Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.
Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.
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DOI：
10.3402/ijch.v74.29256
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发表时间：
2015
影响因子：
1.3
通讯作者：
Hennessy TW
中科院分区：
文献类型：
--
作者：
Foote EM;Singleton RJ;Holman RC;Seeman SM;Steiner CA;Bartholomew M;Hennessy TW
1998 年至 2008 年期间，5 岁以下美洲印第安人和阿拉斯加原住民 (AI/AN) 儿童的下呼吸道感染 (LRTI) 相关住院率有所下降，但 2006 年至 2008 年期间仍比美国一般儿童人口高 1.6 倍。描述 AI/AN 儿童和美国 5 岁以下儿童群体中与 LRTI 相关的住院率的变化。分别使用印度卫生服务直接和合同护理住院患者数据以及全国住院患者样本，对 2009 年至 2011 年期间 AI/AN 儿童和美国 5 岁以下儿童群体的出院 ICD-9-CM 代码 LRTI 住院情况进行回顾性分析。我们计算了住院率，并与之前公布的 1998-1999 年肺炎球菌结合疫苗引入之前的住院率进行了比较。从1998-1999年到2009-2011年，AI/AN（35%，p<0.01）和美国一般儿童群体（19%，SE：4.5%，p<0.01）的平均年LRTI相关住院率下降。 2009-2011年AI/AN儿童平均每年LRTI相关住院率为20.7/1,000，比美国儿童住院率高1.5倍（13.7 95% CI：12.6-14.8）。阿拉斯加（38.9）和西南地区（27.3）的比率最高。婴儿（<1 岁）肺炎相关住院治疗和 2009-2010 年 H1N1 流感相关住院治疗的差异最大。尽管与 LRTI 相关的住院率有所下降，但 2009-2011 年 AI/AN 儿童率仍然高于美国儿童率，特别是在阿拉斯加和西南部地区。剩余的差距可能是多因素造成的，部分与家庭拥挤、室内烟雾暴露、缺乏自来水和贫困有关。需要在 AI/AN 儿童中实施经证实可减少 LRTI 的干预措施。
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. Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years. 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. 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. 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.