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1.
Cancer Control ; 31: 10732748241246958, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38623948

RESUMO

OBJECTIVE: Identify predictors of overall survival (OS) after hypopharyngeal/laryngeal cancer in Florida. MATERIAL AND METHODS: We conducted a retrospective cohort study using data from the Florida Cancer Data System (FCDS) on patients diagnosed with hypopharyngeal or laryngeal cancer from 2010-2017. Primary outcome was OS. Hazard ratios (HRs) were estimated from univariable and multivariable Cox regression models for OS. Data was analyzed from November 1, 2022, to June 30, 2023. RESULTS: We analyzed 6771 patients, who were primarily male (81.2%), White non-Hispanic (WNH) (78.2%), publicly insured (70.1%), married (51.8%), and residents of urban counties (73.6%). Black patients were more likely to be younger at diagnosis (38.9%), single (43.4%), to have distant SEER stage disease (25.6%). Median OS were lowest among patients who were uninsured (34 months), with hypopharyngeal site disease (18 months), and a smoking history (current: 34 months, former: 46 months, no smoking: 63 months). Multivariable Cox regression analysis showed worse OS for single/unmarried vs married (HR 1.47 [95%CI: 1.36-1.59], P < .001), history of tobacco use (current: HR 1.62 [95%CI: 1.440-1.817], P < .001; former smokers: (HR 1.28 [95%CI: 1.139-1.437], P < .001) vs no history). Improved OS was observed among White Hispanics (WH) vs WNH (HR .73 [95%CI: .655-.817], P < .001) and women vs men (HR .88 [95%CI: .807-.954], P = .002). Geographical mapping showed that mortality rates were highest in census tracts with low income and education. CONCLUSION: Our findings suggest that sociodemographic and clinical factors impact OS from hypopharyngeal/laryngeal cancer in Florida and vary geographically within the state. These results will help guide future public health interventions.


Assuntos
Neoplasias Laríngeas , Humanos , Masculino , Feminino , Florida/epidemiologia , Estudos Retrospectivos , Etnicidade , Modelos de Riscos Proporcionais
2.
J Safety Res ; 88: 366-373, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38485379

RESUMO

INTRODUCTION: Understanding the transportation needs of immigrants is crucial for the design and promotion of safe, equitable, and sustainable living environments. This study examines the transportation patterns from a sample of Recent Latinx Immigrants (RLIs) upon arrival to Miami/Dade Co (MDC), Florida. METHODS: Collected between 2018 and 2021, data came from a longitudinal study examining drinking and driving trajectories among 540 RLIs to MDC. Retrospective pre-immigration data (T0) were obtained simultaneously with the first-year post-immigration data (T1). Follow up surveys were conducted one year later, before (T2-BC) or during a pandemic lockout (T2-DC), and two years later (T3). Descriptive and repeated measures mixed-model regression were used to examine the data. RESULTS: Driving declined from T0 to T1, although remained higher than previously reported for other locations. Not having a valid driver's license was the main reason for the decline. The initial reduction in driving was paralleled by an increase in the use of transit, riding as passengers in private vehicles, and walking. A year later (T2), as RLIs' income and access to a driver's license grew, driving rates increased (even during the pandemic lockdown), while the use of other transportation modes decreased. A year after the pandemic lockdown (T3), driving as well as the use of other transportation modes receded. Reasons for this decline are unclear. CONCLUSIONS: RLIs reported elevated driving rates upon their arrival to MDC. The COVID-19 pandemic seems to have altered the RLIs' transportation patterns, provoking an overall decline in mobility that lasted even after the pandemic lockdown ceased. PRACTICAL APPLICATIONS: Transportation planners working on developing safe and equitable transportation systems in MDC should: (1) identify and address barriers to the use of transportation modes other than driving by RLIs; and (2) understand reasons for the broad decline in transportation modes after the pandemic lockdown.


Assuntos
COVID-19 , Emigrantes e Imigrantes , Humanos , Florida/epidemiologia , Pandemias , Estudos Longitudinais , Estudos Retrospectivos , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Hispânico ou Latino
3.
PLoS One ; 19(3): e0299143, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38547145

RESUMO

Epidemic data are often difficult to interpret due to inconsistent detection and reporting. As these data are critically relied upon to inform policy and epidemic projections, understanding reporting trends is similarly important. Early reporting of the COVID-19 pandemic in particular is complicated, due to changing diagnostic and testing protocols. An internal audit by the State of Florida, USA found numerous specific examples of irregularities in COVID-19 case and death reports. Using case, hospitalization, and death data from the the first year of the COVID-19 pandemic in Florida, we present approaches that can be used to identify the timing, direction, and magnitude of some reporting changes. Specifically, by establishing a baseline of detection probabilities from the first (spring) wave, we show that transmission trends among all age groups were similar, with the exception of the second summer wave, when younger people became infected earlier than seniors, by approximately 2 weeks. We also found a substantial drop in case-fatality risk (CFR) among all age groups over the three waves during the first year of the pandemic, with the most drastic changes seen in the 0 to 39 age group. The CFR trends provide useful insights into infection detection that would not be possible by relying on the number of tests alone. During the third wave, for which we have reliable hospitalization data, the CFR was remarkably stable across all age groups. In contrast, the hospitalization-to-case ratio varied inversely with cases while the death-to-hospitalization ratio varied proportionally. Although specific trends are likely to vary between locales, the approaches we present here offer a generic way to understand the substantial changes that occurred in the relationships among the key epidemic indicators.


Assuntos
COVID-19 , Humanos , Recém-Nascido , COVID-19/diagnóstico , COVID-19/epidemiologia , SARS-CoV-2 , Florida/epidemiologia , Pandemias , Hospitalização
4.
Front Public Health ; 12: 1351690, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38439756

RESUMO

The first cases of COVID-19 in Florida were diagnosed on March 1, 2020. Three years later, more than 7.3 million people have had COVID-19 in Florida, and more than 93,000 individuals have died from this illness. When considering the impact of COVID-19 on Florida, several key factors need to be considered, including that Florida was one of the most medically vulnerable states due to a substantial proportion of older individuals and those with underlying medical conditions. Florida also has a centralized Department of Health and Division of Emergency Management structure that facilitated response activities. Looking at the impact of COVID-19 on Florida, two distinct phases need to be considered: the pre-Delta variant phase from March 2020 to July 2021 and the Delta variant and beyond phase that began July 2021 and still continues. During the 16-month first phase, about 38,000 people died. Yet, 24,000 people died during the 5-months of the Delta variant wave from July to November 2021. During the Omicron waves that followed Delta, an additional 31,000 people died. Florida thus went from ranking 26th in death per capita in the United States at the end of the first phase to 10th a few months into the Delta wave and now ranks 8th. Why did these phases differ so dramatically in terms of mortality? During the first phase of the pandemic, adherence to established nonpharmacological and older adult protection measures was recommended. When COVID-19 vaccines became available in December 2020, there was an aggressive campaign to promote COVID-19 vaccination, and public acceptance was high. The second phase followed political opposition to CDC and public health expert guidelines, the rise of anti-vaccine sentiment and misinformation, and falling vaccination rates. These factors contributed to considerable population vulnerability to severe disease when the Delta variant hit. As the former State Surgeon General and Secretary of Health of Florida from June 2019 to September 2021, this report provides perspective on the shifting impact and response to COVID-19 in Florida, which is the third most populous state in the United States. This perspective shows the clear consequences of shifting from standard public health practices and vaccine promotion to attacks on public health and vaccines.


