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1.
BMC Infect Dis ; 20(1): 815, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33167892

RESUMO

BACKGROUND: The availability of effective, oral direct acting antivirals (DAAs) for hepatitis C virus (HCV) treatment has put elimination of HCV as a public health challenge within reach. However, little is known about the characteristics of transmission networks of people who inject drugs (PWID). METHODS: Sequencing of a segment of the HCV genome was performed on samples collected from a community-based cohort of PWID between August 2005 and December 2016. Phylogenetic trees were inferred, and clusters were identified (70% bootstrap threshold; 0.04 maximum genetic distance threshold). We describe sex, race, age difference, and HIV infection status of potential transmission partners. Logistic regression was used to assess factors associated with being in an HCV cluster. RESULTS: Of 508 HCV genotype 1 viremic PWID, 8% (n = 41) were grouped into 20 clusters, consisting of 19 pairs and 1 triad. In adjusted analyses, female sex (odds ratio [OR] 2.3 [95% confidence interval (CI) 1.2-4.5]) and HIV infection (OR 5.7 [CI 2.7-11.9]) remained independently associated with being in an HCV infection cluster. CONCLUSIONS: Molecular epidemiological analysis reveals that, in this cohort of PWID in Baltimore, HIV infection and female sex were associated with HCV clustering. Combination HCV prevention interventions targeting HIV infected PWID and addressing HCV infection prevention needs of women have potential to advance HCV elimination efforts.


Assuntos
Infecções por HIV/epidemiologia , HIV/genética , Hepacivirus/genética , Hepatite C/epidemiologia , Filogenia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , Baltimore/epidemiologia , Análise por Conglomerados , Feminino , Seguimentos , Genótipo , Infecções por HIV/transmissão , Infecções por HIV/virologia , Hepatite C/transmissão , Hepatite C/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores Sexuais , Parceiros Sexuais , Viremia/epidemiologia
2.
BMC Public Health ; 20(1): 1526, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33081743

RESUMO

BACKGROUND: Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking "friendship," so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. METHODS: Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n = 331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. RESULTS: Eliciting respondents' in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio = 2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR = 1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR = 1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR = 0.98, 95% CI (0.62, 1.53)). CONCLUSIONS: Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.


Assuntos
Busca de Comunicante/métodos , Amigos , Gonorreia/epidemiologia , Rede Social , Sífilis/epidemiologia , Adolescente , Adulto , Baltimore/epidemiologia , Revelação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Adulto Jovem
3.
AIDS Educ Prev ; 32(3): 229-242, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32749875

RESUMO

Latinxs in the United States are disproportionately affected by HIV and present with more advanced disease than their non-Latinx peers, due to numerous barriers to care including HIV stigma. We describe the adaptation, implementation, and reach of Sólo Se Vive Una Vez (You Only Live Once), Baltimore's first social marketing campaign promoting HIV screening among Spanish-speaking Latinxs. The 6-month campaign promoted free HIV testing by addressing HIV stigma. The campaign included a website, a social marketing campaign, community outreach events, and advertisements via radio, billboards, local partners, and buses. During the campaign, there were 9,784 unique website users, and ads were served to over 84,592 people on social media platforms. Among Latinx HIV testers at the Baltimore City Health Department, 31.6% reported having seen or heard of Sólo Se Vive Una Vez and 25.3% of Latinx HIV testers reported that the campaign influenced them to get tested.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Relações Comunidade-Instituição , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Promoção da Saúde/métodos , Hispano-Americanos/educação , Marketing Social , Estigma Social , Migrantes/educação , Baltimore , Infecções por HIV/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Hispano-Americanos/psicologia , Humanos , Masculino , Programas de Rastreamento/métodos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Mídias Sociais , Migrantes/psicologia , Estados Unidos
4.
PLoS One ; 15(8): e0238234, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32841266

RESUMO

INTRODUCTION: We performed a cross-sectional study of HIV-uninfected men and women who inject drugs from the ALIVE cohort to examine if black men and women who inject drugs have higher levels of CD4+ T cells expressing the integrin heterodimer α4ß7 compared to white men and women. MATERIALS AND METHODS: Flow cytometry was used to examine expression of α4ß7 and other markers associated with different functional CD4+ T cell subsets in both men and women who inject drugs. RESULTS: Higher levels of α4ß7, CCR5, and CCR6 were observed on CD4+ T cells from black participants compared with white participants. In a multivariable model, α4ß7 expression differed by race, but not sex, age, or other factors. DISCUSSION: Black men and women express higher percentages of α4ß7 expressing CD4+ T cells, which may play a role in HIV disease.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Soronegatividade para HIV/imunologia , Integrinas/sangue , Abuso de Substâncias por Via Intravenosa/imunologia , Adulto , Afro-Americanos , Baltimore , Estudos de Coortes , Estudos Transversais , Grupo com Ancestrais do Continente Europeu , Feminino , Citometria de Fluxo , Humanos , Masculino , Pessoa de Meia-Idade , Abuso de Substâncias por Via Intravenosa/sangue
6.
Environ Pollut ; 266(Pt 2): 115294, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32798905

