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PURPOSE: To determine levels of families' satisfaction and anxiety associated with the early hearing detection and intervention (EHDI) process in Massachusetts, and to assess the relationship between a child's hearing status and l...
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PURPOSE: To determine levels of families' satisfaction and anxiety associated with the early hearing detection and intervention (EHDI) process in Massachusetts, and to assess the relationship between a child's hearing status and levels of family satisfaction. METHOD: Surveys were mailed to families whose infants (a) passed their initial hearing screening (Group 1), (b) did not pass their initial screening but subsequently passed an outpatient rescreen or diagnostic evaluation (Group 2), or (c) were identified with permanent hearing loss (Group 3). Survey instruments measured families' satisfaction and anxiety associated with each stage of the EHDI process. RESULTS: Of the 4,138 families surveyed, 1,106 (27%) responded. Families reported satisfaction with screening services (Group 1 = 88%; Group 2 = 86%; Group 3 = 75%), and few reported anxiety prior to the hearing screening (Group 1= 4%; Group 2 = 15%; Group 3 = 19%). Among families requiring retesting services, 97% of Group 2 and 87% of Group 3 families were satisfied. Among Group 3 families, 94% reported satisfaction with the care their audiologist was providing, and 79% were satisfied with their early intervention services overall. CONCLUSIONS: Families reported satisfaction with the EHDI services they received in Massachusetts and expressed strong support for the universal newborn hearing screening initiative.
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BACKGROUND: In January 2005, a quadrivalent (serogroups A, C , Y, and W-135) meningococcal conjugate vaccine was licensed for use in adolescents. This report describes the epidemiologic features of meningococcal disease in the Uni...
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BACKGROUND: In January 2005, a quadrivalent (serogroups A, C , Y, and W-135) meningococcal conjugate vaccine was licensed for use in adolescents. This report describes the epidemiologic features of meningococcal disease in the United States from January 1998 through December 2007, before and during implementation of adolescent quadrivalent meningococcal conjugate vaccination. METHODS: Data were collected from active surveillance for invasive Neisseria meningitidis conducted through the Active Bacterial Core surveillance (ABCs) sites during 1998-2007. Isolates from cases were serogrouped at the ABCs site and confirmed at the Centers for Disease Control and Prevention. Estimates of the incidence and number of cases in the 50 states were calculated, standardizing for race and age group. RESULTS: In the period 1998-2007, a total of 2262 cases of meningococcal disease were reported from ABCs sites; 11.3% of these cases were fatal. The estimated United States average annual incidence of meningococcal disease was 0.53 cases per 100,000 population (95% confidence interval, 0.51-0.55), and an estimated 1525 (95% confidence interval, 1470-1598) cases occurred annually. The annual incidence decreased 64.1%, from 0.92 cases per 100,000 population in 1998 to 0.33 cases per 100,000 population in 2007. Infants aged <1 year have the highest incidence of meningococcal disease (5.38 cases per 100,000 population). After introduction of the quadrivalent meningococcal conjugate vaccine, no significant decrease in serogroup C or Y meningococcal disease was seen among those aged 11-19 years in 2006-2007, compared with 2004-2005. CONCLUSIONS: Before the introduction of the quadrivalent meningococcal conjugate vaccine, the incidence of meningococcal disease in the United States decreased to a historic low. However, meningococcal disease still causes a substantial burden of disease among all age groups. Future vaccination strategies may include targeting infants and preventing serogroup B meningococcal disease.
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BACKGROUND: In January 2005, a quadrivalent (serogroups A, C , Y, and W-135) meningococcal conjugate vaccine was licensed for use in adolescents. This report describes the epidemiologic features of meningococcal disease in the Uni...
