scholarly journals COVID19 epidemic growth rates have declined since early March in U.S. regions with active hospitalized case surveillance

2020 ◽  
Author(s):  
Rajiv Bhatia
Keyword(s):  
Growth Rates ◽  
Cumulative Incidence ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Harmonic Mean ◽  
Surveillance Program ◽  
Incidence Data ◽  
The Us ◽  
Mortality Incidence

Introduction Optimal pandemic monitoring and management requires unbiased and regionally specific estimates of disease incidence and epidemic growth. Methods I estimated growth rates and doubling times across a 22-week period of the SARS-COV-2 pandemic using hospital admissions incidence data collected through the US CDC COVID-NET surveillance program which operates in 98 U.S. counties located in 13 states. I cross validated the growth measures using mortality incidence data for the same regions and time periods. Results Between March 1 and August 8, 2020, two distinct waves of epidemic activity occurred. During the first wave in the COVID-NET monitoring regions, the harmonic mean of the maximum weekly growth rate was 534% (Median: 575; Range: 250 to 2250) and this maximum occurred in the second or third week of March in different regions. The harmonic mean of the minimum doubling time occurred with maximum growth rate and was 0.35 weeks (Median 0.36 weeks; Range: 0.22 to 0.55 weeks). The harmonic mean of the maximum incidence rate during the first wave of the epidemic was 8.5 hospital admissions per 100,000 people per week (Median: 9.2, Range: 4 to 40.5) and the peak of epidemic infection transmission associated with this maximum occurred on or before March 27, 2020 in eight of the 13 regions. Dividing the 22-week observed period into four intervals, the harmonic mean of the weekly hospitalization incidence rate was highest during the second interval (4.6 hospitalizations per week per 100,000), then fell during the third and fourth intervals. Growth rates declined from 101 percent per week in the first interval to 2.5 percent per week in the last. Doubling time have lengthened from 3/5th of a week in the first interval to 12.5 weeks in the last. Period by period, the cumulative incidence has grown primarily in a linear mode. The mean cumulative incidence of hospitalizations on Aug 8th, 2020 in the COVID-NET regions is 96 hospitalizations per 100,000. Regions which experienced the highest maximum weekly incidence rates or greatest cumulative incidence rates in the first wave, generally, but not uniformly, observed the lower incidence rates in the second wave. Growth measures calculated based on mortality incidence data corroborate these findings. Conclusions Declining epidemic growth rates of SARS-COV-2 infection appeared in early March in the first observations of nationwide hospital admissions surveillance program in multiple U.S. regions. A sizable fraction of the U.S. population may have been infected in a cryptic February epidemic acceleration phase. To more accurately monitor epidemic trends and inform pandemic mitigation planning going forward, the US CDC needs measures of epidemic disease incidence that better reflect clinical disease and account for large variations in case ascertainment strategies over time.

scholarly journals Economic Evaluation Applied to Health Policy in New Zealand

2021 ◽  
Author(s):  
◽  
William Guy Scott
Keyword(s):  
Health Policy ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Data Set ◽  
Aggregated Data ◽  
Study Approach ◽  
Incidence Data ◽  
Additional Information ◽  
First Case

<p>Data available in the public domain are frequently aggregated to preserve confidentiality and to reduce a database to a manageable size. Drawing conclusions from such data may lead to inappropriate policy advice. The aims of this paper are to show how the aggregation of data to form rates may obscure important information and lead to misinterpretation of results. Suggestions are offered on ways in which this problem may be addressed. We also highlight the need to seek additional information in order to clarify findings. We used a case study approach by drawing on illustrative examples to highlight some problems encountered when using aggregated data about population. The focus is on health policy. Two types of problem were discussed in the cases chosen, but a common resolution was appropriate. In the first case policies based on the assumption that hospital admissions equate with disease incidence would be different from policies framed on actual incidence data. In the second, incidence rates changed when they were disaggregated to gender and age-specific rates. Policies formulated from analysis of aggregated data would be different form those based on disaggregated data. In the cases studied, the variables of gender, age and ethnicity influence incidence rates and must not be ignored. Researchers are recommended to study the data-set in the most disaggregated form available, and to check how data have been defined, collected and recorded, before preparing summary tables and graphs. Additional research or data from another source may be needed to clarify findings.</p>

scholarly journals Economic Evaluation Applied to Health Policy in New Zealand

2021 ◽  
Author(s):  
◽  
William Guy Scott
Keyword(s):  
Health Policy ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Data Set ◽  
Aggregated Data ◽  
Study Approach ◽  
Incidence Data ◽  
Additional Information ◽  
First Case

<p>Data available in the public domain are frequently aggregated to preserve confidentiality and to reduce a database to a manageable size. Drawing conclusions from such data may lead to inappropriate policy advice. The aims of this paper are to show how the aggregation of data to form rates may obscure important information and lead to misinterpretation of results. Suggestions are offered on ways in which this problem may be addressed. We also highlight the need to seek additional information in order to clarify findings. We used a case study approach by drawing on illustrative examples to highlight some problems encountered when using aggregated data about population. The focus is on health policy. Two types of problem were discussed in the cases chosen, but a common resolution was appropriate. In the first case policies based on the assumption that hospital admissions equate with disease incidence would be different from policies framed on actual incidence data. In the second, incidence rates changed when they were disaggregated to gender and age-specific rates. Policies formulated from analysis of aggregated data would be different form those based on disaggregated data. In the cases studied, the variables of gender, age and ethnicity influence incidence rates and must not be ignored. Researchers are recommended to study the data-set in the most disaggregated form available, and to check how data have been defined, collected and recorded, before preparing summary tables and graphs. Additional research or data from another source may be needed to clarify findings.</p>

scholarly journals Racial and ethnic disparities in COVID-19 disease incidence independent of comorbidities, among people with HIV in the US

2021 ◽  
Author(s):  
RA Bender Ignacio ◽  
AE Shapiro ◽  
RM Nance ◽  
BM Whitney ◽  
JAC Delaney ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Disease Risk ◽  
Disease Incidence ◽  
Ethnic Disparities ◽  
Incidence Rates ◽  
Cd4 Count ◽  
Risk Scores ◽  
Racial And Ethnic Disparities ◽  
Related Factors ◽  
The Us

ABSTRACTObjectivesTo define the incidence of clinically-detected COVID-19 in people with HIV (PWH) in the US and evaluate how racial and ethnic disparities, comorbidities, and HIV-related factors contribute to risk of COVID-19.DesignObservational study within the CFAR Network of Integrated Clinical Systems cohort in 7 cities during 2020.MethodsWe calculated cumulative incidence rates of COVID-19 diagnosis among PWH in routine care by key characteristics including race/ethnicity, current and lowest CD4 count, and geographic area. We evaluated risk factors for COVID-19 among PWH using relative risk regression models adjusted with disease risk scores.ResultsAmong 16,056 PWH in care, of whom 44.5% were Black, 12.5% were Hispanic, with a median age of 52 years (IQR 40-59), 18% had a current CD4 count < 350, including 7% < 200; 95.5% were on antiretroviral therapy, and 85.6% were virologically suppressed. Overall in 2020, 649 PWH were diagnosed with COVID-19 for a rate of 4.94 cases per 100 person-years. The cumulative incidence of COVID-19 was 2.4-fold and 1.7-fold higher in Hispanic and Black PWH respectively, than non-Hispanic White PWH. In adjusted analyses, factors associated with COVID-19 included female sex, Hispanic or Black identity, lowest historical CD4 count <350 (proxy for CD4 nadir), current low CD4/CD8 ratio, diabetes, and obesity.ConclusionsOur results suggest that the presence of structural racial inequities above and beyond medical comorbidities increased the risk of COVID-19 among PWHPWH with immune exhaustion as evidenced by lowest historical CD4 or current low CD4:CD8 ratio had greater risk of COVID-19.

scholarly journals Effect of Population-Wide Hepatitis B Vaccination in Preventing Liver Cancer Among Children and Young Adults in the United States

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 11s-11s
Author(s):  
A.Z. Shams ◽  
V. Winkler ◽  
H. Pohlabeln ◽  
V. Arndt ◽  
U. Haug
Keyword(s):  
Liver Cancer ◽  
Cancer Incidence ◽  
Cancer Registries ◽  
The United States ◽  
Incidence Rates ◽  
Age Group ◽  
Incidence Data ◽  
Hbv Vaccination ◽  
The Us ◽  
Incident Cases

