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Pediatric Infectious Disease Journal:
Original Studies

Lower Respiratory Tract Infections Among American Indian and Alaska Native Children and the General Population of U.S. Children

Peck, Angela J. MD*†; Holman, Robert C. MS‡; Curns, Aaron T. MPH‡; Lingappa, Jairam R. MD, PhD*; Cheek, James E. MD, MPH§; Singleton, Rosalyn J. MD, MPH∥; Carver, Karen PhD¶; Anderson, Larry J. MD*

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Background and Objective: Lower respiratory tract infections (LRTIs) cause substantial childhood morbidity. This study characterizes and compares LRTI-associated morbidity among American Indian/Alaska Native (AI/AN) children and the general population of U.S. children.

Methods: Hospitalization and outpatient records with a diagnosis indicating LRTIs were evaluated for children aged younger than 5 years during 1990–2001.

Results: For 1999–2001, the LRTI-associated hospitalization rate was significantly higher for AI/AN children than for U.S. children (116.1 versus 63.2/1000, respectively), with the disparity being greater for infants than for 1- to 4-year-old children. Also the rate of LRTI-associated outpatient visits among AI/AN infants was higher than that for all U.S. infants (737.7 versus 207.2/1000, respectively). LRTI hospitalization and outpatient visit rates were highest in the Alaska and Southwest Indian Health Service regions. During 1990–2001, the LRTI hospitalization rate among AI/AN infants in the Alaska region and among the general U.S. infant population increased. Bronchiolitis-associated hospitalization rates increased for AI/AN and U.S. infants, whereas the pneumonia-associated hospitalization rate decreased among AI/AN infants and remained stable among U.S. infants.

Conclusions: LRTIs continue to be an important cause of morbidity in children, especially among AI/AN infants in the Alaska and Southwest regions. Strategies to reduce LRTI hospitalizations and outpatient visits are warranted for all infants, but the greatest potential impact would be among AI/AN infants.

© 2005 Lippincott Williams & Wilkins, Inc.


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