scholarly journals Spatial distribution of tuberculosis incidence in Los Angeles County

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Adam Readhead ◽  
Alicia H. Chang ◽  
Jo Kay Ghosh ◽  
Frank Sorvillo ◽  
Julie Higashi ◽  
...  
Keyword(s):  
Public Health ◽  
Spatial Distribution ◽  
Los Angeles ◽  
Los Angeles County ◽  
Disease Incidence ◽  
The Philippines ◽  
Incidence Rates ◽  
Country Of Birth ◽  
High Incidence ◽  
The U.S

Abstract Background In Los Angeles County, the tuberculosis (TB) disease incidence rate is seven times higher among non-U.S.-born persons than U.S.-born persons and varies by country of birth. But translating these findings into public health action requires more granular information, especially considering that Los Angeles County is more than 4000 mile2. Local public health authorities may benefit from data on which areas of the county are most affected, yet these data remain largely unreported in part because of limitations of sparse data. We aimed to describe the spatial distribution of TB disease incidence in Los Angeles County while addressing challenges arising from sparse data and accounting for known cofactors. Methods Data on 5447 TB cases from Los Angeles County were combined with stratified population estimates available from the 2005–2011 Public Use Microdata Survey. TB disease incidence rates stratified by country of birth and Public Use Microdata Area were calculated and spatial smoothing was applied using a conditional autoregressive model. We used Bayesian Poisson models to investigate spatial patterns adjusting for age, sex, country of birth and years since initial arrival in the U.S. Results There were notable differences in the crude and spatially-smoothed maps of TB disease rates for high-risk subgroups, namely persons born in Mexico, Vietnam or the Philippines. Spatially-smoothed maps showed areas of high incidence in downtown Los Angeles and surrounding areas for persons born in the Philippines or Vietnam. Areas of high incidence were more dispersed for persons born in Mexico. Adjusted models suggested that the spatial distribution of TB disease could not be fully explained using age, sex, country of birth and years since initial arrival. Conclusions This study highlights areas of high TB incidence within Los Angeles County both for U.S.-born cases and for cases born in Mexico, Vietnam or the Philippines. It also highlights areas that had high incidence rates even when accounting for non-spatial error and country of birth, age, sex, and years since initial arrival in the U.S. Information on spatial distribution provided here complements other descriptions of local disease burden and may help focus ongoing efforts to scale up testing for TB infection and treatment among high-risk subgroups.

scholarly journals Challenges and solutions to estimating tuberculosis disease incidence by country of birth in Los Angeles County

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0209051 ◽  
Author(s):  
Adam Readhead ◽  
Alicia H. Chang ◽  
Jo Kay Ghosh ◽  
Frank Sorvillo ◽  
Roger Detels ◽  
...  
Keyword(s):  
Los Angeles ◽  
Los Angeles County ◽  
Disease Incidence ◽  
Country Of Birth ◽  
Tuberculosis Disease

scholarly journals An economic and disease transmission model of human papillomavirus and oropharyngeal cancer in Texas

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chengxue Zhong ◽  
Li Xu ◽  
Ho-Lan Peng ◽  
Samantha Tam ◽  
Li Xu ◽  
...  
Keyword(s):  
Public Health ◽  
Human Papillomavirus ◽  
Oropharyngeal Cancer ◽  
Hpv Vaccine ◽  
Health Benefits ◽  
Incidence Rates ◽  
Vaccine Uptake ◽  
Males And Females ◽  
Quality Adjusted Life ◽  
The U.S

AbstractIn 2017, 46,157 and 3,127 new oropharyngeal cancer (OPC) cases were reported in the U.S. and Texas, respectively. About 70% of OPC were attributed to human papillomavirus (HPV). However, only 51% of U.S. and 43.5% of Texas adolescents have completed the HPV vaccine series. Therefore, modeling the demographic dynamics and transmission of HPV and OPC progression is needed for accurate estimation of the economic and epidemiological impacts of HPV vaccine in a geographic area. An age-structured population dynamic model was developed for the U.S. state of Texas. With Texas-specific model parameters calibrated, this model described the dynamics of HPV-associated OPC in Texas. Parameters for the Year 2010 were used as the initial values, and the prediction for Year 2012 was compared with the real age-specific incidence rates in 23 age groups for model validation. The validated model was applied to predict 100-year age-adjusted incidence rates. The public health benefits of HPV vaccine uptake were evaluated by computer simulation. Compared with current vaccination program, increasing vaccine uptake rates by 50% would decrease the cumulative cases by 4403, within 100 years. The incremental cost-effectiveness ratio of this strategy was $94,518 per quality-adjusted life year (QALY) gained. Increasing the vaccine uptake rate by 50% can: (i) reduce the incidence rates of OPC among both males and females; (ii) improve the quality-adjusted life years for both males and females; (iii) be cost-effective and has the potential to provide tremendous public health benefits in Texas.

