MMWR News Synopsis
Friday, December 14, 2018
- Frequency of Use Among Middle- and High-School Student Tobacco-Product Users — United States, 2015–2017
- Unresolved Splenomegaly in Recently Resettled Congolese Refugees ― Multiple States, 2015–2018
- Low and Decreasing Prevalence and Rate of False Positive HIV Diagnosis — Chókwè District, Mozambique, 2014–2017
- Notes from the Field
Frequency of Use Among Middle- and High-School Student Tobacco-Product Users — United States, 2015–2017
FDA, Office of Media Affairs
Understanding tobacco-product use patterns among youth, including frequency of use, is important for sustained implementation of proven tobacco control strategies and the regulation of tobacco products. The U.S. Food and Drug Administration (FDA) and CDC analyzed combined data from the 2015–2017 National Youth Tobacco Surveys to determine the frequency at which U.S. middle- and high-school students use cigarettes, e-cigarettes, cigars, smokeless tobacco, and hookahs. During 2015–2017, frequent use – defined as use on 20 or more of the past 30 days — varied by product. Among high-school students, frequent use occurred in 28.4% of cigarette smokers, 17.4% of e-cigarette users, 14.0% of cigar smokers, 38.7% of smokeless tobacco users, and 16.7% of hookah smokers. Among middle school students, frequent use occurred in 17.5% of cigarette smokers, 13.1% of e-cigarette users, 13.2% of cigar smokers, 21.5% of smokeless tobacco users, and 24.5% of hookah smokers.
CDC Media Relations
CDC recommends clinicians screen all refugees arriving in the U.S. from Central and East Africa for splenomegaly, and follow CDC recommendations for follow-up treatment, including giving the antimalarial primaquine to refugees with splenomegaly after resettlement. This condition presents no health risk to the general public. Spleen enlargement, or splenomegaly, is often benign, but if left untreated can result in blood disorders such as anemia or splenic rupture from blunt trauma. In tropical regions, splenomegaly is most often associated with recurrent exposure to malaria or schistosomiasis (a disease caused by parasitic worms). This form of splenomegaly typically improves on its own after treatment for the infection and after the person relocates to an area where he or she is no longer exposed. This report describes a population of refugees in the U.S., originating from East African countries, who had persistent splenomegaly with clinical complications for up to 27 months after their arrival. Most refugees with splenomegaly had at least one blood disorder and were clustered within families. CDC recommends clinicians prescribe primaquine (a drug that treats malaria parasites in the liver) to refugees of Congolese origin presenting with splenomegaly due to the possibility that malaria parasites persisting in the liver contribute to splenomegaly.
Low and Decreasing Prevalence and Rate of False Positive HIV Diagnosis — Chókwè District, Mozambique, 2014–2017
CDC Media Relations
A CDC study shows a low and decreasing rate of false-positive HIV diagnosis using a recommended rapid HIV testing algorithm. Although the rate of false diagnosis was low and decreased significantly from 2014 to 2017, observed false diagnoses underscore the importance of routine retesting for verification of HIV infection for all patients before antiretroviral treatment initiation and implementation of a continuous quality improvement program for rapid HIV testing. Although rapid human immunodeficiency virus (HIV) testing has enabled the diagnosis and treatment of 15.3 million people in sub-Saharan Africa in 2017 with life-saving antiretroviral therapy, a recent systematic review of rapid testing suggests higher-than-expected rates of false-positive HIV diagnosis (false diagnosis), caused primarily by suboptimal testing strategies. CDC evaluated trends in the rate of false diagnosis among previously HIV-diagnosed residents of Chókwè District, Mozambique, who were retested with a recommended rapid HIV testing algorithm. Based on follow-up confirmatory testing, the estimated false diagnosis rate in Chókwè District decreased from 0.66 percent in 2014 to 0.00 percent in 2017. The cumulative false diagnosis rate in Chókwè (0.56 percent) was less than one fifth the median rate (3.1 percent) reported in the systematic review.
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