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1.
MMWR Morb Mortal Wkly Rep ; 70(14): 505-509, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33830980

RESUMEN

Psittacosis is typically a mild febrile respiratory illness caused by infection with the bacterium Chlamydia psittaci and usually transmitted to humans by infected birds (1). On average, 11 psittacosis cases per year were reported in the United States during 2000-2017. During August-October 2018, the largest U.S. psittacosis outbreak in 30 years (82 cases identified*) occurred in two poultry slaughter plants, one each in Virginia and Georgia, that shared source farms (2). CDC used C. psittaci real-time polymerase chain reaction (PCR) to test 54 human specimens from this outbreak. This was the largest number of human specimens from a single outbreak ever tested for C. psittaci using real-time PCR, which is faster and more sensitive than commercially available serologic tests. This represented a rare opportunity to assess the utility of multiple specimen types for real-time PCR detection of C. psittaci. C. psittaci was detected more frequently in lower respiratory specimens (59% [10 of 17]) and stool (four of five) than in upper respiratory specimens (7% [two of 28]). Among six patients with sputum and nasopharyngeal swabs tested, C. psittaci was detected only in sputum in five patients. Cycle threshold (Ct) values suggested bacterial load was higher in lower respiratory specimens than in nasopharyngeal swabs. These findings support prioritizing lower respiratory specimens for real-time PCR detection of C. psittaci. Stool specimens might also have utility for diagnosis of psittacosis.


Asunto(s)
Chlamydophila psittaci/aislamiento & purificación , Brotes de Enfermedades , Tamizaje Masivo/métodos , Psitacosis/diagnóstico , Reacción en Cadena en Tiempo Real de la Polimerasa , Adulto , Chlamydophila psittaci/genética , Heces/microbiología , Femenino , Georgia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Psitacosis/epidemiología , Esputo/microbiología , Virginia/epidemiología , Adulto Joven
2.
Cent Eur J Public Health ; 29(1): 23-27, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33831283

RESUMEN

OBJECTIVES: Our recent studies showed that in children in the Batumi region, Georgia, underdiagnosis of asthma is 65%, and that not all children with known asthma had a history of allergic disorders. So, we decided to assess the association of known diagnosis of paediatric asthma with asthma-like symptoms and non-respiratory allergic symptoms and diseases using questionnaire-derived data provided by respiratory health survey. METHODS: Subjects of the cross-sectional population-based study were 3,239 urban and 2,113 rural children aged 5-17 years whose respiratory status was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. For children with a known diagnosis of asthma, the occurrence of respiratory symptoms suggestive of asthmatic tendency and of allergic symptoms and diseases was measured and statistical association of known asthma with the respiratory and allergic symptoms was expressed as odds ratios (OR) and their 95% confidence intervals (95% CI). RESULTS: Respiratory and all allergic symptoms and diseases, except for eczema, were statistically significantly (p < 0.05) more prevalent in children with asthma than in children without asthma. Based on the distribution of asthma vis-à-vis asthmatic tendency without or with allergic symptoms and allergic diseases the following odds ratios expressing likelihood of asthma were obtained: for asthmatic tendency: OR = 18.09 (95% CI: 11.82-27.68), for any allergic symptom: OR = 6.85 (95% CI: 4.69-10.02), for any allergic disease: OR = 10.75 (95% CI: 7.36-15.70), for asthmatic tendency with coexisting any allergic symptom: OR = 18.94 (95% CI: 12.96-27.68), for asthmatic tendency with coexisting any allergic disease: OR = 25.65 (95% CI: 17.47-37.67), and for asthmatic tendency with coexisting any allergic symptom and allergic disease: OR = 27.02 (95% CI: 18.18-40.15). CONCLUSIONS: The findings support the view that in epidemiological setting questionnaire-based studies on asthma seems to more readily identify cases in children with more severe clinical presentation of the disease and with coexisting allergic disorders, perhaps reflecting diagnostic practices of consulting paediatricians.