Some Issues of Morbidity with Temporary Incapacity for Work in the Ural Federal District

2021 ◽  
pp. 37-44
Author(s):  
AS Shastin ◽  
VG Gazimova ◽  
OL Malykh ◽  
TS Ustyugova ◽  
TM Tsepilova
Keyword(s):  
Public Health ◽  
Russian Federation ◽  
Disease Incidence ◽  
Federal District ◽  
Incidence Rates ◽  
Statistical Information ◽  
Working Age ◽  
The Russian Federation ◽  
The Common ◽  
Working Age Population

Introduction: In the context of a decreasing size of the working-age population, monitoring of the health status and disease incidence in this cohort shall be one of the most important tasks of public and occupational health professionals. Health risk management for the working population in the Russian Federation requires complete and reliable data on its morbidity, especially in view of the fact that its average age demonstrates a stable growth. It is, therefore, crucial to have precise and consistent information about the morbidity of the working-age population. Objective: The study aimed to assess incidence rates of diseases with temporary incapacity for work in the constituent entities of the Ural Federal District of the Russian Federation. Materials and methods: We reviewed data on disease incidence rates published by the Federal State Statistics Service in the Common Interdepartmental System of Statistical Information, Section 15.12, Causes of Temporary Disability, and Section 2.9.I.4, Federal Project for Public Health Promotion. The constituent entities under study were ranked according to the number of cases and days of temporary incapacity per 100 workers and E.L. Notkin scale was used to determine grade the incidence. The statistical analysis was performed using STATISTICA 10 software. Long-term average values of certain indicators, median values, standard deviation (σ) and coefficients of variation were estimated. The difference in the indices was assessed using the Mann-Whitney test. Results: Compared to 2010, incidence rates of diseases with temporary incapacity for work in the constituent entities of the Ural Federal District in 2019 demonstrated a significant decline. The sharp drop was observed in 2015. We also established that the Common Interdepartmental System of Statistical Information contains contradictory information on disease incidence. Conclusion: It is expedient to consider the issue of revising guidelines for organization of federal statistical monitoring of morbidity with temporary incapacity for work and to include this indicator in the system of public health monitoring.

scholarly journals Public Health Efforts Can Impact Adoption of Current Susceptibility Breakpoints, but Closer Attention from Regulatory Bodies Is Needed

2018 ◽  
Vol 57 (3) ◽  
Author(s):  
James A. McKinnell ◽  
S. Bhaurla ◽  
P. Marquez-Sung ◽  
A. Pucci ◽  
M. Baron ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Safety ◽  
Los Angeles ◽  
Antimicrobial Susceptibility ◽  
Los Angeles County ◽  
Susceptibility Testing ◽  
Clinical Care ◽  
Public Health Intervention ◽  
Antimicrobial Susceptibility Testing ◽  
Outreach Program

ABSTRACT Microbiological testing, including interpretation of antimicrobial susceptibility testing results using current breakpoints, is crucial for clinical care and infection control. Continued use of obsolete Enterobacteriaceae carbapenem breakpoints is common in clinical laboratories. The purposes of this study were (i) to determine why laboratories failed to update breakpoints and (ii) to provide support for breakpoint updates. The Los Angeles County Department of Public Health conducted a 1-year outreach program for 41 hospitals in Los Angeles County that had reported, in a prior survey of California laboratories, using obsolete Enterobacteriaceae carbapenem breakpoints. In-person interviews with hospital stakeholders and customized expert guidance and resources were provided to aid laboratories in updating breakpoints, including support from technical representatives from antimicrobial susceptibility testing device manufacturers. Forty-one hospitals were targeted, 7 of which had updated breakpoints since the prior survey. Of the 34 remaining hospitals, 27 (79%) assumed that their instruments applied current breakpoints, 17 (50%) were uncertain how to change breakpoints, and 10 (29%) lacked resources to perform a validation study for off-label use of the breakpoints on their systems. Only 7 hospitals (21%) were familiar with the FDA/CDC Antibiotic Resistance Isolate Bank. All hospitals launched a breakpoint update process; 16 (47%) successfully updated breakpoints, 12 (35%) received isolates from the CDC in order to validate breakpoints on their systems, and 6 (18%) were planning to update within 1 year. The public health intervention was moderately successful in identifying and overcoming barriers to updating Enterobacteriaceae carbapenem breakpoints in Los Angeles hospitals. However, the majority of targeted hospitals continued to use obsolete breakpoints despite 1 year of effort. These findings have important implications for the quality of patient care and patient safety. Other public health jurisdictions may want to utilize similar resources to bridge the patient safety gap, while manufacturers, the FDA, and others determine how best to address this growing public health issue.

