title: Age distribution of infection and hospitalization among Canadian First Nations populations during the 2009 H1N1 pandemic.
abstract: OBJECTIVE
  We estimated age-standardized ratios of infection and hospitalization among Canadian First Nations (FN) populations and compared their distributions with those estimated for non-FN populations in Manitoba, Canada.
  
  
  METHODS
  For the spring and fall 2009 waves of the H1N1 pandemic, we obtained daily numbers of laboratory-confirmed and hospitalized cases of H1N1 infection, stratified by 5-year age groups and FN status. We calculated age-standardized ratios with confidence intervals for each wave and compared ratios between age groups in each ethnic group and between the 2 waves for FN and non-FN populations.
  
  
  RESULTS
  Incidence and hospitalization ratios in all FN age groups during the first wave were significantly higher than those in non-FN age groups (P < .001). The highest ratios were observed in FN young children aged 0 to 4 years. During the second wave, these ratios tended to decrease in FN populations and increase in non-FN populations, especially among groups younger than 30 years.
  
  
  CONCLUSIONS
  Incidence and hospitalization ratios in FN populations were higher than or equivalent to ratios in non-FN populations. Our findings support the need to develop targeted prevention and control strategies specifically for vulnerable FN and remote communities.
authors.affiliation: Centre for Disease Modelling, York Institute for Health Research, York University, Toronto, Ontario, Canada.
authors.forename: Luiz C
authors.initials: LC
authors.lastname: Mostaço-Guidolin
authors.forename: Sherry M J
authors.initials: SM
authors.lastname: Towers
authors.forename: David L
authors.initials: DL
authors.lastname: Buckeridge
authors.forename: Seyed M
authors.initials: SM
authors.lastname: Moghadas
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000208:ethnology*; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000208:ethnology*; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D058873:Pandemics / Q000706:statistics & numerical data*; D055815:Young Adult