Lower respiratory tract infections among american Indian and Alaska Native children and the general population of U.S. Children.
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.
Peck
Angela J
AJ
Respiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Atlanta, GA, USA.
Holman
Robert C
RC
Curns
Aaron T
AT
Lingappa
Jairam R
JR
Cheek
James E
JE
Singleton
Rosalyn J
RJ
Carver
Karen
K
Anderson
Larry J
LJ
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