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PubMedDate not supplied

Asthma management practices among children in Georgia.

BACKGROUND: Asthma self-management, the involvement of patients or their caregivers in the management of their disease, reduces healthcare visits and costs. We assessed selected asthma self-management practices among a representative sample of children in Georgia to guide statewide asthma control programs. METHODS: A random-digit-dialed telephone survey of 2,121 households with 3,896 children 17 years of age or younger was conducted. Primary caretakers were asked about asthma and medication use of their children. Child data were weighted according to the number of telephone lines in the household and to the 2000 Georgia Census population. RESULTS: Approximately 10 percent of children in Georgia had asthma. Among children with asthma, 30 percent did not have regular asthma checkups and 66 percent did not have a written management plan; 19 percent filled 2 or more prescriptions per year for quick-relief medicine but did not take control medication. For children with asthma for whom tobacco exposure was a known trigger, 35 percent were exposed to tobacco smoke in the home. CONCLUSIONS: Opportunities exist to improve self-management, pharmacotherapy, and exposure to triggers for children with asthma. These data can be used to guide organizations and agencies working to reduce the burden of asthma.

Adolescent↗
PubMed2005

Sexually transmitted infections and other health conditions of women entering prison in Georgia, 1998-1999.

OBJECTIVES: To assess health needs of women entering the Georgia prison system, prevalence of pregnancy and sexually transmitted infections was estimated. STUDY: Results of admission screening tests of women entering the Georgia prison system in 1998 to 1999 were abstracted retrospectively from prison records. RESULTS: Of 3636 women whose data were abstracted from prison records, 4.3% were pregnant and 8.2%, 4.0%, 5.9%, and 0.7%, respectively, had positive screening tests for trichomoniasis, HIV, chlamydia, and gonorrhea; 19.5% had at least 1 of those conditions. HIV prevalence was higher among inmates who were black or had a rapid plasma reagin test for syphilis reactive at > or =1:8 dilutions (6.0%, 15.8%, respectively) than others (1.3%, 3.7%; P < 0.001). CONCLUSION: Inmates in this study had high rates of sexually transmitted infections and many were pregnant. Black inmates were at higher risk for HIV and high rapid plasma reagin titers than white inmates or other routinely tested Georgia female populations.

Adolescent↗
PubMed1996

Mental health reform in Georgia, 1992 to 1996.

In 1992 Georgia embarked on an ambitious reform of its public mental health system. Regional mental health authorities were created with consumers and family members as decision makers. Reform legislation required that hospital and community funds be combined to provide for flexible shifting of funds to communities as use of state hospitals decreased. However, after four years and at a cost of almost $15 million, few tangible results can be demonstrated. In fact, hospital admissions have increased since 1991. Further, a proposal for a Medicaid section 1115 waiver that would permit managed care organizations to assume responsibility for key decisions threatens to undermine the decision-making authority of regional mental health authorities. This paper summarizes the background leading to Georgia's reform, reviews its accomplishments, and suggests lessons to be gained from Georgia's experiences.

Cost Allocation↗
PubMed2003

The seroprevalence of Johne's disease in Georgia beef and dairy cull cattle.

Beef and dairy cattle serum samples, collected during 2000 at sale barns throughout Georgia, were obtained from the Georgia State Brucellosis Laboratory and were used to conduct a retrospective epidemiological study. Statistical samplings of 5,307 sera, from over 200,000 sera, were tested for antibodies to Mycobacterium avium ssp. paratuberculosis, (Johne's disease) using a commercial enzyme-linked immunosorbent assay test kit. An overall period seroprevalence in all classes of cattle tested was 4.73%. The period seroprevalence in dairy cattle was 9.58%, in beef cattle it was 3.95%, and in cattle of unknown breed it was 4.72%. It was concluded that the seroprevalence of Johne's disease in cull beef and dairy cattle in Georgia is economically significant.

Animals↗
PubMed2005

The emerging HIV/AIDS epidemic in Georgia.

The first case of HIV in Georgia was diagnosed in 1989. Through December 2002, a total of 375 cases of HIV infection were reported. However, the World Health Organization estimates that the true number of infections may be closer to 1700. In all, 70% of reported cases are among injection drug users. Based on the UNAIDS classification, Georgia is a 'low-level HIV country' with an HIV prevalence of less than 1% in all groups, including drug users. However, there is a high prevalence of hepatitis B and C, suggesting a significant risk for the spread of HIV. Georgia, a newly independent republic, is experiencing an increase in injection drug use, a rise in sexually transmitted infections and commercial sex trade that create a fertile soil for the potential rapid spread of HIV. However, it is also a country with a unique window of opportunity for limiting the spread of HIV.

Adolescent↗
PubMed2003

Estimated risk of death among employees in agriculture and agriculture-related industries in Georgia, 1985-1994.

Farming has an enormous impact on the economy of Georgia, with as many as one in six Georgians working in agriculture. The purpose of this study was to compare the risk of death of white and black farmers to non-farmers in Georgia. Mortality data stratified by age and aggregated by race were retrieved from the Georgia Office of Vital Statistics for the years 1985-1994. The classification system used to code occupation on the death certificate was W473-489, which includes farmers and most all other agricultural occupations. For each cause of death, the Breslow-Day Test was used to determine homogeneity of risk across all age strata (alpha=0.05). A common odds ratio (OR) and 95% confidence intervals were calculated for all homogeneous causes of death using the Mantel-Haenzel procedure. Among white farmers, the risk of death was significantly high for tuberculosis [OR=1.64 (1.01, 2.65)], fires [OR=1.60 (1.15, 2.22)], and accidental drowning [OR=1.52 (1.01, 2.28)]. The leading causes of death among black farmers were accidental drowning [OR=1.53 (1.03, 2.26)], cerebrovascular disease [OR=1.27 (1.18, 1.38)], and ischemic heart disease [OR=1.21 (1.14, 1.29)]. Causes of death reported to be significantly low were also investigated. The findings of this study are varied, but trends related to risk of death appear to be similar to observed national trends.

Accidents, Occupational↗
PubMed2000

Georgia's breastfeeding promotion program for low-income women.

OBJECTIVE: Beginning in 1990, Georgia's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) initiated 5 new strategies to promote breastfeeding among its pregnant and postpartum clients. These strategies were implemented in 1991, each to be provided as an addition to its standard program of counseling on breastfeeding and distributing appropriate literature: 1) enhanced breastfeeding education, 2) breast pump loans, 3) hospital-based programs, 4) peer counseling, and 5) community coalitions. The enhanced breastfeeding education strategy provides access to a hotline as well as periodic training of staff, and the breast pump loan provides free breast pumps to mothers who want to use them. The hospital-based strategy provides bedside support and counseling to women who have just given birth and includes staff training, as well as a hotline number for women to call after they leave the hospital. The peer-counseling strategy focuses on identifying former WIC participants who have successfully breastfed their infants; these women are recruited to provide support and encouragement to current WIC participants. Finally, the community coalitions approach is designed to identify existing community attitudes about breastfeeding, establish plans to address gaps in breastfeeding services, to develop resource guides on breastfeeding for the community, and to advocate at the community level to support breastfeeding women. The objective of our research was to evaluate the impact of breastfeeding promotion strategies on breastfeeding initiation among WIC participants in Georgia. METHODS: Using data from the Pregnancy Nutrition Surveillance System (PNSS) for 1992-1996, we examined breastfeeding initiation rate during this period and compared rates among 6 different intervention strategies. Also, we used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) to assess breastfeeding initiation and duration among WIC enrollees. We conducted 13 focus groups to understand the experiences of program participants. Ten focus groups were conducted with women who were breastfeeding their infants, 3 each with women from the community coalitions, hospital-based programs, and standard education programs, and 1 with women from the breast pump loan program. Three focus groups were conducted with women who were feeding their infants formula. RESULTS: PNSS data show that breastfeeding initiation increased in the Georgia WIC program from 31.6% in 1992 to 39.5% in 1996. PRAMS data confirmed the increase in breastfeeding initiation from 33.6% (standard error [SE]: 2.2) in 1993 to 42.1% (SE: 2.4) in 1996 among WIC participants. Both datasets (PRAMS and PNSS) showed breastfeeding initiation to be well below the year 2000 goal of 75%. Overall, PRAMS data show a high breastfeeding initiation among non-WIC participants (range: 64.7% [SE: 2.2]) for 1994 to 70.1% (SE: 2.2) in 1996. The percent change between 1993 and 1996 was 8% for non-WIC participants, and it was 25% for the WIC participants among those responding to the PRAMS questionnaire. Data from PRAMS indicated no statistical change in the percentage of WIC enrollees who breastfed their infants for 8 weeks or more; this estimate was 18.3% (95% confidence interval (CI): 14.9-21.8) in 1993 and 19.4% (95% CI: 15.7-23.2) in 1996, well below the Healthy People 2000 objective of 50% at 6 months. According to PNSS data, the largest increases in breastfeeding initiation for 1992 to 1996 were among younger women (</=19 and 20-24 years old), those with no college (less than high school and high school only), unmarried, and black women (see Table 1). The smallest increases during this period were among older women (30+), those with more than a high school education, and women who were white, Hispanic, or from other ethnic or racial groups. The PRAMS data (1993-1996) generally display similar results, but the pattern by marital status demonstrated larger increases for married women than for unmarried women.

