National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 65 Research Studies DisplayedCampbell JI, Tabatneck M, Wilt GE
Area-based sociodemographic factors associated with latent tuberculosis infection in a low-prevalence setting.
Researchers evaluated associations between census tract poverty, crowding, foreign-born population, and the CDC's Social Vulnerability Index (CDC-SVI) ranking and tuberculosis (TB) infection in children tested for TB infection in Boston, MA. Their findings indicated that census tract poverty was associated with increased odds of TB infection; in separate models, increasing CDC-SVI ranking was also associated with increased odds of TB infection. The researchers concluded that these findings suggest area-based sociodemographic factors may be valuable for characterizing TB infection risk and defining social ecology of pediatric TB infection in low-burden settings
AHRQ-funded; HS000063.
Citation: Campbell JI, Tabatneck M, Wilt GE .
Area-based sociodemographic factors associated with latent tuberculosis infection in a low-prevalence setting.
Am J Trop Med Hyg 2023 Sep 6; 109(3):595-99. doi: 10.4269/ajtmh.22-0788..
Keywords: Respiratory Conditions, Infectious Diseases
Rao S, Armistead I, Tyler A
Respiratory syncytial virus, influenza, and coronavirus disease 2019 hospitalizations in children in Colorado during the 2021-2022 respiratory virus season.
This study compared demographic characteristics, clinical features, and outcomes of children hospitalized with respiratory syncytial virus (RSV), influenza, or severe acute respiratory syndrome coronavirus 2 during their cocirculation 2021-2022 respiratory virus season. The authors conducted a retrospective cohort study using Colorado's hospital respiratory surveillance data comparing coronavirus disease 2019 (COVID-19)-, influenza-, and RSV-hospitalized cases < 18 years of age admitted and undergoing standardized molecular testing between October 1, 2021, and April 30, 2022. The cohort consisted of 847 hospitalized cases, of which 490 (57.9%) were RSV associated, 306 (36.1%) were COVID-19 associated, and 51 (6%) were influenza associated. Most RSV cases were children less than 4 years of age (92.9%), whereas influenza hospitalizations were observed in older children. RSV cases were more likely to require oxygen support higher than nasal cannula compared with COVID-19 and influenza cases, although COVID-19 cases were more likely to require invasive mechanical ventilation than influenza and RSV cases. Compared with children with COVID-19, the risk of intensive care unit admission was highest among children with influenza, whereas the risk of pneumonia, bronchiolitis, longer hospital length of stay, and need for oxygen were more likely among children with RSV.
AHRQ-funded; HS026512.
Citation: Rao S, Armistead I, Tyler A .
Respiratory syncytial virus, influenza, and coronavirus disease 2019 hospitalizations in children in Colorado during the 2021-2022 respiratory virus season.
J Pediatr 2023 Sep; 260:113491. doi: 10.1016/j.jpeds.2023.113491..
Keywords: Children/Adolescents, COVID-19, Respiratory Conditions, Influenza, Hospitalization, Infectious Diseases
Russell A, Jenkins JL, Zhang A
A review of infectious disease epidemiology in emergency medical service clinicians.
This review synthesized existing literature on the prevalence, incidence, and severity of infections in emergency medical service (EMS) workforce personnel. The majority of studies that met the inclusion criteria were focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and Hepatitis C also featured in a small number of studies. In the studies that compared infection rates between EMS clinicians and firefighters, EMS clinicians had a higher chance of hospitalization or death from SAR-CoV-2, a higher prevalence of Hepatitis C, and no significant differences in MRSA colonization. The authors concluded that more research was needed to characterize the incidence and severity of occupationally acquired infections in the EMS workforce.
AHRQ-funded; 75Q80120D00003.
Citation: Russell A, Jenkins JL, Zhang A .
A review of infectious disease epidemiology in emergency medical service clinicians.
Am J Infect Control 2023 Aug; 51(8):931-37. doi: 10.1016/j.ajic.2022.12.001..
Keywords: Infectious Diseases, Emergency Medical Services (EMS)
Miller ME, Rahim MQ, Coven SL
Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration.
