Gounder Prabhu P, Holman Robert C, Seeman Sara M, Rarig Alice J, McEwen Mary, Steiner Claudia A, Bartholomew Michael L, Hennessy Thomas W
1 Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA.
2 Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Rep. 2017 Jan/Feb;132(1):65-75. doi: 10.1177/0033354916679807. Epub 2016 Dec 12.
Reports about infectious disease (ID) hospitalization rates among American Indian/Alaska Native (AI/AN) persons have been constrained by data limited to the tribal health care system and by comparisons with the general US population. We used a merged state database to determine ID hospitalization rates in Alaska.
We combined 2010 and 2011 hospital discharge data from the Indian Health Service and the Alaska State Inpatient Database. We used the merged data set to calculate average annual age-adjusted and age-specific ID hospitalization rates for AI/AN and non-AI/AN persons in Alaska. We stratified the ID hospitalization rates by sex, age, and ID diagnosis.
ID diagnoses accounted for 19% (6501 of 34 160) of AI/AN hospitalizations, compared with 12% (7397 of 62 059) of non-AI/AN hospitalizations. The average annual age-adjusted hospitalization rate was >3 times higher for AI/AN persons (2697 per 100 000 population) than for non-AI/AN persons (730 per 100 000 population; rate ratio = 3.7, P < .001). Lower respiratory tract infection (LRTI), which occurred in 38% (2486 of 6501) of AI/AN persons, was the most common reason for ID hospitalization. AI/AN persons were significantly more likely than non-AI/AN persons to be hospitalized for LRTI (rate ratio = 5.2, P < .001).
A substantial disparity in ID hospitalization rates exists between AI/AN and non-AI/AN persons, and the most common reason for ID hospitalization among AI/AN persons was LRTI. Public health programs and policies that address the risk factors for LRTI are likely to benefit AI/AN persons.
关于美国印第安人/阿拉斯加原住民(AI/AN)人群传染病(ID)住院率的报告受到限于部落医疗保健系统的数据以及与美国普通人群比较的限制。我们使用合并的州数据库来确定阿拉斯加的ID住院率。
我们合并了印第安卫生服务局和阿拉斯加州住院患者数据库2010年和2011年的医院出院数据。我们使用合并数据集计算阿拉斯加AI/AN和非AI/AN人群的平均年龄调整后及特定年龄的ID住院率。我们按性别、年龄和ID诊断对ID住院率进行分层。
ID诊断占AI/AN住院病例的19%(34160例中的6501例),相比之下,非AI/AN住院病例的这一比例为12%(62059例中的7397例)。AI/AN人群的平均年龄调整后住院率(每10万人口2697例)比非AI/AN人群(每10万人口730例;率比 = 3.7,P <.001)高出3倍多。下呼吸道感染(LRTI)发生在38%(6501例中的2486例)的AI/AN人群中,是ID住院的最常见原因。AI/AN人群因LRTI住院的可能性显著高于非AI/AN人群(率比 = 5.2,P <.001)。
AI/AN和非AI/AN人群之间在ID住院率方面存在显著差异,AI/AN人群ID住院的最常见原因是LRTI。解决LRTI危险因素的公共卫生项目和政策可能会使AI/AN人群受益。