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Papers by Alejandro Ujueta

Research paper thumbnail of Prevalence of Elevated Blood Lead Levels and Risk Factors Among Residents Younger Than 6 Years, Puerto Rico-2010

Journal of public health management and practice : JPHMP, Jan 27, 2015

Limited data exist about blood lead levels (BLLs) and potential exposures among children living i... more Limited data exist about blood lead levels (BLLs) and potential exposures among children living in Puerto Rico. The Puerto Rico Department of Health has no formal blood lead surveillance program. We assessed the prevalence of elevated BLLs (≥5 micrograms of lead per deciliter of blood), evaluated household environmental lead levels, and risk factors for BLL among children younger than 6 years of age living in Puerto Rico in 2010. We used a population-based, cross-sectional sampling strategy to enroll an island-representative sample of Puerto Rican children younger than 6 years. We estimated the island-wide weighted prevalence of elevated BLLs and conducted bivariable and multivariable linear regression analyses to ascertain risk factors for elevated BLLs. The analytic data set included 355 households and 439 children younger than 6 years throughout Puerto Rico. The weighted geometric mean BLL of children younger than 6 years was 1.57 μg/dL (95% confidence interval [CI], 1.27-1.88). ...

Research paper thumbnail of Dental Caries and Dental Visits Among U.S. Women 1999-2004

Objective: To compare the mean number of decayed and filled surfaces (DFS) and dental visits in t... more Objective: To compare the mean number of decayed and filled surfaces (DFS) and dental visits in the last year among pregnant women with non-pregnant women participating in the National Health And Nutrition Examination Survey (NHANES) 1999–2004. Method: We included all female participants aged 15–44 years from the NHANES dataset. Pregnancy status was determined by either a laboratory pregnancy test or self-report. Mean DFS was calculated from the oral examination conducted by trained dentists. Results were tabulated by age, race/ethnicity and percent of the Federal Poverty Level (FPL) using SAS and SUDAAN to account for NHANES complex sampling design. Result: Pregnant women Non-pregnant women N Mean DFS(95%CI) Dental visit within last year %( 95%CI) N Mean DFS(95%CI) Dental visit within last year % (95%CI) Overall 847 12.1(10.7,13.5) 49.9(42.1,57.6)* 3711 13.1(12.5,13.8) 58.1(56.0,60.1)* 15–24 years 343 10.0(7.5,12.5)* 39.9(27.3,54.0)* 1870 7.0(6.5,7.6)* 57.9(54.1,61.6)* 25–34 years ...

Research paper thumbnail of Assessing the prevalence of spina bifida and encephalocele in a Kenyan hospital from 2005-2010: implications for a neural tube defects surveillance system

The Pan African medical journal, 2014

Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies... more Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies of the central nervous system. Data on the prevalence of neural tube defects in Kenya are limited. This study characterizes and estimates the prevalence of spina bifida and encephalocele reported in a referral hospital in Kenya from 2005-2010. Cases were defined as a diagnosis of spina bifida or encephalocele. Prevalence was calculated as the number of cases by year and province of residence divided by the total number of live-births per province. From a total of 6,041 surgical records; 1,184 (93%) had reported diagnosis of spina bifida and 88 (7%) of encephalocele. Estimated prevalence of spina bifida and encephalocele from 2005-2010 was 3.3 [95% Confidence Interval (CI): 3.1-3.5] cases per 10,000 live-births. The highest prevalence of cases were reported in 2007 with 4.4 (95% CI: 3.9-5.0) cases per 10,000 live-births. Rift Valley province had the highest prevalence of spina bifida and...

Research paper thumbnail of Prevalence of Elevated Blood Lead Levels and Risk Factors Among Residents Younger Than 6 Years, Puerto Rico-2010

Journal of public health management and practice : JPHMP, Jan 27, 2015

Limited data exist about blood lead levels (BLLs) and potential exposures among children living i... more Limited data exist about blood lead levels (BLLs) and potential exposures among children living in Puerto Rico. The Puerto Rico Department of Health has no formal blood lead surveillance program. We assessed the prevalence of elevated BLLs (≥5 micrograms of lead per deciliter of blood), evaluated household environmental lead levels, and risk factors for BLL among children younger than 6 years of age living in Puerto Rico in 2010. We used a population-based, cross-sectional sampling strategy to enroll an island-representative sample of Puerto Rican children younger than 6 years. We estimated the island-wide weighted prevalence of elevated BLLs and conducted bivariable and multivariable linear regression analyses to ascertain risk factors for elevated BLLs. The analytic data set included 355 households and 439 children younger than 6 years throughout Puerto Rico. The weighted geometric mean BLL of children younger than 6 years was 1.57 μg/dL (95% confidence interval [CI], 1.27-1.88). ...

Research paper thumbnail of Evaluation of an active surveillance system for stillbirths in metropolitan Atlanta

Journal of registry management, 2012

In 2005, a pilot project was started at the Centers for Disease Control and Prevention (CDC) to e... more In 2005, a pilot project was started at the Centers for Disease Control and Prevention (CDC) to expand an existing birth defects surveillance program, the Metropolitan Atlanta Congenital Defects Program (MACDP), to conduct active surveillance of stillbirth. This pilot project was evaluated using CDC's current guidelines for evaluating surveillance systems. We conducted stakeholder interviews with the staff of MACDP's stillbirth surveillance system. We reviewed the published literature on stillbirth ascertainment including 4 previous publications about the MACDP stillbirth surveillance system. Using fetal death certificates (FDC) as a second, independent data source, we estimated the total number and prevalence of stillbirths in metropolitan Atlanta using capture-recapture methods, and calculated the sensitivity of the MACDP stillbirth surveillance system. The MACDP stillbirth surveillance system is useful, flexible, acceptable, and stable. The system's data quality is im...

Research paper thumbnail of Oral Health Conditions and Dental Visits Among Pregnant and Nonpregnant Women of Childbearing Age in the United States, National Health and Nutrition Examination Survey, 1999–2004

Preventing Chronic Disease, 2014

Oral diseases can be prevented or improved with regular dental visits. Our objective was to asses... more Oral diseases can be prevented or improved with regular dental visits. Our objective was to assess and compare national estimates on self-reported oral health conditions and dental visits among pregnant women and nonpregnant women of childbearing age by using data from the National Health and Nutrition Examination Survey (NHANES).

Research paper thumbnail of Infection Control Assessment after an Influenza Outbreak in a Residential Care Facility for Children and Young Adults with Neurologic and Neurodevelopmental Conditions

Infection Control and Hospital Epidemiology, 2013

Objective.To assess the knowledge, attitudes, and practices of infection control among staff in a... more Objective.To assess the knowledge, attitudes, and practices of infection control among staff in a residential care facility for children and young adults with neurologic and neurodevelopmental conditions.Design.Self-administered survey.Setting.Residential care facility (facility A).Participants.Facility A staff (N = 200).Methods.We distributed a survey to staff at facility A. We classified staff with direct care responsibilities as clinical (ie, physicians, nurses, and therapists) or nonclinical (ie, habilitation assistants, volunteers, and teachers) and used X2 tests to measure differences between staff agreement to questions.Results.Of 248 surveys distributed, 200 (81%) were completed; median respondent age was 36 years; 85% were female; and 151 were direct care staff (50 clinical, 101 nonclinical). Among direct care staff respondents, 86% agreed they could identify residents with respiratory symptoms, 70% stayed home from work when ill with respiratory infection, 64% agreed that ...

Research paper thumbnail of Prevalence of Elevated Blood Lead Levels and Risk Factors Among Residents Younger Than 6 Years, Puerto Rico-2010

Journal of public health management and practice : JPHMP, Jan 27, 2015

Limited data exist about blood lead levels (BLLs) and potential exposures among children living i... more Limited data exist about blood lead levels (BLLs) and potential exposures among children living in Puerto Rico. The Puerto Rico Department of Health has no formal blood lead surveillance program. We assessed the prevalence of elevated BLLs (≥5 micrograms of lead per deciliter of blood), evaluated household environmental lead levels, and risk factors for BLL among children younger than 6 years of age living in Puerto Rico in 2010. We used a population-based, cross-sectional sampling strategy to enroll an island-representative sample of Puerto Rican children younger than 6 years. We estimated the island-wide weighted prevalence of elevated BLLs and conducted bivariable and multivariable linear regression analyses to ascertain risk factors for elevated BLLs. The analytic data set included 355 households and 439 children younger than 6 years throughout Puerto Rico. The weighted geometric mean BLL of children younger than 6 years was 1.57 μg/dL (95% confidence interval [CI], 1.27-1.88). ...

Research paper thumbnail of Dental Caries and Dental Visits Among U.S. Women 1999-2004

Objective: To compare the mean number of decayed and filled surfaces (DFS) and dental visits in t... more Objective: To compare the mean number of decayed and filled surfaces (DFS) and dental visits in the last year among pregnant women with non-pregnant women participating in the National Health And Nutrition Examination Survey (NHANES) 1999–2004. Method: We included all female participants aged 15–44 years from the NHANES dataset. Pregnancy status was determined by either a laboratory pregnancy test or self-report. Mean DFS was calculated from the oral examination conducted by trained dentists. Results were tabulated by age, race/ethnicity and percent of the Federal Poverty Level (FPL) using SAS and SUDAAN to account for NHANES complex sampling design. Result: Pregnant women Non-pregnant women N Mean DFS(95%CI) Dental visit within last year %( 95%CI) N Mean DFS(95%CI) Dental visit within last year % (95%CI) Overall 847 12.1(10.7,13.5) 49.9(42.1,57.6)* 3711 13.1(12.5,13.8) 58.1(56.0,60.1)* 15–24 years 343 10.0(7.5,12.5)* 39.9(27.3,54.0)* 1870 7.0(6.5,7.6)* 57.9(54.1,61.6)* 25–34 years ...

