HIV Prevalence Estimates and Alignment Among Recent Diagnoses, Targeted Tests, and Prevention Services by Demographic and Racial/Ethnic Group in Wisconsin

This retrospective cohort study will investigate the timeliness of surgery based on the racial/ethnic group of patients who under colorectal surgery for cancer. Patients are included if they underwent surgical procedures for colon cancer between January 1, 2015 and April 30, 2020. The primary exposure of interest is the racial/ethnic group of the patient. The primary outcome is the the timeliness of surgery, defined as having urgent/emergent surgery (less timely) vs. elective surgery (more timely). Secondary outcomes relate to comprehensiveness of surgery, and include performance of preoperative staging tests, preoperative lab testing, and preoperative teaching of patients, as well as length of stay and additional clinical outcomes. Multivariable logistic regression models will be used to adjust for other demographic and clinical differences between study groups.

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Role of survey response rates on valid inference: an application to HIV prevalence estimates

Emerging Themes in Epidemiology ◽

10.1186/s12982-018-0074-x ◽

2018 ◽

Vol 15 (1) ◽

Cited By ~ 1

Author(s):

Miguel Marino ◽

Marcello Pagano

Keyword(s):

Response Rates ◽

Hiv Prevalence ◽

Survey Response ◽

Valid Inference ◽

Prevalence Estimates

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Do the Benefits of Educational Attainment for Late-life Cognition Differ by Racial/Ethnic Group?

Alzheimer Disease & Associated Disorders ◽

10.1097/wad.0000000000000418 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Chloe W. Eng ◽

Medellena Maria Glymour ◽

Paola Gilsanz ◽

Dan M. Mungas ◽

Elizabeth R. Mayeda ◽

...

Keyword(s):

Educational Attainment ◽

Ethnic Group ◽

Late Life ◽

Racial Ethnic

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Suboptimal HIV status ascertainment at antenatal clinics and the impact on HIV prevalence estimates

10.1101/2021.10.04.21262474 ◽

2021 ◽

Author(s):

Fatihiyya Wangara ◽

Janne Estill ◽

Hillary Kipruto ◽

Kara Wools-Kaloustian ◽

Wendy Chege ◽

...

Keyword(s):

Hiv Testing ◽

Routine Data ◽

Hiv Prevalence ◽

Sentinel Surveillance ◽

List Type ◽

Hiv Status ◽

Hiv Surveillance ◽

New Findings ◽

Prevalence Estimates ◽

Antenatal Clinics

AbstractIntroductionHIV prevalence estimates is a key indicator to inform the coverage and effectiveness of HIV prevention measures. Many countries including Kenya transitioned from sentinel surveillance to the use of routine antenatal care data to estimate the burden of HIV. Countries in Sub Saharan Africa reported several challenges of this transition, including low uptake of HIV testing and sub national / site-level differences in HIV prevalence estimates.MethodsWe examine routine data from Kwale County, Kenya, for the period January 2015 to December 2019 and predict HIV prevalence among women attending antenatal care (ANC) at 100% HIV status ascertainment. We estimate the bias in HIV prevalence estimates as a result of imperfect uptake of HIV testing and make recommendations to improve the utility of ANC routine data for HIV surveillance. We used a generalized estimating equation with binomial distribution to model the observed HIV prevalence as explained by HIV status ascertainment and region (Sub County). We then used marginal standardization to predict the HIV prevalence at 100% HIV status ascertainment.ResultsHIV testing at ANC was at 91.3%, slightly above the global target of 90%. If there was 100% HIV status ascertainment at ANC, the HIV prevalence would be 2.7% (95% CI 2.3-3.2). This was 0.3% lower than the observed prevalence. Similar trends were observed with yearly predictions except for 2018 where the HIV prevalence was underestimated with an absolute bias of -0.2%. This implies missed opportunities for identifying new HIV infections in the year 2018.ConclusionsImperfect HIV status ascertainment at ANC overestimates HIV prevalence among women attending ANC in Kwale County. However, the use of ANC routine data may underestimate the true population prevalence. There is need to address both community level and health facility level barriers to the uptake of ANC services.Key questionsWhat is already known?▪HIV surveillance estimates from antenatal clinics (ANC) can serve as a useful proxy for HIV prevalence trends in the general female population.▪Kenya has conducted multiple studies which have shown that national HIV prevalence estimates from sentinel surveillance and those from routine program data to be similar.▪However, these studies have also revealed ongoing challenges to the suitability of using routine data as compared to sentinel surveillance including sub optimal uptake of HIV testing and sub national/ site-level differences in HIV prevalence estimates.What are the new findings?▪HIV positive pregnant women are more likely to be tested at ANC as compared to HIV negative women, leading to higher HIV prevalence estimates among women attending ANC.▪Health facility level HIV prevalence estimates are lower than that of the general population.What do the new findings imply?▪HIV positive women are underrepresented in antenatal clinics.▪In Kwale County (and similar contexts), use of routine ANC data is still not a reliable method to estimate HIV prevalence, both at facility and community level.