Background: Liver cancer is the second most common cause of death from cancer worldwide1. In 2013, 79,2000 new cases of liver cancer and 818,000 deaths occurred globally2,3. Chronic infection with HBV accounts for at least 50% of liver cancer globally4. In the United States (US), liver cancer constitute the ninth leading cause of cancer death. The incidence of the cancer has persistently increased in the recent decades. Universal HBV vaccination was introduced in 1992 in the US. However, incidence trends of liver cancer among US children is poorly researched or relevant studies are not up-to-date5. Aim: This study aims to explore the effect of HBV population-wide vaccination program in reducing liver cancer incidence in the vaccinated children and adolescents in the US. Methods: Liver cancer incidence data were obtained from Cancer Incidence in Five Continents (CI5) databases (volumes I to X) from International Agency for Cancer Research (IARC). Data acquisition and analysis covered available incidence data between 1978-2007 from 9 cancer registries from Surveillance, Epidemiology, and End Results Program (SEER) from the US presented in the CI5 databases. Age-specific incidence rates of liver cancer (based on 5 year age groups ie 5-9 year, 10-14 year and 15-19 years) were calculated using age and sex-disaggregated incidence and population data from the SEER cancer registries. Stata software version 14.0 (StataCorp, USA) was used to calculate age-specific incidence rates, using number of liver cancer incident cases in each age group by the number of population in the respective age group. Age-specific rates were analyzed by period of diagnosis and by birth year. Rate ratios were estimated from age-group-specific Poisson regressions. Results: A total of 140 liver cancer incident cases were registered in the 9 SEER registries between 1978 to 2007 in the US. The incidence rate of liver cancer in children 5 to 9 years of age from 1978-1982 was 0.10 per 100,000 children. The incidence increased to 0.16 for the period from 2003-2007. The same trend is seen for the age group 10-14 and 15-19 years of age. Overall, age-specific incidence rates for liver cancer increased across age groups of 5-9, 10-14 and 15-19 year in the population covered by the 9 SEER registries in the US. However, risk estimates (incidence rate ratios, resulted from age-group-specific Poisson regressions did not show statistical significant effects. Conclusion: While the global response to implement population-wide HBV vaccination program is out of question, efforts to establish processes to evaluate the effect of such programs seems to be incomparably limited. Estimating the effect of HBV vaccination will relatively improve with time as further incidence data become available eg upon publication of data from new volume of CI5 databases.

29. Anal cancer trends in Puerto Rico (PR) from 1985 to 2005: impact of HIV status

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 584
Author(s):  
Ana P. Ortiz ◽  
Karen J. Ortiz-Ortiz ◽  
Maricarmen Traverso ◽  
Moraima Ríos ◽  
Vivian Colón-Lopez ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Cancer Incidence ◽  
Temporal Trends ◽  
Incidence Rates ◽  
Surveillance Program ◽  
Hiv Status ◽  
Incidence Trends ◽  
Linkage Algorithm ◽  
The Us ◽  
The Impact

Background PR is one of the US jurisdictions with the highest burden of HIV/AIDS. We describe the proportion of HIV+ anal cancer cases in PR and the impact of HIV status on anal cancer incidence trends, by sex and age. Methods: The PR Central Cancer Registry (PRCCR) and the PR AIDS Surveillance Program databases were linked using a probabilistic linkage algorithm with Link Plus v.2.0 software. The proportion of anal cancer cases with and without HIV in PR were calculated. Temporal trends (1985–2005) in the incidence rates (standardised US 2000 population) of anal cancer (overall and after exclusion of HIV+ cancer cases) were calculated through annual per cent changes (APC) and 95% confidence intervals (CIs), using a Joinpoint log-linear model. Results: From 1985 to 2005, 736 cases of anal cancer were diagnosed in PR; 26 cases were HIV+. While most anal cancer patients were female (70.8%), the proportion of HIV+ patients was higher in males (11.4%) than females (0.77%). In men, incidence increased significantly (APC = 3.23, P < 0.05) when HIV+ cases were considered; the increase was reduced (APC = 0.97) when these were excluded (P > 0.05). In females, incidence increased (APC = 2.01) when HIV+ cases were considered, whereas the increase was reduced (APC = 0.85) when these were excluded; these increases were non-significant (P > 0.05). Conclusions: Consistent with data from the US, the increasing anal cancer incidence rates in PR were strongly influenced by the HIV epidemic in males but were independent of HIV infection in females.

