scholarly journals 2497

2017 ◽  
Vol 1 (S1) ◽  
pp. 81-81
Author(s):  
Rebecca Duron ◽  
Michael Mugavero ◽  
Andrew Westfall
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Medical Care ◽  
Surveillance Data ◽  
Hiv Care ◽  
Primary Care Visit ◽  
Care Visit ◽  
Retention In Hiv Care ◽  
State Surveillance ◽  
Status Of Care

OBJECTIVES/SPECIFIC AIMS: Approximately 50% of people who have been diagnosed with HIV are either not linked to a care provider or not retained in medical care. This has substantial implications for both individual and public health outcomes. On an individual level, being retained in care is necessary for continuous receipt of antiretroviral therapy and sustained viral suppression. The public health implications of poor retention in HIV care are also serious, as it is estimated that people with HIV who are not retained in medical care are responsible for a majority of HIV transmissions, even more than the number of transmissions attributable to those who are HIV infected but undiagnosed. State departments of health routinely collect surveillance data including positive HIV test results, CD4 counts and viral load measures for monitoring trends in HIV infection. A shift in the use of these surveillance measures, guided by the CDC, has brought forth the opportunity to use these data for direct patient services and, more specifically, to direct re-engagement and retention in care efforts. Although the risk factors for poor retention in HIV care have been characterized using information from individual or multiple clinics, this study seeks to incorporate state surveillance data into the retention measures. METHODS/STUDY POPULATION: This retrospective cohort study was performed at the University of Alabama at Birmingham 1917 HIV/AIDS Clinic among patients with at least one attended HIV primary care visit during the calendar year of 2015. Retention during the calendar year of 2016 was then measured as whether or not a patient had 2 or more completed clinic visits which were separated by more than 90 days (in accordance with the Health Resources and Services Administration or HRSA guidelines, a National HIV Quality Indicator). For patients who did not have any primary care visit in 2016, the Alabama Department of Public Health will provide a status of care (out of care, in care elsewhere, died, moved out of state, and cannot locate) based on HIV laboratory results reported from all clinics and labs across the state and/or mortality information. A multinominal regression model of the status of care will be fitted to demographic, clinical, laboratory, and behavioral patient reported outcomes captured during an index visit in 2015. RESULTS/ANTICIPATED RESULTS: Data were recently obtained and is currently being analyzed on 3107 patients included in this study. We anticipate that there will be differences in the factors significantly associated with patients classified as out of care, poorly retained (patients who have only one completed clinic visit), and retained in care by the HRSA measure during calendar year 2016. DISCUSSION/SIGNIFICANCE OF IMPACT: By incorporating state surveillance data into our analysis, we expect to obtain a more precise picture of the risk factors for poor retention among HIV patients. For the first time, we will be able to determine if patients lost to our HIV clinic (~10% annually) are entirely lost to medical care or are seeking care elsewhere as indicated by HIV lab data reported to public health via surveillance. Identified risk factors will then be able to better inform the efforts to proactively improve the efficiency for HIV patient retention and re-engagement, and therefore lead to better individual outcomes for HIV patients and reduce the incidence of new HIV cases.

scholarly journals Population-Based Assessment of Clinical Risk Factors for Legionnaires’ Disease

2019 ◽  
Vol 70 (11) ◽  
pp. 2428-2431
Author(s):  
Laura A Cooley ◽  
Tracy Pondo ◽  
Louise K Francois Watkins ◽  
Priti Shah ◽  
Stephanie Schrag ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Population Based ◽  
Healthy Adults ◽  
Surveillance Data ◽  
Clinical Risk Factors ◽  
Health Prevention ◽  
Clinical Risk ◽  
Legionnaires Disease ◽  
Clinical Conditions

Abstract We used US population-based surveillance data to characterize clinical risk factors for Legionnaires’ disease (LD). The LD incidence increased by age and the risk was elevated for 12 clinical conditions, when compared to healthy adults. This information can be used to guide testing, treatment, and public health prevention efforts.

scholarly journals Measuring the HIV Care Continuum Using Public Health Surveillance Data in the United States

2015 ◽  
Vol 70 (5) ◽  
pp. 489-494 ◽  
Author(s):  
Catherine R. Lesko ◽  
Lynne A. Sampson ◽  
William C. Miller ◽  
Jacquelyn Clymore ◽  
Peter A. Leone ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Public Health Surveillance ◽  
The United States ◽  
Health Surveillance ◽  
Surveillance Data ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Health Surveillance Data

scholarly journals Using HIV Surveillance Data to Link People to HIV Medical Care, 5 US States, 2012-2015