Asunto(s)
Asma , Hipersensibilidad , Adolescente , Asma/epidemiología , Niño , Preescolar , Estudios Transversales , Georgia , Humanos , Hipersensibilidad/epidemiología , Prevalencia , Encuestas y Cuestionarios
3.
MMWR Morb Mortal Wkly Rep ; 70(17): 644-650, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33914727

RESUMEN

As of April 19, 2021, 21.6 million COVID-19 cases had been reported among U.S. adults, most of whom had mild or moderate disease that did not require hospitalization (1). Health care needs in the months after COVID-19 diagnosis among nonhospitalized adults have not been well studied. To better understand longer-term health care utilization and clinical characteristics of nonhospitalized adults after COVID-19 diagnosis, CDC and Kaiser Permanente Georgia (KPGA) analyzed electronic health record (EHR) data from health care visits in the 28-180 days after a diagnosis of COVID-19 at an integrated health care system. Among 3,171 nonhospitalized adults who had COVID-19, 69% had one or more outpatient visits during the follow-up period of 28-180-days. Compared with patients without an outpatient visit, a higher percentage of those who did have an outpatient visit were aged ≥50 years, were women, were non-Hispanic Black, and had underlying health conditions. Among adults with outpatient visits, 68% had a visit for a new primary diagnosis, and 38% had a new specialist visit. Active COVID-19 diagnoses* (10%) and symptoms potentially related to COVID-19 (3%-7%) were among the top 20 new visit diagnoses; rates of visits for these diagnoses declined from 2-24 visits per 10,000 person-days 28-59 days after COVID-19 diagnosis to 1-4 visits per 10,000 person-days 120-180 days after diagnosis. The presence of diagnoses of COVID-19 and related symptoms in the 28-180 days following acute illness suggests that some nonhospitalized adults, including those with asymptomatic or mild acute illness, likely have continued health care needs months after diagnosis. Clinicians and health systems should be aware of post-COVID conditions among patients who are not initially hospitalized for acute COVID-19 disease.


Asunto(s)
/complicaciones , Prestación Integrada de Atención de Salud , Aceptación de la Atención de Salud/estadística & datos numéricos , Adolescente , Adulto , Anciano , Atención Ambulatoria/estadística & datos numéricos , /epidemiología , Femenino , Georgia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Adulto Joven
4.
J Sch Health ; 91(5): 356-369, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33843084

RESUMEN

BACKGROUND: Concerns have been raised about the consequences of the COVID-19 pandemic on the mental health of adolescents during an important developmental and social period in their lives. This study examines the mental health impact of the pandemic on high school students shortly after closure of public schools in spring 2020, and whether this impact varies by sex, race/ethnicity, socioeconomic status (SES), and grade level. METHODS: A cross-sectional, one-time online survey was completed by racial/ethnically and socioeconomically diverse students in 9th through 12th grade at 2 semi-rural Georgia public high schools (N = 761). RESULTS: Overall, almost one-fourth of high school students were extremely or very worried about the pandemic, with higher rates of worry among students who are racial/ethnic minorities, lower SES, female and in older grades. Results indicated a concerning impact on the stress, anxiety, depression, and loneliness that students are feeling, particularly among girls and those in older grades. Students of color and low SES, who are already disproportionately impacted by COVID-19, are also more likely to experience mental health challenges. CONCLUSIONS: Findings highlight important demographic differences of the impact of COVID-19 on the mental health of high school students and have implications for schools with addressing these needs.


Asunto(s)
/psicología , Salud Mental , Instituciones Académicas , Estudiantes/psicología , Adolescente , Ansiedad/psicología , Estudios Transversales , Depresión/psicología , Femenino , Georgia/epidemiología , Humanos , Soledad/psicología , Masculino , Factores Raciales , Población Rural , Factores Socioeconómicos
5.
Artículo en Inglés | MEDLINE | ID: mdl-33805459

RESUMEN

Water management plans (WMPs), sometimes referred to as risk management plans (RMPs) or water safety plans (WSPs), are not mandatory for hotels in many countries of the world, including the US. As such, many hotel personnel are uninformed of WMPs and the precautions to take if their hotel water system is compromised. The purpose of this study was to identify hotel personnel's knowledge and practices of WMPs through a survey incorporating the Health Belief Model (HBM). Data were collected from 59 hotels within Fulton County, Georgia, USA, through a questionnaire, and questions were developed tailored to the HBM. Significant associations were found between the perceived susceptibility of contracting a waterborne illness and WMP for hotel personnel as well as between cues to action and having a WMP in general linear models (p ≤ 0.05). The study concludes that many key personnel are not aware of WMPs. Many hotel facilities do not have a plan in place, and some facilities are unaware of a current plan is in place. The study findings provide insight into the importance of WMPs and the risk factors associated with microbial contamination in a hotel building's plumbing system. Future research and potential law change should be emphasized to increase hotel employees' and owner's WMP knowledge.


