Centers For Disease Control Research Articles

Quantifying Patient Preferences and Expectations About Diabetic Retinopathy Monitoring.

Diabetic retinopathy (DR) is the leading cause of blindness among adults in the US. The US Centers for Disease Control and Prevention recommends annual DR monitoring for all individuals with diabetes, yet monitoring rates remain below 70%. To evaluate how patient preferences and expectations about DR monitoring are associated with expected monitoring adherence behaviors. In this survey study, a web-enabled survey instrument was developed and implemented with a discrete-choice experiment to characterize patient preferences for outcomes of DR monitoring and graded-pair questions to quantify patients' expectations about the impact of DR monitoring on blindness risk. The survey was conducted through ResearchMatch, a US National Institutes of Health-developed online platform, among adults with self-reported, physician-diagnosed diabetes. Recruitment occurred between September 15, 2023, and October, 17, 2023, and data analysis occurred between October 2023 and December 2023. Results from the 2 tasks were combined to derive patients' expected monitoring behavior following a recently proposed treatment adherence framework. The survey instrument was pretested in cognitive interviews and validated for the purposes of this study. Survey-based discrete-choice experiment and graded-pair questions. Participants' relative preferences for DR-related blindness risk reductions, monitoring time, and out-of-pocket monitoring costs were quantified, as well as the degree to which participants expected adherence to monitoring to affect the risk of blindness. By combining how much participants valued specific reductions in blindness risk (relative to monitoring costs) and their expected risk reduction through monitoring, the rate at which patients would maximize the benefit of monitoring appointments was assessed. The survey was completed satisfactorily by 304 respondents of 542 individuals invited to participate. Mean (SD) respondent age was 40.5 (11.2) years, and 169 respondents (56.1%) were female. Reductions in blindness risk were valuable to participants. Participants required a 3.87 (95% CI, 1.91-5.88) percentage-point reduction in 5-year blindness risk to be fully adherent to an annual 53-minute monitoring visit with a $26 co-payment, but respondents expected DR monitoring to reduce the 5-year blindness risk by 0.71 (95% CI, 0.21-1.28) percentage points. In this online survey study among adults with diabetes, measurement of patient preferences and expectations about DR monitoring with properly validated instruments offered an opportunity to assess patient health behaviors. The association between preferences and monitoring expectations was generally consistent with monitoring nonadherence among adults with diabetes and offers insights that may help address inconsistent DR monitoring.

Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective study

BackgroundBreast cancer survivors face a higher risk of cardiovascular disease (CVD) compared to non-breast cancer patients, yet contemporary data on CVD-related mortality within this group remains scarce.ObjectiveTo investigate trends and disparities in CVD mortality among breast cancer patients.MethodsWe queried the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC Wonder) and conducted serial cross-sectional analyses on national death certificate data for CVD mortality in breast cancer patients aged 25 and above from 1999 to 2020. We calculated age-adjusted mortality rates (AAMR) per 100,000 individuals and analyzed trends over time using the Joinpoint Regression Program, with further analyses stratified by age, race, census region, and urbanization level.ResultsA total of 74,733 CVDs with comorbid breast cancer in the United States were identified between 1999 and 2020. The AAMR from CVDs with comorbid breast cancer decreased from 2.57 (95% CI [2.50–2.65]) in 1999 to 1.20 (95% CI [1.15–1.24]) in 2020, with an average annual percent change (AAPC) of − 4.3. The three most common causes of CVDs were ischemic heart disease (47.8%), cerebrovascular disease (17.1%), and hypertensive disease (10.6%). Our analysis revealed a significant decrease in AAMR for all CVD subtypes, except for hypertensive diseases and arrhythmias. The decrease in annual percent change (APC) was more pronounced in individuals aged ≥ 65 years compared to those < 65 years (-4.4, 95%CI [-4.9, -3.9] vs. -2.9, 95%CI [-4.1, -1.7], respectively. Notably, non-Hispanic Blacks consistently exhibited the highest AAMR (1.95, 95%CI [1.90–1.99]), whereas Hispanic or Latina patients had the lowest AAMR (0.75, 95% CI [0.72–0.78]). The AAMR was also higher in rural regions than in urban areas (1.64, 95%CI [1.62–1.67] vs. 1.55, 95%CI [1.53–1.56]).ConclusionThe study highlights a significant decline in CVD mortality among breast cancer patients over two decades, with persistent disparities by race and region. Exceptionally, hypertensive diseases and arrhythmias did not follow this declining trend.

