Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Active and latent tuberculosis in prisoners in the Central-West Region of Brazil

Introduction Jailed populations exhibit high rates of tuberculosis (TB) infection and active disease. Methods A cross-sectional study was performed to estimate the prevalence of latent and active TB and to identify factors associated with latent infection in inmates. Results The prevalence of latent TB was 49%, and the prevalence of active TB was 0.4%. The presence of a Bacille Calmette-Guérin (BCG) scar (prevalence ratio (PR)=1.65; 95% confidence interval (CI): 1.09-2.50; p=0.0162) and the World Health Organization (WHO) score for active TB in prisons (PR=1.07; 95% CI: 1.01-1.14; p=0.0181) were correlated with infection. Conclusions The identification of associated factors and the prevalence of latent and active TB allows the development of plans to control this disease in jails

Sugar cane manufacturing is associated with tuberculosis in an indigenous population in Brazil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2015-12-15T12:21:09Z No. of bitstreams: 1 Sacchi EPC Sugar cane manufacturing....pdf: 183803 bytes, checksum: 654d7fe83d7b8a699f368a7f40c7a92a (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2015-12-15T12:38:09Z (GMT) No. of bitstreams: 1 Sacchi EPC Sugar cane manufacturing....pdf: 183803 bytes, checksum: 654d7fe83d7b8a699f368a7f40c7a92a (MD5)Made available in DSpace on 2015-12-15T12:38:09Z (GMT). No. of bitstreams: 1 Sacchi EPC Sugar cane manufacturing....pdf: 183803 bytes, checksum: 654d7fe83d7b8a699f368a7f40c7a92a (MD5) Previous issue date: 2013Federal University of Grande Dourados. University Hospital. Grande Dourados, MGS, Brasil / Federal University of Grande Dourados. Faculty of Health Sciences. Grande Dourados, MGS, BrasilFederal University of Grande Dourados. University Hospital. Grande Dourados, MGS, BrasilFederal University of Grande Dourados. Faculty of Health Sciences. Grande Dourados, MGS, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Epidemiology of Microbial Disease Division. New Haven, USAFederal University of Grande Dourados. Faculty of Health Sciences. Grande Dourados, MGS, BrasilBackground: Tuberculosis (TB) remains one of the leading causes of morbidity and mortality among indigenous peoples in Brazil, and identifying the risk factors for TB in this population secondary to specific epidemiological conditions is essential for recommending interventions aimed at disease control. Methods: This case-control study was conducted with an indigenous population between June 2009 and August 2011 in Dourados, Brazil. Tuberculosis cases reported to the national disease surveillance programme were paired with two control cases matched by age and geographic location. Results: There were 63 cases included in this study, and the annual incidence of TB in the indigenous communities examined was 222 (95% CI, 148–321) per 100 000 inhabitants. The multivariate analysis demonstrated that the variables associated with TB infection included male gender (OR 2.6; 95% CI 1.3–5.3), not owning a home (OR 3.4; 95% CI 1.2–10.1), illiteracy (OR 2.4; 95% CI 1.1–5.0), TB contact (OR 2.4; 95% CI 1.2–4.8) and work performed in a sugar cane factory (OR 6.8; 95% CI 1.2–36.9). Conclusion: There is a potential relationship between exposure to sugar cane manufacturing processes and tuberculosis infection among indigenous populations

Direct costs of dengue hospitalization in Brazil: public and private health care systems and use of WHO guidelines.

Dengue, an arboviral disease, is a public health problem in tropical and subtropical regions worldwide. In Brazil, epidemics have become increasingly important, with increases in the number of hospitalizations and the costs associated with the disease. This study aimed to describe the direct costs of hospitalized dengue cases, the financial impact of admissions and the use of blood products where current protocols for disease management were not followed.To analyze the direct costs of dengue illness and platelet transfusion in Brazil based on the World Health Organization (WHO) guidelines, we conducted a retrospective cross-sectional census study on hospitalized dengue patients in the public and private Brazilian health systems in Dourados City, Mato Grosso do Sul State, Brazil. The analysis involved cases that occurred from January through December during the 2010 outbreak. In total, we examined 8,226 mandatorily reported suspected dengue cases involving 507 hospitalized patients. The final sample comprised 288 laboratory-confirmed dengue patients, who accounted for 56.8% of all hospitalized cases. The overall cost of the hospitalized dengue cases was US $210,084.30, in 2010, which corresponded to 2.5$1,622.40) compared with the group that did not receive blood products (US $550.20).The comparative costs between the public and the private health systems show that both the hospitalization of and platelet transfusion in patients who do not meet the WHO and Brazilian dengue guidelines increase the direct costs, but not the quality, of health care

Comparison of the length of the hospital stay based on age group and the type of health care system.

1<p>Public and private.</p><p>Comparison of the length of the hospital stay based on age group and the type of health care system.</p

Comparison of the hospital stay length and costs according to the dengue classification and the type of health care system.

1<p>– Public and Private.</p><p>Comparison of the hospital stay length and costs according to the dengue classification and the type of health care system.</p

Characteristics of the dengue patients hospitalized in Dourados, Brazil, in 2010 (n = 288).

1<p>Included individuals with PHPs and those making payments with personal resources.</p>2<p>Mixed-race and Asiatic.</p><p>Characteristics of the dengue patients hospitalized in Dourados, Brazil, in 2010 (n = 288).</p