Asunto(s)
Abastecimiento de Agua , Agua , Georgia , Factores de Riesgo , Gestión de Riesgos
6.
Emerg Infect Dis ; 27(4): 1164-1168, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33754981
7.
J Public Health Manag Pract ; 27(3): 251-257, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33762540

RESUMEN

BACKGROUND: The COVID-19 pandemic affects population groups differently, worsening existing social, economic, and health inequities. PURPOSE: This study examined 159 counties within Georgia to identify community characteristics associated with county-level COVID-19 case, hospitalization, and death rates. METHODS: Data from the 2020 County Health Rankings, the 2010 US Census, and the Georgia Department of Public Health COVID-19 Daily Status Report were linked using county Federal Information Processing Standard codes and evaluated through multivariable linear regression models. RESULTS: The percentages of children in poverty, severe housing problems, and people not proficient in the English language were significant predictors associated with increases in case, hospitalization, and death rates. Diabetic prevalence was significantly associated with increases in the hospitalization and death rates; in contrast, the percentages of people with excessive drinking and female were inversely associated with hospitalization and death rates. Other independent variables showing an association with death rate included the percentages of people reporting fair or poor health and American Indian/Alaska Native. IMPLICATION: Local authorities' proper allocation of resources and plans to address community social determinants of health are essential to mitigate disease transmission and reduce hospitalizations and deaths associated with COVID-19, especially among vulnerable groups.


Asunto(s)
/epidemiología , /terapia , Causas de Muerte , Pandemias/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Poblaciones Vulnerables/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Georgia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Resultado del Tratamiento
8.
J Public Health Manag Pract ; 27(3): 258-267, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33762541

RESUMEN

OBJECTIVE: The primary aim of this study was to investigate whether students in minority race categories are more likely to experience race-related bias and hatred in their lifetime and since the onset of COVID-19, after controlling the effect of demographic and other variables. METHODS: This quantitative study used primary data from the survey of 1249 college students at one of the universities in Georgia during April and May 2020. We performed multinomial logistic regression, computing 2 models for the 2 ordinal dependent variables concerning students' experience of race-related bias and hatred-(a) during their lifetime and (b) since the onset of COVID-19 in March 2020-both measured as "never," "rarely," "sometimes," and "fairly often or very often." RESULTS: During their lifetime, 47.5% of students had experienced some level of bias or hatred, ranging from "rarely" to "very often." Since the onset of COVID-19 on March 2 in Georgia, in a short period of 1 to 2 months, 17.6% of students reported experiencing race-related bias or hatred. Univariate statistics revealed substantial differences in race-related bias and hatred by race, experienced during students' lifetime as well as since the onset of COVID-19. Results of multinomial logistic regression showed that the odds of having experienced bias or hatred during their lifetime were significantly higher (P < .05) for the Black students than for White students (adjusted odds ratio [AOR] = 75.8, for very often or often vs never; AOR = 42 for sometimes vs never). Compared with White students, the odds of hatred and bias were also significantly higher for students who were Asian, multiple races, or another non-White race. The odds of having experienced race-related bias and hatred since the onset of COVID-19 were also higher for Black Asian, multiple races, and other non-White students. CONCLUSIONS: This study adds critical scientific evidence about variation in the perception of bias and hatred that should draw policy attention to race-related issues experienced by college students in the United States.