Impacts of the US CDC recommendation on human papillomavirus vaccine uptake, 2010–2015

ObjectivesAs one type of vaccine policy, the effectiveness and spillover effects of the US CDC vaccine recommendations are inadequately evaluated. This study aims to fully evaluate its impacts on male adults, in addition to children, using better data.DesignA before-after study design to examine the CDC’s 2011 HPV vaccine recommendation for men aged 11–21.Data analysisIndividual-level data included the 2010–2015 US National Health Interview Survey full sample of 7,000 male children aged 11–18, younger adults aged 19–21 and 22–25, and older adults aged 26–60. Pooled cross-sectional surveys contained individual-level vaccination, socioeconomic, and demographic information. Outcome variable is an individual HPV vaccination status, measured as individual probability of HPV vaccination. Dummy regressions were estimated by a Linear Probability Model (LPM) with fixed effects for target and non-target age groups.ResultsThe policy was significantly associated with a 14.8% (p &amp;lt; 0.001) increased individual likelihood of HPV vaccination for men aged 11–21. It was also associated with a modest spillover effect, a 5.6% (p &amp;lt; 0.001) increased individual likelihood for men aged 22–25 and marginally for men aged 26–60. African American men and men with poor health were 2.7 and 15.4% less likely to uptake HPV vaccines than white men and men with good or fair health, respectively.ConclusionThis study complements the existing policy evaluation literature on HPV vaccine recommendation among male children by including adults and using better data. Findings offer comprehensive evidence of the effectiveness and spillover effects of this recommendation type of federal-level policy, provide policy lessons for other vaccines, and identify vulnerable subpopulations as targets for future policies.

Development of Effective Medical Countermeasures Against the Main Biowarfare Agents: The Importance of Antibodies

The COVID-19 and mpox crisis has reminded the world of the potentially catastrophic consequences of biological agents. Aside from the natural risk, biological agents can also be weaponized or used for bioterrorism. Dissemination in a population or among livestock could be used to destabilize a nation by creating a climate of terror, by negatively impacting the economy and undermining institutions. The Centers for Disease Control and Prevention (CDC) classify biological agents into three categories (A or Tier 1, B and C) according to the risk they pose to the public and national security. Category A or Tier 1 consists of the six pathogens with the highest risk to the population (Bacillus anthracis, Yersinia pestis, Francisella tularensis, botulinum neurotoxins, smallpox and viral hemorrhagic fevers). Several medical countermeasures, such as vaccines, antibodies and chemical drugs, have been developed to prevent or cure the diseases induced by these pathogens. This review presents an overview of the primary medical countermeasures, and in particular, of the antibodies available against the six pathogens on the CDC’s Tier 1 agents list, as well as against ricin.

Trends and Disparities in Cardiovascular Disease-Related Mortality among Adults with Myeloproliferative Neoplasms in the United States

Abstract Aims We aimed to perform a retrospective cohort study using the Centers for Disease Control and Prevention`s (CDC's) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database to analyze the trends in cardiovascular disease (CVD)-related mortality in patients with myeloproliferative neoplasms (MPN) from 1999-2020. Methods and Results We analyzed the death certificate data from the CDC WONDER database from 1999 to 2020 for CVD with co-morbid myeloproliferative disorders in the US population. Age-adjusted mortality rates (AAMR) and 95% confidence intervals (CIs) were computed per 1 million population by standardizing crude mortality rates to the 2000 US census population. To assess annual national mortality trends, we employed the Joinpoint regression model, calculating the annual percent change (APC) in AAMR and corresponding 95% CIs. A total of 15,269 deaths related to CVD occurred in patients with co-morbid myeloproliferative neoplasms from 1999-2020. Overall, there was a decreasing trend in CVD-related AAMRs throughout these years. Males contributed to 51% of total deaths and their AAMR was persistently higher than women throughout the study. Non-Hispanic (NH) Whites had the highest overall AAMR, followed by NH Blacks, NH American Indians or Alaska Natives, Hispanics or Latinos, and NH Asian or Pacific Islanders. Conclusion Our findings indicate a significant decline with notable gender, racial/ethnic, and regional differences in CVD-related mortality among patients with MPN over the past two decades. We emphasize the importance of a collaborative approach between oncologists and cardiologists in managing these patients, highlighting the potential benefits of integrating cardio-oncology services to enhance patient outcomes.

