title: Lower respiratory tract infections among american Indian and Alaska Native children and the general population of U.S. Children.
abstract: 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.
authors.affiliation: Respiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Atlanta, GA, USA.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Peck
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Curns
authors.forename: Jairam R
authors.initials: JR
authors.lastname: Lingappa
authors.forename: James E
authors.initials: JE
authors.lastname: Cheek
authors.forename: Rosalyn J
authors.initials: RJ
authors.lastname: Singleton
authors.forename: Karen
authors.initials: K
authors.lastname: Carver
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Anderson
mesh_terms: D017677:Age Distribution; D000413:Alaska / Q000453:epidemiology / Q000208:ethnology; D001988:Bronchiolitis / Q000453:epidemiology / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D010045:Outpatients / Q000706:statistics & numerical data; D011014:Pneumonia / Q000453:epidemiology / Q000208:ethnology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000208:ethnology*; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology