{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:24:54Z","timestamp":1790364294232,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100019168","name":"Starship Foundation","doi-asserted-by":"publisher","award":["SF4572"],"award-info":[{"award-number":["SF4572"]}],"id":[{"id":"10.13039\/501100019168","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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 M\u0101ori 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>BJI cases were children aged &lt;\/=\u200915\u2009years admitted with acute haematogenous osteomyelitis (AHO) or septic arthritis (SA) between 2018 and 2023 in the Auckland region. Data were obtained on eczema status, ethnicity and area\u2010based socioeconomic deprivation. BJI incidence was estimated using the 2018 Census. A retrospective case\u2013control study was undertaken to determine the association between eczema and BJI. Ethnicity\u2010matched controls were identified from the nationally representative NZ Health Survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study identified 563 cases and 8840 ethnicity\u2010matched controls. Incidence of AHO remains higher for M\u0101ori (26.7\/100\u2009000) and Pacific (38.5\/100\u2009000) compared with European children (17\/100\u2009000). Eczema was seen more frequently in BJI cases (30% of BJI cases vs. 24% of NZHS controls (<jats:italic>p<\/jats:italic>\u2009=\u20090.0007)). For NZ M\u0101ori and Pacific children, a diagnosis of eczema increased the odds of developing BJI (Pacific aOR\u2009=\u20091.6, 95% CI: 1.1\u20132.3, M\u0101ori aOR\u2009=\u20091.6, 1.1\u20132.4). Pacific children with BJI were more likely than controls to reside in areas of greater socioeconomic deprivation (aOR 1.88, 95% CI: 1.3\u20132.5). European children were more likely to reside in areas of least socioeconomic deprivation (OR 2.3, 95% CI: 1.7\u20133.1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Childhood BJI remains inequitably distributed by ethnicity. Eczema may be a suitable focus for strategies to lower disease risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.70113","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T06:14:38Z","timestamp":1750400078000},"page":"1385-1392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Deprivation, Ethnicity and Eczema: Understanding Associations for Childhood Bone and Joint Infection"],"prefix":"10.1111","volume":"61","author":[{"given":"Sarah","family":"Hunter","sequence":"first","affiliation":[{"name":"University of Auckland Faculty of Medical and Health Sciences  Auckland New Zealand"},{"name":"Paediatric Orthopaedic Department Starship Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsie","family":"Brown","sequence":"additional","affiliation":[{"name":"Paediatric Orthopaedic Department Starship Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mutu\u2010Grigg","sequence":"additional","affiliation":[{"name":"Auckland Orthopaedics Ltd  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haemish","family":"Crawford","sequence":"additional","affiliation":[{"name":"University of Auckland Faculty of Medical and Health Sciences  Auckland New Zealand"},{"name":"Paediatric Orthopaedic Department Starship Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Selak","sequence":"additional","affiliation":[{"name":"University of Auckland Faculty of Medical and Health Sciences  Auckland New Zealand"},{"name":"School of Population Health, University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4032-7230","authenticated-orcid":false,"given":"Cameron","family":"Grant","sequence":"additional","affiliation":[{"name":"University of Auckland Faculty of Medical and Health Sciences  Auckland New Zealand"},{"name":"Department of Child and Youth Health Starship Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2021.03.028"},{"key":"e_1_2_9_3_1","first-page":"490","article-title":"Quality of Life in Children up to 13\u2009Years Following Acute Haematogenous Osteomyelitis","volume":"20","author":"Hunter S.","year":"2022","journal-title":"Journal of Pediatric Orthopaedics, Part B"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198208000-00074"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-020-04611-z"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000002385"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000332"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002885"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.15153"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50361"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12702"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(23)00068-X"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2022.100508"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-021-01741-3"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_2_9_16_1","unstructured":"Te Whatu Ora \u201cIdentity Standards [Internet] \u201dEthnicityDataProtocols https:\/\/www.tewhatuora.govt.nz\/health\u2010services\u2010and\u2010programmes\/digital\u2010health\/data\u2010and\u2010digital\u2010standards\/approved\u2010standards\/identity\u2010standards(2019)."},{"key":"e_1_2_9_17_1","unstructured":"J.Atkinson C.Salmond andP.Crampton \u201cNZDep2018 Index of Deprivation \u201d(2020)."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/14.4.600"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-004-0597-3"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000002443"},{"key":"e_1_2_9_21_1","volume-title":"Epidemiology: An Introduction","author":"Rothman K. 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