P4668Risk of valvular heart disease in bromocriptine-treated women with hyperprolactinaemic disorders

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Clausen ◽  
R Roerth ◽  
C Torp-Pedersen ◽  
G H Gislason ◽  
L Koeber ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Cumulative Incidence ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Cardiac Valve ◽  
Valve Disease ◽  
Incidence Density ◽  
Cardiac Valve Disease ◽  
Age And Sex

Abstract Background Systematic echocardiographic screening is currently recommended for patients with hyperprolactinemic disorders treated with dopamine agonists, due to a perceived risk of cardiac valve regurgitation as observed in patients with Parkinson's disease. The dopamine agonist bromocriptine is used frequently in hyperprolactinemia patients, but its relation to cardiac valve disease remain uncertain. Purpose To determine the incidence of valvular heart disease in bromocriptine-treated women with hyperprolactinaemic disorders compared with matched controls from background population. Methods In nationwide Danish registries, we identified patients with hyperprolactinaemic disorders treated with bromocriptine between 1995–2017. Patients were matched 1:5 with population controls based on age and sex using incidence density sampling. We estimated the risk of valvular heart disease defined as admission and/or outpatient clinic visits. Incidence rates, cumulative incidence curve and adjusted cox-proportional hazard models were used to assess outcomes. Results A total of 23883 female bromocriptine users and 119415 controls were included. Median age was 29.9 years (Q1-Q3 26.4–33.8). Both groups had few comorbidities, 218 (0.9%) patients and 787 (0.7%) controls with hypertension, 160 (0.7%) patients and 629 (0.5%) controls with diabetes, 408 (1.7%) patients and 1305 (1.1%) controls were beta-blocker users. During a mean follow-up of 19 years 106 (0.44%) patients and 416 (0.35%) controls were diagnosed with valvular heart disease. Incidence rates were 0.254 per 1000 patient years (PY) in bromocriptine users (95% CI 0.21–0.31) and 0.198 per 1000 PY in the control cohort (95% CI 0.18–0.22). Overall, the cumulative incidence of valvular heart disease was 0.6% (95% CI 0.48–0.73) among patients and 0.5% (95% CI 0.4–0.51) among controls; P=0.03 (figure 1a). In adjusted analysis bromocriptine users still had a significant higher risk of valvular heart disease (hazard ratio=1.32, 95% CI 1.06–1.64, P=0.01). Incidence of valvular heart disease Conclusion The use of bromocriptine in younger and otherwise healthy women with hyperprolactinaemic disorders, were associated with a low absolute risk of cardiac valve disease. Still risk was approximately 30% higher compared with age- and sex matched controls. Our study suggests a low clinical yield of echocardiographic screening in this patient population. Acknowledgement/Funding Internal grant, Copenhagen University Hospital Rigshospitalet

scholarly journals Incidence and completeness of notification of Legionnaires' disease in The Netherlands: covariate capture–recapture analysis acknowledging regional differences

2007 ◽  
Vol 136 (4) ◽  
pp. 540-550 ◽  
Author(s):  
N. A. H. VAN HEST ◽  
C. J. P. A. HOEBE ◽  
J. W. DEN BOER ◽  
J. K. VERMUNT ◽  
E. P. F. IJZERMAN ◽  
...  
Keyword(s):  
The Netherlands ◽  
Incidence Rate ◽  
Regional Differences ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Incidence Rates ◽  
Average Annual Incidence ◽  
Capture Recapture ◽  
Legionnaires Disease ◽  
Log Linear

SUMMARYTo estimate incidence and completeness of notification of Legionnaires' disease (LD) in The Netherlands in 2000 and 2001, we performed a capture–recapture analysis using three registers: Notifications, Laboratory results and Hospital admissions. After record-linkage, 373 of the 780 LD patients identified were notified. Ascertained under-notification was 52·2%. Because of expected and observed regional differences in the incidence rate of LD, alternatively to conventional log-linear capture–recapture models, a covariate (region) capture–recapture model, not previously used for estimating infectious disease incidence, was specified and estimated 886 LD patients (95% confidence interval 827–1022). Estimated under-notification was 57·9%. Notified, ascertained and estimated average annual incidence rates of LD were 1·15, 2·42 and 2·77/100 000 inhabitants respectively, with the highest incidence in the southern region of The Netherlands. Covariate capture–recapture analysis acknowledging regional differences of LD incidence appears to reduce bias in the estimated national incidence rate.

scholarly journals Epidemiology of mucopolysaccharidoses (MPS) in United States: challenges and opportunities

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yana Puckett ◽  
Alejandra Mallorga-Hernández ◽  
Adriana M. Montaño
Keyword(s):  
United States ◽  
Disease Incidence ◽  
State Level ◽  
The United States ◽  
Incidence Rates ◽  
Mandated Reporting ◽  
Prevalence Rates ◽  
Lysosomal Storage ◽  
Live Births ◽  
The Us

