Authors:
Moore HC, Manoharan KR, Lim FJ, Shellam G, Lehmann D
Authors notes:
The Pediatric infectious disease journal. 2013;32(11):1169-1174
Keywords:
Gastroenteritis, Aboriginal, children, Western Australia, data linkage
Abstract:
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 over two decades, providing a baseline to evaluate the impact of a rotavirus vaccine program begun in 2007.
Gastroenteritis rates were highest in children aged 6-11 months (Aboriginal: 259.3/1000/annum; non-Aboriginal: 22.7/1000/annum).
Rates declined in Aboriginal children between 1983-1994 and 1995-2006, particularly at age 12-17 months (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 8.8 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.
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.