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UNASSIGNED: The diagnosis-based Human Immunodeficiency Virus (HIV) Care Continuum offers a well-established framework for measuring HIV care quality. It is used by the government agencies, community organizations, and health care institutions to \"guide the nation\'s response to HIV\" and assesses HIV care from the time of HIV diagnosis through viral suppression. Our objective is to present the Veteran Health Administration\'s (VHA) HIV Care Continuum, assess postpandemic versus prepandemic performance, and compare VHA performance to Centers for Disease Control and Prevention-published data.
UNASSIGNED: We conducted a nationwide retrospective cohort analysis examining the care continuum for people with HIV (PWH) in VHA care in 2019 versus 2022. Measurements included linkage to care, receipt of care, retention in care, and viral suppression. We used multivariable logistic regression of virological suppression to identify factors associated with viral suppression.
UNASSIGNED: In VHA in 2019, 83% of individuals newly diagnosed with HIV were linked to care, 84% of PWH received care, 76% were retained in care, and viral suppression was 76% among those with HIV and 93% of those with viral load (VL) results. In 2022, 74% were linked to care, 79% received care, 67% were retained in care, and viral suppression was 70% among those with HIV and 94% of those with a VL result.
UNASSIGNED: VHA has achieved >90% viral suppression among those with a VL result. Among all PWH, viral suppression decreased an absolute 5.2% between 2019 and 2022. VHA\'s performance on the HIV Care Continuum exceeds the national HIV Care Continuum reported by the Centers for Disease Control and Prevention.

BACKGROUND: Yearly bronchiolitis and influenza-like illness epidemics in France often involve high morbidity and mortality, which severely impacts healthcare. Epidemics are declared by the French National Institute of Public Health based on syndromic surveillance of primary care and emergency departments (ED), using statistics-based alarms. Although the effective reproduction number (Rt) is used to monitor the dynamics of epidemics, it has never been used as an early warning tool for bronchiolitis or influenza-like illness epidemics in France.We assessed whether Rt is useful for detecting seasonal epidemics by comparing it to the tool currently used (MASS) by epidemiologists to declare epidemic phases.
METHODS: We used anonymized ED syndromic data from the Île-de-France region in France from 2010 to 2022. We estimated Rt and compared the indication of accelerated transmission (Rt >1) to the MASS epidemic alarm time points. We computed the difference between those two time points, time to epidemic peak, and the daily cases documented at first indication and peak.
RESULTS: Rt provided alarms for influenza-like illness and bronchiolitis epidemics that were, respectively, 6 days (IQR[4;8]) and 64 days (IQR[52;80]) - in median - earlier than the alarms provided by MASS.
CONCLUSIONS: Rt detected earlier signals of bronchiolitis and influenza-like illness epidemics. Using this early-warning indicator in combination with others to declare an annual epidemic could provide opportunities to improve healthcare system readiness.

