scholarly journals SARS-CoV-2 Transmission Dynamics in Households With Children, Los Angeles, California

2022 ◽  
Vol 9 ◽  
Author(s):  
Melissa Lucero Tanaka ◽  
Carolyn Jennifer Marentes Ruiz ◽  
Sanchi Malhotra ◽  
Lauren Turner ◽  
Ariana Peralta ◽  
...  
Keyword(s):  
Los Angeles ◽  
Household Income ◽  
Multivariable Analysis ◽  
Urban Setting ◽  
Transmission Dynamics ◽  
Special Focus ◽  
Minority Population ◽  
Community Transmission ◽  
Households With Children ◽  
Index Cases

Objectives: Studies of household transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) focused on households with children are limited. We investigated household secondary attack rate (SAR), transmission dynamics, and contributing factors in households with children.Materials and Methods: In this prospective case-ascertained study in Los Angeles County, California, all households members were enrolled if ≥1 member tested positive for SARS-CoV-2 by polymerase chain reaction (PCR). Nasopharyngeal PCRs, serology, and symptom data were obtained over multiple visits.Results: A total of 489 individuals in 105 households were enrolled from June to December 2020. The majority (77.3%) reported a household annual income of <$50,000, and most (92.9%) were of Hispanic/Latinx ethnicity. Children <18 years old accounted for 46.9% index cases, of whom 45.3% were asymptomatic. Household index cases were predominantly children during low community transmission and adults during the high community transmission period (χ2 = 7.647, p = 0.0036. The mean household SAR was 77.0% (95% CI: 69.4–84.6%). Child and adult index cases both efficiently transmitted SARS-CoV-2 within households [81.9%, (95% CI: 72.1–91.9%) vs. 72.4% (95% CI: 59.8–85.1%), p = 0.23]. Household income and pets were significantly associated with higher SAR in the multivariable analysis of household factors (p = 0.0013 and 0.004, respectively).Conclusions: The SAR in households with children in an urban setting with a large ethnic minority population is much higher than previously described. Children play important roles as index cases. SAR was disproportionately impacted by household income. Vaccination and public health efforts need special focus on children and vulnerable communities to help mitigate SARS-CoV-2 spread.

scholarly journals The role of children in the transmission chain of SARS-CoV-2: a systematic review and update of current evidence

2020 ◽  
Author(s):  
Jonathan E. Suk ◽  
Constantine Vardavas ◽  
Katerina Nikitara ◽  
Revati Phalkey ◽  
Jo Leonardi-Bee ◽  
...  
Keyword(s):  
Potential Role ◽  
Mitigation Measures ◽  
Sufficient Evidence ◽  
Current Evidence ◽  
School Closures ◽  
School Settings ◽  
Transmission Chain ◽  
Community Transmission ◽  
Index Cases

AbstractDecisions on school closures and on safe schooling during the COVID-19 pandemic should be evidence-based. We conducted a systematic literature review to assess child-to-child and child-to-adult SARS-CoV-2 transmission and to characterise the potential role of school closures on community transmission. 1337 peer-reviewed articles published through August 31, 2020 were screened; 22 were included in this review. The literature appraised provides sufficient evidence that children can both be infected by and transmit SARS-CoV-2 in community, household and school settings. Transmission by children was most frequently documented in household settings, while examples of children as index cases in school settings were rare. Included studies suggested that school closures may help to reduce SARS- CoV-2 transmission, but the societal, economic, and educational impacts of prolonged school closures must be considered. In-school mitigation measures, alongside continuous surveillance and assessment of emerging evidence, will promote the protection and educational attainment of students and support the educational workforce.

Risk Factors and Outcomes From All-Terrain Vehicle Injuries Compared With Motor Vehicle Collisions in Children

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1255-1261
Author(s):  
Sriram Ramgopal ◽  
Natan Cramer ◽  
Barbara A. Gaines ◽  
Kavitha A. Conti
Keyword(s):  
Risk Factors ◽  
Household Income ◽  
Motor Vehicle ◽  
Multivariable Analysis ◽  
Risk Groups ◽  
Median Household Income ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Targeted Interventions ◽  
Extremity Injuries

We compared risk factors and outcomes of children injured from all-terrain vehicle (ATV) injuries to those injured from motor vehicle collisions (MVC). We reviewed records of patients ≤18 years of age admitted to a trauma center with ATV- or MVC-related injuries between January 1, 2000, and December 31, 2015. Demographics were compared using logistic regression. Rates of injuries were compared using χ2 tests. Of 6293 patients, 1140 (18%) ATV and 5153 (82%) MVC events were identified. In multivariable analysis (adjusted odds ratio [aOR], 95% confidence interval [CI]), patients with ATV-related injuries occurred more at older age (≥12 years; aOR = 4.29, 95% CI = 3.20-5.77), in rural counties (aOR = 3.72, 95% CI = 2.62-5.28), in regions with lower median household income (aOR = 1.37, 95% CI = 1.03-1.83), and in the spring (aOR = 2.44, 95% CI = 1.87-3.18), and summer (aOR = 2.50, 95% CI = 1.93-3.25) compared with winter. ATV-related injuries occurred less frequently among females (aOR = 0.76, 95% CI = 0.65-0.89). Upper extremity injuries were associated with ATV-related injuries ( P ≤ .001). Findings may facilitate identification of at-risk groups for targeted interventions.

Correlating Geographic Location with Incidence of Motor Vehicle–Induced Pedestrian Injury

2018 ◽  
Vol 84 (6) ◽  
pp. 1049-1053 ◽  
Author(s):  
Neal Bhutiani ◽  
Keith R. Miller ◽  
Matthew V. Benns ◽  
Nicholas A. Nash ◽  
Glen A. Franklin ◽  
...  
Keyword(s):  
Household Income ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Multivariable Analysis ◽  
Geographic Location ◽  
Motor Vehicles ◽  
Median Household Income ◽  
Risk Of Death ◽  
Pedestrian Injury ◽  
The Impact

To date, no studies have examined the relationship between geographic and socioeconomic factors and the frequency of pedestrians sustaining traumatic injuries from a motor vehicle. The objective of this study was to analyze the impact of location on the frequency of pedestrian injury by motor vehicle. The University of Louisville Trauma Registry was queried for patients who had been struck by a motor vehicle from 2010 to 2015. Demographic and injury information as well as outcome measures were evaluated to identify those impacting risk of pedestrian versus motor vehicle accidents. Number of incidents was correlated with lower median household income. There was also a moderate correlation between the number of incidents and population density. Multivariable analysis demonstrated a significant association between increased median household income and distance from downtown Louisville and decreased risk of death following pedestrian versus motor vehicle accident. Incidence of pedestrian injury by motor vehicles is influenced by regional socioeconomic status. Efforts to decrease the frequency of these events should include further investigation into the mechanisms underpinning this relationship.

Lung Cancer in Nonelderly Patients: Facility and Patient Characteristics Associated With Not Receiving Treatment

2019 ◽  
Vol 17 (8) ◽  
pp. 931-939 ◽  
Author(s):  
Elizabeth A. Nardi ◽  
Can-Lan Sun ◽  
Francisco Robert ◽  
Julie A. Wolfson
Keyword(s):  
Lung Cancer ◽  
Los Angeles ◽  
Private Insurance ◽  
Multivariable Analysis ◽  
Small Cell ◽  
Cancer Surveillance ◽  
Disease Stage ◽  
Insurance Status ◽  
Treatment Facility ◽  
Race Ethnicity