Abstract Background Mucopolysaccharidoses (MPS) are rare, inherited lysosomal storage disorders characterized by progressive multiorgan involvement. Previous studies on incidence and prevalence of MPS mainly focused on countries other than the United States (US), showing considerable variation by country. This study aimed to identify MPS incidence and prevalence in the US at a national and state level to guide clinicians and policy makers. Methods This retrospective study examined all diagnosed cases of MPS from 1995 to 2015 in the US using the National MPS Society database records. Data included year of birth, patient geographic location, and MPS variant type. US population information was obtained from the National Center for Health Statistics. The incidence and prevalence rates were calculated for each disease. Incidence rates were calculated for each state. Results We obtained information from 789 MPS patients during a 20-year period. Incidence of MPS in the US was found to be 0.98 per 100,000 live births. Prevalence was found to be 2.67 per 1 million. MPS I, II, and III had the highest incidence rate at birth (0.26/100,000) and prevalence rates of 0.70–0.71 per million. Birth incidences of MPS IV, VI, and VII were 0.14, 0.04 and 0.027 per 100,000 live births. Conclusions This is the most comprehensive review of MPS incidence and prevalence rates in the US. Due to the large US population and state fragmentation, US incidence and prevalence were found to be lower than other countries. Nonetheless, state-level studies in the US supported these figures. Efforts should be focused in the establishment of a national rare disease registry with mandated reporting from every state as well as newborn screening of MPS.

scholarly journals Increase in Invasive Group A Streptococcal Disease and Emergence of Mucoid Strains in a Pediatric Population: February–June 2017

2019 ◽  
Vol 6 (7) ◽  
Author(s):  
Lorne W Walker ◽  
Lindsay Montoya ◽  
Sopio Chochua ◽  
Bernard Beall ◽  
Michael Green
Keyword(s):  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Tertiary Care ◽  
Incidence Rates ◽  
Screening Tests ◽  
Whole Genome ◽  
Invasive Group ◽  
Group A

Abstract Background Infection with group A Streptococcus (GAS) can cause severe systemic and locally invasive disease. Invasive group A streptococcal (iGAS) disease incidence varies both seasonally and year-to-year, and it may exhibit clustered outbreaks. We observed an upswing in iGAS cases at a tertiary care Children’s Hospital, prompting further characterization of local iGAS disease. Methods Cases of iGAS disease were abstracted from the medical record by manual chart review of all positive screening tests and cultures for GAS over a 4-year span. Incidence rates per 1000 hospital admissions and per 100 positive GAS tests were calculated and compared. Selected isolates were further characterized by whole-genome sequencing. Results Significant year-to-year differences in per-admission iGAS incidence rate were observed in February and June, although per-positive test incidence rates were not significantly different. Whole-genome sequencing revealed 2 dominant serotypes—emm3 and emm6—with high rates of mucoid phenotype and systemic bacteremia. Conclusions We document a significant but transient increase in iGAS disease incidence in 2 months of 2017. Genome sequencing revealed 2 dominant serotypes associated with mucoid phenotypes and severe disease, highlighting the dynamic nature of iGAS disease pattern.

Work-related Musculoskeletal Disorders in Emergency Medical Personnel

2020 ◽  
pp. 42-45
Author(s):  
L.M. Karamova ◽  
V.O. Krasovskiy ◽  
D.M. Vagapova ◽  
N.V. Vlasova ◽  
A.S. Khafizova ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Musculoskeletal Disorders ◽  
Disease Incidence ◽  
Medical Personnel ◽  
Incidence Rates ◽  
Connective Tissue Disorders ◽  
Ambulance Personnel ◽  
Occupational Risk Factors ◽  
Emergency Medical ◽  
Emergency Medical Personnel

Relevance. The importance of studying and analyzing contribution of occupational risk factors in musculoskeletal disorders among emergency medical personnel is related to high disease incidence rates and work specifics. The objective of our research envisaged formalization of information obtained for the analysis and assessment of occupational risks of developing musculoskeletal and connective tissue disorders in ambulance personnel. Results. According to professional medical examination results, musculoskeletal and connective tissue disorders ranked second among all diagnosed diseases. The relative risk of developing those disorders was 70% indicating the link between them and transport vibration (category 1) affecting the backbone during long trips in ambulance cars.

Sign in / Sign up

Export Citation Format

Share Document