Unpacking WHO and CDC Bottle Bioassay Methods: A Comprehensive Literature Review and Protocol Analysis Revealing Key Outcome Predictors

Background Resistance monitoring is a key element in controlling vector-borne diseases. The World Health Organization (WHO) and Centres for Disease Control and Prevention (CDC) have each developed bottle bioassay methods for determining insecticide susceptibility in mosquito vectors which are used globally. Methods This study aimed to identify variations in bottle bioassay methodologies and assess the potential impact on the data that is generated. Our approach involved a systematic examination of existing literature and protocols from WHO and CDC, with a focus on the specifics of reported methodologies, variation between versions, and reported outcomes. Building on this, we experimentally evaluated the impact of several variables on bioassay results. Results Our literature review exposed a significant inconsistency in the how bioassay methods are reported, hindering reliable interpretation of data and the ability to compare results between studies. The experimental research provided further insight by specifically identifying two key factors that influence the outcomes of bioassays: mosquito dry weight and relative humidity (RH). This finding not only advances our comprehension of these assays but also underscores the importance of establishing precisely defined methodologies for resistance monitoring. The study also demonstrates the importance of controlling bioassay variables, noting the significant influence of wing length, as an indicator of mosquito size, on mortality rates in standardized bioassays. Conclusions Generating data with improved protocol consistency and precision will not only deepen our understanding of resistance patterns but also better inform vector control measures. We call for continued research and collaboration to refine and build consensus on bioassay techniques, to help bolster the global effort against vector-borne diseases like malaria.

Trends in Sudden Cardiac Death Among Adults Aged 25 to 44 Years in the United States: An Analysis of 2 Large US Databases.

Sudden cardiac death (SCD) in early adults aged 25 to 44 years represents an important and unexpected cause of death. We assessed trends in SCD-related mortality in the United States from 1999 to 2020 among early adults to determine differences by sex, ethnoracial groups, urbanization, and census region. Mortality data were retrieved from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) data set from 1999 to 2020. Age-adjusted mortality rates were assessed using the Joinpoint regression modeling and expressed as estimated average annual percentage change with relative 95% CIs. Trends in prevalence of coronary artery disease/myocardial infarction, heart failure, and stroke, which may have contributed to SCD-related mortality over the same period, were obtained from the National Health and Nutrition Examination Survey. From 1999 to 2020, 10 516 US early adults aged 25 to 44 years had SCD (7832 men and 2684 women), resulting in 3.72 deaths per 1000 population, or a mean of 478 deaths annually. The relative age-adjusted mortality rate increased linearly (average annual percentage change: +1.0% [95% CI, 0.3-1.8]), without sex differences. The age-adjusted mortality rate increase was more pronounced in Black patients, Hispanic/Latinx patients, and residents of rural areas. Higher absolute numbers of SCDs were clustered in the South (47.6%). During the same period, the prevalence of coronary artery disease/myocardial infarction, heart failure, and stroke plateaued. SCD-related mortality associated with opioids/stimulants overdose significantly increased over the entire study period. SCD-related mortality among early adults has increased over the last 2 decades in the United States with notable racial and regional disparities.

Trends in complications of cardiac and vascular prosthetic devices, implants, and grafts mortality rate in the United States (1999–2020)

