Age Distribution of Infection and Hospitalization Among Canadian First Nations Populations During the 2009 H1N1 Pandemic

Abstract

We estimated age-standardized ratios of infection and hospitalization among Canadian First Nations (FN) populations and compared their distributions with those estimated for non-FN populations in Manitoba, Canada. For the spring and fall 2009 waves of the H1N1 pandemic, we obtained daily numbers of laboratory-confirmed and hospitalized cases of H1N1 infection, stratified by 5-year age groups and FN status. We calculated age-standardized ratios with confidence intervals for each wave and compared ratios between age groups in each ethnic group and between the 2 waves for FN and non-FN populations. Incidence and hospitalization ratios in all FN age groups during the first wave were significantly higher than those in non-FN age groups (P < .001). The highest ratios were observed in FN young children aged 0 to 4 years. During the second wave, these ratios tended to decrease in FN populations and increase in non-FN populations, especially among groups younger than 30 years. Incidence and hospitalization ratios in FN populations were higher than or equivalent to ratios in non-FN populations. Our findings support the need to develop targeted prevention and control strategies specifically for vulnerable FN and remote communities.