Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Alaska Native”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed2004

Epidemiology and risk factors for hepatitis C in Alaska Natives.

Large cohorts of persons infected with hepatitis C virus (HCV) that include patients with multiple risk exposures and behaviors have been rarely reported. We herein describe a population-based cohort of 759 Alaska Natives (AN) with HCV who were recruited into a long-term follow-up study. History of injection drug use (IDU) was reported by 60.1% and blood transfusion by 14.0%. The most common genotype was 1a (42.0%), followed by 1b (20.3%), 2b (14.7%), 3a (14.3%), and 2a (7.8%). By multivariable analysis, risk exposures (blood transfusion vs. other; P < 0.01; odds ratio [OR], 2.87; 95% confidence interval [CI], 1.51-5.45) and year of infection (P < 0.01; OR, 3.47; 95% CI, 1.34-8.96) were significantly associated with HCV RNA-positivity. Having an RNA concentration >/=2 million copies/mL was associated with male gender (OR, 1.94) and genotype (P < 0.01 overall; 1a vs. 3a: OR, 1.92; 2b vs. 3a: OR, 3.17) by multivariable analysis. In conclusion, the two principal risk exposures for AN infected with HCV (IDU and blood transfusion) are the same as the overall U.S. population. Persons with a history of blood transfusion were more likely to be HCV RNA positive than those without such history. Higher RNA levels found in males may explain the more severe disease previously reported in this group.

Adult↗
PubMed2000

Bronchiolitis-associated hospitalizations among American Indian and Alaska Native children.

BACKGROUND: Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract illness among infants and young children. Respiratory system diseases account for a large proportion of hospitalizations in American Indian and Alaska Native (AI/AN) children; however, aggregate estimates of RSV-associated hospitalizations among AI/AN children have not been made. METHODS: We used Indian Health Service hospitalization data from 1990 through 1995 to describe hospitalizations associated with bronchiolitis, the most characteristic clinical manifestation of RSV infection, among AI/AN children <5 years old. RESULTS: The overall bronchiolitis-associated hospitalization rate among AI/AN infants < 1 year old was considerably higher (61.8 per 1,000) than the 1995 estimated bronchiolitis hospitalization rate among all US infants (34.2 per 1,000). Hospitalization rates were higher among male infants (72.2 per 1,000) than among females infants (51.1 per 1,000). The highest infant hospitalization rate was noted in the Navajo Area (96.3 per 1,000). Hospitalizations peaked annually in January or February, consistent with national peaks for RSV detection. Bronchiolitis hospitalizations accounted for an increasing proportion of hospitalizations for lower respiratory tract illnesses. CONCLUSIONS: Bronchiolitis-associated hospitalization rates are substantially greater for AI/AN infants than those for all US infants. This difference may reflect an increased likelihood of severe RSV-associated disease or a decreased threshold for hospitalization among AI/AN infants with bronchiolitis compared with all US infants. AI/AN children would receive considerable benefit from lower respiratory tract illness prevention programs, including an RSV vaccine, if and when one becomes available.

Age Distribution↗
PubMedDate not supplied

High utilizers of ambulatory care services: 6-year followup at Alaska Native Medical Center.

In a retrospective study, 100 randomly selected, high utilizers of ambulatory care services in 1972 were followed for a 6-year period, 1973-78. The 22 men and 78 women had visited the Alaska Native Medical Center in Anchorage 15 or more time in 1972. Each patient was matched by age and sex with a control patient who had made three or fewer visits. There were predominately more women than men in all age groups in the high-utilizer group and in all but one age group in the general clinic population. High-utilizer men as a group were older than high-utilizer women. In the followup period, the men in the high-utilizer group had three times the number of hospitalizations as the controls, and women had two times the number. At the end of the followup period, 1 of every 4 men in the high-utilizer group had died, and 1 of every 10 women had died. One-half of these deaths were associated with alcohol. Several approaches to high-utilizer patients are useful. A well-organized medical record, with a complete problem list and index, is imperative. Just as helpful is only having one or several health care providers consistently see the patient at each encounter. Until there is more study of these complex issues, high utilizers must be recognized as a subgroup of patients at high risk for hospitalization and early death.

Adult↗
PubMed1993

Secular trends in hepatitis A virus infection among Alaska Natives.