Asunto(s)
/psicología , Grupos Étnicos/psicología , Grupos Minoritarios/psicología , Racismo/psicología , Racismo/estadística & datos numéricos , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Adulto , Afroamericanos/psicología , Afroamericanos/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Femenino , Georgia/epidemiología , Hispanoamericanos/psicología , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Grupos Minoritarios/estadística & datos numéricos , Factores Socioeconómicos , Encuestas y Cuestionarios , Universidades/estadística & datos numéricos , Adulto Joven
9.
J Public Health Manag Pract ; 27(3): 285-294, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33762544

RESUMEN

CONTEXT: Local agencies across the United States have identified public health isolation sites for individuals with coronavirus disease 2019 (COVID-19) who are not able to isolate in residence. PROGRAM: We describe logistics of establishing and operating isolation and noncongregate hotels for COVID-19 mitigation and use the isolation hotel as an opportunity to understand COVID-19 symptom evolution among people experiencing homelessness (PEH). IMPLEMENTATION: Multiple agencies in Atlanta, Georgia, established an isolation hotel for PEH with COVID-19 and noncongregate hotel for PEH without COVID-19 but at risk of severe illness. PEH were referred to the isolation hotel through proactive, community-based testing and hospital-based testing. Daily symptoms were recorded prospectively. Disposition location was recorded for all clients. EVALUATION: During April 10 to September 1, 2020, 181 isolation hotel clients (77 community referrals; 104 hospital referrals) were admitted a median 3 days after testing. Overall, 32% of community referrals and 7% of hospital referrals became symptomatic after testing positive; 83% of isolation hotel clients reported symptoms at some point; 93% completed isolation. Among 302 noncongregate hotel clients, median stay was 18 weeks; 61% were discharged to permanent housing or had a permanent housing discharge plan. DISCUSSION: Overall, a high proportion of PEH completed isolation at the hotel, suggesting a high level of acceptability. Many PEH with COVID-19 diagnosed in the community developed symptoms after testing, indicating that proactive, community-based testing can facilitate early isolation. Noncongregate hotels can be a useful COVID-19 community mitigation strategy by bridging PEH at risk of severe illness to permanent housing.


Asunto(s)
/prevención & control , Guías como Asunto , Personas sin Hogar/estadística & datos numéricos , Vivienda/normas , Salud Pública/normas , Cuarentena/normas , Aislamiento Social , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Manejo de la Enfermedad , Femenino , Georgia/epidemiología , Vivienda/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Salud Pública/estadística & datos numéricos , Cuarentena/estadística & datos numéricos , Adulto Joven
10.
BMC Nephrol ; 22(1): 81, 2021 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-33676397

RESUMEN

BACKGROUND: Emory Dialysis serves an urban and predominantly African American population at its four outpatient dialysis facilities. We describe COVID-19 infection control measures implemented and clinical characteristics of patients with COVID-19 in the Emory Dialysis facilities. METHODS: Implementation of COVID-19 infection procedures commenced in February 2020. Subsequently, COVID-19 preparedness assessments were conducted at each facility. Patients with COVID-19 from March 1-May 31, 2020 were included; with a follow-up period spanning March-June 30, 2020. Percentages of patients diagnosed with COVID-19 were calculated, and characteristics of COVID-19 patients were summarized as medians or percentage. Baseline characteristics of all patients receiving care at Emory Dialysis (i.e. Emory general dialysis population) were presented as medians and percentages. RESULTS: Of 751 dialysis patients, 23 (3.1%) were diagnosed with COVID-19. The median age was 67.0 years and 13 patients (56.6%) were female. Eleven patients (47.8%) were residents of nursing homes. Nineteen patients (82.6%) required hospitalization and 6 patients (26.1%) died; the average number of days from a positive SARS-CoV-2 (COVID) test to death was 16.8 days (range 1-34). Two patients dialyzing at adjacent dialysis stations and a dialysis staff who cared for them, were diagnosed with COVID-19 in a time frame that may suggest transmission in the dialysis facility. In response, universal masking in the facility was implemented (prior to national guidelines recommending universal masking), infection control audits and re-trainings of PPE were also done to bolster infection control practices. CONCLUSION: We successfully implemented recommended COVID-19 infection control measures aimed at mitigating the spread of SARS-CoV-2. Most of the patients with COVID-19 required hospitalizations. Dialysis facilities should remain vigilant and monitor for possible transmission of COVID-19 in the facility.


