Browsing by Subject "outbreaks"
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Item Adenovirus Infection and Outbreaks: What You Need to Know(ATS, 2019) Dela Cruz, Charles S.; Pasnick, Susan; Gross, Jane E.; Keller, Jon; Carlos, W. Graham; Cao, Bin; Jamil, Shazia; Medicine, School of MedicineItem Daily Situational Brief, December 29, 2014(MESH Coalition, 12/29/14) MESH CoalitionItem Daily Situational Brief, January 13, 2015(MESH Coalition, 1/13/2015) MESH CoalitionItem Daily Situational Brief, January 19, 2015(MESH Coalition, 1/19/2015) MESH CoalitionItem Daily Situational Brief, January 2, 2015(MESH Coalition, 1/2/2015) MESH CoalitionItem Daily Situational Brief, January 20, 2015(MESH Coalition, 1/20/2015) MESH CoalitionItem Reduction of Injection-Related Risk Behaviors After Emergency Implementation of a Syringe Services Program During an HIV Outbreak(Wolters Kluwer, 2018-04) Patel, Monita R.; Foote, Carrie; Duwve, Joan; Chapman, Erika; Combs, Brittany; Fry, Alexandra; Hall, Patti; Roseberry, Jeremy; Brooks, John T.; Broz, Dita; Sociology, School of Liberal ArtsObjective: To describe injection-related HIV risk behaviors preimplementation and postimplementation of an emergency syringe services program (SSP) in Scott County, Indiana, after an HIV outbreak among persons who inject drugs (PWID). Design: Mixed methods retrospective pre–post intervention analysis. Methods: We analyzed routine SSP program data collected at first and most recent visit among clients with ≥2 visits, ≥7 days apart from April 4 to August 30, 2015, to quantify changes in injection-related risk behaviors. We also analyzed qualitative data collected from 56 PWID recruited in Scott County to understand factors contributing to these behaviors. Results: SSP clients included in our analysis (n = 148, 62% of all SSP clients) reported significant (P < 0.001) reductions over a median 10 weeks (range 1–23) in syringe sharing to inject (18%–2%) and divide drugs (19%–4%), sharing other injection equipment (eg, cookers) (24%–5%), and number of uses of the same syringe [2 (interquartile range: 1–4) to 1 (interquartile range: 1–1)]. Qualitative study participants described access to sterile syringes and safer injection education through the SSP, as explanatory factors for these reductions. Injection frequency findings were mixed, but overall suggested no change. The number of syringes returned by SSP clients increased from 0 at first visit to median 57. All qualitative study participants reported using sharps containers provided by the SSP. Conclusions: Analyses of an SSP program and in-depth qualitative interview data showed rapid reduction of injection-related HIV risk behaviors among PWID post-SSP implementation. Sterile syringe access as part of comprehensive HIV prevention is an important tool to control and prevent HIV outbreaks.Item Timeliness of Chlamydia Laboratory and Provider Reports: A Modern Perspective(Office of the Vice Chancellor for Research, 2015-04-17) Lai, Patrick T.S.; Johns, Janae E.; Kirbiyik, Uzay; Dixon, Brian E.Timeliness of reports sent by laboratories and providers is a continuous challenge for disease surveillance and management. Public health organizations often collect communicable disease reports with various degrees of timeliness raising the concern about the delay in patient information received. Timely reports are beneficial to accurately evaluate community health needs and investigate disease outbreaks. According to Indiana state law, chlamydia reports are required to be sent to public health within 3 days after a positive test result confirmation. Therefore, laboratories and providers must be accountable and comply with regulation to ensure accurate data quality of disease assessment. The objective of this research study is to analyze the time delay between a chlamydia positive test diagnosis and when a laboratory and/or a provider send a report to a local public health department. A sample of 2,428 chlamydia laboratory and provider reports were collected during the period from May 2012 through July 2012 from a local health department serving the Indianapolis area. Due to absence of test confirmation dates, dates that a report is sent to public health, and other missing data, only 1,752 reports were included in this study. The time delay was calculated by determining the difference between when the initial report is sent to public health following positive confirmatory test by the laboratory. Reports were differentiated as either a laboratory report or a provider report coming directly from a clinician or a hospital setting. Statistical analyses and frequency tables were conducted using SAS 9.4. Table 1 displays the counts of chlamydia laboratory and provider reports according to the time delay in days, the percentage of reports sent to public health within 3 days, and the summary statistics for the two types of reports with a graphical representation shown in Figure 1. There is a clear lag between a lab test and when a provider report is sent to public health. Negative binomial regression result was highly significant with p < 0.001. This study shows the importance of continuing to examine the timeliness of disease reporting from both laboratory and provider settings. Most lab reports are received electronically and comply with state law. However, reports from providers tend to be fax-based and received later than the 72 hours desired by health officials. Given greater adoption electronic health records, it might be possible to further enhance disease surveillance through more timely provider-based reporting, which could also reduce the volume of missing data from provider reports like observed with ELR. Future research should examine EHR capacity and clinical workflows to improve provider-based reporting processes.