To analyze mortality rates due to complications of cardiac and vascular prosthetic devices, implants, and grafts in the United States, International Classification of Diseases, Tenth Revision, codes were used on the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER) database to retrieve death certificate data between the years 1999 and 2020 for patients aged 55 and above. Age-adjusted mortality rates (AAMRs), per 100 000 people, and annual percentage change along with their respective 95% confidence intervals were also calculated. Complications of cardiac and vascular prosthetic devices, implants, and grafts were responsible for 91 539 deaths among adults aged 55 years and older. The overall AAMR decreased from 9.2 in 1999 to 3.4 in 2020. AAMRs for men were higher than for women (overall AAMR men: 7.5; women: 4.5). Stratifying patients according to race the order of AAMRs from highest to lowest was as follows: non-Hispanic Black or African American (6.8), NH White: (5.9), NH American Indian or Alaska Native (5.7), Hispanic or Latino (4.0) and lastly NH Asian or Pacific Islander (3.2). State wise the top 90th percentile states with regard to mortality included West Virginia, South Carolina, Mississippi, North Dakota, and Alabama. In census regions the South had the highest AAMR (6.2) followed by the Midwest (6.0), the Northeast (5.4), and the West (5.1) with nonmetropolitan areas having higher AAMRs (7.0) than metropolitan areas (5.4). Further research and a more individualized pattern of treatment of older patients are necessary moving forward.

Monitoring measles infections using flight passenger dynamics in Europe: A data-driven approach

This paper presents an open-access repository collecting information on measles virus infections and flight passenger movements in European countries from 2011 to 2023. It provides a comprehensive overview of reported measles cases and measles-mumps-rubella (MMR) vaccination coverage from authoritative organizations such as the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC). In addition, the dataset includes detailed data on passenger movements between countries, facilitating analysis of cross-border disease transmission. This resource enables more precise spatial analyses for monitoring and forecasting measles outbreaks, underscoring the importance of adequate vaccination coverage and sustained international surveillance to prevent the spread of the disease.

Applying an ICD-10 to ICD-11 mapping tool to identify causes of death codes in an Alberta dataset

BackgroundThe most recent and 11th revision of the International Classification of Disease (ICD-11) is in use as of January 2022, and countries around the globe are now preparing for the implementation of ICD-11 and transition from the 10th revision (ICD-10). Translation of current coding is required for historical comparisons.MethodsWe applied the World Health Organization (WHO) mapping tables to current Centers for Disease Control and Prevention (CDC) Lists of ICD-10 coding of underlying causes of death to assess what ICD-11 codes look like in an Alberta sample of causes of death (COD). We prepared frequency tables for a single year of COD in Alberta based on the CDC grouping of COD.ResultsThe mapping success rate at the ICD-10 code level for the adult population (> 18 years) was 96.6% and 100% for children (1–17 years) and infants (< 1 year). The mapping success rate by patient was 99.5% for the adult population patient deaths and 100% for children and infants. We mapped ICD-11 codes to identify the ten most frequently reported underlying COD in Alberta for 24,645 deaths in adults, children, and infants in 2017.ConclusionsApart from two codes, all ICD-10 codes could be mapped to ICD-11 for underlying COD. These findings suggest that the ability to translate from the two iterations of coding will be feasible for future applications of health services data.

A content analysis of government-issued social media posts during multi-jurisdictional enteric illness outbreaks in Canada

IntroductionMost Canadians use at least one social media platform regularly, making social media a potentially effective tool for reaching broad audiences. The Public Health Agency of Canada (PHAC) uses social media as one tool for rapidly communicating with the public during multi-jurisdictional enteric illness outbreaks. However, the effectiveness of social media in enhancing public risk communication during these outbreaks remains unexplored. Addressing this gap may help optimise social media use for risk communication to inform the public and prevent additional illness. This study aims to analyse the engagement with and quality of PHAC’s social media content regarding multi-jurisdictional enteric illness outbreaks.MethodsUsing a search of PHAC’s social media platforms, 482 posts during enteric illness outbreaks (2014–2022) were identified, including 198 posts from Facebook and 284 posts from X (formerly Twitter) in English and French. A codebook was developed using engagement metrics for gauging public interest, the Centers for Disease Control and Prevention’s (CDC) Modified Clear Communication Index (CCI) to assess clarity as a proxy for comprehension, the Health Belief Model (HBM) to evaluate the potential to motivate behaviour change, and measures of consistency. Descriptive statistics were used to analyse post content.ResultsThe average engagement rates for PHAC social media accounts were &amp;lt; 1%, below standard average engagement rates (1–5%). While posts generally adhered to the CDC’s CCI criteria, clear language (45.7% on Facebook, 26.5% on X) and clear communication of risk (7.6% on Facebook, 0.0% on X) were scarce. HBM constructs were present in all posts, but certain constructs, such as barriers were used sparingly (1% on Facebook, 0% on X). Despite this, posts consistently communicated outbreak investigation details and prevention information.DiscussionThe low average engagement rates suggest a lack of public awareness or interest in the posts. The partial adherence to the CCI indicates room for improvement in clarity, a key component for supporting public understanding. Although some HBM constructs were utilised, no posts incorporated all HBM constructs, which may hinder efforts to promote behaviour change. To enhance effective risk communication using social media during multi-jurisdictional enteric illness outbreaks in Canada, tools like the CDC’s CCI should be used to improve message clarity, use of all HBM constructs as applicable, and message consistency across products and channels are recommended to improve overall message quality and content.