Assuntos
COVID-19 , Humanos , Idoso , Florida/epidemiologia , COVID-19/epidemiologia , Vacinas contra COVID-19 , SARS-CoV-2
5.
BMC Public Health ; 24(1): 749, 2024 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-38459461

RESUMO

BACKGROUND: Racial/ethnic disparities in the HIV care continuum have been well documented in the US, with especially striking inequalities in viral suppression rates between White and Black persons with HIV (PWH). The South is considered an epicenter of the HIV epidemic in the US, with the largest population of PWH living in Florida. It is unclear whether any disparities in viral suppression or immune reconstitution-a clinical outcome highly correlated with overall prognosis-have changed over time or are homogenous geographically. In this analysis, we 1) investigate longitudinal trends in viral suppression and immune reconstitution among PWH in Florida, 2) examine the impact of socio-ecological factors on the association between race/ethnicity and clinical outcomes, 3) explore spatial and temporal variations in disparities in clinical outcomes. METHODS: Data were obtained from the Florida Department of Health for 42,369 PWH enrolled in the Ryan White program during 2008-2020. We linked the data to county-level socio-ecological variables available from County Health Rankings. GEE models were fit to assess the effect of race/ethnicity on immune reconstitution and viral suppression longitudinally. Poisson Bayesian hierarchical models were fit to analyze geographic variations in racial/ethnic disparities while adjusting for socio-ecological factors. RESULTS: Proportions of PWH who experienced viral suppression and immune reconstitution rose by 60% and 45%, respectively, from 2008-2020. Odds of immune reconstitution and viral suppression were significantly higher among White [odds ratio =2.34, 95% credible interval=2.14-2.56; 1.95 (1.85-2.05)], and Hispanic [1.70 (1.54-1.87); 2.18(2.07-2.31)] PWH, compared with Black PWH. These findings remained unchanged after accounting for socio-ecological factors. Rural and urban counties in north-central Florida saw the largest racial/ethnic disparities. CONCLUSIONS: There is persistent, spatially heterogeneous, racial/ethnic disparity in HIV clinical outcomes in Florida. This disparity could not be explained by socio-ecological factors, suggesting that further research on modifiable factors that can improve HIV outcomes among Black and Hispanic PWH in Florida is needed.


Assuntos
Etnicidade , Infecções por HIV , Humanos , Teorema de Bayes , Florida/epidemiologia , Disparidades em Assistência à Saúde , Hispânico ou Latino , Infecções por HIV/epidemiologia , Brancos , Negro ou Afro-Americano
6.
Emerg Infect Dis ; 30(4)2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38526187

RESUMO

In 2022, concurrent outbreaks of hepatitis A, invasive meningococcal disease (IMD), and mpox were identified in Florida, USA, primarily among men who have sex with men. The hepatitis A outbreak (153 cases) was associated with hepatitis A virus genotype IA. The IMD outbreak (44 cases) was associated with Neisseria meningitidis serogroup C, sequence type 11, clonal complex 11. The mpox outbreak in Florida (2,845 cases) was part of a global epidemic. The hepatitis A and IMD outbreaks were concentrated in Central Florida and peaked during March--June, whereas mpox cases were more heavily concentrated in South Florida and had peak incidence in August. HIV infection was more common (52%) among mpox cases than among hepatitis A (21%) or IMD (34%) cases. Where feasible, vaccination against hepatitis A, meningococcal disease, and mpox should be encouraged among at-risk groups and offered along with program services that target those groups.


Assuntos
Infecções por HIV , Hepatite A , Infecções Meningocócicas , Varíola dos Macacos , Minorias Sexuais e de Gênero , Masculino , Humanos , Hepatite A/epidemiologia , Florida/epidemiologia , Homossexualidade Masculina , Surtos de Doenças , Infecções Meningocócicas/epidemiologia
7.
PLoS Negl Trop Dis ; 18(2): e0011919, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38354196

