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Diarrhea-associated hospitalizations among children in Hawaii
P V Effler1, R C Holman, U D Parashar
1Hawaii Department of Health, Honolulu 96813, USA.
Insights
Diarrhea hospitalizations are a significant concern for children in Hawaii, with rates lower than the national average. Rotavirus is likely a key contributor to this childhood illness.
Area of Science:
- Pediatric Health
- Infectious Disease Epidemiology
- Public Health Surveillance
Background:
- Diarrhea remains a leading cause of childhood morbidity and hospitalization globally.
- Understanding regional variations in diarrhea-associated hospitalizations is crucial for targeted public health interventions.
- Previous studies have indicated rotavirus as a primary pathogen responsible for severe diarrheal illness in children.
Purpose of the Study:
- To quantify the burden of diarrhea-associated hospitalizations among children in Hawaii.
- To analyze age-specific incidence rates and temporal trends of these hospitalizations.
- To compare Hawaii's hospitalization rates with national data.
Main Methods:
- A retrospective analysis of hospital discharge records from acute care hospitals in Hawaii.
- Inclusion criteria encompassed children aged 1 month to 4 years with a diarrhea-associated diagnosis.
- Data were collected for the period 1994 through 1997.
Main Results:
- A total of 2288 children were hospitalized for diarrhea between 1994-1997, representing 11.3% of all hospitalizations for children under 5.
- The average annual incidence was 62.3 per 10,000 children, higher in infants under 1 year (101.6) than in older children (52.7).
- Hospitalizations peaked from December to June, and median hospital stay was 2 days, increasing to 3 days for rotavirus-associated cases. Hawaii's rates were lower than US national rates (89 per 10,000) during 1993-1995.
Conclusions:
- Diarrhea constitutes a significant cause of hospitalization for children in Hawaii, with an estimated 1 in 32 children hospitalized by age 5.
- Observed age-specific and seasonal trends align with known patterns of rotavirus infections.
- These findings suggest rotavirus is a major driver of diarrhea-related morbidity in this population, underscoring the need for continued surveillance and prevention efforts.
Objective:
To estimate the burden of diarrhea-associated hospitalizations among children in Hawaii.
Design:
Retrospective analysis of hospital discharge records.
Patients:
Children from 1 month through 4 years of age with a diarrhea-associated diagnosis listed on the hospital discharge record in Hawaii.
Setting:
Acute care hospitals in the state of Hawaii, 1994 through 1997.
Results:
During 1994-1997, 2288 children (11.3% of all hospitalizations for children < 5 years of age) had a diarrhea-associated diagnosis listed at hospital discharge. The average annual incidence (per 10,000 children) of diarrhea-associated hospitalizations was 62.3; the incidence was higher for children < 1 year (101.6) than for those 1 through 4 years of age (52.7). Rates for Hawaii were lower than national rates during 1993 through 1995 (US annual rate of 89 per 10,000 children). The median length of hospital stay was 2 days for diarrhea-associated hospitalizations, and 3 days for hospitalizations specifically associated with rotavirus-related diarrhea. Diarrhea-associated hospitalizations were highest during the period December through June.
Conclusions:
Diarrhea is an important cause of hospitalization among children in Hawaii, where approximately 1 in 32 children may be hospitalized by 5 years of age. The age-specific and temporal trends reported here are consistent with those previously described for rotavirus-associated hospitalizations, suggesting that this pathogen is a major contributor to the overall morbidity from diarrhea.