Retrospective analysis of health and economic burden among commercially-insured individuals diagnosed with invasive meningococcal disease in the United States

ABSTRACT Invasive meningococcal disease (IMD) is a life-threatening yet vaccine-preventable disease, with vaccines approved and recommended in the United States by the Centers for Disease Control and Prevention. This study assessed complications, mortality, healthcare resource utilization (HCRU), and healthcare costs among a sample of commercially-insured individuals living in the United States who experienced IMD. We used retrospective data from large claims databases limited to individuals with IMD covered by commercial health plans between January 2010–March 2022. Health outcomes, HCRU, and healthcare costs were analyzed during the acute (index date to 30 days post-hospital discharge) and post-acute (end of acute phase to end of follow-up period) phases. Among 618 IMD cases identified, the most common acute phase complications were severe brain damage, renal failure, and autoimmune disease. The most common post-acute phase complications were autoimmune disease, arthralgia, and renal failure. Acute phase HCRU ranged from 72.7 (95% confidence interval [CI] 19.81–186.12) intensive care unit (ICU) stays to 12,102.9 (95% CI 11,201.07–13,058.00) surgeries per 1,000 patient-years. Post-acute phase HCRU ranged from 3.6 (95% CI 1.18–8.50) ICU stays to 7,808.3 (95% CI 7,661.22–7,957.54) specialty physician visits per 1,000 patient-years. Patients with IMD incurred average healthcare costs of $60,866.23 and $145,883.65 during the acute and post-acute phases, respectively. Negative health outcomes and high HCRU and costs were observed among commercially-insured patients with IMD. Our findings suggest that IMD immunization efforts and healthcare interventions targeting education on vaccine recommendations to healthcare providers and patients could help prevent IMD and reduce disease burden.

Climate Change and Emerging Infectious Diseases: A Precarious Relationship.

Climate change is apparent. Temperatures are rising. Floods are more frequent and devastating. Climate changes can favor the development of emerging infectious diseases. The number of animal reservoirs and vector hosts can increase, further spreading pathogens. Many emerging infectious diseases were not historically considered major threats in US but have become a major concern in US territories and various states. In June 2024, the Centers for Disease Control and Prevention issued a Health Alert Network advisory about an increase in local transmission of dengue fever. Preventing the transmission of emerging infectious diseases has become a focus of regulatory agencies. Nurse education at all levels should include infectious diseases and be coordinated with local, state, and regional institutions. Emerging infectious diseases are now formidable challenges to health care.

Robert (Bob) T. Fraser (1946-2023).

This article memorializes Robert (Bob) T. Fraser (1946-2023), a dedicated advocate for people with disabilities. Bob's contributions were prolific; he authored or coauthored more than 140 peer-reviewed journal articles and book chapters and coedited five texts. He was awarded Federal grants by the National Institute on Disability, Independent Living, and Rehabilitation Research, the Rehabilitation Services Administration, and the Centers for Disease Control and Prevention. Bob was an integral part of a Traumatic Brain Injury Model Systems research team, specializing in outcomes and cost efficacy of return-to-work interventions (e.g., one-to-one placement, supported employment, and paid coworker as trainer) following moderate-to-severe traumatic brain injury. Highlights of Fraser's career and professional contributions are noted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prioritisation of infectious diseases from a public health perspective: a multi-criteria decision analysis study, France, 2024.