This study’s goal was to examine provider views regarding HPV vaccination for pediatric survivors of cancer and pediatric patients with sickle cell disease. The authors conducted qualitative interviews with 20 pediatric hematology/oncology physicians and nurse practitioners. They found that 90% of interviewees support HPV vaccination in their population. The number of providers who reported that they counsel about HPV or provide HPV vaccination was 45%, even in stem cell and sickle cell clinics, where other childhood vaccines are commonly provided. Clinicians identified provider-level, clinic-level, and system-level barriers to giving the HPV vaccination, that included but was not limited to time/flow constraints, lack of resources, and continued education regarding the HPV vaccine.
AHRQ-funded; HS026390.
Citation: Miller ME, Rahim MQ, Coven SL .
Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration.
Hum Vaccin Immunother 2023 Aug 1; 19(2):2224089. doi: 10.1080/21645515.2023.2224089..
Keywords: Vaccination, Sexual Health, Infectious Diseases, Prevention, Provider: Clinician, Provider: Physician
Amaefule AQ, Litvintchouk A, de Cordova P
Reevaluating the significance of infection preventionists and infection prevention and control departments in the post-COVID-19 era.
Infection preventionists are specialized health care professionals responsible for infection control policy development and implementation, prevention education for staff and patients, and investigation of outbreaks. The role of infection preventionists in creating effective methods for infection prevention and control became even more critical during the COVID-19 pandemic. The purpose of this paper was to increase awareness of the importance for health care systems and health care institutions to integrate lessons learned, improve infection prevention and control resources, and increase the workforce of infection preventionists to better prepare for pandemic events in the future.
AHRQ-funded; HS029023.
Citation: Amaefule AQ, Litvintchouk A, de Cordova P .
Reevaluating the significance of infection preventionists and infection prevention and control departments in the post-COVID-19 era.
Am J Med Qual 2023 Jul-Aug; 38(4):206-08. doi: 10.1097/jmq.0000000000000132..
Keywords: COVID-19, Infectious Diseases, Public Health
Mahmud A, Cushing-Haugen K, Wellman R
Understanding the relationship between social risk factors and COVID-19 contacts.
The purpose of this study was to facilitate researchers’ understanding of the prevalence of patients' social risk factors during the pandemic and recognize how social risks may intensify COVID-19. Between January and September 2020, the researchers conducted a national survey of Kaiser Permanente members and analyzed only the data from those who responded to a set of COVID-19 survey items. The survey included questions on their experiences with social risks, whether they knew of people with COVID-19, if COVID-19 affected their emotional and mental health, and their preferred type of assistance. The study found that 62% of respondents reported social risks, with 38% reporting having 2 or more social risks. The most common response was financial strain (45%). One third of respondents reported one or more contact types with COVID-19. respondents with 2 or more COVID-19 contact types reported higher rates of housing instability, financial strain, food insecurity, and social isolation than those with fewer contacts. Fifty percent of respondents reported that COVID-19 affected their emotional, mental health negatively, and 19% of respondents noted that it affected their ability to maintain a job.
AHRQ-funded; HS013853.
Citation: Mahmud A, Cushing-Haugen K, Wellman R .
Understanding the relationship between social risk factors and COVID-19 contacts.
Perm J 2023 Jun 15; 27(2):18-22. doi: 10.7812/tpp/22.146..
Keywords: COVID-19, Risk, Public Health, Infectious Diseases
Jenkins JL, Hsu EB, Zhang A
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
This study’s aim was to summarize current evidence from the United States on the effectiveness of practices and interventions for preventing, recognizing, and controlling occupationally acquired infectious diseases in Emergency Medical Service (EMS) clinicians. A database search was conducted for literature published January 2006 through March 15, 2022 to search for studies in the United States that involved EMS clinicians and firefighters, reported on one or more workplace practices or interventions that prevented or controlled infectious diseases, and included outcome measures. Eleven observational studies reported on infection prevention and control (IPC) practices providing evidence that hand hygiene, standard precautions, mandatory vaccine policies, and on-site vaccine clinics are effective. Less frequent handwashing and less frequent hand hygiene after glove use were positively correlated with nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA). Lack of personal protective equipment (PPE) or PPE breach were correlated with higher severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity and virus 2 (SARS-CoV-2) seropositivity. Workers were more likely to be vaccinated against influenza if their employer offered the vaccine. Vaccination rates for H1N1 influenza increased with the use of active, targeted education modules.