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BACKGROUND: In January 2005, a quadrivalent (serogroups A, C , Y, and W-135) meningococcal conjugate vaccine was licensed for use in adolescents. This report describes the epidemiologic features of meningococcal disease in the United States from January 1998 through December 2007, before and during implementation of adolescent quadrivalent meningococcal conjugate vaccination. METHODS: Data were collected from active surveillance for invasive Neisseria meningitidis conducted through the Active Bacterial Core surveillance (ABCs) sites during 1998-2007. Isolates from cases were serogrouped at the ABCs site and confirmed at the Centers for Disease Control and Prevention. Estimates of the incidence and number of cases in the 50 states were calculated, standardizing for race and age group. RESULTS: In the period 1998-2007, a total of 2262 cases of meningococcal disease were reported from ABCs sites; 11.3% of these cases were fatal. The estimated United States average annual incidence of meningococcal disease was 0.53 cases per 100,000 population (95% confidence interval, 0.51-0.55), and an estimated 1525 (95% confidence interval, 1470-1598) cases occurred annually. The annual incidence decreased 64.1%, from 0.92 cases per 100,000 population in 1998 to 0.33 cases per 100,000 population in 2007. Infants aged <1 year have the highest incidence of meningococcal disease (5.38 cases per 100,000 population). After introduction of the quadrivalent meningococcal conjugate vaccine, no significant decrease in serogroup C or Y meningococcal disease was seen among those aged 11-19 years in 2006-2007, compared with 2004-2005. CONCLUSIONS: Before the introduction of the quadrivalent meningococcal conjugate vaccine, the incidence of meningococcal disease in the United States decreased to a historic low. However, meningococcal disease still causes a substantial burden of disease among all age groups. Future vaccination strategies may include targeting infants and preventing serogroup B meningococcal disease.
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Since the implementation of the 10th International Classification of Disease in 1999, the trend in Alzheimer's disease mortality rate has not been reported. Here, the age-adjusted Alzheimer's disease mortality rate in Puerto Rico ...
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Since the implementation of the 10th International Classification of Disease in 1999, the trend in Alzheimer's disease mortality rate has not been reported. Here, the age-adjusted Alzheimer's disease mortality rate in Puerto Rico and United States from 1999 to 2004 was analyzed. The results showed an increasing trend in Alzheimer's disease mortality rate in both the United States and Puerto Rico. However in Puerto Rico, the Alzheimer's disease mortality rate (32.4/100 000) was higher than that observed in United States (20.9/100 000). Interestingly, the Alzheimer's disease mortality rate of Puerto Ricans living in Puerto Rico is much higher than Puerto Ricans living in the United States. The higher occurrence of Alzheimer's disease mortality in Puerto Rico versus the United States could be explained by factors such as coding practices, genetics, socioeconomics, and health care. These results highlight the need for comprehensive studies on factors that may influence diagnosis, death certificate coding practices, and development of Alzheimer's disease pathology in different geographical regions.
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BACKGROUND: With the introduction of Haemophilus influenzae serotype b (Hib) conjugate vaccines, there has been a dramatic reduction of Hib disease in young children and the epidemiological trends of invasive H. influenzae have sh...
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BACKGROUND: With the introduction of Haemophilus influenzae serotype b (Hib) conjugate vaccines, there has been a dramatic reduction of Hib disease in young children and the epidemiological trends of invasive H. influenzae have shifted. METHODS: Data were collected from active surveillance for invasive H. influenzae disease conducted through Active Bacterial Core surveillance sites during 1989-2008. RESULTS: During 1999-2008, the estimated mean annual incidence of H. influenzae infection was 1.62 cases per 100 000 population; 15.3% of cases were fatal. Incidence was higher among adults aged >/=65 years, compared with other age groups. The largest burden of disease among children aged <5 years was in infants aged <1 year; many of these cases occurred during the first month of life in preterm or low-birth weight infants. An estimated 10% of the total burden of disease among children aged <5 years occurred in American Indian and Alaska Native children. During 1989-2008, 7559 cases of H. influenzae disease were reported from Active Bacterial Core surveillance sites. Small increases in the incidence of serotypes a, e, and f were observed during 1989-2008. The largest of these increases was in serotype f and was primarily among adults aged >/=18 years. CONCLUSIONS: Since the introduction of Hib conjugate vaccines, the incidence of invasive disease caused by H. influenzae in the United States has decreased dramatically; however, a considerable burden of non-Hib disease is still present in the oldest and youngest age groups. There is no evidence of substantial replacement disease with non-b serotypes in young children in the United States.
