Biomedical subjects

M Anita Barry

Publications and source records attributed to M Anita Barry.

4 recordsLinked to original sources

PubMed2006

Predictors of failure to complete treatment for latent tuberculosis infection.

OBJECTIVE: Low rates of completion of treatment for latent tuberculosis infection (LTBI) limit its usefulness as a strategy for elimination of tuberculosis (TB) in the United States. This retrospective cohort study assessed predictors of completion of LTBI treatment among patients seen at an urban United States TB clinic in 1998. METHODS: A retrospective cohort study of acceptance and completion of LTBI treatment among patients first seen in a TB clinic in 1998 was performed. RESULTS: Of 2621 persons with a positive tuberculosis skin test (TST), 1723 were offered treatment and 1572 (91.2%) accepted. Of the 1572 who accepted, treatment was completed by 607 (38.6%). Of those persons who failed to complete treatment, 517/965 (54%) dropped out before the end of the first month of the course. Among 1375 persons under 35 years of age who initiated LTBI treatment, failure to complete was associated with birth in Haiti (OR=2.17, CI(95%) 1.49-3.17) or the Dominican Republic (OR=1.93, CI(95%) 1.08-3.43). CONCLUSION: These results suggest that country-specific cultural and behavioral factors may contribute to failure to complete LTBI treatment, and that interventions to increase completion should focus on the first month after initiation.

Adolescent↗

PubMed2004

Diagnosing smallpox: would you know it if you saw it?

The intentional release of anthrax in the United States in 2001 and other recent acts of terrorism have highlighted the possibility of intentional release of smallpox by terrorists. Little is known about physicians' ability to diagnose smallpox, especially in the critical first days, when the potential for rapid control of transmission is greatest. During December 2002 and January 2003, primary care and emergency physicians at a large urban academic medical center were surveyed regarding the diagnosis and management of patients who present with vesicular rash illness. In addition to demographic and training-related questions, the questionnaire included items about perceived comfort in diagnosing and evaluating rashes, knowledge of the key differential diagnostic characteristics of chickenpox and smallpox, and the diagnostic interpretation of color photographs of patients with smallpox or chickenpox. Responses were summarized as a perceived comfort score, a differential diagnosis score, and a picture score. Of 266 eligible physicians, 178 (67%) responded. Of these, 95% thought clinicians need more education about bioterrorism; only 17% reported comfort in diagnosing smallpox. Although most physicians recognized pictures of smallpox and chickenpox, only 36% correctly answered 3 of 4 questions regarding differential diagnosis, an important aspect of identifying cases early. Those who were comfortable diagnosing rash illnesses had higher differential diagnosis scores. Strategies for bioterrorism-related training could take advantage of physicians' awareness of their own knowledge deficits.

Attitude of Health Personnel↗

PubMedDate not supplied

Immunization registries: costs and savings.

OBJECTIVES: The objectives of this study were to quantify the actual costs of developing, maintaining, and operating the Boston Immunization Information System (BIIS), an electronic registry and tracking system, and to compare the registry's costs with those of performing the same functions manually. METHODS: Cost data were obtained from 23 BIIS health care sites, the city health department, and 13 control sites. Actual costs of developing and operating BIIS in 1998 and projected 1999 costs for a hypothetical expanded registry were measured. Total costs of registry-supported immunization activities were compared with the costs of similar types and volumes of manual activities. RESULTS: The total annual cost of developing, maintaining, and operating BIIS in 1998 was $345,556. Annual total cost per record was $5.45 for all children aged <23 years and $10 when costs were distributed only among active users (children <8 years old). Operating BIIS saved $26,768 in 1998, compared with manual performance. The hypothetical projected total cost of an expanded BIIS in 1999 would have been $577,919, with a projected savings of $689,403 compared with manual costs. CONCLUSIONS: Electronic immunization registries potentially offer an efficient tool for the delivery of immunization services. Registries can save substantial funds if their data are kept up-to-date, and if caregivers are willing and able to use the registries routinely.

Boston↗

PubMedDate not supplied

Local collaborations: development and implementation of Boston's bioterrorism surveillance system.

The Boston Public Health Commission developed and implemented an active surveillance system for bioterrorism and other infectious disease emergencies. A bioterrorism Surveillance Task Force was formed with representatives from local emergency medicine, infection control, infectious diseases, public health, and emergency medical services. These local agencies worked together to develop a reliable, easy to use electronic surveillance system. Collaboration at the local level and building on existing relationships is a key component of this system. Effective follow-up systems and technology back-up plans are essential. Improved communication networks and increased bioterrorism education for clinicians and the general public have also been achieved.

Bioterrorism↗