Asunto(s)
Afroamericanos , Instituciones de Atención Ambulatoria/normas , Control de Infecciones/métodos , Diálisis Renal/normas , Poblaciones Vulnerables/etnología , Anciano , /etnología , Susceptibilidad a Enfermedades , Femenino , Georgia , Humanos , Masculino , Persona de Mediana Edad , Telemedicina , Población Urbana
11.
BMJ Open ; 11(3): e044154, 2021 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-33674374

RESUMEN

OBJECTIVE: Describe the disease course in a cohort of outpatients with COVID-19 and evaluate factors predicting duration of symptoms. DESIGN: Retrospective cohort study. SETTING: Telemedicine clinic at a large medical system in Atlanta, Georgia. PARTICIPANTS: 337 patients with acute COVID-19. Exclusion criteria included intake visit more than 10 days after symptom onset and hospitalisation prior to intake visit. MAIN OUTCOME MEASURES: Symptom duration in days. RESULTS: Common symptoms at intake visit are upper respiratory (73% cough, 55% loss of smell or taste, 57% sinus congestion, 32% sore throat) and systemic (66% headache, 64% body aches, 53% chills, 30% dizziness, 36% fever). Day of symptom onset was earliest for systemic and upper respiratory symptoms (median onset day 1 for both), followed by lower respiratory symptoms (day 3, 95% CI 2 to 4), with later onset of gastrointestinal symptoms (day 4, 95% CI 3 to 5), when present. Cough had the longest duration when present with median 17 days (95% CI 15 to 21), with 42% not resolved at final visit. Loss of smell or taste had the second longest duration with 14 days (95% CI 12 to 17), with 38% not resolved at final visit. Initial symptom severity is a significant predictor of symptom duration (p<0.01 for multiple symptoms). CONCLUSIONS: COVID-19 illness in outpatients follows a pattern of progression from systemic symptoms to lower respiratory symptoms and persistent symptoms are common across categories. Initial symptom severity is a significant predictor of disease duration for most considered symptoms.


Asunto(s)
/diagnóstico , Evaluación de Síntomas/métodos , Telemedicina , Adulto , Anciano , Femenino , Georgia , Humanos , Masculino , Persona de Mediana Edad , Embarazo , Estudios Retrospectivos
12.
JAMA Netw Open ; 4(3): e211283, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33688967

RESUMEN

Importance: Risks for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care personnel (HCP) are unclear. Objective: To evaluate the risk factors associated with SARS-CoV-2 seropositivity among HCP with the a priori hypothesis that community exposure but not health care exposure was associated with seropositivity. Design, Setting, and Participants: This cross-sectional study was conducted among volunteer HCP at 4 large health care systems in 3 US states. Sites shared deidentified data sets, including previously collected serology results, questionnaire results on community and workplace exposures at the time of serology, and 3-digit residential zip code prefix of HCP. Site-specific responses were mapped to a common metadata set. Residential weekly coronavirus disease 2019 (COVID-19) cumulative incidence was calculated from state-based COVID-19 case and census data. Exposures: Model variables included demographic (age, race, sex, ethnicity), community (known COVID-19 contact, COVID-19 cumulative incidence by 3-digit zip code prefix), and health care (workplace, job role, COVID-19 patient contact) factors. Main Outcome and Measures: The main outcome was SARS-CoV-2 seropositivity. Risk factors for seropositivity were estimated using a mixed-effects logistic regression model with a random intercept to account for clustering by site. Results: Among 24 749 HCP, most were younger than 50 years (17 233 [69.6%]), were women (19 361 [78.2%]), were White individuals (15 157 [61.2%]), and reported workplace contact with patients with COVID-19 (12 413 [50.2%]). Many HCP worked in the inpatient setting (8893 [35.9%]) and were nurses (7830 [31.6%]). Cumulative incidence of COVID-19 per 10 000 in the community up to 1 week prior to serology testing ranged from 8.2 to 275.6; 20 072 HCP (81.1%) reported no COVID-19 contact in the community. Seropositivity was 4.4% (95% CI, 4.1%-4.6%; 1080 HCP) overall. In multivariable analysis, community COVID-19 contact and community COVID-19 cumulative incidence were associated with seropositivity (community contact: adjusted odds ratio [aOR], 3.5; 95% CI, 2.9-4.1; community cumulative incidence: aOR, 1.8; 95% CI, 1.3-2.6). No assessed workplace factors were associated with seropositivity, including nurse job role (aOR, 1.1; 95% CI, 0.9-1.3), working in the emergency department (aOR, 1.0; 95% CI, 0.8-1.3), or workplace contact with patients with COVID-19 (aOR, 1.1; 95% CI, 0.9-1.3). Conclusions and Relevance: In this cross-sectional study of US HCP in 3 states, community exposures were associated with seropositivity to SARS-CoV-2, but workplace factors, including workplace role, environment, or contact with patients with known COVID-19, were not. These findings provide reassurance that current infection prevention practices in diverse health care settings are effective in preventing transmission of SARS-CoV-2 from patients to HCP.