RESUMO

Expanding geographic distribution and increased populations of ticks has resulted in an upsurge of human-tick encounters in the United States (US), leading to an increase in tickborne disease reporting. Limited knowledge of the broadscale spatial range of tick species is heightened by a rapidly changing environment. Therefore, we partnered with the Forest Inventory and Analysis (FIA) program of the Forest Service, U.S. Department of Agriculture and used passive tick surveillance to better understand spatiotemporal variables associated with foresters encountering three tick species (Amblyomma americanum L., Dermacentor variabilis Say, and Ixodes scapularis L.) in the southeastern US. Eight years (2014-2021) of tick encounter data were used to fit environmental niche and generalized linear models to predict where and when ticks are likely to be encountered. Our results indicate temporal and environmental partitioning of the three species. Ixodes scapularis were more likely to be encountered in the autumn and winter seasons and associated with soil organic matter, vegetation indices, evapotranspiration, temperature, and gross primary productivity. By contrast, A. americanum and D. variabilis were more likely to be encountered in spring and summer seasons and associated with elevation, landcover, temperature, dead belowground biomass, vapor pressure, and precipitation. Regions in the southeast least suitable for encountering ticks included the Blue Ridge, Mississippi Alluvial Plain, and the Southern Florida Coastal Plain, whereas suitable regions included the Interior Plateau, Central Appalachians, Ozark Highlands, Boston Mountains, and the Ouachita Mountains. Spatial and temporal patterns of different tick species can inform outdoorsmen and the public on tick avoidance measures, reduce tick populations by managing suitable tick habitats, and monitoring areas with unsuitable tick habitat for potential missed encounters.


Assuntos
Ixodes , Animais , Humanos , Estados Unidos/epidemiologia , Sudeste dos Estados Unidos/epidemiologia , Florida/epidemiologia , Região dos Apalaches , Amblyomma
8.
Nursing ; 54(3): 21-28, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38386446

RESUMO

ABSTRACT: Locally acquired malaria is rare in the US; however, in 2023, cases were reported in Florida, Texas, Maryland, and Arkansas. Prompt diagnosis and treatment of malaria are essential to prevent severe malaria disease. This article details malaria and offers treatment guidelines.


Assuntos
Malária , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Texas/epidemiologia , Florida/epidemiologia
9.
Demography ; 61(1): 209-230, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38235780

RESUMO

Sea-level rise is likely to worsen the impacts of hurricanes, storm surges, and tidal flooding on coastal access to basic services. We investigate the historical impact of tidal flooding on mortality rates of the elderly population in coastal Florida using administrative records of individual deaths, demographics, and residential location combined with tidal gauge and high-resolution elevation data. We incorporate data capturing storm and precipitation events into our empirical model to distinguish between disruptions from routine sunny-day flooding and less predictable tropical storm-induced flooding. We find that a 1-standard-deviation (20-millimeter) increase in tidal flooding depth increases mortality rates by 0.46% to 0.60% among those aged 65 or older. Our estimates suggest that future sea-level rises may contribute to an additional 130 elderly deaths per year in Florida relative to 2019, all else being equal. The enhanced risk is concentrated among residents living more than nine minutes away from the nearest hospital. Results suggest that tidal flooding may augment elderly mortality risk by delaying urgent medical care.


Assuntos
Tempestades Ciclônicas , Inundações , Idoso , Humanos , Florida/epidemiologia
10.
Int J Health Geogr ; 23(1): 1, 2024 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-38184599

RESUMO

BACKGROUND: Early diagnosis, control of blood glucose levels and cardiovascular risk factors, and regular screening are essential to prevent or delay complications of diabetes. However, most adults with diabetes do not meet recommended targets, and some populations have disproportionately high rates of potentially preventable diabetes-related hospitalizations. Understanding the factors that contribute to geographic disparities can guide resource allocation and help ensure that future interventions are designed to meet the specific needs of these communities. Therefore, the objectives of this study were (1) to identify determinants of diabetes-related hospitalization rates at the ZIP code tabulation area (ZCTA) level in Florida, and (2) assess if the strengths of these relationships vary by geographic location and at different spatial scales. METHODS: Diabetes-related hospitalization (DRH) rates were computed at the ZCTA level using data from 2016 to 2019. A global ordinary least squares regression model was fit to identify socioeconomic, demographic, healthcare-related, and built environment characteristics associated with log-transformed DRH rates. A multiscale geographically weighted regression (MGWR) model was then fit to investigate and describe spatial heterogeneity of regression coefficients. RESULTS: Populations of ZCTAs with high rates of diabetes-related hospitalizations tended to have higher proportions of older adults (p < 0.0001) and non-Hispanic Black residents (p = 0.003). In addition, DRH rates were associated with higher levels of unemployment (p = 0.001), uninsurance (p < 0.0001), and lack of access to a vehicle (p = 0.002). Population density and median household income had significant (p < 0.0001) negative associations with DRH rates. Non-stationary variables exhibited spatial heterogeneity at local (percent non-Hispanic Black, educational attainment), regional (age composition, unemployment, health insurance coverage), and statewide scales (population density, income, vehicle access). CONCLUSIONS: The findings of this study underscore the importance of socioeconomic resources and rurality in shaping population health. Understanding the spatial context of the observed relationships provides valuable insights to guide needs-based, locally-focused health planning to reduce disparities in the burden of potentially avoidable hospitalizations.


