The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgia.The agency's main goal is the protection of public health and safety through the control and prevention of disease, injury, and disability in the US and worldwide. The CDC focuses national attention on developing and applying disease control and prevention. It especially focuses its attention on infectious disease, food borne pathogens, environmental health, occupational safety and health, health promotion, injury prevention and educational activities designed to improve the health of United States citizens. The CDC also conducts research and provides information on non-infectious diseases, such as obesity and diabetes, and is a founding member of the International Association of National Public Health Institutes.The current Director of the CDC is Rochelle Walensky. The Director reports to the United States Secretary of Health and Human Services.
BACKGROUND:Introduction of pediatric-friendly dolutegravir (DTG) formulations to treat children living with HIV (CLHIV) has presented new opportunities to improve viral suppression; however, there are limited data on emerging patterns of HIV drug resistance (HIVDR) in this population. METHODS:We identified CLHIV aged 0-15 years experiencing virologic failure on first-line antiretroviral therapy in Uganda between January 2021 and November 2021 from the Central Public Health Laboratory database. Remnant viral load samples were tested for HIVDR using Sanger sequencing. Drug resistance mutations (DRMs) were identified, and antiretroviral susceptibility was interpreted using the Stanford University HIVDR Database algorithms. The prevalence of DRMs and HIVDR is summarized using descriptive statistics, and associations with demographic and clinical factors were determined using χ 2 tests. RESULTS:Among 333 successfully genotyped patient samples, 122 (36.6%) CLHIV were on a DTG-based regimen and 136 (40.8%) on a lopinavir-based regimen. Among all CLHIV, 271 (81.4%) had DRMs and 262 (78.7%) had any intermediate-to-high level HIVDR [including DTG (1.8%), lopinavir (9.6%), abacavir (ABC) (25.5%), and zidovudine (19.2%)]. Among CLHIV on a DTG-based regimen, 6.6% had any integrase inhibitor DRMs and 4.1% had intermediate-to-high resistance to DTG. Children on DTG-based regimens were less likely to have DRMs ( P = 0.007) or HIVDR ( P = 0.02) compared with all other regimens. CLHIV on DTG-based regimens with an ABC backbone were no more likely to have DRMs ( P = 0.9) or HIVDR ( P = 0.5) compared with those with a backbone not containing ABC. CONCLUSIONS:Low rates of DTG resistance among Ugandan CLHIV failing first-line DTG-based antiretroviral therapy regimens underscore the durability of DTG. Lack of difference in ABC resistance across all regimens supports maintaining an ABC backbone for CLHIV <30 kg when transitioning to a DTG-based regimen despite virologic failure.
Effective interventions for controlling Anopheles malaria vectors depend on accurately identifying the species. Venezuela has the highest malaria prevalence in the region of the Americas; however, there is very limited knowledge about the vectors, especially regarding species complexes and their distribution. To conduct molecular taxonomy and phylogenetic analysis of the Albitarsis, Nuneztovari, and Oswaldoi complexes from malaria-endemic regions of Guyana and Venezuela using mtCOI sequences. Anopheles were collected in Guyana (Potaro-Siparuni Region) and Venezuela (five municipalities). Species identification was carried out by analyzing mitochondrial cytochrome C oxidase (mtCOI) gene data using MrBayes, TCS, Posterior Probabilities of Correct Identification (P ID), Rosenberg’s P (AB) values, and P (Randomly Distinct) as species delimitation approaches. Four distinct taxa were identified: An. albitarsis F, An. goeldii, An. oswaldoi A and An. oswaldoi B. Anopheles oswaldoi A and An. oswaldoi B occurred sympatrically in Boca de Nichare, Bolívar State, Venezuela. Anopheles goeldii is reported for the first time from Guyana and Venezuela, and discuss its role as vector of malaria parasites in both countries and its relative recent colonization. Anopheles oswaldoi A is reported for the first time from Venezuela. Anopheles albitarsis F, an important malaria vector in Colombia and Venezuela, is confirmed as the only species of the Albitarsis complex widely distributed in Venezuela. Our results will be valuable for future research aimed at clarifying the status of these significant species complexes in the region.
Patient and healthcare provider knowledge were previously found to be significantly associated with viral hepatitis testing in Uzbekistan. However, no survey has assessed awareness and knowledge of viral hepatitis among the general population. In 2022, we conducted a cross-sectional population-based survey among persons aged≥18 years in seven of Uzbekistan’s 14 regions representing 60
Antibiotic misuse among pregnant and breastfeeding women is a critical public health challenge in low-resource settings. Individual attitudes, social expectations, and structural barriers shape women’s intentions to follow medical advice. Thus, this study investigates how attitudes, subjective norms, and perceived behavioral control shape pregnant and breastfeeding women’s intentions to seek medical advice prior to antibiotic use. Using the theory of planned behavior (TPB), this mixed-methods study collected data from 115 women in the urban and rural districts of Mahajanga, Madagascar. Qualitative analysis explored statements and informational practices, whereas linear regressions, partial least squares regressions (PLS-R), and binary logistic regression (BLR) identified determinants of intention. Overall, 79.1
The Uganda Public Health Fellowship Program (UPHFP) is a 2-year, non-degree-granting field epidemiology training program. It enrolls only post-Master's degree fellows, who are integrated during their training into key Ministry of Health (MOH) programs, such as the National Malaria Control Program, and supported technically and financially by the U.S. President's Malaria Initiative (PMI) and U.S. Centers for Disease Control and Prevention. However, the nature and extent of the UPHFP contributions to the malaria control programs have not been systematically documented. We describe how the UPHFP strategies contributed to malaria control programs and share implementation challenges and opportunities to inform future programming. From 2015 to 2022, UPHFP led or supported 50 malaria projects, including 14 malaria surveillance projects, 11 malaria outbreak investigations, 7 epidemiological studies, 5 case studies, 6 malaria quality improvement projects, 3 policy briefs, and 4 training and mentorship projects. These projects have informed policy decisions and strengthened surveillance, coordination, and response to malaria outbreaks. A key challenge is single-source funding that makes the program more vulnerable to changes in donor priorities. Our documentation demonstrates the critical value of UPHFP to the country's malaria control efforts by enhancing epidemiologic workforce capacity and strengthening epidemiological surveillance.
