Background: Our objective was to assess racial differences in the 5-year relative survival rates (RSRs) of Cervical Cancer (CerCancer) by stage at diagnosis, between Black and White women, living in Alabama, USA. Methods: Data for 3484 Blacks and 21,059 Whites diagnosed with CerCancer were extracted from the 2004 to 2013 Surveillance, Epidemiology, and End Results (SEER) database. We incorporated age groups, CerCancer stages, county, and year of diagnosis to compare the RSR between Blacks and Whites, using SEER*Stat software. Results: In urban, Black Belt (BB) and other rural counties, Whites diagnosed with localized stage of CerCancer always had better chances of survival because their RSRs were always more than 77%, compared to Blacks. Only exception was in Blacks living in other rural counties, who had a significantly higher RSR of 83.8% (95% Cl, 74.2-90.1). Which was the same as in Whites (83.8% (95% CI 74.5-89.9) living in BBC. Although, in other rural counties, Whites had a slightly lower RSR of 83.7% (95% CI 79.9-86.8%), their RSR was better compared to Blacks and Whites living in BB and other rural counties who had slightly higher RSRs of 83.8%. This was due to statistical precision, which depended on their larger sample size and a lower variability therefore, more reliability resulting in a tighter confidence interval with a smaller margin of error. In all the three county groups, Whites 15-44 years old diagnosed with localized stage of CerCancer had a higher RSR of 93.6% (95% CI 91.4-95.2%) for those living in urban and BB counties, and 94.6% (95% CI 93.6-95.4) for those living in other rural counties. The only exception was in Blacks 65-74 years old living in other rural counties who had the highest RSR of 96.9% (95% Cl, 82.9-99.5). However, Whites were considered to have a better RSR. This was also due to the statistical precision as mentioned above. Conclusion: There were significant racial differences in the RSRs of CerCancer. Overall, Black women experienced the worst RSRs compared to their White counterparts.

Long endemicity of the Highly Pathogenic Avian Influenza (HPAI) H5N1 subtype in Egypt poses a lot of threats to public health. Contrary to what is previously known, outbreaks have been circulated continuously in the poultry sectors all year round without seasonality. These changes call the need for epidemiological studies to prove or deny the influence of climate variability on outbreak occurrence, which is the aim of this study. This work proposes a modern approach to examine the degree to which the HPAI-H5N1disease event is being influenced by climate variability as a potential risk factor using generalized estimating equations (GEEs). GEE model revealed that the effect of climate variability differs according to the timing of the outbreak occurrence. Temperature and relative humidity could have both positive and negative effects on disease events. During the cold seasons especially in the first quarter, higher minimum temperatures, consistently show higher risks of disease occurrence, because this condition stimulates viral activity, while lower minimum temperatures support virus survival in the other quarters of the year with the highest negative effect in the third quarter. On the other hand, relative humidity negatively affects the outbreak in the first quarter of the year as the humid weather does not support viral circulation, while the highest positive effect was found in the second quarter during which low humidity favors the disease event.

Background: The main purpose of this study was to assess the disparity of cervical cancer (CerCancer) mortality rates change through time between Black and Caucasian women residing in Alabama and the US. Methods: The CerCancer behavioral risk factors and utilization of screening tests data were obtained from CDC's Behavioral Risk Factor Surveillance System (BRFSS) database. Baseline data and target objectives of utilization of CerCancer screening and mortality rates were obtained from Healthy People 2020. The CerCancer mortality rates data were obtained from the Surveillance, Epidemiology, and End Results (SEER). Mortality rates, percentage difference, percentage change and annual percentage change for trends were calculated and compared with the US baseline. Data were stratified by age, gender, race, and geography, using SEER*Stat version 8.4.1 in conjunction with Linear Trendlines analysis to model the racial changes of CerCancer mortality rates through time in Alabama and the US. Results: Our results depicted in general, that although Blacks had higher CerCancer mortality rates at all times, a decreasing trend in CerCancer mortality rates was noted for both races. However, the degree of disparities in mortality rates fluctuated over time and differed by age. In Alabama, Blacks aged 65 years and older have not experienced significant decline in CerCancer mortality rates in recent years, despite a high screening rate compared to Whites. In contrast, between 2002 and 2012, Whites in Alabama and the US made a significant progress toward the Healthy People 2020 goal. Conclusions: Conclusively in Alabama, a disparity still exists for the high CerCancer mortality rates in Blacks despite the higher rates of screening for CerCaner as would otherwise be expected. Additionally, the state has not yet achieved the Healthy People 2020 goal. Thus, although the gap in mortality rates in Alabama has narrowed, however the disparity remains, but if the dismal narrowing is sustained, it will reduce the racial disparities in CerCancer mortality though at a very slow rate. Therefore, Public health officials should monitor progress toward reduction and/or elimination of these disparities. Citation Format: Ehsan M. Abdalla. A comparison study of the disparities of cervical cancer excess mortality between Black and Caucasian women in Alabama and the US. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1778.

