Trends in Precancerous Cervical Lesions by Area-Based Measures of Poverty, Race, and Ethnicity, Connecticut, 2008-2018

Objectives Trends in the incidence of precancerous cervical lesions can be monitored to evaluate the impact of human papillomavirus (HPV) vaccination. The objective of this analysis was to determine whether declines in precancerous cervical lesions varied by area-based measures of poverty, race, and ethnicity. Methods We analyzed 11 years of incidence data (2008-2018) from a statewide active surveillance system of precancerous cervical lesions in Connecticut. We divided area-based measures of poverty, race, and ethnicity (percentage of the population in a census tract who were living below the federal poverty level, who were Black, and who were Hispanic) at the census-tract level into 4 groups (<5.0%, 5.0%-9.9%, 10.0%-19.9%, ≥20.0%) using recommended cut points from the Public Health Disparities Geocoding Project. We estimated incidence rates and average annual percentage changes (AAPCs) stratified by age and each area-based measure using Joinpoint regression software. We used total population and estimated screened population as denominators for each age group to calculate rates and AAPCs. Results During 2008-2018 in Connecticut, 18 878 women aged 21-39 were diagnosed with precancerous cervical lesions. After adjusting for screening, the largest declines occurred among women aged 21-24 (AAPC = −11.5%; 95% CI, −13.6% to −9.4%). We found significant and similar annual declines (~10%-12%) in this age group across all 4 levels of poverty, race, and ethnicity. Conclusions This analysis adds to the growing body of evidence demonstrating the positive impact of population-level HPV vaccination among young women that appears similar across area-based measures of sociodemographic characteristics. Monitoring is necessary to ensure the continuation of this progress in all communities.

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Achievements and Prospects of Vaccination against Human Papillomavirus Infection and Associated Diseases

Epidemiology and Vaccinal Prevention ◽

10.31631/2073-3046-2020-19-2-110-118 ◽

2020 ◽

Vol 19 (2) ◽

pp. 110-118

Author(s):

G. N. Minkina

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccination ◽

Evidence Base ◽

Full Potential ◽

Cervical Lesions ◽

Vaccination Programs ◽

Associated Diseases ◽

Papillomavirus Infection ◽

Precancerous Cervical Lesions ◽

The Impact

Relevance. The past decade has been marked by rapid advances in the prevention of human papillomavirus (HPV) infections and associated diseases.Aims. To sum up the accumulated experience and evidence base of the impact of national HPV vaccination programs on the prevalence of HPV infections, the incidence of genital warts and precancerous cervical lesions. 3.Conclusions. To reach its full potential and have a greater and earlier impact on the population, gender-neutral and, if possible, multi-cohort HPV vaccination should be included in the national immunization calendar.

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Achievements and Prospects of Vaccination against Human Papillomavirus Infection and Associated Diseases

Epidemiology and Vaccinal Prevention ◽

10.31631/2073-3046-2020-20-2-110-118 ◽

2020 ◽

Vol 19 (2) ◽

pp. 110-118

Author(s):

G. N. Minkina

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccination ◽

Evidence Base ◽

Full Potential ◽

Cervical Lesions ◽

Vaccination Programs ◽

Associated Diseases ◽

Papillomavirus Infection ◽

Precancerous Cervical Lesions ◽

The Impact

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Vaccine impact and effectiveness of meningococcal serogroup ACWY conjugate vaccine implementation in the Netherlands: a nationwide surveillance study

Clinical Infectious Diseases ◽

10.1093/cid/ciab791 ◽

2021 ◽

Author(s):

Milou Ohm ◽

Susan J M Hahné ◽

Arie van der Ende ◽

Elizabeth A M Sanders ◽

Guy A M Berbers ◽

...

Keyword(s):

The Netherlands ◽

Incidence Rate ◽

Vaccination Programme ◽

Screening Method ◽

Age Groups ◽

Incidence Rates ◽

Age Group ◽

Mass Campaign ◽

Conjugate Vaccination ◽

The Impact

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.

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Issues and Impacts of the Apricot Value Chain on the Upland Farmers in the Himalayan Range of Pakistan

Sustainability ◽

10.3390/su11164482 ◽

2019 ◽

Vol 11 (16) ◽

pp. 4482 ◽

Cited By ~ 2

Author(s):

Rakhshanda Kousar ◽

Muhammad Sohail Amjad Makhdum ◽

Azhar Abbas ◽

Javaria Nasir ◽

Muhammad Asad ur Rehman Naseer

Keyword(s):