RESUMO

Trees and other vegetation have been advocated as a mitigation measure for urban air pollution mainly due to the fact that they passively filter particles from the air. However, mounting evidence suggests that vegetation may also worsen air quality by slowing the dispersion of pollutants and by producing volatile organic compounds that contribute to formation of ozone and other secondary pollutants. We monitored nanoparticle (>10 nm) counts along distance gradients away from major roads along paired transects across open and forested landscapes in Baltimore (USA), Helsinki (Finland) and Shenyang (China) - i.e. sites in three biomes with different pollution levels - using condensation particle counters. Mean particle number concentrations averaged across all sampling sites were clearly reduced (15%) by the presence of forest cover only in Helsinki. For Baltimore and Shenyang, levels showed no significant difference between the open and forested transects at any of the sampling distances. This suggests that nanoparticle deposition on trees is often counterbalanced by other factors, including differing flow fields and aerosol processes under varying meteorological conditions. Similarly, consistent differences in high frequency data patterns between the transects were detected only in Helsinki. No correlations between nanoparticle concentrations and solar radiation or local wind speed as affecting nanoparticle abundances were found, but they were to some extent associated with canopy closure. These data add to the accumulating evidence according to which trees do not necessarily improve air quality in near-road environments.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/análise , Baltimore , China , Monitoramento Ambiental , Finlândia , Florestas , Material Particulado/análise , Árvores
7.
Stroke ; 51(9): e238-e241, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32781942

RESUMO

BACKGROUND AND PURPOSE: Approximately 8% of Blacks have sickle cell trait (SCT), and there are conflicting reports from recent cohort studies on the association of SCT with ischemic stroke (IS). Most prior studies focused on older populations, with few data available in young adults. METHODS: A population-based case-control study of early-onset IS was conducted in the Baltimore-Washington region between 1992 and 2007. From this study, 342 Black IS cases, ages 15 to 49, and 333 controls without IS were used to examine the association between SCT and IS. Each participant's SCT status was established by genotyping and imputation. For analysis, χ2 tests and logistic regression models were performed with adjustment for potential confounding variables. RESULTS: Participants with SCT (n=55) did not differ from those without SCT (n=620) in prevalence of hypertension, previous myocardial infarction, diabetes mellitus, and current smoking status. Stroke cases had increased prevalence in these risk factors compared with controls. We did not find an association between SCT and early-onset IS in our overall population (odds ratio=0.9 [95% CI, 0.5-1.7]) or stratified by sex in males (odds ratio=1.26 [95% CI, 0.56-2.80]) and females (odds ratio=0.67 [95% CI, 0.28-1.69]). CONCLUSIONS: Our data did not find evidence of increased risk of early-onset stroke with SCT.


Assuntos
Isquemia Encefálica/epidemiologia , Isquemia Encefálica/genética , Traço Falciforme/epidemiologia , Traço Falciforme/genética , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/genética , Adolescente , Adulto , Afro-Americanos , Idade de Início , Baltimore/epidemiologia , Estudos de Casos e Controles , Complicações do Diabetes/epidemiologia , District of Columbia/epidemiologia , Feminino , Genótipo , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Resultados Negativos , Prevalência , Medição de Risco , Fumar/efeitos adversos , Adulto Jovem
12.
Int J Syst Evol Microbiol ; 70(6): 3639-3646, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32501783

