Page images
PDF
EPUB

LE 1. Number and percentage of deaths among persons with AIDS linked electronically to the electronic Death Certificate File
F) and Social Security Death Master File (SSDMF), by reporting status - District of Columbia, 2000–2005

Linked only Linked only Linked to both Known deaths not linked
to eDCF

to SSDMF eDCF and SSDMF to either eDCF or SSDMF *rting status

No. (%)
No. (%) No. (%)

No. (%)

Total is not previously

320 (24)
577 (43) 440 (33)

1,337 orted to HARS* is previously reported

321 (29)
181 (16)
481 (43)

140
(12)

1,123 ARS deaths

641 (26)
758 (31) 921 (37)

(6)

2,460 -AIDS Reporting System.

140

92

** LE 2. Number and percentage of deaths not previously reported to HARS,* by selected characteristics — District of Columbia, --2005

Deaths not previously

reported to HARS
Total deaths
(n = 760)

Adjusted acteristic

(n = 1,562)
No. (%)

odds ratio (95% CIS)
rlying cause of death 11
infection

1,056

367
(35)

Referent ses other than HIV infection

506
393 (78)

7.53

(5.80–9.79)
of death
)

272
99 (36)

Referent
265
(35)

0.90

(0.60–1.34) ?

276

119
(43)

1.37

(0.93–2.02) 3

283
162 (57)

2.83

(1.93–4.14)
268
165 (62)

3.65

(2.47–5.40) j

198
123 (62)

3.38

(2.21–5.17)
Ethinicity
.k, non-Hispanic

1,425
690 (48)

Referent e, non-Hispanic

108
59 (55)

1.42

(0.88–2.29) anic/Other**/Not specified

29
11 (38)

0.73

(0.31-1.72)
7. jmission category
injection-drug use (IDU)

541
285 (53)

Referent who have sex with men (MSM)

361
166 (46)

0.82

(0.58–1.15) 4 and IDU

35 (50)

0.92

(0.51-1.64) -risk heterosexual contacttt

297
132 (44)

0.76

(0.55–1.06) isk factor specified/Other$$

293
142 (48)

0.76

(0.54–1.05)

70

(0.89–1.55)

1,053
505 (48)

Referent ale

509
255 (50)

1.18
at death (yrs)
10

408
182 (45)

Referent 19

653
309 (47)

0.87 59

385
203 (53)

0.99 50

116
66 (57)

0.78
AIDS Reporting System.
vited to the 1,562 deaths with underlying cause of death information from death certificate
nfidence interval.

jed on codes from the International Classification of Diseases, Tenth Revision. . - Hispanic Asian, Pacific Islander, American Indian, or Alaska Native.

cual contact with a person known to be HIV-infected or at high risk for HIV infection (e.g., history of IDU or MSM). udes mother-child transmission (n = 13) and transfusion (n = 3).

(0.65–1.16)
(0.71-1.38)
(0.48–1.28)

Acknowledgments This report is based, in part, on contributions by F John Clarke, PhD, Research and Analysis Div, and J Davidson-Rar Vital Records Div, State Center for Health Statistics Admin. Id of Health, District of Columbia.

death in a person with AIDS. Antiretroviral therapy has reduced the percentage of deaths attributed to HIV infection and, therefore, limited the effectiveness of a manual death ascertainment method (7,8). Electronic record linkage has the advantage of being able to find deaths from all causes among persons with HIV/AIDS because electronic linkage can efficiently process large numbers of death records without being limited to death records that mention HIV infection.

Manual review of death certificates for a state generally is limited to persons who died in that state. A more complete ascertainment of deaths requires electronic linkage to a national death data file, such as SSDMF or the National Death Index. In this study, SSDMF and eDCF provided complementary and independent death information, with most deaths linked to only one of these data files. More deaths linked to SSDMF than eDCF, underscoring the importance of linking to a national death data file. The National Death Index, accessible through CDC's National Center for Health Statistics (9), is a national death certificate data file that is not limited to decedents with a Social Security number and includes information on causes of death. The National Death Index could be used to help ascertain deaths among AIDS patients; however, the index is more expensive to researchers because of fees charged to remunerate the state vital records offices that compile the data.

The findings in this report are subject to at least one limitation. The DC findings might not be entirely generalizable to the 50 states because DC's close proximity to other states might increase the frequency of out-of-state deaths that are not reported to the DC Vital Records Division. The conditions that led to underestimation of deaths, however, including the frequency of deaths with causes other than HIV infection and the possibility that HIV-infected persons might die in another state, affect many areas of the United States.

