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PEDIATRICS Vol. 111 No. 2 February 2003, pp. e176-e182

ELECTRONIC ARTICLE

Infectious Disease Hospitalizations Among American Indian and Alaska Native Infants

Objective. To describe the burden and trends in hospitalizations associated with infectious diseases among American Indian and Alaska Native (AI/AN) infants.

Methods. First-listed infectious disease hospitalizations and hospitalization rates among AI/AN infants and infants in the general US population from 1988–1999 were analyzed by using Indian Health Service/tribal hospital discharge data and the National Hospital Discharge Survey data, respectively.

Results. Infectious disease hospitalizations accounted for 53% of all AI/AN infant hospitalizations and approximately 43% of all US infant hospitalizations during 1988–1999. The annual hospitalization rate for infectious diseases among AI/AN infants declined from 27 486 per 100 000 infants in 1988 to 14 178 per 100 000 infants in 1999. However, the rates for AI/AN infants within the Alaska, Southwest, and Northern Plains regions remained higher than that for the general US infant population at the end of the study period. Lower respiratory tract infection hospitalizations accounted for almost 75% of AI/AN infant infectious disease hospitalizations, and the lower respiratory tract infection hospitalization rate for AI/AN infants was twice that for US infants.

Conclusions. Although infectious disease hospitalization rates for AI/AN infants have declined, AI/AN infants continue to have a higher infectious disease burden than the general US infant population.

Robert C. Holman, MS*, Aaron T. Curns, MPH*, James E. Cheek, MD, MPH{ddagger}, Rosalyn J. Singleton, MD, MPH§, Larry J. Anderson, MD|| and Robert W. Pinner, MD

* Office of the Director, Division of Viral and Rickettsial Diseases (DVRD), National Center for Infectious Diseases (NCID), Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services, Atlanta, Georgia
{ddagger} Epidemiology Program, Office of Public Health, Indian Health Service Headquarters, US Department of Health and Human Services, Albuquerque, New Mexico
§ Alaska Native Tribal Health Consortium and Arctic Investigations Program, NCID, CDC, US Department of Health and Human Services, Anchorage, Alaska
|| Respiratory and Enteric Viruses Branch, DVRD, NCID, CDC, US Department of Health and Human Services, Atlanta, Georgia
Office of the Director, NCID, CDC, US Department of Health and Human Services, Atlanta, Georgia

Key Words: infants • American Indians • Alaska Natives • infectious disease • hospitalizations • epidemiology

Abbreviations: AI/AN, American Indian and Alaska Native • IHS, Indian Health Service • NHDS, National Hospital Discharge Survey • NCHS, National Center for Health Statistics • CI, confidence interval • SE, standard error • RR, risk ratio • LRTI, lower respiratory tract infection • RSV, respiratory syncytial virus

Received for publication Jul 26, 2002; Accepted Oct 2, 2002.




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