Pneumocystosis (PCP) mortality in the U.S. has received less attention in recent years. This study describes recent trends in mortality and the estimated burden of PCP in the U.S., using the national multiple cause of death data during 1999-2014. PCP mortality rates were calculated for age, sex, race and year. Demographic differences were presented for decedents with and without a human immunodeficiency virus (HIV) co-diagnosis. Matched odds ratios (MOR) were generated to describe associations between non-HIV conditions and PCP mortality. In total, 11 512 PCP deaths occurred during 1999-2014. Annual age-adjusted PCP mortality decreased over this time period, from 0.479 to 0.154 per 100 000 population (1999 vs 2014 respectively). Over two-thirds of decedents were male and Blacks had the highest mortality as compared to Whites. HIV co-diagnosis accounted for 48% of all PCP deaths in 2014 vs 71% in 1999. Comorbid conditions such as connective tissue disorders (MOR=12.29; 95% confidence interval=[10.26, 14.71]) were associated with a PCP diagnosis. Productivity losses amounted to >$12 billion during the study period. Although widespread use of antiretroviral therapy and PCP prophylaxis for HIV infection likely contributed to the overall decline in PCP deaths during 1999-2014, a continual need exists to prevent and treat this fungal disease in immune-compromised populations that are not infected with HIV.
Animal-to-human bites can often lead to medical complications. Surveillance is essential in helping to identify, manage, and reduce these highly preventable injuries and direct public health actions and policies on animal bite risk and prevention.
Background The prevalence of current/past coronavirus disease 2019 (COVID-19) in skilled nursing facility (SNF) residents is unknown because of asymptomatic infection and constrained testing capacity early in the pandemic. We conducted a seroprevalence survey (SPS) to determine a more comprehensive prevalence of past COVID-19 in Los Angeles County SNF residents and staff members. Methods We recruited participants from 24 facilities; participants were requested to submit a nasopharyngeal (NP) swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR testing and serum for detection of SARS-CoV-2 antibodies. All participants were cross-referenced with our surveillance database to identify persons with prior positive SARS-CoV-2 results. Results From August 18 to September 24, 2020, we enrolled 3,305 participants (1,340 residents and 1,965 staff members). Among 856 residents providing serum, 362 (42%) had current/past SARS-CoV-2 infection. Of the 346 serology positive residents, 199 (58%) did not have a documented prior positive SARS-CoV-2 PCR result. Among 1,806 staff members providing serum, 454 (25%) had current/past SARS-CoV-2 infection. Of the 447 serology positive staff members, 353 (79%) did not have a documented prior positive SARS-CoV-2 PCR result. Conclusions Past testing practices and policies missed a substantial number of SARS-CoV-2 infections in SNF residents and staff members.
The objective of this study was to assess monetary and non-monetary factors that can influence the decision to participate in a future health survey. A questionnaire was administered to eligible, low-income participants (n = 1502) of the 2012 Los Angeles County Health and Nutrition Examination Survey (LAHANES-II). Multivariable regression analyses were performed to describe factors potentially associated with future intent to participate in similar survey designs. The results of the survey suggest that, overall, female participants had a greater interest in participating under a variety of incentive scenarios. Compared to the 25-34 age group, older participants (35-44, 45-84) reported more interest to participate if $10 cash [prepaid gift/debit card], a coupon for product/travel, or a small item [e.g., granola bar, t-shirt, pen] was offered, whereas younger participants (18-24) reported greater interest for $25 cash or a coupon for product/travel. Non-Whites, when compared to Whites/Non-Hispanics, reported greater interest to participate if any of the incentives was offered. High school graduates, when compared to those with some college education, reported greater interest to participate if $10 cash, a small item, or a lottery ticket was offered. Presence of two or more chronic conditions increased interest while concerns about participation in LAHANES-II was associated with reduced interest to participate in future health-related surveys. The results suggest that both incentives and non-monetary considerations (e.g., personal concerns about participating and individual level characteristics) can influence the decision to participate in health-related surveys and offer insights into strategies that can improve response rates for these assessments that are often used to inform community planning.
This analysis describes the socioeconomic attributes of neighborhoods adjacent to low-income neighborhoods with ≥50% of households that are Supplemental Nutrition Assistance Program Education (SNAP-Ed) eligible. It compares the pricing, availability, and quality of fresh produce between these neighborhoods in Los Angeles County. The Los Angeles County Department of Public Health utilized 2013–2014 community-level data from the Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention (CX3) Project to examine the geographic patterns of fresh produce purchases and accessibility in SNAP-Ed eligible census tracts. Community indicators collected by CX3 included information on pricing, availability, and quality of fruits and vegetables from grocery stores (n = 108) in these eligible neighborhoods (n = 21). Correlation statistics were generated to explore the effects of adjacent neighborhoods' socioeconomic status on fruit and vegetable pricing, availability, and quality in the selected neighborhoods (“CX3 neighborhoods”). Poverty data were obtained from the United States Census' American Community Survey. Residents of CX3 neighborhoods that were surrounded by mixed income neighborhoods paid 43% more for fresh produce than CX3 neighborhoods surrounded by other similarly low-income neighborhoods (median produce price, $1.50 versus $1.05). Study results suggest that while quality of produce remains an issue, it is the higher pricing of fresh produce in CX3 neighborhoods – i.e., in the presence of other surrounding mixed income neighborhoods (those with relatively higher income) – that appeared to potentiate food access barriers. Future SNAP-Ed efforts should take this pricing pattern under consideration when designing, planning, and/or implementing nutrition-related programs in these neighborhoods.
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