AHRQ-funded; 75Q80120D00003.
Citation: Jenkins JL, Hsu EB, Zhang A .
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
Prehosp Disaster Med 2023 Jun; 38(3):371-77. doi: 10.1017/s1049023x23000389..
Keywords: COVID-19, Emergency Department, Evidence-Based Practice, Prevention, Public Health, Infectious Diseases
Teixeira da Silva D, Makeneni S, Wall H
Measuring quality STI care among adolescent female primary care patients in Philadelphia.
The purpose of this study was to develop and apply a cross-setting, sexually transmitted infection (STI) Care Continuum to improve STI care quality, to assess adherence to guideline-recommended care, and to standardize progress measurement toward National Strategic goals. Review of the CDC STI treatment guidelines identified seven distinct steps of care for gonorrhea, chlamydia, and syphilis; researchers used Youth Risk Behavior Surveillance Survey data to estimate step 1, and electronic health record data for steps 2, 3, 4, 6 and 7. The researchers concluded that local application of an STI Care Continuum identified STI testing, retesting, and HIV testing as areas for improvement. Similar methods may be applied to target resources, standardize data collection and reporting, and improve STI care quality.
AHRQ-funded; HS026116.
Citation: Teixeira da Silva D, Makeneni S, Wall H .
Measuring quality STI care among adolescent female primary care patients in Philadelphia.
Sex Transm Infect 2023 Jun; 99(4):272-75. doi: 10.1136/sextrans-2022-055623..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Women, Human Immunodeficiency Virus (HIV), Quality Measures, Quality of Care
Jonas DE, Riley SR, Lee LC
Screening for latent tuberculosis infection in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
This systematic review and evidence report analyzed the benefits and harms of screening for latent tuberculosis infection (LTBI) of adults, which was used to inform the U.S. Preventive Services Task Force for their final recommendation. A systematic review was conducted of English-language studies of LTBI screening, LTBI treatment, or accuracy of the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs). A total of 113 publications were identified, with no studies directly evaluating the benefits and harms of screening. For treatment of LTBI, a large (n = 27,830), good-quality randomized clinical trial found a relative risk (RR) for progression to active tuberculosis at 5 years of 0.35 for 24 weeks of isoniazid compared with placebo (number needed to treat, 112) and an increase in hepatotoxicity (RR, 4.59; number needed to harm, 279). Meta-analysis found greater risk for hepatotoxicity with isoniazid than with rifampin (pooled RR, 4.22; n = 7339).
AHRQ-funded; 75Q80120D00007.
Citation: Jonas DE, Riley SR, Lee LC .
Screening for latent tuberculosis infection in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 May 2; 329(17):1495-509. doi: 10.1001/jama.2023.3954..
Keywords: U.S. Preventive Services Task Force (USPSTF), Infectious Diseases, Screening, Prevention, Evidence-Based Practice
Ahmad FA, Chan P, McGovern C
Adapting an electronic STI risk assessment program for use in pediatric primary care.
This study’s goal was to evaluate the usability of an electronic risk assessment tool to support sexually transmitted disease (STI) testing in the authors’ pediatric emergency department that they had previously designed and implemented. They conducted qualitative interviews of pediatricians, clinic staff, and adolescents from 4 pediatric practices as part of a study whose goal is to ultimately implement STI screening in pediatric primary care. The goal of the interviews was (1) to understand contextual factors related to STI screening in primary care, which they reported previously, and (2) to obtain feedback on their electronic platform, the questionnaire content, and their perspective on implementing it in primary care settings. They received quantitative feedback using the System Usability Scale (SUS). The SUS is a validated, reliable tool to measure the usability of hardware, software, websites, and applications, with a score of 68 (range 0-100) being average usability. They recruited 14 physicians, 9 clinic staff, and 12 adolescents. Participants rated the tool with a median score of 92.5, which shows a high level of usability.
