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 diagnosis of pneumonia. The sample was stratified by ethnicity and included 151 Pacific, 85 Maori and 151 European children. Measurements were made of demographics and prehospital care; vital signs and therapy received in the emergency department and inpatient wards and laboratory investigations performed. Comparisons between the three ethnic groups were adjusted for age, weight, 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 Pacific (15%) and Maori (15%) children than European children (< 1%) had a heart rate elevated for 2 days, OR Pacific versus European 17.2 (3.2, 320), Maori versus European 26.1 (4.4, 508). Compared with European children. a larger proportion of Pacific and Maori children received intravenous fluids and antibiotics. A larger proportion of Pacific (29%) and Maori (27%) children than European children (11%) received oxygen for 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 therapy, Pacific and Maori children hospitalized with pneumonia have more severe pneumonia than European children.