Background: In elderly patients with lung cancer, race/ethnicity is associated with not receiving treatment; however, little attention has been given to nonelderly patients (aged ≤65 years) with a range of disease stages and histologies. Nonelderly patients with lung cancer have superior survival at NCI-designated Comprehensive Cancer Centers (CCCs), although the reasons remain unknown. Patients and Methods: A retrospective cohort study was conducted in 9,877 patients newly diagnosed with small cell or non–small cell lung cancer (all stages) between ages 22 and 65 years and reported to the Los Angeles County Cancer Surveillance Program registry between 1998 and 2008. Multivariable logistic regression examined factors associated with nontreatment. Results: In multivariable analysis, race/ethnicity was associated with not receiving cancer treatment (black: odds ratio [OR], 1.22; P=.004; Hispanic: OR, 1.17; P=.04), adjusting for patient age, sex, disease stage, histology, diagnosis year, distance to treatment facility, type of facility (CCC vs non-CCC), and insurance status. With inclusion of socioeconomic status (SES) in the model, the effect of race/ethnicity was no longer significant (black: OR, 1.02; P=.80; Hispanic: OR, 1.00; P=1.00). Factors independently associated with nontreatment included low SES (OR range, 1.37–2.15; P<.001), lack of private insurance (public: OR, 1.71; P<.001; uninsured: OR, 1.30; P<.001), and treatment facility (non-CCC: OR, 3.22; P<.001). Conclusions: In nonelderly patients with lung cancer, SES was associated with nontreatment, mitigating the effect of race/ethnicity. Patients were also at higher odds of nontreatment if they did not have private insurance or received cancer care at a non-CCC facility. These findings highlight the importance of understanding how both patient-level factors (eg, SES, insurance status) and facility-level factors (eg, treatment facility) serve as barriers to treatment of nonelderly patients with lung cancer.

scholarly journals Oral Hygiene Practices and Associated Factors among Patients Visiting Private Dental Clinics at Hawassa City, Southern Ethiopia, 2018

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Desalegn Humna Beyene ◽  
Bereket Beyene Shashamo ◽  
Lankamo Ena Digesa ◽  
Eshetu Zerihun Tariku
Keyword(s):  
Oral Health ◽  
Oral Hygiene ◽  
Associated Factors ◽  
Multivariable Analysis ◽  
Southern Ethiopia ◽  
Special Focus ◽  
Hygiene Practices ◽  
Dental Clinics ◽  
Hygienic Practice ◽  
Study Participants

Introduction. A poor oral hygiene is associated with dental caries, gingivitis, periodontal diseases, bad breath, respiratory and cardiovascular diseases, and chronic kidney diseases. Moreover, a poor oral health has psychosocial impacts that diminish a quality of life and restrict activities in school, at work, and home. African regions carry a major burden of oral health problems. However, very few studies highlighted about oral hygiene practices and there is also paucity of information in Ethiopia. This study was, therefore, designed to identify an oral hygiene practice on patients/clients visiting dental clinics in Hawassa City, Southern Ethiopia. Objective. To assess oral hygiene practices and associated factors among patients/clients visiting private dental clinics, Hawassa City, Southern Ethiopia. Methods. Institution-based cross-sectional study was employed among patients/clients attending private clinics in Hawassa City from January 27 to February 8, 2018. Systematic random sampling technique was used to select 403 study participants. Data were entered into EpiData 3.1, cleaned, and analyzed by SPSS 20. A multivariable logistic regression analysis was performed to assess the association between independent and outcome variables. Crude and adjusted OR with 95% confidence level was estimated, and variables having P value ≤0.05 in multivariable analysis were considered as significant. Results. 393 study participants participated making a response rate of 97.52%. A median age of respondents was 27 ± 10.9. About 153 (39.9%) of the study participants had poor oral hygienic practice. Male (AOR: 1.63, 95% CI: (1.053, 2.523)), rural residence (AOR: 3.79, 95% CI: (1.724, 8.317)), and poor knowledge about oral hygiene (AOR: 2.38, 95% CI: (1.402, 4.024)) were independently associated to poor oral hygienic practice. Conclusion. More than one-third of the study participants had poor oral hygienic practice. Providing health information regarding oral hygiene for the patients/clients in the facilities with a special focus from rural areas is recommended.

scholarly journals First Nations households living on-reserve experience food insecurity: prevalence and predictors among ninety-two First Nations communities across Canada