Assuntos
Diabetes Mellitus , Regressão Espacial , Estados Unidos , Humanos , Idoso , Florida/epidemiologia , Estudos Retrospectivos , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Hospitalização
11.
Am J Public Health ; 114(S1): S74-S77, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38207267

RESUMO

COVID-19 elucidated the urgency for health justice advocacy for Latinx farmworkers in Florida. While deemed essential, farmworkers' value was not reflected in policy responses to ensure their protection. The deficiency of culturally and linguistically relevant guidance from government agencies and state restrictions requiring identification for COVID-19 services were impediments to farmworkers accessing care. Equitable access was increased through a statewide promotor de salud network delivering health information and mobilizing vaccine partners to serve farmworkers at high risk of COVID-19 infection. (Am J Public Health. 2024;114(S1):S74-S77. https://doi.org/10.2105/AJPH.2023.307454).


Assuntos
COVID-19 , Humanos , Florida/epidemiologia , Fazendeiros
12.
PLoS One ; 19(1): e0296485, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38166125

RESUMO

The population decline and lack of natural recovery of multiple coral species along the Florida reef tract have instigated the expanding application of coral restoration and conservation efforts. Few studies, however, have determined the optimal locations for the survival of outplanted coral colonies from restoration nurseries. This study predicts the optimal locations for Acropora palmata colonies along the Florida reef tract using a boosted-regression-tree model to examine the relationships between the occurrence of wild A. palmata and ten environmental variables. Our model results predicted A. palmata was most likely to occur in shallow reef habitats with (i) generally low mean chlorophyll-a concentrations (< 1 mg m-3), (ii) moderate fetch (3 kJ m-2), (iii) salinities between 20 and 37.5 ppt, (iv) temperatures between 20 and 32°C, (vi) low mean concentrations of total nitrogen (0.16 ppm), and (iv) irradiance between 26.5 and 53.5 mol m-2 s-1. The most suitable habitats for A. palmata were disproportionately allocated to reefs in Biscayne Bay, the Upper Keys, the western-lower Florida Keys, the Marquesas, and the Dry Tortugas. The middle Florida Keys had unfavorable environmental conditions for A. palmata habitat. Results from this study inform where A. palmata, outplanted as part of restoration and conservation efforts, would have suitable environmental conditions to persist over time. This study also provides decision-making support for management focused on the conservation and restoration of the endangered species A. palmata along the Florida reef tract.


Assuntos
Antozoários , Animais , Recifes de Corais , Florida/epidemiologia , Ecossistema , Espécies em Perigo de Extinção
14.
J Zoo Wildl Med ; 54(4): 766-775, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38252000

RESUMO

Septicemia is commonly suspected of sea turtles entering rehabilitation. However, blood culture results of green sea turtles (Chelonia mydas) are infrequently reported in the literature. Aerobic blood cultures were performed for intake examinations of 167 green sea turtles undergoing rehabilitation at Brevard Zoo's Sea Turtle Healing Center, Melbourne, Florida, USA from 2017 to 2020. The incidence of positive cultures during intake examinations was 24% (40/167). The most common bacterial isolates identified were Vibrio alginolyticus, Shewanella algae, Achromobacter xylosoxidans, Photobacterium damselae, Sphingomonas paucimobilis, and Vibrio parahaemolyticus. There was a statistically significant association (P < 0.05) between culture status and evidence of external injury. There was no significant association between culture status and Caryospora-like coccidia infection, or fibropapillomatosis. Culture-positive turtles had significantly lower (P < 0.05) total white blood cell, lymphocyte, monocyte, total protein, albumin, and calculated globulin values compared to turtles with negative blood cultures. Significantly more culture-positive turtles died in rehabilitation compared to culture-negative (P = 0.042). Positive blood cultures suggestive of septicemia are commonly found during intake examinations at a Florida sea turtle rehabilitation facility.


