Risk Factors for Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Homeless Shelters in Chicago, Illinois—March–May, 2020

Abstract Background People experiencing homelessness are at increased risk of coronavirus disease 2019 (COVID-19), but little is known about specific risk factors for infection within homeless shelters. Methods We performed widespread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction testing and collected risk factor information at all homeless shelters in Chicago with at least 1 reported case of COVID-19 (n = 21). Multivariable, mixed-effects log-binomial models were built to estimate adjusted prevalence ratios (aPRs) for SARS-CoV-2 infection for both individual- and facility-level risk factors. Results During March 1 to May 1, 2020, 1717 shelter residents and staff were tested for SARS-CoV-2; 472 (27%) persons tested positive. Prevalence of infection was higher for residents (431 of 1435, 30%) than for staff (41 of 282, 15%) (prevalence ratio = 2.52; 95% confidence interval [CI], 1.78–3.58). The majority of residents with SARS-CoV-2 infection (293 of 406 with available information about symptoms, 72%) reported no symptoms at the time of specimen collection or within the following 2 weeks. Among residents, sharing a room with a large number of people was associated with increased likelihood of infection (aPR for sharing with >20 people compared with single rooms = 1.76; 95% CI, 1.11–2.80), and current smoking was associated with reduced likelihood of infection (aPR = 0.71; 95% CI, 0.60–0.85). At the facility level, a higher proportion of residents leaving and returning each day was associated with increased prevalence (aPR = 1.08; 95% CI, 1.01–1.16), whereas an increase in the number of private bathrooms was associated with reduced prevalence (aPR for 1 additional private bathroom per 100 people = 0.92; 95% CI, 0.87–0.98). Conclusions We identified a high prevalence of SARS-CoV-2 infections in homeless shelters. Reducing the number of residents sharing dormitories might reduce the likelihood of SARS-CoV-2 infection. When community transmission is high, limiting movement of persons experiencing homelessness into and out of shelters might also be beneficial.

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Prevalence of comorbidities and evaluation of their screening in spondyloarthritis: results of the international cross-sectional ASAS-COMOSPA study

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-208174 ◽

2015 ◽

Vol 75 (6) ◽

pp. 1016-1023 ◽

Cited By ~ 102

Author(s):

Anna Moltó ◽

Adrien Etcheto ◽

Désirée van der Heijde ◽

Robert Landewé ◽

Filip van den Bosch ◽

...

Keyword(s):

Risk Factors ◽

Gastroduodenal Ulcer ◽

International Study ◽

Daily Practice ◽

Systematic Evaluation ◽

Cross Sectional ◽

Unknown Risk ◽

Increased Risk ◽

High Prevalence ◽

Cholesterol Measurement

BackgroundIncreased risk of some comorbidities has been reported in spondyloarthritis (SpA). Recommendations for detection/management of some of these comorbidities have been proposed, and it is known that a gap exists between these and their implementation in practice.ObjectiveTo evaluate (1) the prevalence of comorbidities and risk factors in different countries worldwide, (2) the gap between available recommendations and daily practice for management of these comorbidities and (3) the prevalence of previously unknown risk factors detected as a result of the present initiative.MethodsCross-sectional international study with 22 participating countries (from four continents), including 3984 patients with SpA according to the rheumatologist.Statistical analysisThe prevalence of comorbidities (cardiovascular, infection, cancer, osteoporosis and gastrointestinal) and risk factors; percentage of patients optimally monitored for comorbidities according to available recommendations and percentage of patients for whom a risk factor was detected due to this study.ResultsThe most frequent comorbidities were osteoporosis (13%) and gastroduodenal ulcer (11%). The most frequent risk factors were hypertension (34%), smoking (29%) and hypercholesterolaemia (27%). Substantial intercountry variability was observed for screening of comorbidities (eg, for LDL cholesterol measurement: from 8% (Taiwan) to 98% (Germany)). Systematic evaluation (eg, blood pressure (BP), cholesterol) during this study unveiled previously unknown risk factors (eg, elevated BP (14%)), emphasising the suboptimal monitoring of comorbidities.ConclusionsA high prevalence of comorbidities in SpA has been shown. Rigorous application of systematic evaluation of comorbidities may permit earlier detection, which may ultimately result in an improved outcome of patients with SpA.

