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Background Infectious disease forecasting aims to predict characteristics of both seasonal epidemics and future pandemics. Accurate and timely infectious disease forecasts could aid public health responses by informing key preparation and mitigation efforts. Main body For forecasts to be fully integrated into public health decision-making, federal, state, and local officials must understand how forecasts were made, how to interpret forecasts, and how well the forecasts have performed in the past. Since the 2013–14 influenza season, the Influenza Division at the Centers for Disease Control and Prevention (CDC) has hosted collaborative challenges to forecast the timing, intensity, and short-term trajectory of influenza-like illness in the United States. Additional efforts to advance forecasting science have included influenza initiatives focused on state-level and hospitalization forecasts, as well as other infectious diseases. Using CDC influenza forecasting challenges as an example, this paper provides an overview of infectious disease forecasting; applications of forecasting to public health; and current work to develop best practices for forecast methodology, applications, and communication. Conclusions These efforts, along with other infectious disease forecasting initiatives, can foster the continued advancement of forecasting science.

Background People with HIV (PWH) commonly have elevated cholesterol and triglycerides levels that have been linked to medications. However, healthy behaviors including lifestyle changes can lower high cholesterol (CHOL) or high triglycerides (TG), thereby reducing individual risk for cardiovascular diseases. This study aimed to determine the prevalence and risk factors associated with high CHOL or TG among PWH in Texas. Methods Cross-sectional data of 981 PWH from the 2015–2017 Texas and Houston Medical Monitoring Projects were examined. High CHOL or TG was identified by medical chart diagnosis, CHOL or TG medication use, or most recent fasting lab ≥ 200 mg/dl (total CHOL) or ≥ 150 mg/dl (TG). High CHOL or TG associations with sociodemographic and clinical characteristics were assessed using Rao-Scott chi-square tests. Prevalence of high CHOL or TG development was calculated using multivariable logistic regression model. Results High CHOL or TG prevalence was 41% with participants being mostly male (73%), ≥ 40 years (68%), with overweight (31%) or obesity (28%), and virally suppressed (62%). Compared with PWH < 40 years of age, PWH in their 40s, 50s, and ≥ 60s were 57%, 64%, and 62% more likely to have high CHOL or TG, respectively. Participants with overweight and obesity were 41% and 30% more likely to have high CHOL or TG than those with normal weight (BMI: 18.5– < 25), respectively. Conclusion Since high CHOL and TG are modifiable CVD risk factors, increased education and lifestyle modification interventions are warranted to prevent the development of high CHOL or TG among PWH.

Background The utilization of modern-immunotherapies, notably immune checkpoint inhibitors (ICIs), has increased markedly in patients with metastatic melanoma over the past decade and are recommended as standard treatment. Given their increasing adoption in routine care for melanoma, understanding patient access to immunotherapy and patterns of its use in Texas is crucial as it remains one of the few states without Medicaid expansion and with high rates of the uninsured population. The objectives of this study were to examine the trend in the utilization of immunotherapy and to determine factors associated with immunotherapy utilization among patients with metastatic melanoma in the era of ICIs in Texas. Methods A retrospective cohort study was conducted using the Texas Cancer Registry (TCR) database. The cohort comprised of adult (≥ 18 years) patients with metastatic melanoma diagnosed between June 2011 and December 2018. The trend in immunotherapy utilization was assessed by determining the proportion of patients receiving immunotherapy each year. The Average Annual Percent Change (AAPC) in immunotherapy utilization was assessed using joinpoint regression, while multivariable logistic regression was used to determine the association between patient characteristics and immunotherapy receipt. Results A total of 1,795 adult patients with metastatic melanoma were identified from the TCR. Immunotherapy utilization was higher among younger patients, those with no comorbidities, and patients with private insurance. Multivariable analysis showed that the likelihood of receipt of immunotherapy decreased with older age [(adjusted Odds Ratio (aOR), 0.92; 95% CI, 0.89– 0.93, p  = 0.001], living in high poverty neighborhood (aOR, 0.52; 95% CI, 0.44 – 0.66, p  < 0.0001), having Medicaid (aOR, 0.58; 95% CI, 0.44 – 0.73, p  = 0.02), being uninsured (aOR, 0.49; 95% CI, 0.31 – 0.64, p  = 0.01), and having comorbidities (CCI score 1: aOR, 0.48; 95% CI, 0.34 – 0.71, p  = 0.003; CCI score ≥ 2: aOR, 0.32; 95% CI, 0.16 – 0.56, p  < 0.0001). Conclusions and relevance This cohort study identified sociodemographic and socioeconomic disparities in access to immunotherapy in Texas, highlighting the need for policies such as Medicaid expansion that would increase equitable access to this innovative therapy.

