Ethnic comparisons of disease severity in children hospitalized with pneumonia in New Zealand.
OBJECTIVE
To determine if there are ethnic differences in disease severity in children hospitalized with pneumonia in New Zealand.


METHODS
A population based audit of children hospitalized in Auckland with pneumonia over 12 months from 1 November 1994 to 31 October 1995. The study population was children aged from 0 to 14 years with a discharge diagnosis of pneumonia. The sample was stratified by ethnicity and included 151 Pacific, 85 Mäori and 151 European children. Measurements were made of demographics and prehospital care; vital signs and therapy received in the emergency department and inpatient wards and laboratory investigations performed. Comparisons between the three ethnic groups were adjusted for age, weight, gender, socio-economic status and relationship with primary care.


RESULTS
A larger proportion of Pacific (15%) and Mäori (22%) children than European children (8%) had a respiratory rate elevated for > or = 2 days, odds ratio (OR) (95% CI): Pacific versus European 2.7 (1.1, 6.8), Mäori versus European 4.3 (1.7, 11.6). A larger proportion of Pacific (15%) and Mäori (15%) children than European children (< 1%) had a heart rate elevated for > or = 2 days, OR Pacific versus European 17.2 (3.2, 320), Mäori versus European 26.1 (4.4, 508). Compared with European children, a larger proportion of Pacific and Mäori children received intravenous fluids and antibiotics. A larger proportion of Pacific (29%) and Mäori (27%) children than European children (11%) received oxygen for > = 2 days, OR Pacific versus European 3.2 (1.6, 6.6), Mäori versus Europeans 2.6 (1.2, 6.2).


CONCLUSIONS
Based on the comparisons of vital signs and intensity of therapy, Pacific and Mäori children hospitalized with pneumonia have more severe pneumonia than European children.
Grant
C C
CC
Department of Paediatrics, Faculty of Medicine and Health Sciences, The University of Auckland and Department of General Paediatrics, Starship Children's Hospital, Auckland, New Zealand.
Pati
A
A
Tan
D
D
Vogel
S
S
Aickin
R
R
Scragg
R
R
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008485:Medical Audit; D009520:New Zealand / Q000453:epidemiology; D010139:Pacific Islands / Q000208:ethnology; D011014:Pneumonia / Q000145:classification / Q000208:ethnology*; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index