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Deprivation, Ethnicity and Eczema: Understanding Associations for Childhood Bone and Joint Infection
Sarah Hunter1,2, Elsie Brown2, John Mutu-Grigg3
1University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand.
Background:
Rates of childhood bone and joint infection (BJI) in New Zealand (NZ) are among the highest in the world, with a disproportionate burden experienced by Māori and Pacific children. Eczema, also inequitably distributed by ethnicity, is a potential risk factor for BJI. This study describes the recent incidence of BJI and investigates disease risk secondary to eczema.
Methods:
BJI cases were children aged
Results:
This study identified 563 cases and 8840 ethnicity-matched controls. Incidence of AHO remains higher for Māori (26.7/100 000) and Pacific (38.5/100 000) compared with European children (17/100 000). Eczema was seen more frequently in BJI cases (30% of BJI cases vs. 24% of NZHS controls (p = 0.0007)). For NZ Māori and Pacific children, a diagnosis of eczema increased the odds of developing BJI (Pacific aOR = 1.6, 95% CI: 1.1-2.3, Māori aOR = 1.6, 1.1-2.4). Pacific children with BJI were more likely than controls to reside in areas of greater socioeconomic deprivation (aOR 1.88, 95% CI: 1.3-2.5). European children were more likely to reside in areas of least socioeconomic deprivation (OR 2.3, 95% CI: 1.7-3.1).
Conclusions:
Childhood BJI remains inequitably distributed by ethnicity. Eczema may be a suitable focus for strategies to lower disease risk.
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