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Fatalities in Oil and Gas Extraction Database, an Industry-Specific Worker Fatality Surveillance System - United States, 2014-2019. 石油和天然气开采中的死亡人数数据库,一个特定行业的工人死亡监测系统——美国,2014-2019年。
IF 24.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-09-01 DOI: 10.15585/mmwr.ss7208a1
Kaitlin C Wingate, Alejandra Ramirez-Cardenas, Ryan Hill, Sophia Ridl, Kyla Hagan-Haynes
<p><strong>Problem/condition: </strong>The U.S. oil and gas extraction (OGE) industry faces unique safety and health hazards and historically elevated fatality rates. The lack of existing surveillance data and occupational safety and health research called for increased efforts to better understand factors contributing to worker fatalities in the OGE industry. This report describes the creation of the Fatalities in Oil and Gas Extraction (FOG) database, presents initial findings from the first 6 years of data collection (2014-2019), highlights ways that FOG data have been used, and describes the benefits and challenges of maintaining the surveillance system.</p><p><strong>Period covered: </strong>2014-2019.</p><p><strong>Description of system: </strong>In 2013, the National Institute for Occupational Safety and Health (NIOSH) created the FOG database, a surveillance system comprising an industry-specific worker fatality database. NIOSH researchers worked with OGE partners to establish inclusion criteria for the database and develop unique database variables to elucidate industry-specific factors related to each fatality (e.g., phase of operation, worker activity, and working alone). FOG cases are identified through various sources, such as Occupational Safety and Health Administration (OSHA) reports, media reports, and notifications from professional contacts. NIOSH researchers compile source documents; OGE-specific database variables are coded by multiple researchers to ensure accuracy. Data collection ceased in 2019 because grant funding ended.</p><p><strong>Results: </strong>During 2014-2019, a total of 470 OGE worker fatalities were identified in the FOG database. A majority of these fatalities (69.4%) were identified from OSHA reports and Google Alerts (44.7% and 24.7%, respectively). Unique database variables created to characterize fatalities in the OGE industry (i.e., phase of operation, worker activity, working alone, and working unobserved) were identified in approximately 85% of OGE worker fatality cases. The most frequent fatal events were vehicle incidents (26.8%), contact injuries (21.7%), and explosions (14.5%). The event type was unknown among 5.7% of worker fatalities. Approximately three fourths of fatalities identified through the FOG database were among contractors. Approximately 20% of cases included workers who were working alone.</p><p><strong>Interpretation: </strong>The FOG database is a resource for identifying safety and health trends and emerging issues among OGE workers (e.g., exposure to hydrocarbon gases and vapors and fatalities resulting from cardiac events) that might not be available in other surveillance systems. The FOG database also helps researchers better identify groups of workers that are at increased risk for injury in an already high-risk industry. Challenges exist when maintaining an industry-specific surveillance system, including labor-intensive data collection, the need for researchers with substant
问题/状况:美国石油和天然气开采(OGE)行业面临着独特的安全和健康隐患,死亡率历史性地上升。由于缺乏现有的监测数据和职业安全与健康研究,需要加大力度,更好地了解导致OGE行业工人死亡的因素。本报告描述了石油和天然气开采死亡人数(FOG)数据库的创建,介绍了前6年(2014-2019年)数据收集的初步结果,强调了FOG数据的使用方式,并描述了维护监测系统的好处和挑战。涵盖时间:2014-2019年。系统描述:2013年,美国国家职业安全与健康研究所(NIOSH)创建了FOG数据库,这是一个由特定行业的工人死亡数据库组成的监测系统。NIOSH研究人员与OGE合作伙伴合作,为数据库建立纳入标准,并开发独特的数据库变量,以阐明与每例死亡相关的行业特定因素(例如,手术阶段、工人活动和单独工作)。FOG病例是通过各种来源确定的,如职业安全与健康管理局(OSHA)的报告、媒体报道和专业联系人的通知。NIOSH研究人员汇编源文件;OGE特定的数据库变量由多名研究人员编码,以确保准确性。数据收集于2019年停止,原因是赠款资金终止。结果:2014-2019年期间,FOG数据库中共发现470名OGE工人死亡。这些死亡事件中的大多数(69.4%)来自OSHA报告和谷歌警报(分别为44.7%和24.7%)。在大约85%的OGE工人死亡案例中,发现了为描述OGE行业死亡情况而创建的唯一数据库变量(即运营阶段、工人活动、单独工作和未观察到的工作)。最常见的致命事件是车辆事故(26.8%)、接触伤害(21.7%)和爆炸(14.5%)。在5.7%的工人死亡中,事件类型未知。通过FOG数据库确定的死亡人数中,约有四分之三是承包商。大约20%的病例包括独自工作的工人。解释:FOG数据库是一种资源,用于识别OGE工作人员的安全和健康趋势以及新出现的问题(例如,暴露于碳氢化合物气体和蒸汽以及心脏事件导致的死亡),而这些问题在其他监测系统中可能不可用。FOG数据库还帮助研究人员更好地识别在已经高风险的行业中受伤风险增加的工人群体。维护特定行业的监控系统时存在挑战,包括劳动密集型数据收集、需要对行业有深入了解的研究人员、及时获取数据的延迟以及源文件数据的丢失。公共卫生行动:建议继续监测OGE行业的工人死亡情况,以帮助识别新的安全和健康危害,并指导研究和预防活动。行业、学术机构和政府可以利用FOG数据库的研究结果来确定导致OGE致命伤害的因素,并制定干预措施来改善工人的安全和健康。本报告中的研究结果也可用于其他高死亡率行业,以支持工人死亡监测系统的开发。
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引用次数: 1
Travel-Related Diagnoses Among U.S. Nonmigrant Travelers or Migrants Presenting to U.S. GeoSentinel Sites - GeoSentinel Network, 2012-2021. 美国非移民旅行者或移民在美国地理哨兵网站的旅行相关诊断-地理哨兵网络,2012-2021。
IF 24.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-06-30 DOI: 10.15585/mmwr.ss7207a1
Ashley B Brown, Charles Miller, Davidson H Hamer, Phyllis Kozarsky, Michael Libman, Ralph Huits, Aisha Rizwan, Hannah Emetulu, Jesse Waggoner, Lin H Chen, Daniel T Leung, Daniel Bourque, Bradley A Connor, Carmelo Licitra, Kristina M Angelo
<p><strong>Problem/condition: </strong>During 2012-2021, the volume of international travel reached record highs and lows. This period also was marked by the emergence or large outbreaks of multiple infectious diseases (e.g., Zika virus, yellow fever, and COVID-19). Over time, the growing ease and increased frequency of travel has resulted in the unprecedented global spread of infectious diseases. Detecting infectious diseases and other diagnoses among travelers can serve as sentinel surveillance for new or emerging pathogens and provide information to improve case identification, clinical management, and public health prevention and response.</p><p><strong>Reporting period: </strong>2012-2021.</p><p><strong>Description of system: </strong>Established in 1995, the GeoSentinel Network (GeoSentinel), a collaboration between CDC and the International Society of Travel Medicine, is a global, clinical-care-based surveillance and research network of travel and tropical medicine sites that monitors infectious diseases and other adverse health events that affect international travelers. GeoSentinel comprises 71 sites in 29 countries where clinicians diagnose illnesses and collect demographic, clinical, and travel-related information about diseases and illnesses acquired during travel using a standardized report form. Data are collected electronically via a secure CDC database, and daily reports are generated for assistance in detecting sentinel events (i.e., unusual patterns or clusters of disease). GeoSentinel sites collaborate to report disease or population-specific findings through retrospective database analyses and the collection of supplemental data to fill specific knowledge gaps. GeoSentinel also serves as a communications network by using internal notifications, ProMed alerts, and peer-reviewed publications to alert clinicians and public health professionals about global outbreaks and events that might affect travelers. This report summarizes data from 20 U.S. GeoSentinel sites and reports on the detection of three worldwide events that demonstrate GeoSentinel's notification capability.</p><p><strong>Results: </strong>During 2012-2021, data were collected by all GeoSentinel sites on approximately 200,000 patients who had approximately 244,000 confirmed or probable travel-related diagnoses. Twenty GeoSentinel sites from the United States contributed records during the 10-year surveillance period, submitting data on 18,336 patients, of which 17,389 lived in the United States and were evaluated by a clinician at a U.S. site after travel. Of those patients, 7,530 (43.3%) were recent migrants to the United States, and 9,859 (56.7%) were returning nonmigrant travelers.Among the recent migrants to the United States, the median age was 28.5 years (range = <19 years to 93 years); 47.3% were female, and 6.0% were U.S. citizens. A majority (89.8%) were seen as outpatients, and among 4,672 migrants with information available, 4,148 (88.8%) did not receive
