Titre :
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Reduction in disparity for pneumonia hospitalisations between Australian indigenous and non-Indigenous children. (2012)
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Auteurs :
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Hannah-C MOORE ;
Nicholas DE KLERK ;
Peter JACOBY ;
Deborah LEHMANN ;
RICHMOND (Peter-C) : AUS. School of Paediatrics and Child Health. University of Western Australia. Western Australia. ;
Division of Population Sciences. Telethon Institute for Child Health Research. Centre for Child Health Research. University of Western Australia. Western Australia. AUS
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Type de document :
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Article
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Dans :
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Journal of epidemiology and community health (vol. 66, n° 6, 2012)
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Pagination :
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489-494
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Langues:
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Anglais
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Mots-clés :
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Pneumonie
;
Australie
;
Autochtone
;
Enfant
;
Océanie
;
Homme
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Résumé :
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[BDSP. Notice produite par INIST-CNRS AtR0xr8k. Diffusion soumise à autorisation]. Background In the 1990s pneumonia hospitalisation rates in Western Australia (WA) were 13 times higher in Indigenous children than in non-Indigenous children. Rates of invasive pneumococcal disease in Indigenous children declined following the introduction in 2001 of 7-valent pneumococcal conjugate vaccine (7vPCV) in a 2-4-6 month schedule with an 18-month pneumococcal polysaccharide booster (PPV). We investigated population trends for pneumonia hospitalisations between 1996 and 2005. Methods Population-based retrospective data linkage cohort study of singleton live births from 1996-2005. Hospitalisations for acute lower respiratory infections in Indigenous and non-Indigenous children less than 5 years of age were extracted and trends in age-specific incidence rates were examined using log-linear modelling. Results From 245249 births (7.1 % Indigenous), there were 7727 pneumonia episodes. Between 1996 and 2000 and 2001 and 2005 all-cause pneumonia hospitalisations fell by 28-44 % in Indigenous children aged 6-35 months with no equivalent decline in non-Indigenous children or for other acute lower respiratory infections. Incidence rate ratios for pneumonia comparing Indigenous with non-Indigenous children aged 6-11 months fell from 14.6 (95 % CI 12.3 to 17.2) in 1996-2000 to 9.9 (8.4 to 11.6) in 2001-2005. Log-linear modelling showed a steady decline in Indigenous children of 9 %/annum (5-12 %) at age 12-23 months for all-cause pneumonia and 37 %/annum (20-50 %) at age 6-11 months for pneumococcal pneumonia from 1996 to 2005, including the years prior to introduction of pneumococcal vaccines. Conclusions Pneumonia hospitalisations and the disparity between Indigenous and non-Indigenous children has declined by a third. The unique Australian pneumococcal vaccine programme is likely to have had a significant effect but changes in socioeconomic factors have also contributed to the declines.
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