Lack of piped water and sewage services is associated with pediatric lower respiratory tract infection in Alaska
Lack of piped water and sewage services is associated with pediatric lower respiratory tract infection in Alaska
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DOI：
10.1016/j.jpeds.2007.10.049
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发表时间：
2008-05-01
影响因子：
5.1
通讯作者：
Gessner, Bradford D.
中科院分区：
文献类型：
--
作者：
Gessner, Bradford D.
目的确定阿拉斯加州儿童下呼吸道感染（LRI）的高发病率与缺乏现代供水服务之间的关系研究设计：对阿拉斯加所有108个社区进行社区水平的分析，其中至少有15名儿童，1998年至2003年期间参加医疗补助的2岁儿童。社区LRI发病率从医疗补助数据库与标准LRI计费代码确定。可能混淆社区水平。结果在线性回归分析中，社区拥有现代化供水服务的家庭百分比预测社区门诊量（β = -0.53; P < .001）和住院患者（β = -0.15; P = 0.088）在控制了家庭拥挤程度、失业、成人教育、吸烟、使用柴炉和贫困的情况下，LRI发病率。适度的改善供水服务提供没有被证明与LRI burden. Conclusions的变化，缺乏现代化的供水服务在阿拉斯加是与儿童LRI发病率高。这些社区应该得到现代化的供水服务，但单靠这种干预可能不会大大减少LRI负担。
Objectives To determine the association between the high incidence of lower respiratory tract infection (LRI) documented among young Alaskan children and the absence of modern water service (in-home piped water/septic system or water delivered by closed haul truck) found commonly in rural Alaskan communities.Study design A community-level analysis was performed of all 108 Alaskan communities with at least 15 children < 2 years of age enrolled in Medicaid during 1998-2003. Community LRI incidence rates were determined from a Medicaid database with standard LRI billing codes. Potentially confounding community-level. demographic variables were obtained, as was availability of water service.Results During linear regression analysis, the percentage of households with modern water service in a community predicted community-level outpatient (beta = -0.53; P < .001) and inpatient (beta = -0.15; P = .088) LRI incidence rates when controlling for the degree of household crowding, unemployment, adult education, tobacco cigarette use, wood stove use, and poverty. Modest improvements in water service delivery were not shown to be associated with changes in LRI burden.Conclusions Lack of modern water service in Alaska is associated with high pediatric LRI incidence. These communities should receive modern water service, but this intervention alone may not dramatically reduce LRI burden.