We determine the impact of residential mobility in the prevalence and transmission dynamics of sexually transmitted infections. We illustrate our approach on reported chlamydia infections obtained from the Michigan Disease Surveillance System for Kalamazoo County, USA, from 2006 to 2014. We develop two scenarios, one with fixed residential addresses and one considering residential mobility. We then compare the resulting space-time clusters and relative risk (RR) of infection. The space-time scan statistics showed increased RR in an area with previously low risk of sexually transmitted infections. In addition, even though the spatial extent of the three clusters identified did not change significantly at the scale we conducted our analysis at, the temporal extent (duration) did exhibit significant changes and could be considered for unique interventions. The results indicate that residential mobility has some dependency on the prevalence and transmission dynamics of sexually transmitted infections to new areas. We suggest that strategies adopted to reduce the burden of sexually transmitted infections take into consideration the relatively high residential mobility of at-risk populations to reduce spreading the infections to new areas.

We compared severe acute respiratory syndrome–related coronavirus-2 seroprevalence estimated from commercial laboratory residual sera and a community household survey in metropolitan Atlanta during April-May 2020 and found these two estimates to be similar (4.94% versus 3.18%). Compared with more representative surveys, commercial sera can provide an approximate measure of seroprevalence.

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BackgroundWorkers employed in the coal mining sector are at increased risk of respiratory diseases, including coal workers' pneumoconiosis (CWP). We investigated the prevalence of CWP and its association with sociodemographic factors among Medicare beneficiaries.MethodsWe used 5% Medicare Limited Data Set claims data from 2011 to 2014 to select Medicare beneficiaries with a diagnosis of ICD‐9‐CM 500 (CWP). We aggregated the data by county and limited our analysis to seven contiguous states: Illinois, Indiana, Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia. We estimated county‐level prevalence rates using total Medicare beneficiaries and miners as denominators and performed spatial hotspot analysis. We used negative binomial regression analysis to determine the association of county‐wise sociodemographic factors with CWP.ResultsThere was significant spatial clustering of CWP cases in Kentucky, Virginia, and West Virginia. Spatial clusters of 210 and 605 CWP cases representing an estimated 4200 to 12 100 cases of Medicare beneficiaries with CWP were identified in the three states. Counties with higher poverty levels had a significantly elevated rate of CWP (adjusted rate ratios [RR]: 1.15; 95% CI, 1.12‐1.18). There was a small but significant association of CWP with the county‐wise catchment area. Rurality was associated with a more than three‐fold elevated rate of CWP in the unadjusted analysis (RR: 3.28, 95% CI, 2.22‐4.84). However, the rate declined to 1.45 (95% CI, 1.04‐2.01) after adjusting for other factors in the analysis.ConclusionsWe found evidence of significant spatial clustering of CWP among Medicare beneficiaries living in the seven states of the USA.

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The results provide evidence that individual vulnerability to STI has some dependency on individual contextual (race) and exogenous factors at the neighbourhood level such as SES, regardless of that individual's personal history of infection. We suggest place-based intervention strategies be adopted for planning STI interventions instead of current universal screening of at-risk populations.

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