问题/状况:2012-2021年期间,国际旅行量创下历史新高和新低。这一时期还出现了多种传染病或大规模爆发(如寨卡病毒、黄热病和新冠肺炎)。随着时间的推移,旅行的日益便利和频率的增加导致了传染病在全球范围内前所未有的传播。在旅行者中检测传染病和其他诊断可以作为新出现病原体的哨点监测,并为改善病例识别、临床管理以及公共卫生预防和应对提供信息。报告期:2012-2021.系统描述:GeoSentinel网络成立于1995年,由美国疾病控制与预防中心和国际旅行医学学会合作,是一个全球、基于临床护理的旅行和热带医学监测和研究网络,监测影响国际旅行者的传染病和其他不良健康事件。GeoSentinel包括29个国家的71个站点,临床医生在这些站点诊断疾病,并使用标准化报告表收集有关疾病和旅行期间获得的疾病的人口统计、临床和旅行相关信息。数据通过美国疾病控制与预防中心的安全数据库以电子方式收集,并且生成每日报告以帮助检测哨点事件(即异常模式或疾病集群)。GeoSentinel网站通过回顾性数据库分析和收集补充数据来填补特定知识空白,合作报告特定疾病或人群的发现。GeoSentinel还通过使用内部通知、ProMed警报和同行评审出版物,向临床医生和公共卫生专业人员通报可能影响旅行者的全球疫情和事件,以此作为一个通信网络。本报告总结了20个美国GeoSentinel站点的数据,并报告了三个全球事件的检测情况,这些事件证明了GeoSentinel'S的通知能力。结果:2012-2021年期间,所有GeoSentinel网站收集了约20万名患者的数据,这些患者约有244000例确诊或可能与旅行有关的诊断。在10年的监测期内,来自美国的20个GeoSentinel站点提供了记录,提交了18336名患者的数据,其中17389名患者居住在美国,并在旅行后由美国站点的临床医生进行了评估。在这些患者中,7530人(43.3%)是最近移民到美国的,9859人(56.7%)是返回的非移民旅行者。在最近移居美国的移民中,中位年龄为28.5岁(范围=解释:在旅行后在美国地理哨兵网站评估的患病美国旅行者中,大多数是非移民旅行者,他们最常被诊断为胃肠道疾病,这意味着来自美国的国际旅行人员可能接触到受污染的食物和水。移民最常被确诊为维生素等疾病D缺乏症和潜伏性肺结核,这可能是由于移民前和移民期间的不利环境造成的(例如营养不良和粮食不安全、获得适当环境卫生和个人卫生的机会有限以及住房拥挤)。在移民和非移民旅行者中都诊断出了疟疾,只有少数人报告说服用了疟疾化学预防药物,这可能是由于旅行前获得医疗保健(尤其是VFR)的障碍和旅行期间缺乏预防措施(例如使用驱虫剂)。2020年和2021年,由于新冠肺炎大流行和相关的旅行限制,美国地理哨兵网站评估的旅行后患病旅客人数与前几年相比有所减少。由于缺乏全球诊断检测能力,GeoSentinel检测到的新冠肺炎病例有限,在大流行早期没有检测到任何哨点病例。公共卫生行动:本报告中的调查结果描述了移民和返回美国的非移民旅行者获得的健康相关疾病的范围,说明了在旅行中获得疾病的风险。此外,某些旅行者即使前往高风险、可预防疾病流行的地区,也不会寻求旅行前的医疗保健。医疗保健专业人员可以通过提供评估和针对目的地的建议来帮助国际旅行者。卫生保健专业人员应培养信任,并加强VFR的旅行前预防信息,众所周知,VFR是一个在旅行后严重疾病(如疟疾和肠热)发生率较高的群体。卫生保健专业人员应继续倡导为服务不足的人群(如VFR和移民)提供医疗保健,以防止疾病进展、复发以及潜在的向弱势人群传播和在弱势人群中传播。 由于旅行和传染病都在进化,公共卫生专业人员应该探索如何加强对新出现的疾病的检测,这些疾病可能不会被当前的非现场监测系统捕捉到。
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引用次数: 0
Foodborne Illness Outbreaks at Retail Food Establishments - National Environmental Assessment Reporting System, 25 State and Local Health Departments, 2017-2019. 零售食品场所的食源性疾病暴发——国家环境评估报告系统,25个州和地方卫生部门,2017-2019。
IF 24.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-06-02 DOI: 10.15585/mmwr.ss7206a1
Erin D Moritz, Shideh Delrahim Ebrahim-Zadeh, Beth Wittry, Meghan M Holst, Bresa Daise, Adria Zern, Tonia Taylor, Adam Kramer, Laura G Brown
<p><strong>Problem/condition: </strong>Each year, state and local public health departments report hundreds of foodborne illness outbreaks associated with retail food establishments (e.g., restaurants or caterers) to CDC. Typically, investigations involve epidemiology, laboratory, and environmental health components. Health departments voluntarily report epidemiologic and laboratory data from their foodborne illness outbreak investigations to CDC through the National Outbreak Reporting System (NORS); however, minimal environmental health data from outbreak investigations are reported to NORS. This report summarizes environmental health data collected during outbreak investigations and reported to the National Environmental Assessment Reporting System (NEARS).</p><p><strong>Period covered: </strong>2017-2019.</p><p><strong>Description of system: </strong>In 2014, CDC launched NEARS to complement NORS surveillance and to use these data to enhance prevention efforts. State and local health departments voluntarily enter data from their foodborne illness outbreak investigations of retail food establishments into NEARS. These data include characteristics of foodborne illness outbreaks (e.g., etiologic agent and factors contributing to the outbreak), characteristics of establishments with outbreaks (e.g., number of meals served daily), and food safety policies in these establishments (e.g., ill worker policy requirements). NEARS is the only available data source that collects environmental characteristics of retail establishments with foodborne illness outbreaks.</p><p><strong>Results: </strong>During 2017-2019, a total of 800 foodborne illness outbreaks associated with 875 retail food establishments were reported to NEARS by 25 state and local health departments. Among outbreaks with a confirmed or suspected agent (555 of 800 [69.4%]), the most common pathogens were norovirus and Salmonella, accounting for 47.0% and 18.6% of outbreaks, respectively. Contributing factors were identified in 62.5% of outbreaks. Approximately 40% of outbreaks with identified contributing factors had at least one reported factor associated with food contamination by an ill or infectious food worker. Investigators conducted an interview with an establishment manager in 679 (84.9%) outbreaks. Of the 725 managers interviewed, most (91.7%) said their establishment had a policy requiring food workers to notify their manager when they were ill, and 66.0% also said these policies were written. Only 23.0% said their policy listed all five illness symptoms workers needed to notify managers about (i.e., vomiting, diarrhea, jaundice, sore throat with fever, and lesion with pus). Most (85.5%) said that their establishment had a policy restricting or excluding ill workers from working, and 62.4% said these policies were written. Only 17.8% said their policy listed all five illness symptoms that would require restriction or exclusion from work. Only 16.1% of establishments with outbreaks
问题/状况:每年,州和地方公共卫生部门向疾病预防控制中心报告数百起与零售食品场所(如餐馆或餐饮服务商)有关的食源性疾病暴发。通常,调查包括流行病学、实验室和环境卫生组成部分。卫生部门自愿通过国家疫情报告系统(NORS)向疾病预防控制中心报告食源性疾病疫情调查的流行病学和实验室数据;然而,只有极少的疫情调查的环境卫生数据向国家统计局报告。本报告总结了疫情调查期间收集的环境卫生数据,并向国家环境评估报告系统(NEARS)报告。涵盖时间:2017-2019年。系统描述:2014年,疾病预防控制中心启动了near,以补充NORS监测并利用这些数据加强预防工作。州和地方卫生部门自愿将零售食品场所食源性疾病爆发调查的数据输入near。这些数据包括食源性疾病暴发的特征(例如,导致暴发的病原和因素)、暴发场所的特征(例如,每天提供的膳食数量)以及这些场所的食品安全政策(例如,患病工人政策要求)。near是收集食源性疾病暴发零售场所环境特征的唯一可用数据源。结果:2017-2019年期间,25个州和地方卫生部门向near报告了与875家零售食品企业相关的800起食源性疾病暴发。在800例确诊或疑似病原体暴发中(555例/ 800例[69.4%]),最常见的病原体为诺如病毒和沙门氏菌,分别占暴发的47.0%和18.6%。62.5%的疫情确定了致病因素。在已确定致病因素的暴发中,大约40%至少有一个报告的因素与患病或有传染性的食品工人造成的食品污染有关。在679例(84.9%)暴发中,调查人员对一名机构管理人员进行了访谈。在接受采访的725名管理人员中,大多数(91.7%)表示,他们的企业有一项政策要求食品工人在生病时通知他们的经理,66.0%的人还表示这些政策是书面的。只有23.0%的人表示,他们的政策列出了员工需要通知管理人员的所有五种疾病症状(即呕吐、腹泻、黄疸、喉咙痛伴有发烧和脓液损伤)。大多数受访者(85.5%)表示,他们所在的机构有限制或排除患病员工工作的政策,62.4%的受访者表示有书面政策。只有17.8%的人表示,他们的保单列出了需要限制或禁止工作的所有五种疾病症状。在爆发疫情的企业中,只有16.1%的企业制定了解决与患病或感染工人有关的所有四个组成部分的政策(即,政策要求工人在生病时通知管理人员,政策规定了工人需要通知管理人员的所有五种疾病症状,政策限制或排除患病工人工作,政策规定了需要限制或排除工作的所有五种疾病症状)。解释:诺如病毒是向near报告的疫情中最常见的确定原因,患病或感染性食品工人对食品的污染导致了已确定因素的约40%的疫情。这些发现与其他国家暴发数据集的发现一致,并突出了患病工人在食源性疾病暴发中的作用。尽管大多数管理人员报告他们的企业有患病工人政策,但这些政策往往缺少旨在减少食源性疾病风险的组成部分。患病或有传染性的食品工人污染食品是疾病暴发的重要原因;因此,现有政策的内容和执行可能需要重新审查和改进。公共卫生行动:食品零售场所可以通过适当的手部卫生保护食品免受污染,并禁止患病或有传染性的工人工作,从而减少病毒性食源性疾病的爆发。制定和实施防止工人污染食品的政策对于减少食源性疾病暴发非常重要。near数据可以帮助确定食品安全政策和做法方面的差距,特别是与患病工人有关的差距。通过描述企业的特点和食品安全政策和做法与食源性疾病暴发的关系,未来对将特定暴发因子和食品与暴发因素联系起来的分层数据进行分析,可以帮助指导制定有效的预防方法。
{"title":"Foodborne Illness Outbreaks at Retail Food Establishments - National Environmental Assessment Reporting System, 25 State and Local Health Departments, 2017-2019.","authors":"Erin D Moritz,&nbsp;Shideh Delrahim Ebrahim-Zadeh,&nbsp;Beth Wittry,&nbsp;Meghan M Holst,&nbsp;Bresa Daise,&nbsp;Adria Zern,&nbsp;Tonia Taylor,&nbsp;Adam Kramer,&nbsp;Laura G Brown","doi":"10.15585/mmwr.ss7206a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss7206a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Each year, state and local public health departments report hundreds of foodborne illness outbreaks associated with retail food establishments (e.g., restaurants or caterers) to CDC. Typically, investigations involve epidemiology, laboratory, and environmental health components. Health departments voluntarily report epidemiologic and laboratory data from their foodborne illness outbreak investigations to CDC through the National Outbreak Reporting System (NORS); however, minimal environmental health data from outbreak investigations are reported to NORS. This report summarizes environmental health data collected during outbreak investigations and reported to the National Environmental Assessment Reporting System (NEARS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2017-2019.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;In 2014, CDC launched NEARS to complement NORS surveillance and to use these data to enhance prevention efforts. State and local health departments voluntarily enter data from their foodborne illness outbreak investigations of retail food establishments into NEARS. These data include characteristics of foodborne illness outbreaks (e.g., etiologic agent and factors contributing to the outbreak), characteristics of establishments with outbreaks (e.g., number of meals served daily), and food safety policies in these establishments (e.g., ill worker policy requirements). NEARS is the only available data source that collects environmental characteristics of retail establishments with foodborne illness outbreaks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During 2017-2019, a total of 800 foodborne illness outbreaks associated with 875 retail food establishments were reported to NEARS by 25 state and local health departments. Among outbreaks with a confirmed or suspected agent (555 of 800 [69.4%]), the most common pathogens were norovirus and Salmonella, accounting for 47.0% and 18.6% of outbreaks, respectively. Contributing factors were identified in 62.5% of outbreaks. Approximately 40% of outbreaks with identified contributing factors had at least one reported factor associated with food contamination by an ill or infectious food worker. Investigators conducted an interview with an establishment manager in 679 (84.9%) outbreaks. Of the 725 managers interviewed, most (91.7%) said their establishment had a policy requiring food workers to notify their manager when they were ill, and 66.0% also said these policies were written. Only 23.0% said their policy listed all five illness symptoms workers needed to notify managers about (i.e., vomiting, diarrhea, jaundice, sore throat with fever, and lesion with pus). Most (85.5%) said that their establishment had a policy restricting or excluding ill workers from working, and 62.4% said these policies were written. Only 17.8% said their policy listed all five illness symptoms that would require restriction or exclusion from work. Only 16.1% of establishments with outbreaks","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"72 6","pages":"1-11"},"PeriodicalIF":24.9,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9564273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Surveillance for Violent Deaths - National Violent Death Reporting System, 48 States, the District of Columbia, and Puerto Rico, 2020. 暴力死亡监测-全国暴力死亡报告系统,48个州,哥伦比亚特区和波多黎各,2020年。
