Publications by authors named "Amitabh B Suthar"

Mortality surveillance systems can have limitations, including reporting delays, incomplete reporting, missing data, and insufficient detail on important risk or sociodemographic factors that can impact the accuracy of estimates of current trends, disease severity, and related disparities across subpopulations. The Centers for Disease Control and Prevention used multiple data systems during the COVID-19 emergency response-line-level case‒death surveillance, aggregate death surveillance, and the National Vital Statistics System-to collectively provide more comprehensive and timely information on COVID-19‒associated mortality necessary for informed decisions. This article will review in detail the line-level, aggregate, and National Vital Statistics System surveillance systems and the purpose and use of each.

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  • A study in Cambodia analyzed HIV diagnosis and recent infections among individuals aged 15 and older who accessed testing from August 2020 to August 2022.
  • Out of 53,031 people tested, 6,868 were newly diagnosed, while 192 were identified as having a recent infection acquired in the past year.
  • The research highlighted that certain groups, like men who have sex with men, transgender women, and entertainment workers, were nearly twice as likely to be recently infected compared to those simply diagnosed, suggesting that tracking recent infections could enhance HIV prevention strategies.
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  • - Early in the COVID-19 pandemic, the CDC adapted its existing surveillance system to monitor cases and deaths efficiently, implementing a new aggregate case surveillance system for quicker data collection and emergency response.
  • - This new system enabled the CDC to gather and analyze COVID-19 data at national, state, and county levels, using innovative methods like web scraping and algorithms to streamline data accuracy and validation.
  • - The review emphasizes the importance of having a robust aggregate surveillance system ready for future health emergencies, providing near-real-time data to enhance response efforts beyond traditional individual case reporting.
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Dr Amitabh Suthar and Dr Christopher Dye give their perspective on infection, immunity and surveillance of COVID-19.

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  • - During the COVID-19 pandemic, the CDC implemented an aggregate case and death surveillance (ACS) system to effectively track cumulative COVID-19 data, supplementing traditional reporting methods.
  • - As public health jurisdictions updated their historical data, the CDC developed a manual process for updating the ACS dataset to improve the accuracy of reported case and death numbers.
  • - By March 2022, the CDC began integrating data from three jurisdictions via application programming interfaces (APIs), which streamline data transfer and may enhance emergency response efficiency moving forward.
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Background: We assessed the prevalence of acquired HIV drug resistance (HIVDR) and associated factors among patients receiving first-line antiretroviral therapy (ART) in Rwanda.

Methods: This cross-sectional study included 702 patients receiving first-line ART for at least 6 months with last viral load (VL) results ≥1000 copies/mL. Blood plasma samples were subjected to VL testing; specimens with unsuppressed VL were genotyped to identify HIVDR-associated mutations.

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Objective: To evaluate the impact of vaccine scale-up on population level covid-19 mortality and incidence in the United States.

Design: Observational study.

Setting: US county level case surveillance and vaccine administration data reported from 14 December 2020 to 18 December 2021.

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We compared case definitions for suspected, probable, and confirmed coronavirus disease (COVID-19), as well as diagnostic testing criteria, used in the 25 countries with the highest reported case counts as of October 1, 2020. Of the identified countries, 56% followed World Health Organization (WHO) recommendations for using a combination of clinical and epidemiologic criteria as part of the suspected case definition. A total of 75% of identified countries followed WHO recommendations on using clinical, epidemiologic, and diagnostic criteria for probable cases; 72% followed WHO recommendations to use PCR testing to confirm COVID-19.

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COVID-19 vaccine breakthrough infection surveillance helps monitor trends in disease incidence and severe outcomes in fully vaccinated persons, including the impact of the highly transmissible B.1.617.

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Although COVID-19 generally results in milder disease in children and adolescents than in adults, severe illness from COVID-19 can occur in children and adolescents and might require hospitalization and intensive care unit (ICU) support (1-3). It is not known whether the B.1.