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754. Prevalence of Latent Tuberculosis Infection Among Healthcare Workers at a Tertiary Care University Hospital

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.761 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S271-S271

Author(s):

Eun Ju Choo ◽

Se Yoon Park

Keyword(s):

Risk Factors ◽

Healthcare Workers ◽

Latent Tuberculosis Infection ◽

Tertiary Care ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

University Hospital ◽

Increased Risk ◽

High Prevalence ◽

Univariate Analyses

Abstract Background We investigated the prevalence of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) and analyzed its risk factors in a tertiary care university hospital in South Korea in a population with intermediate tuberculosis (TB) burden. Methods A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant. QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay and chest radiography were performed to investigate the rate of LTBI. Results A total of 1,429 participants, 213 (14.9%) doctors and 988 (69.1%) nurses and 228 (16.0%) others were enrolled. The mean age of the subjects was 33.0 years old, and 1,175 (82.2%) were female. Of the participants, 94.5% had received BCG vaccine. QFT-GIT assays were positive for 156 subjects (10.9%). Of the 213 doctors, 28 (13.1%) were positive by QFT-GIT, and among the 988 nurses, 94 (9.5%) had positive QFT-GIT results. Experience of working in hospital was significantly associated with positive LTBI test results by QFT-GIT assay. Gender and duration of employment as an HCW were significantly associated with having a positive QFT-GIT result in univariate analyses. In multivariate analyses, duration of employment as an HCW (>15 years) (odds ratio, 1.98; 95% confidence interval, 1.14–3.43) was independently associated with increased risk of a positive QFT-GIT result. Conclusion A high prevalence of LTBI was found among our HCWs. Considering the association between the experience of working in hospital and high risk of LTBI. The risk for tuberculosis infection among HCWs was higher than general population, which suggests that stricter preventive strategies against nosocomial tuberculosis infection should be implemented. Disclosures All authors: No reported disclosures.

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Simultaneity and aggregation of risk factors for noncommunicable diseases among brazilian adolescents

Escola Anna Nery ◽

10.1590/2177-9465-ean-2018-0320 ◽

2019 ◽

Vol 23 (3) ◽

Author(s):

Fabiana Lucena Rocha ◽

Gustavo Velasquez-Melendez

Keyword(s):

Risk Factors ◽

Physical Inactivity ◽

School Health ◽

Fruits And Vegetables ◽

Prevalence Ratio ◽

Risk Groups ◽

Noncommunicable Diseases ◽

High Prevalence ◽

Random Aggregation ◽

Low Consumption

Abstract Objective: To estimate the prevalence of concurrency of risk factors for Noncommunicable Diseases and non-random aggregation of these in Brazilian school adolescents. Method: Descriptive study, with data from the National School Health Survey (Pesquisa Nacional de Saúde do Escolar), 2015. The prevalence of concurrent risk factors was estimated: smoking, alcohol use, physical inactivity and low consumption of fruits and vegetables. Aggregation was verified when the observed-expected prevalence ratio was greater than 1. The analyses were performed in Stata 15.0 software. Results: The proportion of concurrent risk factors was higher for those who had two risk factors (56.1%; 95%CI: 55.5-56.6). The most prevalent risk factors combination was “Low consumption of fruits and vegetables + Physical inactivity” (66%; 95% CI: 65.8-66.9). There was an aggregation of risk factors, and the highest ratio between observed and expected prevalence was: “Smoking + Alcohol” (79.0%; 95%CI: 73.8-84.2). Conclusion and implications for practice: The findings show a high prevalence of concurrent risk factors, with aggregation of these in adolescents. Identifying these risk groups may favor early interventions by minimizing exposure and targeting primary prevention strategies in early exposure to risk factors.

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Risk factors and comorbidities associated with magnesium deficiency in pregnant women and women with hormone-related conditions: Analysis of a large real-world dataset

10.21203/rs.3.rs-48032/v2 ◽

2020 ◽

Author(s):

Svetlana Orlova ◽

Galina Dikke ◽

Gisele Pickering ◽

Natalya Yaltseva ◽

Sofya Konchits ◽

...