Research paper thumbnail of Assessing the prevalence of spina bifida and encephalocele in a Kenyan hospital from 2005-2010: implications for a neural tube defects surveillance system

The Pan African medical journal, 2014

Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies... more Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies of the central nervous system. Data on the prevalence of neural tube defects in Kenya are limited. This study characterizes and estimates the prevalence of spina bifida and encephalocele reported in a referral hospital in Kenya from 2005-2010. Cases were defined as a diagnosis of spina bifida or encephalocele. Prevalence was calculated as the number of cases by year and province of residence divided by the total number of live-births per province. From a total of 6,041 surgical records; 1,184 (93%) had reported diagnosis of spina bifida and 88 (7%) of encephalocele. Estimated prevalence of spina bifida and encephalocele from 2005-2010 was 3.3 [95% Confidence Interval (CI): 3.1-3.5] cases per 10,000 live-births. The highest prevalence of cases were reported in 2007 with 4.4 (95% CI: 3.9-5.0) cases per 10,000 live-births. Rift Valley province had the highest prevalence of spina bifida and...

Research paper thumbnail of Prevalence of Elevated Blood Lead Levels and Risk Factors Among Residents Younger Than 6 Years, Puerto Rico-2010

Journal of public health management and practice : JPHMP, Jan 27, 2015

Limited data exist about blood lead levels (BLLs) and potential exposures among children living i... more Limited data exist about blood lead levels (BLLs) and potential exposures among children living in Puerto Rico. The Puerto Rico Department of Health has no formal blood lead surveillance program. We assessed the prevalence of elevated BLLs (≥5 micrograms of lead per deciliter of blood), evaluated household environmental lead levels, and risk factors for BLL among children younger than 6 years of age living in Puerto Rico in 2010. We used a population-based, cross-sectional sampling strategy to enroll an island-representative sample of Puerto Rican children younger than 6 years. We estimated the island-wide weighted prevalence of elevated BLLs and conducted bivariable and multivariable linear regression analyses to ascertain risk factors for elevated BLLs. The analytic data set included 355 households and 439 children younger than 6 years throughout Puerto Rico. The weighted geometric mean BLL of children younger than 6 years was 1.57 μg/dL (95% confidence interval [CI], 1.27-1.88). ...

Research paper thumbnail of Evaluation of an active surveillance system for stillbirths in metropolitan Atlanta

Journal of registry management, 2012

In 2005, a pilot project was started at the Centers for Disease Control and Prevention (CDC) to e... more In 2005, a pilot project was started at the Centers for Disease Control and Prevention (CDC) to expand an existing birth defects surveillance program, the Metropolitan Atlanta Congenital Defects Program (MACDP), to conduct active surveillance of stillbirth. This pilot project was evaluated using CDC's current guidelines for evaluating surveillance systems. We conducted stakeholder interviews with the staff of MACDP's stillbirth surveillance system. We reviewed the published literature on stillbirth ascertainment including 4 previous publications about the MACDP stillbirth surveillance system. Using fetal death certificates (FDC) as a second, independent data source, we estimated the total number and prevalence of stillbirths in metropolitan Atlanta using capture-recapture methods, and calculated the sensitivity of the MACDP stillbirth surveillance system. The MACDP stillbirth surveillance system is useful, flexible, acceptable, and stable. The system's data quality is im...

Research paper thumbnail of Oral Health Conditions and Dental Visits Among Pregnant and Nonpregnant Women of Childbearing Age in the United States, National Health and Nutrition Examination Survey, 1999–2004

Preventing Chronic Disease, 2014

Oral diseases can be prevented or improved with regular dental visits. Our objective was to asses... more Oral diseases can be prevented or improved with regular dental visits. Our objective was to assess and compare national estimates on self-reported oral health conditions and dental visits among pregnant women and nonpregnant women of childbearing age by using data from the National Health and Nutrition Examination Survey (NHANES).

Research paper thumbnail of Infection Control Assessment after an Influenza Outbreak in a Residential Care Facility for Children and Young Adults with Neurologic and Neurodevelopmental Conditions

Infection Control and Hospital Epidemiology, 2013

Objective.To assess the knowledge, attitudes, and practices of infection control among staff in a... more Objective.To assess the knowledge, attitudes, and practices of infection control among staff in a residential care facility for children and young adults with neurologic and neurodevelopmental conditions.Design.Self-administered survey.Setting.Residential care facility (facility A).Participants.Facility A staff (N = 200).Methods.We distributed a survey to staff at facility A. We classified staff with direct care responsibilities as clinical (ie, physicians, nurses, and therapists) or nonclinical (ie, habilitation assistants, volunteers, and teachers) and used X2 tests to measure differences between staff agreement to questions.Results.Of 248 surveys distributed, 200 (81%) were completed; median respondent age was 36 years; 85% were female; and 151 were direct care staff (50 clinical, 101 nonclinical). Among direct care staff respondents, 86% agreed they could identify residents with respiratory symptoms, 70% stayed home from work when ill with respiratory infection, 64% agreed that ...