Electronic linkage of the HIV/AIDS case registry with a state's death-certificate registry and with a national death registry such as SSDMF is a more efficient and thorough method to ascertain deaths among persons with HIV/AIDS than manual linkage limited to in-state death certificates that mention HIV. Improved death ascertainment can enable more accurate estimates of HIV/AIDS prevalence and a more effective allocation of HIV prevention and treatment resources. These findings support the CDC/CSTE recommendation to perform electronic record linkage to ascertain deaths annually

of routine HIV/AIDS surveillance activities (3). Most state HIV/AIDS surveillance programs have followed this recommendation (CSTE, unpublished data, 2007), but a barrier in some areas has been the lack of personnel skilled at computer programming to perform these electronic linkages.

References 1. Glynn M, Rhodes P. Estimated HIV prevalence in the United Sz:

the end of 2003. (Abstract] 2005 National HIV Prevention Com ence, June 12–15, Atlanta, GA. Available at http://www.aegis ca

conferences/NHIVPC/2005/T1-B1101.html. 2. CDC. Cases of HIV infection and AIDS in the United States

dependent areas, 2005: HIV/AIDS surveillance report, 2005. Vo Revised ed. Atlanta, GA: US Department of Health and Hud Services, CDC; 2007. Available at http://www.cdc.gov/hivi top

surveillance/resources/reports/2005report/default.htm. 3. CDC and Council of State and Territorial Epidemiologists. Techn

guidance for HIV/AIDS surveillance programs, volume I: policies al procedures. Atlanta GA: US Department of Health and Human

Services, CDC; 2005. 4. National Program of Cancer Registries. Link Plus. Atlanta, GA 15

Department of Health and Human Services, CDC; 2007. Availadt a

http://www.cdc.gov/cancer/npcr/tools/registryplus/lp.htm. 5. CDC. 1993 revised classification system for HIV infection and expand

surveillance case definition for AIDS among adolescents and ads

MMWR 1992;41(No. RR-17):1–19. 6. CDC. Guidelines for national human immunodeficiency virus cx

surveillance, including monitoring for human immunodeficiency vis infection and acquired immunodeficiency syndrome. MMWR 1974

48(No. RR-18). 7. Mocroft A, Brettle R, Kirk O, et al. Changes in the cause of death anum

HIV positive subjects across Europe: results from the EuroSIDA STECL

AIDS 2002;16:1663–71. 8. Sackoff JE, Hanna DB, Pfeiffer MR, Torian LV. Causes of death anu

persons with AIDS in the era of highly active antiretroviral the

New York City. Ann Intern Med 2006;145:397-406. 9. CDC. National Death Index. Hyattsville, MD: US Departmen:

Health and Human Services, CDC, National Center for Health Sztics. Available at http://www.cdc.gov/nchs/ndi.htm.

Notice to Readers

World Elder Abuse Awareness Day 2008

June 15, 2008 By 2030, nearly one in five persons in the United Surs (approximately 72 million persons) will be aged 265 yes (1). As the number of older adults grows, so does the numid of persons who might experience elder abuse or neglect, and associated injuries, social isolation, diminished well being, and increased risks for suicide and premature death.

World Elder Abuse Awareness Day, June 15, 2008, is a car paign coordinated by the International Network for the te vention of Elder Abuse to raise awareness of elder abuse and neglect worldwide. The theme of this year's campaign is \y World... Your World... Our World - Free of Elder Abuse In support of this campaign, organizations around the word are hosting events to increase recognition of elder abuse and

as part

men neglect as public health and human rights issues and raise

awareness of the many factors that can lead to or limit abuse. Additional information regarding World Elder Abuse Awareness Day activities is available from the International Network or the Prevention of Elder Abuse at http://www.inpea.net.

Reference
1. Administration on Aging. Older population by age: 1900 to 2050.

