Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 1600 Clifton Rd. NE, MS A-39, Atlanta, GA 30333, USA.
Public Health Rep. 2011 Jul-Aug;126(4):508-21. doi: 10.1177/003335491112600407.
We described disparities in infectious disease (ID) hospitalizations for American Indian/Alaska Native (AI/AN) people.
We analyzed hospitalizations with an ID listed as the first discharge diagnosis in 1998-2006 for AI/AN people from the Indian Health Service National Patient Information Reporting System and compared them with records for the general U.S. population from the Nationwide Inpatient Survey.
The ID hospitalization rate for AI/AN people declined during the study period. The 2004-2006 mean annual age-adjusted ID hospitalization rate for AI/AN people (1,708 per 100,000 populiation) was slightly higher than that for the U.S. population (1,610 per 100,000 population). The rate for AI/AN people was highest in the Southwest (2,314 per 100,000 population), Alaska (2,063 per 100,000 population), and Northern Plains West (1,957 per 100,000 population) regions, and among infants (9,315 per 100,000 population). ID hospitalizations accounted for approximately 22% of all AI/AN hospitalizations. Lower-respiratory-tract infections accounted for the largest proportion of ID hospitalizations among AI/AN people (35%) followed by skin and soft tissue infections (19%), and infections of the kidney, urinary tract, and bladder (11%).
Although the ID hospitalization rate for AI/AN people has declined, it remains higher than that for the U.S. general population, and is highest in the Southwest, Northern Plains West, and Alaska regions. Lower-respiratory-tract infections; skin and soft tissue infections; and kidney, urinary tract, and bladder infections contributed most to these health disparities. Future prevention strategies should focus on high-risk regions and age groups, along with illnesses contributing to health disparities.
我们描述了美国印第安人/阿拉斯加原住民(AI/AN)人群中传染病(ID)住院治疗的差异。
我们分析了 1998-2006 年期间,印第安卫生服务国家患者信息报告系统中 ID 作为第一出院诊断的 AI/AN 人群的住院情况,并将其与全国住院患者调查中美国一般人群的记录进行了比较。
在研究期间,AI/AN 人群的 ID 住院率有所下降。2004-2006 年 AI/AN 人群的年均年龄调整后 ID 住院率(每 10 万人 1708 人)略高于美国人口(每 10 万人 1610 人)。AI/AN 人群的发病率最高的地区是西南部(每 10 万人 2314 人)、阿拉斯加(每 10 万人 2063 人)和北普拉特西部(每 10 万人 1957 人),以及婴儿(每 10 万人 9315 人)。ID 住院治疗约占 AI/AN 总住院治疗的 22%。下呼吸道感染占 AI/AN 人群 ID 住院治疗的最大比例(35%),其次是皮肤和软组织感染(19%)以及肾脏、尿路和膀胱感染(11%)。
尽管 AI/AN 人群的 ID 住院率有所下降,但仍高于美国一般人群,在西南部、北普拉特西部和阿拉斯加地区发病率最高。下呼吸道感染、皮肤和软组织感染以及肾脏、尿路和膀胱感染是造成这些健康差异的主要原因。未来的预防策略应重点关注高风险地区和年龄组,以及导致健康差异的疾病。