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Int J Circumpolar Health. 2015 Nov 5;74:29256. doi: 10.3402/ijch.v74.29256. eCollection 2015.
Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.
Foote EM1, Singleton RJ2,3, Holman RC4, Seeman SM5, Steiner CA6, Bartholomew M7, Hennessy TW4.
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Abstract
BACKGROUND:
The lower respiratory tract infection (LRTI)-associated hospitalization rate in American Indian and Alaska Native (AI/AN) children aged <5 years declined during 1998-2008, yet remained 1.6 times higher than the general US child population in 2006-2008.
PURPOSE:
Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years.
METHODS:
A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009-2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998-1999 rates prior to pneumococcal conjugate vaccine introduction.
RESULTS:
The average annual LRTI-associated hospitalization rate declined from 1998-1999 to 2009-2011 in AI/AN (35%, p<0.01) and the general US child population (19%, SE: 4.5%, p<0.01). The 2009-2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6-14.8). The Alaska (38.9) and Southwest regions (27.3) had the highest rates. The disparity was greatest for infant (<1 year) pneumonia-associated and 2009-2010 H1N1 influenza-associated hospitalizations.
CONCLUSIONS:
Although the LRTI-associated hospitalization rate declined, the 2009-2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children.
KEYWORDS:
Alaska Native; American Indian; epidemiology; pneumonia; respiratory
PMID: 26547082 [PubMed - in process] Free full text
Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.
Foote EM1, Singleton RJ2,3, Holman RC4, Seeman SM5, Steiner CA6, Bartholomew M7, Hennessy TW4.
Author information
Abstract
BACKGROUND:
The lower respiratory tract infection (LRTI)-associated hospitalization rate in American Indian and Alaska Native (AI/AN) children aged <5 years declined during 1998-2008, yet remained 1.6 times higher than the general US child population in 2006-2008.
PURPOSE:
Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years.
METHODS:
A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009-2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998-1999 rates prior to pneumococcal conjugate vaccine introduction.
RESULTS:
The average annual LRTI-associated hospitalization rate declined from 1998-1999 to 2009-2011 in AI/AN (35%, p<0.01) and the general US child population (19%, SE: 4.5%, p<0.01). The 2009-2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6-14.8). The Alaska (38.9) and Southwest regions (27.3) had the highest rates. The disparity was greatest for infant (<1 year) pneumonia-associated and 2009-2010 H1N1 influenza-associated hospitalizations.
CONCLUSIONS:
Although the LRTI-associated hospitalization rate declined, the 2009-2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children.
KEYWORDS:
Alaska Native; American Indian; epidemiology; pneumonia; respiratory
PMID: 26547082 [PubMed - in process] Free full text