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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*

Pediatric Infectious Disease Journal:
Original Studies
Abstract

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.

Author Information

From the *Respiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, the †Epidemiology Program Office and the ‡Office of the Director, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, United States Department of Health and Human Services, Atlanta, GA; the §Division of Epidemiology, Office of Public Health Support, Indian Health Service, Albuquerque, NM; the ∥Alaska Native Tribal Health Consortium and Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, United States Department of Health and Human Services, Anchorage, AK; and the ¶Division of Program Statistics, Office of Public Health Support, Indian Health Service, Rockville, MD.

Accepted for publication October 27, 2004.

Presented in part at the Pediatric Academic Societies’ Annual Meeting, San Francisco, May 2004 (poster presentation).

Dr Peck's current affiliation is the University of Washington, Division of Pediatric Infectious Diseases, Children's Hospital and Regional Medical Center, Seattle, WA.

Dr Lingappa's current affiliation is the University of Washington, Partners in Prevention, Seattle, WA.

Reprints not available.

© 2005 Lippincott Williams & Wilkins, Inc.