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Colorectal Cancer Incidence Trends by Age, Stage, and Racial/Ethnic Group in California, 1990–2014

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-18-0030 ◽

2018 ◽

Vol 27 (9) ◽

pp. 1011-1018 ◽

Cited By ~ 11

Author(s):

Libby Ellis ◽

Renata Abrahão ◽

Meg McKinley ◽

Juan Yang ◽

Ma Somsouk ◽

...

Keyword(s):

Colorectal Cancer ◽

Ethnic Group ◽

Cancer Incidence ◽

Incidence Trends ◽

Colorectal Cancer Incidence ◽

Racial Ethnic

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Abstract P286: The Prevalence of Comorbid Depression & Diabetes across Racial/Ethnic Backgrounds: The National Health and Nutrition Examination Study

Circulation ◽

10.1161/circ.129.suppl_1.p286 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Veronica Y Womack ◽

Peter De Chavez ◽

Kiarri Andrews ◽

Mercedes R Carnethon

Keyword(s):

Depressive Symptoms ◽

Mexican Americans ◽

Type Ii Diabetes ◽

Ethnic Background ◽

Type Ii ◽

Comorbid Depression ◽

Health And Nutrition ◽

Prevalence Estimates ◽

Antidepressant Use ◽

Racial Ethnic

Background: Depression, both diagnosed and based on elevated symptom scores, is highly prevalent in individuals with Type II Diabetes (T2DM). Depression predisposes individuals to poorer glycemic control, higher rates of T2DM complications and elevated mortality. African Americans and Hispanics are less likely to be diagnosed with depression than non-Hispanic whites; however, prevalence studies in the general (i.e., non-diabetic) population report that rates of elevated depressive symptoms are similar across race/ethnic groups. Objective: To calculate the age-adjusted prevalence of comorbid depression and Type II Diabetes by race/ethnicity and to investigate whether the patterns vary according to treatment of depression or elevated depressive symptoms (EDS). We hypothesize that racial/ethnic differences in depression among adults with diabetes will vary according to whether depression is treated or based on elevated depressive symptoms. Methods: Participants from the National Health and Nutrition Examination Study (2005-2010) classified as White (n=459), Black (n=250), Mexican American (n=233), or “Other Racial/Ethnic Background” (n=149) and had T2DM (i.e., fasting glucose >=126, clinician diagnosis, or diabetic medication use) and responses to current prescription drug use and depression syndrome measures were included in the analysis (n=1,091, Mean age=48.2 year). Undiagnosed depression was determined by an elevated depressive symptoms (EDS) score => 10 on the Patient Health Questionnaire-9 and no report of current antidepressant use. Treatment for depression was determined by self-reported current antidepressant use (e.g., SSRI, MAOI, and TCA). Weighted age-adjusted prevalence rates of depression among adults who have diabetes were stratified by race/ethnic background. Results: Twelve percent used antidepressants and 7% of the sample had EDS without antidepressant use. The age-adjusted prevalence of antidepressant use among adults with diabetes was higher in Whites (16%, 95% CI: 9%, 22%) than Black (9%, 95% CI: 3%, 15%), Mexican Americans (5%, 95% CI: 3%, 8%), and “Others” (6%, 95% CI: 1%, 10%). These prevalence estimates remained significantly different after adjusting for healthcare provider and income. The prevalence of EDS among adults with diabetes was not significantly different across race/ethnic background groups (Whites- 5%, 95% CI: 3%, 8%; Blacks- 8%, 95% CI: 2%, 13%; Mexican Americans- 8%, 95% CI: 3%, 13%; “Others”- 8%, 95% CI %, 14%). The prevalence estimates of EDS and antidepressants by race/ethnic group did not vary by gender. Conclusions: Although African Americans and Mexican-Americans with diabetes were as likely to experience EDS, they were less likely to have to be treated for depression. These findings highlight the importance of screening for both treated depression and EDS in individuals who have Type II Diabetes.

