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Pediatr Res
Get PDFBackgroundThe present study examined the association between 9/11-related adolescent behavioral problems on mental health outcomes in early adulthood.MethodsData from enrollees of the World Trade Center Health Registry who completed at least one adolescent (2006-2007 or 2011-2012) and adult survey (2011-2012 or 2015-2016) were analyzed. Adolescent behavioral difficulties were assessed using the adolescent-reported Strengths and Difficulties Questionnaire (SDQ). Adult mental health outcomes included: binge drinking; smoking status history; 9/11-related post-traumatic stress disorder (PTSD); depression; and the self-reported number of physician mental health diagnoses. Multivariable regression was used to estimate associations of SDQ with mental health outcomes.ResultsOf the 297 enrollees, 16.8% (n=50) had abnormal/borderline SDQ as an adolescent. Binge drinking was not associated with adolescent SDQ. Enrollees with abnormal/borderline SDQ as an adolescent were more likely to be a consistent smoker (odds ratio (OR): 5.6, 95% confidence interval (CI): 1.2-25.2), have probable PTSD (OR: 3.5, 95% CI: 1.3-9.8); depression (OR: 6.2, 95% CI: 2.7-13.9); and to have 2 or more self-reported physician diagnosed mental health conditions as an adult (OR 5.6, 95% CI: 2.0-12.5).ConclusionsThis study\u2019s findings underscore the need to intervene early with children exposed to traumatic events so as to avert later adolescent and adult problem behaviors.U50 OH009739/OH/NIOSH CDC HHS/United StatesU50 TS272750/TS/ATSDR CDC HHS/United StatesU50OH009739/ACL HHS/United States2019-02-01T00:00:00Z29907850PMC6185774vault:3097
Improving completeness and accuracy of data for elimination of mother-to-child transmission of HIV : tested changes and guidance from Uganda
Get PDFThe Ministry of Health with support from the United States President\u2019s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID), U.S. Centers for Disease Control and Prevention (CDC), USAID Applying Science to Strengthen and Improve Systems (ASSIST), Strengthening Partnerships, Results and Innovations in Nutrition Globally (SPRING), Food and Nutrition Technical Assistance III (FANTA III), the AIDS Support Organization (TASO), Strengthening the Tuberculosis and HIV/AIDS Response South West (STAR SW), and Strengthening the Tuberculosis and HIV/AIDS Response East Central (STAR EC), has been implementing the Partnership for HIV-Free Survival (PHFS) initiative since March 2013, when it was officially launched. The aim of this initiative is to ensure a well-nourished, healthy HIV-free baby, through implementation of eMTCT and nutrition interventions using the quality improvement approach. Among the objectives of this initiative was to generate best practices from implementing sites that can be scaled up to other health facilities in the same district and the country.phfs_data_quality_change_packagea4_oct2014.pdf201
PLoS One
Get PDFIntroductionAntiretroviral therapy reduces the risk of serious illness among people living with HIV and can prevent HIV transmission. We implemented a Test, Treat, and Prevent HIV Program among men who have sex with men (MSM) and transgender women at five hospitals in four provinces of Thailand to increase HIV testing, help those who test positive start antiretroviral therapy, and increase access to pre-exposure prophylaxis (PrEP).MethodsWe implemented rapid HIV testing and trained staff on immediate antiretroviral initiation at the five hospitals and offered PrEP at two hospitals. We recruited MSM and transgender women who walked-in to clinics and used a peer-driven intervention to expand recruitment. We used logistic regression to determine factors associated with prevalent HIV infection and the decision to start antiretroviral therapy and PrEP.ResultsDuring 2015 and 2016, 1880 people enrolled. Participants recruited by peers were younger (p<0.0001), less likely to be HIV-infected (p<0.0001), and those infected had higher CD4 counts (p = 0.04) than participants who walked-in to the clinics. Overall, 16% were HIV-positive: 18% of MSM and 9% of transgender women; 86% started antiretroviral therapy and 46% of eligible participants started PrEP. A higher proportion of participants at hospitals with one-stop HIV services started antiretroviral therapy than other hospitals. Participants who started PrEP were more likely to report sex with an HIV-infected partner (p = 0.002), receptive anal intercourse (p = 0.02), and receiving PrEP information from a hospital (p<0.0001).ConclusionsWe implemented a Test, Treat, and Prevent HIV Program offering rapid HIV testing and immediate access to antiretroviral therapy and PrEP. Peer-driven recruitment reached people at high risk of HIV and people early in HIV illness, providing an opportunity to promote HIV prevention services including PrEP and early antiretroviral therapy. Sites with one-stop HIV services had a higher uptake of antiretroviral therapy and PrEP.2018U2G GH000616/GH/CGH CDC HHS/United States30044867PMC60594771021