To assess the epidemiologic characteristics of the population susceptible to hepatitis A virus (HAV) infection and determine the natural history of infection, a retrospective survey was done using banked serum specimens. A random sample of 4030 Alaska Natives statewide was selected, stratified by year of birth and community of residence. Overall, 1988 serum samples (49.3%) tested positive for antibody to HAV (anti-HAV). Past HAV infection was strongly age-related, increasing from 7% in persons born since 1975 to 85% among persons born before 1945. Prevalence of infection also varied between regions. In small communities, a clear demarcation typically existed between previously infected older persons and younger anti-HAV-negative persons. This indicated that village-wide outbreaks of HAV infection have been the norm and appear to be dependent on the presence of a young susceptible population. Widespread vaccination with hepatitis A vaccine to maintain a high proportion of young anti-HAV-positive persons may be successful in preventing future epidemics.

Alaska↗
PubMed2005

American Indians and Alaska Natives in California: women's cancer screening and results.

BACKGROUND AND METHODS: The purpose of this article was to examine differences in demographics, general health status, and utilization of breast and cervical cancer screening for subgroups of American Indians and Alaska Natives (AIAN) using the 2001 California Health Interview Survey. RESULTS: The statewide distribution of California American Indians, non-California AIANs, and unknown AIANs are 10%, 51%, and 39%, respectively. Significant differences exist among the 3 tribal subgroups. CONCLUSIONS: Overall, AIAN women aged 40+ years are close to the Healthy People 2010 goals for receipt of a mammogram in the past 2 years and for receipt of a Pap test ever and in the past 3 years. Less than 5% of AIAN in California report Indian Health Service coverage.

Adolescent↗
PubMed2003

Surveillance for health behaviors of American Indians and Alaska Natives. Findings from the Behavioral Risk Factor Surveillance System, 1997-2000.

PROBLEM/CONDITION: In the United States, disparities in risks for chronic disease (e.g., diabetes, cardiovascular disease, and cancer) and human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are evident among American Indians and Alaska Natives (AI/ANs) and other groups. This report summarizes findings from the 1997-2000 Behavioral Risk Factor Surveillance System (BRFSS) for health-status indicators, health-risk behaviors, and HIV testing and perceived risk for HIV infection among AI/ANs, compared with other racial/ethnic groups in five regions of the United States. REPORTING PERIOD COVERED: 1997-2000. DESCRIPTION OF SYSTEM: BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (i.e., persons aged > or =18 years) population. For this report, responses from the 36 states covered by the Indian Health Service administrative areas were analyzed. RESULTS: Region and sex-specific variations occurred in the prevalence of high-risk behaviors and health-status indicators. For example, the prevalence of current cigarette smoking ranged from 21.2% in the Southwest to 44.1% in the Northern Plains, and the awareness of diabetes was lower in Alaska than in other regions. Men were more likely than women to report binge drinking and drinking and driving. For the majority of health behaviors and status measures, AI/ANs were more likely than respondents of other racial/ethnic groups to be at increased risk. For example, AI/ANs were more likely than respondents of other racial/ethnic groups to report obesity (23.9% versus 18.7%) and no leisure-time physical activity (32.5% versus 27.5%). INTERPRETATION: The 1997-2000 BRFSS data demonstrate that health behaviors vary regionally among AI/ANs and by sex. The data also reveal disparities in health behaviors between AI/ANs and other racial/ethnic groups. The reasons for these differences by region and sex, and for the racial/ethnic disparities, are subjects for further study. However, such patterns should be monitored through continued surveillance, and the data should be used to guide prevention and research activities. For example, states with substantial AI/AN populations, and certain tribes, have successfully used BRFSS data to develop and monitor diabetes and tobacco prevention and control programs. PUBLIC HEALTH ACTIONS: Federal and state agencies, tribes, Indian health boards, and urban Indian health centers will continue to use BRFSS data to develop and guide public health programs and policies. The BRFSS data will also be used to monitor progress in eliminating racial and ethnic health disparities. Regional Indian health boards, tribal epidemiology centers, and Indian Health Service Area Offices can use the findings of this report to prioritize interventions to prevent specific health problems in their geographic areas. Moreover, tribes and other institutions that promote AI/AN health care can use the report to document health needs when applying for resources.

AIDS Serodiagnosis↗
PubMed2002

Type 1 diabetes-related autoantibodies are rare in Alaska native populations.