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Magnesium Deficiency ◽

Serum Magnesium ◽

Secondary Analysis ◽

Epidemiological Studies ◽

Univariate Logistic Regression Analysis ◽

Increased Risk ◽

High Prevalence ◽

Low Serum

Abstract BackgroundAn accumulating body of literature indicates that magnesium deficiency is associated with a number of hormone-related conditions (HRC) in women, and epidemiological studies are needed to assess its prevalence and risk factors. Here, we present a secondary analysis of data pooled from four large observational studies that assessed magnesium deficiency among pregnant women and women with HRC across the Russian Federation.MethodsThe main objective of this analysis was to estimate the prevalence of magnesium deficiency in this population and to describe risk factors and comorbidities associated with low serum magnesium. Univariate logistic regression analysis was performed to identify the risk factors and comorbid conditions associated with an increased risk of low serum magnesium level.ResultsA total of 983 pregnant women and 9444 women with HRC were eligible for analysis. Prevalence of hypomagnesemia (magnesium serum level cut-off <0.66 mmol/L/<0.8 mmol/L) was 34.0%/78.9% in pregnant women and 21.4%/54.8% in women with HRC. The highest prevalence of magnesium deficiency was observed for osteoporosis and climacteric syndrome. Risk factors included diastolic blood pressure, previous pregnancy complications, infections and edema for pregnant women, and age, body mass index, and various comorbidities for women with HRC.ConclusionsThese results confirm the high prevalence of hypomagnesemia in pregnant women and women with HRC and underline the importance of routine screening, since risk factors are mostly non-specific.

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Risk factors and comorbidities associated with magnesium deficiency in pregnant women and women with hormone-related conditions: analysis of a large real-world dataset

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03558-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Svetlana Orlova ◽

Galina Dikke ◽

Gisele Pickering ◽

Natalya Yaltseva ◽

Sofya Konchits ◽

...

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Magnesium Deficiency ◽

Serum Magnesium ◽

Secondary Analysis ◽

Epidemiological Studies ◽

Univariate Logistic Regression Analysis ◽

Increased Risk ◽

High Prevalence ◽

Low Serum

Abstract Background An accumulating body of literature indicates that magnesium deficiency is associated with a number of hormone-related conditions (HRC) in women, and epidemiological studies are needed to assess its prevalence and risk factors. Here, we present a secondary analysis of data pooled from four large observational studies that assessed magnesium deficiency among pregnant women and women with HRC across the Russian Federation. Methods The main objective of this analysis was to estimate the prevalence of magnesium deficiency in this population and to describe risk factors and comorbidities associated with low serum magnesium. Univariate logistic regression analysis was performed to identify the risk factors and comorbid conditions associated with an increased risk of low serum magnesium level. Results A total of 983 pregnant women and 9444 women with HRC were eligible for analysis. Prevalence of hypomagnesemia (magnesium serum level cut-off < 0.66 mmol/L/< 0.8 mmol/L) was 34.0%/78.9% in pregnant women and 21.4%/54.8% in women with HRC. The highest prevalence of magnesium deficiency was observed for osteoporosis and climacteric syndrome. Risk factors included diastolic blood pressure, previous pregnancy complications, infections and edema for pregnant women, and age, body mass index, and various comorbidities for women with HRC. Conclusions These results confirm the high prevalence of hypomagnesemia in pregnant women and women with HRC and underline the importance of routine screening, since risk factors are mostly non-specific.

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Monitoring for COVID-19 by universal testing in a homeless shelter in Germany: a prospective feasibility cohort study

10.1101/2020.10.04.20205401 ◽

2020 ◽

Author(s):

Andreas K. Lindner ◽

Navina Sarma ◽

Luise Marie Rust ◽

Theresa Hellmund ◽

Svetlana Krasovski-Nikiforovs ◽

...

Keyword(s):

Cohort Study ◽

Program Planning ◽

Retention Rates ◽

Homeless Shelters ◽

Homeless Shelter ◽

Major Barrier ◽

Oral Swab ◽

Universal Testing ◽

Increased Risk ◽

Community Transmission

AbstractBackgroundLiving conditions in homeless shelters may facilitate the transmission of COVID-19. Social determinants and pre-existing health conditions place homeless people at increased risk of severe disease. Described outbreaks in homeless shelters resulted in high proportions of infected residents and staff members. In addition to other infection prevention strategies, regular shelter-wide (universal) testing for COVID-19 may be valuable, depending on the level of community transmission and when resources permit.MethodsThis was a prospective feasibility cohort study to evaluate universal testing for COVID-19 at a homeless shelter with 106 beds in Berlin, Germany. Co-researchers were recruited from the shelter staff. A PCR analysis of saliva or self-collected nasal/oral swab was performed weekly over a period of 3 weeks in July 2020. Acceptability and implementation barriers were analyzed by process evaluation using mixed methods including evaluation sheets, focus group discussion and a structured questionnaire.ResultsNinety-three out of 124 (75%) residents were approached to participate in the study. Fifty-one out of the 93 residents (54.8%) gave written informed consent. High retention rates (88.9% – 93.6%) of a weekly respiratory specimen were reached, but repeated collection attempts, as well as assistance were required. A self-collected nasal/oral swab was considered easier and more hygienic to collect than a saliva specimen. No resident was tested positive. Language barriers were the main reason for non-participation. Flexibility of sample collection schedules, the use of video and audio materials, and concise written information were the main recommendations of the co-researchers for future implementation.ConclusionVoluntary universal testing for COVID-19 is feasible in homeless shelters. Universal testing of high-risk facilities will require flexible approaches, considering the level of the community transmission, the available resources, and the local recommendations. Lack of human resources and laboratory capacity may be a major barrier for implementation of universal testing, requiring adapted approaches compared to standard individual testing. Assisted self-collection of specimens and barrier free communication may facilitate implementation in homeless shelters. Program planning must consider homeless people’s needs and life situation, and guarantee confidentiality and autonomy.

