Infectious Disease Hospitalizations among Alaska Native Infants, Alaska, USA

Sunday, 17 August 2014
Exhibit hall (Dena'ina Center)
Robert C Holman, MS , CDC, Atlanta, GA
Thomas Hennessy, MD , CDC Arctic Investigations Program, Anchorage, AK
Rosalyn J Singleton, MD , ANTHC, Anchorage, AK
Sara M Seeman, BS , CDC, Atlanta, GA
John T Redd, MD , IHS, Santa Fe, NM
Claudia A Steiner, MD , AHRQ, Rockville, MD
Michael L Bartholomew, MD , IHS, Rockville, MD
Michael G Bruce, MD , CDC Arctic Investigations Program, Anchorage, AK
INTRODUCTION:  The study examines the disparities in infectious disease (ID) hospitalization among Alaska Native (AN) infants, the age group with the highest rate.   

METHODS: Hospitalizations with a first-listed ID diagnosis during 2001-2011 were selected for AN infants (<1 year of age) living in Alaska from the Indian Health Service direct and contract healthcare inpatient data. For comparison, ID hospitalizations for the general US infant population were selected from the Nationwide Inpatient Sample.  Hospitalization rates for IDs and ID groups were analyzed.   

RESULTS:  Infectious diseases accounted for 53% of hospitalizations among AN infants during 2001-2011.  The average annual ID hospitalization rate decreased from 17,525/100,000 infants in 2001-2003 to 15,776/100,000 infants in 2009-2011.  The 2009-2011 rate was about 3 times higher than that for the general US infant population (5237; 95% CI=4758 – 5716).  For 2009-2011, the highest hospitalization rates in the Alaska regions in two rural Alaska regions A and B (51,583 and 47,075/100,000) with IDs accounting for 62% and 40% of the hospitalizations, respectively.  Lower respiratory tract infections (LRTIs) accounted for 75% of all ID hospitalizations in 2009-2011, and 77% of ID hospitalizations in regions A, B, and C.   

CONCLUSIONS: The ID hospitalization rate for AN infants is much higher than that for the general US infant population, particularly in Alaska regions A and B.  Prevention measures to reduce ID morbidity, primarily LRTIs, among AN infants should be increased in high-risk regions.