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Treatment with zidovudine (AZT) does not appear to decrease health care costs associated with AIDS. The health care costs incurred between 1987 and 1989 by 101 patients who received zidovudine before diagnosis with AIDS or within 60 days of diagnosis were compared with those of 279 patients who never took zidovudine. Those who took zidovudine survived for a median of 605 days compared with a median of 235 days for those who never took the drug. Overall, patients who took zidovudine had higher lifetime charges that were primarily attributed to longer survival. The average cost of care for those who took zidovudine was $74,400 compared with $46,100 for those who did not take zidovudine. It is unclear how relevant these results are to 1994 costs for a number of reasons including the fact that recommendations for prescribing zidovudine have changed.

Few data on intracranial group A Streptococcus (GAS) infection in children are available. Here, we describe the demographic, clinical, and diagnostic characteristics of 91 children with intracranial GAS infection.

Objective. Invasive pneumococcal disease (IPD) surveillance systems monitor morbidity, mortality, and vaccine impact; accurate surveillance is important to detect changes in epidemiology. We evaluated completeness of IPD reporting in New Mexico by comparing data from the Hospital Inpatient Discharge Database (HIDD) and the New Mexico Active Bacterial Core Surveillance (ABCs) program.Methods. We linked data from the HIDD and the ABCs program. We defined cases of IPD in the HIDD among New Mexico residents with hospitalizations during 2007–2009 as specific (320.1 or 038.2) or nonspecific (481, 320.2, or 041.2) using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. To validate if HIDD records that could not be matched to ABCs data were true IPD cases, we reviewed laboratory data and determined if Streptococcus pneumoniae(S. pneumoniae) had been isolated from a sterile body site.Results. We examined 732 HIDD records for cases that were not matched in the ABCs database; of such records, S. pneumoniaewas isolated from a sterile body site in 10 HIDD records.Conclusion. ABCs data detected the majority of IPD cases in New Mexico. Laboratory and medical record review is essential when using HIDD data because ICD-9-CM coding alone does not ensure data accuracy. The addition of IPD cases to the ABCs program from the HIDD was minimally beneficial to active surveillance and reporting completeness in New Mexico. States that rely exclusively on passive reporting and that have access to HIDD data might use linkages of pneumococcal and IPD-specific ICD-9-CM–coded HIDD data to improve IPD surveillance and case ascertainment.

Abstract: We studied prevalence and correlates of injection drug use, awareness of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and risky behaviors among drug users serviced by a nongovernmental organization catering to drug users in three Pakistani cities (Quetta, Peshawar, and Rawalpindi). Logistic regression analysis was used to identify correlates of injection drug use. Of 608 drug users, 99.8% were male; median age was 32 years, and 44% were married. Most (79.8%) were Pakistani; 15.3% were Afghani. The majority used heroin (98.7%), mostly by inhalation; 15.2% injected drugs. Only 41% had heard of HIV/AIDS, and 30% had been paid for donating blood. Injection drug use and needle sharing were highest in Quetta. Injecting drug users (IDUs) were nearly twice as likely to have donated blood and to have heard about HIV/AIDS compared to other drug users. Interventions to discourage transitions to injection, increase HIV testing, and safeguard the blood supply in Pakistan are urgently needed.

In 2002, updated national guidelines recommended universal culture-based antenatal screening of pregnant women during labor and delivery for detection of colonization with group B streptococcus. Four years later, a population-based surveillance study reported a 27% decrease in incidence of early-onset neonatal group B streptococcal (GBS) disease. It is unclear, however, whether there has been an increase in the rate of screening. This retrospective cohort study examined the medical records of a selected population of more than 800,000 live births to evaluate the implementation of the 2002 screening and chemoprophylaxis guidelines for the prevention of early onset neonatal GBS disease. It also assessed missed opportunities for prevention among the women who were not screened. The source of the data was the Active Bacterial Core Surveillance System, a 10-state network that monitors invasive GBS disease. Between 2003 and 2004, the investigators examined labor and delivery records of a stratified random sample of all live births (newborns without the disease) and of all cases (newborns with early-onset GBS disease). These data were compared with those from a similar study evaluating screening practices between 1998 and 1999.