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Factors associated with childhood anaemia in Afro-descendant communities in Alagoas, Brazil

Public Health Nutrition ◽

10.1017/s1368980020004711 ◽

2020 ◽

pp. 1-11

Author(s):

Haroldo da Silva Ferreira ◽

Laíse Gabrielly Matias de Lima Santos ◽

Carla Mariana Xavier Ferreira ◽

Samir Buainain Kassar ◽

Tamara Rodrigues dos Santos ◽

...

Keyword(s):

Risk Factors ◽

Public Health Problem ◽

Wealth Index ◽

Prevalence Ratio ◽

Factors Associated ◽

Independent Variables ◽

High Prevalence ◽

Mother And Child ◽

Hierarchical Selection ◽

Measure Of Association

Abstract Objective: To investigate factors associated with anaemia in preschool children. Design: A home survey was conducted in 2018. Anaemia in children (capillary blood Hb level < 110 g/l) was the outcome, and socio-economic, demographic and health factors of the mother and child were the independent variables. The measure of association was the prevalence ratio, and its 95 % CI was calculated using Poisson’s regression with robust variance and hierarchical selection of independent variables. Setting: Afro-descendants communities living in the state of Alagoas, northeast Brazil. Participants: Children aged 6–59 months and their mothers (n 428 pairs). Results: The prevalence of child anaemia was 38·1 % (95 % CI 33·5, 42·7). The associated factors with child anaemia were male sex, age < 24 months, larger number of residents at home (> 4), relatively taller mothers (highest tertile) and higher z-score of BMI for age, after further adjustment for wealth index, vitamin A supplementation in the past 6 months and clinical visit in the last 30 d. Conclusions: The high prevalence of anaemia observed reveals a relevant public health problem amongst children under five from the quilombola communities of Alagoas. Considering the damage caused to health and multiplicity of risk factors associated with anaemia, the adoption of intersectoral strategies that act on modifiable risk factors and increase vigilance concerning those that are not modifiable becomes urgent.

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Metabolic Syndrome Pathophysiology and Predisposing Factors

International Journal of Sports Medicine ◽

10.1055/a-1263-0898 ◽

2020 ◽

Author(s):

António Bovolini ◽

Juliana Garcia ◽

Maria Amparo Andrade ◽

José Alberto Duarte

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Atherogenic Dyslipidemia ◽

Diet Patterns ◽

Glucose Levels ◽

Increased Risk ◽

High Prevalence ◽

Inflammatory State ◽

Unhealthy Diet ◽

Diagnosis Criteria

AbstractMetabolic syndrome (MetS) is a cluster of cardiometabolic risk factors with high prevalence among adult populations and elevated costs for public health systems worldwide. Despite the lack of consensus regarding the syndrome definition and diagnosis criteria, it is characterized by the coexistence of risk factors such as abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, a prothrombotic and pro-inflammatory state, insulin resistance (IR), and higher glucose levels, factors indubitably linked to an increased risk of developing chronic conditions, such as type 2 diabetes (T2D) and cardiovascular disease (CVD). The syndrome has a complex and multifaceted origin not fully understood; however, it has been strongly suggested that sedentarism and unbalanced dietary patterns might play a fundamental role in its development. The purpose of this review is to provide an overview from the syndrome epidemiology, costs, and main etiological traits from its relationship with unhealthy diet patterns and sedentary lifestyles.

