Surveillance of Infectious Diseases Among American Indians and Alaska Natives

We assessed participation in public health surveillance networks among Indian Health Service, tribal, and urban (I/T/U) Indian health facilities for a group of infectious diseases, and barriers to participation. We conducted surveys of I/T/U facilities and key informant interviews with representatives of tribal, urban, and national American Indian/Alaska Native (AI/AN) agencies. For the surveys, frequencies and percentages of responses in each response category were calculated. Qualitative methods were used to analyze interview content. The proportion of facilities participating in case reporting is suboptimal across facility types and diseases. Even when reporting is occurring, there is little feedback to tribal agencies. Lack of trust between tribal authorities and state/local governments, lack of feedback on surveillance efforts, and gaps in coordination of activities were identified as barriers to participation in surveillance. Our findings indicate weaknesses in surveillance systems for monitoring infectious diseases among AI/AN people, and have implications for addressing health disparities

Heart failure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies conference

The incidence and prevalence of heart failure (HF) and chronic kidney disease (CKD) are increasing, and as such a better understanding of the interface between both conditions is imperative for developing optimal strategies for their detection, prevention, diagnosis, and management. To this end, Kidney Disease: Improving Global Outcomes (KDIGO) convened an international, multidisciplinary Controversies Conference titled Heart Failure in CKD. Breakout group discussions included (i) HF with preserved ejection fraction (HFpEF) and nondialysis CKD, (ii) HF with reduced ejection fraction (HFrEF) and nondialysis CKD, (iii) HFpEF and dialysis-dependent CKD, (iv) HFrEF and dialysis-dependent CKD, and (v) HF in kidney transplant patients. The questions that formed the basis of discussions are available on the KDIGO website http://kdigo.org/conferences/heart-failure-in-ckd/, and the deliberations from the conference are summarized here