Coccidioidomycosis Among American Indians and Alaska Natives, 2001–2014
Advanced Search
Select up to three search categories and corresponding keywords using the fields to the right. Refer to the Help section for more detailed instructions.

Search our Collections & Repository

For very narrow results

When looking for a specific result

Best used for discovery & interchangable words

Recommended to be used in conjunction with other fields

Dates

to

Document Data
Library
People
Clear All
Clear All

For additional assistance using the Custom Query please check out our Help Page

i

Coccidioidomycosis Among American Indians and Alaska Natives, 2001–2014

Filetype[PDF-211.69 KB]


English
Details Supporting Files You May Also Like

Details:

  • Alternative Title:
    Open Forum Infect Dis
  • Personal Author:
  • Description:
    Background

    American Indians and Alaska Natives (AI/ANs) may be uniquely vulnerable to coccidioidomycosis given the large population residing in the Southwestern United States. We describe coccidioidomycosis-associated hospitalizations and outpatient visits during 2001–2014 in the Indian Health Service (IHS) system and compare hospitalizations with data from the Agency for Healthcare Research and Quality’s National (Nationwide) Inpatient Sample (NIS).

    Methods

    We identified hospitalizations in the IHS and the NIS and outpatient visits in the IHS using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 114.0–114.9. We calculated average annual hospitalization and outpatient visit rates per 1 000 000 population and used Poisson regression to calculate rate ratios (RRs) and 95% confidence intervals (CIs). We used multivariable logistic regression to assess factors associated with IHS hospitalization.

    Results

    AI/ANs had the highest average annual hospitalization rate (58.0; 95% CI, 49.5–66.6) of any racial/ethnic group in the NIS, compared with 13.4 (95% CI, 12.7–14.2) for non-Hispanic whites. IHS data showed a hospitalization rate of 37.0; the median length of stay (interquartile range) was 6 (3–10) days. The average annual outpatient visit rate in IHS was 764.2, and it increased from 529.9 in 2001 to 845.9 in 2014. Male sex, age ≥65 years, diabetes, and extrapulmonary or progressive coccidioidomycosis were independently associated with increased risk for hospitalization. Twenty-four percent of patients had ICD-9-CM codes for community-acquired pneumonia in the 3 months before coccidioidomycosis diagnosis.

    Conclusions

    AI/ANs experience high coccidioidomycosis-associated hospitalization rates, high morbidity, and possible missed opportunities for earlier diagnosis. Yearly trends in IHS data were similar to the general increase in hospitalizations and reported cases nationwide in the same period.

  • Subjects:
  • Source:
    Open Forum Infect Dis. 2019; 6(3)
  • Pubmed ID:
    30882015
  • Pubmed Central ID:
    PMC6411209
  • Document Type:
    Journal Article
  • Place as Subject:
    United States
  • Collection(s):
  • Main Document Checksum:
  • Download URL:
  • File Type:

You May Also Like

Checkout today's featured content at stacks.cdc.gov