AIDS
Get PDF20182019-09-24T00:00:00ZK01 TW009488/TW/FIC NIH HHS/United StatesU54 CA190152/CA/NCI NIH HHS/United StatesP20 CA210285/CA/NCI NIH HHS/United StatesP30 CA016086/CA/NCI NIH HHS/United StatesU2G PS001965/PS/NCHHSTP CDC HHS/United StatesP30 AI050410/AI/NIAID NIH HHS/United StatesR21 CA180815/CA/NCI NIH HHS/United States30212407PMC6137810670
PLoS Negl Trop Dis
Get PDFIntroductionUnder the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted seven rounds of mass drug administration (MDA) from 2000\u20132006. The World Health Organization recommends systematic post-MDA surveillance using Transmission Assessment Surveys (TAS) for epidemiological assessment of recent LF transmission. We compared the effectiveness of two survey designs for post-MDA surveillance: a school-based survey of children aged 6\u20137 years, and a community-based survey targeting people aged 658 years.MethodsIn 2016, we conducted a systematic school-based TAS in all elementary schools (N = 29) and a cluster survey in 28 villages on the two main islands of American Samoa. We collected information on demographics and risk factors for infection using electronic questionnaires, and recorded geo-locations of schools and households. Blood samples were collected to test for circulating filarial antigen (CFA) using the Alere Filariasis Test Strip. For those who tested positive, we prepared slides for microscopic examination of microfilaria and provided treatment. Descriptive statistics were performed for questionnaire variables. Data were weighted and adjusted to account for sampling design and sex for both surveys, and for age in the community survey.ResultsThe school-based TAS (n = 1143) identified nine antigen-positive children and found an overall adjusted CFA prevalence of 0.7% (95% CI: 0.3\u20131.8). Of the nine positive children, we identified one microfilariaemic 7-year-old child. The community-based survey (n = 2507, 711 households) identified 102 antigen-positive people, and estimated an overall adjusted CFA prevalence of 6.2% (95% CI: 4.5\u20138.6). Adjusted village-level prevalence ranged from 0\u201347.1%. CFA prevalence increased with age and was higher in males. Of 86 antigen-positive community members from whom slides were prepared, 22 (25.6%) were microfilaraemic. School-based TAS had limited sensitivity (range 0\u201323.8%) and negative predictive value (range 25\u201383.3%) but had high specificity (range 83.3\u2013100%) and positive predictive value (range 0\u2013100%) for identifying villages with ongoing transmission.ConclusionsAmerican Samoa failed the school-based TAS in 2016, and the community-based survey identified higher than expected numbers of antigen-positive people. School-based TAS was logistically simpler and enabled sampling of a larger proportion of the target population, but the results did not provide a good indication of the overall CFA prevalence in older age groups and was not sensitive at identifying foci of ongoing transmission. The community-based survey, although operationally more challenging, identified antigen-positive individuals of all ages, and foci of high antigen prevalence. Both surveys confirmed recrudescence of LF transmission.201830011276PMC60621251021
Nutrients
Get PDFWe estimated iodine status (median urinary iodine concentration (mUIC (µg/L))) for the US population (6 years and over; | = 4613) and women of reproductive age (WRA) (15\u207b44 years; | = 901). We estimated mean intake of key iodine sources by race and Hispanic origin. We present the first national estimates of mUIC for non-Hispanic Asian persons and examine the intake of soy products, a potential source of goitrogens. One-third of National Health and Nutrition Examination Survey (NHANES) participants in 2011\u207b2014 provided casual urine samples; UIC was measured in these samples. We assessed dietary intake with one 24-h recall and created food groups using the USDA’s food/beverage coding scheme. For WRA, mUIC was 110 µg/L. For both non-Hispanic white (106 µg/L) and non-Hispanic Asian (81 µg/L) WRA mUIC was significantly lower than mUIC among Hispanic WRA (133 µg/L). Non-Hispanic black WRA had a mUIC of 124 µg/L. Dairy consumption was significantly higher among non-Hispanic white (162 g) compared to non-Hispanic black WRA (113 g). Soy consumption was also higher among non-Hispanic Asian WRA (18 g compared to non-Hispanic black WRA (1 g). Differences in the consumption pattern of key sources of iodine and goitrogens may put subgroups of individuals at risk of mild iodine deficiency. Continued monitoring of iodine status and variations in consumption patterns is needed
mSphere
