Dataset Information

Lessons learned during dengue outbreaks in the United States, 2001-2011.

ABSTRACT: Since 2001, three autochthonous dengue fever outbreaks have occurred in the United States: in Hawaii (2001); Brownsville, Texas (2005); and southern Florida (2009-2011). We sought to characterize and describe the response to these outbreaks from the perspectives of public health and vector control officials. By conducting a medical literature review through PubMed and news media searches through Google, we identified persons involved in managing each outbreak; 26 persons then participated in qualitative, semistructured interviews. After analyzing the 3 outbreaks, we found the following prominent themes in the response efforts: timely detection of illness; communication of up-to-date, correct information; and development of a rapid response that engages the community. We therefore recommend that public health authorities involve the clinical and laboratory community promptly, provide accurate information, and engage the local community in vector control and case identification and reporting.

SUBMITTER: Adalja AA

PROVIDER: S-EPMC3309700 | biostudies-literature | 2012 Apr

REPOSITORIES: biostudies-literature

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Lessons learned during dengue outbreaks in the United States, 2001-2011.

Adalja Amesh A AA Sell Tara Kirk TK Bouri Nidhi N Franco Crystal C

Emerging infectious diseases 20120401 4

Since 2001, three autochthonous dengue fever outbreaks have occurred in the United States: in Hawaii (2001); Brownsville, Texas (2005); and southern Florida (2009-2011). We sought to characterize and describe the response to these outbreaks from the perspectives of public health and vector control officials. By conducting a medical literature review through PubMed and news media searches through Google, we identified persons involved in managing each outbreak; 26 persons then participated in qua ...[more]

PMID: 22469195

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Project description:ImportanceOtitis media (OM) is a leading cause of pediatric health care visits and the most frequent reason children consume antibiotics or undergo surgery. During recent years, several interventions have been introduced aiming to decrease OM burden.ObjectiveTo study the trend in OM-related health care use in the United States during the pneumococcal conjugate vaccine (PCV) era (2001-2011).Design, setting, and participantsAn analysis of an insurance claims database of a large, nationwide managed health care plan was conducted. Enrolled children aged 6 years or younger with OM visits were identified.Main outcomes and measuresAnnual OM visit rates, OM-related complications, and surgical interventions were analyzed.ResultsOverall, 7.82 million unique children (5.51 million child-years) contributed 6.21 million primary OM visits; 52% were boys and 48% were younger than 2 years. There was a downward trend in OM visit rates from 2004 to 2011, with a significant drop that coincided with the advent of the 13-valent vaccine (PCV-13) in 2010. The observed OM visit rates in 2010 (1.00/child-year) and 2011 (0.81/child-year) were lower than the projected rates based on the 2005-2009 trend had there been no intervention (P < .001). Recurrent OM (≥3 OM visits within 6-month look-back) rates decreased at 0.003/child-year (95% CI, 0.002-0.004/child-year) in 2001-2009 and at 0.018/child-year (95% CI, 0.008-0.028/child-year) in 2010-2011. In the PCV-13 premarket years, there was a stable rate ratio (RR) between OM visit rates in children younger than 2 years and in those aged 2 to 6 years (RR, 1.38; 95% CI, 1.38-1.39); the RR decreased significantly (P < .001) during the transition year 2010 (RR 1.32; 95% CI, 1.31-1.33) and the postmarket year 2011 (RR 1.01; 95% CI, 1.00-1.02). Tympanic membrane perforation/otorrhea rates gradually increased (from 3721 per 100,000 OM child-years in 2001 to 4542 per 100,000 OM child-years in 2011; P < .001); the increase was significant only in the older children group. Mastoiditis rates substantially decreased (from 61 per 100,000 child-years in 2008 to 37 per 100,000 child-years in 2011; P < .001). Ventilating tube insertion rate decreased by 19% from 2010 to 2011 (P = .03).Conclusions and relevanceThere was an overall downward trend in OM-related health care use from 2001 to 2011. The significant reduction in OM visit rates in 2010-2011 in children younger than 2 years coincided with the advent of PCV-13. Although tympanic membrane perforation/otorrhea rates steadily increased during that period, mastoiditis and ventilating tube insertion rates decreased in the last years of the study.

Project description:BackgroundTransgender men (TGM) are underrepresented in genital microbiome research. Our prospective study in Birmingham, AL investigated genital microbiota changes over time in TGM initiating testosterone, including the development of incident bacterial vaginosis (iBV). Here, we present lessons learned from recruitment challenges encountered during the conduct of this study.MethodsInclusion criteria were assigned female sex at birth, TGM or non-binary identity, age ≥18 years, interested in injectable testosterone but willing to wait 7 days after enrollment before starting, and engaged with a testosterone-prescribing provider. Exclusion criteria were recent antibiotic use, HIV/STI infection, current vaginal infection, pregnancy, or past 6 months testosterone use. Recruitment initiatives included community advertisements via flyers, social media posts, and referrals from local gender health clinics.ResultsBetween February 2022 and October 2023, 61 individuals contacted the study, 17 (27.9%) completed an in-person screening visit, and 10 (58.8%) of those screened were enrolled. The primary reasons for individuals failing study screening were having limited access to testosterone-prescribing providers, already being on testosterone, being unwilling to wait 7 days to initiate testosterone therapy, or desiring the use of topical testosterone. Engagement of non-White TGM was also minimal.ConclusionDespite robust study inquiry by TGM, screening and enrollment challenges were faced including engagement by TGM not yet in care and specific study eligibility criteria. Excitement among TGM for research representation should be leveraged in future work by engaging transgender community stakeholders at the inception of study development, particularly regarding feasibility of study inclusion and exclusion criteria, as well as recruitment of TGM of color. These results also highlight the need for more clinical resources for prescribing gender-affirming hormone therapy, especially in the Southeastern US.

Project description:Research on spatial non-stationarity of land-cover classification accuracy has been ongoing for over two decades with most of the work focusing on single date maps. We extend the understanding of thematic map accuracy spatial patterns by: (1) quantifying spatial patterns of map-reference agreement for class-specific land-cover change rather than class-specific land cover for both omission and commission expressions of map error; (2) reporting goodness-of-fit estimates for the empirical models, which have been lacking in previous assessments, and; (3) using the empirical model results to map the locations of the relative likelihoods of map-reference agreement for specific land-cover change classes. We evaluated 10 map-based explanatory variables in single and multivariable logistic regression models to predict the likelihood of agreement between map and reference land-cover change (2001-2011) labels using the National Land Cover Database (NLCD) 2011 land cover and accuracy data. Logistic models for omission error had better goodness-of-fit estimates than models for commission error. For the omission error models, the explanatory variable, density of the mapped class-specific change in the immediate neighbourhood surrounding the sample pixel, produced the best model fit results (Tjur coefficient of discrimination, D, ranged from 0.59 to 0.98) compared to multivariable models and all other single explanatory variable models. Maps of the predicted likelihood of map-reference agreement produced from the best fitting omission error models provide a spatially explicit description of spatial variation of classification uncertainty at both local and regional scales. Application of the models indicated higher likelihoods of agreement (>50%) comprised a greater proportion of the land-cover change class area than the proportion of the land-cover change class with lower likelihoods of agreement. NLCD users can apply reported equations to map land-cover change uncertainty.

Dataset Information

Lessons learned during dengue outbreaks in the United States, 2001-2011.

Publications

Lessons learned during dengue outbreaks in the United States, 2001-2011.

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