Infectious Disease
Tuberculosis, hepatitis B, HIV/AIDS, and parasitic diseases are of particular concern in AAPI populations. Tuberculosis, for example, has an overall incidence of 41.6 per 100,000, compared with 2.8 for white non-Hispanics and 22.4 for black non-Hispanics (APIAHF 2003; Chin and Bigby 2003; Chin 1999).
Approximately 1.25 million people are chronically infected with the hepatitis B virus (HBV). Annually, 5,000 deaths are caused by HBV-induced liver failure. Although AAPIs make up only about 4.5% of the total population, they account for approximately 50% of HBV infections and 50% of deaths caused by HBV-induced liver failure. This disparity is particularly unfortunate, since there is a vaccine for hepatitis B (Moritsugu et al. 2002).
The incidence of intestinal parasitic infestation among AAPIs entering the US has been shown to be as high as 80%, and multiple parasitic infestations have been found in as many as 55% of the Southeast Asian refugees screened (Hann 1994). Common types of parasites are hookworm Giardia (9%), Ascaris (7%), and Strongyloides (6%) (Hann 1994). School-aged children most heavily infested.
Liver flukes are trematode worms endemic in many areas of the Far East, specifically China, Japan, Korea, Hong Kong, Taiwan, Vietnam, Thailand, Laos, and Cambodia (Jong 1987). Humans acquire liver fluke infection by consuming raw, smoked, pickled, or undercooked fish (Chin 2000).
Although malaria is not a significant problem in the US, it may occur among refugees and travelers from regions where it is endemic or among military personnel stationed there. Thus, more than 99% of cases are imported; 55% occur in Southeast Asian refugees, more occur in males than in females, and the highest incidence is in the 10 to 29 age group. Vivax malaria is the predominant form (82%) among refugees in the US (Hann 1994).
Recommendations for Reducing Chronic Hepatitis B Virus Infection in Infants and Young Children (Perinatal Infection)
Each year, 16,000 to 18,000 children in the US are born to mothers infected with HBV. Without prevention programs, about 8,000 of these infants would become infected with HBV. However, 95% of these infections are preventable through appropriate maternal screening and infant care.
Screening pregnant women during an early prenatal visit is essential to identify those who are infected. Women at high risk should be retested late in pregnancy.
To be maximally effective, steps to prevent the transmission of HBV to infants born to infected mothers must begin as soon as the child is born. Such infants should receive a first dose of hepatitis B vaccine within 12 hours of birth, and hepatitis B immune globulin between the ages of 12 and 15 months to ensure that they are not infected and have developed immunity to the virus (US DHHS 2000). |
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