MMWR

Morbidity and Mortality Weekly Report

Under-Registration of Deaths Among Extremely Low Birthweight Infants — Ohio, 2006

PRESS CONTACT: Michael Cooper
CDC
Office of Workforce and Career Development
(614) 728-5976

States who are not following up on the discharge status of extremely low birthweight infants may be under-estimating their infant mortality rates. In the United States, infants with birthweights <750 g account for <1% of total births, but one third of total infant mortality. Deaths in these extremely low birthweight infants may go unregistered due to their small size and sometimes extremely short life span, and under-registration of these deaths leads to an under-estimation of the overall infant mortality rate. Investigators at the Ohio Department of Health performed this investigation for infants born January-June 2006, and found that 7% of deaths in the <750 g weight category were unregistered. Accurate infant mortality rates are important for program planning and evaluation, identification of health disparities and emerging trends, and development of prevention strategies.

Reported HIV Status of Tuberculosis Patients — United States, 1993–2005

PRESS CONTACT: CDC
National Center for HIV/AIDS, Hepatitis, STD and TB Prevention
Office of Communications
(404) 639-8895

A CDC analysis finds that in 2005, 9 percent of TB patients were also infected with HIV, and nearly one-third of TB patients (31 percent) had unknown HIV infection status, underscoring the importance of expanding HIV testing efforts among this population. CDC researchers analyzed data on HIV status from 1993 through 2005 reported to the National TB Surveillance System from 49 states and the District of Columbia. Researchers found that although reporting of HIV status among TB patients has increased since 1993, it has remained stable in recent years. In 2005, TB patients with the highest HIV prevalence (over 9 percent) included drug users, homeless persons, blacks, correctional inmates, and alcohol abusers. Identification of HIV infection among TB patients is critical; HIV infection is one of the most important risk factors in progression to TB disease from latent infection, and provider knowledge of HIV infection is vital to facilitate provision of the best and most appropriate patient care. Of the approximately 31 percent of TB patients with unknown status, approximately half were not offered testing, representing a missed opportunity for identifying HIV infection and providing improved patient care. The authors note that CDC is committed to increasing opportunities for TB-infected individuals to be tested for HIV.

Trends in Folic Acid Supplement Intake Among Women of Reproductive Age — California, 2002–2006

PRESS CONTACT: Suzanne Haydu and Aldona Herrndorf
California Department of Public Health
(916) 650-0382 and (916) 650-0398

To reduce the risk of having a baby with a serious birth defect, all California women capable of becoming pregnant should consume a breakfast cereal fortified with 100% of the recommended daily value of folic acid or by taking a supplement with 400µg of folic acid daily. Additional targeted and evidence-based strategies for increasing folic acid intake among Hispanic and women with lower educational attainment are needed. Findings from the California Women’s Health Survey indicate that folic acid supplement use is decreasing among California Hispanic women and among women of lower educational attainment. When consumed daily prior to pregnancy, 400µg of folic acid can reduce the risk of women having a fetus or infant with a neural tube defect such as spina bifida and anencephaly by as much as 80%. These findings are of particular concern since the rate of neural tube-affected pregnancies are twice as high among Hispanic women than white women in California, the number of births in Hispanics in California has steadily increased in the last 10 years, and Hispanics account for 52% of all births in the state. The Institute of Medicine recommends that all women of reproductive age consume 400µg of folic acid every day to prevent these serious birth defects.

Baseline Data from the Nyando Integrated Child Health and Education Project — Kenya, 2007

PRESS CONTACT: CDC Division of Media Relations
(404) 639-3286

By combining multiple interventions and using a variety of community-based implementation approaches, we hope to improve childrens’ health in rural African villages. Nearly 10 million children die each year in the developing world, often from preventable diseases. Inexpensive, effective, life-saving interventions that can prevent these diseases already exist, but do not always reach children with the greatest need. To address this problem, CDC has joined with partners to create the Nyando Integrated Child Health and Education Project (NICHE) in an impoverished rural district in western Kenya. By combining multiple interventions and using a variety of community based implementation approaches, the NICHE Project hopes to simultaneously improve access to multiple preventive measures and improve health. To assess the effectiveness of this approach, CDC has embarked on a 2-year evaluation of the project. If proven successful, this approach might serve as a blue print for child-survival programs in other regions of Kenya and elsewhere in Africa.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES