Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Schweitzer B[original query] |
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Improved water, sanitation, hygiene and waste services in health-care facilities, Ukraine
Montgomery M , Vodianyk A , Piven N , Hayter A , Schweitzer R , Skapa T , Gordon B , Schmoll O . Bull World Health Organ 2025 103 (1) 66-70 PROBLEM: Water, sanitation and waste infrastructure and services in Ukrainian health-care facilities often fail to meet global and national standards, hindering the provision of safe, quality care. The war has worsened existing problems. APPROACH: To incrementally improve water, sanitation, hand hygiene, environmental cleaning and health-care waste practices, the World Health Organization (WHO) is working with the health ministry, the Ukrainian Public Health Centre and regional United States Centers for Disease Prevention and Control (CDC) to implement the Water and Sanitation for Health Facility Improvement Tool (WASH FIT). In December 2022, WHO trained staff from the regional CDC, Ukrainian Public Health Centre and nine priority health-care facilities. Facility teams assessed services, and developed and implemented improvement plans in January 2023. Follow-up assessments were conducted after six months. LOCAL SETTING: About 4300 health-care facilities operate in Ukraine. Funding for new water and sanitation infrastructure, as well as operating and maintaining existing services, is likely inadequate. RELEVANT CHANGES: After implementation, the average WASH FIT score increased from 66 out of a maximum of 100 (range: 57-73) to 83 (range: 69-93). Facilities more effectively managed water-related risks, replaced broken taps, improved waste management practices and installed backup water supply and storage sources. LESSONS LEARNT: WASH FIT can be used to identify gaps in water, sanitation, hygiene and waste services and track progress towards addressing these gaps. Engaged local leaders, health-based national water, sanitation, hygiene standards, regular on-site training and mentoring drive these improvements. Strengthening public health entities is critical to institutionalize the process. |
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. |
Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19.
Choudhary R , Webber BJ , Womack LS , Dupont HK , Chiu SK , Wanga V , Gerdes ME , Hsu S , Shi DS , Dulski TM , Idubor OI , Wendel AM , Agathis NT , Anderson K , Boyles T , Click ES , Silva JD , Evans ME , Gold JAW , Haston JC , Logan P , Maloney SA , Martinez M , Natarajan P , Spicer KB , Swancutt M , Stevens VA , Rogers-Brown J , Chandra G , Light M , Barr FE , Snowden J , Kociolek LK , McHugh M , Wessel DL , Simpson JN , Gorman KC , Breslin KA , DeBiasi RL , Thompson A , Kline MW , Boom JA , Singh IR , Dowlin M , Wietecha M , Schweitzer B , Morris SB , Koumans EH , Ko JY , Siegel DA , Kimball AA . Hosp Pediatr 2022 12 (9) 760-783 ![]() OBJECTIVES: To describe COVID-19-related pediatric hospitalizations during a period of B.1.617.2 (Delta) variant predominance and to determine age-specific factors associated with severe illness. PATIENTS AND METHODS: We abstracted data from medical charts to conduct a cross-sectional study of patients aged <21 years hospitalized at 6 US children's hospitals during July-August 2021 for COVID-19 or with an incidental positive SARS-CoV-2 test. Among patients with COVID-19, we assessed factors associated with severe illness by calculating age-stratified prevalence ratios (PR). We defined severe illness as receiving high-flow nasal cannula, positive airway pressure, or invasive mechanical ventilation. RESULTS: Of 947 hospitalized patients, 759 (80.1%) had COVID-19, of whom 287 (37.8%) had severe illness. Factors associated with severe illness included coinfection with RSV (PR 3.64) and bacteria (PR 1.88) in infants; RSV coinfection in patients aged 1-4 years (PR 1.96); and obesity in patients aged 5-11 (PR 2.20) and 12-17 years (PR 2.48). Having ≥2 underlying medical conditions was associated with severe illness in patients aged <1 (PR 1.82), 5-11 (PR 3.72), and 12-17 years (PR 3.19). CONCLUSIONS: Among patients hospitalized for COVID-19, factors associated with severe illness included RSV coinfection in those aged <5 years, obesity in those aged 5-17 years, and other underlying conditions for all age groups <18 years. These findings can inform pediatric practice, risk communication, and prevention strategies, including vaccination against COVID-19. |
Trends in Clinical Severity of Hospitalized Patients With Coronavirus Disease 2019-Premier Hospital Dataset, April 2020-April 2021.
Whitfield GP , Harris AM , Kadri SS , Warner S , Bamrah Morris S , Giovanni JE , Rogers-Brown JS , Hinckley AF , Kompaniyets L , Sircar KD , Yusuf HR , Koumans EH , Schweitzer BK . Open Forum Infect Dis 2022 9 (1) ofab599 ![]() BACKGROUND: Clinical severity of coronavirus disease 2019 (COVID-19) may vary over time; trends in clinical severity at admission during the pandemic among hospitalized patients in the United States have been incompletely described, so a historical record of severity over time is lacking. METHODS: We classified 466677 hospital admissions for COVID-19 from April 2020 to April 2021 into 4 mutually exclusive severity grades based on indicators present on admission (from most to least severe): Grade 4 included intensive care unit (ICU) admission and invasive mechanical ventilation (IMV); grade 3 included non-IMV ICU and/or noninvasive positive pressure ventilation; grade 2 included diagnosis of acute respiratory failure; and grade 1 included none of the above indicators. Trends were stratified by sex, age, race/ethnicity, and comorbid conditions. We also examined severity in states with high vs low Alpha (B.1.1.7) variant burden. RESULTS: Severity tended to be lower among women, younger adults, and those with fewer comorbidities compared to their counterparts. The proportion of admissions classified as grade 1 or 2 fluctuated over time, but these less-severe grades comprised a majority (75%-85%) of admissions every month. Grades 3 and 4 consistently made up a minority of admissions (15%-25%), and grade 4 showed consistent decreases in all subgroups, including states with high Alpha variant burden. CONCLUSIONS: Clinical severity among hospitalized patients with COVID-19 has varied over time but has not consistently or markedly worsened over time. The proportion of admissions classified as grade 4 decreased in all subgroups. There was no consistent evidence of worsening severity in states with higher vs lower Alpha prevalence. |
Characteristics and Clinical Outcomes of Children and Adolescents Aged <18 Years Hospitalized with COVID-19 - Six Hospitals, United States, July-August 2021.
Wanga V , Gerdes ME , Shi DS , Choudhary R , Dulski TM , Hsu S , Idubor OI , Webber BJ , Wendel AM , Agathis NT , Anderson K , Boyles T , Chiu SK , Click ES , Da Silva J , Dupont H , Evans M , Gold JAW , Haston J , Logan P , Maloney SA , Martinez M , Natarajan P , Spicer KB , Swancutt M , Stevens VA , Brown J , Chandra G , Light M , Barr FE , Snowden J , Kociolek LK , McHugh M , Wessel D , Simpson JN , Gorman KC , Breslin KA , DeBiasi RL , Thompson A , Kline MW , Bloom JA , Singh IR , Dowlin M , Wietecha M , Schweitzer B , Morris SB , Koumans EH , Ko JY , Kimball AA , Siegel DA . MMWR Morb Mortal Wkly Rep 2021 70 (5152) 1766-1772 During June 2021, the highly transmissible(†) B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19, became the predominant circulating strain in the United States. U.S. pediatric COVID-19-related hospitalizations increased during July-August 2021 following emergence of the Delta variant and peaked in September 2021.(§) As of May 12, 2021, CDC recommended COVID-19 vaccinations for persons aged ≥12 years,(¶) and on November 2, 2021, COVID-19 vaccinations were recommended for persons aged 5-11 years.** To date, clinical signs and symptoms, illness course, and factors contributing to hospitalizations during the period of Delta predominance have not been well described in pediatric patients. CDC partnered with six children's hospitals to review medical record data for patients aged <18 years with COVID-19-related hospitalizations during July-August 2021.(††) Among 915 patients identified, 713 (77.9%) were hospitalized for COVID-19 (acute COVID-19 as the primary or contributing reason for hospitalization), 177 (19.3%) had incidental positive SARS-CoV-2 test results (asymptomatic or mild infection unrelated to the reason for hospitalization), and 25 (2.7%) had multisystem inflammatory syndrome in children (MIS-C), a rare but serious inflammatory condition associated with COVID-19.