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Study Population and Data Sources
This study utilized an historical cross-sectional study design. The data source for this study was Maryland Medicaid administrative claims data (including demographic, eligibility, managed care organization (MCO) enrollment data, medical, and institutional fee-for-service claims) and MCO encounter data. In accordance with patient confidentiality concerns, this study was approved by the State of Maryland (Protocol # 01-16). It has also been reviewed and deemed to be exempt by the Institutional Review Board of the University of Maryland (Exemption No. CDM-040101).
BACKGROUND
Cancers of the lung, colon, breast, and prostate accounted for 54% of all 1998 cancer deaths in Maryland, compared with 52.7% of all 1998 cancer deaths in the United States. Disparities in cancer stage, treatment intensity, and mortality between blacks and whites are well-documented; however, there is a paucity of data examining racial disparities in similarly insured, low-income populations. Previous authors have postulated that low socioeconomic status is a stronger predictor of cancer outcome than race. A recent study by Sung et al. showed that in rural Georgia, differences between whites and blacks in prevalence rates for cervical carcinoma mostly disappeared in the Medicaid population, a population of homogenous economic status. However, the disparities persisted among Medicaid enrollees in urban Georgia. We examined prevalence rates between whites and blacks for cancers of the lung, colorectum, breast, and prostate in a population of Maryland Medicaid recipients, an economically homogenous group. We also explored the potential reasons for differing patterns of racial disparities across regions.
Since microscopic examination cannot distinguish with certainty between E. dispar and E. histolytica parasites, the amoebal infection detected with the microscope wrongly overestimated the number of people infected with E. histolytica. Even if the microscope test is positive for E. histolytica, it is still highly likely (1-PPV=95%) that the patient does not have E. histolytica infection. However, when microscopic examination revealed negative results, then E. histolytica infection is very unlikely.
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- Tags: amebiasis, microscopic, misdiagnosis
AMEBIASIS AND COMPARISON OF MICROSCOPY: RESULTS
23 Dec2009
The analysis of the records of amoebal infection in various hospitals in Kilimanjaro indicated frequent occurrence of amebiasis. The results of this study indicated that the population over the age of five years had a higher rate of amoebal infection compared to the population under the age of five years. However, both age groups had similar patterns of amoebal infection throughout the study period (Figure 1). This study indicated that females over the age of five had a higher rate of infection during February-March of 2000. However, during February-March of 2001, males over the age of five had a higher rate of infection, which remained high until the middle of the year; otherwise, there was no significant difference in the amoebal infection between the male and female populations (Figure 2).
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- Tags: amebiasis, microscopic, misdiagnosis
Study Areas
The study was carried out in the foothills of Mount Kilimanjaro in Tanzania. Residents in this area are mainly engaged in coffee and banana farming. The main source of water is microbial-contaminated furrow water from rivers flowing from the mountain springs. The Kilimanjaro area is considered an endemic area for amebiasis in the tropics. Other diseases in this area from the records of health centers include malaria, upper respiratory infections, diarrheal diseases, and intestinal worms. Three villages (Rundugai, Mabogini, and Mvuleni) with an average population of 5,000 and one health center were selected for active cases (people who were not sick/no symptoms of infection). Three hospitals (Kibosho, Kilimanjaro Christian Medical College, and Kibongoto) were included in this study for passive cases (people who had symptoms of amoebal infection). Information relating to population structure; disease cases; possible sources of amoebal infection; personal hygiene; history of amebiasis; and the source of drinking, cooking, and washing water was obtained from the health center serving the area.
- In: Main
- Tags: amebiasis, microscopic, misdiagnosis
AMEBIASIS AND COMPARISON OF MICROSCOPY
21 Dec2009
INTRODUCTION
In human amebiasis, the differentiation of the invasive parasite Entamoeba histolytica from the commensal organism Entamoeba dispar is of great concern to the medical community. Amebiasis is transmitted by fecal contamination of drinking water and foods, direct contact with dirty hands or objects, anal sexual contact, and poor sanitation and hygiene. For many years E. histolytica and E. dispar have been known to be two distinct species. The description of E. dispar by Brumpt was dismissed as a synonym of E. histolytica. However, later evidence mounted in support of Brumpt’s description of E. dispar as a separate species. E. histolytica and E. dispar are genetically distinct but closely related protozoan species. Both colonize the human gut, but only E. histolytica is able to invade tissues leading to massive and sometimes lethal pathological alterations, such as ulcerative colitis or abscesses of various organs—most commonly, the liver.
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- Tags: amebiasis, microscopic, misdiagnosis
Our findings support the growing concern about problems of overweight and obesity among school-age children and the need to use BMI as a percentile according to sex and age to properly evaluate such students. Because our study sample was mostly black students, we will focus on concerns about this portion of the U.S. population. Of the 54 black students evaluated, 48 (88.9%) met current CDC criteria for overweight children or children at risk for overweight (Figure 4). More than 50% of all our black students reached or exceeded the 95th percentile of BMI for sex and age.