CONCLUSIONS: In the setting of multiple disease outbreaks, the characteristics of infected patients may be largely similar. Some people with dual infection may show unusual test results or symptom patterns compared with those with only one infection. Large public health studies with robust reporting systems and laboratory screening are vital for early detection of dual infections. Public health strategies to educate providers and outreach teams enhance response during concurrent outbreaks....

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CONCLUSIONS: PHS predictors differed by HIV status. The current findings highlight the importance of leveraging SSP and drug use treatment to combat HIV stigma effectively.

A quantitative understanding of local transmission dynamics is essential for designing effective prevention strategies. In this study, we developed a computational workflow to identify viral introductions and trace locally circulating clusters. We analyzed over 26,000 SARS-CoV-2 genomes and their associated metadata, collected between January and October 2021, to explore introduction and local dispersal patterns in Greater Houston, a major metropolitan area known for its demographic diversity....

CONCLUSIONS: While 50% of the city experienced power outages from high winds, total ED visits, acute cardiac events, and heat-related illness were statistically higher in the first 3 days after Beryl than expected. Houston developed targeted messaging to mitigate these events in future disasters.

CONCLUSIONS: In this study, we introduce the Source Sink Score, which determines whether a localized outbreak serves as a source or sink for other regions, and the Local Import Score, which assesses whether the outbreak has transitioned to local transmission rather than being maintained by continued introductions. These epidemiological statistics provide actionable insights for developing public health interventions tailored to the needs of affected areas.

Measles is a potentially deadly viral infection spread via respiratory droplets from infected individuals. Outbreaks occur when vaccine coverage drops below the threshold of herd, or community, immunity. Using a sequencing-based approach, we report the prospective (January 7, 2025) detection of measles in nucleic acid extracts from 2 wastewater treatment plants in Houston, Texas, with a population of more than 218 000 residents. The sequencing data from 2 samples contained 53 unique reads...

Long-acting antiretroviral (LAARV) agents have the potential to enhance treatment and prevention by eliminating the need for daily oral medications and increasing available options. This paper reviewed recent evidence on LAARVs and explores the opportunities and challenges of implementing these innovative prevention and treatment strategies in Sub-Saharan Africa (SSA). Several clinical trials and studies on the effectiveness, drug-drug interactions, and resistance of LAARVs in key populations in...

Salmonella enterica serovar Enteritidis (S. Enteritidis) is one of the most common causes of bacterial foodborne infections worldwide. It has an extensive host range, including birds and humans, making it one of the most adaptable Salmonella serovars. This study aims to define the virulence gene profile of S. Enteritidis and identify genes critical to its host specificity. Currently, there is limited understanding of the molecular mechanisms that allow S. Enteritidis to continue as an important...

CONCLUSIONS: The novel procedure integrated real-time monitoring data and geospatial data science to enhance the design and adaptive delivery of a community-based randomized trial. Adaptive selection effectively prioritized the most in-need communities and allowed for a rigorous evaluation of community-based interventions in a multilevel trial. This methodology has broad applicability and can be adapted to other public health intervention and prevention programs, providing a powerful tool for...

In the United States (US), sexuality-based stigma continues to undermine HIV prevention and care efforts. We assessed sexual behavior stigma burden across family, healthcare, and social domains and determined associations with HIV-related outcomes among cisgender gay, bisexual, and other men who have sex with men (MSM) in nine US metropolitan statistical areas. MSM (N = 4,086) recruited at places of MSM social congregation via venue-based, time-sampling procedures completed a survey on sexual...

OBJECTIVES: Pre-exposure prophylaxis (PrEP) is a key biomedical intervention for ending the HIV epidemic in the United States, but its uptake is impeded by systemic barriers, including fragmented workflows and ineffective data coordination. This study aims to design PrEPLinker, a blockchain-based, client-centered platform to enhance care to address these challenges by improving care coordination and enabling clients to securely manage their identity and PrEP-related data.

Wastewater surveillance of vaccine-preventable diseases may provide early warning of outbreaks and identify areas to target for immunization. To advance wastewater monitoring of measles, mumps, and rubella viruses, we developed and validated a multiplexed RT-ddPCR assay for the detection of their RNA. Because the measles-mumps-rubella (MMR) vaccine is an attenuated live virus vaccine, we also developed an assay that distinguishes between wild-type and vaccine strains of measles in wastewater and...

In 2020, the Houston Health Department (HHD) in Texas launched a citywide wastewater surveillance program, including a pilot program that monitored manholes at schools in Houston's largest school district (prekindergarten-12th grade). By 2022, the pilot program monitored wastewater for SARS-CoV-2, influenza A and B, and respiratory syncytial virus. To ensure effective communication of wastewater surveillance results to school communities, HHD designed and implemented a text- and email-based...

Since the start of the COVID-19 pandemic, wastewater surveillance hasemerged as a critical tool for tracking the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and other pathogens in communities throughout the United States. In 2020, the Centers for Disease Control and Prevention (CDC) launched the National Wastewater Surveillance System (NWSS), which partners with state, local, tribal, and territorial health departments to develop and implement wastewater...

Latent classification model is a class of statistical methods for identifying unobserved class membership among the study samples using some observed data. In this study, we proposed a latent classification model that takes a censored longitudinal binary outcome variable and uses its changing pattern over time to predict individuals' latent class membership. Assuming the time-dependent outcome variables follow a continuous-time Markov chain, the proposed method has two primary goals: (1)...

CONCLUSIONS: This study showed differences in risks from melanoma survival based on patient demographic and clinical characteristics. Low socioeconomic status increased mortality risk, and first-line immunotherapy use favored survival. Health policies and tailored interventions that will promote equity in patient survival and survivorship are essential for managing metastatic melanoma.

OBJECTIVES: To build on the success of wastewater surveillance during the COVID-19 pandemic, jurisdictions funded under the Centers for Disease Control and Prevention National Wastewater Surveillance System are looking to expand their wastewater programs to detect more pathogens. However, many public health agencies do not know how to use the collected wastewater data to formulate public health responses, underscoring a need for guidance. To address this knowledge gap, the Houston Health...

Objective This study aimed to explore mental and behavioral health support trends for children aged 3-17, analyzing treatment and counseling using United States data from the 2016-2020 National Survey of Children's Health (NSCH) database. Methods Employing a retrospective observational design, we systematically retrieved and analyzed NSCH Database data from 2016 to 2020. The focus was on understanding mental and behavioral health treatment percentages over time, specifically targeting...

Evaluating routine HIV testing and treatment and use of services for people who inject drugs (PWID) is critical to curb the ongoing HIV epidemic. We analyzed data from the 2018 National HIV Behavioral Surveillance of PWID aged 18 years or older, recruited using respondent-driven sampling and offered anonymous HIV testing after survey. We performed bivariate and multivariable analyses with log-linked Poisson regression of the generalized linear models to examine the associations between...