(§§) Among the 713 patients hospitalized for COVID-19, 24.7% were aged <1 year, 17.1% were aged 1-4 years, 20.1% were aged 5-11 years, and 38.1% were aged 12-17 years. Approximately two thirds of patients (67.5%) had one or more underlying medical conditions, with obesity being the most common (32.4%); among patients aged 12-17 years, 61.4% had obesity. Among patients hospitalized for COVID-19, 15.8% had a viral coinfection(¶¶) (66.4% of whom had respiratory syncytial virus [RSV] infection). Approximately one third (33.9%) of patients aged <5 years hospitalized for COVID-19 had a viral coinfection. Among 272 vaccine-eligible (aged 12-17 years) patients hospitalized for COVID-19, one (0.4%) was fully vaccinated.*** Approximately one half (54.0%) of patients hospitalized for COVID-19 received oxygen support, 29.5% were admitted to the intensive care unit (ICU), and 1.5% died; of those requiring respiratory support, 14.5% required invasive mechanical ventilation (IMV). Among pediatric patients with COVID-19-related hospitalizations, many had severe illness and viral coinfections, and few vaccine-eligible patients hospitalized for COVID-19 were vaccinated, highlighting the importance of vaccination for those aged ≥5 years and other prevention strategies to protect children and adolescents from COVID-19, particularly those with underlying medical conditions. |
Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0-17 Years - United States, August 2020-August 2021.
Siegel DA , Reses HE , Cool AJ , Shapiro CN , Hsu J , Boehmer TK , Cornwell CR , Gray EB , Henley SJ , Lochner K , Suthar AB , Lyons BC , Mattocks L , Hartnett K , Adjemian J , van Santen KL , Sheppard M , Soetebier KA , Logan P , Martin M , Idubor O , Natarajan P , Sircar K , Oyegun E , Dalton J , Perrine CG , Peacock G , Schweitzer B , Morris SB , Raizes E . MMWR Morb Mortal Wkly Rep 2021 70 (36) 1249-1254 Although COVID-19 generally results in milder disease in children and adolescents than in adults, severe illness from COVID-19 can occur in children and adolescents and might require hospitalization and intensive care unit (ICU) support (1-3). It is not known whether the B.1.617.2 (Delta) variant,* which has been the predominant variant of SARS-CoV-2 (the virus that causes COVID-19) in the United States since late June 2021,(†) causes different clinical outcomes in children and adolescents compared with variants that circulated earlier. To assess trends among children and adolescents, CDC analyzed new COVID-19 cases, emergency department (ED) visits with a COVID-19 diagnosis code, and hospital admissions of patients with confirmed COVID-19 among persons aged 0-17 years during August 1, 2020-August 27, 2021. Since July 2021, after Delta had become the predominant circulating variant, the rate of new COVID-19 cases and COVID-19-related ED visits increased for persons aged 0-4, 5-11, and 12-17 years, and hospital admissions of patients with confirmed COVID-19 increased for persons aged 0-17 years. Among persons aged 0-17 years during the most recent 2-week period (August 14-27, 2021), COVID-19-related ED visits and hospital admissions in the states with the lowest vaccination coverage were 3.4 and 3.7 times that in the states with the highest vaccination coverage, respectively. At selected hospitals, the proportion of COVID-19 patients aged 0-17 years who were admitted to an ICU ranged from 10% to 25% during August 2020-June 2021 and was 20% and 18% during July and August 2021, respectively. Broad, community-wide vaccination of all eligible persons is a critical component of mitigation strategies to protect pediatric populations from SARS-CoV-2 infection and severe COVID-19 illness. |
Heartland Virus in Lone Star Ticks, Alabama, USA.