IF 24.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-05-26 DOI: 10.15585/mmwr.ss7205a1
Grace S Liu, Brenda L Nguyen, Bridget H Lyons, Kameron J Sheats, Rebecca F Wilson, Carter J Betz, Katherine A Fowler
<p><strong>Problem/condition: </strong>In 2020, approximately 71,000 persons died of violence-related injuries in the United States. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths that occurred in 48 states, the District of Columbia, and Puerto Rico in 2020. Results are reported by sex, age group, race and ethnicity, method of injury, type of location where the injury occurred, circumstances of injury, and other selected characteristics.</p><p><strong>Period covered: </strong>2020.</p><p><strong>Description of system: </strong>NVDRS collects data regarding violent deaths obtained from death certificates, coroner and medical examiner records, and law enforcement reports. This report includes data collected for violent deaths that occurred in 2020. Data were collected from 48 states (all states with exception of Florida and Hawaii), the District of Columbia, and Puerto Rico. Forty-six states had statewide data, two additional states had data from counties representing a subset of their population (35 California counties, representing 71% of its population, and four Texas counties, representing 39% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each violent death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident.</p><p><strong>Results: </strong>For 2020, NVDRS collected information on 64,388 fatal incidents involving 66,017 deaths that occurred in 48 states (46 states collecting statewide data, 35 California counties, and four Texas counties), and the District of Columbia. In addition, information was collected for 729 fatal incidents involving 790 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately. Of the 66,017 deaths, the majority (58.4%) were suicides, followed by homicides (31.3%), deaths of undetermined intent (8.2%), legal intervention deaths (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm deaths (<1.0%). The term "legal intervention" is a classification incorporated into the International Classification of Diseases, Tenth Revision, and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.Demographic patterns and circumstances varied by manner of death. The suicide rate was higher for males than for females. Across all age groups, the suicide rate was highest among adults aged ≥85 years. In addition, non-Hispanic American Indian or Alaska Native (AI/AN) persons had the highest suicide rates among all racial and ethnic groups. Among both males and females, the most common method of injury for suicide was a firearm. Among all suicide victims, when circumstances were known, suicide was most often preceded by a mental
问题/状况:2020年,美国约有7.1万人死于与暴力有关的伤害。本报告总结了疾病预防控制中心国家暴力死亡报告系统(NVDRS)关于2020年发生在48个州、哥伦比亚特区和波多黎各的暴力死亡的数据。结果按性别、年龄组、种族和民族、受伤方法、受伤发生的位置类型、受伤情况和其他选定的特征报告。涵盖时间:2020年。系统描述:NVDRS从死亡证明、验尸官和法医记录以及执法报告中收集有关暴力死亡的数据。本报告包括收集的2020年发生的暴力死亡数据。数据收集自48个州(除佛罗里达和夏威夷外的所有州)、哥伦比亚特区和波多黎各。46个州有全州范围的数据,另外两个州有代表其人口子集的县的数据(加利福尼亚州35个县,占其人口的71%,德克萨斯州4个县,占其人口的39%),哥伦比亚特区和波多黎各有管辖范围的数据。NVDRS对每一起暴力死亡事件的信息进行整理,并将相关的死亡事件(例如,多次杀人、杀人后自杀或多次自杀)联系到一起。结果:2020年,NVDRS收集了发生在48个州(46个州收集全州数据,35个加州县和4个德克萨斯州县)和哥伦比亚特区的64,388起致命事件的信息,涉及66,017例死亡。此外,还收集了波多黎各729起致命事件的资料,涉及790人死亡。波多黎各的数据被单独分析。在66,017例死亡中,大多数(58.4%)是自杀,其次是他杀(31.3%)、意图不明的死亡(8.2%)、法律干预死亡(1.3%)(即由执法人员和其他依法有权使用致命武力执行任务的人造成的死亡,不包括合法处决)和非故意枪支死亡(解释:本报告提供了NVDRS关于2020年发生的暴力死亡的详细数据摘要。自杀率在黑人和白人男性中最高,而凶杀率在黑人男性受害者中最高。亲密伴侣暴力导致很大比例的女性被杀。精神健康问题、亲密伴侣问题、人际冲突和急性生活压力是多种类型暴力死亡的主要情况。公共卫生行动:暴力是可以预防的,国家和社区可以利用数据指导公共卫生行动。NVDRS数据用于监测与暴力有关的致命伤害的发生,并协助公共卫生当局制定、实施和评估减少和预防暴力死亡的方案、政策和做法。例如,科罗拉多州暴力死亡报告系统(VDRS)、肯塔基州VDRS和俄勒冈州VDRS已经使用他们的VDRS数据来指导自杀预防工作,并生成报告,强调需要额外关注的地方。在科罗拉多州,VDRS数据被用于检查该州第一和最后响应者自杀风险的增加。肯塔基州VDRS使用当地数据来强调COVID-19大流行的心理和社会影响如何增加自杀风险,特别是在弱势群体中。俄勒冈VDRS利用他们的数据开发了一个公开可用的数据仪表板,显示枪支死亡率的趋势和比率,以支持该州的枪支安全运动。同样,参与NVDRS的州使用他们的VDRS数据来检查他们州的杀人事件。例如,伊利诺斯州的VDRS发现,州预算削减与芝加哥青少年凶杀案显著增加有关。随着参与国家和司法管辖区的增加,本报告标志着在提供具有全国代表性的数据方面取得了进展。
{"title":"Surveillance for Violent Deaths - National Violent Death Reporting System, 48 States, the District of Columbia, and Puerto Rico, 2020.","authors":"Grace S Liu,&nbsp;Brenda L Nguyen,&nbsp;Bridget H Lyons,&nbsp;Kameron J Sheats,&nbsp;Rebecca F Wilson,&nbsp;Carter J Betz,&nbsp;Katherine A Fowler","doi":"10.15585/mmwr.ss7205a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss7205a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;In 2020, approximately 71,000 persons died of violence-related injuries in the United States. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths that occurred in 48 states, the District of Columbia, and Puerto Rico in 2020. Results are reported by sex, age group, race and ethnicity, method of injury, type of location where the injury occurred, circumstances of injury, and other selected characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;NVDRS collects data regarding violent deaths obtained from death certificates, coroner and medical examiner records, and law enforcement reports. This report includes data collected for violent deaths that occurred in 2020. Data were collected from 48 states (all states with exception of Florida and Hawaii), the District of Columbia, and Puerto Rico. Forty-six states had statewide data, two additional states had data from counties representing a subset of their population (35 California counties, representing 71% of its population, and four Texas counties, representing 39% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each violent death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For 2020, NVDRS collected information on 64,388 fatal incidents involving 66,017 deaths that occurred in 48 states (46 states collecting statewide data, 35 California counties, and four Texas counties), and the District of Columbia. In addition, information was collected for 729 fatal incidents involving 790 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately. Of the 66,017 deaths, the majority (58.4%) were suicides, followed by homicides (31.3%), deaths of undetermined intent (8.2%), legal intervention deaths (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm deaths (&lt;1.0%). The term \"legal intervention\" is a classification incorporated into the International Classification of Diseases, Tenth Revision, and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.Demographic patterns and circumstances varied by manner of death. The suicide rate was higher for males than for females. Across all age groups, the suicide rate was highest among adults aged ≥85 years. In addition, non-Hispanic American Indian or Alaska Native (AI/AN) persons had the highest suicide rates among all racial and ethnic groups. Among both males and females, the most common method of injury for suicide was a firearm. Among all suicide victims, when circumstances were known, suicide was most often preceded by a mental","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"72 5","pages":"1-38"},"PeriodicalIF":24.9,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9923219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Epidemiologic Trends of Dengue in U.S. Territories, 2010-2020. 2010-2020年美国登革热流行趋势
IF 24.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-05-19 DOI: 10.15585/mmwr.ss7204a1
Kyle R Ryff, Aidsa Rivera, Dania M Rodriguez, Gilberto A Santiago, Freddy A Medina, Esther M Ellis, Jomil Torres, Ann Pobutsky, Jorge Munoz-Jordan, Gabriela Paz-Bailey, Laura E Adams