Breast Feeding↗
PubMed2004

Disease agents in Amblyomma americanum from northeastern Georgia.

Amblyomma americanum (lone star tick) is known or suspected to vector several organisms that are implicated as human pathogens, including Ehrlichia chaffeensis, E. ewingii, and Borrelia lonestari. These three agents have also been detected in white-tailed deer (Odocoileus virginianus). Because northeastern Georgia has a high abundance of both lone star ticks and white-tailed deer, and one of these organisms, E. chaffeensis, is already known to be endemic in the area, we assayed individual adult A. americanum, collected during the spring of 2001, 2002, and 2003, for these three organisms. A total of 400 ticks were dissected and tissues assayed by polymerase chain reaction (PCR) using Ehrlichia species-specific and Borrelia genus-wide primers. Of ticks tested, 2.0% (8/398) had evidence of E. chaffeensis, 4.8% (19/398) had evidence of E. ewingii, and 1.0% (4/398) had evidence of B. lonestari. Borrelia sp. spirochetes were also visualized by an indirect fluorescent antibody test, using an anti-flagellin monoclonal antibody (H9724), in a total of 10.7% (32/300) of ticks tested in 2003. These results reconfirm the presence of E. chaffeensis and establish evidence of E. ewingii and B. lonestari in questing adult A. americanum ticks from northeastern Georgia. Detection of at least two of the three organisms in ticks collected each year suggests that people in northeastern Georgia are at risk of infection with these organisms.

Animals↗
PubMed1980

The underregistration of neonatal deaths: Georgia 1974--77.

We reviewed the neonatal outcome of 3,369 infants who weighed less than or equal to 1500 grams and who were born in Georgia during the years 1974--76. We matched 1,465 of these infants with a death certificate registered in the State's Vital Records. Upon review of the hospital records of the remaining infants, we identified 453 infants that died during the neonatal period without a death certificate being registered. Subsequently, we compared the hospital death registries for 1977 in Georgia and death certificates registered in Vital Records during 1977. We identified an additional 236 infants who died without a death certificate being registered. Forty per cent of these infants weighed greater than 1500 grams. Two major procedural errors regarding the filing of death certificates in Georgia at the local level contributed to this 21 per cent underregistratioon of neonatal deaths in 1974--77. The underregistration occurred disproportionately for rural areas, for unmarried mothers, and for Black infants. The reason for underregistration included failure of hospitals and morticians to file death certificates with the county registrars.

Adult↗
PubMed2005

Ochlerotatus japonicus japonicus (Theobald) in Georgia and North Carolina.

Although the 1st published record of Ochlerotatus japonicus japonicus in Georgia (Rabun County) occurred in 2004, we report here a 2002 collection and identification in Fulton County, Georgia (metro Atlanta). The finding of Oc. j. japonicus in Fulton County represents the most southern record of this species in the United States to date. Also, subsequent collections in North Carolina and 4 additional counties in northeast Georgia are reported.

Animals↗
PubMed1998

Occurrence of Loma cf. salmonae in brook, brown and rainbow trout from Buford trout hatchery, Georgia, USA.