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Background The poultry industry in Egypt has been suffering from endemic highly pathogenic avian influenza (HPAI) virus, subtype H5N1 since 2006. However, the emergence of H9N2, H5N8, and H5N2 in 2011, 2016, and 2019 respectively, has aggravated the situation. Our objective was to evaluate how effective are the mitigation strategies by a Quantitative Risk Assessment (QRA) model which used daily outbreak data of HPAI-H5N1 subtype in Egypt, stratified by different successive epidemic waves from 2006 to 2016. Results By applying the epidemiologic problem-oriented approach methodology, a conceptual scenario tree was drawn based on the knowledgebase. Monte Carlo simulations of QRA parameters based on outbreak data were performed using @Risk software based on a scenario-driven decision tree. In poultry farms, the expected probability of HPAI H5N1 prevalence is 48% due to failure of mitigation strategies in 90% of the time during Monte Carlo simulations. Failure of efficacy of these mitigations will raise prevalence to 70% with missed vaccination, while failure in detection by surveillance activities will raise it to 99%. In backyard poultry farms, the likelihood of still having a high HPAI-H5N1 prevalence in different poultry types due to failure of passive and active surveillance varies between domestic, mixed and reservoir. In mixed poultry, the probability of HPAI-H5N1 not detected by surveillance was the highest with a mean and a SD of 16.8 × 10–3 and 3.26 × 10–01 respectively. The sensitivity analysis ranking for the likelihood of HPAI-H5N1 in poultry farms due to missed vaccination, failure to be detected by passive and active surveillance was examined. Among poultry farms, increasing vaccination by 1 SD will decrease the prevalence by 14%, while active and passive surveillance decreases prevalence by 12, and 6%, respectively. In backyard, the active surveillance had high impact in decreasing the prevalence by 16% in domestic chicken. Whereas the passive surveillance had less impact in decreasing prevalence by 14% in mixed poultry and 3% in domestic chicken. Conclusion It could be concluded that the applied strategies were not effective in controlling the spread of the HPAI-H5N1 virus. Public health officials should take into consideration the evaluation of their control strategies in their response.

The COVID-19 pandemic has posed an unprecedented challenge to public health across the world and has further exposed health disparities and the vulnerability of marginal groups. Since the pandemic has exhibited marked regional differences, it is necessary to better understand the levels of vulnerability to the disease at local levels and provide policymakers with additional tools that will allow them to develop finely targeted policies. In this study, we develop for the State of Alabama (USA) a composite vulnerability index at county level that can be used as a tool that will help in the management of the pandemic. Twenty-four indicators were assigned to the following three categories: exposure, sensitivity, and adaptive capacity. The resulting subindices were aggregated into a composite index that depicts the vulnerability to COVID-19. A multivariate analysis was used to assign factor loadings and weights to indicators, and the results were mapped using Geographic Information Systems. The vulnerability index captured health disparities very well. Many of the most vulnerable counties were found in the Alabama Black Belt region. A deconstruction of the overall index and subindices allowed the development of individual county profiles and the detection of local strengths and weaknesses. We expect the model developed in this study to be an efficient planning tool for decision-makers.

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