scholarly journals Validation of population‐level HIV‐1 incidence estimation by cross‐sectional incidence assays in the HPTN 071 (PopART) trial

2021 ◽  
Vol 24 (12) ◽  
Author(s):  
Ethan Klock ◽  
Ethan Wilson ◽  
Reinaldo E. Fernandez ◽  
Estelle Piwowar‐Manning ◽  
Ayana Moore ◽  
...  
Keyword(s):  
Population Level ◽  
Cross Sectional ◽  
Incidence Estimation ◽  
Hiv 1

scholarly journals Performance of the Maxim and Sedia Limiting Antigen Avidity assays for population-level HIV incidence surveillance

2019 ◽  
Author(s):  
Joseph B. Sempa ◽  
Alex Welte ◽  
Michael P. Busch ◽  
Jake Hall ◽  
Dylan Hampton ◽  
...  
Keyword(s):  
Viral Load ◽  
Population Level ◽  
Performance Characteristics ◽  
Recent Infection ◽  
Cross Sectional ◽  
Repeat Testing ◽  
Incidence Estimation ◽  
Treatment Naïve ◽  
Context Specific ◽  
Hiv 1

AbstractBackgroundTwo manufacturers, Maxim Biomedical and Sedia Biosciences Corporation, supply US CDC-approved versions of the HIV-1 Limiting Antigen Avidity EIA (LAg assay) for detecting ‘recent’ HIV infection in cross-sectional incidence estimation. This study assesses and compares the performance of the Maxim and Sedia LAg assays for incidence surveillance.MethodsWe ran both assays on a panel of 2,500 well-characterized HIV-1-infected specimens, most with estimated dates of (detectable) infection. We analysed concordance of assay results, assessed reproducibility using repeat testing and estimated the critical performance characteristics of a test for recent infection—mean duration of recent infection (MDRI) and false-recent rate (FRR)—for a range of normalized optical density (ODn) recency discrimination thresholds, alone and in combination with viral load thresholds. We further defined three hypothetical surveillance scenarios and evaluated overall performance for incidence surveillance, defined as the precision of incidence estimates, by estimating context-specific performance characteristics.ResultsThe Maxim assay produced lower ODn values than the Sedia assay on average, largely as a result of higher calibrator readings (mean calibrator OD of 0.749 vs. 0.643). Correlation of non-normalized OD readings was greater (R2 = 0.938) than those of ODn readings (R2 = 0.908), and the slope was closer to unity (1.054 vs. 0.899). Reproducibility of repeat testing of three blinded control specimens (25 replicates each) was slightly better for the Maxim assay (CV 8.9% to 14.8% vs. 13.2% to 15.0%). The MDRI of a Maxim-based algorithm at the ‘standard’ recency discrimination threshold in combination with viral load (ODn ≤1.5 & VL >1,000) was 201 days (95% CI: 180,223) and for Sedia was 171 days (95% CI: 152,191). Commensurately, the Maxim algorithm had a higher FRR in treatment-naive subjects (1.7% vs. 1.1%). We observed statistically significant differences in MDRI using the ODn alone (≤1.5) and in combination with viral load (>1,000). Under three fully-specified hypothetical surveillance scenarios (comparable to South Africa, Kenya and a concentrated epidemic), recent infection testing algorithms based on the two assays produced similar precision of incidence estimates.ConclusionsDifferences in ODn measurements between the Maxim and Sedia LAg assays on the same specimens largely resulted from differences in the reactivity of calibrators supplied by the manufacturers. Performance for surveillance purposes was extremely similar, although different ODn thresholds were optimal and different values of MDRI and FRR were appropriate for use in survey planning and incidence estimation.

scholarly journals Evaluation of multi-assay algorithms for identifying individuals with recent HIV infection: HPTN 071 (PopART)

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0258644
Author(s):  
Wendy Grant-McAuley ◽  
Ethan Klock ◽  
Oliver Laeyendecker ◽  
Estelle Piwowar-Manning ◽  
Ethan Wilson ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Point Of Care ◽  
Population Level ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Individual Level ◽  
Viral Loads ◽  
Incidence Estimation ◽  
Duration Of Infection ◽  
Recent Hiv Infection