2021 ◽  
Vol 112 (S1) ◽  
pp. 52-63 ◽  
Author(s):  
Malek Batal ◽  
Hing Man Chan ◽  
Karen Fediuk ◽  
Amy Ing ◽  
Peter R. Berti ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
First Nations ◽  
Food Sovereignty ◽  
Multivariable Analysis ◽  
Household Food Security ◽  
Barriers And Enablers ◽  
Environment Study ◽  
Households With Children

Abstract Objective To describe the prevalence of food insecurity in First Nations households across Canada while identifying barriers and enablers to traditional food (TF) consumption. Methods The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of on-reserve First Nations from 2008 to 2018. The Household Food Security Survey Module was used to capture income-related challenges experienced by First Nations households. Households were classified as food secure, or marginally, moderately, or severely food insecure. Barriers and enablers to TF access and use were identified describing the Indigenous experience. Results Almost half of on-reserve First Nations households were food insecure and the prevalence was higher than that for non-Indigenous households in Canada. On-reserve food insecurity prevalence was higher in western regions of Canada. First Nations households with children experienced greater food insecurity than those without children. More adults experienced severe food insecurity than children. Most adults would like to have more TF in their diet but state that factors such as financial and household constraints, industrial activities, government regulations, climate change, and fear of contamination impede greater access. Food costs were substantially higher in remote First Nations communities, but remoteness was not associated with food security in multivariable analysis. Conclusion Existing systems have been unsuccessful in curbing the food insecurity in First Nations households. Improving food security hinges on achieving Indigenous Food Sovereignty, the key to long-term conservation and stewardship of the land and the co-management of these by Indigenous Peoples. Studies investigating the feasibility of increasing TF from an Indigenous perspective are required.

scholarly journals Coronavirus Disease in Pakistan: Response and Challenges from Prevention to Care

2020 ◽  
Vol 3 (9) ◽  
pp. 1090-1094
Author(s):  
Syeda Ghadeer Zehra Naqvi ◽  
Kainat Fatima ◽  
Kanwal Jamal ◽  
Muhammad Waqaruddin Sheroze
Keyword(s):  
Social Economic ◽  
Transmission Dynamics ◽  
Resource Limited ◽  
Community Transmission

Immensely contagious Coronavirus disease was imported in Pakistan and became health emergency concern in no time. Pakistan, being a resource limited nation has encountered worst transmission dynamics and received public, social, economic challenges. Pakistani officials responded sufficiently to outbreak. However, community transmission became an emergent threat and proportion of mortalities became exponential.  Hence, Pakistan was scantily prepared to respond to an overhanging hazardous outbreak. This study comment on response of Pakistani government to Coronavirus disease, sheds light on challenges faced during the Covid-19 pandemic and concluded by highlighting concept of preparedness and providing some recommendations.

scholarly journals 497. Changing Molecular Epidemiology of CRE from 2016–2018, Increase in the Unknown

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S242-S242
Author(s):  
Mi Le ◽  
Sandeep Bhaurla ◽  
Kelsey OYong ◽  
James McKinnell ◽  
Yang Yang ◽  
...  
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Molecular Epidemiology ◽  
Invasive Procedure ◽  
Healthcare Facility ◽  
Central Line ◽  
Resistance Mechanisms ◽  
Urban Setting ◽  
Resistant Organism ◽  
Case Characteristics

