Centers For Disease Control Research Articles

First detection of multiple cases related to CV-A16 strain of B1c clade in Beijing in 2022.

Coxsackievirus A16 (CV-A16) is a significant etiologic agent of hand, foot, and mouth disease (HFMD) and herpangina (HA), with the capacity to progress to severe complications, including encephalitis, aseptic meningitis, acute flaccid paralysis, myocarditis, and other critical conditions. Beijing's epidemiological surveillance system, established in 2008, encompasses 29 hospitals and 16 district disease control centers. From 2019 to 2021, the circulation of CV-A16 was characterized by the co-circulation of B1a and B1b clades. Multiple cases of HFMD linked to clade B1c has not been reported in Beijing until 2022. This study enrolled 400 HFMD and 493 HA cases. Employing real-time RT-PCR, 368 enterovirus-positive cases were identified, with 180 selected for sequencing. CV-A16 was detected in 18.89% (34/180) of the cases, second only to CV-A6, identified in 63.33% (114/180). Full-length VP1 gene sequences were successfully amplified and sequenced in 22 cases, revealing the presence of clades B1a, B1b, and B1c in 14, 3, and 5 cases, respectively. A cluster of five B1c clade cases occurred between June 29 and July 17, 2022, within a 7-km diameter region in Shunyi District. Phylogenetic analysis of five complete VP1 gene sequences and two full-genome sequences revealed close clustering with the 2018 Indian strain (GenBank accession: MH780757.1) within the B1c India branch, with NCBI BLAST results showing over 98% similarity. Comparative sequence analysis identified three unique amino acid variations (P3S, V25A, and I235V). The 2022 Shunyi District HFMD cases represent the first instances of spatiotemporally correlated CV-A16 B1c clade infections in Beijing, underscoring the necessity for heightened surveillance of B1c clade CV-A16 in HFMD and HA in this region.

First detection of multiple cases related to CV-A16 strain of B1c clade in Beijing in 2022.

Coxsackievirus A16 (CV-A16) is a significant etiologic agent of hand, foot, and mouth disease (HFMD) and herpangina (HA), with the capacity to progress to severe complications, including encephalitis, aseptic meningitis, acute flaccid paralysis, myocarditis, and other critical conditions. Beijing's epidemiological surveillance system, established in 2008, encompasses 29 hospitals and 16 district disease control centers. From 2019 to 2021, the circulation of CV-A16 was characterized by the co-circulation of B1a and B1b clades. Multiple cases of HFMD linked to clade B1c has not been reported in Beijing until 2022. This study enrolled 400 HFMD and 493 HA cases. Employing real-time RT-PCR, 368 enterovirus-positive cases were identified, with 180 selected for sequencing. CV-A16 was detected in 18.89% (34/180) of the cases, second only to CV-A6, identified in 63.33% (114/180). Full-length VP1 gene sequences were successfully amplified and sequenced in 22 cases, revealing the presence of clades B1a, B1b, and B1c in 14, 3, and 5 cases, respectively. A cluster of five B1c clade cases occurred between June 29 and July 17, 2022, within a 7-km diameter region in Shunyi District. Phylogenetic analysis of five complete VP1 gene sequences and two full-genome sequences revealed close clustering with the 2018 Indian strain (GenBank accession: MH780757.1) within the B1c India branch, with NCBI BLAST results showing over 98% similarity. Comparative sequence analysis identified three unique amino acid variations (P3S, V25A, and I235V). The 2022 Shunyi District HFMD cases represent the first instances of spatiotemporally correlated CV-A16 B1c clade infections in Beijing, underscoring the necessity for heightened surveillance of B1c clade CV-A16 in HFMD and HA in this region.

Six-year evaluation of device-associated nosocomial infections in intensive care units.