Factor Analysis ◽

Value Chain ◽

Positive Impact ◽

Sampling Technique ◽

Poverty Level ◽

Cross Sectional ◽

Farming Communities ◽

Production Policy ◽

Matching Estimates ◽

The Impact

The livelihood of the people in the Himalayan range of Pakistan is largely dependent on the cultivation of fruits. Apricot and apple are the major fruits of this region, which are marketed throughout the country and also exported to other countries. Due to high perishability and the poor farm-to-market infrastructure in the region, farmers are unable to get maximum returns. This study was conducted keeping in view the importance of the region and the impacts of fruits on the livelihood of the farmhands. Cross-sectional data from 200 respondents were collected through a multistage random sampling technique. Factor analysis was employed to find out the constraint in the apricot production and propensity score matching estimates were employed to see the impact of apricot production on the farming communities in the study area. The results of the factor analysis show the most important group of constraints in the growth of the apricot industry is awareness, which is an internal factor. This is followed by production, policy, and marketing constraints. The least important is processing technology. Furthermore, the results show that apricot production has a significant positive impact on decreasing the poverty level of the household, depicting a great potential for the development of resilient livelihoods.

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Relationship Between Census Tract–Level Poverty and Domestically Acquired Salmonella Incidence: Analysis of Foodborne Diseases Active Surveillance Network Data, 2010–2016

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz605 ◽

2019 ◽

Vol 222 (8) ◽

pp. 1405-1412

Author(s):

James L Hadler ◽

Paula Clogher ◽

Tanya Libby ◽

Elisha Wilson ◽

Nadine Oosmanally ◽

...

Keyword(s):

Socioeconomic Status ◽

Relative Risk ◽

Active Surveillance ◽

Census Tract ◽

Incidence Rates ◽

International Travel ◽

Poverty Level ◽

Surveillance Network ◽

Catchment Population ◽

Salmonella Infections

Abstract Background The relationships between socioeconomic status and domestically acquired salmonellosis and leading Salmonella serotypes are poorly understood. Methods We analyzed surveillance data from laboratory-confirmed cases of salmonellosis from 2010–2016 for all 10 Foodborne Disease Active Surveillance Network (FoodNet) sites, having a catchment population of 47.9 million. Case residential data were geocoded, linked to census tract poverty level, and then categorized into 4 groups according to census tract poverty level. After excluding those reporting international travel before illness onset, age-specific and age-adjusted salmonellosis incidence rates were calculated for each census tract poverty level, overall and for each of the 10 leading serotypes. Results Of 52 821geocodable Salmonella infections (>96%), 48 111 (91.1%) were domestically acquired. Higher age-adjusted incidence occurred with higher census tract poverty level (P < .001; relative risk for highest [≥20%] vs lowest [<5%] census tract poverty level, 1.37). Children <5 years old had the highest relative risk (2.07). Although this relationship was consistent by race/ethnicity and by serotype, it was not present in 5 FoodNet sites or among those aged 18–49 years. Conclusion Children and older adults living in higher-poverty census tracts have had a higher incidence of domestically acquired salmonellosis. There is a need to understand socioeconomic status differences for risk factors for domestically acquired salmonellosis by age group and FoodNet site to help focus prevention efforts.

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Characteristics of hospitalizations with influenza diagnosis, France, 2012-2017

European Journal of Public Health ◽

10.1093/eurpub/ckz187.074 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M Pivette ◽

V de Lauzun ◽

N Nicolay ◽

A Scanff ◽

B Hubert

Keyword(s):

Length Of Stay ◽

Diagnosis Related Groups ◽

Laboratory Data ◽

Incidence Rates ◽

H3n2 Virus ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Age Group ◽

Hospital System ◽

The Impact

Abstract Background Seasonal influenza surveillance in France is based on several data sources (ambulatory data, emergency department and intensive care unit (ICU) admissions, laboratory data, mortality). However, the data do not provide a complete measure of the impact of the epidemics on the hospital system. The objective of the study was to describe the characteristics of influenza hospitalizations from the French national hospital discharge database (PMSI) between 2012 and 2017 and to precise the burden of influenza by age group and by season. Methods All hospitalizations in metropolitan France with at least one ICD-10 code related to influenza (J09, J10, J11) as a principal, related or associated diagnosis between 1 July 2012 to 30 June 2017 were extracted from the PMSI. For each season, the total number of hospitalizations, admissions to ICU, incidence and lethality rates, lengths of stay and classification in diagnosis-related groups were described by age group. Results During the 5 seasons, 91 255 hospitalizations with an influenza-diagnosis were identified. The incidence varied significantly between seasons, from 12.7/100 000 in 2013-2014 to 45.9/100 000 in 2016-2017. A high number of cases was observed in elderlies in 2014-2015 and 2016-2017, marked by the circulation of A (H3N2) virus. The proportion of hospitalizations with an admission in ICU was 10%, and was higher in the 40-79 age group (19%). Lethality increased steadily with age, from 0.5% under 20 years to 10% in 80 years and older. Length of stay also increased with age. Significant regional disparities were observed, with higher incidence rates in South-Eastern France each season. Conclusions The analysis of influenza hospitalizations from the PMSI provides important elements on influenza burden, not available in the current surveillance systems. An annual analysis, stratified by age group, would provide an indicator of the impact of the epidemics on hospital system at the end of each influenza season. Key messages Important influenza incidence variations were observed between seasons by age groups. Severity and impact of influenza (mortality, ICU, length of stay) varied significantly by age group.

