There is scant information on tuberculosis symptoms from a population-based perspective. We prospectively identified 526 tuberculosis cases reported in Los Angeles County over a 6-month period. Of 313 persons who completed our questionnaire, 72.7% had cough, 48.2% for >2 weeks, and 52.3% had fever, 29.4% for >2 weeks. Among those with pulmonary disease, only 52.4% had cough for >2 weeks. In a multivariate model, persons with significant symptoms typical of tuberculosis disease (defined as cough or fever for >2 weeks, weight loss, or hemoptysis) were associated with lack of medical insurance, negative tuberculin skin test, diagnosis during a process other than screening, and non-Asian race. In summary, classic symptoms of prolonged cough and fever are insensitive predictors of tuberculosis. Our data suggest that Asians may need to be added to the list of persons who present with tuberculosis atypically. We believe that the Infectious Diseases Society of America guidelines for community-acquired pneumonia should emphasize demographic features in addition to clinical symptoms when suggesting which patients require evaluation for Mycobacterium tuberculosis.
No recent population-based data on HIV testing in people with high-risk sexual behavior are available. We sought predictors of testing using data from the 1997 Los Angeles County Health Survey, a random-digit telephone survey of 8004 county households. An estimated 2.3 million (35.5%) adults were tested for HIV in the past 2 years and approximately 370,000 (5.6%) engaged in high-risk sexual behavior (defined as having > or =2 partners in the past 12 months and not always using condoms). Among high-risk persons, an estimated 46% of heterosexual men, 56% of heterosexual women, and 72% of men who had sex with men (MSM) were tested for HIV. In a multivariable model of high-risk people, both heterosexual men (odds ratio [OR], 0.31; 95% confidence interval [CI], 0.16-0.61) and women (OR, 0.41; 95% CI, 0.19-0.87) had significantly lower proportions of testing than MSM. Although African Americans and Hispanics had significantly higher testing proportions than whites overall among all county residents, those reporting high-risk sexual behavior did not test at higher proportions. We conclude that the proportion of adults with high-risk sexual behavior tested for HIV is higher than almost a decade ago. However, testing among this group remains suboptimal. Future public health campaigns should intensify efforts to encourage HIV testing among this population.
With increases in unemployment and individuals experiencing mental health symptoms, the effects of the COVID-19 pandemic have become a prevalent issue in society. The purpose of this paper is to educate communities about the current effects of COVID-19 on the economy as well as mental health. We aim to establish connections between economic hardships and patterns of depression and anxiety across different demographic groups within the U.S. labor force participation pool aged 18 or older. We analyzed existing literature on past recessions, past pandemics, and the current pandemic’s impacts. The findings from past literature suggest that the pandemic has caused various economic impacts which in turn affect mental health, particularlyanxiety and depression rates. We used data from the U.S. Census Bureau Household Pulse Survey (HPS) to conduct chi-squared tests of independence on employment income loss and symptoms of anxiety and depression over 12 weeks of the pandemic. For each demographic variable (race, income level, gender, and age), we found an association between each categoryand experienced employment income loss. The tests yielded the same conclusions for the data of the symptoms of anxiety and depression.
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