2018 ◽  
Vol 133 (4) ◽  
pp. 385-391 ◽  
Author(s):  
John Beltrami ◽  
Odessa Dubose ◽  
Reginald Carson ◽  
Janet C. Cleveland
Keyword(s):  
Public Health ◽  
Hiv Prevention ◽  
Linkage To Care ◽  
Surveillance Data ◽  
Hiv Care ◽  
Performance Standard ◽  
Health Staff ◽  
Health Departments ◽  
Hiv Surveillance ◽  
Prevention Activities

Introduction: From 2012 through 2015, the Centers for Disease Control and Prevention (CDC) provided funding to 5 health departments for demonstration projects using HIV surveillance data to link people with newly diagnosed HIV to care. We assessed how well these health departments established linkage to care, how the demonstration projects helped them with this work, and if they sustained these activities after CDC funding ended. Materials and Methods: We obtained quantitative and qualitative data on linkage-to-care activities from health department communications and progress reports submitted to CDC. We calculated and combined linkage-to-care results for the 5 health departments, and we compared these results with the combined linkage-to-care results for 61 health departments that received CDC funding for routine HIV prevention activities (eg, HIV testing, linkage to and reengagement in HIV care, HIV partner services) and for the same 5 health departments when they used only routine HIV prevention activities for linkage to care. Results: Of 1269 people with a new HIV diagnosis at the 5 health departments, 1124 (89%) were linked to care, a result that exceeded the 2010-2015 National HIV/AIDS Strategy goal (85%), the CDC Funding Opportunity Announcement performance standard (80%), and combined results for the 61 health departments (63%) and the same 5 health departments (66%) using routine HIV prevention activities. Benefits of the projects were improved collaboration and coordination and more accurate, up-to-date surveillance data. All health departments continued linkage-to-care activities after funding ended. Practice Implications: Using HIV surveillance data to link people with HIV to care resulted in substantial clinical and public health benefits. Our observations underscore the importance of collaboration among medical providers, public health staff members, community-based organizations, and people with HIV to ensure the best possible clinical and public health outcomes.

scholarly journals Use of routine death and illness surveillance data to provide insight for UK pandemic planning: lessons from COVID-19

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044707
Author(s):  
Helen E Clough ◽  
K Marie McIntyre ◽  
Grace E Patterson ◽  
John P Harris ◽  
Jonathan Rushton
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Disease Burden ◽  
Disease Risk ◽  
Risk Groups ◽  
Surveillance Data ◽  
Care Staff ◽  
Mitigation Measures ◽  
Secondary Outcome ◽  
The Uk

ObjectivesReporting of COVID-19 cases, deaths and testing has often lacked context for appropriate assessment of disease burden within risk groups. The research considers how routine surveillance data might provide initial insights and identify risk factors, setting COVID-19 deaths early in the pandemic into context. This will facilitate the understanding of wider consequences of a pandemic from the earliest stage, reducing fear, aiding in accurately assessing disease burden and ensuring appropriate disease mitigation.SettingUK, 2020.ParticipantsThe study is a secondary analysis of routine, public domain, surveillance data and information from Office for National Statistics (ONS), National Health Service (NHS) 111 and Public Health England (PHE) on deaths and disease.Primary and secondary outcome measuresOur principal focus is ONS data on deaths mentioning COVID-19 on the death certificate. We also consider information provided in NHS 111 and PHE data summaries.ResultsDeaths with COVID-19 significantly contributed to, yet do not entirely explain, abnormally elevated all-cause mortality in the UK from weeks 12–18 of 2020. Early in the UK epidemic, COVID-19 was the greatest threat to those with underlying illness, rarely endangering people aged under 40 years. COVID-19-related death rates differed by region, possibly reflecting underlying population structure. Risk of COVID-19-related death was greater for healthcare and social care staff and black, Asian and minority ethnic individuals, having allowed for documented risk factors.ConclusionEarly contextualisation of public health data is critical to recognising who gets sick, when and why. Understanding at-risk groups facilitates a targeted response considering indirect consequences of society’s reaction to a pandemic alongside disease-related impacts. COVID-19-related deaths mainly mirror historical patterns, and excess non-COVID-19-related deaths partly reflect reduced access to and uptake of healthcare during lockdown. Future outbreak response will improve through better understanding of connectivity between disease monitoring systems to aid interpretation of disease risk patterns, facilitating nuanced mitigation measures.