<p><strong>Problem/condition: </strong>Dengue is one of the most common vectorborne flaviviral infections globally, with frequent outbreaks in tropical regions. In 2019 and 2020, the Pan American Health Organization reported approximately 5.5 million dengue cases from the Americas, the highest number on record. In the United States, local dengue virus (DENV) transmission has been reported from all U.S. territories, which are characterized by tropical climates that are highly suitable for Aedes species of mosquitoes, the vector that transmits dengue. Dengue is endemic in the U.S. territories of American Samoa, Puerto Rico, and the U.S. Virgin Islands (USVI). Dengue risk in Guam and the Commonwealth of the Northern Mariana Islands is considered sporadic or uncertain. Despite all U.S. territories reporting local dengue transmission, epidemiologic trends over time have not been well described.</p><p><strong>Reporting period: </strong>2010-2020.</p><p><strong>Description of system: </strong>State and territorial health departments report dengue cases to CDC through ArboNET, the national arboviral surveillance system, which was developed in 2000 to monitor West Nile virus infections. Dengue became nationally notifiable in ArboNET in 2010. Dengue cases reported to ArboNET are categorized using the 2015 Council of State and Territorial Epidemiologists case definition. In addition, DENV serotyping is performed at CDC's Dengue Branch Laboratory in a subset of specimens to support identification of circulating DENV serotypes.</p><p><strong>Results: </strong>During 2010-2020, a total of 30,903 dengue cases were reported from four U.S. territories to ArboNET. Puerto Rico reported the highest number of dengue cases (29,862 [96.6%]), followed by American Samoa (660 [2.1%]), USVI (353 [1.1%]), and Guam (28 [0.1%]). However, annual incidence rates were highest in American Samoa with 10.2 cases per 1,000 population in 2017, followed by Puerto Rico with 2.9 in 2010 and USVI with 1.6 in 2013. Approximately one half (50.6%) of cases occurred among persons aged <20 years. The proportion of persons with dengue who were hospitalized was high in three of the four territories: 45.5% in American Samoa, 32.6% in Puerto Rico, and 32.1% in Guam. In Puerto Rico and USVI, approximately 2% of reported cases were categorized as severe dengue. Of all dengue-associated deaths, 68 (0.2%) were reported from Puerto Rico; no deaths were reported from the other territories. During 2010-2020, DENV-1 and DENV-4 were the predominant serotypes in Puerto Rico and USVI.</p><p><strong>Interpretation: </strong>U.S. territories experienced a high prevalence of dengue during 2010-2020, with approximately 30,000 cases reported, and a high incidence during outbreak years. Children and adolescents aged <20 years were disproportionately affected, highlighting the need for interventions tailored for this population. Ongoing education about dengue clinical management for health care providers in U.S. t
问题/状况:登革热是全球最常见的媒介传播的黄病毒感染之一,经常在热带地区暴发。2019年和2020年,泛美卫生组织报告了美洲约550万例登革热病例,这是有记录以来的最高数字。在美国,所有美国领土都报告了当地登革热病毒(DENV)传播,这些领土的特点是热带气候,非常适合传播登革热的媒介伊蚊。登革热是美国属地美属萨摩亚、波多黎各和美属维尔京群岛(USVI)的地方病。关岛和北马里亚纳群岛联邦的登革热风险被认为是零星的或不确定的。尽管所有美国领土都报告了当地登革热传播,但长期以来的流行趋势尚未得到很好的描述。报告期:2010-2020年。系统描述:州和地区卫生部门通过国家虫媒病毒监测系统ArboNET向疾病预防控制中心报告登革热病例,该系统是2000年为监测西尼罗河病毒感染而开发的。登革热于2010年在ArboNET中成为全国必须报告的疾病。报告给ArboNET的登革热病例使用2015年州和地区流行病学家委员会的病例定义进行分类。此外,在疾控中心登革热分科实验室对一部分标本进行登革热病毒血清分型,以支持对流行登革热病毒血清型的识别。结果:2010-2020年期间,美国4个领土共报告了30,903例登革热病例。波多黎各报告的登革热病例数最多(29,862例[96.6%]),其次是美属萨摩亚(660例[2.1%])、美属维尔京群岛(353例[1.1%])和关岛(28例[0.1%])。然而,年发病率最高的是美属萨摩亚,2017年每1000人中有10.2例病例,其次是波多黎各,2010年为2.9例,美属维尔京群岛2013年为1.6例。解释:美国领土在2010-2020年期间经历了登革热的高流行,报告了大约30,000例病例,并且在爆发年份发病率很高。公共卫生行动:免疫做法咨询委员会建议对既往有登革热感染证据并生活在登革热流行地区的9-16岁儿童接种登卡夏疫苗。登革热疫苗的建议为公共卫生专业人员和卫生保健提供者提供了一种新的干预措施,以预防四个地区疾病负担最高的年龄组的疾病和住院(Paz Bailey G, Adams L, Wong JM,等)。登革热疫苗:免疫做法咨询委员会的建议,美国,2021年。MMWR提案Rep 2021;70[No. 7]RR-6])。美属萨摩亚、波多黎各和美属维尔京群岛都被认为是流行地区,居住在这些地区的人有资格接种新的登革热疫苗。在那些有既往登革热感染实验室证据的司法管辖区,9-16岁的人可以接种登革热疫苗,从而降低出现症状性疾病、住院或严重登革热的风险。这些地区的卫生保健提供者应熟悉接种疫苗的资格标准和建议,以减轻有症状疾病最高风险人群的登革热负担。对卫生保健提供者进行关于登革热病例识别和管理的教育,可以改善患者的预后,并改善登革热病例的监测和报告。
{"title":"Epidemiologic Trends of Dengue in U.S. Territories, 2010-2020.","authors":"Kyle R Ryff,&nbsp;Aidsa Rivera,&nbsp;Dania M Rodriguez,&nbsp;Gilberto A Santiago,&nbsp;Freddy A Medina,&nbsp;Esther M Ellis,&nbsp;Jomil Torres,&nbsp;Ann Pobutsky,&nbsp;Jorge Munoz-Jordan,&nbsp;Gabriela Paz-Bailey,&nbsp;Laura E Adams","doi":"10.15585/mmwr.ss7204a1","DOIUrl":"https://doi.org/10.15585/mmwr.ss7204a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Dengue is one of the most common vectorborne flaviviral infections globally, with frequent outbreaks in tropical regions. In 2019 and 2020, the Pan American Health Organization reported approximately 5.5 million dengue cases from the Americas, the highest number on record. In the United States, local dengue virus (DENV) transmission has been reported from all U.S. territories, which are characterized by tropical climates that are highly suitable for Aedes species of mosquitoes, the vector that transmits dengue. Dengue is endemic in the U.S. territories of American Samoa, Puerto Rico, and the U.S. Virgin Islands (USVI). Dengue risk in Guam and the Commonwealth of the Northern Mariana Islands is considered sporadic or uncertain. Despite all U.S. territories reporting local dengue transmission, epidemiologic trends over time have not been well described.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Reporting period: &lt;/strong&gt;2010-2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;State and territorial health departments report dengue cases to CDC through ArboNET, the national arboviral surveillance system, which was developed in 2000 to monitor West Nile virus infections. Dengue became nationally notifiable in ArboNET in 2010. Dengue cases reported to ArboNET are categorized using the 2015 Council of State and Territorial Epidemiologists case definition. In addition, DENV serotyping is performed at CDC's Dengue Branch Laboratory in a subset of specimens to support identification of circulating DENV serotypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During 2010-2020, a total of 30,903 dengue cases were reported from four U.S. territories to ArboNET. Puerto Rico reported the highest number of dengue cases (29,862 [96.6%]), followed by American Samoa (660 [2.1%]), USVI (353 [1.1%]), and Guam (28 [0.1%]). However, annual incidence rates were highest in American Samoa with 10.2 cases per 1,000 population in 2017, followed by Puerto Rico with 2.9 in 2010 and USVI with 1.6 in 2013. Approximately one half (50.6%) of cases occurred among persons aged &lt;20 years. The proportion of persons with dengue who were hospitalized was high in three of the four territories: 45.5% in American Samoa, 32.6% in Puerto Rico, and 32.1% in Guam. In Puerto Rico and USVI, approximately 2% of reported cases were categorized as severe dengue. Of all dengue-associated deaths, 68 (0.2%) were reported from Puerto Rico; no deaths were reported from the other territories. During 2010-2020, DENV-1 and DENV-4 were the predominant serotypes in Puerto Rico and USVI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;U.S. territories experienced a high prevalence of dengue during 2010-2020, with approximately 30,000 cases reported, and a high incidence during outbreak years. Children and adolescents aged &lt;20 years were disproportionately affected, highlighting the need for interventions tailored for this population. Ongoing education about dengue clinical management for health care providers in U.S. t","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"72 4","pages":"1-12"},"PeriodicalIF":24.9,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9520400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Medication for Opioid Use Disorder During Pregnancy - Maternal and Infant Network to Understand Outcomes Associated with Use of Medication for Opioid Use Disorder During Pregnancy (MAT-LINK), 2014-2021. 妊娠期阿片类药物使用紊乱--了解妊娠期阿片类药物使用紊乱相关结果的母婴网络(MAT-LINK),2014-2021 年。
IF 37.3 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-05-05 DOI: 10.15585/mmwr.ss7203a1
Kathryn Miele, Shin Y Kim, Rachelle Jones, Juneka H Rembert, Elisha M Wachman, Hira Shrestha, Michelle L Henninger, Teresa M Kimes, Patrick D Schneider, Vaseekaran Sivaloganathan, Katherine A Sward, Vikrant G Deshmukh, Pilar M Sanjuan, Jessie R Maxwell, Neil S Seligman, Sarah Caveglia, Judette M Louis, Tanner Wright, Carolyne Cody Bennett, Caitlin Green, Nisha George, Lucas Gosdin, Emmy L Tran, Dana Meaney-Delman, Suzanne M Gilboa