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One-Dose Human Papillomavirus Vaccination and the Risk of Genital Warts: A Danish Nationwide Population-based Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1067 ◽

2020 ◽

Author(s):

Louise Baandrup ◽

Christian Dehlendorff ◽

Susanne K Kjaer

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccination ◽

Age Groups ◽

Genital Warts ◽

Population Based ◽

Incidence Rates ◽

Real World Data ◽

Calendar Time ◽

Human Papillomavirus Vaccination ◽

The Impact

Abstract Background Increasing evidence suggests that 1-dose human papillomavirus (HPV) vaccination may protect significantly against HPV-related disease. We provide nationwide, real-world data on the risk of genital warts (GWs) after <3 vaccine doses. Methods All Danish women born in 1985–2003 were identified, and individual-level vaccination data were retrieved. The cohort was followed up for first occurrence of GWs until 31 December 2016. Using Poisson regression, we calculated incidence rates (IRs) of GWs per 100 000 person-years and IR ratios (IRRs) with corresponding 95% confidence intervals (CIs) for GWs, according to vaccination status, age at first dose, and calendar time. Results The cohort comprised 1 076 945 girls and women, of whom 485 408 were vaccinated. For girls initiating vaccination at age 12–14 years and 15–16 years, 1-dose vaccine effectiveness (VE) was 71% (IRR = 0.29; 95% CI, .22–.38) and 62% (0.38; .29–.49), respectively, compared with unvaccinated girls. In the same age groups, 2-dose VE was 78% (IRR, 0.22; 95% CI, .18–.26) and 68% (0.32; .26–.38), respectively. After 2009, the IRRs for 3 versus 1 dose and 2 versus 1 dose increased towards unity over calendar time, being 0.69 (95% CI, .57–.84) and 0.86 (.68–1.08) in 2016, respectively. Conclusions In this study, 1 or 2 doses of quadrivalent HPV vaccine was associated with substantial protection against GWs in girls vaccinated at age ≤16 years. The 1-dose VE approached that of 3 or 2 doses over calendar time, probably reflecting the impact of herd protection.

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Increasing HPV vaccination uptake among adolescents: A Systematic Review

European Journal of Public Health ◽

10.1093/eurpub/ckz185.455 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A Acampora ◽

A Grossi ◽

A Barbara ◽

V Colamesta ◽

F A Causio ◽

...

Keyword(s):

Systematic Review ◽

Vaccination Coverage ◽

Positive Impact ◽

Hpv Vaccination ◽

Vaccination Strategy ◽

The United States ◽

Medical Visit ◽

Specific Context ◽

Vaccination Uptake ◽

The Impact

Abstract Background Human Papillomavirus (HPV) is responsible for the development of several pathologies besides the cervical cancer and HPV vaccination is a key strategy for primary prevention. The aim of this research was to identify strategies adopted to increase HPV vaccination coverage among the adolescents. Methods A systematic review was carried-out by searching electronic databases (Pubmed, Scopus, and Web of Science) using selected keywords as “papillomavirus vaccine”, “vaccination strategy” and “efficacy”. Articles conducted in high-income countries and evaluating the impact of one or more strategies on vaccination coverage (initiation e/o completion) in adolescents were included. Results Out of 3571 single citations screened, 42 papers (2011-2018) were included. Study size ranged from 50 to 325229 individuals. The major part of the studies was from the United States (n = 35; 83,3%) and conducted with an experimental design (n = 17; 40,5%). The evaluated outcomes included first dose uptake, schedule completion, vaccination timeliness and the number of administered doses. Identified strategies included reminds (9), education activities (9), multicomponent strategies (22) and others (2) and were focused on adolescents/parents and/or healthcare providers. Significant positive results were reported in seven studies (77,8%) evaluating the impact of reminds, four studies (44,4%) on education strategies, and in 12 studies (54,5%) on multicomponent strategies. Offering vaccination in “bundle” or during any medical visit was also reported as significantly effective. Conclusions Increasing the vaccination coverage is essential to achieve HPV-related diseases control. Several types of strategies are available and showed a positive impact on vaccination uptake, in particular those relied on reminds. Nonetheless, the heterogeneity of interventions suggests the importance to adapt such initiatives to the specific context in order to maximize the improvement in vaccination uptake. Key messages Several types of strategies to increase vaccination uptake are available at international level and showed a positive impact among adolescents. These interventions are heterogeneous suggesting the importance of their adaptation to the specific context in order to gain the maximum improvement in vaccination uptake.