Background Assays and multi-assay algorithms (MAAs) have been developed for population-level cross-sectional HIV incidence estimation. These algorithms use a combination of serologic and/or non-serologic biomarkers to assess the duration of infection. We evaluated the performance of four MAAs for individual-level recency assessments. Methods Samples were obtained from 220 seroconverters (infected <1 year) and 4,396 non-seroconverters (infected >1 year) enrolled in an HIV prevention trial (HPTN 071 [PopART]); 28.6% of the seroconverters and 73.4% of the non-seroconverters had HIV viral loads ≤400 copies/mL. Samples were tested with two laboratory-based assays (LAg-Avidity, JHU BioRad-Avidity) and a point-of-care assay (rapid LAg). The four MAAs included different combinations of these assays and HIV viral load. Seroconverters on antiretroviral treatment (ART) were identified using a qualitative multi-drug assay. Results The MAAs identified between 54 and 100 (25% to 46%) of the seroconverters as recently-infected. The false recent rate of the MAAs for infections >2 years duration ranged from 0.2%-1.3%. The MAAs classified different overlapping groups of individuals as recent vs. non-recent. Only 32 (15%) of the 220 seroconverters were classified as recent by all four MAAs. Viral suppression impacted the performance of the two LAg-based assays. LAg-Avidity assay values were also lower for seroconverters who were virally suppressed on ART compared to those with natural viral suppression. Conclusions The four MAAs evaluated varied in sensitivity and specificity for identifying persons infected <1 year as recently infected and classified different groups of seroconverters as recently infected. Sensitivity was low for all four MAAs. These performance issues should be considered if these methods are used for individual-level recency assessments.

scholarly journals Modeling Hearing Loss Progression and Asymmetry in the Older Old: A National Population-Based Survey

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 214-215
Author(s):  
Rahul Sharma ◽  
Anil Lalwani ◽  
Justin Golub
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Population Level ◽  
Population Based ◽  
National Database ◽  
Cross Sectional ◽  
Adult Lifespan ◽  
Pure Tone Average ◽  
Age Related ◽  
Public Datasets

Abstract The progression and asymmetry of age-related hearing loss has not been well characterized in those 80 years of age and older because public datasets mask upper extremes of age to protect anonymity. We aimed to model the progression and asymmetry of hearing loss in the older old using a representative, national database. This was a cross-sectional, multicentered US epidemiologic analysis using the National Health and Nutrition Examination Study (NHANES) 2005-2006, 2009-2010, and 2011-2012 cycles. Subjects included non-institutionalized, civilian adults 80 years and older (n=621). Federal security clearance was granted to access publicly-restricted age data. Outcome measures included pure-tone average air conduction thresholds and the 4-frequency pure tone average (PTA). 621 subjects were 80 years old or older (mean=84.2 years, range=80-104 years), representing 10,600,197 Americans. Hearing loss exhibited constant acceleration across the adult lifespan at a rate of 0.0052 dB/year2 (95% CI = 0.0049, 0.0055). Compounded over a lifetime, the velocity of hearing loss would increase five-fold, from 0.2 dB loss/year at age 20 to 1 dB loss/year at age 100. This model predicted mean PTA within 2 dB of accuracy for most ages between 20 and 100 years. There was no change in the asymmetry of hearing loss with increasing age over 80 years (linear regression coefficient of asymmetry over age=0.07 (95% CI=-0.01, 0.24). In conclusion, hearing loss steadily and predictably accelerates across the adult lifespan to at least age 100, becoming near-universal. These population-level statistics will guide treatment and policy recommendations for hearing health in the older old.

scholarly journals Recall of government healthy eating campaigns by consumers in five countries

2021 ◽  
pp. 1-31
Author(s):  
Samantha Goodman ◽  
Gabriela Armendariz ◽  
Adele Corkum ◽  
Laura Arellano ◽  
Alejandra Jáuregui ◽  
...  
Keyword(s):  
Healthy Eating ◽  
Fruits And Vegetables ◽  
Food Policy ◽  
Logistic Models ◽  
Population Level ◽  
Policy Study ◽  
Cross Sectional ◽  
Sugary Drinks ◽  
Income Adequacy ◽  
Low Education

ABSTRACT Objective: To examine awareness and recall of healthy eating public education campaigns in five countries. Design: Data were cross-sectional and collected as part of the 2018 International Food Policy Study. Respondents were asked whether they had seen government healthy eating campaigns in the past year; if yes (awareness), they were asked to describe the campaign. Open-ended descriptions were coded to indicate recall of specific campaigns. Logistic models regressed awareness of healthy eating campaigns on participant country, age, sex, ethnicity, education, income adequacy and BMI. Analyses were also stratified by country. Setting: Online surveys. Participants: Participants were Nielsen panelists aged ≥18 years in Australia, Canada, Mexico, UK and US (n=22,463). Results: Odds of campaign awareness were higher in Mexico (50.9%) than UK (18.2%), Australia (17.9%), US (13.0%) and Canada (10.2%) (P<0.001). Awareness was also higher in UK and Australia versus Canada and US, and US versus Canada (P<0.001). Overall, awareness was higher among males versus females and respondents with medium or high versus low education (P<0.001 for all). Similar results were found in stratified models, although no sex difference was observed in Australia or UK (P>0.05), and age was associated with campaign awareness in UK (P<0.001). Common key words in all countries included sugar/sugary drinks, fruits and vegetables, and physical activity. The top five campaigns recalled were Chécate, mídete, muévete (Mexico), PrevenIMSS (Mexico), Change4Life (UK), LiveLighter® (Australia), and Actívate, Vive Mejor (Mexico). Conclusions: In Mexico, UK and Australia, comprehensive campaigns to promote healthy lifestyles appear to have achieved broad, population-level reach.

