Housing stability and diabetes among people living in New York city public housing

Public housing provides affordable housing and, potentially, housing stability for low-income families. Housing stability may be associated with lower incidence or prevalence and better management of a range of health conditions through many mechanisms. We aimed to test the hypotheses that public housing residency is associated with both housing stability and reduced risk of diabetes incidence, and the relationship between public housing and diabetes risk varies by levels of housing stability. Using 2004-16 World Trade Center Health Registry data, we compared outcomes (housing stability measured by sequence analysis of addresses, self-reported diabetes diagnoses) between 730 New York City public housing residents without prevalent diabetes at baseline and 730 propensity score-matched non-public housing residents. Sequence analysis found 3 mobility patterns among all 1460 enrollees, including stable housing (65%), limited mobility (27%), and unstable housing patterns (8%). Public housing residency was associated with stable housing over 12 years. Diabetes risk was not associated with public housing residency; however, among those experiencing housing instability, a higher risk of diabetes was found among public housing versus non-public housing residents. Of those stably housed, the association remained insignificant. These findings provide important evidence for a health benefit of public housing via housing stability among people living in public housing

Management of Extensively Drug-Resistant Tuberculosis in Peru: Cure Is Possible

Aim: To describe the incidence of extensive drug-resistant tuberculosis (XDR-TB) reported in the Peruvian National multidrug-resistant tuberculosis (MDR-TB) registry over a period of more than ten years and present the treatment outcomes for a cohort of these patients. Methods: From the Peruvian MDR-TB registry we extracted all entries that were approved for second-line anti-TB treatment between January 1997 and June of 2007 and that had Drug Susceptibility Test (DST) results indicating resistance to both rifampicin and isoniazid (i.e. MDR-TB) in addition to results for at least one fluoroquinolone and one second-line injectable (amikacin, capreomycin and kanamycin). Results: Of 1,989 confirmed MDR-TB cases with second-line DSTs, 119(6.0%) XDR-TB cases were detected between January 1997 and June of 2007. Lima and its metropolitan area account for 91% of cases, a distribution statistically similar to that of MDR-TB. A total of 43 XDR-TB cases were included in the cohort analysis, 37 of them received ITR. Of these, 17(46%) were cured, 8(22%) died and 11(30%) either failed or defaulted treatment. Of the 14 XDR-TB patients diagnosed as such before ITR treatment initiation, 10 (71%) were cured and the median conversion time was 2 months. Conclusion: In the Peruvian context, with long experience in treating MDR-TB and low HIV burden, although the overall cure rate was poor, a large proportion of XDR-TB patients can be cured if DST to second-line drugs is performed early and treatment is delivered according to the WHO Guidelines

Near-infrared spectroscopy to predict provitamin A carotenoids content in maize

Vitamin A deficiency (VAD) is a public health issue worldwide. Provitamin A (PVA) biofortified maize serves as an alternative to help combat VAD. Breeding efforts to develop maize varieties with high PVA carotenoid content combine molecular and phenotypic selection strategies. The phenotypic assessment of carotenoids is currently done using liquid chromatography, a precise but time-and resource-consuming methodology. Using near-infrared spectroscopy (NIRS) could increase the breeding efficiency. This study used ultra-performance liquid chromatography (UPLC) data from 1857 tropical maize genotypes as a training set and NIRS data to do an independent test of a set of 650 genotypes to predict PVA carotenoids using Bayesian and modified partial least square (MPLS) regression models. Both regression methods produced similar prediction accuracies for the total carotenoids (r2 = 0.75), lutein (r2 = 0.55), zeaxanthin (r2 = 0.61), β-carotene (r2 = 0.22) and β-cryptoxanthin (BCX) (r2 = 0.57). These results demonstrate that Bayesian and MPLS regression of BCX on NIRS data can be used to predict BCX content, the current focus on PVA enhancement, and thus offers opportunities for high-throughput phenotyping at a low cost, especially in the early stages of PVA maize breeding pipeline when many genotypes must be screened

Treatment and outcomes in children with multidrug-resistant tuberculosis: a systematic review and individual patient data meta-analysis.

CAPRISA, 2018.Abstract available in pdf

Enhanced Tuberculosis Infection Treatment Outcomes after Implementation of QuantiFERON®-Gold Testing.

Use of the tuberculin skin test (TST) for diagnosis of latent tuberculosis infection (LTBI) among individuals who received the Bacille Calmette-Guérin (BCG) vaccine is complicated by its potential cross-reaction with TST antigens which may cause false-positive results and lead to patient and physician reluctance to initiate LTBI treatment. QuantiFERON®-TB Gold (QFT-G) lacks this cross-reaction. We sought to study the impact of implementing QFT-G testing in 2006 on LTBI treatment initiation and completion at NYC chest clinics.QFT-G results from 10/2006-12/2008 in NYC Department of Health and Mental Hygiene chest clinics were obtained from the electronic medical record system. The proportions of patients who initiated and completed treatment among patients tested with QFT-G were compared to those tested with TST from 10/2004-9/2006.Among 36,167 patients tested with QFT-G, 2,300 (6%) tested positive, 33,327 (93%) tested negative, and 540 (1%) had an indeterminate result. Among those who had a positive QFT-G test and deemed eligible, 985 (80%) initiated LTBI treatment and 490 (40%) completed treatment. Historically, among patients tested with TST, 7,073 (19%) tested positive (p<0.0001 compared to QFT-G); 3,182 (79%) of those eligible initiated LTBI treatment and 1,210 (30%) completed treatment (p<0.0001 compared to QFT-G).QFT-G implementation increased the proportion of patients completing LTBI treatment. Additional studies are needed in more settings to determine whether using QFT-G leads to a sustained increase in treatment completion

Enhanced Tuberculosis Infection Treatment Outcomes after Implementation of QuantiFERON®-Gold Testing.