During a 6 mo study of moribund trout from Buford hatchery, Buford, Georgia, USA, a Loma cf. salmonae microsporidian parasite was studied in the gills of brook trout Salvelinus fontinalis, brown trout Salmo trutta, and rainbow trout Oncorhynchus mykiss. This parasite was morphologically similar to L. salmonae and L. fontinalis but differed in spore size. Scanning and transmission electron microscopy demonstrated that xenomas were embedded in gill filaments. Transmission electron micrographs prepared from fresh tissue showed mature spores with 12 to 15 turns of their polar tube. Spore diameters for the Georgia strain from formalin-fixed gill tissues measured 3.5 (SD +/- 0.1) by 1.8 (SD +/- 0.1) microns. Electron micrographs of formalin-fixed, deparaffinized tissues of rainbow trout from Pennsylvania and West Virginia show spores with a diameter of 3.5 (+/- 0.2) by 1.7 (+/- 0.1) microns and 3.4 (+/- 0.2) by 1.8 (+/- 0.1) microns, respectively. Transmission electron micrographs of spores from Pennsylvania and West Virginia show that mature spores from both states had 13 to 15 turns of their polar tubes. Measurements from transmission electron micrographs prepared from alcohol-fixed tissues from Virginia fish contained spores with a diameter of 3.0 (+/- 0.3) by 1.1 (+/- 0.3) microns and 12 to 15 turns of their polar tubes. These measurements are consistent with L. salmonae and therefore suggest that the parasite is present on the east coast of the United States. During the height of the Georgia epizootic, the percentage of fish with observed xenomas reached 62.2% (N = 87), and the highest number of xenomas counted per 10 gill filaments was 133 (N = 87). The microsporidian epizootic occurred either during the autumn months or when intake river water quality reached combined iron-manganese concentrations as high as 1.01 (mean 0.44, SD +/- 0.42) mg-1.

Animals↗
PubMed1995

The Georgia Information Network for Public Health Officials (INPHO): a demonstration of the CDC INPHO concept.

The Georgia Division of Public Health is serving as the first demonstration model of a statewide implementation of the Centers for Disease Control and Prevention Information Network for Public Health Officials. The goals of the project are to make communication easy, to make information accessible, and to make data exchange as swift and as smooth as technology will allow. By having a state-of-the-art telecommunications network, public health officials will be able to rapidly collect health data and transform them into meaningful health status information that can be used to inform health policy decisions. The Georgia Information Network for Public Health Officials is a unique consortium of private and public sector partners funded with a grant from the Robert W. Woodruff Foundation. The project will install the telecommunications infrastructure and the supporting software to position Georgia public health as the health information leader of the state.

Centers for Disease Control and Prevention, U.S.↗
PubMed2000

Winter ectoparasites of mammals in the northeastern piedmont area of Georgia.

Twenty-three species of ectoparasites were recovered from 10 species of mammals (89 individuals) in Mistletoe State Park, Columbia County, Georgia, during three winter months of 1998. The collection consisted of 9 species of fleas, 6 mites, 4 sucking lice, 3 ticks, and 1 mammal-associated beetle. Some rarely-collected arthropods were recorded including the ctenophthalmid fleas, Doratopsylla blarinae C. Fox and Epitedia cavernicola Traub, the laelapid mite, Echinonyssus blarinae (Herrin) (first records from Georgia for these three ectoparasites), and the leptinid beetle, Leptinus orientamericanus Peck (second record for Georgia). Varying degrees of host-specificity were exhibited by the 23 species of ectoparasites. Because relatively few mammal ectoparasite surveys are completed during the winter months, some seemingly rare species may, in reality, be more common at this time of year.

Animals↗
PubMed2001

Stroke awareness among Georgia adults: epidemiology and considerations regarding measurement.

BACKGROUND: To design and evaluate interventions for reducing the impact of stroke in Georgia, we assessed knowledge of signs, risk factors, and burden of stroke. METHODS: Adults in Georgia were studied with a random digit dial telephone survey. RESULTS: Answering an unaided question, 39% of 602 respondents named > or =1 stroke warning sign. Awareness was considerably greater when assessed with prompted questions. Most respondents (70%) said they would call 911 if someone had a stroke; almost all (95%) considered stroke an emergency. Risk factor awareness ranged from 97% (previous stroke) to 69% (diabetes). Altogether, 6% reported having had a stroke; 48% reported a stroke in their family. CONCLUSIONS: Georgia adults have low awareness of stroke warning signs. Our findings underscore the importance of conducting an effective educational campaign. Furthermore, a need exists for questions on stroke awareness that approximate more closely the situation in which a person must identify a potential stroke.