Get PDFThere is increasing evidence that retail food may serve as a source of | that causes community-acquired urinary tract infections, but the impact of this source in a community is not known. We conducted a prospective, population-based study in one community to examine the frequency of recovery of uropathogenic | genotypes from retail meat samples. We analyzed | isolates from consecutively collected urine samples of patients suspected to have urinary tract infections (UTIs) at a university-affiliated health service and retail meat samples from the same geographic region. We genotyped all | isolates by multilocus sequence typing (MLST) and tested them for antimicrobial susceptibility. From 2016 to 2017, we cultured 233 | isolates from 230 (21%) of 1,087 urine samples and 177 | isolates from 120 (28%) of 427 retail meat samples. Urine samples contained 61 sequence types (STs), and meat samples had 95 STs; 12 STs (ST10, ST38, ST69, ST80, ST88, ST101, ST117, ST131, ST569, ST906, ST1844, and ST2562) were common to both. Thirty-five (81%) of 43 meat isolates among the 12 STs were from poultry. Among 94 isolates in the 12 STs, 26 (60%) of 43 retail meat isolates and 15 (29%) of 51 human isolates were pan-susceptible (| 0.005). We found that 21% of | isolates from suspected cases of UTIs belonged to STs found in poultry. Poultry may serve as a possible reservoir of uropathogenic | (UPEC). Additional studies are needed to demonstrate transmission pathways of these UPEC genotypes and their food sources.| Community-acquired urinary tract infection caused by | is one of the most common infectious diseases in the United States, affecting approximately seven million women and costing approximately 11.6 billion dollars annually. In addition, antibiotic resistance among | bacteria causing urinary tract infection continues to increase, which greatly complicates treatment. Identifying sources of uropathogenic | and implementing prevention measures are essential. However, the reservoirs of uropathogenic | have not been well defined. This study demonstrated that poultry sold in retail stores may serve as one possible source of uropathogenic | This finding adds to a growing body of evidence that suggests that urinary tract infection may be a food-borne disease. More research in this area can lead to the development of preventive strategies to control this common and costly infectious disease.30111626PMC609405
Congenit Heart Dis
Get PDFObjectiveTo examine the financial burdens and mental health needs of families of children with special healthcare needs (CSHCN) with congenital heart disease (CHD).MethodsData from the 2009\u20132010 National Survey of Children with Special Health Care Needs (NS-CSHCN) were used to examine parent-reported financial burdens (out-of-pocket expenses, financial problems, employment impact, caregiving hours) and family members\u2019 need for mental health services in families of CSHCN with CHD. Multivariable logistic regression was used to compare financial burdens and family members\u2019 need for mental health services among CSHCN with and without CHD. Among CSHCN with CHD, multivariable logistic regression, stratified by age (0-5 and 6\u201317 years), was used to assess characteristics associated with the outcomes.ResultsOverall, families of 89.1% of CSHCN with CHD experienced at least one financial burden and 14.9% needed mental health services due to the child\u2019s condition. Compared with CSHCN without CHD, those with CHD had families with a higher prevalence of all financial burdens (adjusted prevalence ratio [aPR] range: 1.4\u20131.8) and similar family member need for mental health services (aPR = 1.3, 95% CI [1.0, 1.6]). Across both age groups, insurance type, activity limitations, and comorbidities were significantly associated with financial burdens and/or family members\u2019 need for mental health services.ConclusionsCSHCN with CHD, compared with those without CHD, lived in families with more financial burdens. Interventions that reduce financial burdens and improve mental health of family members are needed, especially among CSHCN with CHD who are uninsured and have comorbidities or activity limitations.20182019-07-01T00:00:00ZCC999999/Intramural CDC HHS/United States29624879PMC6105538794
Salmonella surveillance report no. 30, October 28, 1964
No full textDuring September, 2,624 human isolations of salmonellae were reported, for an average weekly total of 525, an increase of 81 over the August figure.The percentage of Salmonella derby isolations reported continues to drop (Table VII). The percentage of jS. infant is recoveries increased to 16.2 which was more than triple last month's figure. This was due entirely to a large hospital-associated outbreak of salmonellosis in Philadelphia attributed to S. infantis.A total of 562 nonhuman isolations were reported in September, for an increase of 51 over last month.I. SUMMARY -- II. REPORTS OF ISOLATIONS FROM THE STATES -- III. CURRENT INVESTIGATIONS -- IV. REPORTS FROM STATES -- V. SPECIAL REPORTS -- VI. INTERNATIONAL -- VII. FOOD AND FEED SURVEILLANCE..196