BackgroundWithin the International Health Regulations framework, the French High Council for Public Health was mandated in 2022 by health authorities to establish a list of priority infectious diseases for public health, surveillance and research in mainland and overseas France.AimOur objective was to establish this list.MethodsA multi-criteria decision analysis was used, as recommended by the European Centre for Disease Prevention and Control. A list of 95 entities (infectious diseases or groups of these, including the World Health Organization (WHO)-labelled 'Disease X') was established by 17 infectious disease experts. Ten criteria were defined to score entities: incidence rate, case fatality rate, potential for emergence and spread, impact on the individual, on society, on socially vulnerable groups, on the healthcare system, and need for new preventive tools, new curative therapies, and surveillance. Each criterion was assigned a relative weight by 77 multidisciplinary experts. For each entity, 98 physicians from various specialties rated each criterion against the entity, using a four-class Likert-type scale; the ratings were converted into numeric values with a nonlinear scale and respectively weighted to calculate the entity score.ResultsFifteen entities were ranked as high-priorities, including Disease X and 14 known pathologies (e.g. haemorrhagic fevers, various respiratory viral infections, arboviral infections, multidrug-resistant bacterial infections, invasive meningococcal and pneumococcal diseases, prion diseases, rabies, and tuberculosis).ConclusionThe priority entities agreed with those of the WHO in 2023; almost all were currently covered by the French surveillance and alert system. Repeating this analysis periodically would keep the list updated.

Do not let perfect be the enemy of good: the current reality of Bordetella testing.

Diagnosis of Bordetella pertussis is made by using polymerase chain reaction (PCR) to detect insertion sequence 481 (IS481). However, IS481 is found in both B. pertussis and Bordetella holmesii. In a recent study, Cole et al. (Microbiol Spectr 12:e00783-24. https://doi.org/10.1128/spectrum.00783-24) compared the accuracy of assays performed at two different commercial laboratories that used IS481 as a molecular target against a multiplex PCR assay performed at the Centers for Disease Control and Prevention (CDC) that can differentiate the different Bordetella species. The results demonstrated that the overall agreement among the assays from the commercial laboratories and the CDC was 85%. Only a small percentage (1.4%) of specimens positive for IS481 were identified as B. holmesii. This study suggests that PCR tests using IS481 as a target provide reliable diagnosis for pertussis. However, end users should recognize the limitations of PCR testing for pertussis including the inability to differentiate and monitor transmission of non-pertussis Bordetella species.

The Prevalence of Sickle Cell Disease in Colorado and Methodologies of the Colorado Sickle Cell Data Collection Program: Public Health Surveillance Study.

Sickle cell disease (SCD) is a genetic blood disorder that affects approximately 100,000 individuals in the United States, with the highest prevalence among Black or African American populations. While advances in care have improved survival, comprehensive state-level data on the prevalence of SCD remain limited, which hampers efforts to optimize health care services. To address this gap, the Colorado Sickle Cell Data Collection (CO-SCDC) program was established in 2021 as part of the Centers for Disease Control and Prevention's initiative to enhance surveillance and public health efforts for SCD. The objectives of this study were to describe the establishment of the CO-SCDC program and to provide updated estimates of the prevalence and birth prevalence of SCD in Colorado, including geographic dispersion. Additional objectives include evaluating the accuracy of case identification methods and leveraging surveillance activities to inform public health initiatives. Data were collected from Health Data Compass (a multi-institutional data warehouse) containing electronic health records from the University of Colorado Health and Children's Hospital Colorado for the years 2012-2020. Colorado newborn screening program data were included for confirmed SCD diagnoses from 2001 to 2020. Records were linked using the Colorado University Record Linkage tool and deidentified for analysis. Case definitions, adapted from the Centers for Disease Control and Prevention's Registry and Surveillance System for Hemoglobinopathies project, classified cases as possible, probable, or definite SCD. Clinical validation by hematologists was performed to ensure accuracy, and prevalence rates were calculated using 2020 US Census population estimates. In 2019, 435 individuals were identified as living with SCD in Colorado, an increase of 16%-40% over previous estimates, with the majority (n=349, 80.2%) identifying as Black or African American. The median age of individuals was 19 years. The prevalence of SCD was highest in urban counties, with concentrations in Arapahoe, Denver, and El Paso counties. Birth prevalence of SCD increased from 11.9 per 100,000 live births between 2010 and 2014 to 20.1 per 100,000 live births between 2015 and 2019 with 58.5% (n=38) of cases being hemoglobin (Hb) SS or HbSβ0 thalassemia subtypes. The study highlighted a 67% (n=26) increase in SCD births over the decade, correlating with the growth of the Black or African American population in the state. The CO-SCDC program successfully established the capacity to perform SCD surveillance and, in doing so, identified baseline prevalence estimates for SCD in Colorado. The findings highlight geographic dispersion across Colorado counties, highlighting the need for equitable access to specialty care, particularly for rural populations. The combination of automated data linkage and clinical validation improved case identification accuracy. Future efforts will expand surveillance to include claims data to better capture health care use and address potential underreporting. These results will guide public health interventions aimed at improving care for individuals with SCD in Colorado.