Adult↗
PubMed1975

An epizootic of bovine tuberculosis in Georgia.

A tuberculous beef animal was detected Aug 29, 1973, by a veterinary medical officer in a Georgia slaughter establishment. Animal identification and traceback eventually led to a purebred beef herd in Decatur County, Georgia. Investigation and tuberculin testing of 23,000 cattle in 350 herds revealed 11 Mycobacterium bovis-infected beef herds and resulted in the complete depopulation of 5 herds. The epizootic was confined to Georgia and was eradicated by April, 1975.

Animals↗
PubMed2002

The Georgia Emerging Infections Program: monitoring trends in invasive pneumococcal disease.

The active, population-based surveillance system of the Georgia EIP has provided valuable insights into the characteristics of invasive pneumococcal disease in Georgia and continues to provide an important mechanism to assess the impact of the newly introduced PCV7 vaccine. The problem of antimicrobial resistance has been carefully documented among isolates from invasive pneumococcal disease in all age groups, particularly young children. Fluoroquinolone resistance is now present in our area and will require close monitoring in the coming months and years. Over 80% of invasive pneumococcal disease and over 85% of penicillin and cefotaxime resistant invasive disease occurring in young children in our surveillance area involve serotypes included in the new conjugate vaccine approved for use in children. Preliminary data suggest an early decline in invasive pneumococcal disease in young children has occurred since the introduction of the conjugate vaccine and the effect upon the prevalence of antimicrobial resistance remains to be determined. The high rates of invasive pneumococcal disease, the significant associated morbidity and mortality and antimicrobial resistance highlight the need for enhanced prevention measures in both adults and children. Ongoing surveillance in the Georgia EIP will allow accurate measurement of the impact of prevention efforts, provide essential information on trends in antimicrobial resistance and document any changes in the pneumococcal serotypes responsible for invasive disease in the conjugate vaccine era.

Adolescent↗
PubMed2003

Observational survey of smoking provisions in food service establishments--Southeast Health District, Georgia, 2001.

In the United States, approximately 38,000 deaths are attributable to second hand smoke (SHS) exposure each year. One of the national health objectives for 2010 is to reduce public exposure to environmental tobacco smoke (ETS) (objective 27.10). To reduce public exposure to ETS, CDC recommends smoking bans and restrictions in public places. Some of the highest reported exposures to concentrations of SHS are found in food service establishments; however, Georgia does not have a state law prohibiting smoking in these places. In March 2001, the director of Georgia's Southeast Health District requested assistance from the state health department in developing a surveillance system of smoking provisions in food service establishments. This report summarizes an observational survey of smoking provisions in food service establishments of Georgia's Southeast Health District in 2001, which found that although 69.4% (506) of all surveyed establishments were completely smoke free, the remaining establishments failed to provide several physical modifications designed to minimize ETS exposure. Public health officials in the Southeast Health District will use survey results to target interventions toward establishments lacking ETS-minimizing provisions.

Catchment Area, Health↗
PubMedDate not supplied

Increasing incidence of anemia among clinically ill Georgia broilers: 1988-89 vs. 1990.

The incidence of anemia in clinically ill Georgia broilers climbed from 66.4% (324/488) during 1988-89 to 80.9% (531/656) during 1990. The incidence of polycythemia fell from 1.6% (8/488) during 1988-89 to 1.5% (10/656) during 1990. Specifically, compared with 1988-89, the 1990 incidence of anemia increased significantly in chicks at age 7 days (P = 0.0002) and 28 days (P = 0.05). We have no certain explanation for this shifting incidence of anemia in clinically ill Georgia broilers. Anemic chicks have plasma that contains virus particles with morphologic characteristics consistent with a virus (chicken anemia agent [CAA]) known to cause anemia in chickens. If CAA is the predominant etiology for anemia in clinically ill Georgia broilers, then our observation could be easily explained. The increasing rate of anemia could indicate a decline in broiler health over time.

Anemia↗