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C A Peña

Publications and source records attributed to C A Peña.

9 recordsLinked to original sources
PubMed2000

Racial differences in reported Lyme disease incidence.

In the United States, the incidence of Lyme disease is considered to be disproportionately high among Whites because of risk of exposure. For assessment of racial differences in Lyme disease incidence and the role of risk exposure, incidence rate ratios (IRRs) for Lyme disease and its manifestations between Whites and African Americans in Maryland and in its focus of endemicity, the Upper Eastern Shore, were calculated. Calculations were based on reported cases of Lyme disease in Maryland during the years 1992-1996. The IRR for Lyme disease between Whites and African Americans was 6.3 (95% confidence interval (CI): 5.0, 8.0), decreasing to 1.8 (95% CI: 1.2, 2.7) for the Upper Eastern Shore. Statewide, there was a significant difference between the White to African American IRR for erythema migrans and for Lyme disease-associated arthritis, at 17.7 (95% CI: 11.2, 27.8) and 2.3 (95% CI: 1.7, 3.2), respectively. On the Upper Eastern Shore, the IRR for arthritis reversed, indicating higher incidence among African Americans than among Whites: IRR = 5.7 (95% CI: 2.4, 13.9) for erythema migrans and IRR = 0.7 (95% CI: 0.4, 1.1) for arthritis. White patients were more likely to have erythema migrans (risk ratio = 2.8, 95% CI: 1.9, 4.1) and less likely to have arthritis than were African Americans (risk ratio = 0.4, 95% CI: 0.3, 0.5). Among all patients, there was a significant negative association between arthritis and erythema migrans. Although much of the racial disparity in incidence rates diminishes in a rural, endemic area, consistent with exposure risk being responsible for much of the variation, a difference remains. This may be due to failure to recognize early disease (erythema migrans) among African Americans, resulting in increased rates of late manifestations. Geographic spread of the disease warrants efforts to increase awareness of Lyme disease and its manifestations among people of color and the health care providers who serve them.

Arthritis↗
PubMed1997

Utilization and cost of serologic tests for Lyme disease in Maryland.

To ascertain use of serologic tests for Lyme disease (LD) in Maryland, all laboratories registered with the State Health Department were surveyed. Results show that from 1992 to 1995, 17 laboratories performed 100,000 serologic tests costing $7.1 million on Maryland residents; 90% of these tests were EIAs. The proportion of positive EIAs increased from 3.4% in 1992 to approximately 7.0% in 1994 and 1995, and the percentage of positive second tests (Western blot, WB) fell from 7.9% to 5.0%-5.5%. The large number of EIAs performed in comparison with the low incidence of LD in the state results in a low predictive value of a positive EIA test. Therefore, the WB is indicated to confirm equivocal and positive EIA tests when characteristic clinical findings of LD are not present. The 30,000 tests for LD performed annually on Maryland residents at a cost of over $2 million in direct medical costs must be added to the public health burden of LD in this state.

Blotting, Western↗
PubMedDate not supplied

Incidence rates of Lyme disease in Maryland: 1993 through 1996.

The incidence rate per 100,000 population by gender and age group was calculated for the 24 Maryland jurisdictions using 1,392 cases reported to the Lyme Disease Registry during 1993 to 1996. The overall incidence rate for the state was 7.0 cases per 100,000 inhabitants. Males (incidence rate = 7.7) were 1.2 times more affected than females (incidence rate = 6.2) (p < 0.001). The bimodal overall age distribution shows a peak in the 10 to 19 age category (incidence rate = 8.5) and in the 50 to 59 age group (incidence rate = 8.9), and in the 20 to 29 age group (incidence rate = 3.9). The incidence rate by jurisdiction ranged from 0.7 in Allegany County from Western Maryland to 88.3 in Kent County on the Upper Eastern Shore. Results from this study show that counties from the Upper Eastern Shore region had the highest specific incidence rate by age group/gender/jurisdiction while counties from Western Maryland had the lowest specific incidence rates and have not reported Lyme disease patients younger than 10 or older than 59 years of age. This difference might be explained primarily by the kind of outdoor activities in which the different age groups are involved and the relative abundance of Ixodes scapularis infected with the etiologic agent of Lyme disease, Borrelia burgdorferi, in these two regions.

Adolescent↗