10th November 2017, Volume 130 Number 1465

Fiona Catherine Langridge, Sione Vaioleti Hufanga, Malakai Mahunui ‘Ofanoa, Toakase Fakakovikaetau, Teuila Mary Percival, Cameron Charles Grant

The Millennium Development Goals have provided a focus for the global reporting of child health in recent decades1 by describing child population health using under-five year, neonatal and infant mortality…

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Summary

New Zealand is situated close to the Pacific Islands geographically and has a high Pacific population. Unfortunately, children living in these small but important Pacific nations have not received much attention in regards to their health status. In this paper, 85% of admissions to hospital in Tonga for primary school children were for injury and poisoning, non-respiratory infectious disease, respiratory conditions, abdominal/surgical conditions and dental disease. This information is helpful to inform healthcare priorities for Tonga and other similar countries.

Abstract

Aim

To describe inpatient utilisation patterns for primary school aged children in Tonga.

Method

We described admissions for children aged 5–11 years to the main hospital in Tonga from January 2009 to December 2013. Rates with 95% confidence intervals (CI) were compared using rate ratios (RR).

Results

There were 1,816 admissions. The average annual admission rate was 20.2/1,000 (95% CI 19.3–21.1). Hospital admission rates were higher in younger than older children (5–7 versus 8–11 years, RR=1.28, 95% CI 1.18–1.41) and in boys than girls (RR=1.52, 95% CI 1.38–1.68). Injury and poisoning (28%), non-respiratory infectious diseases (19%), respiratory conditions (16%), abdominal/surgical conditions (13%) and dental (9%) were the most frequent admission reasons. A larger proportion of younger versus older children were hospitalised for dental (16% vs 1%, P<0.001) or respiratory conditions (18% vs 14%, P=0.02). A larger proportion of older children were hospitalised for abdominal/surgical conditions (15% vs 11%, P=0.008), other infectious diseases (21% vs 17%, P=0.04), other conditions (10% vs 6%, P<0.001) and cardiac conditions (2% vs 1%, P<0.001).

Conclusion

In children 5–11 years in Tonga, 85% of admissions were for five groups of conditions. These data inform priority areas for healthcare spending and enable comparisons over time and between different Pacific countries.

Author Information

Fiona Catherine Langridge, PhD Candidate, Departments of Pacific Health, Paediatrics: Child and Youth Health, The University of Auckland, Auckland; Sione Vaioleti Hufanga, Biostatistician, Biostatistics Department, Chief Information Officer, Ministry of Health, Tonga;
Malakai Mahunui ‘Ofanoa, Senior Lecturer, Departments of Pacific Health;
Toakase Fakakovikaetau, Paediatrician, Paediatrics Department, Vaiola Hospital, Nuku’alofa, Tonga; Teuila Mary Percival, Paediatrician and Senior Lecturer, Departments of Pacific Health;
Cameron Charles Grant, Paediatrician and Professor, Paediatrics: Child and Youth Health, The University of Auckland, Auckland, Starship Children’s Hospital, Auckland.

Acknowledgements

The authors would like to thank the Ministry of Health in Tonga. We acknowledge NZAID, The Oticon Foundation, NZOVRF and the Ranchhod Foundation for funding support. FL is supported by The University of Auckland Doctoral Scholarship. The authors have no competing interests to declare.

Correspondence

Fiona Langridge, Department of Pacific Health, Faculty of Medicine and Health Sciences, University of Auckland, Private Bag 92019, Auckland.

Correspondence Email

f.langridge@auckland.ac.nz

Competing Interests

Mrs Langridge reports grants from University of Auckland during the conduct of the study; grants from New Zealand Optometric Vision Research Foundation, grants from The Oticon Foundation, non-financial support from The Ranchhod Foundation, outside the submitted work. MO is part of the supervision team for this PhD candidate (main author).

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