Use of the tuberculin skin test (TST) for diagnosis of latent tuberculosis infection (LTBI) among individuals who received the Bacille Calmette-Guérin (BCG) vaccine is complicated by its potential cross-reaction with TST antigens which may cause false-positive results and lead to patient and physician reluctance to initiate LTBI treatment. QuantiFERON®-TB Gold (QFT-G) lacks this cross-reaction. We sought to study the impact of implementing QFT-G testing in 2006 on LTBI treatment initiation and completion at NYC chest clinics.QFT-G results from 10/2006-12/2008 in NYC Department of Health and Mental Hygiene chest clinics were obtained from the electronic medical record system. The proportions of patients who initiated and completed treatment among patients tested with QFT-G were compared to those tested with TST from 10/2004-9/2006.Among 36,167 patients tested with QFT-G, 2,300 (6%) tested positive, 33,327 (93%) tested negative, and 540 (1%) had an indeterminate result. Among those who had a positive QFT-G test and deemed eligible, 985 (80%) initiated LTBI treatment and 490 (40%) completed treatment. Historically, among patients tested with TST, 7,073 (19%) tested positive (p<0.0001 compared to QFT-G); 3,182 (79%) of those eligible initiated LTBI treatment and 1,210 (30%) completed treatment (p<0.0001 compared to QFT-G).QFT-G implementation increased the proportion of patients completing LTBI treatment. Additional studies are needed in more settings to determine whether using QFT-G leads to a sustained increase in treatment completion

Data on location and retail price of a standard food basket in supermarkets across New York City

Previous work has suggested that the price of food sold at supermarkets may vary according to the socioeconomic characteristics of a neighborhood. Given the importance of food prices in securing access to food, understanding how food prices vary across neighborhoods is crucial to assessing affordability. To study food pricing in New York City (NYC) a defined standard food basket (SFB) was collected in supermarkets across NYC neighborhoods. A dataset was created that includes pricing data collected in-person for ten pre-determined food items from 163 supermarkets across 71 of the 181 NYC neighborhoods during March through August of 2019. Included in these data are raw and processed pricing data files that illustrate the complexity of standardizing pricing across items. An additional dataset includes neighborhood-level variables of selected socioeconomic and demographic characteristics from the 2014–2018 American Community Survey that is publicly available via the Census API. The pricing data and the data on neighborhood-level characteristics were merged. Basic statistical measures suggest some distributional differences in the price of a SFB by socioeconomic differences between neighborhoods. This database can be used to describe spatial patterns in food pricing in a dense urban setting, while exploring pricing inequities across neighborhoods. In addition, by working with these data, researchers, policy analysts and educators will gain an understanding of the methodologies used to generate pricing data for an SFB

LTBI treatment completion among patients with an indication for LTBI treatment, New York City Department of Health and Mental Hygiene chest clinics during QFT-G (2006–2008) and TST (2004–2006) utilization periods.

<p>QFT-G = QuantiFERON-TB Gold, TST = tuberculin skin test</p><p>^a Excludes 2205 patients who had both TST and QFT-G performed</p><p>^b Includes Native American, Pacific Islander</p><p>^c 60 patients were missing a country of birth and 1 foreign-born patient was missing time in the US.</p><p>^d Contacts were those exposed to a patient with infectious TB disease and were tested as part of a NYC DOHMH contact investigation. Non-contacts included patients tested for any other reason.</p><p>^e Estimates of relative risk were adjusted for age at test, reason for test, primary language (English, not English), birth in the US, race/ethnicity and year that the test was performed. Sex was excluded based on the results of the bivariate analysis.</p><p>LTBI treatment completion among patients with an indication for LTBI treatment, New York City Department of Health and Mental Hygiene chest clinics during QFT-G (2006–2008) and TST (2004–2006) utilization periods.</p

Baseline characteristics of persons undergoing testing for LTBI during QFT-G (2006–2008) and TST (2004–2006) utilization in New York City Department of Health and Mental Hygiene chest clinics.^a

<p>QFT-G = QuantiFERON-TB Gold, TST = tuberculin skin test</p><p>^a Excludes 2205 patients who had both TST and QFT-G performed</p><p>^b Includes Native American, Pacific Islander</p><p>^c 60 patients were missing a country of birth and 1 foreign-born patient was missing time in the US.</p><p>^d Contacts were those exposed to a patient with infectious TB disease and were tested as part of a NYC DOHMH contact investigation. Non-contacts included patients tested for any other reason</p><p>Baseline characteristics of persons undergoing testing for LTBI during QFT-G (2006–2008) and TST (2004–2006) utilization in New York City Department of Health and Mental Hygiene chest clinics.<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138349#t001fn002" target="_blank">^a</a></p