Lower respiratory tract infections among american Indian and Alaska Native children and the general population of U.S. Children

Pediatr Infect Dis J. 2005 Apr;24(4):342-51. doi: 10.1097/01.inf.0000157250.95880.91.


Background and 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.

Publication types

  • Comparative Study

MeSH terms

  • Age Distribution
  • Alaska / epidemiology
  • Alaska / ethnology
  • Bronchiolitis / epidemiology
  • Bronchiolitis / ethnology
  • Child
  • Child, Preschool
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Indians, North American / statistics & numerical data*
  • Infant
  • Infant, Newborn
  • Inuits / statistics & numerical data*
  • Male
  • Outpatients / statistics & numerical data
  • Pneumonia / epidemiology
  • Pneumonia / ethnology
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / ethnology*
  • Sex Distribution
  • United States / epidemiology