Ethnic comparisons of disease severity in children hospitalized with pneumonia in New Zealand

Objective: To determine if there are ethnic differences in disease severity in children hospitalized with pneumonia in New Zealand. Methodology: A population based audit of children hospitalized in Auckland with pneumonia over 12 months from 1 November 1994 to 31 October 1995. The study population was children aged from 0 to 14 years with a discharge diag nosis of pneumonia. The sample was stratified by ethnicity and included 151 Pacific, 85 Maori and 151 European children. Measurements were made of dem ographics and prehospital care; vital signs and therapy received in the eme rgency department and inpatient wards and laboratory investigations perform ed. Comparisons between the three ethnic groups were adjusted for age, weig ht, gender, socio-economic status and relationship with primary care. Results: A larger proportion of Pacific (15%) and Maori (22%) children than European children (8%) had a respiratory rate elevated for greater than or equal to 2 days, odds ratio (OR) (95% CI): Pacific versus European 2.7 (1. 1, 6.8), Maori versus European 4.3 (1.7, 11.6). A larger proportion of Paci fic (15%) and Maori (15%) children than European children (< 1%) had a hear t rate elevated for <greater than or equal to> 2 days, OR Pacific versus Eu ropean 17.2 (3.2, 320), Maori versus European 26.1 (4.4, 508). Compared wit h European children. a larger proportion of Pacific and Maori children rece ived intravenous fluids and antibiotics. A larger proportion of Pacific (29 %) and Maori (27%) children than European children (11%) received oxygen fo r greater than or equal to 2 days, OR Pacific versus European 3.2 (1.6, 6.6 ), Maori versus Europeans 2.6 (1.2, 6.2). Conclusions: Based on the comparisons of vital signs and intensity of thera py, Pacific and Maori children hospitalized with pneumonia have more severe pneumonia than European children.