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OBJECTIVES: We sought to describe disparities and trends in tuberculosis (TB) risk factors and treatment outcomes between correctional inmate and noninmate populations. METHODS: We analyzed data reported to the national TB surveil...
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OBJECTIVES: We sought to describe disparities and trends in tuberculosis (TB) risk factors and treatment outcomes between correctional inmate and noninmate populations. METHODS: We analyzed data reported to the national TB surveillance system from 1993 through 2003. We compared characteristics between inmate and non-inmate men aged 15-64 years. RESULTS: Of the 210976 total US TB cases, 3.8% (7820) were reported from correctional systems. Federal and state prison case rates were 29.4 and 24.2 cases per 100000 inmates, respectively, which were considerably higher than those in the noninmate population (6.7 per 100000 people). Inmates with TB were more likely to have at least 1 TB risk factor compared with noninmates (60.1% vs 42.0%, respectively) and to receive directly observed therapy (65.0% vs 41.0%, respectively); however, they were less likely to complete treatment (76.8% vs 89.4%, respectively). Among inmates, 58.9% completed treatment within 12 months compared with 73.2% of noninmates. CONCLUSIONS: Tuberculosis case rates in prison systems remain higher than in the general population. Inmates with TB are less likely than noninmates to complete treatment.
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BACKGROUND: In January 2005, a quadrivalent meningococcal conjugate vaccine (MenACWYD) was licensed for use in the United States. The Advisory Committee on Immunization Practices recommends MenACWYD for all adolescents 11 to 18 ye...
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BACKGROUND: In January 2005, a quadrivalent meningococcal conjugate vaccine (MenACWYD) was licensed for use in the United States. The Advisory Committee on Immunization Practices recommends MenACWYD for all adolescents 11 to 18 years of age and others at increased risk for meningococcal disease. METHODS: Reports of breakthrough meningococcal disease after vaccination with MenACWYD were collected. A simulation approach was used to estimate the expected number of cases in vaccinated persons. RESULTS: Between 2005 and 2008, 14 breakthrough cases, including 3 deaths occurred. At a vaccine effectiveness (VE) of 90%, 7 breakthrough cases would be expected (range, 1-17); at VE of 85%, 11 cases (range, 2-30); at VE of 80%, 15 cases (range, 5-28); and at VE of 75%, 18 cases (range, 7-32) would be expected. The probability of the >/=14 observed cases occurring was 2.9% at VE of 90%, 29.3% at VE of 85%, 66.1% at VE of 80%, and 83.0% at VE of 75%. CONCLUSIONS: This report provides an early estimate of MenACWYD effectiveness within 3 to 4 years after vaccination, and suggests that MenACWYD effectiveness is 80% to 85%, similar to the VE reported for meningococcal polysaccharide vaccine.
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BACKGROUND: The proportion of tuberculosis (TB) cases diagnosed among residents of correctional facilities in Arizona increased from 2.7% in 1993 to 8.0% in 2000, while the national average remained at approximately 4%. The purpos...
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BACKGROUND: The proportion of tuberculosis (TB) cases diagnosed among residents of correctional facilities in Arizona increased from 2.7% in 1993 to 8.0% in 2000, while the national average remained at approximately 4%. The purpose of this study was to determine the proportion of TB cases in Maricopa County, Arizona with a history of incarceration in the local county jail, and to describe missed opportunities for the prevention and early detection of active TB cases in this population. METHODS: A cross-match was used to identify persons reported to have TB in Maricopa County in 1999 and 2000 who also had a history of incarceration in the county jail. Jail medical records of cases were reviewed to determine if they had been screened for TB while incarcerated and the type of screening received. TB isolates for cases who had been in jail were genotyped using IS6110 restriction fragment-length polymorphism (RFLP) with secondary spoligotyping. RESULTS: Nearly one quarter (24.3%) of TB cases had a history ofincarceration in the county jail. Most (82.8%) received no TB screening while in jail. Of 34 cases with available isolates, six shared a single genotype by RFLP and spoligotyping. CONCLUSIONS: Increased screening and treatment of latent TB infection in jails might assist with TB control in the community.
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