OBJECTIVES: When clinical data were initially gathered from the Alaskan Eskimos in the 1950's, diabetes mellitus was noted to be quite rare. The prevalence of diabetes has increased significantly since that time, with rates of 10% reported recently in some Alaska native populations. Our goal was to understand the pathogenesis of diabetes among these groups, with the hypothesis that Alaskan Eskimos were predominantly affected by type 2 diabetes, not by latent autoimmune diabetes in adults (LADA). STUDY DESIGN: Population based case control study METHODS: We tested sera from subjects in two Eskimo villages for the presence of type 1 diabetes-related autoantibodies against glutamic acid decarboxylase (GAD65Ab) and tyrosine phosphatase-like islet antigen-2 (IA-2Ab). RESULTS: Among subjects from one Inupiat village (#1) and one SiberianYup'ik village (#2), there were 21 subjects with diabetes mellitus (DM), 17 with impaired glucose tolerance (IGT), and 226 healthy controls with normal glucose tolerance (NGT). In village 1, GAD65 antibodies were not present in either diabetic subjects or those with IGT. One of the healthy controls (1%; 1/97) was positive for GAD65Ab. Similarly, no subjects from this village with DM or IGT had positive IA-2Ab titers, and one healthy control (1%; 1/97) was positive for IA-2Ab. In village 2, no DM subject was GAD65Ab positive. One (10%; 1/10) of the IGT subjects and two (1.6%;2/129) of the healthy controls were positive for GAD65Ab. In this village, two of the DM subjects (12%;2/17), one of the IGT subjects (10%; 1/10), and one of the healthy controls (0.8%;1/129) were IA-2Ab positive. No individual was positive for both GAD65Ab and IA-2Ab. CONCLUSION: Alaskan Inupiat and Siberian Yup'ik Eskimos appear to be predominantly affected by type 2 diabetes, not LADA.

Adult↗
PubMed2003

Cancer rates among American Indians and Alaska Natives: is there a national perspective.

BACKGROUND: Two important goals of cancer surveillance are to provide milestones in the effort to reduce the cancer burden and to generate observations that form the basis for cancer research and intervention for cancer prevention and control. Determination of the cancer burden among American Indians and Alaska Natives (AIAN) has been difficult largely due to lack of data collection efforts in many areas of the country and misclassification of racial data that results in undercounting of Native Americans. There is a revitalized commitment to improve data collection among the national agencies and organizations. METHODS: Data on cancer trends from 12 areas covered by the Surveillance, Epidemiology and End Results (SEER) Program were reviewed for incidence and death rates for 1992-2000. AIAN trends were examined and compared with trends among other racial/ethnic population groups. Reference was made to studies of disease-specific survival for nine of the SEER areas for 1988-1997. RESULTS: In SEER areas, cancer incidence rates for AIAN populations appeared to be decreasing significantly for lung and breast cancers among women and for prostate cancer among men. However, death rates rose, although not significantly, over the same period, except for a significant decrease in prostate cancer. Among the cancers with rising death rates were lung cancer (AIAN women) and colorectal cancer (AIAN men). In addition, survival often was lower for AIAN populations. CONCLUSIONS: Although the incidence was stable or decreased among AIAN populations, increased death rates and lower survival rates indicate the need for intensified application of cancer prevention and control measures, including screening and treatment. Difficulties in interpretation of data include small population size and substantial interregional differences in rates.

Alaska↗
PubMed1999

American Indian and Alaska Native health behavior: findings from the behavioral risk factor surveillance system, 1992-1995.

OBJECTIVE: The purpose of this study was to evaluate differences between American Indian and white adults in behavioral risk factors for chronic disease and injury. METHODS: Data were drawn from the 1992-1995 Behavioral Risk Factor Surveillance System, an ongoing telephone survey of health behaviors of adults. Prevalence estimates by sex were calculated for American Indian and white respondents in 15 states and the significance of their differences evaluated by chi-square tests. RESULTS: American Indians were found to be at significantly higher risk than whites for fair to poor general health status, medical cost difficulties, binge drinking, cigarette smoking, not always using safety belts, being diagnosed as diabetic, and obesity. CONCLUSIONS: To reduce the gap in behavioral risk factors between American Indians and whites, more resources need to be dedicated to American Indian health. Note. The term "American Indian" henceforth refers to those who identify themselves as American Indian or Alaska Native.

Adolescent↗
PubMed1995

Risk factors for invasive disease caused by Streptococcus pneumoniae among Alaska native children younger than two years of age.

Streptococcus pneumoniae causes a significant amount of illness and death from pneumonia, bacteremia and meningitis among children < 2 years of age. No currently available effective vaccine exists to prevent pneumococcal disease in this age group. To identify modifiable risk factors we conducted a retrospective case-control study of 29 Alaska Native residents of Bethel, AK, < 2 years of age who had invasive pneumococcal illness from 1983 to 1992 and 85 controls matched for race, city of residence and date of birth. Data were collected through reviews of medical records and telephone interviews. In matched univariate analysis the following variables were associated with illness at P < or = 0.25 and were included in the multivariate model: at least one prior episode of pneumonia; at least one prior hospitalization; group child care center attendance; at least one tobacco smoker in the household; at least one tobacco chewer in the household; and lack of breast-feeding. Using a conditional multiple logistic regression analysis, we found that group child care center attendance (odds ratio, 98.6; 95% confidence interval, 5.1 to 1920.6) and the presence in the household of at least one person who chewed tobacco (odds ratio, 20.6; 95% confidence interval, 1.4 to 294.5) were independently associated with illness while breast-feeding was protective (odds ratio, 0.1; 95% confidence interval, 0.0 to 1.0). These data suggest that breast-feeding may prevent invasive pneumococcal disease and that strategies for decreasing risks should target children in group child care settings. Further studies are needed to evaluate the interaction of tobacco and pneumococcal illness.