Invasive device-associated nosocomial infections commonly occur in intensive care units (ICUs). These infections include intravascular catheter-related bloodstream infection (CRBSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI). This study aimed to evaluate the factors associated with invasive device-associated nosocomial infections based on the underlying diseases of the patients and antibiotic resistance profiles of the pathogens causing the infections detected in the ICU in our hospital over a five-year period. Invasive device-associated infections (CRBSI, VAP, and CAUTI) were detected retrospectively by the laboratory- and clinic-based active surveillance system according to the criteria of the US Centers for Disease Control and Prevention (CDC) in patients hospitalized in the ICU of the tertiary hospital between 1 January 2018 and 30 June 2023. A total of 425 invasive device-associated nosocomial infections and 441 culture results were detected (179 CRBSI, 176 VAP, 70 CAUTI). Out of them, 57 (13.4%) patients had hematological malignancy, 145 (34.1%) had solid organ malignancy, and 223 (52.5%) had no histopathologic diagnosis of any malignancy. An increase in extended-spectrum beta lactamase (ESBL) and carbapenem resistance in pathogens was detected during the study period. Antibiotic resistance of the Gram-negative bacteria associated with invasive device-associated infections increased during the study period. Antimicrobial stewardship will reduce rates of nosocomial infections, reduce mortality, and shorten hospital stay. Long-term catheterization and unnecessary antibiotic use should be avoided.

Covid-19 Review: A Trend Analysis of the Impact of Religious Festivities and Non-Adherence to Social Distancing in Nigeria

The global negative impact of Covid-19 pandemic necessitates curtailing measures and policies in case of future outbreak. A trend analysis of the spread of Covid-19 showing the effect of social gatherings especially during religious festivals was done. Covid-19 monthly spread and associated weather data from Nigerian Centre for Disease Control (NCDC) for the period of March 2020 to April 2022 was used to study the spread trend during religious festivities. The trend analysis revealed a significant spread increase for four of the geopolitical zones at r = 0.023, 0.000, 0.000, 0.000 respectively during religious festivals. A consistent increase in the spread of the disease during religious festivals across the six zones and a downward trend immediately after the festivities. A t test value of -29.027 was significant at p-value of 0.000 confirming that the change in spread trend during festivals was not a chance occurrence

A Systematic Review of Maternal Mortality in African Countries

Introduction: The goal of this review is to investigate maternal mortality rates (MMR) in African countries. Because the MMR of Black women in the United States is 3-5x higher than in White women, this study aims to identify if a similar racial disparity is present in Africa where the majority of the birthing population identifies as Black. Methods: Four bibliographic databases were searched - PubMed, Web of Science Core Collection, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) – and a variety of search terms were identified, including “Maternal Mortality”, “Ethnic Groups”, “Minority Groups”, “Continental Population Groups”, “Medically Underserved Area”, “Race Factors” and “Racial Disparities”. Inclusion criteria were manuscripts with statistics on maternal mortality or severe maternal morbidity in African countries or regions; exclusion criteria included “wrong outcome”, “wrong study type”, and studies only discussing maternal morbidity without mention of mortality. Papers that were not written in or that did not include information about an African country or region were excluded. Results: Overwhelmingly, hypertension-related mortality was identified as a leading cause of death in nearly every study, followed closely by post-partum hemorrhage, often due to over- or underuse of anticoagulation therapy. Unsafe abortion contributed to higher rates of adolescent mortality (37% of adolescents in one study) while accounting for 9-27% of the overall mortality rate. MMR across the continent varied significantly. Countries with the highest average recorded MMRs include Tunisia (1,820/100,000), Sierra Leone (1,800/100,000), Guinea (1,600/100,000), and Somalia (1,600/100,000). The lowest average MMRs found in this study included Tanzania (120/100,000), Egypt (124.5/100,000), Algeria (160/100,000), and Libya (220/100,000). Factors contributing to higher rates of mortality included extremes in maternal age, with the highest rates being in those older than 40 and younger than 20. Educational status played a large role, with up to 68% of mortality in one study occurring in people considered to be illiterate. Low socioeconomic status and being a member of a minority religious and/or ethnic group within a population corresponded with higher mortality rates, in addition to either late or minimal access to antenatal care (up to 28x higher MMR). A common comorbidity related to maternal mortality was patients having an established HIV diagnosis. Though mortality rates were significant in both HIV-positive and HIV-negative patients, most deaths in HIV-positive patients were related to advanced disease as opposed to obstetric complications, with one study finding the MMR of HIV-infected patients to be 6.2 times higher than HIV-negative patients. Among these deaths, tuberculosis, pneumocystis jirovecii pneumonia, and meningitis were among the most common causes. One study investigated the association between antiretroviral (ART) therapy and decreased rates of HIV-positive mortality. The recorded MMR of both HIV-positive and HIV-negative women decreased over the 10 years in this study; however, the HIV-positive MMR in the third time period was still 3.2 times higher than that of HIV-negative women (4.1 times higher in the second period, 7.1 times higher in the first period) with HIV-positive patients making up 33.3% of maternal deaths. One 2021 study focused on the effects of a COVID-19 infection on maternal outcomes – identifying no statistically significant difference in MMR, except that HIV-positive patients were twice as likely to contract COVID than controls. Conclusion: According to US CDC, the 2020 US national MMR was 23.8 per 100,000 live births, compared with the lowest national MMR in this study - Tanzania at 120/100,000; 6-fold higher than the US national average. In this systematic review, multiple factors were found to contribute to higher MMR, including low socioeconomic status, poor access to trained medical professionals, and patients having untreated or severe comorbidities such as HIV or tuberculosis. Two studies used a data collection method called ‘The Sisterhood Method’ which gathered retrospective data via interviewing women about the maternal outcomes of their biological sisters. Though this method of collection is useful for countries and/or regions that have limited access to electronic medical records (EMR) or census data, it relies on the memory and the willingness of interviewees to provide information, which may create recall bias and alter the validity of those studies. Our work identifies a need for further maternal mortality research to identify differences in healthcare systems across countries (both in Africa and worldwide) leading to higher death rates in some nations. Additionally, training programs (such as “Human Resources for Health,” “Pan-African Academy of Christian Surgeons [PAACS]”, “East, Central, and Southern African Health Community [ECSA-HC]”, etc.) should be supported with funding and other resources to address this crisis, while also supporting ongoing initiatives to expand medical education and training in African countries. Efforts should also be made to increase patient education about early signs of obstetric complications. Though maternal mortality rates have trended downward in recent decades, further research is needed to highlight and address disparities across countries and populations to provide equitable care to all.

Accuracy of US CDC COVID-19 forecasting models.

Accurate predictive modeling of pandemics is essential for optimally distributing biomedical resources and setting policy. Dozens of case prediction models have been proposed but their accuracy over time and by model type remains unclear. In this study, we systematically analyze all US CDC COVID-19 forecasting models, by first categorizing them and then calculating their mean absolute percent error, both wave-wise and on the complete timeline. We compare their estimates to government-reported case numbers, one another, as well as two baseline models wherein case counts remain static or follow a simple linear trend. The comparison reveals that around two-thirds of models fail to outperform a simple static case baseline and one-third fail to outperform a simple linear trend forecast. A wave-by-wave comparison of models revealed that no overall modeling approach was superior to others, including ensemble models and errors in modeling have increased over time during the pandemic. This study raises concerns about hosting these models on official public platforms of health organizations including the US CDC which risks giving them an official imprimatur and when utilized to formulate policy. By offering a universal evaluation method for pandemic forecasting models, we expect this study to serve as the starting point for the development of more accurate models.

A Bayesian Survival Analysis on Long COVID and non Long COVID patients: A Cohort Study Using National COVID Cohort Collaborative (N3C) Data.

Since the outbreak of COVID-19 pandemic in 2020, numerous researches and studies have focused on the long-term effects of COVID infection. The Centers for Disease Control (CDC) implemented an additional code into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for reporting 'Post COVID-19 condition, unspecified (U09.9)' effective on October 1st 2021, representing that Long COVID is a real illness with potential chronic conditions. The National COVID Cohort Collaborative (N3C) provides researchers with abundant electronic health records (EHR) data by aggregating and harmonizing EHR data across different clinical organizations in the United States, making it convenient to build up a survival analysis on Long COVID patients and non Long COVID patients among large amounts of COVID positive patients.