<p><strong>Problem: </strong>Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care.</p><p><strong>Period covered: </strong>2014-2021.</p><p><strong>Description of the system: </strong>Established in 2019, the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is a surveillance network of seven clinical sites in the United States. Boston Medical Center, Kaiser Permanente Northwest, The Ohio State University, and the University of Utah were the initial clinical sites in 2019. In 2021, three clinical sites were added to the network (the University of New Mexico, the University of Rochester, and the University of South Florida). Persons receiving care at the seven clinical sites are diverse in terms of geography, urbanicity, race and ethnicity, insurance coverage, and type of MOUD received. The goal of MAT-LINK is to capture demographic and clinical information about persons with OUD during pregnancy to better understand the effect of MOUD on outcomes and, ultimately, provide information for clinical care and public health interventions for this population. MAT-LINK maintains strict confidentiality through robust information technology architecture. MAT-LINK surveillance methods, population characteristics, and evaluation findings are described in this inaugural surveillance report. This report is the first to describe the system, presenting detailed information on funding, structure, data elements, and methods as well as findings from a surveillance evaluation. The findings presented in this report are limited to selected demographic characteristics of pregnant persons overall and by MOUD treatment status. Clinical and outcome data are not included because data collection and cleaning have not been completed; initial analyses of clinical and outcome data will begin in 2023.</p><p><strong>Results: </strong>The MAT-LINK surveillance network gathered data on 5,541 reported pregnancies with a known pregnancy outcome during 2014-2021 among persons with OUD from seven clinical sites. The mean maternal age was 29.7 (SD = ±5.1) years. By race and ethnicity, 86.3% of pregnant persons were identified as White, 25.4% as Hispanic or Latino, and 5.8% as Black or African American. Among pregnant persons, 81.6% had public insurance, and 84.4% lived in urban areas. Compared with persons not receiving MOUD during pregnancy, those receiving MOUD during pregnancy were more likely to be older and White and to have public insurance. The evaluation of the surveillance system found that the initial four clinical sites were not representative of demographics of the South or Southwest regions of the United States and had low representation from certain racial and ethnic groups compared with the ov
问题:建议妊娠期阿片类药物使用障碍(OUD)患者服用治疗阿片类药物使用障碍(MOUD)的药物。然而,关于孕期阿片类药物使用障碍管理的最佳实践还存在知识差距,需要这些数据来指导临床护理:了解孕期阿片类药物使用障碍相关结果的母婴网络(MAT-LINK)成立于 2019 年,是一个由美国 7 个临床站点组成的监测网络。波士顿医疗中心、西北凯撒医疗集团、俄亥俄州立大学和犹他大学是 2019 年的首批临床基地。2021 年,该网络又增加了三个临床站点(新墨西哥大学、罗切斯特大学和南佛罗里达大学)。在这七个临床基地接受治疗的人在地理位置、城市化程度、种族和民族、保险覆盖率以及接受的 MOUD 类型等方面各不相同。MAT-LINK 的目标是收集孕期 OUD 患者的人口统计和临床信息,以便更好地了解 MOUD 对治疗效果的影响,最终为这一人群的临床治疗和公共卫生干预提供信息。MAT-LINK 通过强大的信息技术架构严格保密。MAT-LINK 监测方法、人群特征和评估结果将在这份首次监测报告中进行介绍。本报告是第一份描述该系统的报告,详细介绍了该系统的资金、结构、数据元素和方法,以及监测评估结果。本报告中介绍的结果仅限于孕妇的总体人口统计特征和 MOUD 治疗状况。由于数据收集和清理工作尚未完成,因此不包括临床和结果数据;临床和结果数据的初步分析将于 2023 年开始:MAT-LINK监测网络收集了2014-2021年期间来自7个临床站点的5,541例已知妊娠结果的OUD患者的妊娠报告数据。产妇的平均年龄为 29.7 岁(SD = ±5.1)。按种族和民族划分,86.3% 的孕妇被认定为白人,25.4% 被认定为西班牙裔或拉丁裔,5.8% 被认定为黑人或非裔美国人。在孕妇中,81.6%有公共保险,84.4%居住在城市地区。与怀孕期间未接受钼靶治疗的人相比,怀孕期间接受钼靶治疗的人更有可能是老年人、白人和有公共保险的人。对监测系统的评估发现,最初的四个临床站点不能代表美国南部或西南部地区的人口构成,与美国总人口相比,某些种族和民族群体的代表性较低;然而,2021 年新增的三个临床站点使监测网络更具代表性。自动提取和处理提高了数据收集和分析的速度。MAT-LINK能够增加新的临床站点和变量,这充分体现了MAT-LINK的灵活性:MAT-LINK是首个从多个临床站点收集与妊娠期MOUD相关的围产期结局的孕妇-婴儿二人组综合纵向数据的监测系统。对临床地点数据的分析表明,MOUD 治疗组和非 MOUD 治疗组之间存在不同的社会人口特征:公共卫生行动:MAT-LINK 是一个及时、灵活的监测系统,拥有约 5,500 例妊娠的数据。持续的数据收集和分析将为临床和公共卫生指导提供信息支持,以改善患有 OUD 的孕妇及其子女的健康状况。
{"title":"Medication for Opioid Use Disorder During Pregnancy - Maternal and Infant Network to Understand Outcomes Associated with Use of Medication for Opioid Use Disorder During Pregnancy (MAT-LINK), 2014-2021.","authors":"Kathryn Miele, Shin Y Kim, Rachelle Jones, Juneka H Rembert, Elisha M Wachman, Hira Shrestha, Michelle L Henninger, Teresa M Kimes, Patrick D Schneider, Vaseekaran Sivaloganathan, Katherine A Sward, Vikrant G Deshmukh, Pilar M Sanjuan, Jessie R Maxwell, Neil S Seligman, Sarah Caveglia, Judette M Louis, Tanner Wright, Carolyne Cody Bennett, Caitlin Green, Nisha George, Lucas Gosdin, Emmy L Tran, Dana Meaney-Delman, Suzanne M Gilboa","doi":"10.15585/mmwr.ss7203a1","DOIUrl":"10.15585/mmwr.ss7203a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem: &lt;/strong&gt;Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2014-2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of the system: &lt;/strong&gt;Established in 2019, the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is a surveillance network of seven clinical sites in the United States. Boston Medical Center, Kaiser Permanente Northwest, The Ohio State University, and the University of Utah were the initial clinical sites in 2019. In 2021, three clinical sites were added to the network (the University of New Mexico, the University of Rochester, and the University of South Florida). Persons receiving care at the seven clinical sites are diverse in terms of geography, urbanicity, race and ethnicity, insurance coverage, and type of MOUD received. The goal of MAT-LINK is to capture demographic and clinical information about persons with OUD during pregnancy to better understand the effect of MOUD on outcomes and, ultimately, provide information for clinical care and public health interventions for this population. MAT-LINK maintains strict confidentiality through robust information technology architecture. MAT-LINK surveillance methods, population characteristics, and evaluation findings are described in this inaugural surveillance report. This report is the first to describe the system, presenting detailed information on funding, structure, data elements, and methods as well as findings from a surveillance evaluation. The findings presented in this report are limited to selected demographic characteristics of pregnant persons overall and by MOUD treatment status. Clinical and outcome data are not included because data collection and cleaning have not been completed; initial analyses of clinical and outcome data will begin in 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The MAT-LINK surveillance network gathered data on 5,541 reported pregnancies with a known pregnancy outcome during 2014-2021 among persons with OUD from seven clinical sites. The mean maternal age was 29.7 (SD = ±5.1) years. By race and ethnicity, 86.3% of pregnant persons were identified as White, 25.4% as Hispanic or Latino, and 5.8% as Black or African American. Among pregnant persons, 81.6% had public insurance, and 84.4% lived in urban areas. Compared with persons not receiving MOUD during pregnancy, those receiving MOUD during pregnancy were more likely to be older and White and to have public insurance. The evaluation of the surveillance system found that the initial four clinical sites were not representative of demographics of the South or Southwest regions of the United States and had low representation from certain racial and ethnic groups compared with the ov","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"72 3","pages":"1-14"},"PeriodicalIF":37.3,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10154076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10297375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. 4岁儿童自闭症谱系障碍的早期识别——自闭症与发育障碍监测网络,美国,2020。
IF 24.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-03-24 DOI: 10.15585/mmwr.ss7201a1
Kelly A Shaw, Deborah A Bilder, Dedria McArthur, Ashley Robinson Williams, Esther Amoakohene, Amanda V Bakian, Maureen S Durkin, Robert T Fitzgerald, Sarah M Furnier, Michelle M Hughes, Elise T Pas, Angelica Salinas, Zachary Warren, Susan Williams, Amy Esler, Andrea Grzybowski, Christine M Ladd-Acosta, Mary Patrick, Walter Zahorodny, Katie K Green, Jennifer Hall-Lande, Maya Lopez, Kristen Clancy Mancilla, Ruby H N Nguyen, Karen Pierce, Yvette D Schwenk, Josephine Shenouda, Kate Sidwell, Alison Vehorn, Monica DiRienzo, Johanna Gutierrez, Libby Hallas, Allison Hudson, Margaret H Spivey, Sydney Pettygrove, Anita Washington, Matthew J Maenner