Abstract Background Historically, endemic Klebsiella pneumoniae carbapenemase (KPC) has accounted for the majority of carbapenem-resistant Enterobacteriaceae (CRE) in Los Angeles County (LAC). The LAC Department of Public Health (DPH) initiated enhanced CRE surveillance in 2016 to determine CRE prevalence and track emerging non-KPC resistance mechanisms (IMP, NDM, OXA, and VIM) among CRE to describe characteristics and identify local epidemiology for novel multi-drug-resistant organism (N-MDRO) infection and colonization. Methods CRE isolates were voluntarily submitted by local clinical laboratories for mechanism detection by LAC Public Health Laboratory via MALDI-TOF and Nanosphere BC-GN. Baseline isolates were collected in 2016. Results are then presented by year through 2018. For N-MDRO cases, LACDPH interviewed healthcare facility (HCF) staff and cases to obtain case characteristics. Data were analyzed via Microsoft Access and SAS. Results CRE surveillance isolates were voluntarily submitted by 31 labs representing 34% (34/96) LAC hospitals and 1 large regional lab serving 60% of skilled nursing facilities from January 2016 to December 2018. LACDPH tested 1438 CRE isolates during the study period, 1168 (81%) were carbapenemase producing (CP). The proportion of CP CRE and KPC CRE declined over the study period (Table 1). NDM was the most common non-KPC (n = 30) followed by OXA (n = 28). The proportion of CRE with no genotypic marker increased over the course of the study. Case characteristics were obtained from 41 non-KPC CP CRE cases; median age was 66 years (range: 6–94 years); 12 (29%) expired. Among the 41 cases, 20 (49%) had a central line; 11 (27%) had surgery; 14 (34%) had antibiotics in the 6 months prior to culture date. Of the 41 cases, 11 (27%) had international healthcare exposure within 12 months with an invasive procedure and/or antibiotics. Conclusion Surveillance in a large urban setting suggests the molecular epidemiology of CRE is changing, with declining prevalence of KPC, increasing metallo-β-lactamase CP, and large proportion of isolates without resistance markers detected. Given the worrisome trends in non-KPC CRE, more systematic surveillance is warranted, potentially using more robust molecular epidemiology. Disclosures All authors: No reported disclosures.

scholarly journals 542. Los Angeles County Acute Care Regional Antibiogram Suggests Changing Landscape of MDRO Threats Between 2015 and 2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S258-S259
Author(s):  
James McKinnell ◽  
Chelsea Foo ◽  
Kelsey OYong ◽  
Janet Hindler ◽  
Sandra Ceja ◽  
...  
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Acute Care ◽  
Los Angeles County ◽  
Multivariable Analysis ◽  
Multidrug Resistant ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Level Data ◽  
Facility Level

Abstract Background National surveillance for multidrug-resistant organisms (MDRO) are limited by narrow geographic sampling, few hospitals, and failure to account for local epidemiology. A Los Angeles County (LAC) regional antibiogram was created to inform public health interventions and provide a baseline for susceptibility patterns countywide. We present data to compare the 2015 and 2017 LAC regional antibiogram. Methods We conducted a cross-sectional survey of cumulative facility-level antibiograms from all hospitals in LAC; 83 hospitals (AH) and 9 Long-term Acute Care (LTAC). For 2015, submission was voluntary, 2017 data were collected by public health order. Non-respondents were contacted by phone and in person. Isolates from sterile sources were pooled. Countywide susceptibility was calculated by weighting each facility’s isolate count by its reported susceptibility rate with minimum–maximim observed (2015) and Interquartile range (IQR) for 2017. Change from 2015 mean susceptibility is reported. Results Seventy-five (75) facilities submitted antibiograms for 2015 and 86 facilities for 2017. Among non-respondents in 2017, two facilities could not provide an adequate antibiogram and 4 were specialty hospitals with too few cultures to create an antibiogram. Regional summmary tables are presented in Tables 1–4. Klebsiella pneumoniae (n = 50 hospitals/19,382 isolates) % S to meropenem was 97% (IQR 94–100%), no change from 2015. Pseudomonas aeruginosa (PA) (n = 52 hospitals/17,770 isolates)% S to meropenem was 84% (IQR 74–93%), no change from 2015. Susceptibility to Acinetobacter baumannii (AB) was reported by 48 hospitals, including 1,4361 isolates,% S to meropenem was 39% (IQR 25–75%), 14% lower than 2015. Streptococcus agalactiae (n = 13 hospitals/647 isolates)% S to clindamycin was 43% (IQR 13–59%), a 22% increase from 2015. Conclusion LAC regional antibiograms identified stable patterns of antimicrobial resistance for most pathogens, but concerning results with AB and PA. Analysis of highly drug-resistant pathogens such as AB and PA would be improved with patient-level data to generate a combination antibiogram. We favor presenting IQR %S as done for 2017. Ongoing analysis will include multivariable analysis of observed changed S controlling for hospital characteristics. Disclosures All authors: No reported disclosures.

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