Alaska↗
PubMed2006

Hepatitis C infection in Alaska Natives with persistently normal, persistently elevated or fluctuating alanine aminotransferase levels.

BACKGROUND/AIMS: An estimated one-third of patients with chronic hepatitis C virus (HCV) infection have persistently normal alanine transaminase (PNALT); however, in many previous studies alanine aminotransferase (ALT) levels were followed for < or = 12 months. METHODS: We analyzed data from a population-based cohort of 935 Alaska Natives with HCV, recruited from 1994 to 2005, to determine the proportion of persons with PNALT, persistently elevated ALT (PEALT), and fluctuating ALT (FLUXALT) to determine factors for each ALT state. We selected persons with two positive HCV RNA results > or = 1 year apart and > or = 6 ALT levels measured over the subsequent 3 years with at least 1 month between ALT measurements (n = 265). We defined a person as having PNALT, PEALT, or FLUXALT when all six ALT levels were normal, elevated, or did not fit either of the above two categories, respectively, during the 3-year follow-up period. RESULTS: Among 208 persistently HCV RNA-positive persons, 13 had PNALT, 121 PEALT, 74 FLUXALT. Among 77 persons who underwent liver biopsy, those with PEALT were more likely to have Ishak fibrosis scores > 2 compared with persons with FLUXALT (44% vs. 10%, OR 7.0, 95% CI: 1.5-33.2). No statistically significant differences were found in ALT classification by age, gender, infection duration, median body mass index, alcohol consumption, residence, risk behavior, RNA level, or genotype. CONCLUSIONS: Only 6% of persons with chronic HCV had PNALT. Persons with PEALT were significantly more likely to have higher fibrosis scores on liver biopsy than those with FLUXALT. Previous studies with short follow-up periods may have overestimated the proportion of persons with normal ALT levels.

Adult↗
PubMedDate not supplied

Correctness of racial coding of American Indians and Alaska Natives on the Washington State death certificate.

Underestimation of death rates for specific races can obscure health problems and impair the ability of public programs to prevent premature death and disability. For accurate race-specific death rates, the racial classification of both the population at risk and the decreased population must be accurately ascertained. However, studies suggest that the American Indian (AI) and Alaska Native (AN) races may be not be accurately recorded on the death certificate. We performed a computerized linkage between the Indian Health Service (IHS) patient registry and the 1985-1990 computerized Washington State death certificate data. The deceased was correctly identified as AI or AN on the death certificate for 1,088 (87.2%) of 1,248 matched deaths. The majority (93%) of deceased persons identified on the death certificate as not AI or AN were listed as white. The percentage of American Indian ancestry was strongly associated with correct racial classification on the death certificate (P < .001). Birth in Washington State, membership in a large Washington State tribe, and death from an alcohol condition independently added to the likelihood of correct AI or AN racial classification. Persons who died from cancer were significantly less likely to be correctly coded as AI or AN on the death certificate.

Alaska↗
PubMed2000

Immunogenicity of a heptavalent pneumococcal conjugate vaccine in Apache and Navajo Indian, Alaska native, and non-native American children aged <2 years.

High rates of invasive pneumococcal disease have been described among infants living in various Native American communities. In this study, we evaluated the immunogenicity of a 7-valent pneumococcal vaccine consisting of serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F covalently linked to the outer membrane protein complex of Neisseria meningitidis in Apache and Navajo Indian, Alaska Native, and non-Native American children. The vaccine was administered at ages 2, 4, and 6 months; a booster dose was given at age 15 months. Levels of serotype-specific immunoglobulin G (IgG) were measured by a standardized enzyme-linked immunosorbent assay. The responses after 3 primary doses of vaccine were similar in all 3 groups of children, except for those to serotypes 14 and 23F. One month after the booster dose, geometric mean concentrations (GMCs) of serotype-specific IgG antibodies increased significantly in all 3 groups of children, compared with GMCs of IgG antibodies to pneumococcal serotypes before the booster dose.

Antibodies, Bacterial↗