<p><strong>Problem/condition: </strong>Autism spectrum disorder (ASD).</p><p><strong>Period covered: </strong>2020.</p><p><strong>Description of system: </strong>The Autism and Developmental Disabilities Monitoring Network is an active surveillance program that estimates prevalence and characteristics of ASD and monitors timing of ASD identification among children aged 4 and 8 years. In 2020, a total of 11 sites (located in Arizona, Arkansas, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, Tennessee, Utah, and Wisconsin) conducted surveillance of ASD among children aged 4 and 8 years and suspected ASD among children aged 4 years. Surveillance included children who lived in the surveillance area at any time during 2020. Children were classified as having ASD if they ever received 1) an ASD diagnostic statement in an evaluation, 2) a special education classification of autism (eligibility), or 3) an ASD International Classification of Diseases (ICD) code (revisions 9 or 10). Children aged 4 years were classified as having suspected ASD if they did not meet the case definition for ASD but had a documented qualified professional's statement indicating a suspicion of ASD. This report focuses on children aged 4 years in 2020 compared with children aged 8 years in 2020.</p><p><strong>Results: </strong>For 2020, ASD prevalence among children aged 4 years varied across sites, from 12.7 per 1,000 children in Utah to 46.4 in California. The overall prevalence was 21.5 and was higher among boys than girls at every site. Compared with non-Hispanic White children, ASD prevalence was 1.8 times as high among Hispanic, 1.6 times as high among non-Hispanic Black, 1.4 times as high among Asian or Pacific Islander, and 1.2 times as high among multiracial children. Among the 58.3% of children aged 4 years with ASD and information on intellectual ability, 48.5% had an IQ score of ≤70 on their most recent IQ test or an examiner's statement of intellectual disability. Among children with a documented developmental evaluation, 78.0% were evaluated by age 36 months. Children aged 4 years had a higher cumulative incidence of ASD diagnosis or eligibility by age 48 months compared with children aged 8 years at all sites; risk ratios ranged from 1.3 in New Jersey and Utah to 2.0 in Tennessee. In the 6 months before the March 2020 COVID-19 pandemic declaration by the World Health Organization, there were 1,593 more evaluations and 1.89 more ASD identifications per 1,000 children aged 4 years than children aged 8 years received 4 years earlier. After the COVID-19 pandemic declaration, this pattern reversed: in the 6 months after pandemic onset, there were 217 fewer evaluations and 0.26 fewer identifications per 1,000 children aged 4 years than children aged 8 years received 4 years earlier. Patterns of evaluation and identification varied among sites, but there was not recovery to pre-COVID-19 pandemic levels by the end of 2020 at most sites or overall. For 2020
问题/状况:自闭症谱系障碍(ASD)。涵盖时间:2020年。系统描述:自闭症和发育障碍监测网络是一个主动监测项目,用于估计自闭症谱系障碍的患病率和特征,并监测4至8岁儿童自闭症谱系障碍的识别时间。2020年,共有11个地点(位于亚利桑那州、阿肯色州、加利福尼亚州、佐治亚州、马里兰州、明尼苏达州、密苏里州、新泽西州、田纳西州、犹他州和威斯康星州)对4岁和8岁儿童的ASD和4岁儿童的疑似ASD进行了监测。监测对象包括2020年期间任何时间居住在监测区内的儿童。如果儿童曾经收到1)评估中的ASD诊断声明,2)自闭症的特殊教育分类(资格),或3)ASD国际疾病分类(ICD)代码(修订版9或10),则将其归类为患有ASD。如果4岁的儿童不符合ASD的病例定义,但有合格的专业人员的书面声明表明怀疑患有ASD,则将其归类为疑似ASD。本报告重点关注2020年4岁儿童与2020年8岁儿童的对比。结果:2020年,不同地区4岁儿童的ASD患病率各不相同,从犹他州的12.7 / 1000到加利福尼亚州的46.4 / 1000。总体患病率为21.5,各地点男孩的患病率均高于女孩。与非西班牙裔白人儿童相比,西班牙裔儿童的ASD患病率是非西班牙裔白人儿童的1.8倍,非西班牙裔黑人儿童的1.6倍,亚洲或太平洋岛民儿童的1.4倍,多种族儿童的1.2倍。在58.3%的4岁儿童ASD和智力信息中,48.5%的儿童在最近的智商测试或考官智力残疾声明中智商得分≤70分。在有发育评估记录的儿童中,78.0%在36个月前进行了评估。与8岁儿童相比,4岁儿童在48个月时ASD诊断或资格的累积发生率更高;风险比从新泽西州和犹他州的1.3到田纳西州的2.0不等。在世界卫生组织宣布2020年3月COVID-19大流行之前的6个月里,与4年前相比,每1000名4岁儿童中接受评估的人数增加了1593人,每1000名8岁儿童中有1.89人被诊断为ASD。在宣布COVID-19大流行后,这种模式发生了逆转:在大流行发生后的6个月内,与4年前相比,每1000名4岁儿童接受的评估减少了217次,每1000名4岁儿童接受的鉴定减少了0.26次。各站点的评估和识别模式各不相同,但到2020年底,大多数站点或总体上都没有恢复到covid -19大流行前的水平。2020年,每1000名4岁儿童中疑似ASD的患病率从0.5(加利福尼亚州)到10.4(阿肯色州)不等,五个地区(亚利桑那州、阿肯色州、马里兰州、新泽西州和犹他州)的患病率较2018年有所增加。4岁疑似ASD儿童的人口学特征和认知特征与4岁ASD儿童相似。解释:观察到4岁前ASD的大范围患病率,表明社区之间早期ASD识别实践存在差异。2020年,在所有地区,4岁儿童中48月龄ASD的累积发病率高于8岁儿童,这表明ASD的早期识别有所改善。在2020年COVID-19大流行爆发之前,4岁儿童的评估次数和诊断率明显较高。在大流行爆发后,大多数地点的ASD评估和识别水平持续较低,这可能表明,到2020年底,卫生服务提供者和学校的评估和识别的典型做法将中断。恢复程度较高的站点可能表明减少服务中断的成功战略,例如转向远程保健方法进行评估。公共卫生行动:从2016年到2020年2月,4岁儿童队列中的ASD评估和识别超过了4年前(从2012年到2016年3月)的8岁儿童队列中的ASD评估和识别。从2016年到2020年3月,4岁儿童的ASD评估和识别在2020年超过了2012年至2016年3月的8岁儿童。与2019冠状病毒病大流行开始同时发生的评估中断以及2020年疑似ASD患病率的增加可能导致ASD识别和干预措施的延误。 随着受影响群体中的儿童年龄的增长,社区可以评估这些中断的影响,并考虑减轻未来突发公共卫生事件造成的服务中断的战略。
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引用次数: 11
Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. 自闭症谱系障碍在 8 岁儿童中的患病率和特征 - 自闭症和发育障碍监测网络,11 个站点,美国,2020 年。
IF 24.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-03-24 DOI: 10.15585/mmwr.ss7202a1
Matthew J Maenner, Zachary Warren, Ashley Robinson Williams, Esther Amoakohene, Amanda V Bakian, Deborah A Bilder, Maureen S Durkin, Robert T Fitzgerald, Sarah M Furnier, Michelle M Hughes, Christine M Ladd-Acosta, Dedria McArthur, Elise T Pas, Angelica Salinas, Alison Vehorn, Susan Williams, Amy Esler, Andrea Grzybowski, Jennifer Hall-Lande, Ruby H N Nguyen, Karen Pierce, Walter Zahorodny, Allison Hudson, Libby Hallas, Kristen Clancy Mancilla, Mary Patrick, Josephine Shenouda, Kate Sidwell, Monica DiRienzo, Johanna Gutierrez, Margaret H Spivey, Maya Lopez, Sydney Pettygrove, Yvette D Schwenk, Anita Washington, Kelly A Shaw
<p><strong>Problem/condition: </strong>Autism spectrum disorder (ASD).</p><p><strong>Period covered: </strong>2020.</p><p><strong>Description of system: </strong>The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance program that provides estimates of the prevalence of ASD among children aged 8 years. In 2020, there were 11 ADDM Network sites across the United States (Arizona, Arkansas, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, Tennessee, Utah, and Wisconsin). To ascertain ASD among children aged 8 years, ADDM Network staff review and abstract developmental evaluations and records from community medical and educational service providers. A child met the case definition if their record documented 1) an ASD diagnostic statement in an evaluation, 2) a classification of ASD in special education, or 3) an ASD International Classification of Diseases (ICD) code.</p><p><strong>Results: </strong>For 2020, across all 11 ADDM sites, ASD prevalence per 1,000 children aged 8 years ranged from 23.1 in Maryland to 44.9 in California. The overall ASD prevalence was 27.6 per 1,000 (one in 36) children aged 8 years and was 3.8 times as prevalent among boys as among girls (43.0 versus 11.4). Overall, ASD prevalence was lower among non-Hispanic White children (24.3) and children of two or more races (22.9) than among non-Hispanic Black or African American (Black), Hispanic, and non-Hispanic Asian or Pacific Islander (A/PI) children (29.3, 31.6, and 33.4 respectively). ASD prevalence among non-Hispanic American Indian or Alaska Native (AI/AN) children (26.5) was similar to that of other racial and ethnic groups. ASD prevalence was associated with lower household income at three sites, with no association at the other sites.Across sites, the ASD prevalence per 1,000 children aged 8 years based exclusively on documented ASD diagnostic statements was 20.6 (range = 17.1 in Wisconsin to 35.4 in California). Of the 6,245 children who met the ASD case definition, 74.7% had a documented diagnostic statement of ASD, 65.2% had a documented ASD special education classification, 71.6% had a documented ASD ICD code, and 37.4% had all three types of ASD indicators. The median age of earliest known ASD diagnosis was 49 months and ranged from 36 months in California to 59 months in Minnesota.Among the 4,165 (66.7%) children with ASD with information on cognitive ability, 37.9% were classified as having an intellectual disability. Intellectual disability was present among 50.8% of Black, 41.5% of A/PI, 37.8% of two or more races, 34.9% of Hispanic, 34.8% of AI/AN, and 31.8% of White children with ASD. Overall, children with intellectual disability had earlier median ages of ASD diagnosis (43 months) than those without intellectual disability (53 months).</p><p><strong>Interpretation: </strong>For 2020, one in 36 children aged 8 years (approximately 4% of boys and 1% of girls) was estimated to have ASD. These estimates are
问题/条件:自闭症谱系障碍(ASD):自闭症谱系障碍 (ASD).覆盖时期:2020 年.系统描述:自闭症和发育障碍监测(ADDM)网络是一项积极的监测计划,提供8岁儿童中自闭症谱系障碍患病率的估计值。2020 年,全美共有 11 个 ADDM 网络站点(亚利桑那州、阿肯色州、加利福尼亚州、佐治亚州、马里兰州、明尼苏达州、密苏里州、新泽西州、田纳西州、犹他州和威斯康星州)。为了确定 8 岁儿童是否患有 ASD,ADDM 网络的工作人员从社区医疗和教育服务提供者处审查和摘录发育评估和记录。如果儿童的记录中包含:1)评估中的 ASD 诊断声明;2)特殊教育中的 ASD 分类;或 3)ASD 国际疾病分类 (ICD) 代码,则该儿童符合病例定义:2020 年,在所有 11 个 ADDM 站点中,每千名 8 岁儿童的 ASD 患病率从马里兰州的 23.1 到加利福尼亚州的 44.9 不等。每 1000 名 8 岁儿童中 ASD 的总体患病率为 27.6(每 36 人中有 1 人),男孩的患病率是女孩的 3.8 倍(43.0 对 11.4)。总体而言,非西班牙裔白人儿童(24.3)和两个或两个以上种族儿童(22.9)的 ASD 患病率低于非西班牙裔黑人或非裔美国人(黑人)、西班牙裔和非西班牙裔亚裔或太平洋岛民(A/PI)儿童(分别为 29.3、31.6 和 33.4)。非西班牙裔美国印第安人或阿拉斯加原住民(AI/AN)儿童的 ASD 患病率(26.5)与其他种族和族裔群体的患病率相似。在三个研究地点,ASD发病率与较低的家庭收入有关,而在其他研究地点则没有关联。在所有研究地点,每千名8岁儿童中完全基于有据可查的ASD诊断陈述的ASD发病率为20.6(范围=威斯康星州的17.1至加利福尼亚州的35.4)。在符合 ASD 病例定义的 6,245 名儿童中,74.7% 有 ASD 诊断陈述记录,65.2% 有 ASD 特殊教育分类记录,71.6% 有 ASD ICD 编码记录,37.4% 有所有三种 ASD 指标。最早确诊 ASD 的年龄中位数为 49 个月,从加利福尼亚州的 36 个月到明尼苏达州的 59 个月不等。在 4,165 名(66.7%)有认知能力信息的 ASD 儿童中,37.9% 被归类为智力残疾。在患有 ASD 的儿童中,50.8% 的黑人儿童、41.5% 的 A/PI 儿童、37.8% 的两个或两个以上种族儿童、34.9% 的西班牙裔儿童、34.8% 的美国原住民/印第安人儿童和 31.8% 的白人儿童患有智力障碍。总体而言,智障儿童确诊 ASD 的中位年龄(43 个月)早于非智障儿童(53 个月):据估计,2020 年每 36 名 8 岁儿童中就有一名(约占男孩的 4%,女孩的 1%)患有 ASD。这些估计值高于 2000-2018 年期间 ADDM 网络的先前估计值。在 8 岁儿童中,白人儿童的 ASD 患病率首次低于其他种族和族裔群体,扭转了过去观察到的 ASD 患病率种族和族裔差异的方向。患有自闭症的黑人儿童仍比患有自闭症的白人儿童更有可能同时患有智力残疾:被确认患有 ASD 的儿童人数持续增加,尤其是非白人儿童和女童,这突出表明需要加强基础设施建设,为所有患有 ASD 的儿童提供公平的诊断、治疗和支持服务。与之前的报告期类似,各网络站点的研究结果差异很大,这表明有必要开展更多研究,以了解这些差异的性质,并有可能在各州应用成功的识别策略。