Incidentally Detected SARS-COV-2 Among Hospitalized Patients in Los Angeles County, August to October 2020

2021 ◽  
Vol 16 (8) ◽  
Author(s):  
Jennifer Tsai ◽  
Elizabeth Traub ◽  
Kymberly Aoki ◽  
Kelsey Oyong ◽  
Heidi Sato ◽  
...  
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Emergency Preparedness ◽  
Medical Records ◽  
Confidence Limit ◽  
Los Angeles County ◽  
Resource Planning ◽  
Hospital Discharges ◽  
Hospitalization Rates ◽  
Test Result

We aimed to determine the percentage of COVID-19–associated hospitalizations reported to Los Angeles County (LAC) Public Health that might have been misclassified because of incidentally detected SARS-CoV-2. We retrospectively reviewed medical records from a randomly selected set of hospital discharges reported to LAC Public Health from August to October 2020 for a clinical diagnosis of COVID-19 or a positive SARS-CoV-2 test result. Among the 13,813 discharges from 85 hospitals reported to LAC Public Health as COVID-19–associated hospitalizations from August to October 2020, 346 were randomly selected and reviewed. SARS-CoV-2 detection was incidental to the reason for hospitalization in 12% (95% confidence limit, 9%-16%) of COVID-19 classified hospital discharges. Adjusting COVID-19–associated hospitalization rates to account for incidental SARS-CoV-2 detection could help public health policymakers and emergency preparedness personnel improve resource planning.

Introduction and History of Public Health in Los Angeles County

2012 ◽  
pp. 1-12
Author(s):  
Jonathan E. Fielding ◽  
Jonathan Freedman ◽  
Stephanie N. Caldwell
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Los Angeles County ◽  
History Of Public Health ◽  
History Of

scholarly journals Capturing a Complexity of Nutritional, Environmental, and Economic Impacts on Selected Health Parameters in the Russian High North

2020 ◽  
Vol 12 (5) ◽  
pp. 2151
Author(s):  
Tianming Gao ◽  
Vasilii Erokhin
Keyword(s):  
Public Health ◽  
Disease Incidence ◽  
Indigenous Communities ◽  
Incidence Rates ◽  
Health Impacts ◽  
The Arctic ◽  
Russian Arctic ◽  
Running Water ◽  
Sustainable Solutions ◽  
Health Parameters

The rapid pace of economic exploration of the Arctic against the backdrop of progressing environmental change put a high priority on improving understanding of health impacts in the northern communities. Deficiencies in the capability to capture the complexity of health-influencing parameters along with a lack of observations in circumpolar territories present major challenges to establishing credible projections of disease incidence across varying northern environments. It is thus crucial to reveal the relative contributions of coacting factors to provide a basis for sustainable solutions in the sphere of public health. In order to better understand the adverse effects associated with public health, this study employed six-stage multiple regression analysis of incidence rates of fourteen diseases (International Classification of Diseases (ICD-11) codes most widespread in the Russian Arctic) against a set of environmental, nutritional, and economic variables. Variance inflationary factor and best-subsets regression methods were used to eliminate collinearity between the parameters of regression models. To address the diversity of health impacts across northern environments, territories of the Arctic zone of Russia were categorized as (1) industrial sites, (2) urban agglomerations, (3) rural inland, and (4) coastline territories. It was suggested that, in Type 1 territories, public health parameters were most negatively affected by air and water pollution, in Type 2 territories—by low-nutrient diets, in Type 3 and Type 4 territories—by economic factors. It was found that in the Western parts of the Russian Arctic, poor quality of running water along with low access to the quality-assured sources of water might increase the exposure to infectious and parasitic diseases and diseases of the circulatory, respiratory, and genitourinary systems. Low living standards across the Russian Arctic challenged the economic accessibility of adequate diets. In the cities, the nutritional transition to low-quality cheap market food correlated with a higher incidence of digestive system disorders, immune diseases, and neoplasms. In indigenous communities, the prevalence of low diversified diets based on traditional food correlated with the increase in the incidence rates of nutritional and metabolic diseases.