Washington, DC: US Department of Health and Human Services; 2005.
Available at http://www.aoa.gov/prof/statistics/online_stat_data/
agepop 2050.asp

QuickStats

FROM THE NATIONAL CENTER FOR HEALTH STATISTICS

Age-Adjusted Percentage of Adults Aged >40 Years with Diagnosed
Diabetes Who Have Glycosylated Hemoglobin (HbA1c), Total Blood

Cholesterol, and Blood Pressure Under Control, by Race/Ethnicity
National Health and Nutrition Examination Survey, United States, 2003–2006

[merged small][graphic][merged small][subsumed][merged small][merged small][subsumed][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][ocr errors]

During 2003–2006, non-Hispanic white adults aged >40 years with diabetes were more likely than their non-
Hispanic black and Mexican-American counterparts to have HbA1c controlled to the recommended level. No
statistically significant differences were observed by race/ethnicity in the percentage of adults aged >40 years
with diabetes whose total blood cholesterol and blood pressure were controlled to recommended levels.
SOURCE: National Health and Nutrition Examination Survey data, 2003–2006. Available at http://www.cdc.gov/
nchs/nhanes.htm.

1

[ocr errors]

1

[ocr errors]

[ocr errors]
[ocr errors]
[ocr errors]

looo

[ocr errors]
[ocr errors]

A A NAWO

TABLE I. Provisional cases of infrequently reported notifiable diseases (<1,000 cases reported during the preceding year) - United States, week ending June 7, 2008 (23rd Week)*

5-year Current Cum weekly

Total cases reported for previous years Disease

week 2008 average 2007 2006 2005 2004 2003 States reporting cases during current week (No Anthrax

1 Botulism: foodborne

4

0 32 20 19 16 20 infant

32

2

85 97 85 87 76 other (wound & unspecified)

5

27 48 31 30 33 CA (1) Brucellosis

32

2 129 121 120 114 104 Chancroid

23
23 33

17 30 54 Cholera

0
7
9
8
6

2 Cyclosporiasis

2 31 11
93 137 543

160 75 FL (2) Diphtheria

1 Domestic arboviral diseases 1: California serogroup

1

53 67 80 112 108 eastern equine

4
8
21

6

14 Powassan

1
1

1 St. Louis

10
13

12 41
western equine
Ehrlichiosis/Anaplasmosis$. *
Ehrlichia chaffeensis

10 57 11 829 578

506
338

321 MN (1), MD (7), TN (1), AL (1)
Ehrlichia ewingii
Anaplasma phagocytophilum

1
19
15
870
646 786 537 362

MN (1) undetermined

2

7 367 231 112 59 44
Haemophilus influenzae, **
invasive disease (age <5 yrs):
serotype b

15
23 29

9

19 32 nonserotype b

78

197 175 135 135 117 unknown serotype

102

181
179
217 177

227 NY (1) Hansen diseases

32
. 101

66

87 105 95 Hantavirus pulmonary syndromes

5
1 32 40 26 24

26 Hemolytic uremic syndrome, postdiarrheals

1
42
297 288 221 200 178

MO (1)
Hepatitis C viral, acute

7 313

16
856 766

652 720 1,102 MO (1), KS (2), FL (1), TX (2), WA (1) HIV infection, pediatric (age <13 yrs)$$

380
436

504 Influenza-associated pediatric mortalitys. m

1 81
1 76 43 45

N

TX (1) Listeriosis 7 205 14 818 884 896 753

696 NY (1), PA (1), OH (1), WI (1), WA (1), CA (2) Measles***

2 78

2
43 55 66

37

56 MD (1), GA (1)
Meningococcal disease, invasivetit:
A, C, Y, & W-135

1 138
322 318 297

FL (1) serogroup B

75

4

168 193 156 other serogroup

34 32 27 unknown serogroup 11 326 14 559 651 765

MD (2), GA (1), FL (2), CO (1), AZ (1). CA (3). AK *, Mumps

1 233 35 867 6,584 314 258 231 CA (1) Novel influenza A virus infections

1
N
N
N

N
Plague

1

7
17
8
3

1 Poliomyelitis, paralytic

1 Poliovirus infection, nonparalytics

N
N
N

N
Psittacosis

2

12
21
16

12 12 Q fever:946 total:

2 23

176 169 136 70 71 acute 2 20

CA (2) chronic

3 Rabies, human

1
3
2
7

2 Rubella

12.
11
11
10

7 Rubella, congenital syndrome

1

1 SARS-CoVS."

8 -: No reported cases. N: Not notifiable. Cum: Cumulative year-to-date counts.