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114. HIV Prevalence and Associated Factors Among Persons Experiencing Homelessness (PEH) During a Multi-shelter Tuberculosis (TB) Outbreak in Atlanta, Georgia (2008 – 2018)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.424 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S185-S186

Author(s):

Udodirim Onwubiko

Keyword(s):

Risk Factors ◽

Screening Program ◽

Prevalence Ratio ◽

The United States ◽

Hiv Prevalence ◽

Control Measures ◽

Homeless Shelters ◽

Hiv Status ◽

The South ◽

Hiv Test

Abstract Background Jointly and independently, HIV and homelessness are strong risk factors for acquiring tuberculosis (TB) in the United States (US). However, public health programs geared towards addressing TB among persons experiencing homelessness (PEH) are often not used as prime opportunities to also actively address HIV among PEH. Here, we describe the prevalence and risk factors associated with HIV among PEH who were screened during a city-wide TB screening program among PEH initiated in response to a multi-shelter TB outbreak in Atlanta, Georgia. Methods Retrospective analysis of data on 18,605 PEH screened for TB between 2008 and 2018 was done. HIV status was either self-reported (SR) or laboratory-confirmed (LC). Modified Poisson regression models with robust error variances were used to assess associations between socio-demographic characteristics and being HIV-positive. Results Of 18,605 PEH screened for TB, 9,308 (53%) had a known HIV status. Of these, 38% (n=3,559) received a HIV test while 62% (n=5,749) were only SR HIV status. The prevalence of HIV positivity among all PEH who SR a HIV status (n=7,404) was 4.0% (296/7404) while the prevalence of LC HIV infection was 3.6% (129/3559). Among PEH with LC HIV results, gender (male, transgender), year of screening (2008–2010, 2011–2013) and location of screening (onsite) were independently associated with higher HIV prevalence (p< 0.05). Adjusted analysis showed statistically significant interaction between gender and age [Adjusted prevalence ratio for men vs. women: young PEH (0–29 years) 8.47 (5.13, 14.00), p< 0.0001]. Year of screening and shelter of residence also remained significant in the adjusted model. Conclusion The prevalence of HIV among PEH in Atlanta is more than four times higher than the prevalence in the general Atlanta population (0.86%). In addition to essential TB control measures needed in congregate settings like homeless shelters, strong efforts to concurrently increase access to HIV prevention and care at homeless shelters may also help reduce both HIV transmission and TB acquisition in this at-risk population in the South and move the South closer to achieving the US End TB and Ending the HIV Epidemic goals. Disclosures All Authors: No reported disclosures

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Monitoring for COVID-19 by universal testing in a homeless shelter in Germany: a prospective feasibility cohort study

BMC Infectious Diseases ◽

10.1186/s12879-021-06945-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Andreas K. Lindner ◽

Navina Sarma ◽

Luise Marie Rust ◽

Theresa Hellmund ◽

Svetlana Krasovski-Nikiforovs ◽

...

Keyword(s):

Cohort Study ◽

Program Planning ◽

Homeless Shelters ◽

Homeless Shelter ◽

Sample Collection ◽

Major Barrier ◽

Oral Swab ◽

Universal Testing ◽

Increased Risk ◽

Community Transmission

Abstract Background Living conditions in homeless shelters facilitate the transmission of COVID-19. Social determinants and pre-existing health conditions place homeless people at increased risk of severe disease. Described outbreaks in homeless shelters resulted in high proportions of infected residents and staff members. In addition to other infection prevention strategies, regular shelter-wide (universal) testing for COVID-19 may be valuable, depending on the level of community transmission and when resources permit. Methods This was a prospective feasibility cohort study to evaluate universal testing for COVID-19 at a homeless shelter with 106 beds in Berlin, Germany. Co-researchers were recruited from the shelter staff. A PCR analysis of saliva or self-collected nasal/oral swab was performed weekly over a period of 3 weeks in July 2020. Acceptability and implementation barriers were analyzed by process evaluation using mixed methods including evaluation sheets, focus group discussion and a structured questionnaire. Results Ninety-three out of 124 (75%) residents were approached to participate in the study. Fifty-one out of the 93 residents (54.8%) gave written informed consent; thus 41.1% (51 out of 124) of all residents were included in the study. Among these, high retention rates (88.9–93.6%) of a weekly respiratory specimen were reached, but repeated collection attempts, as well as assistance were required. Around 48 person-hours were necessary for the sample collection including the preparation of materials. A self-collected nasal/oral swab was considered easier and more hygienic to collect than a saliva specimen. No resident was tested positive by RT-PCR. Language barriers were the main reason for non-participation. Flexibility of sample collection schedules, the use of video and audio materials, and concise written information were the main recommendations of the co-researchers for future implementation. Conclusions Voluntary universal testing for COVID-19 is feasible in homeless shelters. Universal testing of high-risk facilities will require flexible approaches, considering the level of the community transmission, the available resources, and the local recommendations. Lack of human resources and laboratory capacity may be a major barrier for implementation of universal testing, requiring adapted approaches compared to standard individual testing. Assisted self-collection of specimens and barrier free communication may facilitate implementation in homeless shelters. Program planning must consider homeless people’s needs and life situation, and guarantee confidentiality and autonomy.

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