Cortese M M, Wolff M, Almeido-Hill J, Reid R, Ketcham J, Santosham M
Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
Arch Intern Med. 1992 Nov;152(11):2277-82.
In this article we determine the incidence and clinical spectrum of invasive pneumococcal disease in the White Mountain Apache population, a group known to have a high incidence of invasive disease due to Haemophilus influenzae type b.
Patients from whom cultures of normally sterile body sites yielded Streptococcus pneumoniae were identified retrospectively through review of hospital laboratory records from a 6.8-year period. Clinical data were reviewed and incidence rates were computed.
The Whiteriver Indian Health Service Hospital is located on the 1.7-million-acre White Mountain Apache Reservation in eastern Arizona.
Approximately 10,000 members of the White Mountain Apache Tribe reside on or near the reservation and receive health care through the Whiteriver Indian Health Service Hospital.
The average annual incidence rates of invasive pneumococcal disease were calculated and clinical characteristics were reviewed.
One hundred thirty-eight cases of invasive pneumococcal disease were identified. The average annual incidence rate was 207 per 100,000 population, and 156 per 100,000 population when adjusted for age by direct standardization to the 1988 US population. The incidence rate was highest in children between 1 and 2 years--2396 per 100,000. The overall case-fatality rate was 5%. Pneumococcal pneumonia was the diagnosis in 79% of the patients 5 years of age or older. Alcohol abuse, identified in 66% of the cases in adults, was the most common underlying medical condition.
The incidence rates in White Mountain Apaches are the highest reported for any population. A vaccine effective in children would greatly benefit this population.
在本文中，我们确定了白山阿帕契人群侵袭性肺炎球菌疾病的发病率和临床谱，该人群因b型流感嗜血杆菌导致侵袭性疾病的发病率较高而闻名。
通过回顾6.8年期间的医院实验室记录，对正常无菌身体部位培养出肺炎链球菌的患者进行回顾性鉴定。审查临床数据并计算发病率。
怀特河印第安卫生服务医院位于亚利桑那州东部占地170万英亩的白山阿帕契保留地。
约10000名白山阿帕契部落成员居住在保留地或附近，并通过怀特河印第安卫生服务医院接受医疗保健。
计算侵袭性肺炎球菌疾病的年平均发病率，并审查临床特征。
确定了138例侵袭性肺炎球菌疾病病例。年平均发病率为每10万人207例，经直接标准化调整年龄后，按照1988年美国人口计算为每10万人156例。发病率在1至2岁儿童中最高——每10万人2396例。总体病死率为5%。79%的5岁及以上患者诊断为肺炎球菌肺炎。在66%的成人病例中发现的酒精滥用是最常见的基础疾病。
白山阿帕契人的发病率是所报道的任何人群中最高的。一种对儿童有效的疫苗将使该人群受益匪浅。
