Evidence map›Paper›PMID 41117477›Full record

ArticleJournal of public health management and practice : JPHMP

A Review of Malaria, Diphtheria, and Botulism Medication Distributions by CDC Port Health Stations From May 2006 to February 2024.

Lily Rubin, Jennifer Fowler, Srikar Ranga, Máire Kirley, Joshua Tchan, Maria Pacheco, Leigh Ellyn Preston, Michelle A Waltenburg, Olubunmi Akinkugbe, Michael H Kinzer and 3 more

Abstract read
In one paragraph

Article in Journal of public health management and practice : JPHMP. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Lily RubinAuthor Affiliations: Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Kirley, Dr Rubin, Dr Fowler, Mr Tchan, Dr Pacheco, Dr Preston, Dr Akinkugbe, Dr Kinzer, Dr Alvarado-Ramy, Dr Brown, Dr Gertz); Epidemiology Elective Program, National Center for State, Tribal, Local and Territorial Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, Georgia (Rubin); Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia (Mr Ranga, Dr Waltenburg); and Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee (Mr Ranga).
Joshua Tchan
Maria Pacheco
Leigh Ellyn PrestonORCID 0000-0003-0521-4844
Michelle A Waltenburg
Olubunmi AkinkugbeORCID 0009-0000-6639-1276
Francisco Alvarado-RamyORCID 0000-0001-6308-9653

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

objectivesThe Centers for Disease Control and Prevention (CDC) maintains a formulary of biologic agents and drugs not available commercially in the United States. For a subset of these (botulism and diphtheria antitoxins and, until 2022, intravenous artesunate for severe malaria), distribution is coordinated through CDC port health stations (PHS), located mainly at major US international airports. CDC aims for these drugs to reach their destinations within 8 hours of release authorization. We analyzed CDC records to identify areas for efficiency improvement.

designWe queried records detailing drug distributions from PHS that occurred May 2006 to February 2024, including timing of release authorization and delivery, geographic origins and destinations, mode of transportation, and patient characteristics and outcomes. We conducted descriptive and multivariate analyses to identify variables that may have delayed delivery.

settingCDC port health stations.

main outcome measuresTime from release authorization to drug delivery.

resultsCDC PHS distributed 2912 drug shipments between May 2006 and February 2024 via 17 distribution sites to 54 jurisdictions across the US and 3 countries. Of 850 shipments for which data were available (those occurring December 2019 or later), 83% (n = 702/850) occurred within 8 hours of authorization. Commercial air transport (compared to other types of transport) (aOR: 11.43, 95% confidence interval [CI]: 6.94-18.81, P < .001) and release authorization time (outside of vs within routine work hours) (aOR: 5.10, 95% CI: 3.31-7.86, P < .001) were significantly associated with delays.

conclusionsCDC PHS facilitated emergency distributions of life-saving drugs for botulism, diphtheria, and severe malaria to locations throughout the US mostly within 8 hours of authorization. Staffing, distribution locations, and expanded options for ground transportation are important considerations that may minimize delays.

Indexed as

BotulismDiphtheriaMalariaCenters for Disease Control and Prevention, U.S.HumansUnited Statesartesunateartesunic acidbotulism antitoxin heptavalentdiphtheria antitoxindrug distribution

Identifiers

PMID41117477
PMCPMC12779171

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.