Asunto(s)
/epidemiología , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Exposición Profesional/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Georgia/epidemiología , Humanos , Illinois/epidemiología , Masculino , Maryland/epidemiología , Persona de Mediana Edad , Características de la Residencia , Factores de Riesgo , Estudios Seroepidemiológicos , Estados Unidos/epidemiología
14.
South Med J ; 114(2): 57-62, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33537783

RESUMEN

OBJECTIVES: We hypothesized that the proportion of Black individuals in a county would be associated with higher rates of coronavirus disease 2019 (COVID-19) cases and deaths, even after accounting for other high-risk socioecologic factors such as poverty, population density, and household crowding, and uninsured rates. We also expected that counties designated as primary care health professional shortage areas (PCHPSAs) would be associated with higher COVID-19 death rates, and the lack of primary care access would exacerbate racial disparities in death rates. We undertook this study to test these hypotheses and discern the independent effects of racial composition, socioecologic characteristics, and healthcare system factors on COVID-19 cases and deaths in Georgia counties. METHODS: We used county-level COVID-19 cases and deaths on April 23, 2020 from the Johns Hopkins Coronavirus Resource Center and estimates of 2019 county-level populations from the US Census Bureau to calculate the cumulative event rates for the state of Georgia. We used multiple regression models to examine crude and adjusted associations of socioecologic and health system variables with county-level COVID-19 case and mortality rates. RESULTS: After adjustment, a 1% increase in the proportion of Black people in the county resulted in a 2.3% increase in the county COVID-19 confirmed case rate and a 3.0% increase in the death rate (relative risk 1.03, 95% confidence interval 1.01-1.05, P < 0.001). Primary care shortage areas had a 74% higher death rate (relative risk 1.74, 95% confidence interval 1.00-3.00, P = 0.049). CONCLUSIONS: These results highlight the impact of racial disparities on the spatial patterns of COVID-19 disease burden in Georgia, which can guide interventions to mitigate racial disparities. The results also support the need for robust primary care infrastructure throughout the state.


Asunto(s)
Afroamericanos/estadística & datos numéricos , /mortalidad , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Atención Primaria de Salud/organización & administración , Adulto , Anciano , Femenino , Georgia/epidemiología , Disparidades en el Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos
15.
Mar Pollut Bull ; 165: 112108, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33581567

RESUMEN

In this study, metal compositions in anchovy (Engraulis encrasicolus) sampled from 11 different sites representing Turkey, Georgia, and Abkhazia coasts of the Black Sea were investigated. For this purpose, micro (Al, Zn, Mn, Co, Cr, Cu, Fe, Ni, Cd, Pb, Se, As, and Hg) and macro (K, Ca, Na, Mg, P) element content in edible muscle tissue of anchovy were determined. In addition, the potential risks associated with human consumption of the samples were evaluated using quality indices such as estimated weekly intake (EWI), target hazard quotient (THQ), and total exposure hazard index (HI). The results showed that the potassium (K) concentration was the highest in edible tissue of the anchovies from all stations. Anchovies were also found to be rich in phosphorus and calcium. When the metal content of anchovies was compared, there were statistically variations among metal concentrations (except for Co, Ni, Cu, Cr, Cd, Pb, and Hg) in the muscle tissue of anchovies according to the stations (P<0.05). The concentrations of Pb, Cd, Zn, Cu, Ni, and Cr in anchovy were found below the maximum permissible values determined by various national and international organizations for seafood. Besides, when the samples were examined in terms of EWI, THQ, and HI quality indices, it was determined that anchovy consumption did not pose a potential hazard to human health for the consumption of the anchovy. The present study conclusively indicated that no health problem can be raised from human consumption of the examined commercial anchovy along the Turkey, Georgia, and Abkhazia coasts of the Black Sea.


