Epidemiology and Evaluation Unit
Epidemiology and Evaluation Unit
Khuu D.,University of California at Los Angeles |
Khuu D.,Epidemiology and Evaluation Unit |
Eberhard M.L.,Center for Global Health |
Bristow B.N.,University of California at Los Angeles |
And 5 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2017
Few data are available on the burden of malaria hospitalization in the United States. Study of malaria using hospital-based data can better define the impact of malaria and help inform prevention efforts. U.S. malaria cases identified from hospitalization discharge records in the 2000-2014 Nationwide Inpatient Sample were examined. Frequencies and population rates were reported by demographics, infecting species, clinical, financial, institutional, geographic, and seasonal characteristics, and disparities were identified. Time trends in malaria cases were assessed using negative binomial regression. From 2000 to 2014, there were an estimated 22,029 malaria-related hospitalizations (4.88 per 1 million population) in the United States, including 182 in-hospital deaths and 4,823 severe malaria cases. The rate of malaria-related hospitalizations did not change significantly over the study period. The largest number of malariarelated hospitalizations occurred in August. Malaria-related hospitalizations occurred disproportionately among patients who were male, black, or 25-44 years of age. Plasmodium falciparum accounted for the majority of malaria-related hospitalizations. On average, malaria patients were hospitalized for 4.36 days with charges of $25,789. Patients with a malaria diagnosis were more often hospitalized in the Middle Atlantic and South Atlantic census divisions, urban teaching, private not-for-profit, and large-bed-size hospitals. Malaria imposes a substantial disease burden in the United States. Enhanced primary and secondary prevention measures, including strategies to increase the use of pretravel consultations and prompt diagnosis and treatment are needed. © 2017 by The American Society of Tropical Medicine and Hygiene.
PubMed | UDIAT CD, Epidemiology and Evaluation Unit and Autonomous University of Barcelona
Type: Journal Article | Journal: United European gastroenterology journal | Year: 2015
In a previous study, UBiT-100mg, (Otsuka, Spain), a commercial (13)C-urea breath test omitting citric acid pre-treatment, had a high rate of false-positive results; however, it is possible that UBiT detected low-density occult infection missed by other routine reference tests. We aimed to validate previous results in a new cohort and to rule out the possibility that false-positive UBiT were due to an occult infection missed by reference tests.Dyspeptic patients (n = 272) were prospectively enrolled and UBiT was performed, according to the manufacturers recommendations. Helicobacter pylori infection was determined by combining culture, histology and rapid urease test results. We calculated UBiT sensitivity, specificity, positive and negative predictive values (with 95% CI). In addition, we evaluated occult H. pylori infection using two previously-validated polymerase chain reaction (PCR) methods for urease A (UreA) and 16S sequences in gastric biopsies. We included 44 patients with a false-positive UBiT, and two control groups of 25 patients each, that were positive and negative for all H. pylori tests.UBiT showed a false-positive rate of 17%, with a specificity of 83%. All the positive controls and 12 of 44 patients (27%) with false-positive UBiT were positive for all two PCR tests; by contrast, none of our negative controls had two positive PCR tests.UBiT suffers from a high rate of false-positive results and sub-optimal specificity, and the protocol skipping citric acid pre-treatment should be revised; however, low-density occult H. pylori infection that was undetectable by conventional tests accounted for around 25% of the false-positive results.