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HPV Screening Test for the Detection of Precancerous Cervical Lesions and Cervical Cancer in Israeli Women

Acta Cytologica ◽

10.1159/000518324 ◽

2021 ◽

pp. 1-7

Author(s):

Tali Feinberg ◽

Einav Yehuda-Shnaidman ◽

Tamar Wolf ◽

Judith Sandbank ◽

Jacob Segal ◽

...

Keyword(s):

Cervical Cancer ◽

Screening Test ◽

The Other ◽

Premalignant Lesions ◽

First Year ◽

Screening Methods ◽

Age Group ◽

Cervical Lesions ◽

Precancerous Cervical Lesions ◽

Cytology Screening

Objectives: This work is aimed to summarize the first year of the high-risk human papillomavirus (hrHPV) screening test and compare it to the cytology screening test, regarding positivity rates and premalignant lesions diagnosed in the Israeli population. A specific consideration is for the age group 25–30 that is not considered mandatory for the HPV primary screening testing. Methods: A retrospective study was performed in women who were screened for prevention of cervical cancer in Maccabi HealthCare HMO from March 2017 to March 2019. Screening methods included hrHPV typing for types 16, 18, and the other 12 hrHPV types and the PAP LBC test. Results: A total of 115,807 cervical samples were tested for HPV presence and 91% (105,225) were found negative for hrHPV. The other 9% (10,582) were positive for one or more of the 14 hrHPV types tested, and 37% (3,916) of them showed abnormal PAP LBC results. In the age group of 25–30, 3,104 (17.5%) women were found positive for hrHPV (825 had hrHPV types 16 and/or 18), of which 42% (1,293) of them showed abnormal PAP LBC results. During the hrHPV versus PAP LBC screening era, 258 more women were diagnosed with precancerous cervical lesions (CIN2/3), 70% increased detection versus cytology screening. Conclusions: The hrHPV screening test is currently the best method for the detection of precancerous cervical lesions and cervical cancer, and it is better started at age 25.

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Varicella vaccination as useful strategy for reducing the risk of varicella-related hospitalizations

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1258 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Marrella ◽

A Casuccio ◽

E Amodio ◽

F Vitale

Keyword(s):

Vaccination Coverage ◽

Age Groups ◽

Incidence Rates ◽

Varicella Vaccination ◽

Age Group ◽

Annual Percent Change ◽

High Coverage ◽

Joint Point ◽

Hospitalization Rates ◽

The Impact

Abstract Introduction The present study summarizes evidences of the impact of varicella vaccination (VV) on hospitalization rates attributable to this infectious disease in Italy. Methods We have carried out a retrospective observational study that analysed hospital discharge records and VV coverage at 24 months collected from 2003 to 2018 by the Italian Health Ministry. All hospitalizations with the presence of an ICD-9 CM 059.X code in the principal diagnosis or in any of the five secondary diagnoses were considered as related to varicella. The hospitalization rate reduction was evaluated by calculating average annual percent change (AAPC) through joint-point analysis. Results Hospitalization rates showed a decreasing risk by age: children aged <1 year were the most affected age group in each region (42.56/100,000 per year), whereas lower incidence rates were found in older age groups (23.76/100,000 in 1 to 5 years age group and <4/100,000 in the following groups). Varicella hospitalization rates decreased significantly after the introduction of VV (3.42 vs. 2.67 per 100,000; P < 0.001). During the first five years after vaccination introduction hospitalization rates showed a statistically significant decrease especially for infants aged <1 year (AAPC -34.98%; p < 0.001) and 1 to 5 years old (AAPC -35.22%; P < 0.01). VV coverage was strongly correlated with hospitalization rates decrease over each paediatric age group (R-squared 0.38 in aged <1 year, p < 0.001; 0.71 in 1 to 5 years old, p < 0.001; 0.93 in 6 to 14 years old, p < 0.0001). Conclusions All the previously reported findings confirm that hospitalization rates are strictly related to both the number of years since vaccination introduction and the vaccination coverage. VV confirms to be an important step in public health strategies and the introduction of universal vaccination, with high vaccination coverage, should be considered as an extremely powerful tool for reducing the risk of complications. Key messages This study adds update findings to the literature and shows that varicella hospitalizations in Italy, from 2003 to 2018, have reduced their burden, that was high in years before varicella vaccination. Varicella vaccination introduction and high coverage are powerful tools for reducing the risk of varicella complications and related hospitalizations in the general population.

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