title: Bronchiolitis and pneumonia requiring hospitalization in young first nations children in Northern Ontario, Canada.
abstract: BACKGROUND
  High rates of lower respiratory tract infection (LRTI), including bronchiolitis and pneumonia, have been reported in Inuit infants living in arctic Canada. We examined rates of LRTI in First Nations Canadian infants living in the Sioux Lookout Zone, in Northern Ontario.
  
  
  METHODS
  A retrospective review of hospital admissions for LRTI during a 5-year period, in patients <1 year of age was carried out at the Sioux Lookout Meno Ya Win Health Centre, an acute-care hospital that provides secondary care to 31 mainly isolated communities and the town of Sioux Lookout. Admission rates were compared with those in the province of Ontario, as a whole.
  
  
  RESULTS
  One-hundred and seventeen subjects were identified. The annualized rate of admission for nonbacterial LRTI was 44 per 1000 infants <1 year of age per year. This rate was significantly higher than for the whole province (P = 0.011). Admission rates also varied significantly between communities (P < 0.001).Thirteen percent of subjects required transfer to a tertiary care center. A virus was identified in 55% (36/65) of subjects tested for respiratory viruses, and respiratory syncytial virus and parainfluenza virus were identified most often. Of patients who had a blood culture performed, bacteria were found in 10% (6/59) of subjects. Many patients had radiographic evidence of consolidation, consistent with pneumonia.
  
  
  CONCLUSIONS
  Rates of LRTI are significantly elevated in First Nations infants living in the Sioux Lookout Zone. Varying rates between communities suggest that environmental factors may be contributing to rates of LRTI in this population.
authors.affiliation: From the *Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom; †Division of Clinical Sciences, Northern Ontario School of Medicine; ‡Medical Records, Sioux Lookout Meno Ya Win Health Center, Sioux Lookout; and §Divison of Respirology, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: McCuskee
authors.forename: Michael
authors.initials: M
authors.lastname: Kirlew
authors.forename: Len
authors.initials: L
authors.lastname: Kelly
authors.forename: Sonya
authors.initials: S
authors.lastname: Fewer
authors.forename: Thomas
authors.initials: T
authors.lastname: Kovesi
mesh_terms: D001110:Arctic Regions; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D001988:Bronchiolitis / Q000453:epidemiology*; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D004930:Inuit; D008297:Male; D009864:Ontario / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology*; D012189:Retrospective Studies; D014780:Viruses / Q000145:classification / Q000302:isolation & purification*