Category: Nevin Manimala

NCHS Data Brief. 2025 Dec;(542). doi: 10.15620/cdc/174628.

ABSTRACT

INTRODUCTION: Using data from the 2022-2023 National Survey of Family Growth (NSFG), this report estimates ever use of individual fertility services among women ages 20-49 in the United States, as well as ever use of medical help to get pregnant, medical help to prevent pregnancy loss, and any fertility services overall, by selected socioeconomic characteristics.

METHODS: Data from 4,856 women surveyed in the 2022-2023 NSFG, a survey of the U.S. household reproductive-age population, were used in this report. Estimates are shown by Hispanic origin and race, family income as a percentage of the federal poverty level, and current health insurance coverage. Point estimates and the corresponding standard errors were produced using SAS-callable SUDAAN to account for the complex sample design of NSFG. Differences between percentages were evaluated using two-tailed t tests at the 5% level.

KEY FINDINGS: Among women ages 20-49 in 2022-2023, 13.7% had ever used any fertility services, defined as any medical help to get pregnant or prevent pregnancy loss, at some time in their lives. Use of any fertility services or any medical help to get pregnant varied by race and Hispanic origin, family income, and current health insurance coverage, but use of any medical help to prevent pregnancy loss did not vary by these characteristics.

PMID:41678837 | DOI:10.15620/cdc/174628

NCHS Data Brief. 2025 Dec;(543). doi: 10.15620/cdc/174629.

ABSTRACT

INTRODUCTION: This report describes rates and characteristics of health center visits by adults with diagnosed attention-deficit/hyperactivity disorder (ADHD), using data from the 2023 National Ambulatory Medical Care Survey Health Center (NAMCS HC) Component.

METHODS: Data for this report are from the 2023 NAMCS HC Component, and 95 health centers participated out of the 315 health centers that were contacted to participate, resulting in a response rate of 30.2% (unweighted). Data analyses were performed using the statistical packages SAS version 9.4 (SAS Institute, Cary, N.C.) and SAS-callable SUDAAN version 11.0 (RTI International, Research Triangle Park, N.C.). Two-tailed t tests with a significance level of p < 0.05 were used to determine statistically significant differences.

KEY FINDINGS: The health center visit rate for adults with ADHD was 52.6 visits per 10,000 adults in 2023 and decreased by age, with adults with ADHD ages 18-24 having the highest rate (92.6) and those age 65 and older having the lowest rate (6.5). An estimated 69.6% of health center visits by adults with ADHD included documentation in the electronic health record of a co-diagnosis of any of the selected mental health disorders.

PMID:41678835 | DOI:10.15620/cdc/174629

NCHS Data Brief. 2026 Jan;(547). doi: 10.15620/cdc/174631.

ABSTRACT

INTRODUCTION: This report uses 2024 National Health Interview Survey (NHIS) data to present the percentage of adults age 65 and older who had an influenza vaccination in the past 12 months and who ever had a pneumonia vaccination, by selected sociodemographic characteristics. Trends in vaccination from 2019 to 2024 are also presented.

METHODS: Data from the 2024 NHIS were used for this analysis. Point estimates and corresponding variances for this analysis were calculated using SAS-callable SUDAAN software to account for the complex sample design of NHIS. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. Linear and quadratic trends by family income were evaluated using orthogonal polynomials in logistic regression.

KEY FINDINGS: The percentage of adults age 65 and older who had an influenza vaccine in the past 12 months and also the percentage who ever had a pneumonia vaccine were lower in 2024 compared with 2019. In 2024, 67.1% of older adults had an influenza vaccine in the past 12 months, with vaccination lowest among adults ages 65-74 (62.6%) compared with ages 75-84 (71.9%) and age 85 and older (75.3%). Women were more likely than men to have ever received a pneumonia vaccine, but there were no significant differences by sex for receipt of influenza vaccine.

PMID:41678833 | DOI:10.15620/cdc/174631

NCHS Data Brief. 2025 Dec;(544). doi: 10.15620/cdc/174633.

ABSTRACT

INTRODUCTION: This report describes the rates and characteristics of health center visits by adults with an opioid use disorder (OUD). Health centers provide primary care to health professional shortage areas.

