Centre for Disease Modelling, York Institute for Health Research, York University, Toronto, Ontario, Canada.
Am J Public Health. 2013 Feb;103(2):e39-44. doi: 10.2105/AJPH.2012.300820. Epub 2012 Dec 13.
We estimated age-standardized ratios of infection and hospitalization among Canadian First Nations (FN) populations and compared their distributions with those estimated for non-FN populations in Manitoba, Canada.
For the spring and fall 2009 waves of the H1N1 pandemic, we obtained daily numbers of laboratory-confirmed and hospitalized cases of H1N1 infection, stratified by 5-year age groups and FN status. We calculated age-standardized ratios with confidence intervals for each wave and compared ratios between age groups in each ethnic group and between the 2 waves for FN and non-FN populations.
Incidence and hospitalization ratios in all FN age groups during the first wave were significantly higher than those in non-FN age groups (P < .001). The highest ratios were observed in FN young children aged 0 to 4 years. During the second wave, these ratios tended to decrease in FN populations and increase in non-FN populations, especially among groups younger than 30 years.
Incidence and hospitalization ratios in FN populations were higher than or equivalent to ratios in non-FN populations. Our findings support the need to develop targeted prevention and control strategies specifically for vulnerable FN and remote communities.
我们估计了加拿大第一民族(FN)人群中感染和住院的年龄标准化比值,并将其分布与加拿大马尼托巴省非 FN 人群的分布进行了比较。
在 2009 年春季和秋季 H1N1 大流行的两个波次中,我们获得了实验室确诊的 H1N1 感染病例和住院病例的每日数量,按 5 岁年龄组和 FN 状态进行了分层。我们计算了每个波次的年龄标准化比值及其置信区间,并比较了每个族裔群体中各年龄组之间以及 FN 和非 FN 人群在两个波次之间的比值。
在第一个波次中,所有 FN 年龄组的发病率和住院率比值均明显高于非 FN 年龄组(P <.001)。FN 幼儿(0 至 4 岁)的比值最高。在第二个波次中,FN 人群中的这些比值趋于下降,而非 FN 人群中的比值趋于上升,尤其是在 30 岁以下人群中。
FN 人群的发病率和住院率比值高于或等同于非 FN 人群的比值。我们的研究结果支持有必要专门为脆弱的 FN 和偏远社区制定有针对性的预防和控制策略。