Other information suggests that immigrants might have relatively low screening levels. In a neighborhood site screening program, only 51 per cent of Haitians reported a previous Pap test, compared to 77 per cent of ESC women and 89 per cent of US-born Black women.6 Haiti, the poorest Caribbean country, has limited medical services through which Pap tests can be provided.7 English-speaking Caribbean countries vary in the extent and quality of their health services, but many women receive Pap tests during prenatal or contraceptive care.8 The frequency of screening among immigrants is a function of age, socioeconomic level, and country of origin. In the USA, cultural, financial, and linguistic barriers (compounded by documentation problems) lead to a relatively low use of preventive health services among low-income Caribbean immigrants.Haitians have a higher incidence of tuberculosis than other immigrants,9 but evaluations of the health status and the need for services among the varied groups within Black and immigrant communities are lacking. Such studies are essential if focused, cost-effective education and screening services are to be implemented.
In an institution for the mentally retarded, a total of 13 (2.4%) susceptible employees seroconverted for hepatitis B during 539 person-years. Two of them developed acute hepatitis B; the cost of their medical care and temporary disability was $7,772. Eleven seroconverters had no elevation of serum alanine aminotransferase, and all seroconverters recovered without chronic sequelae. Nine converters acquired antibody to HBsAg alone; three of these had no client contact. Difficulty in identifying nonoccupational causes of hepatitis B infection in the institutional setting often leads to labeling of all seroconversions as occupationally acquired. Hepatitis B vaccine is recommended for client-care personnel.
Sera of 500 residents were screened for parvovirus B19 immunoglobulin M (IgM) and immunoglobulin G (IgG) by enzyme-linked immunosorbent assay. Positive IgM and equivocal IgG or IgM results were confirmed by immunofluorescent antibody and Western blot. IgM was detected in 13 sera (2.6%), and IgG was detected in 285 (57%). Records of IgM-positive residents contained no evidence of erythema infectiosum or polyarthropathy.
Sera of 500 residents were screened for parvovirus B19 immunoglobulin M (IgM) and immunoglobulin G (IgG) by enzyme-linked immunosorbent assay. Positive IgM and equivocal IgG or IgM results were confirmed by immunofluorescent antibody and Western blot. IgM was detected in 13 sera (2.6%), and IgG was detected in 285 (57%). Records of IgM-positive residents contained no evidence of erythema infectiosum or polyarthropathy.
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