scholarly journals The prevalence of M. tuberculosis among acid fast bacilli cultures from military health system and veterans affairs beneficiaries in Hawaii and the Pacific Islands from 2002 to 2019

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254312
Author(s):  
Elena M. Crecelius ◽  
Michael B. Lustik ◽  
Timothy S. Horseman ◽  
Milissa U. Jones
Keyword(s):  
Health System ◽  
Pacific Islands ◽  
Pacific Islander ◽  
Incidence Rates ◽  
Veterans Affairs ◽  
Military Health System ◽  
Military Health ◽  
Asian Pacific Islander ◽  
The Pacific ◽  
Asian Pacific

The prevalence of tuberculosis among military health system (MHS) and Veterans Affairs (VA) beneficiaries in Hawaii and the Pacific Islands has not been previously reported. Our analysis evaluates the prevalence of M. tuberculosis (MTB) among acid fast bacilli culture(s) (AFB) tested at Tripler Army Medical Center (TAMC) on Oahu, HI and describes demographic factors associated with positive samples. We analyzed 9,768 AFBs from 4,129 individuals with AFB specimens processed at TAMC from January 2002 to November 2019: of those who were tested 3,178 were MHS beneficiaries and 951 were VA beneficiaries. There were a total of 40 individuals with MTB-positive cultures over the period of study: 31 MHS beneficiaries and 9 VA beneficiaries. Of the MTB-positive specimens, 93% were from pulmonary samples while the remainder were from lymph node aspirates (5%) and peritoneal samples (2%). Cumulative incidence rates of MTB-isolation were 1.8 per 100,000 MHS beneficiaries and 1.2 per 100,000 VA beneficiaries, both of which were lower than reported incidence rates in Hawaii, the U.S.-affiliated Pacific Islands and the United States for the study period. MHS beneficiaries of Asian-Pacific Islander race or ethnicity had nearly 20 times higher odds of positive AFB than white MHS beneficiaries (OR = 19.56, 95% CI 5.52, 69.29, p = < 0.001). This study demonstrated a higher odds of MTB-positivity associated with Asian-Pacific Islander race or ethnicity and low incidence rates of TB among MHS and VA beneficiaries in Hawaii and the Pacific Islands when compared with the civilian population.

scholarly journals 1662. The Prevalence of M. tuberculosis among Acid Fast Cultures from Military Health System Beneficiaries from Hawaii and Pacific Islands from January 2002 to November 2019

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S819-S819
Author(s):  
Elena M Crecelius ◽  
Michael Lustik ◽  
Timothy Horseman ◽  
Milissa Jones
Keyword(s):  
Risk Factors ◽  
Health System ◽  
Pacific Islands ◽  
Demographic Factors ◽  
Active Duty ◽  
The State ◽  
Military Health System ◽  
Military Health ◽  
Factors Associated ◽  
Asian Pacific

Abstract Background Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is the leading infectious cause of death worldwide and the state of Hawaii (HI) has the second highest case rate of TB in the United States. The prevalence of TB among military health system (MHS) beneficiaries (active duty service members, retirees, dependents, civilians and eligible Pacific Island civilians) in HI has not been previously reported. Our analysis evaluates the prevalence of MTB among acid fast cultures (AFCs) tested at Tripler Army Medical Center (TAMC) on Oahu, HI and describes demographic factors associated with positive samples. Methods We analyzed AFC results from TAMC clinical diagnostic microbiology laboratory from January 2002 to November 2019. Demographic data were recorded for each individual with an AFC sample during the study period. Prevalence was calculated based on the number of MTB-positive AFCs per all AFCs over the study period. Multivariable logistic regression was used to evaluate associations between demographic factors and MTB-positive AFC results. Results From January 2002 to November 2019 there were 4768 AFCs resulted at TAMC with 49 MTB-positive AFC, leading to a cumulative prevalence of 1.03 percent (Figure 1). After controlling for other factors, Asian-Pacific Islanders had nearly 15 times higher odds of having a positive AFC than whites (OR=14.96, 95% CI 5.03, 44.55, p=&lt; 0.001) and active duty personnel had 2.6 times the odds of having a positive AFC than dependents, civilians and retirees (OR=2.6, 95% CI 0.94, 7.22, p=0.067). Figure 1. The Prevalence of M. tuberculosis (MTB) among Acid Fast Cultures (AFC) from Military Health System Beneficiaries from Hawaii and Pacific Islands from January 2002 to November 2019. Conclusion The low prevalence of MTB among AFCs performed at our institution over nearly 16 years suggests that living in the state of HI does not appear to confer high rates of TB to MHS beneficiaries. Persons with Asian-Pacific Islander ethnicity have higher odds of positive AFC which corroborates prior studies regarding risk factors for MTB. Further analysis is needed to further define risk factors associated with positive AFC among MHS beneficiaries in HI. Follow-up analysis is underway to describe the clinical course of the persons with MTB-positive AFC from this study. Disclosures All Authors: No reported disclosures

scholarly journals Incidence Rates of Gynecologic Cancers in the U.S. Active Duty Military Population