RESUMO

A Gram-stain-negative, microaerophilic, non-motile, rod-shaped bacterium strain designated PMP191FT, was isolated from a human peritoneal tumour. Phylogenetic analysis based on 16S rRNA gene sequences indicated that the organism formed a lineage within the family Chitinophagaceae that was distinct from members of the genus Pseudoflavitalea (95.1-95.2 % sequence similarity) and Pseudobacter ginsenosidimutans (94.4 % sequence similarity). The average nucleotide identity values between strain PMP191FT and Pseudoflavitalea rhizosphaerae T16R-265T and Pseudobacter ginsenosidimutans Gsoil 221T was 68.9 and 62.3% respectively. The only respiratory quinone of strain PMP191FT was MK-7 and the major fatty acids were iso-C15 : 0, iso-C15 : 1 G and summed feature 3 (C16:1 ω7c and/or C16:1 ω6c). The polar lipids consisted of phosphatidylethanolamine and some unidentified amino and glycolipids. The G+C content of strain PMP191FT calculated from the genome sequence was 43.4 mol%. Based on phylogenetic, phenotypic and chemotaxonomic evidence, strain PMP191FT represents a novel species and genus for which the name Parapseudoflavitalea muciniphila gen. nov., sp. nov. is proposed. The type strain is PMP191FT (=DSM 104999T=ATCC BAA-2857T = CCUG 72691T). The phylogenetic analyses also revealed that Pseudobacter ginsenosidimutans shared over 98 % sequence similarly to members of the genus Pseudoflavitalea. However, the average nucleotide identity value between Pseudoflavitalea rhizosphaerae T16R-265T, the type species of the genus and Pseudobacter ginsenosidimutans Gsoil 221T was 86.8 %. Therefore, we also propose that Pseudobacter ginsenosidimutans be reclassified as Pseudoflavitalea ginsenosidimutans comb. nov.


Assuntos
Bacteroidetes/classificação , Neoplasias Peritoneais/microbiologia , Filogenia , Técnicas de Tipagem Bacteriana , Bacteroidetes/isolamento & purificação , Baltimore , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Glicolipídeos/química , Humanos , Fosfatidiletanolaminas/química , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Vitamina K 2/análogos & derivados , Vitamina K 2/química
13.
J Adolesc Health ; 67(2): 290-295, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32527573

RESUMO

Adolescents and young adults, aged 13-24 years, are disproportionately affected by HIV in the United States. Youth with HIV (YHIV) face many psychosocial and structural challenges resulting in poor clinical outcomes including lower rates of medication adherence and higher rates of uncontrolled HIV. The Johns Hopkins Intensive Primary Care clinic, a longstanding HIV care program in Baltimore, Maryland, cares for 76 YHIV (aged 13-24 years). The multidisciplinary team provides accessible, evidenced-based, culturally sensitive, coordinated and comprehensive patient and family-centered HIV primary care. However, the ability to provide these intensive, in-person services was abruptly disrupted by the necessary institutional, state, and national coronavirus disease 2019 (COVID-19) mitigation strategies. As most of our YHIV are from marginalized communities (racial/ethnic, sexual, and gender minorities) with existing health and social inequities that impede successful clinical outcomes and increase HIV disparities, there was heightened concern that COVID-19 would exacerbate these inequities and amplify the known HIV disparities. We chronicle the structural and logistic approaches that our team has taken to proactively address the social determinants of health that will be negatively impacted by the COVID-19 pandemic, while supporting YHIV to maintain medication adherence and viral suppression.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Disparidades nos Níveis de Saúde , Pandemias , Pneumonia Viral/epidemiologia , Adolescente , Baltimore/epidemiologia , Feminino , Infecções por HIV/etnologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Adesão à Medicação , Determinantes Sociais da Saúde , Carga Viral , Adulto Jovem
14.
J Zoo Wildl Med ; 51(2): 259-264, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32549553

RESUMO

Failure of passive transfer of immunity (FPT) leads to increased calf morbidity and mortality and requires intensive, time-sensitive, and often expensive management for nondomestic ruminants. Without species-specific information with which to make informed decisions, neonatal data from domestic ruminants are often extrapolated to nondomestic zoo-housed species. To date, there have been no studies evaluating FPT in sitatunga (Tragelaphus spekii). The goal of the present study was to establish parameters to characterize adequate passive transfer in sitatunga calves and compare them to published reference intervals in other species. Medical records of 22 sitatunga calves (12 female, 10 male) were reviewed. Seventeen of these calves were defined as "healthy," having survived at least 60 days without colostrum administration or a plasma transfusion. Calf weight, serum glucose, serum gamma-glutamyl transferase (GGT), total protein (TP), globulin concentrations, and results of a zinc sulfate turbidity test (ZSTT) were noted where possible. Mean birth weight of healthy calves at 24 hr was 4.5 kg (range: 3.76.5 kg, n = 12). The mean blood glucose in healthy calves was 152 mg/dl (range: 80-182, n = 16), mean serum TP concentration was 5.9 g/dl (range: 4.9-7.5, n = 16), mean serum globulin concentration was 3.3 g/dl (range: 1.7-4.7, n = 17), and mean serum GGT concentration was 466 U/L (range: 91-1901, n = 16). A ZSTT was performed for 10 healthy calves, resulting in four negative ZSTT results despite having no clinical signs of FPT and the calves having been observed nursing before testing. Sitatunga appear to have lower values for normal FPT parameters than those developed for domestic cattle. This study illustrates the difficulty of cross-species comparisons, as even closely related species can vary greatly in biologic parameters.