Assuntos
Sepse , Tartarugas , Animais , Hemocultura/veterinária , Florida/epidemiologia , Estudos Retrospectivos , Sepse/veterinária
16.
AIDS Patient Care STDS ; 38(1): 14-22, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38227279

RESUMO

Florida is one of the HIV epicenters with high incidence and marked sociodemographic disparities. We analyzed a decade of statewide electronic health record/claims data-OneFlorida+-to identify and characterize pre-exposure prophylaxis (PrEP) recipients and newly diagnosed HIV cases in Florida. Refined computable phenotype algorithms were applied and a total of 2186 PrEP recipients and 7305 new HIV diagnoses were identified between January 2013 and April 2021. We examined patients' sociodemographic characteristics, stratified by self-reported sex, along with both frequency-driven and expert-selected descriptions of clinical conditions documented within 12 months before the first PrEP use or HIV diagnosis. PrEP utilization rate increased in both sexes; higher rates were observed among males with sex differences widening in recent years. HIV incidence peaked in 2016 and then decreased with minimal sex differences observed. Clinical characteristics were similar between the PrEP and new HIV diagnosis cohorts, characterized by a low prevalence of sexually transmitted infections (STIs) and a high prevalence of mental health and substance use conditions. Study limitations include the overrepresentation of Medicaid recipients, with over 96% of female PrEP users on Medicaid, and the inclusion of those engaged in regular health care. Although PrEP uptake increased in Florida, and HIV incidence decreased, sex disparity among PrEP recipients remained. Screening efforts beyond individuals with documented prior STI and high-risk behavior, especially for females, including integration of mental health care with HIV counseling and testing, are crucial to further equalize PrEP access and improve HIV prevention programs.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Estados Unidos , Humanos , Feminino , Masculino , Florida/epidemiologia , Registros Eletrônicos de Saúde , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Demografia
17.
Malar J ; 23(1): 24, 2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38238772

RESUMO

BACKGROUND: Malaria outbreaks have sporadically occurred in the United States, with Anopheles quadrimaculatus serving as the primary vector in the eastern region. Anopheles crucians, while considered a competent vector, has not been directly implicated in human transmission. Considering the locally acquired Plasmodium vivax cases in Sarasota County, Florida (7 confirmed cases), Cameron County, Texas (one confirmed case), and Maryland (one confirmed case) in the summer of 2023. The hypothesis of this study is that major cities in the United States harbour sufficient natural populations of Anopheles species vectors of malaria, that overlap with human populations that could support local transmission to humans. The objective of this study is to profile the most abundant Anopheles vector species in Miami-Dade County, Florida-An. crucians and An. quadrimaculatus. METHODS: This study was based on high-resolution mosquito surveillance data from 2020 to 2022 in Miami-Dade County, Florida. Variations on the relative abundance of An. crucians and An. quadrimaculatus was assessed by dividing the total number of mosquitoes collected by each individual trap in 2022 by the number of mosquitoes collected by the same trap in 2020. In order to identify influential traps, the linear distance in meters between all traps in the surveillance system from 2020 to 2022 was calculated and used to create a 4 km buffer radius around each trap in the surveillance system. RESULTS: A total of 36,589 An. crucians and 9943 An. quadrimaculatus were collected during this study by the surveillance system, consisting of 322 CO2-based traps. The findings reveal a highly heterogeneous spatiotemporal distribution of An. crucians and An. quadrimaculatus in Miami-Dade County, highlighting the presence of highly conducive environments in transition zones between natural/rural and urban areas. Anopheles quadrimaculatus, and to a lesser extent An. crucians, pose a considerable risk of malaria transmission during an outbreak, given their high abundance and proximity to humans. CONCLUSIONS: Understanding the factors driving the proliferation, population dynamics, and spatial distribution of Anopheles vector species is vital for implementing effective mosquito control and reducing the risk of malaria outbreaks in the United States.


