Designing strategies for eradication of Helicobacter pylori based on prevalence patterns of infection and antibiotic resistance in a low‐income, medically underserved community in the United States

The proportion of children in the United States without private or public health insurance increased from roughly 13 percent to 18 percent between 1977 and 1987, according to a new study by the Agency for Health Care Policy and Research (AHCPR). The growth in the proportion of uninsured children in poor and low-income families over the decade was even more dramatic—it rose from 21 percent to 31 percent.

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Near-Drowning

Pediatrics in Review ◽

10.1542/pir.14.4.148 ◽

1993 ◽

Vol 14 (4) ◽

pp. 148-151

Author(s):

Debra H. Fiser

Keyword(s):

United States ◽

Low Income ◽

The United States ◽

Western United States ◽

King County ◽

Near Drowning ◽

Time Period ◽

States Data ◽

Low Income Groups ◽

Bodies Of Water

Definition Drowning is defined as death caused by submersion, whereas near-drowning connotes survival for some time period following submersion. The following remarks pertain to the near-drowning victim who presents for acute medical management. Epidemiology Because reporting of near-drowning incidents is incomplete, most of the available epidemiologic information focuses on drowning deaths, which number more than 6500 per year in the United States. Data from King County, Washington, however, suggest that near-drownings slightly out-number drownings. Drowning rates are highest for children under the age of 5 years and between the ages of 15 and 24 years. Males drown 4 times more frequently than females. African-Americans and low-income groups also are affected disproportionately, except for those drownings involving boats and residential swimming pools, which more often are owned by middle class groups. Drownings peak during the summer months and are most common in the southern and western United States and Alaska. Forty to 45% of all drownings occur while the victim is swimming and 12% to 29% are boat-related. Alcohol plays a substantial role in these deaths. Between one half and three quarters of all drownings occur in lakes, ponds, rivers, and the ocean. More than 40% of all submersions in these bodies of water involve older adolescents or young adults.

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The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis

BMC Infectious Diseases ◽

10.1186/s12879-016-1990-4 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 15

Author(s):

Constantinos I. Michaelidis ◽

Michael J. Fine ◽

Chyongchiou Jeng Lin ◽

Jeffrey A. Linder ◽

Mary Patricia Nowalk ◽

...

Keyword(s):

United States ◽

Antibiotic Resistance ◽

The United States ◽

Societal Cost ◽

Exploratory Analysis

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Efforts to slacken antibiotic resistance: Labeling meat products from animals raised without antibiotics in the United States

The Science of The Total Environment ◽

10.1016/j.scitotenv.2016.05.082 ◽

2016 ◽

Vol 563-564 ◽

pp. 1088-1094 ◽

Cited By ~ 3

Author(s):

Terence J. Centner

Keyword(s):

United States ◽

Antibiotic Resistance ◽

Meat Products ◽

The United States

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Environmental risk factors associated with Helicobacter pylori seroprevalence in the United States: a cross-sectional analysis of NHANES data

Epidemiology and Infection ◽

10.1017/s0950268814003938 ◽

2015 ◽

Vol 143 (12) ◽

pp. 2520-2531 ◽

Cited By ~ 25

Author(s):

W. S. KRUEGER ◽

E. D. HILBORN ◽

R. R. CONVERSE ◽

T. J. WADE

Keyword(s):

United States ◽

Risk Factors ◽

Helicobacter Pylori ◽

Environmental Risk ◽

The United States ◽

Environmental Risk Factors ◽

Living Conditions ◽

Well Water ◽

Factors Associated ◽

H Pylori

SUMMARYHelicobacter pylori imparts a considerable burden to public health. Infections are mainly acquired in childhood and can lead to chronic diseases, including gastric ulcers and cancer. The bacterium subsists in water, but the environment's role in transmission remains poorly understood. The nationally representative National Health and Nutrition Examination Survey (NHANES) was examined for environmental risk factors associated with H. pylori seroprevalence. Data from 1999–2000 were examined and weighted to represent the US population. Multivariable logistic regression estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for associations with seropositivity. Self-reported general health condition was inversely associated with seropositivity. Of participants aged <20 years, seropositivity was significantly associated with having a well as the source of home tap water (aOR 1·7, 95% CI 1·1–2·6) and living in a more crowded home (aOR 2·3, 95% CI 1·5–3·7). Of adults aged ⩾20 years, seropositivity was not associated with well water or crowded living conditions, but adults in soil-related occupations had significantly higher odds of seropositivity compared to those in non-soil-related occupations (aOR 1·9, 95% CI 1·2–2·9). Exposures to both well water and occupationally related soil increased the effect size of adults' odds of seropositivity compared to non-exposed adults (aOR 2·7, 95% CI 1·3-5·6). Environmental exposures (well-water usage and occupational contact with soil) play a role in H. pylori transmission. A disproportionate burden of infection is associated with poor health and crowded living conditions, but risks vary by age and race/ethnicity. These findings could help inform interventions to reduce the burden of infections in the United States.

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