METHODS: Data are from the 2023 National Ambulatory Medical Care Survey (NAMCS) Health Center Component, a nationally representative survey of federally qualified health centers (FQHCs), which receive federal funding from the Health Resources and Services Administration (HRSA), and FQHC look-alikes, which meet HRSA requirements but do not receive HRSA funding. Weighting was conducted to account for sampling probabilities and nonresponse, resulting in nationally representative estimates of health center visits in all 50 U.S. states and the District of Columbia.

KEY FINDINGS: The health center visit rate for adults with an OUD was 4.8 visits per 1,000 adults in 2023. Visit rates were highest among adults ages 25-49 (7.7) and lowest among adults ages 18-24 (0.8). An estimated 29.0% of health center visits by adults with an OUD also included a diagnosis of nicotine use disorder. Among health center visits by adults with an OUD, mood disorders and anxiety disorders were the two most frequently observed mental health disorders. An estimated 49.6% of health center visits by adults with an OUD had a documented prescription for buprenorphine.

PMID:41678832 | DOI:10.15620/cdc/174633

NCHS Data Brief. 2026 Jan;(548). doi: 10.15620/cdc/174641.

ABSTRACT

INTRODUCTION: This report presents final 2024 U.S. mortality data on deaths and death rates by variables such as sex, age, race and Hispanic origin, and cause of death.

KEY FINDINGS: Life expectancy for the U.S. population in 2024 was 79.0 years, an increase of 0.6 year from 2023. The age-adjusted death rate decreased by 3.8% from 750.5 deaths per 100,000 standard population in 2023 to 722.1 in 2024. Age-specific death rates decreased from 2023 to 2024 for all age groups 1 year and older except ages 5-14.

METHODS: The data shown in this report reflect information collected by the National Center for Health Statistics for 2023 and 2024 from death certificates filed in all 50 states and the District of Columbia and compiled into national data known as the National Vital Statistics System. The race and Hispanic-origin groups shown in this report follow the 1997 Office of Management and Budget standards and differ from the bridged-race categories shown in reports for data years before 2018.

PMID:41678830 | DOI:10.15620/cdc/174641

NCHS Data Brief. 2026 Jan;(545). doi: 10.15620/cdc/174634.

ABSTRACT

INTRODUCTION: This report uses data from the 2024 National Health Interview Survey (NHIS) to describe the prevalence of diagnosed seasonal allergies, eczema, and food allergies among adults in the United States, by age, sex, race and Hispanic origin, and urbanization level.

METHODS: Point estimates and the corresponding confidence intervals for this analysis were calculated using SAS-callable SUDAAN software to account for the complex sample design of NHIS. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. Linear and quadratic trends by age group were evaluated using orthogonal polynomials.

KEY FINDINGS: In 2024, 31.7% of adults had a diagnosed seasonal allergy, diagnosed eczema, or a diagnosed food allergy. The percentage of adults with a diagnosed seasonal allergy was higher among those living in nonmetropolitan areas (28.1%) than those living in metropolitan areas (24.8%). Women (9.5%) were more likely to have diagnosed eczema compared with men (5.7%). The prevalence of these selected allergic conditions varied by age group and race and Hispanic origin.

PMID:41678829 | DOI:10.15620/cdc/174634

J Glob Health. 2026 Feb 13;16:04052. doi: 10.7189/jogh.16.04052.

ABSTRACT

BACKGROUND: The continuity and quality of maternal and child health (MCH) services represent significant challenges in low- and middle-income countries (LMICs). Home-based records (HBRs), including the integrated Maternal and Child Health Handbook (MCHHB), may support consistent service usage and improved care quality. We aimed to evaluate the association between HBRs and continued quality MCH care, identifying differences in associations between MCHHBs and the continuum of care and those between other HBR types and the continuum of care.

METHODS: We conducted a pooled analysis of Demographic and Health Surveys (DHS) from 18 LMICs, including women and their youngest eligible children for the health card module. We defined the continuum of quality MCH care using receipt of quality antenatal care (ANC), skilled birth attendance, and quality postnatal care (qPNC), with ANC and PNC measured as composite indicators. We based the HBR ownership on the DHS variable ‘Has health card’. We used multivariable logistic regressions to examine associations between HBR ownership, HBR type, and the continuum of care, adjusting for residence, maternal education, and wealth.

RESULTS: The final analysis included 89 902 samples. Ownership of HBR was associated with significantly higher odds of completing the continuum of quality MCH care compared with not owning HBR. However, no significant differences were observed between owners of MCHHB and those of other HBR types. Based on analysing the subgroups of MCH service components, the MCHHB may facilitate the provision of ANC services, such as urine and blood tests, more effectively than other HBR types.