scholarly journals Factors Influencing HIV Drug Resistance among Pregnant Women in Luanda, Angola: Findings from a Cross-Sectional Study

2021 ◽  
Vol 6 (1) ◽  
pp. 29
Author(s):  
Cruz S. Sebastião ◽  
Joana Morais ◽  
Miguel Brito
Keyword(s):  
Drug Resistance ◽  
Pregnant Women ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Drug Resistant ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hiv Drug Resistance ◽  
Hiv 1 ◽  
High Educational

The increase in HIV infection and drug-resistant strains is an important public health concern, especially in resource-limited settings. However, the identification of factors related to the propagation of infectious diseases represents a crucial target offering an opportunity to reduce health care costs as well as deepening the focus on preventing infection in high-risk groups. In this study, we investigate the factors related to drug resistance among HIV-infected pregnant women in Luanda, the capital city of Angola. This was a part of a cross-sectional study conducted with 42 HIV-positive pregnant women. A blood sample was collected, and HIV-1 genotyping was carried out using an in-house method. Multivariate analyses were performed to determine the interaction between sociodemographic characteristics and drug resistance. HIV drug resistance was detected in 44.1% of the studied population. High probabilities of drug resistance were observed for HIV-infected pregnant women living in rural areas (AOR: 2.73; 95% CI: 0.50–14.9) with high educational level (AOR: 6.27; 95% CI: 0.77–51.2) and comorbidities (AOR: 5.47; 95% CI: 0.28–106) and infected with a HIV-1 non-B subtype other than subtype C (AOR: 1.60; 95% CI: 0.25–10.3). The present study reports high HIV drug resistance. Furthermore, older-age, rural areas, high educational levels, unemployed status, having comorbidities, and HIV-1 subtypes were factors related to drug resistance. These factors impact on drug susceptibility and need to be urgently addressed in order to promote health education campaigns able to prevent the spread of drug-resistant HIV strains in Angola.

scholarly journals Examining the Effects of the Sacramento Dockless E-Bike Share on Bicycling and Driving

2021 ◽  
Vol 13 (1) ◽  
pp. 368
Author(s):  
Dillon T. Fitch ◽  
Hossain Mohiuddin ◽  
Susan L. Handy
Keyword(s):  
Travel Behavior ◽  
Regression Models ◽  
Population Level ◽  
Panel Survey ◽  
Multilevel Regression ◽  
Combine Data ◽  
Cross Sectional ◽  
Individual Level ◽  
Before And After ◽  
Bike Share

One way cities are looking to promote bicycling is by providing publicly or privately operated bike-share services, which enable individuals to rent bicycles for one-way trips. Although many studies have examined the use of bike-share services, little is known about how these services influence individual-level travel behavior more generally. In this study, we examine the behavior of users and non-users of a dockless, electric-assisted bike-share service in the Sacramento region of California. This service, operated by Jump until suspended due to the coronavirus pandemic, was one of the largest of its kind in the U.S., and spanned three California cities: Sacramento, West Sacramento, and Davis. We combine data from a repeat cross-sectional before-and-after survey of residents and a longitudinal panel survey of bike-share users with the goal of examining how the service influenced individual-level bicycling and driving. Results from multilevel regression models suggest that the effect of bike-share on average bicycling and driving at the population level is likely small. However, our results indicate that people who have used-bike share are likely to have increased their bicycling because of bike-share.

scholarly journals Potential value of the current mental health monitoring of children in state care in England

BJPsych Open ◽  
2018 ◽  
Vol 4 (6) ◽  
pp. 486-491 ◽  
Author(s):  
Christine Cocker ◽  
Helen Minnis ◽  
Helen Sweeting
Keyword(s):  
Mental Health ◽  
Missing Data ◽  
Mental Health Problems ◽  
Population Level ◽  
Cross Sectional ◽  
Data Set ◽  
Looked After Children ◽  
Education Data ◽  
Sample Attrition ◽  
Aggregate Population

BackgroundRoutine screening to identify mental health problems in English looked-after children has been conducted since 2009 using the Strengths and Difficulties Questionnaire (SDQ).AimsTo investigate the degree to which data collection achieves screening aims (identifying scale of problem, having an impact on mental health) and the potential analytic value of the data set.MethodDepartment for Education data (2009–2017) were used to examine: aggregate, population-level trends in SDQ scores in 4/5- to 16/17-year-olds; representativeness of the SDQ sample; attrition in this sample.ResultsMean SDQ scores (around 50% ‘abnormal’ or ‘borderline’) were stable over 9 years. Levels of missing data were high (25–30%), as was attrition (28% retained for 4 years). Cross-sectional SDQ samples were not representative and longitudinal samples were biased.ConclusionsMental health screening appears justified and the data set has research potential, but the English screening programme falls short because of missing data and inadequate referral routes for those with difficulties.Declaration of interestNone.

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