Air pollution contributes significantly to morbidity and mortality globally. The Niger Delta Region of Nigeria flares the second largest amount of natural gas in the world, with residents of oil-producing communities bearing the burden of outdoor pollution that may have adverse effects on their health and well-being. Our study aimed to investigate the haematological indices of residents of a selected gas-flaring site. We conducted a cross-sectional study, wherein a total of eighty adults aged 24 to 73 years were recruited from communities located within a radius of approximately 5 to 10 km from the gas-flaring facility. Blood specimens were collected from consenting participants and analysed for various haematological parameters, including Red Blood Cell (RBC) count, Packed Cell Volume (PCV), Haemoglobin (HB), Mean Cell Haemoglobin (MCH), platelet count (PLT), White Blood Cell (WBC) count, neutrophil (NEU), lymphocytes (LYMs), and Monocyte + Basophil + Eosinophil (MXD). The analysis was performed using an automated Sysmex KX21N haematological analyser. Overall, there was a significant decrease in RBC counts (p < 0.001) and a significant elevation in WBCs (p < 0.001) among people residing within a 5 km radius compared to those residing within a 10 km radius. About 42.5% of males residing within a 5 Km radius exhibited low RBC counts in contrast to only 15% of males residing within a 10 km radius. The WBC levels were found to be significantly higher (p < 0.001) than the reference range among both males and females residing within a 5 km radius compared to those residing at a distance of 10 km. In the female population, 15% of individuals residing within a 5 km and 10 Km radius exhibited RBC levels below the reference category, while 7.5% showed RBC levels above the reference range. Exposure to gas flaring may alter haematological indices. It is, therefore, recommended that a comprehensive longitudinal study be conducted among residents of oil-producing communities and workers at gas-flaring facilities in the Niger Delta region of Nigeria to assess the potential environmental and health implications of their exposure to chemical pollutants.

Background: The COVID-19 pandemic constitutes a global health threat and poses a major burden on the African continent. We assessed the real-world burden of COVID-19 infection in African Union (AU) member states to determine the distributional patterns of epidemiological measures during the first 1 year of the pandemic. Methods: This retrospective cross-sectional study utilized COVID-19 data from publicly available data repositories of the African Center for Disease Control and Prevention and Our World in Data for the period February 2020 to January 2021. AU member states were classified into low, medium, and high burdens based on COVID-19 morbidity. We conducted descriptive and inferential analyses of COVID-19-reported cases, deaths, recoveries, active cases, COVID-19 tests, and epidemiological measures that included morbidity and mortality rates, case fatality rate (CFR), and case ratios. Results: A total of 3.21 million cases were reported during the 1-year period, with 2.6 million recoveries, 536,784 cases remaining active, and 77,486 deaths. Most countries (49.1%, n = 26) in AU experienced a low burden of COVID-19 infection compared to 28.3% (n = 15) with medium burden and 22.6% (n = 12) with high burden. AU nations with a high burden of the disease were mainly in the northern and southern regions. South Africa recorded the highest number of cases (1.31 million), followed by Morocco with 457,625 and Tunisia with 175,065 cases. Correspondently, death tolls for these countries were 36,467, 7888, and 5528 deaths, respectively. Of the total COVID-19 tests performed (83.8 million) during the first 1 year, 62.43% were from high-burden countries. The least testing occurred in the medium-burden (18.42%) countries. The overall CFR of AU was 2.21%. A morbidity rate of 327.52/105 population and mortality rate of 5.96/105 population were recorded during the first 1-year period with significant variations (p < 0.0001) across burden levels. Continental morbidity and mortality rates of 17,359/105 and 315.933/105 populations were recorded with significant correlation (r = 0.863, p < 0.0001) between them and variations across selected epidemiological measures by COVID-19 burden levels. Conclusion: Understanding the true burden of the disease in AU countries is important for establishing the impact of the pandemic in the African continent and for intervention planning, preparedness, and deployment of resources during COVID-19 surges and future pandemics.

