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Volume 17, Number 9—September 2011

Research

Geographic Distribution of Endemic Fungal Infections among Older Persons, United States1

John W. BaddleyComments to Author , Kevin L. Winthrop, Nivedita M. Patkar, Elizabeth Delzell, Timothy Beukelman, Fenglong Xie, Lang Chen, and Jeffrey R. Curtis
Author affiliations: Author affiliations: University of Alabama at Birmingham, Birmingham, Alabama, USA (J.W. Baddley, N.M. Patkar, E. Delzell, T. Beukelman, F. Xie, L. Chen, J.R. Curtis); Birmingham VA Medical Center, Birmingham (J.W. Baddley); Oregon Health and Science University, Portland, Oregon, USA (K.L. Winthrop)

Main Article

Table 1

Characteristics of Medicare beneficiaries with mycoses, United States, 1999–2008

Characteristic No. (%) patients
Histoplasmosis,
n = 357 Coccidioidomycosis,
n = 345 Blastomycosis,
n = 74 Total,
n = 1,913,247*
Male sex 180 (50.4) 200 (58.1) 42 (56.5) 807,204 (42.2)
White race
342 (95.8)
62 (89.9)
61 (82.4)
1,679,198 (87.8)
Region
Midwest 169 (47.3) 63 (18.3) 29 (39.2) 494,139 (25.8)
North 24 (6.72) 14 (4.0) 2 (2.7) 375,987 (19.7)
South 145 (40.6) 25 (7.25) 41 (55.4) 733,676 (38.4)
West
19 (5.3)
243 (70.4)
2 (2.7)
309,525 (16.2)
Rural location†
137 (38.4)
52 (15.1)
34 (46.6)
502,973 (26.3)
Concurrent medical conditions
Chronic obstructive pulmonary disease 142 (39.8) 107 (31.0) 21 (28.4) 102,936 (5.4)
Diabetes mellitus 71 (19.9) 80 (23.2) 20 (27.0) 204,726 (10.7)
Solid malignancy 67 (18.8) 41 (11.9) 20 (27.0) 128,766 (6.7)
Hematologic malignancy‡ 12 (3.4) <11 <11 13,393 (0.7)
Rheumatoid arthritis 19 (5.3) 21 (6.1) 0 21,046 (1.1)
Chronic kidney disease‡ 20 (5.6) 25 (7) <11 13,393 (0.7)
Neutropenia‡
<11
<11
<11
3,826 (0.2)
90-day mortality§ 35 (9.2) 32 (9.3) <11

*Random national sample of 5% of Medicare beneficiaries with claims during 1999–2008; selected for cohort were those who were age >65 years at start of follow-up, had full Medicare coverage (parts A and B, not in a Medicare Advantage plan) for at least 13 consecutive months; lived in the 50 US states or Washington, DC; and did not have claims for any endemic mycosis during a 12-month period before the start of follow-up. Mean age of those with mycoses was 75.7 years.
†Rural residential status defined by linkage of 9-digit ZIP codes to the rural-urban commuting area code for the corresponding census block.
‡Per Centers for Medicare and Medicaid Services data use guidelines, cell sizes <11 cannot be shown.
§Those who died within 90 days after mycosis diagnosis.

Main Article

1This research was presented in part at the 74th American College of Rheumatology Annual Meeting, November 7–11, 2010, Atlanta, Georgia, USA.

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