AHRQ-funded; HS026704.
Citation: Ahmad FA, Chan P, McGovern C .
Adapting an electronic STI risk assessment program for use in pediatric primary care.
J Prim Care Community Health 2023 Jan-Dec; 14:21501319231172900. doi: 10.1177/21501319231172900..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Health Information Technology (HIT), Screening, Prevention
Chen Y, Lopman BA, Hall AJ
Factors driving norovirus transmission in long-term care facilities: a case-level analysis of 107 outbreaks.
Norovirus stands as the leading cause of gastroenteritis outbreaks in long-term care facilities (LTCFs) throughout the United States, resulting in significant disease impact on both residents and employees. The purpose of this study was to gain insight into the symptoms and features of individual cases that influence norovirus transmission can enhance the implementation of outbreak management strategies in LTCFs. In this study, the researchers analyzed line lists from 107 norovirus outbreaks occurring in LTCFs across five U.S. states between 2015 and 2019. The individual effective reproduction number, R(i), was calculated to determine the infectiousness of each case, while exploring the influence of vomiting, diarrhea, and being a resident (as opposed to staff) on case infectiousness. The study found that cases involving vomiting led to 1.28 times more secondary infections than those without vomiting, while LTCF residents caused 1.31 times more secondary infections than staff members. No significant difference in infectiousness was observed between cases with and without diarrhea.
AHRQ-funded; HS025987
Citation: Chen Y, Lopman BA, Hall AJ .
Factors driving norovirus transmission in long-term care facilities: a case-level analysis of 107 outbreaks.
Epidemics 2023 Mar;42:100671. doi: 10.1016/j.epidem.2023.100671.
Keywords: Long-Term Care, Infectious Diseases
Tabatneck ME, He W, Lamb GS
Interferon gamma release asssay results and testing trends among patients younger than 2 years old at two US health centers.
Researchers performed a retrospective cohort study of interferon-gamma release assay (IGRA) use for the diagnosis of tuberculosis infection in patients under 2 years old in two large Boston healthcare systems. A total of 321 IGRA results were analyzed; over 90 percent were valid. The proportion of invalid/indeterminate results was found to be significantly higher among immunocompromised patients. The researchers concluded that the high proportion of valid IGRA test results in patients less than 2 years of age in a low TB prevalence setting supported the adoption of IGRAs for this age group in certain clinical scenarios. They note that the interpretation of IGRAs, particularly in immunocompromised patients, should consider the broader clinical context.
AHRQ-funded; HS000063.
Citation: Tabatneck ME, He W, Lamb GS .
Interferon gamma release asssay results and testing trends among patients younger than 2 years old at two US health centers.
Pediatr Infect Dis J 2023 Mar; 42(3):189-94. doi: 10.1097/inf.0000000000003794..
Keywords: Newborns/Infants, Diagnostic Safety and Quality, Infectious Diseases
Majumder MS, Cusick M, Rose S
Measuring concordance of data sources used for infectious disease research in the USA: a retrospective data analysis.
This study’s objective was to investigate the strengths and limitations of sources currently being used for infectious disease research. This retrospective data analysis used four different data sources to determine differences in the yearly number of national-level and state-level disease-specific case counts and disease clusters for three diseases (measles, mumps, and varicella) during a 5-year study period (2013-2017). The four sources used were Optum (health insurance billing claims data), HealthMap (online news surveillance data), Morbidity and Mortality Weekly Reports (official government reports) and National Notifiable Disease Surveillance System (government case surveillance data). The authors found that when compared with the other three sources of interest, Optum data showed substantially higher, implausible standardized case counts for all three diseases. All four sources identified variations in state-level reporting.
AHRQ-funded; HS026128.
Citation: Majumder MS, Cusick M, Rose S .
Measuring concordance of data sources used for infectious disease research in the USA: a retrospective data analysis.
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Keywords: Infectious Diseases, Research Methodologies
Asher GN, Feltner C, Harrison WN
Serologic screening for genital herpes: updated evidence report and systematic review for the US Preventive Services Task Force.
