Relationship of Demographic Variables and Classification of Leprosy Cases in Georgia since the early 1900s. 公开
McCormick, Carter (Spring 2018)
Published
Abstract
Introduction: Leprosy (also known as Hansen’s Disease) is a disease that is diagnosed in approximately 160 people in the USA each year. Recent studies have shown different forms of transmission in the southern US (zoonotic versus person-to-person), but epidemiologic data are lacking about factors associated with multibacillary infection, the most infectious form.
Purpose: To examine if location of birth, dichotomized between domestic (United States) born and born abroad, is related to disease presentation (multibacillary versus paucibacillary) in cases of leprosy in Georgia when controlling for other demographic characteristics.
Methods: Data was collected from surveillance reports on 123 leprosy patients from the National Hansen’s Disease Program who had been reported by or lived in the state of Georgia since the early 1900’s. Two logistic regression models were built, one using all years and one using post-1995 cases. Location of birth was the variable of interest and the outcome was type of leprosy (multibacillary vs. paucibacillary). Sex, age, and ethnicity was controlled for.
Results: While the model showed no significant relationship between country of origin and type of leprosy, being Asian or Pacific Islander (97.36% of which were foreign born) was associated with a higher risk of multibacillary infection when controlled with the other variables (aOR = 5.714; 95% CI: 1.254 – 26.287). This trend was repeated in the model using post-1995 data.
Conclusion: Leprosy is known to be highly endemic in Micronesia and other areas in Asia. There have been several articles describing the epidemiological data of Asians and Pacific Islanders in the USA, such as the Marshallese in Arkansas and Micronesians in Hawaii. However, more research should be done to see if these population is at greater risk for multibacillary leprosy. With the global community dedicated to the elimination of leprosy, understanding which populations are at greater risk for this more infectious type of leprosy is important to create targeted interventions and prevention strategies.
Table of Contents
Table of Contents
Chapter 1: Introduction…………1
---Background…………1
---Problem Statement …………2
---Purpose Statement…………3
---Research Question…………3
---Significance Statement…………3
Chapter 2: Literature Review 4
---Leprosy in the United States Among Immigrants…………4
---Leprosy in the United States Among Domestic Born Citizens…………6
---Paucibacillary vs. Multibacillary Cases in the United States…………8
Chapter 3: Manuscript (For Submission to Emerging Infectious Diseases) …………10
---Contribution of Student…………10
---Abstract…………10
---Introduction…………11
---Methods…………13
---Results…………14
---Discussion…………16
Chapter 4: Conclusion & Recommendations…………20
Bibliography…………24
Appendix…………26
---Table 1 – Demographic Characteristics of Cases in the Study…………26
---Table 2 – Logistic Regression Model for all Years…………27
---Table 3 – Logistic Regression Model for cases after 1995…………27
---Figure 1…………28
---Figure 2…………29
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