scholarly journals Innovative Quality-Assurance Strategies for Tuberculosis Surveillance in the United States

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Lilia Ponce Manangan ◽  
Cheryl Tryon ◽  
Elvin Magee ◽  
Roque Miramontes
Keyword(s):  
United States ◽  
Quality Assurance ◽  
Data Quality ◽  
The United States ◽  
Surveillance Systems ◽  
Web Based ◽  
High Data ◽  
National Tuberculosis ◽  
Control And Prevention ◽  
Reporting Discrepancies

Introduction. The Centers for Disease Control and Prevention (CDC)’s National Tuberculosis Surveillance System (NTSS) is the national repository of tuberculosis (TB) data in the United States. Jurisdictions report to NTSS through the Report of Verified Case of Tuberculosis (RVCT) form that transitioned to a web-based system in 2009.Materials and Methods. To improve RVCT data quality, CDC conducted a quality assurance (QA) needs assessment to develop QA strategies. These include QA components (case detection, data accuracy, completeness, timeliness, data security, and confidentiality); sample tools such as National TB Indicators Project (NTIP) to identify TB case reporting discrepancies; comprehensive training course; resource guide and toolkit.Results and Discussion. During July–September 2011, 73 staff from 34 (57%) of 60 reporting jurisdictions participated in QA training. Participants stated usefulness of sharing jurisdictions’ QA methods; 66 (93%) wrote that the QA tools will be effective for their activities. Several jurisdictions reported implementation of QA tools pertinent to their programs. Data showed >8% increase in NTSS and NTIP enrollment through Secure Access Management Services, which monitors system usage, from August 2011–February 2012.Conclusions. Despite challenges imposed by web-based surveillance systems, QA strategies can be developed with innovation and collaboration. These strategies can also be used by other disease programs to ensure high data quality.

The Under-Enrollment of HIV-infected Foster Children in Clinical Trials and Protocols and the Need for Corrective State Action

1994 ◽  
Vol 20 (3) ◽  
pp. 231-249
Author(s):  
Briar McNutt
Keyword(s):  
United States ◽  
New York ◽  
Hiv Infection ◽  
The United States ◽  
Hiv And Aids ◽  
Medical Community ◽  
State Action ◽  
Pediatric Aids ◽  
Control And Prevention ◽  
Year 2000

The incidence of HIV infection and AIDS in children has grown at an alarming rate. Approximately one million children worldwide have HIV infection. By the year 2000, an estimated ten million children will suffer from the disease. Currently, the United States has a population of an estimated 10,000 to 20,000 HIV-infected children. As of June 30, 1993, the Centers for Disease Control and Prevention (CDC) reported 4,710 known AIDS cases in children twelve years-old and younger. At that point, New York City reported 1,124 pediatric AIDS cases which represented twenty-four percent of all cases in the United States.With the rising number of HIV-infected children, the medical community in the United States has begun to search for HIV-and AIDS-related treatments particularized for children. In addition to establishing guidelines for HIV-infected children's frequent check-ups and timely immunizations, the medical community has initiated research studies involving HIV-infected children.

Abstract P636: Social Determinants of Stroke Hospitalization and Mortality in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Randhir Sagar Yadav ◽  
Durgesh Chaudhary ◽  
Shima Shahjouei ◽  
Jiang Li ◽  
Vida Abedi ◽  
...  
Keyword(s):  
United States ◽  
Income Inequality ◽  
Social Determinants ◽  
Hemorrhagic Stroke ◽  
The United States ◽  
Care Physician ◽  
County Level ◽  
Medicare Beneficiaries ◽  
Level Data ◽  
Control And Prevention

Introduction: Stroke hospitalization and mortality are influenced by various social determinants. This ecological study aimed to determine the associations between social determinants and stroke hospitalization and outcome at county-level in the United States. Methods: County-level data were recorded from the Centers for Disease Control and Prevention as of January 7, 2020. We considered four outcomes: all-age (1) Ischemic and (2) Hemorrhagic stroke Death rates per 100,000 individuals (ID and HD respectively), and (3) Ischemic and (4) Hemorrhagic stroke Hospitalization rate per 1,000 Medicare beneficiaries (IH and HH respectively). Results: Data of 3,225 counties showed IH (12.5 ± 3.4) and ID (22.2 ± 5.1) were more frequent than HH (2.0 ± 0.4) and HD (9.8 ± 2.1). Income inequality as expressed by Gini Index was found to be 44.6% ± 3.6% and unemployment rate was 4.3% ± 1.5%. Only 29.8% of the counties had at least one hospital with neurological services. The uninsured rate was 11.0% ± 4.7% and people living within half a mile of a park was only 18.7% ± 17.6%. Age-adjusted obesity rate was 32.0% ± 4.5%. In regression models, age-adjusted obesity (OR for IH: 1.11; HH: 1.04) and number of hospitals with neurological services (IH: 1.40; HH: 1.50) showed an association with IH and HH. Age-adjusted obesity (ID: 1.16; HD: 1.11), unemployment (ID: 1.21; HD: 1.18) and income inequality (ID: 1.09; HD: 1.11) showed an association with ID and HD. Park access showed inverse associations with all four outcomes. Additionally, population per primary-care physician was associated with HH while number of pharmacy and uninsured rate were associated with ID. All associations and OR had p ≤0.04. Conclusion: Unemployment and income inequality are significantly associated with increased stroke mortality rates.

scholarly journals Impact of External Quality Assurance on the Quality of Xpert MTB/RIF Testing in Viet Nam