Genital herpes, a viral sexually transmitted infection (STI) caused by herpes simplex virus (HSV) subtypes HSV-1 or HSV-2, is a prevalent STI in the US. Early identification of unrecognized HSV-2 infection could reduce transmission and morbidity. In 2016, the US Preventive Services Task Force (USPSTF) recommended against routine serologic screening for genital herpes in asymptomatic individuals. This updated evidence report aimed to identify studies published since the previous 2016 evidence review. A literature search was conducted from September 30, 2015, through January 16, 2022, with ongoing surveillance through July 22, 2022. The review identified no new eligible studies, leading to unchanged overall conclusions from the 2016 recommendation against screening. The prior recommendation was based on psychosocial harms from false-positive test results due to poor screening test accuracy and uncertain benefit of preventive viral medications for reducing viral shedding or improving health outcomes. The review focused on the general population of asymptomatic adolescents and adults and may not be applicable to populations at higher risk for infection, such as those with HIV or other immunosuppressive conditions.
AHRQ-funded; 75Q80120D00007.
Citation: Asher GN, Feltner C, Harrison WN .
Serologic screening for genital herpes: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Feb 14; 329(6):510-12. doi: 10.1001/jama.2022.20356..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Screening, Guidelines, Evidence-Based Practice, Prevention
Stone CA, Jr., Robinson LB, Li L
Clinical phenotypes of immediate first-dose reactions to mRNA COVID-19: a multicenter latent class analysis.
The objectives of this retrospective study were to define distinct clinical phenotypes of immediate reactions after dose 1 of mRNA COVID-19 vaccination, and to assess the relation of clinical phenotype to mRNA COVID-19 vaccine second dose tolerance. Researchers identified 265 patients who experienced dose-1 immediate reactions with 3 phenotype clusters: limited or predominantly cutaneous, sensory, or systemic. Of these, 223 patients received a second dose and 200 tolerated the second dose; sensory cluster (numbness or tingling) was associated with a higher likelihood of second dose intolerance, but this finding did not persist when accounting for objective signs.
AHRQ-funded; HS026395.
Citation: Stone CA, Jr., Robinson LB, Li L .
Clinical phenotypes of immediate first-dose reactions to mRNA COVID-19: a multicenter latent class analysis.
J Allergy Clin Immunol Pract 2023 Feb;11(2):458-65.e1. doi: 10.1016/j.jaip.2022.08.048.
Keywords: COVID-19, Medication, Adverse Drug Events (ADE), Adverse Events, Infectious Diseases, Vaccination
Patel P, Deshpande A, Yu PC
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
The purpose of this study was to explore the relationships between the antibiotic regimens of empiric therapy with a respiratory fluoroquinolone or cephalosporin plus macrolide combination and the development of hospital-onset Clostridioides difficile infection (CDI). The researchers used data from 638 United States hospitals and included adults admitted with pneumonia and discharged from July 2010 through June 2015 with a pneumonia diagnosis code who received 3 or more days of either antibiotic regimen. The study sample included 58,060 patients treated with either cephalosporin plus macrolide (36,796 patients) or a fluoroquinolone alone (21,264 patients). 0.35% of patients who received cephalosporin plus macrolide and 0.31% who received a fluoroquinolone developed CDI, making CDI risks similar for fluoroquinolones versus cephalosporin plus macrolide.
AHRQ-funded; HS024277.
Citation: Patel P, Deshpande A, Yu PC .
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
Infect Control Hosp Epidemiol 2023 Jan; 44(1):47-54. doi: 10.1017/ice.2022.60..
Keywords: Pneumonia, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Infectious Diseases, Community-Acquired Infections
Holmer HK, Mackey K, Fiordalisi CV
Major update 2: antibody response and risk for reinfection after SARS-CoV-2 infection-final update of a living, rapid review.