CONCLUSIONS: Owning HBR was positively associated with greater use of quality MCH services. However, no significant differences were observed for MCHHBs, despite MCHHB ownership being significantly associated with improved uptakes of urine and blood tests. Further research is needed to explore the influence of actual HBR use, provider-related factors, and variations in HBR content and type.

PMID:41678823 | DOI:10.7189/jogh.16.04052

J Glob Health. 2026 Feb 13;16:04055. doi: 10.7189/jogh.16.04055.

ABSTRACT

BACKGROUND: Chikungunya has emerged as a growing global health threat with a new sharp rise in outbreaks across 119 countries. However, its transmission patterns remain poorly characterised. We aimed to describe the global burden and spatiotemporal trends of chikungunya, and identify country-level environmental and socioeconomic factors associated with local transmission.

METHODS: We compiled annual country-level autochthonous chikungunya cases from 2004 to 2024, using data from regional surveillance systems and peer-reviewed sources. We calculated the incidence rates using the number of new cases and the population. We employed a generalised additive model (GAM) to flexibly model nonlinear associations between chikungunya incidence and environmental and socioeconomic factors. We performed subgroup analyses across the six WHO regions and conducted multiple sensitivity analyses addressing data structure, variable selection, and alternative model specifications to assess robustness.

RESULTS: Between 2004 and 2024, the global incidence of chikungunya from autochthonous cases rose from 0.28 to 11.13 per 100 000. In 2024, the Americas bore the heaviest burden (43.9 per 100 000; 431 305 cases), followed by South-East Asia (14.3 per 100 000; 258 854 cases), while Africa, Europe, and the Western Pacific reported few cases. Local outbreaks occurred recurrently in several countries across the Americas, South-East Asia, and Western Pacific, but remained sporadic in temperate regions. Using a GAM, we identified significant nonlinear effects of temperature, urbanisation, and GDP per capita on incidence: incidence rose sharply above 17°C; urban population percentage demonstrated a complex, nonlinear relationship; and GDP showed an inverse association at low to moderate levels. After adjusting for environmental and socioeconomic factors, the temporal trend of incidence generally declined. We identified notable heterogeneity across regions, while our results otherwise remained broadly consistent across the sensitivity analyses.

CONCLUSIONS: Chikungunya burden has expanded globally, shaped by environmental and socioeconomic factors. Strengthened surveillance, integration of climate information into preparedness efforts, and improvements in socioeconomic conditions are needed to reduce disparities and support more effective prevention of future outbreaks.

PMID:41678821 | DOI:10.7189/jogh.16.04055

Neurology. 2026 Mar 24;106(6):e214702. doi: 10.1212/WNL.0000000000214702. Epub 2026 Feb 12.

ABSTRACT

BACKGROUND AND OBJECTIVES: The benefit of IV thrombolysis (IVT) with alteplase before endovascular thrombectomy (EVT) compared with EVT alone has been shown to be limited and time dependent. Data on tenecteplase, its recommended alternative, are limited. We aimed to assess the efficacy and safety of IVT with tenecteplase plus mechanical thrombectomy (TNK + EVT) compared with EVT in patients with large vessel occlusion stroke and determine whether its potential benefit decreases with treatment time.

METHODS: We conducted a retrospective pooled analysis of 2 nationwide, real-world registries of patients with anterior circulation large vessel occlusion stroke within 4.5 hours of known symptom onset and with no contraindication to thrombolysis, treated with TNK + EVT (TETRIS) or EVT (ETIS). The efficacy outcome was the 3-month modified Rankin Scale (mRS) score, analyzed in ordinal and dichotomized (mRS score ≤2) approaches. We used propensity score-weighted logistic regression to assess associations between treatment groups and outcomes of interest.