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1590-e1595
Author(s):  
Steffanie Owens ◽  
Tara Blando ◽  
Yohannes B Tesema ◽  
Elizabeth Butts ◽  
Jessica Newton ◽  
...  
Keyword(s):  
Health System ◽  
Active Duty ◽  
Incidence Rates ◽  
Data Repository ◽  
Military Health System ◽  
Gynecologic Cancers ◽  
Military Health ◽  
Tumor Registry ◽  
System Data ◽  
Health System Data

Abstract Introduction Despite an increasing number of female service members, incidence rates of gynecologic cancers (other than cervical cancer) have not been previously documented in the U.S. active duty military population. This study sought to determine the incidence rates of all gynecologic, including peritoneal, malignancies in the U.S. Active Duty population compared to the general US population as reported in the Surveillance, Epidemiology, and End Results Program database. Materials and Methods Gynecologic cancers diagnosed in U.S. Active Duty women aged 20–59 between 2004 and 2013 were retrospectively ascertained. Cancer cases were identified in both the Automated Central Tumor Registry and the Military Health System Data Repository. All cases in Automated Central Tumor Registry plus cases recorded in Military Health System Data Repository, but not duplicative of Automated Central Tumor Registry cases, were included. Age-specific and age-adjusted incidence rates were calculated in military and Surveillance, Epidemiology, and End Results cases. Results In U.S. Active Duty women, 327 incident cases of gynecologic cancer were identified. There were 110 cases of cervical cancer, 40 cases of endometrial cancer, 152 cases of ovarian cancer, and 25 other gynecologic malignancies. Of the 327 cases, 154 were ascertained from the Automated Central Tumor Registry database and the remainder from Military Health System Data Repository claims data. The age-adjusted rate of all gynecologic cancers for U.S. Active Duty women was 49.17 per 105 (95%CI 37.58, 65.12), while the age-adjusted rate for Surveillance, Epidemiology, and End Results −18 was 42.09 per 105 (95%CI 41.83, 42.35). The kappa coefficient assessing the overlap between the data sources was −0.1937. Though insufficient in numbers for statistical analysis, the observed proportion of ovarian to cervical cancer cases in active duty women &lt; 45 years of age was substantially greater than in the general population. Conclusions U.S. Active Duty women exhibited a similar age-adjusted rate of gynecologic cancer as the general US population. There was suboptimal overlap between the Automated Central Tumor Registry and Military Health System Data Repository databases, indicating the necessity of using both databases in order to obtain reliable data in the active duty population. This study is the current best estimate of a baseline rate of gynecologic cancer in U.S. active duty military women. This rate might change over time as women’s roles and exposures in recent and future military conflicts evolve.

From Merging Histories to Emerging Identities: An “Asian” Museum as a Site of Pan-ethnic Identity Promotion

2007 ◽  
Vol 5 (2) ◽  
pp. 33-54
Author(s):  
Chong-suk Han ◽  
Edward Echtle
Keyword(s):  
Ethnic Identity ◽  
Asian American ◽  
Social Ties ◽  
Pacific Islander ◽  
American Identity ◽  
Asian Pacific Islander ◽  
Common Problems ◽  
Asian American Identity ◽  
Asian Pacific ◽  
A Site

In this paper, we explore the significance of the Wing Luke Asian Museum (WLAM) in Seattle, Washington as a site where pan-ethnic Asian American identity can be promoted by analyzing the strategies employed by the staff and artists of the WLAM to promote, foster and disseminate a larger Asian Pacific Islander American pan-ethnic identity. We argue that museums are a significant site that can “provide a setting for persons of diverse Asian backgrounds to establish social ties and to discuss their common problems and experiences.”

Asian/Pacific Islander Youth Violence Prevention Center: Interpersonal Violence and Deviant Behaviors among Youth in Hawai‘i

2006 ◽  
Vol 39 (2) ◽  
pp. 276.e1-276.e11 ◽  
Author(s):  
David T. Mayeda ◽  
Earl S. Hishinuma ◽  
Stephanie T. Nishimura ◽  
Orlando Garcia-Santiago ◽  
Gregory Y. Mark
Keyword(s):  
Violence Prevention ◽  
Interpersonal Violence ◽  
Youth Violence ◽  
Pacific Islander ◽  
Youth Violence Prevention ◽  
Deviant Behaviors ◽  
Asian Pacific Islander ◽  
Prevention Center ◽  
Asian Pacific
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