BACKGROUND: Yunnan province borders Myanmar, Laos, and Vietnam, giving it one of the longest borders in China. We aimed to determine the trends in prevalence and impact of COVID-19 on depressive symptoms among adolescents (12-18 years) from 2018 to 2022 in Yunnan, southwest China.
OBJECTIVE: We evaluated the impact of the COVID-19 epidemic on adolescents\' mental health, with the aim of reducing the effect of psychological emergency syndrome and promoting healthy, happy adolescent growth.
METHODS: This longitudinal, observational study used Students\' Health Survey data on adolescents\' depressive symptoms from 2018 to 2022 (before and during COVID-19) in Yunnan. We used multistage, stratified sampling in 3 prefectures in 2018 and 16 prefectures from 2019 to 2022. In each prefecture, the study population was classified by gender and residence (urban or rural), and each group was of equal size. Depressive symptoms were diagnosed based on Center for Epidemiological Studies Depression Scale (CES-D) scores. We used ANOVA to assess the differences in mean CES-D scores stratified by gender, age, residence, grade, and ethnicity. Chi-square tests were used to compare depressive symptoms by different variables. For comparability, the age-standard and gender-standard population prevalences were calculated using the 2010 China Census as the standard population. The association between COVID-19 and the risk of a standardized prevalence of depressive symptoms was identified using unconditional logistic regression analysis.
RESULTS: The standardized prevalence of depressive symptoms for all participants was 32.98%: 28.26% in 2018, 30.89% in 2019, 29.81% in 2020, 28.77% in 2021, 36.33% in 2022. The prevalences were 30.49% before COVID-19,29.29% in early COVID-19, and 36.33% during the COVID-19 pandemic. Compared with before COVID-19, the risks of depressive symptoms were 0.793 (95% CI 0.772-0.814) times higher in early COVID-19 and 1.071 (95% CI 1.042-1.100) times higher than during COVID-19. The average annual increase in depressive symptoms was 1.61%. During the epidemic, the prevalence of depressive symptoms in girls (36.87%) was higher than that in boys (28.64%), and the acceleration rate of girls was faster than that of boys. The prevalences of depressive symptoms and acceleration rates by age group were as follows: 27.14% and 1.09% (12-13 years), 33.99% and 1.8% (14-15 years), 36.59% and 1.65% (16-18 years). Prevalences did not differ between Han (32.89%) and minority (33.10%) populations. However, the acceleration rate was faster for the former than for the latter. The rate for senior high school students was the highest (34.94%). However, the acceleration rate for vocational high school students was the fastest (2.88%), followed by that for junior high school students (2.32%). Rural residents (35.10%) had a higher prevalence and faster acceleration than urban residents (30.16%).
CONCLUSIONS: From 2018 to 2022, there was a significant, continuous increase in the prevalence of depressive symptoms among adolescents in Yunnan, China, especially during the COVID-19 pandemic. This represents an emergency public health problem that should be given more attention. Effective, comprehensive psychological and lifestyle intervention measures should be used to reduce the prevalence of mental health issues in adolescents.

There is a rich body of literature on numbers as tools of governance. But the attention of the corpus in question is almost entirely on the rational properties of quantification. This article shows that government by numbers is also, and inseparably, a government by feelings. The Covid-19 pandemic was also a datademic in the sense that numbers populated and spread through the public sphere. We focus on three cases. Death tolls were associated with fear, immunization rates were linked to hope, and the threshold of 100,000 deaths was credited with symbolic significance. This article, based on the French case, examines how data like these, frequently perceived as objective evidence, can at the same time be a source of emotional engagement and, as such, be used to inform modes of public governance in times of crises.

Latino immigrants living in the United States were highly vulnerable to the health and economic consequences brought on by the COVID-19 pandemic. We use the conceptual framing of workplace dignity, worth that is acknowledged based on performance of job responsibilities, to explore Latino immigrants\' experiences during the early months of the pandemic. A qualitative study was conducted with La Clínica del Pueblo (La Clínica), a community health center serving low-income Latino immigrants. From June to December 2020, we conducted in-depth video interviews with 29 Latino immigrant clients to explore pandemic-related challenges, including workplace changes, discriminatory experiences, and effects on health. We conducted thematic analysis using Dedoose software. Nearly half of participants were undocumented immigrants. Most participants were unemployed or underemployed due to the pandemic and 26-49 years of age; one-third were still working, and one-quarter were 50 years or older. About half were cisgender women and two were transgender women. Employed participants experienced a lack of dignity through being socially isolated and stigmatized at work; receiving no compensation for their extra labor or for sick leave; and experiencing discriminatory labor practices. Unemployed participants experienced a lack of dignity in being the first to lose their jobs without government support; losing self-esteem; and not being rehired. Participants associated denial of dignity with worsening health conditions and increased anxiety and depression. Our study suggests that denial of workplace dignity-through job loss, underemployment, and poor working conditions-is linked to adverse health outcomes for Latino immigrants. More research should recognize workplace dignity as an important social determinant of health.