RESULTS: Among 1,890 patients who were analyzed (TNK + EVT: n = 798; EVT: n = 1,092; median age 73 years [interquartile range 61-82]; 49.6% women), the median expected onset-to-thrombolysis time was 146 minutes [interquartile range 119-180]. More than half of patients (n = 1,063; 56.2%) were admitted first to a primary stroke center. All baseline characteristics were balanced between treatment groups after overlap weighting. Overall, TNK + EVT was associated with better 3-month functional outcome over the full mRS (weighted common odds ratio [OR] 1.53 [95% CI 1.29-1.82]; p < 0.001) and regarding functional independence (propensity score overlap weighting [PSOW]-OR 1.50 [95% CI 1.23-1.84]; p < 0.001). This benefit did not differ statistically between patients admitted first to a primary or comprehensive stroke center (p-interaction = 0.12). There was no significant effect of the expected onset-to-thrombolysis time on the association between TNK + EVT and better functional outcome (p-interaction = 0.11). There were no significant differences in parenchymal hematoma (PSOW-OR 1.29 [95% CI 0.94-1.79]; p = 0.12) and symptomatic intracerebral hemorrhage (PSOW-OR 1.13 [95% CI 0.69-1.86]; p = 0.61) rates.

DISCUSSION: Among patients treated within 4.5 hours of symptom onset, TNK + EVT was associated with better functional outcome than EVT, without safety concerns. This benefit does not seem to be time dependent. These findings support the routine use of tenecteplase before EVT in the early time window.

CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, in patients with stroke due to anterior circulation large vessel occlusion, IV tenecteplase plus thrombectomy is associated with better functional outcomes at 3 months compared with thrombectomy alone.

TRIALS REGISTRATION INFORMATION: NCT03776877 (ETIS registry) and NCT05534360 (TETRIS registry).

PMID:41678809 | DOI:10.1212/WNL.0000000000214702

Obstet Gynecol. 2026 Feb 12. doi: 10.1097/AOG.0000000000006191. Online ahead of print.

ABSTRACT

OBJECTIVE: We sought to evaluate the association between the timing of new-onset hypertensive disorders of pregnancy (HDP) development (ie, antepartum, intrapartum, or postpartum) and the risk of incident hypertension 2-7 years after delivery in nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be) and nuMoM2b-HHS (the nuMoM2b Heart Health Study).

METHODS: This is a secondary analysis of a multisite prospective observational cohort study conducted at eight clinical sites that enrolled nulliparous individuals with singleton pregnancies in their first trimester who were followed during pregnancy and subsequently underwent a cardiovascular screening visit 2-7 years after delivery. For this analysis, we excluded individuals with prepregnancy chronic hypertension in their nuMoM2b pregnancy. We compared rates of stage 1 hypertension (blood pressure 130/80 mm Hg or higher or use of antihypertensive medications) at the 2-7 year postpartum study visit based on the timing of the onset of HDP (categorized as antepartum, intrapartum, postpartum) with no HDP (referent). Multivariable logistic regression models adjusted for baseline covariates (age, insurance, tobacco use, diabetes, and early pregnancy body mass index [BMI]) were used to generate adjusted odds ratios (aOR) and 95% CIs. Interaction analysis was performed to evaluate effect modification by the presence of severe features of HDP. P<.05 was considered statistically significant.

RESULTS: Of 4,342 individuals included in this analysis (mean age 27.0 years [SD 5.6 years]), 23.2%% (n=1,007) had new-onset HDP. Among those with HDP, 53.6% (n=540) were diagnosed antepartum, 42.4% (n=427) were diagnosed intrapartum, and 4.0% (n=40) were diagnosed postpartum. At a mean follow-up of 3.2±0.9 years after delivery, the frequency of incident hypertension was elevated regardless of whether HDP occurred antepartum (37.6%, n=203), intrapartum (26.0%, n=111), or postpartum (40.0%, n=16) (compared with no HDP [16.5%, n=550]). After adjustment for maternal age, insurance type, tobacco use, prepregnancy diabetes, and early pregnancy BMI, the risk of chronic hypertension remained elevated regardless of when HDP was diagnosed, although the risk was higher when it developed antepartum (aOR 2.40, 95% CI, 1.95-2.95) or postpartum (aOR 2.90, 95% CI, 1.49-5.64) compared with when it developed intrapartum (aOR 1.55, 95% CI, 1.21-1.97; referent no HDP, P<.01 for all).

CONCLUSION: New-onset HDP, regardless of whether it is diagnosed antepartum, intrapartum, or postpartum, is associated with an increased risk of incident hypertension 2-7 years after delivery, compared with individuals without HDP during their first birth. Greater awareness of cardiovascular disease risk after HDP-even when HDP is diagnosed during labor or postpartum-is needed to appropriately risk stratify and help prevent hypertension after delivery.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02231398.

PMID:41678805 | DOI:10.1097/AOG.0000000000006191