scholarly journals Effect of the Work Week on Demographics of Heat-Related Illness Patients in Syndromic Surveillance

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Em Stephens
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Risk Factors ◽  
African Americans ◽  
Patient Population ◽  
Syndromic Surveillance ◽  
Heat Waves ◽  
Heat Exposure ◽  
Surveillance Data ◽  
Urban Residence

ObjectiveTo describe the differences in patient populations between those who seek care for heat exposure during the work week and those who seek care during the weekend.IntroductionAs global temperatures increase, so too does interest in the effect of climate change on the population’s health. 2016 represented the hottest year on record globally and well above the 20th century average in Virginia.1,2 With large-scale climate change comes an increase in severe weather patterns, including heat waves.3 Heat waves can have immense health impacts on a community, including heat stroke, heat exhaustion, and dehydration.Previous analyses of emergency department (ED) data indicate that certain populations – specifically males and rural residents – are more at risk for heat-related illness.4,5 None of these studies, however, looked for temporal relationships between the population seeking care and the day of the week. Syndromic surveillance data can be used to further describe those communities affected by heat exposure as well as identify any temporal patterns in visits.MethodsThe Virginia Department of Health (VDH) receives data from 148 EDs and urgent care centers (UCCs) as part of its syndromic surveillance program. During regular surveillance of a heat wave, it was observed that males made up a larger proportion of heat-related visits during the week than they did over the weekend. Data received on visits between January 1, 2015 and July 31, 2017 were used for a retrospective, cross-sectional analysis of demographic risk factors for heat-related illness. During this time frame, 6,739 visits were identified using the September 2016 Council for State and Territorial Epidemiologists (CSTE) syndrome definition for heat-related illness.6The effect of various demographics and visit factors on weekday heat exposure was measured using chi-squared tests. The variables in question included sex, race, ethnicity, rural vs. urban residence, and age group. Odds ratios, 95% confidence intervals, and p-values were reported for these analyses. Analyses were conducted using SAS 9.3 with a significance level of 0.05.ResultsOf the total 6,739 visits identified for heat-related illness, 4,782 (71.0%) occurred during the work week and 1,957 (29.0%) occurred on the weekend. The odds of seeking care for heat-related illness on a weekday were 1.84 times higher for males than for females, p < 0.001, 95% CI [1.65, 2.06]. Blacks or African Americans were more likely to seek care than whites during the work week with an odds ratio of 1.38, p < 0.001. 95% CI [1.20, 1.57]. Adults aged 18-64 years were more likely to seek care during the work week than both children aged 0-17 years (OR = 1.61, p < 0.001, 95% CI [1.37, 1.89]) and adults aged 65 years or older (OR = 1.36, p < 0.001, 95% CI [1.17, 1.58]). No significant relationship between ethnicity or rural vs. urban residence and work week visits for heat-related illness was observed.ConclusionsThe patient population that seeks care for heat-related illness differs between the work week and the weekend. These data suggest the presence of potential mediators or confounders that make males, blacks or African Americans, and adults aged 18-64 more likely to suffer from heat-related illness during the week. Collecting data on patients’ health behaviors, risk factors, and occupation could further elucidate this relationship. Syndromic surveillance, however, does not include the level of detail needed to investigate anything beyond basic demographics.With an increase in the intensity and frequency of heat waves on the horizon, the issue of heat-related illness is one of growing public health concern. Syndromic surveillance data can be used to describe patterns in the patient population most at risk. Public health action is then needed to protect these communities while further research explores the relationships in greater depth.References1 Nuccitelli, D. (2017, July 31). 2017 is so far the second-hottest year on record thanks to global warming. The Guardian. Retrieved from http://bit.ly/2vkPZpg2 Boyer, J. (2017, January 18). 2016 was the planet’s warmest year in modern records, but it wasn’t for Richmond or even Va. Richmond Times-Dispatch. Retrieved from http://bit.ly/2jptCKg3 Duffy, P. B. (2012, January 21). Increasing prevalence of extreme summer temperatures in the U.S. Climate Change, 111(2), 487-495. https://doi.org/10.1007/s10584-012-0396-64 Hess, J. J., Saha, S., & Luber, G. (2014 November). Summertime Acute Heat Illness in U.S. Emergency Departments from 2006 through 2010: Analysis of a Nationally Representatitve Sample. Environmental Health Perspectives 122(11), 1209. http://dx.doi.org.proxy.library.vcu.edu/10.1289/ehp.13067965 Sanchez, C. A., Thomas, K. E., Malilay, J., & Annest, J. L. (2010, January). Nonfatal natural and environmental injuries treated in emergency departments, United States, 2001-2004. Family & Community Health 33(1), 3-10. doi:10.1097/FCH.0b013e3181c4e2fa6 Berisha, V., Braun, C. R., Cameron, L., Hoppe, B., Lane, K., Mamou, F., Menager, H., Roach, M., White, J. R., Wurster, J. (2016, September). Heat-Related Illness Syndrome Query: A Guidance Document for Implementing Heat-Related Illness Syndromic Surveillance in Public Health Practice. Retrieved from http://bit.ly/2w884aJ

