Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
J Pediatr. 2013 Jun;162(6):1270-5. doi: 10.1016/j.jpeds.2012.11.087. Epub 2013 Jan 16.
To examine dog bites among American Indian (AI) and Alaska Native (AN) children visiting Indian Health Service and tribal health facilities.
We retrospectively analyzed hospitalizations and outpatient visits with a diagnosis of dog bite between 2001 and 2008 in AI/AN children aged <20 years. Rates of dog bite hospitalizations and outpatient visits were estimated by age group, sex, region, and number and location of open wounds using Indian Health Service data. Analyses of hospitalizations for the general US population aged<20 years used the Nationwide Inpatient Sample.
The average annual dog bite hospitalization rate was higher among AI/AN children in Alaska (6.1/100,000 population) and the Southwest region (5.3/100,000) compared with the general US child population (3.1/100,000; 95% CI, 2.9-3.3/100,000). The average annual outpatient visit rate in AI/AN children was highest in the Alaska (596.4/100,000), Southwest (540.0/100,000), and Northern Plains West (537.6/100,000) regions. The hospitalization rate was highest in both AI/AN and US males aged<5 years, and outpatient visit rates were highest in AI/AN males aged 5-9 years. Open wounds diagnoses were most commonly seen on the head, neck, and face in hospitalized children (45.5% of open wounds in AI/AN children, 59.3% in US children; SE, 1.0%) and on the leg in AI/AN outpatients (35.6%).
Dog bites represent a significant public health threat in AI/AN children in the Alaska, the Southwest, and Northern Plains West regions of the US. Enhanced animal control and education efforts should reduce dog bite injuries and associated problems with pets and stray dogs, such as emerging infectious diseases.
研究美国印第安人(AI)和阿拉斯加原住民(AN)儿童在印第安人健康服务和部落卫生设施就诊时的狗咬伤情况。
我们回顾性分析了 2001 年至 2008 年期间年龄<20 岁的 AI/AN 儿童因狗咬伤而住院和门诊就诊的病例。利用印第安人健康服务数据,按年龄组、性别、地区以及开放性伤口数量和位置估计狗咬伤住院和门诊就诊的发生率。使用全国住院患者样本分析了年龄<20 岁的一般美国人群的住院治疗情况。
与一般美国儿童(3.1/100,000;95%置信区间,2.9-3.3/100,000)相比,阿拉斯加(6.1/100,000 人)和西南部地区(5.3/100,000 人)的 AI/AN 儿童的平均年狗咬伤住院率更高。AI/AN 儿童的平均年门诊就诊率在阿拉斯加(596.4/100,000)、西南部(540.0/100,000)和北普拉特西部(537.6/100,000)地区最高。住院率在 AI/AN 和美国男性<5 岁儿童中均最高,门诊就诊率在 AI/AN 男性 5-9 岁儿童中最高。在住院儿童中,头部、颈部和面部的开放性伤口诊断最为常见(AI/AN 儿童中为 45.5%的开放性伤口,美国儿童中为 59.3%;SE,1.0%),而在 AI/AN 门诊患者中,腿部开放性伤口诊断最为常见(35.6%)。
狗咬伤对美国阿拉斯加、西南部和北普拉特西部地区的 AI/AN 儿童构成重大公共卫生威胁。加强动物控制和教育工作应能减少与宠物和流浪狗有关的狗咬伤伤害以及新兴传染病等问题。