Listeriosis is a severe infection caused by Listeria monocytogenes. Since 2004, the Centers for Disease Control and Prevention has requested that listeriosis patients be interviewed using a standardized Listeria Initiative (LI) questionnaire. In January 2009, states and the Centers for Disease Control and Prevention began investigating a multistate outbreak of listeriosis among pregnant, Hispanic women. We defined a case as an illness occurring between October 2008 and March 2009 with an L. monocytogenes isolate indistinguishable from the outbreak strain by pulsed-field gel electrophoresis. We conducted a multistate case-control study using controls that were selected from L. monocytogenes illnesses in non-outbreak-related pregnant, Hispanic women that were reported to the LI during 2004 to 2008. Eight cases in five states were identified. Seven of these were pregnant, Hispanic females aged 21 to 43 years, and one was a 3-year-old Hispanic girl, who was excluded from the study. Seven (100%) cases but only 26 (60%) of 43 controls had consumed Mexican-style cheese in the month before illness (odds ratio, 5.89; 95% confidence interval, 1.07 to ∞; P = 0.04). Cultures of asadero cheese made from pasteurized milk collected at a manufacturing facility during routine sampling by the Michigan Department of Agriculture on 23 February 2009 yielded the outbreak strain, leading to a recall of cheeses produced in the plant. Recalled product was traced to stores where at least three of the women had purchased cheese. This investigation highlights the usefulness of routine product sampling for identifying contaminated foods, of pulsed-field gel electrophoresis analysis to detect multistate outbreaks, and of the LI for providing timely exposure information for case-control analyses. Recalls of contaminated cheeses likely prevented additional illnesses.
OBJECTIVE: Plateau in testicular cancer incidence in some parts of the United States (US) especially among non-Hispanic white males in Los Angeles had been observed. We conducted three decades temporal trends analysis to assess the evidence of such a plateau, and to examine whether the rate remains stable across racial/ethnic groups as well as the influence of age at diagnosis on the incidence rate. STUDY DESIGN:Population-based temporal trends analysis. METHODS:Using the Surveillance Epidemiology and End Results (SEER), we identified between 1975 and 2004, 16,580 of newly diagnosed testicular cancer cases, aged 15−49 years. The incidence rates were examined by calculating the age-adjusted rates and their 95% Confidence Interval (CI) for the age at diagnosis, SEER areas, and race by the year of diagnosis. The percent change and annual percent change were examined for trends. RESULTS:Incidence of testicular cancer continues to increase among US males, albeit the plateau of the 1990s. Between 1975 and 2004 the age-adjusted incidence rate for ages, 15−49 years increased from 2.9 (1975) to 5.1(2004) per 100,000. The trends indicated a percent change of 71.9% and a statistically significant annual percent change of 1.6 %,( 95% CI, 1.3−2.0), p < 0.05. Though the rates in blacks remained strikingly low, 0.3 to 1.4 per 100,000, the highest annual percent change was observed among blacks, 2.3%, (95%, CI, 0.8−3.9), p < 0.05 for trends. The rates were intermediate among Asians/ Pacific Islanders and American Indian and Alaska Natives 0.7 to 2.9 per 100,000, percent change (117.3%) and a statistically significant annual change of 1.5%, (95% CI, 0.3−2.7) p < 0.05 for trends. The highest rates were reported among Whites, 3.2 to 6.3 per 100,000, percent change (90.4%) , with a statistically significant annual percent change of 2.0%, (95% CI, 1.6 −2.3), p < 0.05. The peak age at diagnosis was, 30−34 years while the lowest rates were reported in
Despite the availability of the female condoms and theoretically based interventions to promote its use, studies have indicated a low level of acceptability of their use among women in most populations. We aimed to determine female condom use prevalence and the potential markers among African-American women. In an intervention trial to test the efficacy of the Information-Motivation-Behavioral Skills model in increasing condom use, we utilized the baseline data of 280 subjects and examined the potential predictors of female condom use. Chi square statistic and unconditional logistic regression were used to test for group independence among users and non-users of the female condom and to assess the potential markers of female condom use respectively. After adjustment for relevant covariates associated independently with female condom use, the significant potential markers for female condom use were age, multiple sexual relationships, knowledge of female condom, and educational status. Women having multiple sexual relationships compared with a monogamous relationship were five times more likely to use the female condom, while women with high school education were three times more likely to use the female condom; prevalence odds ratio, POR=5.32, 95% CI=1.79-15.83 and POR=3.01, 95% CI=1.01-8.93. Women who were not knowledgeable of the female condom, compared to those who were, were 81% less likely to use the female condom, POR=0.19, 95% CI=0.08-0.45. Among African-American women in this sample, knowledge of female condom use, age, educational status, and multiple sexual relationships were significant markers of female condom use. This study is therefore suggestive of the need to educate African-American women on female condom use, given the obstacles in male condom negotiation, especially among the socio-economically challenged.
Substantial racial variation occurred in the reasons for being tested for HIV in the United States, indicative of the need to understand such rationale for effective HIV screening and testing.
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