Epidemic of Cashew Fusarium wilt disease (CFWD) has been a continuous focal challenge in the cashew farming, in Tanzania. Limited to edaphic conditions as a major factor in its epidemic, the current study aimed to assess the habitat-disease relationship. Purposive surveys involving assessment of disease prevalence and habitat compositions were conducted across four landscapes of southeastern zone from 2019 to 2023. Findings revealed a widespread of CFWD across diversified landscapes possessing varying habitat characteristics, mainly cultivated land with mature cashew, brownish sand loamy soils, grassland or shrub vegetation, seasonal river streamlines and natural water wells. The highest disease incidence and severity were noted at Nachingwea/Masasi plain (99.28:88.34%) followed by Liwale inland plain (98.64:89.3%), Coastal zone (72.72:59.83%) and Tunduru dissected plain (62.13:54.54%). The habitat characteristics were strongly similar within the landscape (0.86-Jaccard index) except between villages of the coastal zone (0.71-Jaccard index). Across landscapes, Nachingwea/Masasi plains and the Coastal zone were strongly similar to Tunduru dissected plain (0.63-1.0-Jaccard index), but strongly dissimilar with the Liwale inland plain (0.67-0.70- Jaccard distance). Furthermore, the presence of greater than 0.5 suitability indices across landscapes were revealed, with Liwale inland plain having strongest suitability index of 0.743 followed by Coastal zone (0.681), Tunduru dissected plain (0.617) and Nachingwea/Masasi plain. Significantly, the habitats had an increase of 0.1 suitability index, and positively correlated with disease prevalence by triggering disease incidence of 13.9% and severity of 31.4%. The study for the first time revealed the presence of an association between disease prevalence and landscape habitat characteristics of southeastern, Tanzania; paving the way to inclusive thinking of habitat as one of the drivers in the prevalence of fusarium wilt disease of cashews. Further research on the genetic coevolution of Fusarium oxysporum across landscapes to strengthen disease risk management in the cashew industry is recommended.

We extend the unstructured homogeneously mixing epidemic model introduced by Lamprinakou et al. (2023) to a finite population stratified by age bands. We model the actual unobserved infections using a latent marked Hawkes process and the reported aggregated infections as random quantities driven by the underlying Hawkes process. We apply a Kernel Density Particle Filter (KDPF) to infer the marked counting process, the instantaneous reproduction number for each age group and forecast the epidemic\'s trajectory in the near future. Taking into account the individual inhomogeneity in age does not increase significantly the computational cost of the proposed inference algorithm compared to the cost of the proposed algorithm for the homogeneously unstructured epidemic model. We demonstrate that considering the individual heterogeneity in age, we can derive the instantaneous reproduction numbers per age group that provide a real-time measurement of interventions and behavioural changes of the associated groups. We illustrate the performance of the proposed inference algorithm on synthetic data sets and COVID-19-reported cases in various local authorities in the UK, and benchmark our model to the unstructured homogeneously mixing epidemic model. Our paper is a \"demonstration\" of a methodology that might be applied to factors other than age for stratification.

Q fever is an important zoonotic disease with a worldwide distribution. Outbreaks of Q fever are unpredictable and can affect many people, resulting in a significant burden on public health. The epidemiology of the disease is complex and substantial efforts are required to understand and control Q fever outbreaks. The purpose of this study was to systematically review previous investigations of outbreaks and summarise important epidemiological features. This will improve knowledge of the factors driving the occurrence of Q fever outbreaks and assist decision makers in implementing mitigation strategies. A search of four electronic databases identified 94 eligible articles published in English between 1990 and 2022 that related to 81 unique human Q fever outbreaks. Outbreaks were reported across 27 countries and mostly in industrialised nations. Documented Q fever outbreaks varied in size (2 to 4107 cases) and duration (4 to 1722 days). Most outbreaks (43/81) occurred in communities outside of traditional at-risk occupational settings and were frequently associated with living in proximity to livestock holdings (21/43). Indirect transmission via environmental contamination, windborne spread or fomites was the most common route of infection, particularly for large community outbreaks. Exposure to ruminants and/or their products were confirmed as the principal risk factors for infection, with sheep (28/81) as the most common source followed by goats (12/81) and cattle (7/81). Cooperation and data sharing between human and animal health authorities is valuable for outbreak investigation and control using public health and veterinary measures, but this multisectoral approach was seldom applied (14/81). Increased awareness of Q fever among health professionals and the public may facilitate the early detection of emerging outbreaks that are due to non-occupational, environmental exposures in the community.