Assuntos
Anopheles , Malária , Animais , Humanos , Malária/epidemiologia , Mosquitos Vetores , Florida/epidemiologia
18.
Emerg Infect Dis ; 30(2): 376-379, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38232709

RESUMO

During May 2022-April 2023, dengue virus serotype 3 was identified among 601 travel-associated and 61 locally acquired dengue cases in Florida, USA. All 203 sequenced genomes belonged to the same genotype III lineage and revealed potential transmission chains in which most locally acquired cases occurred shortly after introduction, with little sustained transmission.


Assuntos
Vírus da Dengue , Dengue , Humanos , Vírus da Dengue/genética , Dengue/epidemiologia , Florida/epidemiologia , Viagem , Sequência de Bases , Genótipo , Sorogrupo , Filogenia
19.
AIDS Behav ; 28(3): 820-836, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37792227

RESUMO

HIV test counselors are well positioned to refer individuals to pre-exposure prophylaxis (PrEP) and behavioral health treatments. HIV test counselors in Miami-Dade County (N = 20), a priority jurisdiction for Ending the HIV Epidemic, completed interviews to assess determinants of PrEP and behavioral health treatment referrals. To identify determinants, we used a rapid deductive qualitative analysis approach and the Consolidated Framework for Implementation Research (CFIR). Identified determinants sometimes served as facilitators (e.g., relative priority, leadership importance) and sometimes as barriers (e.g., lack of access to knowledge and information, available resources for referrals) to making referrals. We also observed differences in determinants between PrEP and behavioral health referrals. For example, complexity (perceived difficulty of the referral) was a barrier to behavioral health more often than PrEP referral. Our findings suggest that determinants across many CFIR domains affect referral implementation, and the corresponding need for multiple implementation strategies to improve implementation of PrEP and behavioral health referrals in the context of HIV testing.


Assuntos
Conselheiros , Infecções por HIV , Profilaxia Pré-Exposição , Humanos , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Florida/epidemiologia , Encaminhamento e Consulta , Teste de HIV
20.
J Agromedicine ; 29(1): 80-90, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37940868

RESUMO

BACKGROUND: Little is known about polydrug use among Latino seasonal farmworkers. This cross-sectional study with male Latino seasonal workers (LSWs) living in South Florida categorized distinct classes of drug use and then characterized each drug use typology by demographic, structural, and psychological factors. METHODS: One hundred and twenty-five male LSWs were recruited during community events using convenience sampling between July 2019-March 2020. Latent class analysis was conducted by leveraging measures of self-reported use of nine drugs in the past year (sedatives, cannabis, stimulants, heroin, opioids, cocaine, PCP, hallucinogens, and inhalants). Correlates of latent class membership were examined using 3-step categorical latent variable logistic regression. Analyses were performed using Mplus version 8 and SAS 9.4. RESULTS: Four drug use classes were identified, male LSWs who exhibited: 1) use of illegal opioids only (n = 32); 2) concurrent cannabis and cocaine use (n = 75); 3) concurrent sedative and cannabis use (n = 13); and 4) high concurrent drug use (n = 5). About 84.7% of the sample reported use of at least one drug in the past 12 months. LSWs who identified as White and were married or in a stable relationship were likely to only use illegal opioids. LSWs with less than high school education and self-reported good to excellent health were more likely to use cannabis and cocaine. Men with moderate to severe anxiety and self-reported bad health were classified as engaging in sedative and cannabis co-use. Survivors of physical abuse were more commonly classified as people using high concurrent substances relative to non-abused men among the four classes. CONCLUSIONS: This pilot study suggests the presence of heterogeneity in polydrug use classes among LSWs in South Florida.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Humanos , Masculino , Estudos Transversais , Florida/epidemiologia , Análise de Classes Latentes , Projetos Piloto , Estações do Ano , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Hispânico ou Latino , Migrantes
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