Quaternary Ammonium Disinfectants: Current Practices and Future Perspective in Infection Control: Review Article

Hospital-acquired infections (HAIs) are one of the most tangled difficulties in advanced clinical practices. These infections lead to financial implications and have a significant impact on morbidity and mortality. It is very difficult to eradicate the HAIs however both disinfection and sterilization account for the best measure to control HAIs. Of all the disinfectants in use, one of the chemical disinfectants which seem to be user-friendly, non-corrosive, and used extensively are Quaternary ammonium compounds (QACs) based disinfectants. To improve the efficacy of these disinfectants and tackle the challenge of antimicrobial resistance (concerning QACs), from time to time newer QACs disinfectants were introduced which are termed as first, second, third, fourth, and fifth-generation QACs disinfectants. Manufacturers of these newer generations QACs disinfectants claim these compounds as high-level, broad-spectrum disinfectants while leading healthcare agencies like the Centre for Disease Control & Prevention (CDC) mention QACs as mild disinfectants and not sporicidal. Sadly, the antimicrobial efficacy of QACs has been largely assessed using old methods like phenol coefficient methods & suspension methods, and not using an internationally standardized method. These loopholes raise a lot of queries about the true efficacies of the QACs and thus, increase the chances of the development of resistant HAIs. Therefore, there is an urgent need for better and standardized methods to study the efficacy of different generation QACs. The present review discusses the status of currently available methods and gaps in the literature that would be useful to highlight the potential use of QACs for infection control and prevention in better ways.

Unraveling the Influence of Social, Economic, and Demographic Factors in Texas on Breast Cancer Survival.

According to the Centers for Disease Control (CDC), breast cancer is the second most common cancer among women in the United States. Affected people are financially challenged due to the high out-of-pocket cost of breast cancer treatment, as it is the most expensive treatment. Using a 16-year cohort study of breast cancer survival data in Texas, we investigate the factors that might explain why some breast cancer patients live longer than others. Performing a survival analysis consisting of the log-rank test, a survival time regression, and Cox proportional hazards regression, we explore the breast cancer survivors' specific attributes to identify the main determinants of survival time. Analyses show that the factors: stage, grade, primary site of the cancer, number of cancers each patient has, histology of the cancer, age, race, and income are among the main variables that enlighten why some breast cancer survivors live much longer than others. For instance, compared to White non-Hispanics, Black non-Hispanics have a shorter length of survival with a hazard ratio of (1.282). The best prognostic for White non-Hispanics, Hispanics (all races), and Black non-Hispanics is a woman aged between 40 to 49 years old, diagnosed with localized stage and grade one with Axillary tail of breast as a primary site with only one cancer and with a household income of 75,000.00 and over. Policymakers should promote early diagnosis and screening and better assist the older and the poor to improve the survival time for breast cancer patients.

Projecting the Potential Clinical and Economic Impact of Human Immunodeficiency Virus Prevention Resource Reallocation in Tennessee.

In 2023, Tennessee replaced $6.2 M in US Centers for Disease Control and Prevention (CDC) human immunodeficiency virus (HIV) prevention funding with state funds to redirect support away from men who have sex with men (MSM), transgender women (TGW), and heterosexual Black women (HSBW) and to prioritize instead first responders (FR), pregnant people (PP), and survivors of sex trafficking (SST). We used a simulation model of HIV disease to compare the clinical impact of Current, the present allocation of condoms, preexposure prophylaxis (PrEP), and HIV testing to CDC priority risk groups (MSM/TGW/HSBW); with Reallocation, funding instead increased HIV testing and linkage of Tennessee-determined priority populations (FR/PP/SST). Key model inputs included baseline condom use (45%-49%), PrEP provision (0.1%-8%), HIV testing frequency (every 2.5-4.8 years), and 30-day HIV care linkage (57%-65%). We assumed Reallocation would reduce condom use (-4%), PrEP provision (-26%), and HIV testing (-47%) in MSM/TGW/HSBW, whereas it would increase HIV testing among FR (+47%) and HIV care linkage (to 100%/90%) among PP/SST. Reallocation would lead to 166 additional HIV transmissions, 190 additional deaths, and 843 life-years lost over 10 years. HIV testing reductions were most influential in sensitivity analysis; even a 24% reduction would result in 287 more deaths compared to Current. With pessimistic assumptions, we projected 1359 additional HIV transmissions, 712 additional deaths, and 2778 life-years lost over 10 years. Redirecting HIV prevention funding in Tennessee would greatly harm CDC priority populations while conferring minimal benefits to new priority populations.

