Respiratory Diseases in Minorities of the United States

Dejong, Jw; Teengs, J. P.; Postma, Dirkje S.; Vandermark, Tw; Koeter, Gh; Demonchy, Jgr

doi:10.1164/ajrccm/149.3_pt_2.s91

Cited by 37 publications

(39 citation statements)

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“…This is much higher than previously reported [3], higher than black American children (13.4%), similar to Hispanic American children (20.1%) [10] and to nonindigenous Australians who have one of the highest prevalence rates in the world [11,12].…”

Section: Discussionmentioning

confidence: 62%

High prevalence of asthma in five remote indigenous communities in Australia

Valery

Chang²,

Shibasaki³

et al. 2001

Eur Respir J

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Data on the prevalence of asthma in children residing in remote indigenous communities in Australia are sparse, despite the many reports of high prevalence in nonindigenous children of this country. Two previous Australian studies have had poor participation rates, limiting interpretation of their results.A study of children in the Torres Strait and Northern Peninsula Area of Australia was conducted to document the prevalence of asthma symptoms. Five indigenous communities were randomly selected and trained interviewers, who were local indigenous health workers, recruited participants using a house-by-house approach. Information was collected by a structured face-to-face interview based on a standardized questionnaire constructed from the protocol International Study of Asthma and Allergy in Childhood; 1,650 children were included in the study with a 98% response rate.Overall, the prevalence of self-reported ever wheezing was 21%; 12% reported wheezing in the previous year; and 16% reported ever having asthma. There was significant variation in the prevalence of asthma symptoms between communities.It is concluded that there are significant intercommunity variations in the prevalence of asthma symptoms in remote communities and that the prevalence in these communities is as high as in nonindigenous groups.

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Section: Discussionmentioning

confidence: 62%

High prevalence of asthma in five remote indigenous communities in Australia

Valery

Chang²,

Shibasaki³

et al. 2001

Eur Respir J

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“…25 In addition, black people experience more episodic rather than routine care for respiratory problems. 26 Black children may demonstrate a less severe RSV bronchiolitis in our study due to more prompt use of the health care system or a certain protective genetic effect; however, the exact cause of this finding is not known. An analysis of the time of onset of respiratory symptoms to the date of admission revealed no significant effect of race.…”

mentioning

confidence: 59%

Severity of Respiratory Syncytial Virus Bronchiolitis Is Affected by Cigarette Smoke Exposure and Atopy

Bradley¹,

Bacharier

Bonfiglio³

et al. 2005

Pediatrics

186

124

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ABSTRACT. Objective. Respiratory syncytial virus (RSV) bronchiolitis is a common cause of hospitalizations in children and has been increasingly identified as a risk factor in the development of asthma. Little is known about what determines the severity of RSV bronchiolitis, which may be helpful in the initial assessment of these children.Design. We evaluated a variety of environmental and host factors that may contribute to the severity of RSV bronchiolitis in the RSV Bronchiolitis in Early Life prospective cohort study. Severity of bronchiolitis was based on the quantization of lowest O 2 saturation and the length of stay. These factors included the child's and family's demographics, presence of household allergens (dust mite, cat, dog, and cockroach), peripheral blood eosinophil count, immunoglobulin E level, infant feeding, prior illnesses, exposure to intrauterine and postnatal cigarette smoke, and family history of atopy.Patients. We prospectively enrolled 206 hospitalized infants, all under 12 months old (4.0 ؎ 3.3 months old), with their first episode of severe RSV bronchiolitis (mean O 2 saturation: 91.6 ؎ 7.3%; length of stay: 2.5 ؎ 2.5 days; presence of radiographic opacities: 75%). Patients were excluded for a variety of reasons including previous wheezing, regular use of bronchodilator or antiinflammatory medications, any preexisting lung disease including asthma, chronic lung disease of prematurity/bronchopulmonary dysplasia, or cystic fibrosis; gastroesophageal reflux disease on medical therapy; or congenital anomalies of the chest or lung.Results. Age was found to be a significant factor in the severity of infection. The younger an infant was, the more severe the infection tended to be as measured by the lowest oxygen (O 2 ) saturation. We also found that infants exposed to postnatal cigarette smoke from the mother had a lower O 2 saturation than those not exposed. However, there was no significant difference in RSV bronchiolitis severity between infants exposed only to intrauterine smoke and those infants never exposed to cigarette smoke. Infants with a family history of atopy, especially a maternal history of asthma or hay fever, had a higher O 2 saturation. Although a history of maternal atopy seemed to be protective, there was no association between allergens and bronchiolitis severity, although 25% of households had elevated allergen levels. Black infants demonstrated less severe RSV bronchiolitis than their white counterparts. Multivariate analysis revealed age, race, maternal atopy, and smoking to be associated with severity of RSV bronchiolitis.Conclusion. R espiratory syncytial virus (RSV) infection is very common in early life: Ͼ95% of children have been infected by 2 years of age. RSV infections are responsible for ϳ100 000 hospital admissions in the United States annually, mostly affecting infants. 1 Of RSV-related admissions, 7% to 21% will require ventilatory support because of respiratory insufficiency. 2-4 Therefore, RSV infection imposes a significant burden on children early in ...

