , Lyons Ronan , Mabweijano Jacqueline , MacIntyre Michael F , Malekzadeh Reza , Mallinger Leslie , Manivannan Sivabalan , Marcenes Wagner , March Lyn , Margolis David J , Marks Guy B , Marks Robin , Matsumori Akira , Matzopoulos Richard , Mayosi Bongani M , McAnulty John H , McDermott Mary M , McGill Neil , McGrath John , Medina-Mora Maria Elena , Meltzer Michele , Mensah George A , Merriman Tony R , Meyer Ana-Claire , Miglioli Valeria , Miller Matthew , Miller Ted R , Mitchell Philip B , Mock Charles , Mocumbi Ana Olga , Moffitt Terrie E , Mokdad Ali A , Monasta Lorenzo , Montico Marcella , Moradi-Lakeh Maziar , Moran Andrew , Morawska Lidia , Mori Rintaro , Murdoch Michele E , Mwaniki Michael K , Naidoo Kovin , Nair M Nathan , Naldi Luigi , Narayan K M Venkat , Nelson Paul K , Nelson Robert G , Nevitt Michael C , Newton Charles R , Nolte Sandra , Norman Paul , Norman Rosana , O'Donnell Martin , O'Hanlon Simon , Olives Casey , Omer Saad B , Ortblad Katrina , Osborne Richard , Ozgediz Doruk , Page Andrew , Pahari Bishnu , Pandian Jeyaraj Durai , Rivero Andrea Panozo , Patten Scott B , Pearce Neil , Padilla Rogelio Perez , Perez-Ruiz Fernando , Perico Norberto , Pesudovs Konrad , Phillips David , Phillips Michael R , Pierce Kelsey , Pion Sebastien , Polanczyk Guilherme V , Polinder Suzanne , Pope C Arden 3rd , Popova Svetlana , Porrini Esteban , Pourmalek Farshad , Prince Martin , Pullan Rachel L , Ramaiah Kapa D , Ranganathan Dharani , Razavi Homie , Regan Mathilda , Rehm Jurgen T , Rein David B , Remuzzi Guiseppe , Richardson Kathryn , Rivara Frederick P , Roberts Thomas , Robinson Carolyn , De Leon Felipe Rodriguez , Ronfani Luca , Room Robin , Rosenfeld Lisa C , Rushton Lesley , Sacco Ralph L , Saha Sukanta , Sampson Uchechukwu , Sanchez-Riera Lidia , Sanman Ella , Schwebel David C , Scott James Graham , Segui-Gomez Maria , Shahraz Saeid , Shepard Donald S , Shin Hwashin , Shivakoti Rupak , Singh David , Singh Gitanjali M , Singh Jasvinder A , Singleton Jessica , Sleet David A , Sliwa Karen , Smith Emma , Smith Jennifer L , Stapelberg Nicolas J C , Steer Andrew , Steiner Timothy , Stolk Wilma A , Stovner Lars Jacob , Sudfeld Christopher , Syed Sana , Tamburlini Giorgio , Tavakkoli Mohammad , Taylor Hugh R , Taylor Jennifer A , Taylor William J , Thomas Bernadette , Thomson W Murray , Thurston George D , Tleyjeh Imad M , Tonelli Marcello , Towbin Jeffrey A , Truelsen Thomas , Tsilimbaris Miltiadis K , Ubeda Clotilde , Undurraga Eduardo A , van der Werf Marieke J , van Os Jim , Vavilala Monica S , Venketasubramanian N , Wang Mengru , Wang Wenzhi , Watt Kerrianne , Weatherall David J , Weinstock Martin A , Weintraub Robert , Weisskopf Marc G , Weissman Myrna M , White Richard A , Whiteford Harvey , Wiebe Natasha , Wiersma Steven T , Wilkinson James D , Williams Hywel C , Williams Sean R M , Witt Emma , Wolfe Frederick , Woolf Anthony D , Wulf Sarah , Yeh Pon-Hsiu , Zaidi Anita K M , Zheng Zhi-Jie , Zonies David , Lopez Alan D , Global Burden of Disease Study 2010 . Lancet 2013 380 (9859) 2197-223 BACKGROUND: Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time. METHODS: We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights. FINDINGS: Global DALYs remained stable from 1990 (2.503 billion) to 2010 (2.490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. INTERPRETATION: Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results. FUNDING: Bill & Melinda Gates Foundation. |
Genomic comparison of Escherichia coli O104:H4 isolates from 2009 and 2011 reveals plasmid, and prophage heterogeneity, including shiga toxin encoding phage stx2.
Ahmed SA , Awosika J , Baldwin C , Bishop-Lilly KA , Biswas B , Broomall S , Chain PS , Chertkov O , Chokoshvili O , Coyne S , Davenport K , Detter JC , Dorman W , Erkkila TH , Folster JP , Frey KG , George M , Gleasner C , Henry M , Hill KK , Hubbard K , Insalaco J , Johnson S , Kitzmiller A , Krepps M , Lo CC , Luu T , McNew LA , Minogue T , Munk CA , Osborne B , Patel M , Reitenga KG , Rosenzweig CN , Shea A , Shen X , Strockbine N , Tarr C , Teshima H , van Gieson E , Verratti K , Wolcott M , Xie G , Sozhamannan S , Gibbons HS . PLoS One 2012 7 (11) e48228 In May of 2011, an enteroaggregative Escherichia coli O104:H4 strain that had acquired a Shiga toxin 2-converting phage caused a large outbreak of bloody diarrhea in Europe which was notable for its high prevalence of hemolytic uremic syndrome cases. Several studies have described the genomic inventory and phylogenies of strains associated with the outbreak and a collection of historical E. coli O104:H4 isolates using draft genome assemblies. We present the complete, closed genome sequences of an isolate from the 2011 outbreak (2011C-3493) and two isolates from cases of bloody diarrhea that occurred in the Republic of Georgia in 2009 (2009EL-2050 and 2009EL-2071). Comparative genome analysis indicates that, while the Georgian strains are the nearest neighbors to the 2011 outbreak isolates sequenced to date, structural and nucleotide-level differences are evident in the Stx2 phage genomes, the mer/tet antibiotic resistance island, and in the prophage and plasmid profiles of the strains, including a previously undescribed plasmid with homology to the pMT virulence plasmid of Yersinia pestis. In addition, multiphenotype analysis showed that 2009EL-2071 possessed higher resistance to polymyxin and membrane-disrupting agents. Finally, we show evidence by electron microscopy of the presence of a common phage morphotype among the European and Georgian strains and a second phage morphotype among the Georgian strains. The presence of at least two stx2 phage genotypes in host genetic backgrounds that may derive from a recent common ancestor of the 2011 outbreak isolates indicates that the emergence of stx2 phage-containing E. coli O104:H4 strains probably occurred more than once, or that the current outbreak isolates may be the result of a recent transfer of a new stx2 phage element into a pre-existing stx2-positive genetic background. |
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