PEDIATRICS Vol. 103 No. 1 January 1999, p. e11
ELECTRONIC ARTICLE:
Trends in Diarrhea-associated Hospitalizations Among American
Indian and Alaska Native Children, 1980-1995
Received Jun 26, 1998; accepted Aug 24, 1998.
, §,
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From the * Office of the Director and Viral Gastroenteritis
Section, Division of Viral and Rickettsial Diseases, National Center
for Infectious Diseases; and § Epidemic Intelligence Service,
Epidemiology Program Office, Centers for Disease Control and
Prevention, US Department of Health and Human Services, Atlanta,
Georgia; and Indian Health Service, US Department of Health and
Human Services, Rockville, Maryland.
Objective. To describe trends in diarrhea- associated hospitalizations among American Indian and Alaska Native (AI/AN) children and to estimate the morbidity from rotavirus.
Design. Retrospective analysis of Indian Health Service hospital discharge records.
Patients. AI/AN children 1 month through 4 years of age with a diarrhea-associated diagnosis listed on the hospital discharge record.
Setting. Hospitals on or near US Indian reservations from 1980 through 1995.
Results. During 1980 through 1995, 21 669 diarrhea-associated hospitalizations were reported among AI/AN children. The annual incidence of diarrhea-associated hospitalizations declined by 76% from 276 per 10 000 in 1980 to 65 per 10 000 in 1995. The median length of hospital stay decreased from 4 days during 1980-1982 to 2 days during 1993-1995. Diarrhea-associated hospitalizations peaked during the winter months (October through March), especially among children 4-35 months of age, with the peaks appearing first in the Southwest during October and moving to the East in March. In the early years of the study (1980-1982), the rate of diarrhea-associated hospitalizations among AI/AN children (236 per 10 000) was greater than the national rate (136 per 10 000). By the end of the study period (1993-1995), the rate for AI/AN children (71 per 10 000) was similar to the national rate (89 per 10 000), although the rate for AI/AN infants remained higher than the national rate for infants.
Conclusions. Diarrhea-associated hospitalization rates for AI/AN children have declined to a level similar to that of the national population. Rotavirus may be an important contributor to diarrheal morbidity among AI/AN children, underscoring the need for vaccines against this pathogen. Key words: Indian health, diarrhea, hospitalizations, epidemiology, children, rotavirus.
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