142nd APHA Annual Meeting and Exposition

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297873
Cryptococcosis-Related Mortality, 2000-2010

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 8:30 AM - 8:45 AM

Noel Barragan, MPH , Division of Chronic Diease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA
Frank Sorvillo, PhD , Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA
Tony Kuo, MD, MSHS , Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA
Introduction: There are few specific reports of mortality burden of cryptococcosis, and none encompassing the entire United States (US). We examined the US mortality burden for this infection (both gattii and neoformans species) using the national multiple-cause-of-death (MCD) data. 

 

Methods: Cryptococcus-related deaths from 2000-2010 were identified from the MCD data set based on the ICD-10 coding for this disease. Crude and age-adjusted mortality rates were calculated by race/ethnicity, sex, and region. Poisson regression analysis was performed to model mortality trends over time. A matched case-control analysis was conducted to describe associations between this disease and other comorbid conditions that contributed to death.

Results: A total of 3,212 Cryptococcus-related deaths were identified (n=1,134 were underlying cases). A majority of deaths were in whites (53%, n=1,710) and blacks (29%, n=937).  The age-adjusted rate ratio for blacks, using whites as the referent group, was 2.89 (95% CI 3.71-4.09). Males comprised over two-thirds of cases (71%, n=2,288) and had a higher age-adjusted mortality rate than females (0.15 per 100,000 population, 95% CI 0.14-0.16). Mortality rates have trended downward over the 10-year study period, decreasing from 0.13 per 100,000 population in 2000 to 0.07 per 100,000 population in 2010.  A number of comorbid conditions were associated with cryptococcosis related deaths: HIV (MOR = 36.14; 95% CI 28.38-46.03), Leukemia (MOR = 16.10; 95% CI 11.24-23.06); non-Hodgkin’s Lymphoma (MOR = 7.18; 95% CI 5.39-9.57); Autoimmune/connective tissue disorders (MOR = 6.86; 95% CI 5.40-8.70).

Discussion: Despite a significant decline in mortality rates over the last ten years, cryptococcosis remains an important cause of death in the US. The dramatic decline in mortality is likely related to the improved control of HIV infection.

Learning Areas:

Epidemiology

Learning Objectives:
Evaluate the mortality burden of cryptococcosis in the United States from 2000-2010 Describe the association between cryptococcosis and other comorbid conditions contributing to death

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am trained in epidemiology and have co-authored peer reviewed publications which have used the same data set and similar analysis methods as those used in this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.