Risk Factors for Advanced HIV Disease and Late Entry to HIV Care: National 1994–2012 HIV Surveillance Data for Wuhan, China

2015 ◽  
Vol 29 (10) ◽  
pp. 541-549 ◽  
Author(s):  
Hongbo Jiang ◽  
Nianhua Xie ◽  
Yunzhou Fan ◽  
Zhixia Zhang ◽  
Jianhua Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surveillance Data ◽  
Hiv Care ◽  
Hiv Disease ◽  
Hiv Surveillance ◽  
Late Entry ◽  
Advanced Hiv Disease

scholarly journals HIV Care Continuum among Postpartum Women Living with HIV in Atlanta

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Christina M. Meade ◽  
Martina Badell ◽  
Stephanie Hackett ◽  
C. Christina Mehta ◽  
Lisa B. Haddad ◽  
...  
Keyword(s):  
Primary Care ◽  
Viral Suppression ◽  
Retention In Care ◽  
Hiv Care ◽  
Women Living With Hiv ◽  
Care Visit ◽  
Retention In Hiv Care ◽  
Hiv Primary Care ◽  
Living With Hiv

Introduction. While increased healthcare engagement and antiretroviral therapy (ART) adherence occurs during pregnancy, women living with HIV (WLWH) are often lost to follow-up after delivery. We sought to evaluate postpartum retention in care and viral suppression and to identify associated factors among WLWH in a large public hospital in Atlanta, Georgia. Methods. Data from the time of entry into prenatal care until 24 months postpartum were collected by chart review from WLWH who delivered with ≥20 weeks gestational age from 2011 to 2016. Primary outcomes were retention in HIV care (two HIV care visits or viral load measurements >90 days apart) and viral suppression (<200 copies/mL) at 12 and 24 months postpartum. Obstetric and contraception data were also collected. Results. Among 207 women, 80% attended an HIV primary care visit in a mean 124 days after delivery. At 12 and 24 months, respectively, 47% and 34% of women were retained in care and 41% and 30% of women were virally suppressed. Attending an HIV care visit within 90 days postpartum was associated with retention in care at 12 months (aOR 3.66, 95%CI 1.72-7.77) and 24 months (aOR 4.71, 95%CI 2.00-11.10) postpartum. Receiving ART at pregnancy diagnosis (aOR 2.29, 95%CI 1.11-4.74), viral suppression at delivery (aOR 3.44, 95%CI 1.39-8.50), and attending an HIV care visit within 90 days postpartum (aOR 2.40, 95%CI 1.12-5.16) were associated with 12-month viral suppression, and older age (aOR 1.09, 95% CI 1.01-1.18) was associated with 24-month viral suppression. Conclusions. Long-term retention in HIV care and viral suppression are low in this population of postpartum WLWH. Prompt transition to HIV care in the postpartum period was the strongest predictor of optimal HIV outcomes. Efforts supporting women during the postpartum transition from obstetric to HIV primary care may improve long-term HIV outcomes in women.

Substance Abuse and Drug-Related Death, Suicidal Ideation, and Suicide: A Review

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Annie Mino ◽  
Arnaud Bousquet ◽  
Barbara Broers
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Substance Abuse ◽  
Suicidal Ideation ◽  
Family Support ◽  
Drug Users ◽  
Suicide Attempts ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Hiv Epidemic

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.

Sign in / Sign up

Export Citation Format

Share Document