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Volume 23, Number 3—March 2017

Research

Epidemiology of Nontuberculous Mycobacterial Lung Disease and Tuberculosis, Hawaii, USA

Jennifer AdjemianComments to Author , Timothy B. Frankland, Yihe G. Daida, Jennifer R. Honda, Kenneth N. Olivier, Adrian Zelazny, Stacey Honda, and D. Rebecca Prevots
Author affiliations: United States Public Health Service, Commissioned Corps, Rockville, Maryland, USA (J. Adjemian); National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA (J. Adjemian, A. Zelazny, D.R. Prevots); Kaiser Permanente, Honolulu, Hawaii, USA (T.B. Frankland, Y.G. Daida, S. Honda); University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA (J.R. Honda); National Jewish Health, Denver, Colorado, USA (J.R. Honda); National Heart, Lung, and Blood Institute, Bethesda (K.N. Olivier)

Main Article

Table 3

Risk for nontuberculous mycobacterial pulmonary disease (by mycobacteria species) or tuberculosis among Kaiser Permanente Hawaii patients, by demographic characteristics and co-morbid condition, Hawaii, 2005–2013*

Characteristic aOR (95% CI)
NTM M. abscessus MAC M. fortuitum group TB
Racial/ethnicity
White 0.9 (0.7–1.1) 0.7 (0.4–1.1) 1.0 (0.7–1.2) 1.0 (0.6–1.5) 0.2 (0.05–0.6)
NHOPI 0.5 (0.3–0.9) 0.1 (0.01–1.4) 0.4 (0.2–0.9) 0.5 (0.2–1.3) 0.5 (0.1–2.6)
Black 0.6 (0.1–3.1) 1.1 (0.7–16.4) 1.0 (0.2–4.8) 0.7 (0.05–11.5) NA
Asian 1.4 (1.2–1.7) 2.5 (1.7–3.9) 1.4 (1.1–1.8) 1.5 (1.0–2.2) 4.9 (2.6–9.2)
Filipino 1.3 (1.0–1.7) 2.0 (1.2–3.3) 1.5 (1.1–2.1) 1.3 (0.7–2.1) 8.8 (4.9–16.0)
Japanese 1.2 (1.0–1.6) 2.0 (1.2–3.2) 1.0 (0.7–1.4) 1.6 (1.0–2.5) NA
Chinese 1.3 (0.9–2.0) 1.9 (0.9–3.9) 1.5 (0.95–2.3) 0.3 (0.06–1.5) 1.0 (0.2–5.0)
Korean 1.9 (1.1–3.4) 2.0 (0.6–7.0) 1.4 (0.6–3.2) 4.0 (1.7–9.5) 5.9 (1.7–20.4)
Vietnamese
3.7 (1.6–8.6)
5.0 (1.0–24.6)
3.7 (1.3–10.6)
8.7 (3.0–25.0)
9.6 (2.0–46.8)
Island of residence
Oahu 1.5 (1.2–1.9) 2.6 (1.4–5.2) 1.6 (1.2–2.2) 1.3 (0.8–2.0) 0.6 (0.3–1.2)
Maui 0.7 (0.6–1.0) 0.4 (0.2–0.9) 0.7 (0.5–1.0) 0.8 (0.5–1.4) 2.3 (1.2–4.3)
Hawaii
0.6 (0.4–1.0)
0.5 (0.2–1.4)
0.6 (0.4–1.1)
0.9 (0.5–2.0)
0.7 (0.2–2.3)
Age group, y
<18 Referent Referent Referent Referent Referent
18–49 7.4 (2.9–19.3) 1.9 (0.3–11.3) 7.8 (2.2–27.9) 8.3 (1.6–42.7) 3.9 (0.7–21.0)
50–64 31.2 (12.2–79.7) 22.1 (4.4–111.8) 32.7 (9.3–114.6) 26.8 (5.3–135.5) 13.4 (2.6–69.1)
>65
106.4 (42.0–270.0)
65.1 (13.0–325.1)
127.1 (36.6–441.3)
61.4 (12.2–308.1)
16.6 (3.1–88.5)
Sex
M Referent Referent Referent Referent Referent
F
1.0 (0.9–1.3)
1.4 (0.9–2.1)
1.1 (0.9–1.4)
0.8 (0.6–1.2)
0.4 (0.2–0.8)
Years in KPH
1 Referent Referent Referent Referent Referent
2–4 2.6 (1.4–4.7) 1.1 (0.4–2.9) 2.7 (1.1–6.3) 7.0 (1.3–36.3) 1.7 (0.5–5.7)
>5
6.4 (3.6–11.2)
2.3 (0.96–5.4)
7.7 (3.5–16.8)
14.9 (3.0–74.2)
2.3 (0.8–6.9)
Co-morbid condition†
Bronchiectasis 8.3 (6.5–10.7) 12.0 (7.6–18.8) 7.0 (5.2–9.2) 4.6 (2.9–7.1) 0.4 (0.09–2.2)
COPD 1.8 (1.4–2.2) 1.3 (0.8–2.0) 1.9 (1.5–2.5) 1.5 (1.0–2.3) 0.4 (0.2–1.1)
Coccidiomycosis 4.5 (1.4–15.1) 2.0 (0.1–38.4) 3.5 (0.8–15.2) 4.0 (0.7–23.4) 2.8 (0.2–50.1)
Sarcoidosis 2.0 (0.6–7.2) 1.2 (0.1–22.8) 2.2 (0.5–9.4) 3.5 (0.6–20.0) 3.0 (0.2–54.6)
Malignant neoplasm‡ 0.7 (0.5–0.9) 0.5 (0.2–1.0) 0.6 (0.4–0.9) 0.7 (0.4–1.3) 0.07 (0.01–1.0)
Other malignancies 0.7 (0.5–0.8) 0.5 (0.3–0.8) 0.7 (0.5–0.9) 0.7 (0.5–1.1) 0.3 (0.1–0.8)

*aOR, adjusted odds ratio; COPD, chronic obstructive pulmonary disease; KPH, Kaiser Permanente Hawaii; MAC, Mycobacterium avium complex; NHOPI, Native Hawaiian and Other Pacific Islander; NTM, nontuberculous mycobacteria; Ref, referent group; TB, tuberculosis; NA, not available because limited sample size resulted in unstable model estimates. All aORs and 95% CIs associated with each racial/ethnic group, island, and co-morbid condition were assessed independently as a binary variable via logistic regression models, adjusted for age, sex, and years in KPH. Estimates for years in KPH, age, and sex were obtained from a single adjusted multivariable model. Race/ethnicity was self-reported; race/ethnicity-specific analyses were limited to patients reporting only 1 racial/ethnic group. Statistical significance (p<0.05) is indicated with boldface font.
†Data only available for KPH patients with a mycobacterial culture performed; percentages listed are out of total patient population with that co-morbidity.
‡Of trachea, bronchus, or lung.

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