government measures to contain the COVID-19 pandemic cannot be effective without widespread compliance by the public. A greater understanding of citizens' perceptions of these measures can help government agencies adapt their strategies to boost compliance. We examined citizens' perceptions of government's measures to contain the COVID-19 pandemic and its implications on compliance using data from Onitsha city, Anambra State Nigeria. data was obtained through in-person interviews of 140 consenting adults in March 2020. Descriptive and inferential statistics were used to summarize the data. most participants (84.7%) doubted government's ability to manage the COVID-19 outbreak, raising concerns about ineffective governance (25.7%) and inadequate health facilities (20.7%). However, participants expressed a favorable perception of school closures (92.3%) and a ban on large gatherings (83.9%), driven mostly by the need to contain the COVID-19 and avoid its spread. But, they were generally indifferent about the closure of the markets and workplaces due to concerns for food insecurity and lack of government's relief programs. Participants who had a positive perception of the ban on large gatherings were more likely to have high knowledge and to adopt good COVID-19 preventive practices. the study showed a lack of public's confidence in the government's ability to manage the pandemic. This provides an opportunity for the city government and the public to reflect on the existing relationships, build mutual trust, and devise collaborative engagement that will boost compliance and help contain the devastating impact of COVID-19 pandemic.

Cyathula prostrata (Linn.) Blume is a tropical herbal plant known for its important phytochemical contents and medicinal properties. But its impact on animal reproduction and fertility is yet to be fully established. Therefore, we tested the hypothesis that C. prostrata (Linn.) Blume will improve the semen quality characteristics of New Zealand White buck rabbit. Twenty-eight post-pubertal buck rabbits were used for the study. The animals were randomly assigned to four treatment groups (n = 7 per treatment) where they were fed either the control diet—0 g C. prostrata (Linn.) Blume or any of the three experimental diets containing the graded levels of C. prostrata (Linn.) Blume incorporated into rabbit pellets at 10, 20 or 30 g C. prostrata (Linn.) Blume per kg feed. The results showed that the semen volume and pH were not different between groups. Interestingly, sperm motility significantly decreased (P < 0.05) in a dose-dependent manner. Similarly, the sperm morphology also decreased in a dose-related fashion with 20 g (77.75 ± 1.31%) and 30 g (79.00 ± 2.20%) C. prostrata (Linn.) Blume being significantly (P < 0.05) lower compared with groups 0 g (88.50 ± 1.44%) and 10 g (87.50 ± 4.33%) C. prostrata (Linn.) Blume, respectively. In conclusion, the addition of C. prostrata (Linn.) Blume into the normal rabbit feeds had a positive effect on sperm count, but reduced sperm motility and morphology, and may be associated with spermatogenesis-related problems.

Background: Seasonal influenza constitutes an enormous public health burden. The 2017-2018 influenza season was the most severe since the 2009 novel Influenza A (H1N1) pandemic. The State of Texas, like other states, experienced unusually high and persistent influenza activity. Methods: Data on confirmed cases of influenza and influenza-like illness (ILI) in Brazos County during December 2017 were collected by the Brazos County Health Department (BCHD) from medical records. Records of vaccine administered between January 1 and December 31, 2017 were collected from vaccination providers. The total number of influenza cases for 2017 was compiled from regular weekly influenza counts reported to BCHD by healthcare providers. Results: A total of 1651 cases of laboratory-confirmed influenza were reported in Brazos County residents in December 2017, 10 times more than that reported in December 2016. The highest rates of infection were in 2 ZIP codes where vaccination rates were also high. A total of 16 027 influenza vaccinations were given to individuals reporting a residential address in Brazos County in 2017. Vaccination coverage was lowest among adults aged 18 to 49, whereas those aged 65 or older and Hispanics were most likely to be hospitalized. Discussion: Overall, vaccination coverage in Brazos County, Texas is low, less than half of the Healthy People 2020 target. The development of health education materials and an increased use of social media, local television and radio, and communication methods that can reach parents, younger adults, and Hispanic residents are needed.

The study describes the HIV care providers' sociodemographic and medical practice characteristics and the health care services offered to patients during medical care encounters in Houston/Harris County, Texas. We used data from the pilot cycle of the Centers for Disease Control and Prevention Medical Monitoring Project Provider Survey conducted in June to September 2009. The average age and HIV care experience of the providers were 46.7 and 11.7 years, respectively, and they provided care to an average of 113 patients monthly. The average proportion of HIV-infected patients seen per month by race/ethnicity was 43.3% for blacks, 28.5% for whites, 26.6% for Hispanics, 1.3% for Asians, and 0.6% for other races. A total of 67% of providers offered HIV testing to all patients 13 to 64 years of age. Most HIV care providers (73.9%) reported that patients in their practices sought HIV care only after experiencing symptoms. Understanding the HIV care delivery system from providers' perspectives may help enhance support services, patients' ongoing care and retention, leading to improved health outcomes.