2018 ◽  
Vol 57 (3) ◽  
Author(s):  
Vidyanidhi Gumma ◽  
Kyle DeGruy ◽  
Davara Bennett ◽  
Thanh Nguyen Thi Kim ◽  
Heidi Albert ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Positive Impact ◽  
Production Capacity ◽  
Control Program ◽  
External Quality Assurance ◽  
World Health ◽  
External Quality ◽  
National Tuberculosis ◽  
Control And Prevention ◽  
Health Organization

ABSTRACT Following the endorsement of the Xpert MTB/RIF assay (Cepheid, Sunnyvale, CA, USA) by the World Health Organization (WHO) in 2010, Viet Nam’s National Tuberculosis Control Program (NTP) began using GeneXpert instruments in NTP laboratories. In 2013, Viet Nam’s NTP implemented an Xpert MTB/RIF external quality assurance (EQA) program in collaboration with the U.S. Centers for Disease Control and Prevention (CDC) and the Foundation for Innovative New Diagnostics (FIND). Proficiency-testing (PT) panels comprising five dried tube specimens (DTS) were sent to participating sites approximately twice a year from October 2013 to July 2016. The number of enrolled laboratories increased from 22 to 39 during the study period. Testing accuracy was assessed by comparing reported and expected results; percentage scores were assigned; and feedback reports were provided to sites. On-site evaluation (OSE) was conducted for underperforming laboratories. The results from the first five rounds demonstrate the positive impact of PT and targeted OSE visits on testing quality. On average, for every additional round of feedback, the odds of achieving PT scores of ≥80% increased 2.04-fold (95% confidence interval, 1.39- to 3.00-fold). Future work will include scaling up PT to all sites and maintaining the performance of participating laboratories while developing local panel production capacity.

scholarly journals Levofloxacin-Resistant Invasive Streptococcus pneumoniae in the United States: Evidence for Clonal Spread and the Impact of Conjugate Pneumococcal Vaccine

2004 ◽  
Vol 48 (9) ◽  
pp. 3491-3497 ◽  
Author(s):  
Mathias W. R. Pletz ◽  
Lesley McGee ◽  
James Jorgensen ◽  
Bernard Beall ◽  
Richard R. Facklam ◽  
...  
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
The United States ◽  
Fluoroquinolone Resistance ◽  
Active Efflux ◽  
Vaccine Serotypes ◽  
Drug Classes ◽  
Control And Prevention ◽  
Clonal Spread ◽  
The Impact

ABSTRACT The emergence of fluoroquinolone resistance in sterile-site isolates of Streptococcus pneumoniae is documented in this study characterizing all invasive levofloxacin-resistant (MIC, ≥8 mg/liter) S. pneumoniae isolates (n = 50) obtained from the Centers for Disease Control and Prevention Active Bacterial Core Surveillance from 1998 to 2002. Resistance among all isolates increased from 0.1% in 1998 to 0.6% in 2001 (P = 0.008) but decreased to 0.4% in 2002, while resistance among vaccine serotypes continued to increase from 0.3% in 1998 to 1.0% in 2002, suggesting that fluoroquinolones continue to exert selective pressure on these vaccine serotypes. Only 22% of resistant isolates were not covered by the conjugate vaccine serogroups. Multilocus sequence typing revealed that 58% of resistant strains were related to five international clones identified by the Pneumococcal Molecular Epidemiology Network, with the Spain23F-1 clone being most frequent (16% of all isolates). Thirty-six percent of the isolates were coresistant to penicillin, 44% were coresistant to macrolides, and 28% were multiresistant to penicillin, macrolides, and fluoroquinolones. Fifty percent of the isolates were resistant to any three drug classes. Ninety-four percent of the isolates had multiple mutations in the quinolone resistance-determining regions of the gyrA, gyrB, parC, and parE genes. In 16% of the isolates, there was evidence of an active efflux mechanism. An unusual isolate was found that showed only a single parE mutation and for which the ciprofloxacin MIC was lower (2 mg/liter) than that of levofloxacin (8 mg/liter). Our results suggest that invasive pneumococcal isolates resistant to levofloxacin in the United States show considerable evidence of multiple resistance and of clonal spread.

scholarly journals Covid-19 pandemic: What is the truth?

2021 ◽  
Vol 12 ◽  
pp. 591
Author(s):  
Russell L. Blaylock
Keyword(s):  
United States ◽  
Young People ◽  
Severe Acute Respiratory Syndrome ◽  
Early Treatment ◽  
The United States ◽  
Treatment Protocols ◽  
Scientific Support ◽  
Control And Prevention ◽  
History Of ◽  
Irreparable Damage

The ongoing “pandemic” involving the severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2) has several characteristics that make it unique in the history of pandemics. This entails not only the draconian measures that some countries and individual states within the United States and initiated and made policy, most of which are without precedent or scientific support, but also the completely unscientific way the infection has been handled. For the 1st time in medical history, major experts in virology, epidemiology, infectious diseases, and vaccinology have not only been ignored, but are also demonized, marginalized and in some instances, become the victim of legal measures that can only be characterized as totalitarian. Discussions involving various scientific opinions have been eliminated, top scientists have been frightened into silence by threats to their careers, physicians have lost their licenses, and the concept of early treatment has been virtually eliminated. Hundreds of thousands of people have died needlessly as a result of, in my opinion and the opinion of others, poorly designed treatment protocols, mostly stemming from the Center for Disease Control and Prevention, which have been rigidly enforced among all hospitals. The economic, psychological, and institutional damage caused by these unscientific policies is virtually unmeasurable. Whole generations of young people will suffer irreparable damage, both physical and psychological, possibly forever. The truth must be told.

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