Asunto(s)
Metales Pesados , Animales , Mar Negro , Monitoreo del Ambiente , Georgia , Humanos , Metales Pesados/análisis , Medición de Riesgo , Alimentos Marinos/análisis , Turquia
16.
MMWR Morb Mortal Wkly Rep ; 70(6): 197-201, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33571179

RESUMEN

An estimated 1.4 million adults in the United States live with congenital heart defects (CHDs), yet their health outcomes are not well understood (1). Using self-reported, cross-sectional data from 1,482 respondents in the 2016-2019 Congenital Heart Survey To Recognize Outcomes, Needs, and well-beinG (CH STRONG) (2), CDC and academic partners estimated the prevalence of comorbidities among adults with CHDs aged 20-38 years born in Arizona (AZ), Arkansas (AR), and metropolitan Atlanta, Georgia (GA) compared with the general population (aged 20-38 years) from the National Health and Nutrition Examination Survey (NHANES) during 2015-2018 (3) and the AZ, AR, and GA Behavioral Risk Factor Surveillance Systems (BRFSS) during 2016-2018 (4). Adults with CHDs were more likely than those in the general population to report cardiovascular comorbidities, such as a history of congestive heart failure (4.3% versus 0.2%) and stroke (1.4% versus 0.3%), particularly those with severe CHDs (2). Adults with CHDs were more likely to report current depressive symptoms (15.1% versus 8.5%), but less likely to report previous diagnoses of depression (14.2% versus 22.6%), asthma (12.7% versus 16.9%), or rheumatologic disease (3.2% versus 8.0%). Prevalence of noncardiovascular comorbidities was similar between adults whose CHD was considered severe and those with nonsevere CHDs. Public health practitioners and clinicians can encourage young adults with CHDs to seek appropriate medical care to help them live as healthy a life as possible.


Asunto(s)
Cardiopatías Congénitas/epidemiología , Adulto , Arizona/epidemiología , Arkansas/epidemiología , Ciudades/epidemiología , Comorbilidad , Femenino , Georgia/epidemiología , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Calidad de Vida , Encuestas y Cuestionarios , Adulto Joven
17.
Artículo en Inglés | MEDLINE | ID: mdl-33573225

RESUMEN

Culturally and linguistically different immigrants in the U.S. are considered populations with low health literacy in general, thereby having a high risk of negative health outcomes such as frailty. The purpose of this study is to identify the effects of social support and acculturation on the relationship between health literacy and frailty of Korean immigrants in existing models of health literacy. A total of 244 Korean immigrants aged 50 years and older residing in Southern United States (Alabama and Georgia) were recruited. Path analysis was used to examine the pathways among variables, and the indirect effects of health literacy were analyzed. The results revealed that health literacy and social support directly influenced frailty; social support and acculturation were identified to influence health literacy. Health literacy had a partial mediating effect in the relationship between social support and frailty and a complete mediating effect in the relationship between acculturation and frailty. Therefore, to prevent frailty, it is necessary to consider enhancing immigrants' health literacy by elevating acculturation and social supports.


Asunto(s)
Emigrantes e Inmigrantes , Fragilidad , Alfabetización en Salud , Aculturación , Anciano , Alabama , Georgia , Humanos , Persona de Mediana Edad , República de Corea , Apoyo Social , Estados Unidos
18.
MMWR Morb Mortal Wkly Rep ; 70(8): 289-292, 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33630823

RESUMEN

In-person learning benefits children and communities (1). Understanding the context in which transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), occurs in schools is critical to improving the safety of in-person learning. During December 1, 2020-January 22, 2021, Cobb and Douglas Public Health (CDPH), the Georgia Department of Public Health (GDPH), and CDC investigated SARS-CoV-2 transmission in eight public elementary schools in a single school district. COVID-19 cases* among educators and students were either self-reported or identified by local public health officials. Close contacts (contacts)† of persons with a COVID-19 case received testing. Among contacts who received positive test results, public health investigators assessed epidemiologic links, probable transmission directionality, and the likelihood of in-school transmission.§ Nine clusters of three or more epidemiologically linked COVID-19 cases were identified involving 13 educators and 32 students at six of the eight elementary schools. Two clusters involved probable educator-to-educator transmission that was followed by educator-to-student transmission and resulted in approximately one half (15 of 31) of school-associated cases. Sixty-nine household members of persons with school-associated cases were tested, and 18 (26%) received positive results. All nine transmission clusters involved less than ideal physical distancing, and five involved inadequate mask use by students. Educators were central to in-school transmission networks. Multifaceted mitigation measures in schools, including promotion of COVID-19 precautions outside of school, minimizing in-person adult interactions at school, and ensuring universal and correct mask use and physical distancing among educators and students when in-person interaction is unavoidable, are important in preventing in-school transmission of SARS-CoV-2. Although not required for reopening schools, COVID-19 vaccination should be considered as an additional mitigation measure to be added when available.