Trends in sepsis-associated cardiovascular disease mortality in the United States, 1999 to 2022

PurposeCardiovascular disease (CVD) is the leading cause of death in the United States, and sepsis significantly contributes to hospitalization and mortality. This study aims to assess the trends of sepsis-associated CVD mortality rates and variations in mortality based on demographics and regions in the US.MethodsThe Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to identify CVD and sepsis-related deaths from 1999 to 2022. Data on gender, race and ethnicity, age groups, region, and state classification were statistically analyzed to obtain crude and age-adjusted mortality rates (AAMR). The Joinpoint Regression Program was used to determine trends in mortality within the study period.ResultsDuring the study period, there were a total of 1,842,641 deaths with both CVD and sepsis listed as a cause of death. Sepsis-associated CVD mortality decreased between 1999 and 2013, from AAMR of 65.7 in 1999 to 58.8 in 2013 (APC −1.06*%, 95% CI: −2.12% to −0.26%), then rose to 74.3 in 2022 (APC 3.23*%, 95% CI: 2.18%–5.40%). Throughout the study period, mortality rates were highest in men, NH Black adults, and elderly adults (65+ years old). The Northeast region, which had the highest mortality rate in the initial part of the study period, was the only region to see a decline in mortality, while the Northwest, Midwest, and Southern regions experienced significant increases in mortality rates.ConclusionSepsis-associated CVD mortality has increased in the US over the past decade, and both this general trend and the demographic disparities have worsened since the onset of the COVID-19 pandemic.

The Scientific Basis and The Critiical Importance of Hand Hygiene in Fighting Infection and Preventing the Transmission of Diseases

Introduction. Hand hygiene is one of the most important preventive methods to combat infections and prevent the transmission of harmful germs. It is an easy way to protect oneself from infections and the accumulation of germs. Hands are the primary pathways for the transmission of germs, either through direct contact with other people or by touching contaminated surfaces and objects. Washing hands with soap and water or using hand sanitizers plays a vital role in reducing the spread and transmission of many diseases caused by touching the mouth, eyes, or nose. Methods. To complete this research on hand hygiene, I followed a systematic approach and employed several methods to ensure a comprehensive and accurate output. Here's the process: Searching for Reliable Scientific Sources. I relied on reputable global organizations, such as Centers for Disease Control and Prevention (CDC): To understand the appropriate techniques and health benefits of handwashing. Conclusion: This research was prepared with a rigorous methodology, combining scientific analysis and logical organization to deliver content that effectively meets the reader's needs

Assessing Resources Devoted to Electronic Reporting and Automation Among Central Cancer Registries Meeting National Program of Cancer Registries (NPCR) Quality Standards

The Centers for Disease Control and Prevention (CDC) has emphasized a need for data modernization initiatives (DMIs) to improve the quality and timeliness of cancer surveillance data. To guide such DMI efforts, we need data on the resources required to generate high-quality data. Twenty-one central cancer registries (CCRs) collected data from July 2020 to June 2021. We explored the potential relationship between resources for (1) electronic reporting and automation and (2) the quality of CCR data. We then compared activity-based costs of registries that always (n = 8), sometimes (n = 6), or seldom/never (n = 7) met data quality standards for completeness, timeliness, duplicate rate, and missing values. We found the registries that consistently met data quality standards used more resources on setting up processes to acquire data, training staff, and processing data. Compared to high-quality registries, registries that seldom/never met quality standards spent the most on case finding/data abstraction of non-hospital records. This study provides key findings for resource use, which can guide advancements when implementing electronic reporting and automation to improve CCR operations.