{"title":"Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.","authors":"Matthew J Maenner, Zachary Warren, Ashley Robinson Williams, Esther Amoakohene, Amanda V Bakian, Deborah A Bilder, Maureen S Durkin, Robert T Fitzgerald, Sarah M Furnier, Michelle M Hughes, Christine M Ladd-Acosta, Dedria McArthur, Elise T Pas, Angelica Salinas, Alison Vehorn, Susan Williams, Amy Esler, Andrea Grzybowski, Jennifer Hall-Lande, Ruby H N Nguyen, Karen Pierce, Walter Zahorodny, Allison Hudson, Libby Hallas, Kristen Clancy Mancilla, Mary Patrick, Josephine Shenouda, Kate Sidwell, Monica DiRienzo, Johanna Gutierrez, Margaret H Spivey, Maya Lopez, Sydney Pettygrove, Yvette D Schwenk, Anita Washington, Kelly A Shaw","doi":"10.15585/mmwr.ss7202a1","DOIUrl":"10.15585/mmwr.ss7202a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;Autism spectrum disorder (ASD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance program that provides estimates of the prevalence of ASD among children aged 8 years. In 2020, there were 11 ADDM Network sites across the United States (Arizona, Arkansas, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, Tennessee, Utah, and Wisconsin). To ascertain ASD among children aged 8 years, ADDM Network staff review and abstract developmental evaluations and records from community medical and educational service providers. A child met the case definition if their record documented 1) an ASD diagnostic statement in an evaluation, 2) a classification of ASD in special education, or 3) an ASD International Classification of Diseases (ICD) code.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For 2020, across all 11 ADDM sites, ASD prevalence per 1,000 children aged 8 years ranged from 23.1 in Maryland to 44.9 in California. The overall ASD prevalence was 27.6 per 1,000 (one in 36) children aged 8 years and was 3.8 times as prevalent among boys as among girls (43.0 versus 11.4). Overall, ASD prevalence was lower among non-Hispanic White children (24.3) and children of two or more races (22.9) than among non-Hispanic Black or African American (Black), Hispanic, and non-Hispanic Asian or Pacific Islander (A/PI) children (29.3, 31.6, and 33.4 respectively). ASD prevalence among non-Hispanic American Indian or Alaska Native (AI/AN) children (26.5) was similar to that of other racial and ethnic groups. ASD prevalence was associated with lower household income at three sites, with no association at the other sites.Across sites, the ASD prevalence per 1,000 children aged 8 years based exclusively on documented ASD diagnostic statements was 20.6 (range = 17.1 in Wisconsin to 35.4 in California). Of the 6,245 children who met the ASD case definition, 74.7% had a documented diagnostic statement of ASD, 65.2% had a documented ASD special education classification, 71.6% had a documented ASD ICD code, and 37.4% had all three types of ASD indicators. The median age of earliest known ASD diagnosis was 49 months and ranged from 36 months in California to 59 months in Minnesota.Among the 4,165 (66.7%) children with ASD with information on cognitive ability, 37.9% were classified as having an intellectual disability. Intellectual disability was present among 50.8% of Black, 41.5% of A/PI, 37.8% of two or more races, 34.9% of Hispanic, 34.8% of AI/AN, and 31.8% of White children with ASD. Overall, children with intellectual disability had earlier median ages of ASD diagnosis (43 months) than those without intellectual disability (53 months).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;For 2020, one in 36 children aged 8 years (approximately 4% of boys and 1% of girls) was estimated to have ASD. These estimates are ","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"72 2","pages":"1-14"},"PeriodicalIF":24.9,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9265448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abortion Surveillance - United States, 2020. 堕胎监控 - 美国,2020 年。
IF 37.3 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-11-25 DOI: 10.15585/mmwr.ss7110a1
Katherine Kortsmit, Antoinette T Nguyen, Michele G Mandel, Elizabeth Clark, Lisa M Hollier, Jessica Rodenhizer, Maura K Whiteman
<p><strong>Problem/condition: </strong>CDC conducts abortion surveillance to document the number and characteristics of women obtaining legal induced abortions and number of abortion-related deaths in the United States.</p><p><strong>Period covered: </strong>2020.</p><p><strong>Description of system: </strong>Each year, CDC requests abortion data from the central health agencies for the 50 states, the District of Columbia, and New York City. For 2020, a total of 49 reporting areas voluntarily provided aggregate abortion data to CDC. Of these, 48 reporting areas provided data each year during 2011-2020. Census and natality data were used to calculate abortion rates (number of abortions per 1,000 women aged 15-44 years) and ratios (number of abortions per 1,000 live births), respectively. Abortion-related deaths from 2019 were assessed as part of CDC's Pregnancy Mortality Surveillance System (PMSS).</p><p><strong>Results: </strong>A total of 620,327 abortions for 2020 were reported to CDC from 49 reporting areas. Among 48 reporting areas with data each year during 2011-2020, in 2020, a total of 615,911 abortions were reported, the abortion rate was 11.2 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 198 abortions per 1,000 live births. From 2019 to 2020, the total number of abortions decreased 2% (from 625,346 total abortions), the abortion rate decreased 2% (from 11.4 abortions per 1,000 women aged 15-44 years), and the abortion ratio increased 2% (from 195 abortions per 1,000 live births). From 2011 to 2020, the total number of reported abortions decreased 15% (from 727,554), the abortion rate decreased 18% (from 13.7 abortions per 1,000 women aged 15-44 years), and the abortion ratio decreased 9% (from 217 abortions per 1,000 live births).In 2020, women in their 20s accounted for more than half of abortions (57.2%). Women aged 20-24 and 25-29 years accounted for the highest percentages of abortions (27.9% and 29.3%, respectively) and had the highest abortion rates (19.2 and 19.0 abortions per 1,000 women aged 20-24 and 25-29 years, respectively). By contrast, adolescents aged <15 years and women aged ≥40 years accounted for the lowest percentages of abortions (0.2% and 3.7%, respectively) and had the lowest abortion rates (0.4 and 2.6 abortions per 1,000 women aged <15 and ≥40 years, respectively). However, abortion ratios were highest among adolescents (aged ≤19 years) and lowest among women aged 25-39 years.Abortion rates decreased from 2011 to 2020 among all age groups. The decrease in abortion rate was highest among adolescents compared with any other age group. From 2019 to 2020, abortion rates decreased or did not change for all age groups. Abortion ratios decreased from 2011 to 2020 for all age groups, except adolescents aged 15-19 years and women aged 25-29 years for whom abortion ratios increased. The decrease in abortion ratio was highest among women aged ≥40 years compared with any other age group. From 2019 to
问题/条件:疾病预防控制中心对人工流产进行监测,以记录美国合法人工流产妇女的数量和特征,以及与人工流产相关的死亡人数:每年,疾病预防控制中心都会要求 50 个州、哥伦比亚特区和纽约市的中央卫生机构提供堕胎数据。就 2020 年而言,共有 49 个报告地区自愿向疾病预防控制中心提供堕胎综合数据。其中,48 个报告地区在 2011-2020 年期间每年都提供了数据。人口普查和出生率数据分别用于计算堕胎率(每千名 15-44 岁女性的堕胎数)和比率(每千名活产婴儿的堕胎数)。作为疾病预防控制中心妊娠死亡监测系统(PMSS)的一部分,对2019年与人工流产相关的死亡进行了评估:49 个报告地区共向疾病预防控制中心报告了 620,327 例 2020 年人工流产。在 2011-2020 年期间每年都有数据的 48 个报告地区中,2020 年共报告了 615,911 例人工流产,人工流产率为每 1,000 名 15-44 岁女性中有 11.2 例人工流产,人工流产率为每 1,000 例活产中有 198 例人工流产。从 2019 年到 2020 年,堕胎总数减少了 2%(堕胎总数为 625 346 例),堕胎率下降了 2%(每千名 15-44 岁女性的堕胎率为 11.4 例),堕胎率上升了 2%(每千名活产婴儿的堕胎率为 195 例)。从 2011 年到 2020 年,报告的堕胎总数下降了 15%(从 727 554 例下降到 727 554 例),堕胎率下降了 18%(从每千名 15-44 岁妇女 13.7 例堕胎下降到每千名 15-44 岁妇女 13.7 例堕胎),堕胎率下降了 9%(从每千名活产婴儿 217 例堕胎下降到每千名活产婴儿 217 例堕胎)。20-24 岁和 25-29 岁妇女的堕胎比例最高(分别为 27.9% 和 29.3%),堕胎率也最高(每千名 20-24 岁和 25-29 岁妇女的堕胎率分别为 19.2 和 19.0)。相比之下,妊娠 13 周的青少年堕胎率始终较低(≤9.2%)。2020 年,妊娠≤9 周的早期药物流产所占比例最高(51.0%),其次是妊娠≤13 周的手术流产(40.0%)、妊娠>13 周的手术流产(6.7%)和妊娠>9 周的药物流产(2.4%);所有其他方法都不常见(解释:在 48 个连续报告数据的地区中,妊娠≤9 周的早期药物流产所占比例最高(51.0%),其次是妊娠≤13 周的手术流产(40.0%)、妊娠>13 周的手术流产(6.7%)和妊娠>9 周的药物流产(2.4%):在 2011-2020 年间连续报告数据的 48 个地区中,2011-2020 年间报告的堕胎总数、比率和比例总体下降。从 2019 年到 2020 年,报告的堕胎总数和堕胎率也有所下降;但堕胎总比率却上升了 2%:流产监测可用于帮助评估旨在促进美国公平获得以患者为中心的优质避孕服务的计划,以减少意外怀孕。