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Background: Civil registration and vital statistics (CRVS) systems play a key role in upholding human rights and generating data for health and good governance. They also can help monitor progress in achieving the United Nations Sustainable Development Goals. Although many countries have made substantial progress in strengthening their CRVS systems, most low- and middle-income countries still have underdeveloped systems.

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Objectives: Achieving the Sustainable Development Goals will require data-driven public health action. There are limited publications on national health information systems that continuously generate health data. Given the need to develop these systems, we summarised their current status in low-income and middle-income countries.

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In a Perspective on the research article from Jacobson and colleagues, Amitabh Suthar and colleagues from the Centers for Disease Control and Prevention discuss the importance of and considerations for developing real-time and large-scale reporting systems for tracking and controlling antimicrobial resistance.

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Introduction: Modelling suggests that early diagnosis and immediate antiretroviral therapy (ART) among key populations would have a substantial impact in reducing HIV transmission and mortality in Vietnam. An implementation research project of "test-and-treat" among people who inject drugs (PWID) was developed to inform effective roll-out of such interventions.

Methods: "Test-and-treat" was offered to PWID in two high burden provinces, Thai Nguyen and Thanh Hoa.

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Objective: To respond to the World Health Assembly call for dissemination of lessons learnt from countries that have begun implementing the International Health Regulations, 2005 revision; IHR (2005).

Methods: In November 2015, we conducted a systematic search of the following online databases and sources: PubMed®, Embase®, Global Health, Scopus, World Health Organization (WHO) Global Index Medicus, WHO Bulletin on IHR Implementation and the International Society for Disease Surveillance. We included identified studies and reports summarizing national experience in implementing any of the IHR (2005) core capacities or their components.

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In a Perspective, Amitabh Suthar and Till Bärnighausen discuss progress made so far in reducing HIV-related mortality in South Africa and keys towards further population mortality reductions going forward.

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Background: In Rwanda, HIV prevalence among adults aged 15-49 years has been stable at 3% since 2005. The aim of this study was to characterise HIV incidence across Rwanda.

Methods: We did a nationally representative, prospective HIV incidence survey for the period of 2013-14, which used two-stage sampling.

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Background: Although domestic HIV/AIDS financing is increasing, international HIV/AIDS financing has plateaued. Providing incentives for the health system (i.e.

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The international community has committed to ending the epidemics of HIV/AIDS, tuberculosis, malaria, and neglected tropical infections by 2030, and this bold stance deserves universal support. In this paper, we discuss whether this ambitious goal is achievable for HIV/AIDS and what is needed to further accelerate progress. The joint United Nations Program on HIV/AIDS (UNAIDS) 90-90-90 targets and the related strategy are built upon currently available health technologies that can diagnose HIV infection and suppress viral replication in all people with HIV.

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Background: Viremia copy-years (VCY), a time-updated measure of cumulative HIV exposure, predicts AIDS/death; although its utility in deciding when to start combination antiretroviral therapy (cART) remains unclear. We aimed to assess the impact of initiating versus deferring cART on risk of AIDS/death by levels of VCY both independent of and within CD4 cell count strata ≥500 cells per cubic millimeter.

Methods: Using Concerted Action on Seroconversion to AIDS and Death in Europe (CASCADE) data, we created a series of nested "trials" corresponding to consecutive months for individuals ≥16 years at seroconversion after 1995 who were cART-naive and AIDS-free.

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Article Synopsis
  • Antiretroviral therapy (ART) is crucial for reducing illness and death in adults with HIV, but it's often started too late in resource-limited countries, especially in sub-Saharan Africa, leading to high morbidity and mortality rates.
  • Co-trimoxazole and isoniazid preventive therapies can significantly reduce these risks and tuberculosis rates, but they are underused in low-income areas.
  • The authors suggest creating a single daily pill that combines co-trimoxazole and isoniazid with vitamin B6 to improve patient compliance and facilitate widespread adoption of these treatments.
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