This paper is a final updated living rapid review to synthesize evidence on the SARS-CoV-2 antibody response and reinfection risk with a focus on gaps identified in the author’s prior reports. A literature review was done for English-language cohort studies evaluating IgG antibody duration at least 12 months after SARS-CoV-2 infection, the antibody response among immunocompromised adults, predictors of nonseroconversion, and reinfection risk. Study data was extracted and two investigators rated quality. Most adults had IgG antibodies after SARS-CoV-2 infection at time points greater than 12 months. Although most immunocompromised adults develop antibodies, the overall proportion with antibodies is lower compared with immunocompetent adults. Prior infection provided substantial, sustained protection against symptomatic reinfection with the Delta variant (high strength of evidence) and reduced the risk for severe disease due to Omicron variant (moderate strength of evidence). Prior infection was less protective against reinfection with Omicron overall (moderate strength of evidence), but protection from earlier variants waned rapidly (low strength of evidence).
AHRQ-funded; 290201700003C.
Citation: Holmer HK, Mackey K, Fiordalisi CV .
Major update 2: antibody response and risk for reinfection after SARS-CoV-2 infection-final update of a living, rapid review.
Ann Intern Med 2023 Jan; 176(1):85-91. doi: 10.7326/m22-1745..
Keywords: COVID-19, Evidence-Based Practice, Infectious Diseases, Risk
Feldman AG, O'Leary ST, Danziger-Isakov L
The risk of resurgence in vaccine-preventable infections due to coronavirus disease 2019-related gaps in immunization.
This paper discusses the decline in immunization delivery during the COVID-19 pandemic. The global community is at risk for a resurgence in vaccine-preventable infections including measles, pertussis, and polio. Outbreaks in the United States are likely to occur when social distancing stops and children return to school. Partnerships between healthcare providers, community leaders, and local, state, regional, and national public health departments are needed to reassure families that vaccine delivery during COVID-19 is safe as well as to identify and catch up those children who are under-immunized.
AHRQ-funded; HS026510.
Citation: Feldman AG, O'Leary ST, Danziger-Isakov L .
The risk of resurgence in vaccine-preventable infections due to coronavirus disease 2019-related gaps in immunization.
Clin Infect Dis 2021 Nov 16;73(10):1920-23. doi: 10.1093/cid/ciab127..
Keywords: COVID-19, Children/Adolescents, Vaccination, Infectious Diseases
Cantor A, Dana T, Griffin JC
Screening for chlamydial and gonococcal infections: updated evidence report and systematic review for the US Preventive Services Task Force.
This is the evidence summary and updated review for the September 2021 U.S. Preventive Services Task Force final recommendation on screening for chlamydial and gonococcal infections among sexually active women 25 years or older and sexually active men. The Task Force concluded that for women screening is recommended, but for men the current evidence is insufficient to assess the balance of benefits and harms. This systematic review screened over 2200 articles and included 20 articles. The articles included helped to answer the 4 key questions that were included in the research plan.
AHRQ-funded; 290201500009I.
Citation: Cantor A, Dana T, Griffin JC .
Screening for chlamydial and gonococcal infections: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Sep 14;326(10):957-66. doi: 10.1001/jama.2021.10577..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Screening, Evidence-Based Practice, Guidelines, Prevention
Miller AC, Koeneman SH, Arakkal AT
Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study.
This retrospective cohort study determined the frequency and duration of diagnostic delays for herpes simplex encephalitis (HSE) that are associated with increased morbidity and mortality. Data from the IBM Marketscan Databases from 2001-2017 was used. The authors estimated the number of visits with HSE-related symptoms before diagnosis that would be expected to occur in the absence of delays and compared this estimate to the observed pattern of visits. Then a simulation-based approach was used to compute the number of visits representing a delay. They identified 2667 patients diagnosed with HSE and estimated 45.9% of patients experienced at least 1 missed opportunity, with 21.9% of patients having delays lasting >7 days. Risk factors for delays included being seen only in the emergency department, age 65 or older, or a history of sinusitis or schizophrenia.
AHRQ-funded; HS027375.
Citation: Miller AC, Koeneman SH, Arakkal AT .
Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study.
Open Forum Infect Dis 2021 Sep;8(9):ofab400. doi: 10.1093/ofid/ofab400..
