Browsing by keyword "Public Health Informatics"

Now showing items 1-4 of 4

    • A new approach to monitoring dengue activity
      Madoff, Lawrence C.; Fisman, David N.; Kass-Hout, Taha (2011-05-31)
      Discusses informal surveillance tools for monitoring dengue activity, such as ProMED, GPHIN HealthMap and BioCaster.

    • Early loss of HIV-infected patients on potent antiretroviral therapy programmes in lower-income countries
      Brinkhof, Martin W. G.; Dabis, Francios; Myer, Landon; Bangsberg, David R.; Boulle, Andrew; Nash, Denis; Schechter, Mauro; Laurent, Christian; Keiser, Olivia; May, Margaret; et al. (2008-07-01)
      OBJECTIVE: To analyse the early loss of patients to antiretroviral therapy (ART) programmes in resource-limited settings. METHODS: Using data on 5491 adult patients starting ART (median age 35 years, 46% female) in 15 treatment programmes in Africa, Asia and South America with (3) 12 months of follow-up, we investigated risk factors for no follow-up after treatment initiation, and loss to follow-up or death in the first 6 months. FINDINGS: Overall, 211 patients (3.8%) had no follow-up, 880 (16.0%) were lost to follow-up and 141 (2.6%) were known to have died in the first 6 months. The probability of no follow-up was higher in 2003-2004 than in 2000 or earlier (odds ratio, OR: 5.06; 95% confidence interval, CI: 1.28-20.0), as was loss to follow-up (hazard ratio, HR: 7.62; 95% CI: 4.55-12.8) but not recorded death (HR: 1.02; 95% CI: 0.44-2.36). Compared with a baseline CD4-cell count (3) 50 cells/microl, a count < 25 cells/microl was associated with a higher probability of no follow-up (OR: 2.49; 95% CI: 1.43-4.33), loss to follow-up (HR: 1.48; 95% CI: 1.23-1.77) and death (HR: 3.34; 95% CI: 2.10-5.30). Compared to free treatment, fee-for-service programmes were associated with a higher probability of no follow-up (OR: 3.71; 95% CI: 0.97-16.05) and higher mortality (HR: 4.64; 95% CI: 1.11-19.41). CONCLUSION: Early patient losses were increasingly common when programmes were scaled up and were associated with a fee for service and advanced immunodeficiency at baseline. Measures to maximize ART programme retention are required in resource-poor countries.

    • Global TravEpiNet: a national consortium of clinics providing care to international travelers--analysis of demographic characteristics, travel destinations, and pretravel healthcare of high-risk US international travelers, 2009-2011
      LaRocque, Regina C.; Rao, Sowmya R.; Lee, Jennifer S.; Ansdell, Vernon; Yates, Johnnie A.; Schwartz, Brian S.; Knouse, Mark; Cahill, John; Hagmann, Stefan; Vinetz, Joseph; et al. (2011-12-07)
      BACKGROUND: International travel poses a risk of destination-specific illness and may contribute to the global spread of infectious diseases. Despite this, little is known about the health characteristics and pretravel healthcare of US international travelers, particularly those at higher risk of travel-associated illness. METHODS: We formed a national consortium (Global TravEpiNet) of 18 US clinics registered to administer yellow fever vaccination. We collected data regarding demographic and health characteristics, destinations, purpose of travel, and pretravel healthcare from 13235 international travelers who sought pretravel consultation at these sites from January 2009 through January 2011. RESULTS: The destinations and itineraries of Global TravEpiNet travelers differed from those of the overall population of US international travelers. The majority of Global TravEpiNet travelers were visiting low- or lower-middle-income countries, and Africa was the most frequently visited region. Seventy-five percent of travelers were visiting malaria-endemic countries, and 38% were visiting countries endemic for yellow fever. Fifty-nine percent of travelers reported >/=1 medical condition. Atovaquone/proguanil was the most commonly prescribed antimalarial drug, and most travelers received an antibiotic for self-treatment of travelers' diarrhea. Hepatitis A and typhoid were the most frequently administered vaccines. CONCLUSIONS: Data from Global TravEpiNet provide insight into the characteristics and pretravel healthcare of US international travelers who are at increased risk of travel-associated illness due to itinerary, purpose of travel, or existing medical conditions. Improved understanding of this epidemiologically significant population may help target risk-reduction strategies and interventions to limit the spread of infections related to global travel.

    • Mandatory Public Reporting: Build It and Who Will Come?
      Bell, Sigall; Benneyan, James; Best, Allan; Birnbaum, David; Borycki, Elizabeth M.; Gallagher, Thomas H.; Goeschel, Chris; Jarvis, Bill; Kushniruk, Andre W.; Mazor, Kathleen M.; et al. (2011-01-01)
      Summary: Rates of healthcare-associated infections (HAI) are being reported on an increasing number of public information websites in response to legislative mandates driven by consumer advocacy. This represents a new strategy to advance patient safety and quality of care by informing a broad audience about the relative performance of individual healthcare facilities. Unlike typical consumer health informatics products, the target audience and targeted health behaviors are less easily defined; further, the impact on providers to improve care is unknown relative to other incentives to improve. To address critical knowledge gaps facing all state agencies embarking on this new frontier, we found it essential and straightforward to recruit the assistance of university research faculty from a variety of disciplines. That interdisciplinary group was quickly able to define a 5-year applied evaluation research agenda spanning a progressive set of crucial questions.