Effect of increased ART-CPT uptake on tuberculosis outcomes and associated factors,Burundi, 2009–2013

We retrospectively examined 3579 records of human immunodeficiency virus infected tuberculosis (TB) patients diagnosed from January 2009 to June 2013 in 55 TB treatment facilities in Burundi, to demonstrate whether improvement of combined cotrimoxazole preventive therapy and antiretroviral therapy (ART) uptake was accompanied by improvement of treatment outcomes, and to describe associated factors. Treatment success rates increased from 71% to 80% (P < 0.001). While loss to follow-up and transfer-out rates declined significantly, death rates decreased modestly, and remained high, at 14%. ART uptake was worse in suburban areas and private for-profit institutions. World Health Organization targets could be achieved if peripheral health facilities were prioritised.     

The impact of inter-survey differences in the definition of current smokeless tobacco use on comparability of US national and state-specific prevalence estimates, 2009–2011

BackgroundWe assessed how varying definitions of adult current smokeless tobacco (SLT) use affected overall prevalence estimates.MethodsNational prevalence estimates were from five surveys: 2009–2010 National Health and Nutrition Examination Survey (NHANES), 2009–2010 National Adult Tobacco Survey (NATS), 2010–2011 Tobacco Use Supplement of the Current Population Survey (TUS-CPS), 2010 National Survey on Drug Use and Health (NSDUH), and 2010 National Health Information Survey (NHIS). State-specific prevalence estimates were from three surveys: 2009–2010 NATS, 2010–2011 TUS-CPS, and 2010 Behavioral Risk Factor Surveillance System (BRFSS). Current SLT use definitions were as follows: past 5-day use (NHANES), past 30-day use (NATS and NSDUH), and “every day” or “some days” use (TUS-CPS, NHIS, and BRFSS). Inter-survey variations further existed in number and types of SLT products assessed.ResultsNational prevalence estimates of current SLT use were as follows: NATS (3.9%), NSDUH (3.6%), NHIS (2.8%), NHANES (2.3%), and TUS-CPS (1.6%). State-specific prevalence estimates of SLT use were generally lower for TUS-CPS (median = 2.1%, range: 0.5% in California and New York, to 7.2% in Wyoming) compared to either BRFSS (median = 4.0%: range: 0.9% in Washington D.C., to 8.2% in Wyoming) or NATS (median = 4.7%; range: 1.3% in New Jersey, to 9.8% in Wyoming).ConclusionConcerted efforts are needed among interagency groups to harmonize SLT definition within different surveys.