Keywords: Infectious Diseases, Neurological Disorders, Diagnostic Safety and Quality, Risk
Bartsch SM, Wong KF, Mueller LE
Modeling interventions to reduce the spread of multidrug-resistant organisms between health care facilities in a region.
The objective of this study was to identify a group of target facilities and to assess which multidrug-resistant organism (MDRO) intervention would be best to implement in the Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, a large regional public health collaborative in Orange County, California. Findings suggested that decolonization would be the best strategy for the Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County.
AHRQ-funded; HS023317; HS028165.
Citation: Bartsch SM, Wong KF, Mueller LE .
Modeling interventions to reduce the spread of multidrug-resistant organisms between health care facilities in a region.
JAMA Netw Open 2021 Aug 2;4(8):e2119212. doi: 10.1001/jamanetworkopen.2021.19212..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Public Health
Van Gerwen OT, Camino AF, Bourla LN
Management of trichomoniasis in the setting of 5-nitroimidazole hypersensitivity.
Metronidazole and other 5-nitroimidazoles are the mainstay of Trichomonas vaginalis treatment, with few efficacious and safe treatment options available outside of this class. Patients with trichomoniasis and a history of a clinically confirmed hypersensitivity reaction to 5-nitroimidazoles present a management challenge for clinicians. In this study, the investigators examine management of Trichomoniasis in the setting of 5-nitroimidazole hypersensitivity.
AHRQ-funded; HS013852.
Citation: Van Gerwen OT, Camino AF, Bourla LN .
Management of trichomoniasis in the setting of 5-nitroimidazole hypersensitivity.
Sex Transm Dis 2021 Aug;48(8):e111-e15. doi: 10.1097/olq.0000000000001326..
Keywords: Infectious Diseases, Sexual Health, Antibiotics, Medication
Cunningham-Erves J, Campbell L, Barlow C
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
AHRQ-funded; HS022990.
Citation: Cunningham-Erves J, Campbell L, Barlow C .
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614..
Keywords: Sexual Health, Infectious Diseases, Cancer, Disparities, Racial and Ethnic Minorities, Men's Health, Prevention, Health Promotion, Education: Patient and Caregiver
Bramante CT, Buse J, Tamaritz L
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
This study investigated whether outpatient metformin use is associated with reduced severity of COVID-19 in adults with overweight or obesity. Metformin can decrease interleukin-6 and tumor-necrosis factor- α, which appears to contribute to COVID-19 mortality. The authors conducted a retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March and December 2020. Inclusion criteria included data for BMI > 25 kg/m(2); age range 30-85 years; and a positive SARS-CoV-2 polymerase chain reaction test. Metformin was associated with a decrease in mortality from COVID-19 and a nonsignificant decrease in hospital admission in the overall cohort.
AHRQ-funded; HS026379.
Citation: Bramante CT, Buse J, Tamaritz L .
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
J Med Virol 2021 Jul;93(7):4273-79. doi: 10.1002/jmv.26873..
Keywords: COVID-19, Infectious Diseases, Obesity, Medication, Treatments, Outcomes
Magee LA, Fortenberry JD, Nelson T
Sexually transmitted infections in association with area-level prostitution and drug-related arrests.
Using justice and public health sexually transmitted infections (STIs) /HIV data in Marion County (Indianapolis), Indiana, during an 18-year period, the authors assessed the overall association of area-level prostitution and drug-related arrests and STI/HIV, and mediators and moderators of the relationship. Results indicated a positive relationship between numbers of prostitution arrests and area-level STI rates. There was a dose-response relationship between prostitution arrests and STI rates when accounting for drug-related arrests. The authors stated that these findings inform public health agencies and community-based organizations that conduct outreach in these areas to expand their efforts to include harm reduction and HIV/STI testing for both sex workers and individuals experiencing substance use disorder.
AHRQ-funded; HS023318.
Citation: Magee LA, Fortenberry JD, Nelson T .
Sexually transmitted infections in association with area-level prostitution and drug-related arrests.
Sex Transm Dis 2021 Jul;48(7):508-14. doi: 10.1097/olq.0000000000001345..
Keywords: Sexual Health, Human Immunodeficiency Virus (HIV), Infectious Diseases