Assuntos
Animais de Zoológico/imunologia , Antílopes/imunologia , Imunização Passiva/veterinária , Animais , Baltimore , Feminino , Masculino
15.
J Zoo Wildl Med ; 51(2): 371-378, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32549567

RESUMO

The anatomy of the avian gastrointestinal (GI) tract is uniquely suited to each species' dietary requirements. African penguins (Spheniscus demersus) are charismatic and popular exhibit animals. As their prevalence grows, there is a need to understand their unique digestive tract to diagnose abnormalities. Reference material specific to the digestive tract of piscivores is scant, and knowledge of the GI tract of a healthy penguin is based on information from other birds. The purpose of this study is to determine the normal gross anatomy, transit time, and histopathologic structures of the penguin GI tract. Twelve clinically healthy penguins were selected for this study from the colony at the Maryland Zoo in Baltimore, which, at the time of this study, consisted of 55 birds. All penguins underwent a barium contrast study, and radiographic images were obtained until the entire GI tract was empty. Approximately 2 wk later, each penguin was anesthetized, and an endoscopic evaluation of the anterior GI tract was performed. Time from barium administration to defecation ranged from 17 to 70 min, and on average, barium clearance was 17.6 hr (range, 5-36 hr). Fluid from the ventriculus had an average pH of 2.75 and contained a mixed bacterial population. Koilin presence and thickness appreciated on endoscopy did not correspond with the thickness determined on histopathology. The results of this study provide a comparative baseline to use during diagnostic workups and help guide treatment decisions.


Assuntos
Endoscopia do Sistema Digestório/veterinária , Trato Gastrointestinal/anatomia & histologia , Radiografia Abdominal/veterinária , Spheniscidae/anatomia & histologia , Animais , Animais de Zoológico/anatomia & histologia , Baltimore , Digestão , Feminino , Trato Gastrointestinal/diagnóstico por imagem , Masculino
16.
PLoS One ; 15(6): e0234601, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32589693

RESUMO

Body weight is substantially determined by eating behaviors, which are themselves driven by biological factors interacting with the environment. Previous studies in young children suggest that genetic influences on dopamine function may confer differential susceptibility to the environment in such a way that increases behavioral obesity risk in a lower socioeconomic status (SES) environment but decreases it in a higher SES environment. We aimed to test if this pattern of effect could also be observed in adolescence, another critical period for development in brain and behavior, using a novel measure of predicted expression of the dopamine receptor 4 (DRD4) gene in prefrontal cortex. In a sample of 76 adolescents (37 boys and 39 girls from Baltimore, Maryland/US, aged 14-18y), we estimated individual levels of DRD4 gene expression (PredDRD4) in prefrontal cortex from individual genomic data using PrediXcan, and tested interactions with a composite SES score derived from their annual household income, maternal education, food insecurity, perceived resource availability, and receipt of public assistance. Primary outcomes were snack intake during a multi-item ad libitum meal test, and food-related impulsivity assessed using a food-adapted go/no-go task. A linear regression model adjusted for sex, BMI z-score, and genetic ethnicity demonstrated a PredDRD4 by composite SES score interaction for snack intake (p = 0.009), such that adolescents who had lower PredDRD4 levels exhibited greater snack intake in the lower SES group, but lesser snack intake in the higher SES group. Exploratory analysis revealed a similar pattern for scores on the Perceived Stress Scale (p = 0.001) such that the low PredDRD4 group reported higher stress in the lower SES group, but less stress in the higher SES group, suggesting that PredDRD4 may act in part by affecting perceptions of the environment. These results are consistent with a differential susceptibility model in which genes influencing environmental responsiveness interact with environments varying in obesogenicity to confer behavioral obesity risk in a less favorable environment, but behavioral obesity protection in a favorable one.