Hospital-Onset Bacteremia Among Neonatal Intensive Care Unit Patients

The Centers for Disease Control and Prevention plans to introduce hospital-onset bacteremia (HOB) as a health care-associated infection measure. The epidemiology and clinical characteristics of HOB among infants admitted to the neonatal intensive care unit (NICU) are unknown. To estimate the rate of HOB among infants admitted to the NICU, measure the association of HOB risk with birth weight group and postnatal age, and estimate HOB-attributable mortality. This retrospective multicenter cohort study and emulated trial from 2016 to 2021 included a convenience sample of 322 NICUs in the United States. Participants were infants admitted to participating NICUs for 4 or more days. The primary exposures were birth weight and postnatal age. Additional exposures included small for gestational age and central line presence. The primary study outcomes were HOB and HOB-attributable mortality. Of 451 443 included infants, 250 763 (55.6%) were male, 200 680 (44.4%) were female, and 62 091 (13.8%) were born 1500 g or less. Of 9015 HOB events that occurred among 8356 infants (2%) during 8 163 432 days at risk (unadjusted incidence rate, 1.1 per 1000 patient-days; 95% CI, 1.0-1.2), 4888 HOB events (54.2%) occurred in the absence of a central line. Within the first 2 weeks after birth, the HOB rate was 14.2 per 1000 patient-days (95% CI, 12.6-16.1) among infants born 750 g or less, to 0.4 events per 1000 patient-days among infants born more than 2500 g (95% CI, 0.4-0.5). Among infants born 750 g or less, the relative HOB risk decreased by 90% after day 42 compared with days 4 to 14 (incidence rate ratio [IRR], 0.10; 95% CI, 0.1-0.1). Conversely, among infants born more than 2500 g, the relative HOB risk increased by 50% after day 42 compared with days 4 to 14 (IRR, 1.5, 95% CI, 1.2-1.9). Compared with otherwise similar infants without HOB, infants with HOB had an absolute difference in attributable mortality of 5.5% (95% CI, 4.7-6.3). This study found that HOB events in the NICU are associated with increased mortality. Birth weight is an important risk factor for HOB; however, the relative rate of HOB decreases over postnatal age among low-birth-weight infants and increases among infants born more than 2500 g. Identifying strategies to prevent HOB and programs to decrease HOB risk are urgently needed to reduce infant mortality.

Association of State Firearm Laws With Firearm Ownership and Mortality

IntroductionFirearm injury is a leading cause of death among Americans. As the right to bear arms is protected by the Second Amendment, policy-makers must consider the impact of legislation on both firearm ownership and firearm harms. Current state of knowledge in firearm research majorly examines the impact of firearm legislation on firearm injuries and fatalities alone, and it relies on correlational analyses. The few studies that consider causal effects employ counterfactual-based inference. This study introduces information-theoretic tools to explore the role of firearm laws in mitigating firearm harms while maintaining citizens’ right to bear arms MethodsWe study monthly time series from January 2000 to October 2019 for the implementation of firearm laws from RAND's State Firearm Law Database, firearm deaths by intent from the Centers for Disease Control and Prevention databases, and firearm ownership from an econometric model. We employ transfer entropy, an information-theoretic method that relies on Granger causality, to infer relationships from time series. Specifically, we examine transfer entropy from firearm restrictiveness to deaths per firearm owner, firearm ownership, and firearm deaths, independently ResultsOn a national level, we uncover a negative association from firearm restrictiveness to deaths per firearm owner and a positive association from firearm restrictiveness to firearm ownership. On a regional level, we identify a negative association from firearm restrictiveness to deaths per firearm owner in the Northeast, a negative association from firearm restrictiveness to firearm ownership in the Midwest, and a negative association from firearm restrictiveness to firearm suicides in the South ConclusionsWe present an information-theoretic approach to study relationships in firearm research. Our method provides preliminary evidence for the role of restrictive legislation in promoting safe firearm ownership. We find that firearm acquisition considerably increases following the implementation of restrictive firearm laws and, simultaneously, firearm deaths decrease. These effects vary with respect to death by intent and the geographical region laws were implemented in.