{"title":"Abortion Surveillance - United States, 2020.","authors":"Katherine Kortsmit, Antoinette T Nguyen, Michele G Mandel, Elizabeth Clark, Lisa M Hollier, Jessica Rodenhizer, Maura K Whiteman","doi":"10.15585/mmwr.ss7110a1","DOIUrl":"10.15585/mmwr.ss7110a1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Problem/condition: &lt;/strong&gt;CDC conducts abortion surveillance to document the number and characteristics of women obtaining legal induced abortions and number of abortion-related deaths in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Period covered: &lt;/strong&gt;2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Description of system: &lt;/strong&gt;Each year, CDC requests abortion data from the central health agencies for the 50 states, the District of Columbia, and New York City. For 2020, a total of 49 reporting areas voluntarily provided aggregate abortion data to CDC. Of these, 48 reporting areas provided data each year during 2011-2020. Census and natality data were used to calculate abortion rates (number of abortions per 1,000 women aged 15-44 years) and ratios (number of abortions per 1,000 live births), respectively. Abortion-related deaths from 2019 were assessed as part of CDC's Pregnancy Mortality Surveillance System (PMSS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 620,327 abortions for 2020 were reported to CDC from 49 reporting areas. Among 48 reporting areas with data each year during 2011-2020, in 2020, a total of 615,911 abortions were reported, the abortion rate was 11.2 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 198 abortions per 1,000 live births. From 2019 to 2020, the total number of abortions decreased 2% (from 625,346 total abortions), the abortion rate decreased 2% (from 11.4 abortions per 1,000 women aged 15-44 years), and the abortion ratio increased 2% (from 195 abortions per 1,000 live births). From 2011 to 2020, the total number of reported abortions decreased 15% (from 727,554), the abortion rate decreased 18% (from 13.7 abortions per 1,000 women aged 15-44 years), and the abortion ratio decreased 9% (from 217 abortions per 1,000 live births).In 2020, women in their 20s accounted for more than half of abortions (57.2%). Women aged 20-24 and 25-29 years accounted for the highest percentages of abortions (27.9% and 29.3%, respectively) and had the highest abortion rates (19.2 and 19.0 abortions per 1,000 women aged 20-24 and 25-29 years, respectively). By contrast, adolescents aged &lt;15 years and women aged ≥40 years accounted for the lowest percentages of abortions (0.2% and 3.7%, respectively) and had the lowest abortion rates (0.4 and 2.6 abortions per 1,000 women aged &lt;15 and ≥40 years, respectively). However, abortion ratios were highest among adolescents (aged ≤19 years) and lowest among women aged 25-39 years.Abortion rates decreased from 2011 to 2020 among all age groups. The decrease in abortion rate was highest among adolescents compared with any other age group. From 2019 to 2020, abortion rates decreased or did not change for all age groups. Abortion ratios decreased from 2011 to 2020 for all age groups, except adolescents aged 15-19 years and women aged 25-29 years for whom abortion ratios increased. The decrease in abortion ratio was highest among women aged ≥40 years compared with any other age group. From 2019 to","PeriodicalId":48549,"journal":{"name":"Mmwr Surveillance Summaries","volume":"71 10","pages":"1-27"},"PeriodicalIF":37.3,"publicationDate":"2022-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9707346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10465302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surveillance for Sickle Cell Disease - Sickle Cell Data Collection Program, Two States, 2004-2018. 镰状细胞病监测-镰状细胞数据收集计划,两个州,2004-2018。
IF 24.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-10-07 DOI: 10.15585/mmwr.ss7109a1
Angela B Snyder, Sangeetha Lakshmanan, Mary M Hulihan, Susan T Paulukonis, Mei Zhou, Sophia S Horiuchi, Karon Abe, Shammara N Pope, Laura A Schieve
<p><strong>Problem/condition: </strong>Sickle cell disease (SCD), an inherited blood disorder affecting an estimated 100,000 persons in the United States, is associated with multiple complications and reduced life expectancy. Complications of SCD can include anemia, debilitating acute and chronic pain, infection, acute chest syndrome, stroke, and progressive organ damage, including decreased cognitive function and renal failure. Early diagnosis, screenings and preventive interventions, and access to specialist health care can decrease illness and death. Population-based public health surveillance is critical to understanding the course and outcomes of SCD as well as the health care use, unmet health care needs, and gaps in essential services of the population affected by SCD.</p><p><strong>Period covered: </strong>2004-2018.</p><p><strong>Description of the program: </strong>In 2015, CDC established the Sickle Cell Data Collection (SCDC) program to characterize the epidemiology of SCD in two states (California and Georgia). Previously, surveillance for SCD was conducted by two short-term projects: Registry and Surveillance System for Hemoglobinopathies (RuSH), which was conducted during 2010-2012 and included 2004-2008 data, and Public Health Research, Epidemiology, and Surveillance for Hemoglobinopathies (PHRESH), which was conducted during 2012-2014 and included 2004-2008 data. Both California and Georgia participated in RuSH and PHRESH, which guided the development of the SCDC methods and case definitions. SCDC is a population-based tracking system that uses comprehensive data linkages in state health systems. These linkages serve to synthesize and disseminate population-based, longitudinal data for persons identified with SCD from multiple sources using selected International Classification of Diseases, Ninth Revision, Clinical Modification, and Tenth Revision codes and laboratory results confirmed through state newborn screening (NBS) programs or clinic case reporting. Administrative and clinical data sources include state Medicaid and Children's Health Insurance Program databases, death certificates, NBS programs, hospital discharge and emergency department records, and clinical records or case reports. Data from multiple sources and years are linked and deduplicated so that states can analyze and report on SCD population prevalence, demographic characteristics, health care access and use, and health outcomes. The SCD case definition is based on an algorithm that classifies cases with laboratory confirmation as confirmed cases and those with a reported clinical diagnosis or three or more diagnostic codes over a 5-year period from an administrative data source as probable cases. In 2019, nine states (Alabama, California, Georgia, Indiana, Michigan, Minnesota, North Carolina, Tennessee, and Virginia) were funded as part of an SCDC capacity-building initiative. The newly funded states developed strategies for SCD case identification and data l
问题/状况:镰状细胞病(SCD)是一种遗传性血液病,在美国约有10万人患病,与多种并发症和预期寿命缩短有关。SCD的并发症可能包括贫血、使人衰弱的急性和慢性疼痛、感染、急性胸部综合征、中风和进行性器官损伤,包括认知功能下降和肾衰竭。早期诊断、筛查和预防性干预以及获得专业医疗保健可以减少疾病和死亡。基于人口的公共卫生监测对于了解SCD的过程和结果,以及受SCD影响的人群的医疗保健使用、未满足的医疗保健需求和基本服务差距至关重要。涵盖时间:2004-2018。项目描述:2015年,美国疾病控制与预防中心建立了镰状细胞数据收集(SCDC)计划,以表征两个州(加利福尼亚州和佐治亚州)的镰状细胞病流行病学。此前,SCD的监测由两个短期项目进行:血红蛋白病登记和监测系统(RuSH),于2010-2012年进行,包括2004-2008年的数据;公共卫生研究、流行病学和血红蛋白病监测(PHRESH),于2012-2014年进行,包括2004-2008年数据。加利福尼亚州和乔治亚州都参与了RuSH和PHRESH,指导了SCDC方法和案例定义的发展。SCDC是一个基于人口的跟踪系统,在州卫生系统中使用全面的数据链接。这些联系有助于综合和传播来自多个来源的SCD患者的基于人群的纵向数据,这些数据使用选定的国际疾病分类、第九次修订、临床修改和第十次修订代码以及通过国家新生儿筛查(NBS)计划或临床病例报告确认的实验室结果。行政和临床数据来源包括州医疗补助和儿童健康保险计划数据库、死亡证明、NBS计划、出院和急诊科记录以及临床记录或病例报告。将来自多个来源和年份的数据联系起来并消除重复,以便各州能够分析和报告SCD人口流行率、人口统计特征、医疗保健的获得和使用以及健康结果。SCD病例定义基于一种算法,该算法将实验室确认的病例分类为确诊病例,并将行政数据源在5年内报告的临床诊断或三个或三个以上诊断代码的病例归类为可能病例。2019年,作为SCDC能力建设倡议的一部分,九个州(阿拉巴马州、加利福尼亚州、佐治亚州、印第安纳州、密歇根州、明尼苏达州、北卡罗来纳州、田纳西州和弗吉尼亚州)获得了资助。新资助的州制定了类似于加利福尼亚州和佐治亚州的SCD病例识别和数据链接策略。截至2021年,SCDC计划已扩展到11个州,增加了科罗拉多州和威斯康星州。结果:2004-2018年,加利福尼亚州和佐治亚州确诊和疑似SCD病例的累计流行率分别为9875例和14777例。2018年加利福尼亚州的年度流行率为6027例,佐治亚州为9141例。2014-2018年期间,通过贡献数据源对流行率计数的检查显示,每个数据源在加利福尼亚州捕获了16%-71%的病例,在佐治亚州捕获了17%-87%的病例;因此,没有任何单独的来源足以估计全州的人口流行率。儿科SCD患者(0-18岁儿童)的比例在加利福尼亚州为27%,在佐治亚州为40%。加利福尼亚州和乔治亚州女性SCD患者的比例分别为58%和57%。在有SCD基因分型数据的病例中(n=5856),63%的患者患有镰状细胞性贫血。SCDC数据已被用于直接向医疗保健提供者和政策制定者通报SCD患者的医疗保健需求和差距。例如,佐治亚州SCDC的一项评估表明,在2004-2016年期间出生的SCD婴儿中,10%的婴儿居住在距离任何SCD专科护理选择超过1小时车程的地方,另有14%的婴儿居住的地方距离定期SCD专科诊所不到1小时车程。同样,SCDC加利福尼亚州的一项评估表明,在2016-2018年期间,洛杉矶县的大多数SCD患者居住在距离有SCD护理经验的血液学家约15-60英里的地方。2020-2021年期间,对所有11个SCDC州的监测能力和性能评估表明,各州在用于SCD监测的数据源的可用性和访问每个州数据源的时间框架方面存在差异。尽管如此,所有参与国都制定了报告标准化的方法。 解读:本报告首次全面描述了美国疾病控制与预防中心与参与州合作,通过SCDC计划建立、维持和扩大SCD监测,以改善SCD患者的健康状况。来自加利福尼亚州和乔治亚州的分析结果强调了增加SCD专科诊所的必要性。尽管采用了不同的方法,但使用所有参与州制定的标准化、严格的方法,报告疾病流行率、医疗保健需求和使用情况以及死亡情况,将SCDC扩展到多个州是可能的。公共卫生行动:监测结果可用于改善和监测SCD患者的护理和结果。这些和其他SCDC分析在开设新的SCD诊所、教育医疗保健提供者、制定州医疗保健政策和指导新的研究举措方面发挥了作用。公共卫生官员可以将这份报告作为指导框架,为SCD患者规划或实施监测计划。与数据相关的活动(数据源;患者标识符;以及获取、传输和链接数据)和行政考虑因素(利益相关者参与、成本和资源以及长期可持续性)对这些计划的成功至关重要。
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引用次数: 4
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Mmwr Surveillance Summaries
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