Newman BC , Sutton WB , Moncayo AC , Hughes HR , Taheri A , Moore TC , Schweitzer CJ , Wang Y . Emerg Infect Dis 2020 26 (8) 1954-1956 ![]() ![]() We detected Heartland virus (HRTV) in lone star nymphs collected in 2018 in northern Alabama, USA. Real-time reverse transcription PCR selective for the small segment of the HRTV genome and confirmatory sequencing of positive samples showed high identity with HRTV strains sequenced from Tennessee and Missouri. |
Detecting emerging infectious diseases: An overview of the Laboratory Response Network for Biological Threats
Villanueva J , Schweitzer B , Odle M , Aden T . Public Health Rep 2019 134 16s-21s The Laboratory Response Network (LRN) was established in 1999 to ensure an effective laboratory response to high-priority public health threats. The LRN for biological threats (LRN-B) provides a laboratory infrastructure to respond to emerging infectious diseases. Since 2012, the LRN-B has been involved in 3 emerging infectious disease outbreak responses. We evaluated the LRN-B role in these responses and identified areas for improvement. LRN-B laboratories tested 1097 specimens during the 2014 Middle East Respiratory Syndrome Coronavirus outbreak, 180 specimens during the 2014-2015 Ebola outbreak, and 92 686 specimens during the 2016-2017 Zika virus outbreak. During the 2014-2015 Ebola outbreak, the LRN-B uncovered important gaps in biosafety and biosecurity practices. During the 2016-2017 Zika outbreak, the LRN-B identified the data entry bottleneck as a hindrance to timely reporting of results. Addressing areas for improvement may help LRN-B reference laboratories improve the response to future public health emergencies. |
Hypertensive disorders in pregnancy and maternal and neonatal outcomes in Haiti: the importance of surveillance and data collection
Bridwell M , Handzel E , Hynes M , Jean-Louis R , Fitter D , Hogue C , Grand-Pierre R , Pierre H , Pearce B . BMC Pregnancy Childbirth 2019 19 (1) 208 BACKGROUND: This study aims to determine reported prevalence of hypertensive disorders in pregnancy (HDP) and maternal and neonatal outcomes associated with these disorders among women delivering at selected hospitals across Haiti. METHODS: A retrospective review of 8822 singleton deliveries between January 2012 and December 2014 was conducted at four hospitals in separate Departments across Haiti. Researchers examined the proportion of women with reported HDP (hypertension, preeclampsia, eclampsia) and the association between women with HDP and three neonatal outcomes: low birth weight, preterm birth, and stillbirths; and two maternal outcomes: placental abruption and maternal death in Hopital Albert Schweitzer (HAS). Odds ratios for associations between HDP and perinatal outcomes at HAS were assessed using logistic regression, adjusting for potential confounders. RESULTS: Of the 8822 singleton births included in the study, 510 (5.8%) had a reported HDP (including 285 (55.9%) preeclampsia, 119 (23.3%) eclampsia, and 106 (20.8%) hypertension). Prevalence of HDP among each hospital was: HAS (13.5%), Hopital Immaculee Conception des Cayes (HIC) (3.2%), Fort Liberte (4.3%), and Hopital Sacre Coeur de Milot (HSC) (3.0%). Among women at HAS with HDP, the adjusted odds of having a low birth weight baby was four times that of women without HDP (aOR 4.17, 95% CI 3.19-5.45), more than three times that for stillbirths (aOR 3.51, 95% CI 2.43-5.06), and five times as likely to result in maternal death (aOR 5.13, 95% CI 1.53-17.25). Among the three types of HDP, eclampsia was associated with the greatest odds of adverse events with five times the odds of having a low birth weight baby (aOR 5.00, 95% CI 2.84-8.79), six times the odds for stillbirths (aOR 6.34, 95% CI 3.40-11.82), and more than twelve times as likely to result in maternal death (aOR 12.70, 95% CI 2.33-69.31). CONCLUSIONS: A high prevalence of HDP was found among a cohort of Haitian mothers. HDP was associated with higher rates of adverse maternal and neonatal outcomes in HAS, which is comparable to studies of HDP conducted in high-income countries. |
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