Western and Traditional African Medicine in the Fight Against Tropical Diseases in Africa

Based on the intensity of infection and the severity of tropical diseases in patients, epidemiologists attribute many regions of the African continent to being the most problematic in the world. The wide prevalence of tropical diseases has a negative impact not only on the health of the local population but also on the incomes of some sectors of the economy, in particular, trade and tourism. However, to date, almost no state in Sub-Saharan Africa has its own full-fledged system of epidemiological control and the provision of adequate assistance to those in need. The vast majority of the rural and urban population, if necessary, turn to traditional healers, which is explained by the significant financial accessibility of this type of medical care and its openness to all segments of the population. Health care institutions in most African countries experience a deficit of modern medical and diagnostic equipment and qualified high- and middle-tier personnel needed to ensure wider coverage of the population with affordable and high-quality medical care. Assistance in this to the states of the continent is provided by various specialized organizations, including the World Health Organization, UNICEF, the African Center for Disease Control and Prevention, as well as epidemiological surveillance services. It is concluded that at present, it is the traditional methods of prevention and treatment of diseases characteristic of the climatic features of Africa that are widely demanded by the population, both in rural areas and in cities. In recent decades, in many countries on the continent, traditional medicine has received a status equal to professional medicine.

Western and Traditional African Medicine in the Fight Against Tropical Diseases in Africa

Based on the intensity of infection and the severity of tropical diseases in patients, epidemiologists attribute many regions of the African continent to being the most problematic in the world. The wide prevalence of tropical diseases has a negative impact not only on the health of the local population but also on the incomes of some sectors of the economy, in particular, trade and tourism. However, to date, almost no state in Sub-Saharan Africa has its own full-fledged system of epidemiological control and the provision of adequate assistance to those in need. The vast majority of the rural and urban population, if necessary, turn to traditional healers, which is explained by the significant financial accessibility of this type of medical care and its openness to all segments of the population. Health care institutions in most African countries experience a deficit of modern medical and diagnostic equipment and qualified high- and middle-tier personnel needed to ensure wider coverage of the population with affordable and high-quality medical care. Assistance in this to the states of the continent is provided by various specialized organizations, including the World Health Organization, UNICEF, the African Center for Disease Control and Prevention, as well as epidemiological surveillance services. It is concluded that at present, it is the traditional methods of prevention and treatment of diseases characteristic of the climatic features of Africa that are widely demanded by the population, both in rural areas and in cities. In recent decades, in many countries on the continent, traditional medicine has received a status equal to professional medicine.

Sex and Racial Disparities in Proportionate Mortality of Premature Myocardial Infarction in the United States: 1999 to 2020.

The incidence of premature myocardial infarction (PMI) in women (<65 years and men <55 years) is increasing. We investigated proportionate mortality trends in PMI stratified by sex, race, and ethnicity. CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) was queried to identify PMI deaths within the United States between 1999 and 2020, and trends in proportionate mortality of PMI were calculated using the Joinpoint regression analysis. We identified 3 017 826 acute myocardial infarction deaths, with 373 317 PMI deaths corresponding to proportionate mortality of 12.5% (men 12%, women 14%). On trend analysis, proportionate mortality of PMI increased from 10.5% in 1999 to 13.2% in 2020 (average annual percent change of 1.0 [0.8-1.2, P <0.01]) with a significant increase in women from 10% in 1999 to 17% in 2020 (average annual percent change of 2.4 [1.8-3.0, P <0.01]) and no significant change in men, 11% in 1999 to 10% in 2020 (average annual percent change of -0.2 [-0.7 to 0.3, P=0.4]). There was a significant increase in proportionate mortality in both Black and White populations, with no difference among American Indian/Alaska Native, Asian/Pacific Islander, or Hispanic people. American Indian/Alaska Natives had the highest PMI mortality with no significant change over time. Over the last 2 decades, there has been a significant increase in the proportionate mortality of PMI in women and the Black population, with persistently high PMI in American Indian/Alaska Natives, despite an overall downtrend in acute myocardial infarction-related mortality. Further research to determine the underlying cause of these differences in PMI mortality is required to improve the outcomes after acute myocardial infarction in these populations.