Assuntos
Comportamento Alimentar , Receptores de Dopamina D4/metabolismo , Lanches , Adolescente , Baltimore , Feminino , Humanos , Masculino , Obesidade , Córtex Pré-Frontal/metabolismo , Receptores Dopaminérgicos , Receptores de Dopamina D4/fisiologia , Fatores de Risco , Classe Social
17.
AIDS Educ Prev ; 32(2): 152-168, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32539478

RESUMO

LGBTQ populations, particularly Black men who have sex with men and transgender women, experience significant HIV disparities; public health messages may inadvertently stigmatize LGBTQ populations. We sought to use qualitative methods to inform a PrEP campaign. Unstructured focus groups were conducted among predominantly Black LGBTQ persons recruited through social media and events. Discussions were audio-recorded, transcribed, and analyzed in NVivo using categorical analysis. Eighty individuals participated in 13 focus groups; 80% (64) identified as sexual or gender minorities. Eighty-eight percent (70) identified as Black/African American. Four themes emerged: (1) culturally competent, community-informed, locally relevant messaging, (2) avoiding stigmatizing language or images, (3) inaccessibility of clinical language, and (4) using identity labels representing local communities and their diversity. Findings suggest PrEP campaigns need to be developed through community-informed processes to engage and avoid stigmatizing priority populations. Ongoing partnerships between public health and LGBTQ communities can facilitate development of campaigns with engaging, acceptable language.


Assuntos
Afro-Americanos/psicologia , Grupo com Ancestrais do Continente Africano/etnologia , Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/etnologia , Idioma , Profilaxia Pré-Exposição/métodos , Minorias Sexuais e de Gênero/psicologia , Adulto , Grupo com Ancestrais do Continente Africano/psicologia , Fármacos Anti-HIV/uso terapêutico , Baltimore/epidemiologia , Participação da Comunidade , Feminino , Grupos Focais , Infecções por HIV/tratamento farmacológico , Infecções por HIV/etnologia , Homossexualidade Masculina/psicologia , Humanos , Masculino , Pesquisa Qualitativa , Comportamento Sexual , Minorias Sexuais e de Gênero/estatística & dados numéricos , Envio de Mensagens de Texto
20.
MMWR Morb Mortal Wkly Rep ; 69(19): 569-574, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32407307

RESUMO

Identifying persons with hepatitis C virus (HCV) infection has become an urgent public health challenge because of increasing HCV-related morbidity and mortality, low rates of awareness among infected persons, and the advent of curative therapies (1). Since 2012, CDC has recommended testing of all persons born during 1945-1965 (baby boomers) for identification of chronic HCV infection (1); urban emergency departments (EDs) are well positioned venues for detecting HCV infection among these persons. The United States has witnessed an unprecedented opioid overdose epidemic since 2013 that derives primarily from commonly injected illicit opioids (e.g., heroin and fentanyl) (2). This injection drug use behavior has led to an increase in HCV infections among persons who inject drugs and heightened concern about increases in human immunodeficiency virus (HIV) and HCV infection within communities disproportionately affected by the opioid crisis (3,4). However, targeted strategies for identifying HCV infection among persons who inject drugs is challenging (5,6). During 2015-2016, EDs at the University of Alabama at Birmingham; Highland Hospital, Oakland, California; Johns Hopkins Hospital, Baltimore, Maryland; and Boston University Medical Center, Massachusetts, adopted opt-out (i.e., patients can implicitly accept or explicitly decline testing), universal hepatitis C screening for all adult patients. ED staff members offered HCV antibody (anti-HCV) screening to patients who were unaware of their status.* During similar observation periods at each site, ED staff members tested 14,252 patients and identified an overall 9.2% prevalence of positive results for anti-HCV among the adult patient population. Among the 1945-1965 birth cohort, prevalence of positive results for anti-HCV (13.9%) was significantly higher among non-Hispanic blacks (blacks) (16.0%) than among non-Hispanic whites (whites) (12.2%) (p<0.001). Among persons born after 1965, overall prevalence of positive results for anti-HCV was 6.7% and was significantly higher among whites (15.3%) than among blacks (3.2%) (p<0.001). These findings highlight age-associated differences in racial/ethnic prevalences and the potential for ED venues and opt-out, universal testing strategies to improve HCV infection awareness and surveillance for hard-to-reach populations. This opt-out, universal testing approach is supported by new recommendations for hepatitis C screening at least once in a lifetime for all adults aged ≥18 years, except in settings where the prevalence of positive results for HCV infection is <0.1% (7).


Assuntos
Serviço Hospitalar de Emergência , Hepatite C/epidemiologia , Hospitais Urbanos , Adulto , Idoso , Alabama/epidemiologia , Baltimore/epidemiologia , Boston/epidemiologia , California/epidemiologia , Feminino , Hepatite C/diagnóstico , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Prevalência
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