COCCIDIO DOMYCOSIS AMONG SOUTHWESTERN AMERICAN INDIANS

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Abstract
In a 5-year hospital study of southwestern Indians, the coccidioidin skin test was found to be positive much more often for tribes whose reservations are within the endemic coccidioidal zone than for those outside the area. The frequency of reaction to both PPD and coccidioidin increased progressively with age, except for a decline in the older age groups; but the decrease came at an earlier age and was of greater magnitude for coccidioidin, which suggest that tuberculin sensitivity is more durable. No significant difference in the results for males as compared with females was noted. Disseminated coccidioidomycosis was apparently acquired most often on the San Carlos Apache Reservation. This region also had the highest frequency of positive coccidioidin skin tests, as previous investigators have also observed. The rate of reaction to coccidioidin for southwestern Indians from reservations within the endemic coccidioidal area was lower than anticipated. It approximated that reported for whites in Phoenix and other selected non-reservation areas of Arizona and was much lower than that found in a survey of southwestern Indians 22 years earlier. Further investigation is needed to determine the reasons for this apparent decreases in the frequency of coccidioidal infection among Indian tribes in the endemic zone.

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