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Racial and Ethnic Variations in Mortality Rates for Patients Undergoing Maintenance Dialysis Treated in US Territories Compared with the US 50 States

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.03920319 ◽

2019 ◽

Vol 15 (1) ◽

pp. 101-108 ◽

Cited By ~ 1

Author(s):

Guofen Yan ◽

Jenny I. Shen ◽

Rubette Harford ◽

Wei Yu ◽

Robert Nee ◽

...

Keyword(s):

United States ◽

Confidence Interval ◽

Ethnic Group ◽

Proportional Hazards ◽

The United States ◽

Mortality Rates ◽

American Samoa ◽

Cox Proportional Hazards ◽

Maintenance Dialysis ◽

Racial Ethnic

Background and objectivesIn the United States mortality rates for patients treated with dialysis differ by racial and/or ethnic (racial/ethnic) group. Mortality outcomes for patients undergoing maintenance dialysis in the United States territories may differ from patients in the United States 50 states.Design, setting, participants, & measurementsThis retrospective cohort study of using US Renal Data System data included 1,547,438 adults with no prior transplantation and first dialysis treatment between April 1, 1995 and September 28, 2012. Cox proportional hazards regression was used to calculate hazard ratios (HRs) of death for the territories versus 50 states for each racial/ethnic group using the whole cohort and covariate-matched samples. Covariates included demographics, year of dialysis initiation, cause of kidney failure, comorbid conditions, dialysis modality, and many others.ResultsOf 22,828 patients treated in the territories (American Samoa, Guam, Puerto Rico, Virgin Islands), 321 were white, 666 were black, 20,299 were Hispanic, and 1542 were Asian. Of 1,524,610 patients in the 50 states, 838,736 were white, 444,066 were black, 182,994 were Hispanic, and 58,814 were Asian. The crude mortality rate (deaths per 100 patient-years) was lower for whites in the territories than the 50 states (14 and 29, respectively), similar for blacks (18 and 17, respectively), higher for Hispanics (27 and 16, respectively), and higher for Asians (22 and 15). In matched analyses, greater risks of death remained for Hispanics (HR, 1.65; 95% confidence interval, 1.60 to 1.70; P<0.001) and Asians (HR, 2.01; 95% confidence interval, 1.78 to 2.27; P<0.001) living in the territories versus their matched 50 states counterparts. There were no significant differences in mortality among white or black patients in the territories versus the 50 states.ConclusionsMortality rates for patients undergoing dialysis in the United States territories differ substantially by race/ethnicity compared with the 50 states. After matched analyses for comparable age and risk factors, mortality risk no longer differed for whites or blacks, but remained much greater for territory-dwelling Hispanics and Asians.

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