Illinois Public Health Institute

Abstract Background: Despite the availability of an effective vaccine, measles remains a major public health problem in Ethiopia, with recurrent outbreaks reported in several areas in Amhara Regional State. Understanding measles vaccination coverage and real-world protective effectiveness is critical for assessing immunization program performance and guiding elimination strategies. Therefore, this study was conducted to determine the regional measles vaccine coverage and the vaccine protective effectiveness level in the region. Methods: A retrospective test-negative case-control analysis of measles surveillance data and retrospective analysis of district health information system 2 (DHIS2) data from 2019-2024 was employed to determine vaccine effectiveness and vaccine coverage respectively. Measles vaccine coverage was determined by dividing the number of children vaccinated as numerator to the expected number of children legible for vaccination as denominator. Measles vaccine effectiveness level was determined using field evaluation approaches of vaccine effectiveness. The adjusted vaccine effectiveness was calculated using the multivariable logistic regression after adjustment of potential confounders, including age, sex, residence, and outbreak year. Results: Measles vaccination coverage for both vaccine doses showed variation across geographic locations, time periods with clear seasonal and monthly differences. A total of 3417 participants comprising 2528 cases and 889 controls were enrolled in the analysis of measles vaccine effectiveness. A cumulative vaccine effectiveness estimates was 67% in the region with a clear variation across different years. The subgroup analysis showed comparable level of measles vaccine effectiveness (66.6% vs 66.9%) between males and females. The higher level of measles vaccine effectiveness estimates, 76.2%, among children aged 9 months-2 years while lower vaccine effectiveness estimates, 41.1%, was demonstrated among individuals aged ≥15 years. Conclusion: It was identified a high and increasing administrative measles vaccine coverage with geographical disparities. The estimated overall vaccine effectiveness level was low far apart from the expected level of protection against the vaccine coverage. Two vaccine doses administered individuals had a higher protection level than a single dose received individuals. There was a better vaccine protection level during the recent periods of vaccination compared to earlier periods. Therefore, it is important to increase the access of vaccines to the most unreachable areas maintaining vaccine integrity during delivery. Vaccine coverage should be monitored based on the head count of legible children in each district in the region. It is also important to strengthen the routine measles vaccination practices in any situations and booster dose should also be administered for those older age children.

The goal of this study is to explore the association between racial/ethnic, sex, and age category concordance and participant retention and weight loss among participants enrolled in the National Diabetes Prevention Program lifestyle change program (National DPP LCP). This analysis was conducted using a sample of 653 participants who were enrolled in a 12-month National DPP LCP at one of 17 Chicago community-based organizations between June 2019 and July 2023. Using multilevel logistic regression modeling, we examined the association between participant lifestyle-coach racial/ethnic, sex, and age category concordance and retention, as well as weight loss. All models controlled for coach education, coach training, program-engagement level, as well as participant education, sex, age, and race/ethnicity if not already accounted for in the concordance variable. In adjusted models, we observed a statistically significant relationship between race/ethnic concordance and increased odds of retention. There was no significant relationship between demographic concordance and weight change > = 3%. Our findings suggest that there is increased odds of retention among racially concordant pairs. We did not observe a significant relationship between gender and age concordant pairs and retention nor race, gender, and age concordant pairs and weight loss. Our findings suggest that National DPP LCP programs could consider racial concordance in their program design and implementation as a factor to boost participant retention.

To compare 30-day postoperative complications for patients with advanced ovarian cancer who underwent resection to no gross residual disease versus optimal and suboptimal cytoreduction. A retrospective cohort study of women drawn from the National Surgical Quality Improvement Program who underwent cytoreductive surgery for advanced ovarian cancer between 2014 and 2019 was performed. Exposure of interest was extent of surgical resection defined as no gross residual disease; residual disease <1 cm (optimal); and residual disease >1 cm (suboptimal). Primary outcome was postoperative complication. Associations were examined with bivariable tests and multivariable logistic regression. A total of 2248 women underwent cytoreductive surgery; 68.4% (n = 1538) underwent resection to no gross residual disease, 22.4% (n = 504) had an optimal, and 9.2% (n = 206) had a suboptimal cytoreduction. Optimal cytoreduction patients had the highest rates of any postoperative complication (35.5%, p < 0.001). They also had the longest operative times and procedures that were most surgically complex (203 min, 43.6 relative value units, both p < 0.05). However, patients who underwent optimal cytoreduction did not have increased odds of major complications (adjusted odds ratio: 1.20, 95% confidence interval: 0.91-1.58). Patients who underwent optimal cytoreduction had more postoperative complications, required the most operating room time, and represented more complex surgeries compared with suboptimal cytoreduction or resection to no gross residual disease.

Women account for 25% of all people living with HIV and 19% of new diagnoses in the United States. African American (AA) women are disproportionately affected. Yet, differences in the care continuum entry are not well understood between patient populations and healthcare sites. We aim to examine gender differences in diagnosis and linkage to care (LTC) in the Expanded HIV Testing and Linkage to Care (X-TLC) program within healthcare settings. Data were collected from 14 sites on the South and West sides of Chicago. Multivariate logistic regression analysis was used to determine the differences in HIV diagnoses and LTC by gender and HIV status. From 2011 to 2016, X-TLC performed 281,017 HIV tests; 63.7% of those tested were women. Overall HIV seroprevalence was 0.57%, and nearly one third (29.4%) of HIV-positive patients identified were cisgender women. Of newly diagnosed HIV-positive women, 89% were AA. 58.5% of new diagnoses in women were made at acute care hospitals, with the remainder at community health centers. Women who were newly diagnosed had a higher baseline CD4 count at diagnosis compared with men. Overall, women had lower odds of LTC compared with men (adjusted odds ratio = 0.58, 95% confidence interval 0.44-0.78) when controlling for patient demographics and newly versus previously diagnosed HIV status. Thus, interventions that focus on optimizing entry into the care continuum for AA women need to be explored.

Summary and ConclusionsIn a study of the micro Eagle test on the sera of 57 syphilitic white mice, we found that: (1) of 28 mice infected 30 days, none was positive; (2) of 47 mice infected 60 days 2 or 4.3% were positive; and (3) of 38 mice infected 120 days 1 or 2.6% was positive. These findings confirm those of other authors; namely, that a positive serologic test for syphilis infrequently occurs in the syphilitic mouse and is, therefore, of no value in studying the course of experimental syphilis in this animal.