Trends in genitourinary cancer mortality in the United States: analysis of the CDC-WONDER database 1999-2020.

Sociodemographic disparities in genitourinary cancer-related mortality have been insufficiently studied, particularly across multiple cancer types. This study aimed to investigate gender, racial, and geographic disparities in mortality rates for the most common genitourinary cancers in the United States. Mortality data for prostate, bladder, kidney, and testicular cancers were obtained from the Centers for Disease Control and Prevention (CDC) WONDER database between 1999 and 2020. Age-adjusted mortality rates (AAMRs) were analyzed by year, gender, race, urban-rural status, and geographic region using a significance level of p < 0.05. Overall, AAMRs for prostate, bladder, and kidney cancer declined significantly, while testicular cancer-related mortality remained stable. Bladder and kidney cancer AAMRs were 3-4 times higher in males than females. Prostate cancer mortality was highest in black individuals/African Americans and began increasing after 2015. Bladder cancer mortality decreased significantly in White individuals, Black individuals, African Americans, and Asians/Pacific Islanders but remained stable in American Indian/Alaska Natives. Kidney cancer-related mortality was highest in White individuals but declined significantly in other races. Testicular cancer mortality increased significantly in White individuals but remained stable in Black individuals and African Americans. Genitourinary cancer mortality decreased in metropolitan areas but either increased (bladder and testicular cancer) or remained stable (kidney cancer) in non-metropolitan areas. Prostate and kidney cancer mortality was highest in the Midwest, bladder cancer in the South, and testicular cancer in the West. Significant sociodemographic disparities exist in the mortality trends of genitourinary cancers in the United States. These findings highlight the need for targeted interventions and further research to address these disparities and improve outcomes for all populations affected by genitourinary cancers.

Prevalence of cefixime-resistant Neisseria gonorrhoeae in Melbourne, Australia, 2021-2022.

While ceftriaxone remains the first-line treatment for gonorrhoea, the US CDC recommended cefixime as a second-line treatment in 2021. We tested 1176 Neisseria gonorrhoeae isolates among clients attending the Melbourne Sexual Health Centre in 2021-2022. The prevalence of cefixime resistance was 6.3% (74/1176), azithromycin resistance was 4.9% (58/1176) and ceftriaxone resistance was 0% (0/1176). Cefixime resistance was the highest among women (16.4%, 10/61), followed by men-who-have-sex-with-women (6.4%, 7/109), and men-who-have-sex-with-men (5.8%, 57/982). The prevalence of cefixime-resistant N. gonorrhoeae exceeds the threshold of the 5% resistance level recommended by the World Health Organization; and thus, cefixime treatment would have limited benefits in Australia.

EXPRESS: Non-Hodgkin Lymphoma Mortality Disparities Across Different Sexes, Races, and Geographic Locations.

Non-Hodgkin lymphoma (NHL) is one of the common hematological cancers in the United States (U.S.). The mortality rate of NHL in the U.S. is the sixth highest among all cancers. Our study aims to examine the trends and disparity in NHL mortality. We analyzed death certificate data from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) U.S. to determine the NHL mortality trends among the U.S. population aged ≥ 15 years. NHL (ICD-10 C82-85) was listed as the underlying cause of death. Age-adjusted mortality rates (AAMRs) per 100,000 individuals and joinpoint trend analysis were performed to determine the average annual percent change (AAPC) in AAMR trends. From 1999 to 2020, NHL accounted for 457,143 deaths in the United States, of which 54% are men and 46% are women. The NHL AAMR decreased significantly from 10.59 to 6.21 per 100,000 individuals with the AAPC of -2.55. Men had a higher AAMR than women (10.10 vs. 6.29 per 100,000 individuals). Whites recorded the highest AAMR (8.43 per 100,000 individuals), followed by Blacks (5.71 per 100,000 individuals), Hispanics (6.32 per 100,000 individuals), American Indians (5.31 per 100,000 individuals), and Asians (5.10 per 100,000 individuals). Those who lived in the Midwest and the rural areas had the highest AAMR at 8.60 and 8.35 per 100,000 individuals respectively. Despite the declining NHL mortality rate, this study calls for targeted intervention to improve outcomes for susceptible individuals affected by NHL.