Incidence data for reporting years 2007 and 2008 are provisional, whereas data for 2003, 2004, 2005, and 2006 are finalized.
Calculated by summing the incidence counts for the current week, the 2 weeks preceding the current week, and the 2 weeks following the current week, for a total of 5

preceding years. Additional information is available at http://www.cdc.gov/epo/dphsi/phs/files/5yearweeklyaverage.pdf.
s Not notifiable in all states. Data from states where the condition is not notifiable are excluded from this table, except in 2007 and 2008 for the domestic arboviral diseases and
influenza-associated pediatric mortality, and in 2003 for SARS-COV. Reporting exceptions are available at http://www.cdc.gov/epo/dphsi/phs/infdis.htm.
Includes both neuroinvasive and nonneuroinvasive. Updated weekly from reports to the Division of Vector-Borne Infectious Diseases, National Center for Zoonotic. Vector
Borne, and Enteric Diseases (ArboNET Surveillance). Data for West Nile virus are available in Table II.
The names of the reporting categories changed in 2008 as a result of revisions to the case definitions. Cases reported prior to 2008 were reported in the categones
Ehrlichiosis, human monocytic (analogous to E. chaffeensis); Ehrlichiosis, human granulocytic (analogous to Anaplasma phagocytophilum), and Ehrlichiosis, unspecified or

other agent (which included cases unable to be clearly placed in other categories, as well as possible cases of E. ewingii). 1 Data for H. influenzae (all ages, all serotypes) are available in Table II. $$ Updated monthly from reports to the Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Implementation of HIV reporting

influences the number of cases reported. Updates of pediatric HIV data have been temporarily suspended until upgrading of the national HIV/AIDS surveillance data

management system is completed. Data for HIV/AIDS, when available, are displayed in Table IV, which appears quarterly. 11 Updated weekly from reports to the Influenza Division, National Center for Immunization and Respiratory Diseases. Eighty cases occurring during the 2007-08 influenza

season have been reported.

The two measles cases reported for the current week were indigenous. 117 Data for meningococcal disease (all serogroups) are available in Table II. $$$ In 2008, Q fever acute and chronic reporting categories were recognized as a result of revisions to the Q fever case definition. Prior to that time, case counts were not

differentiated with respect to acute and chronic Q fever cases. 119 No rubella cases were reported for the current week.

Updated weekly from reports to the Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases.

15

[ocr errors]
[ocr errors]
[ocr errors]
[ocr errors]
[ocr errors]
[ocr errors]
[ocr errors]

1

27

20

1
1

ABLE I. (Continued) Provisional cases of infrequently reported notifiable diseases (<1,000 cases reported during the preceding year) — United States, week ending June 7, 2008 (23rd Week)*

5-year Current Cum weekly

Total cases reported for previous years Disease

week 2008 averaget 2007 2006 2005 2004 2003 States reporting cases during current week (No.) Smallpoxs Streptococcal toxic-shock syndrome

2 73

3 132 125 129 132 161 OH (1), MD (1) syphilis, congenital (age <1 yr)

63 8 381 349 329 353 413 etanus

2

41 27 34 oxic-shock syndrome (staphylococcal) 27 2 92 101 90 95 133

CA (1) richinellosis

3 0
6 15 16 5 6

CA (1) ularemia

2

137 95 154 134 129 NC (1), OK (1) yphoid fever

153
439 353 324 322 356

CA (1) 'ancomycin-intermediate Staphylococcus aureus

6

N 'ancomycin-resistant Staphylococcus aureus

0
2
1
3

N

PA (1) libriosis (noncholera Vibrio species infections) 4 63 2 402 N N N N MN (1), FL (3) 'ellow fever - No reported cases. N: Not notifiable. Cum: Cumulative year-to-date counts. * Incidence data for reporting years 2007 and 2008 are provisional, whereas data for 2003, 2004, 2005, and 2006 are finalized. Calculated by summing the incidence counts for the current week, the 2 weeks preceding the current week, and the 2 weeks following the current week, for a total of 5

preceding years. Additional information is available at http://www.cdc.gov/epo/dphsi/phs/files/5yearweeklyaverage.pdf. $ Not notifiable in all states. Data from states where the condition is not notifiable are excluded from this table, except in 2007 and 2008 for the domestic arboviral diseases and

influenza-associated pediatric mortality, and in 2003 for SARS-CoV. Reporting exceptions are available at http://www.cdc.gov/epo/dphsi/phs/infdis.htm.

16

4

1

28

[ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors]
« PreviousContinue »