Background Although disproportionately affected by cardiovascular disease, Black adults remain underrepresented in clinical trials. The National Institutes of Health recommends that studies define goals for recruitment of underrepresented populations. However, the extent to which cardiovascular trials incorporate evidence‐based recruitment strategies in their protocols is understudied. Methods and Results We systematically reviewed National Institutes of Health‐funded cardiovascular clinical trials registered in ClinicalTrials.gov between 2000 and 2019. Based on publicly available or requested protocols, we focused on enrollment of Black adults as well as the following recruitment strategies: community‐based, electronic medical record‐based, and provider‐based recruitment. A total of 100 clinical trials focused on cardiovascular disease were included in our analysis, of which 62% had published protocols, and 46% of trials had enrolled populations that were <25% Black. In our analysis of available trial protocols, 21% of trials defined a recruitment target for underrepresented groups; however, only one study reported achieving its enrollment goal. While 13% of trial protocols referenced community‐based recruitment strategies, 5% explicitly mentioned involving community members in the trial design process. Defining recruitment targets was associated with higher enrollment of Black participants. Conclusions Black adults are underrepresented in National Institutes of Health‐funded cardiovascular trials, and the majority of these trials did not specify a Black enrollment target, did not meet targets, and largely did not report specific plans to enroll Black adults in their studies. Future interventions should target trial design and planning phases before study initiation to address these enrollment disparities.
Tinea capitis is a fungi infection of the scalp that disproportionately affects children in rural and underserved communities in Nigeria. A case-control study was conducted to identify the causative agents and factors that predispose school pupils to tinea capitis in two selected government-owned public primary schools in Osogbo, Southwestern Nigeria. A total of 230 participants were included in the study: 115 cases and 115 controls. Head scrapings were collected from pupils with suspected T. capitis lesions, viewed under Potassium Hydroxide smear microscopy and cultured in Sabouraud’s Dextrose Agar (SDA) for characteristic fungal elements. A total of 105 (91%) samples were successfully cultured, of which 56% (59/105) were from male pupils. Tricophyton rubrum (34%), Tricophyton mentagrophyte (31%) and Microsporum canis (18%) were the most prevalent organisms. Other dermatophytes obtained include Microsporum nanuum (3%), Epidermophyton floccusum (6%), Tricophyton verucosum (1%), and Microsporum gypseum (8%). Pupils between the ages of 4 and 7 years had the highest distribution (67%) followed by those between the ages of 8 and 11 years (39%). Playing with animals, the sharing of combs and not bathing with soap were significantly associated with tinea capitis infection (P < 0.05) in each case. This study showed a high prevalence of tinea capitis caused by the identified dermatophytes in the area.
Approximately 2150 adults die every day in the U.S. from Cardiovascular Diseases (CVD) and another 115 deaths are attributed to opioid-related causes. Studies have found conflicting results on the relationship between opioid therapy and the development of cardiovascular diseases. This study examined whether an association exists between the use of prescription opioid medicines and cardiovascular diseases, using secondary data from the National Hospital Ambulatory Medical Care Survey (NAMCS) 2015 survey. Of the 1829 patients, 1147 (63%) were male, 1762 (98%) above 45 years of age, and 54% were overweight. The rate of cardiovascular diseases was higher among women [(p < 0.001), 95% CI: 0.40–0.51]. The covariates were age, race/ethnicity, sex, diabetes mellitus, hyperlipidemia, and hypertension; and were adjusted. Diabetes mellitus, hyperlipidemia, and hypertension were significant predictors of CVD [(p < 0.001, 95% CI: 0.57–0.78); (p < 0.001, 95% CI: 0.34–0.44); (p < 0.001, 95% CI: 0.49–0.59)]. There was no significant association between prescription opioid medication use and coronary artery disease [first opioid group p = 0.34, Prevalence Odds Ratio (POR): 1.39, 95% CI: 0.71–2.75; second opioid group: p = 0.59, POR: 1.20, 95% CI: 0.61–2.37, and third opioid group: p = 0.62, POR: 0.85, 95% CI: 0.45–1.6]. The results of this study further accentuate the conflicting results in literature. Further research is recommended, with a focus on those geographical areas where high prevalence of cardiovascular diseases exists.
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