Using decision analysis to select alternate modes of dispensing: An example from Los Angeles County Public Health

2009 ◽  
Vol 7 (2) ◽  
pp. 39
Author(s):  
Sinan Khan, MPH, MA ◽  
Anke Richter, PhD
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Decision Analysis ◽  
Los Angeles County ◽  
Relative Effectiveness ◽  
Health Maintenance Organization ◽  
Sensitivity Analyses ◽  
Health Maintenance ◽  
Response Planning ◽  
The Many

Objective: To comply with the Center for Disease Control’s mass prophylaxis mandates, many public health jurisdictions must supplement their existing Points of Dispensing (POD)-based system. Because of limited budgets and personnel availability, only one or two alternatives out of the many potential options can be implemented.Design: Multicriteria decision analysis is a powerful tool that allows public health officials to assess the relative effectiveness of alternate modes of dispensing while incorporating the opinions of their multidisciplinary emergency response planning teams.Setting: This process was utilized to analyze the effectiveness of alternate modes of dispensing that could be used to supplement the existing POD system within the Los Angeles County (LAC) Department of Public Health (DPH).Results: The top two options for LAC were prepositioning for civil service and partnership with a major Health Maintenance Organization. These choices were stable under a variety of sensitivity analyses, and the differences in opinion between the agencies and other stakeholders do not change them.Conclusions: The transparency of the model and analysis may allow decision makers and planners in the LAC DPH to garner support for their alternate modes of dispensing plans. By making the decision criteria clear and demonstrating the robustness of the results in the sensitivity analyses, public health partners gain a deeper understanding of the issues and their potential roles. The process can be repeated by any jurisdiction, but definition of “best” will rely on the issues and gaps that are identified with the jurisdiction’s POD plan for mass prophylaxis.

First Report of National Estimates of the Incidence of Myelodysplastic Syndromes and Chronic Myeloproliferative Disorders from the U.S. SEER Program.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 247-247 ◽  
Author(s):  
Dana E. Rollison ◽  
Matthew Hayat ◽  
Martyn Smith ◽  
Sara S. Strom ◽  
William D. Merritt ◽  
...  
Keyword(s):  
Myelodysplastic Syndromes ◽  
Disease Incidence ◽  
Myeloproliferative Disorders ◽  
The United States ◽  
Incidence Rates ◽  
Age At Diagnosis ◽  
Seer Program ◽  
Refractory Anemia ◽  
Chronic Myeloproliferative Disorders ◽  
The U.S

Abstract BACKGROUND: Incidence rates for myelodysplastic syndromes (MDS) and chronic myeloproliferative disorders (CMD) in the United States were unavailable prior to the addition of these stem cell malignancies to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program and other central cancer registries in 2001. Description of national incidence rates for 2001–2003 will provide an important baseline for future studies of secular trends and allow for the examination of rates by selected demographic factors to define risk profiles of these malignancies in the American population. METHODS: Incidence rates of MDS and CMD were calculated for 18 SEER areas between 2001–2003. These rates were stratified by disease subtype using the FAB classification (including chronic myelomonocytic leukemia [CMML]) with the addition of the WHO deletion 5q category, sex, age at diagnosis and race. Based on the observed SEER incidence rates, counts were estimated for the entire U.S. population. RESULTS: In 2003, 2,538 cases of MDS and 1,421 cases of CMD were observed for all 18 SEER areas combined. Similar numbers of cases were observed in 2001 and 2002. Age-adjusted incidence rates for 2001–2003 were significantly higher among males than females for MDS (4.5 per 100,000 in males vs. 2.7 per 100,000 in females, p <0.0001) and CMD (2.4 per 100,000 in males vs. 1.7 per 100,000 in females, p<0.0001). This gender rate difference was observed consistently across all disease subtypes, including refractory anemia (2.0 per 100,000 in males vs. 1.2 per 100,000 in females (p<0.0001). Incidence rates were significantly associated with age at diagnosis for both MDS (p=0.01) and CMD (p=0.001), and were highest among White, non-Hispanics (2.4 per 100,000 for CMD; 4.2 per 100,000 for MDS). An estimated national total of 14,648 cases of MDS (including CMML) and CMD were diagnosed in 2003, with overall incidence rates for MDS and CMD of 3.1 and 1.9 per 100,000, respectively. The MDS incidence rate for the U.S. is remarkably similar to those previously reported from European countries including England and Wales (3.6 per 100,000), Germany (4.1 per 100,000), Sweden (3.6 per 100,000) and France (3.2 per 100,000). Estimated incidence rates in the U.S. were greater among men than women for all diseases, including CMML (0.40 per 100,000 in males versus 0.3 per 100,000 in females, p< 0.0001). Disease incidence increased with age for MDS, CMD, and CMML, although the increase was greatest for MDS, with an approximate five-fold difference in estimated rates for those diagnosed at ages 60–69 years vs. 80 years and older (7.4 per 100,000 vs. 36.3 per 100,000). The increase in MDS incidence with age was greater for males than females, whereas the age-related increase in CMD and CMML incidence was similar across sexes. Rates of CMD, MDS and CMML were all estimated to be highest among White, non-Hispanics. CONCLUSION: Male sex and advanced age are important risk factors for the development of CMD and MDS. Diagnostic recording differences may underestimate the total annual U.S. MDS and CMD case burden. Future prevention intervention and disease causality studies of MDS and CMD should target high-risk groups.

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