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“…26,[32][33][34][35][36] Exposure to environmental tobacco smoke has been associated with increased risk of respiratory tract infections, and programs to eliminate maternal smoking could reduce RSV morbidity among infants. [37][38][39][40] Because RSV is the most common cause of bronchiolitis and pneumonia in infancy, [41][42][43] the development of a vaccine for RSV and implementation of other interventions should substantially benefit the health of AI/AN infants. [44][45][46][47][48] There are limitations associated with the use of ICD-9-CM codes to estimate RSV hospitalizations.…”

Section: Discussionmentioning

confidence: 99%

Respiratory Syncytial Virus Hospitalizations Among American Indian and Alaska Native Infants and the General United States Infant Population

et al. 2004

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ABSTRACT. Objective. To determine the burden of respiratory syncytial virus (RSV) disease among American Indian (AI) and Alaska Native (AN) infants, by examining RSV-associated hospitalizations.Methods. Infant hospitalizations from 1997 through 2001 with RSV listed as a diagnosis were selected by using Indian Health Service/tribal hospital discharge data for AIs/ANs and National Hospital Discharge Survey data for the general US population.Results. In 2000 -2001, RSV disease was listed as a diagnosis for 14.4% of all AI/AN infant hospitalizations, with bronchiolitis attributable to RSV infection (12.2%) being among the top 5 listed diagnoses. The rate of RSV-specific hospitalizations was 34.4 hospitalizations per 1000 infants for AI/AN infants and 27.4 hospitalizations per 1000 births for the general US infant population. The hospitalization rates for AI/AN infants living in the Alaska and Southwest regions (70.9 and 48.2 hospitalizations per 1000 infants, respectively) were much higher than the overall rate for US infants. R espiratory syncytial virus (RSV) infection remains a major cause of lower respiratory tract disease among infants and children. 1,2 Most RSV-related childhood hospitalizations occur among infants Ͻ6 months of age, and almost all children are infected with RSV by 2 years of age. 2,3 One study estimated that between 73 000 and 126 000 RSVassociated hospitalizations per year occurred among US infants in 1994 -1996. 1 Another study, using the newly introduced, RSV-specific diagnostic codes, estimated that ϳ96 000 RSV hospitalizations occurred annually in 1997-2000. 4 That study also noted that bronchiolitis attributable to RSV was the leading cause of hospitalization among the general population of infants in the United States. Conclusions. RSV infection is one of the leading causes of hospitalization among all infants in the UnitedThe availability of effective prophylaxis for some infants and young children and the promise of future vaccines make the identification of at-risk populations and the quantification of risk levels important for developing RSV prevention strategies. The risk of severe RSV-associated disease varies with age and is increased by the presence of comorbidities, such as underlying lung, cardiac, and immune-compromising conditions. 2,5,6 Infants born prematurely are also at increased risk for RSV disease. In addition, previous studies suggested that American Indian (AI) and Alaska Native (AN) children and infants have higher rates of hospitalization associated with respiratory infections, compared with the general US population, with RSV being considered an important cause of these infections. [7][8][9][10][11][12][13][14] One study reported that almost 75% of all infectious disease hospitalizations among AI/AN infants were associated with lower respiratory tract infections. 13 It is estimated that 50% to 80% of infant hospitalizations for treatment of bronchiolitis and one-third of hospitalizations for treatment of pneumonia are RSV-related. 1,6 RSV-specific International...

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Respiratory Diseases in Minorities of the United States

Cited by 37 publications

References 0 publications

High prevalence of asthma in five remote indigenous communities in Australia

High prevalence of asthma in five remote indigenous communities in Australia

Severity of Respiratory Syncytial Virus Bronchiolitis Is Affected by Cigarette Smoke Exposure and Atopy

Respiratory Syncytial Virus Hospitalizations Among American Indian and Alaska Native Infants and the General United States Infant Population

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