Asunto(s)
/epidemiología , Maestros/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , /prevención & control , Análisis por Conglomerados , Georgia/epidemiología , Humanos , Instituciones Académicas
19.
Emerg Radiol ; 28(2): 339-347, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33420529

RESUMEN

PURPOSE: To investigate the effect of the COVID-19 pandemic on emergency department (ED) imaging. METHODS: This retrospective study included all ED visits at a four-hospital academic health system in two matched 5-week periods. Demographic information, COVID-19 status, and disposition were reviewed. Type of imaging, acquisition time, and radiology reports were analyzed. Significance level was set at p < 0.05. RESULTS: A 43.2% decrease in ED visits and 12% reduction in overall ED imaging occurred during the pandemic period. Mean age was unchanged, but a shift in gender and racial characteristics was observed (p < 0.001). In the pandemic period, COVID-19 ED patients were older (61.8 ± 16.9 years, p < 0.001) and more likely to be Black (64.2%; p < 0.001) than non-COVID-19 patients. Imaging per ED encounter increased to 2.4 ± 2.8 exams from 1.7 ± 1.1 (p < 0.001). Radiography increased (57.2% vs. 52.4%) as a fraction of total ED imaging, while computed tomography (23.4% vs. 27.2%) and ultrasound (8.5% vs. 9.6%) decreased (pre-pandemic vs. pandemic). COVID-19 ED patients underwent CT and US at a lower rate (11.5% and 5.4%) than non-COVID-19 patients (25.4% and 9.1%). The proportion of imaging study reports concluding "no disease" or "no acute disease" decreased from 56.7 to 40.6% (p < 0.001). CONCLUSION: The COVID-19 pandemic led to a significant reduction in ED visits, a shift in patient demographics, and a significant decrease in imaging volume. Additional impact included a significant increase in the proportion of positive imaging studies.


Asunto(s)
/epidemiología , Diagnóstico por Imagen/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Georgia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Retrospectivos
20.
J Infect Dis ; 223(6): 1019-1028, 2021 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-33507308

RESUMEN

BACKGROUND: The global COVID-19 pandemic has the potential to indirectly impact transmission dynamics and prevention of HIV and other sexually transmitted infections (STI). It is unknown what combined impact reductions in sexual activity and interruptions in HIV/STI services will have on HIV/STI epidemic trajectories. METHODS: We adapted a model of HIV, gonorrhea, and chlamydia for a population of approximately 103 000 men who have sex with men (MSM) in the Atlanta area. Model scenarios varied the timing, overlap, and relative extent of COVID-19-related sexual distancing and service interruption within 4 service categories (HIV screening, preexposure prophylaxis, antiretroviral therapy, and STI treatment). RESULTS: A 50% relative decrease in sexual partnerships and interruption of all clinical services, both lasting 18 months, would generally offset each other for HIV (total 5-year population impact for Atlanta MSM, -227 cases), but have net protective effect for STIs (-23 800 cases). If distancing lasted only 3 months but service interruption lasted 18 months, the total 5-year population impact would be an additional 890 HIV cases and 57 500 STI cases. CONCLUSIONS: Immediate action to limit the impact of service interruptions is needed to address the indirect effects of the global COVID-19 pandemic on the HIV/STI epidemic.


Asunto(s)
/epidemiología , Infecciones por VIH/epidemiología , Conducta Sexual/estadística & datos numéricos , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Georgia/epidemiología , Homosexualidad Masculina , Humanos , Incidencia , Masculino , Modelos Estadísticos , Pandemias , Parejas Sexuales , Minorías Sexuales y de Género
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