Surveillance of cryptococcosis in Alabama, 1992-1994.

Purpose: Although cryptococcosis is a significant opportunistic infection among patients with human immunodeficiency virus (HIV), there is conflicting information on rates of cryptococcosis among HIV-positive and HIV-negative patients. Precise state-wide epidemiologic data for cryptococcosis are not...

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Publicado en:Annals of Epidemiology Vol. 8; no. 4; pp. 212 - 217
Autores principales: Thomas CJ, Lee JY, Conn LA, Bradley ME, Gillespie RW, Dill SR, Pinner RW, Pappas PG, Thomas, C J, Lee, J Y, Conn, L A, Bradley, M E, Gillespie, R W, Dill, S R, Pinner, R W, Pappas, P G
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. 1998 May
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 1998 May
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        atl: Surveillance of cryptococcosis in Alabama, 1992-1994.
      aug:
        au:
          Thomas CJ
          Lee JY
          Conn LA
          Bradley ME
          Gillespie RW
          Dill SR
          Pinner RW
          Pappas PG
          Thomas, C J
          Lee, J Y
          Conn, L A
          Bradley, M E
          Gillespie, R W
          Dill, S R
          Pinner, R W
          Pappas, P G
        affil: University of Alabama at Birmingham, USA
      sug:
        subj:
          Cryptococcosis Epidemiology
          AIDS-Related Opportunistic Infections Epidemiology
          Epidemiological Research
          Alabama
          Cryptococcus
          Step-Wise Multiple Regression
          P-Value
          Adult
          Middle Age
          Aged
          Male
          Female
          Funding Source
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Purpose: Although cryptococcosis is a significant opportunistic infection among patients with human immunodeficiency virus (HIV), there is conflicting information on rates of cryptococcosis among HIV-positive and HIV-negative patients. Precise state-wide epidemiologic data for cryptococcosis are not available in Alabama.Methods: We conducted an active laboratory and hospital medical record-based surveillance for cryptococcosis in Alabama from October 1, 1992 to September 30, 1994. A case of cryptococcosis was defined as a patient's initial episode of cryptococcal disease and based on either a positive culture for C. neoformans from any normally sterile site, a positive latex agglutination serologic test for cryptococcal antigen in CSF or serum, or histopathologic findings consistent with C. neoformans.Results: Over the two year period, 153 cases were identified. The diagnosis was based on positive culture (37%), positive antigen (24%), positive autopsy culture (2%), and histopathologic findings (4%). Further, 33% of the total cases were diagnosed from combined positive culture, antigen, or histopathology. Of the total 153 cases, 55% were in HIV-positive patients and 44% were in HIV-negative individuals and one case (1%) had an unknown HIV status. The overall annual incidence rate of cryptococcosis was 1.89 cases per 100,000 population. The incidence was 1638.7 per 100,000 in the HIV-positive population and 0.84 per 100,000 in the HIV-negative population.Conclusion: The first Alabama statewide active surveillance system for cryptococcosis confirms previous observations that rates of cryptococcosis are consistently higher in HIV-infected individuals than in their HIV-negative counterparts. In Alabama, cryptococcosis occurs more commonly in urban residents and in men. Cryptococcosis in HIV-positive persons is more likely to occur in the 20 to 44 year age group, whereas cryptococcosis in HIV-negative persons is more likely to occur in those greater than 45 years old.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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