Browsing by Author "Carrico, Savannah"
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Item Open Access Combating COVID-19 Vaccine Inequity During the Early Stages of the COVID-19 Pandemic.(Journal of racial and ethnic health disparities, 2023-03) Mortiboy, Marissa; Zitta, John-Paul; Carrico, Savannah; Stevens, Elizabeth; Smith, Alecia; Morris, Corey; Jenkins, Rodney; Jenks, Jeffrey DThroughout the COVID-19 pandemic, populations of color have been disproportionately impacted, with higher rates of infection, hospitalization, and mortality, compared to non-Hispanic whites. These disparities in health outcomes are likely related to a combination of factors including underlying socioeconomic inequities, unequal access to healthcare, higher rates of employment in essential or public-facing occupations, language barriers, and COVID-19 vaccine inequities. In this manuscript the authors discuss strategies of how one local health department responded to vaccine inequities to better serve historically excluded communities throughout the early stages of the COVID-19 pandemic in 2021. These efforts helped increase vaccination rates in marginalized communities, primarily in the Black or African American population in Durham County, North Carolina.Item Open Access Mpox Vaccination and the Role of Social Vulnerability in Durham County, North Carolina, USA(Journal of Racial and Ethnic Health Disparities) Carrico, Savannah; Zitta, John-Paul; Stevens, Elizabeth; Jenkins, Rodney; Mortiboy, Marissa; Jenks, Jeffrey DItem Open Access Relationship Between Sexually Transmitted Infections and Social Determinants of Health in Durham County, North Carolina, United States(Open Forum Infectious Diseases, 2023-07-01) Jenks, Jeffrey D; Nipp, Emma; Tadikonda, Ananya; Karumuri, Nishitha; Morales-Lagunes, Kristie; Carrico, Savannah; Mortiboy, Marissa; Zitta, John-PaulAbstract Background Sexually transmitted infections (STIs) are increasing in the United States, and certain populations are more at risk than others. One explanation for this is inequities in underlying social determinants of health (SDOH). Methods We analyzed chlamydia, gonorrhea, and syphilis cases in Durham County, North Carolina, from 01/01/2020 to 12/31/2020 by select SDOH at the census tract level. We included 48 variables of interest, including variables related to income, education, transportation, and health insurance. For each variable, we modeled STI incidence at the census tract level using Poisson regression. Wald's chi-square was used to determine which variables were significantly associated with STI incidence. Results Of 24 variables that were statistically associated with STI incidence at the census tract level, 9 were negatively associated and 15 positively associated with STI incidence. Having employer health insurance was most strongly associated with lower-than-expected STI incidence, and having Medicaid insurance, no health insurance, using public transportation, and income below the poverty level were most strongly associated with higher-than-expected STI incidence. Lastly, STI incidence was not associated with race or ethnicity overall across Durham County, except in historically marginalized areas, where we found higher-than-expected STI incidence. Conclusions We found that lacking health insurance, having Medicaid insurance, using public transportation, and income below the poverty level were most strongly associated with higher-than-expected STI incidence. Strategies to combat increasing STIs may include improving access to health insurance, reducing barriers to cost-effective and timely transportation to medical appointments, and raising wages to bring individuals out of poverty.Item Open Access Test-of-Cure After Treatment of Pharyngeal Gonorrhea in Durham, North Carolina, 2021-2022.(Sexually transmitted diseases, 2022-10) Jenks, Jeffrey D; Hester, Lizeth; Ryan, Emily; Stancil, Candy; Hauser, Quinn; Zitta, John-Paul; Mortiboy, Marissa; Rayner, Malkia; Stevens, Elizabeth; Carrico, Savannah; Jenkins, RodneyBackground
In December 2020, the Centers for Disease Control and Prevention updated its treatment guidelines for gonococcal infection and, for the first time, recommended universal test-of-cure for all individuals treated for pharyngeal gonorrhea. After the release of these guidelines, data are lacking on rates of return for the test-of-cure, particularly in populations other than men who have sex with men.Methods
We analyzed the demographic characteristics, clinical characteristics, rate of return for the recommended test-of-cure, and percent positivity for Neisseria gonorrhoeae on repeat pharyngeal specimens at a local public health department in Durham, NC.Results
Of 101 individuals treated for pharyngeal gonorrhea between March 2021 and April 2022, 54.5% were men, 71.2% Black or African American, and 58.4% between the ages of 20 and 29 years. Most identified as either women who have sex with men (38.6%), men who have sex with men (24.8%), or men who have sex with women (22.8%). Of these individuals, 41 (40.6%) returned for a test-of-cure, with LGBTQ+ individuals more likely to return than men who have sex with women and women who have sex with men. Of those who returned for the test-of-cure, 4.9% of pharyngeal samples were equivocal and 2.4% positive for N. gonorrhoeae by nucleic acid amplification testing, likely reflecting false-positive tests.Conclusion
Despite recommendations to perform a test-of-cure 7 to 14 days after treatment of pharyngeal gonorrhea, rates of return continue to be low. Alternative strategies should be investigated to increase test-of-cure rates.Item Open Access Trichomoniasis and retesting in Durham County, North Carolina, United States, 2021 - 2022(International Journal of STD & AIDS) Jenks, Jeffrey D; Ryan, Emily; Stancil, Candy; Harris, Kimberly; Hester, Lizeth; Carrico, Savannah; Mortiboy, Marissa; Zitta, John-PaulBackground The Centers for Disease Control and Prevention recommends universal retesting within 3 months after treatment of Trichomonas vaginalis infection given high rates of persistent infection or reinfection, or if this is not possible, within 12 months following treatment. Data is lacking on how often this is actually done. Methods We analyzed the demographic and clinical characteristics, rate of return for the recommended retesting, concordance between wet prep and nucleic acid amplification testing, and percent positivity for T. vaginalis on repeat vaginal specimens at a local public health department in Durham, North Carolina, United States. Results Of 193 females treated for trichomoniasis between March 1, 2021 – May 31, 2022, 83% were Black or African American and 44% between the ages of 20 and 29 years. Of these individuals, 32% had retesting performed within 3 months and 50% within 365 days after treatment. Females between the ages of 20 and 29 years were more likely to return for retesting than those between the ages of 30 and 39 years. Of those who returned for retesting, 10% were positive on repeat testing. Conclusion In this study, 50% of females diagnosed with trichomoniasis completed retesting within 365 days. Improved scheduling of clients at the time of trichomoniasis treatment and improved identification in our electronic health record of individuals diagnosed with trichomoniasis within the prior year would likely improve retesting rates. Given the high prevalence of trichomoniasis, expanded screening of asymptomatic females in settings where this is feasible may be warranted.