Population Percentage and Population Size of Men Who Have Sex With Men in the United States, 2017-2021: Meta-Analysis of 5 Population-Based Surveys.

Male-to-male sexual transmission continues to account for the greatest proportion of new HIV diagnoses in the United States. However, calculating population-specific surveillance metrics for HIV and other sexually transmitted infections requires regularly updated estimates of the number and proportion of men who have sex with men (MSM) in the United States, which are not collected by census surveys. The purpose of this analysis was to estimate the number and percentage of MSM in the United States from population-based surveys. We used data from 5 population-based surveys to calculate weighted estimates of the proportion of MSM in the United States and pooled these estimates using meta-analytic procedures. We estimated the proportion of MSM using sexual behavior-based questions (encompassing anal or oral sex) for 3 recall periods-past 12 months, past 5 years, and lifetime. In addition, we estimated the proportion of MSM using self-reported identity and attraction survey responses. The total number of MSM and non-MSM in the United States were calculated from estimates of the percentage of MSM who reported sex with another man in the past 12 months. The percentage of MSM varied by recall period: 3.3% (95% CI 1.7%-4.9%) indicated sex with another male in the past 12 months, 4.7% (95% CI 0.0%-33.8%) in the past 5 years, and 6.2% (95% CI 2.9%-9.5%) in their lifetime. There were comparable percentages of men who identified as gay or bisexual (3.4%, 95% CI 2.2%-4.6%) or who indicated that they are attracted to other men (4.9%, 95% CI 3.1%-6.7%) based on pooled estimates. Our estimate of the total number of MSM in the United States is 4,230,000 (95% CI 2,179,000-6,281,000) based on the history of recent sexual behavior (sex with another man in the past 12 months). We calculated the pooled percentage and number of MSM in the United States from a meta-analysis of population-based surveys collected from 2017 to 2021. These estimates update and expand upon those derived from the Centers for Disease Control and Prevention in 2012 by including estimates of the percentage of MSM based on sexual identity and sexual attraction. The percentage and number of MSM in the United States is an important indicator for calculating population-specific disease rates and eligibility for preventive interventions such as pre-exposure prophylaxis.

A Qualitative Evaluation of the Acceptability of Shigellosis Prevention Recommendations Among Gay, Bisexual, and Other Men Who Have Sex With Men.

Shigellosis is diarrheal disease caused by highly infectious Shigella bacteria. Shigella can spread in multiple ways, including sexual contact. Gay, bisexual, and other men who have sex with men are particularly at risk for shigellosis. To evaluate the acceptability of 3 Centers for Disease Control and Prevention-developed behavioral recommendations for the prevention of sexually transmitted shigellosis, virtual in-depth interviews were conducted among 26 gay or bisexual men in March to May 2021. Participants had a median age of 25 years; 65% were non-Hispanic White, 12% were Hispanic White, 12% Asian, 4% Hispanic Black, and 8% multiracial/other. Respondents indicated willingness to engage in certain prevention behaviors (e.g., washing hands, genitals, and anus before and after sex), but were less willing to engage in behaviors that were viewed as outside social norms or difficult to practice (e.g., dental dams for oral-anal contact; latex gloves for fingering or fisting). Respondents thought recommendations may be more feasible if knowledge of shigellosis was greater; however, some perceived that the severity of shigellosis is low and did not warrant the effort of engaging in prevention behaviors. Educational efforts to increase awareness of shigellosis and other enteric diseases spread through sexual contact are needed and public health practitioners should consider the acceptability of how realistic it is for individuals to engage in certain prevention behaviors. Rather than recommending behaviors that do not have buy-in, it may be more efficacious to focus recommendations on adopting behaviors reported as acceptable to the target audience.