Ending preventable maternal and newborn deaths due to infection.

Over 300,000 maternal deaths occur each year, 11% of which are thought to be due to infectious causes, and approximately one million newborns die within the first week of life annually due to infectious causes. Infections in pregnancy may result in a variety of adverse obstetrical outcomes, including preterm delivery, pre-labor rupture of membranes, stillbirth, spontaneous abortion, congenital infection, and anomalies. This paper reviews the burden of disease due to key infections and their contribution to maternal, perinatal, and newborn morbidity and mortality, as well as key interventions to prevent maternal and newborn deaths related to these infections. Research needs include more accurate clinical and microbiologic surveillance systems, validated risk stratification strategies, better point-of-care testing, and identification of promising vaccine strategies.

Intensified case-finding for latent tuberculosis infection among the Baltimore City Hispanic population.

Foreign-born immigrants are at high risk for latent TB infection (LTBI). In conjunction with the Baltimore City Health Department (BCHD), student volunteers conducted intensified LTBI case-finding (ICF) using tuberculin skin testing (TST) in the Hispanic community from 2006-2010. We sought to determine the yield of ICF and estimate the LTBI prevalence. Retrospective cross-sectional study. Among 478 individuals screened, 164 (34.3 %) had a positive TST, 227 (47.5 %) had a negative TST, and 87 (18.2 %) did not return. Among those who completed screening, the prevalence of LTBI was 164/391 (41.9, 95 % CI 0.37-0.47). ICF referrals accounted for 4.4 % of all LTBI referrals to BCHD and for 41 % of referrals among Hispanics. We found a high rate of undiagnosed LTBI within the Hispanic community. This student-run ICF program accounted for almost half of all LTBI cases among Hispanics. Community resources are needed to target this high-risk population.

Role of preventive medicine residencies in medical education: a national survey.

BACKGROUND: In an era of substantial reform to the nation's health system, there has never been a greater need for physicians to understand public health. One way to foster public health in medical education is to utilize the resources within General Preventive Medicine and Public Health (PM) residency programs. Trained in public health and clinical medicine, PM physicians are uniquely positioned to bridge these disciplines. PURPOSE: Little is known about the level of engagement of PM residency programs in medical education. This study explores the current state of their involvement. METHODS: Program directors from all Accreditation Council for Graduate Medical Education-accredited PM residency programs were asked to participate in a survey to assess involvement in medical student and non-PM resident education, including on nine key engagement criteria covering teaching, rotations, career interest groups, and other activities. The study was conducted and data analyzed in 2010. RESULTS: Thirty-five of 38 (92%) programs responded. Seventy-four percent reported that PM faculty taught medical students, and 34% taught at non-PM residency programs. The lowest level of engagement was seen in PM residents teaching non-PM residents (12%). Over half of all programs met four or fewer of the nine criteria. The most common barriers to engagement were lack of funding (53%) and lack of time (50%). CONCLUSIONS: These results suggest that PM residency programs are an underutilized resource in fostering public health in medical education, especially on engagement at the level of graduate medical education. Strategies to improve engagement should consider the nine criteria outlined in this study, as well as common barriers.