Diverging trends in gastroenteritis hospitalizations during 2 decades in western Australian Aboriginal and non-Aboriginal children.
Pediatr Infect Dis J
; 32(11): 1169-74, 2013 Nov.
Article
in En
| MEDLINE
| ID: mdl-23958809
ABSTRACT
BACKGROUND:
Gastroenteritis is a major cause of pediatric morbidity. We describe temporal, spatial and seasonal trends in age-specific gastroenteritis hospitalizations among Aboriginal and non-Aboriginal Australian children during 2 decades, providing a baseline to evaluate the impact of a rotavirus vaccine program begun in 2007.METHODS:
We conducted a population-based, data linkage study of Aboriginal and non-Aboriginal births in Western Australia, 1983 to 2006, and analyzed gastroenteritis-coded hospitalizations before age 15 years in the cohort of 596,465 births. Hospitalization rates in Aboriginal and non-Aboriginal children and between geographical regions were compared between 1983 to 1994 and 1995 to 2006.RESULTS:
Gastroenteritis rates were highest in children 6-11 months of age (Aboriginal 259.3/1000/annum; non-Aboriginal 22.7/1000/annum). Rates declined in Aboriginal children between 1983 to 1994 and 1995 to 2006, particularly in those 12-17 months of age (309/1000 to 179/1000). Rates in non-Aboriginal children<5 years increased 10-40%. The disparity for gastroenteritis rates between Aboriginal and non-Aboriginal children<5 years declined from being 15.4 times higher to 7.6 times higher in those aged 12-17 months and from 8.4 to 4.4 in those aged 2-4 years. Rates were highest in rural and remote regions, and diverging temporal trends were seen in different geographical regions. Seasonality varied between Aboriginal and non-Aboriginal children and climatic zones.CONCLUSIONS:
This is the largest study of gastroenteritis hospitalization trends in children. We found diverging trends of gastroenteritis hospitalization rates in Aboriginal and non-Aboriginal children. Although rates have declined in Aboriginal children, disparity between Aboriginal and non-Aboriginal children continues. Our findings highlight the need to consider age, ethnicity, seasonality and climate when evaluating rotavirus vaccine programs.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Native Hawaiian or Other Pacific Islander
/
Gastroenteritis
/
Hospitalization
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Humans
/
Infant
Country/Region as subject:
Oceania
Language:
En
Journal:
Pediatr Infect Dis J
Journal subject:
DOENCAS TRANSMISSIVEIS
/
PEDIATRIA
Year:
2013
Document type:
Article
Affiliation country:
Australia