{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T08:44:14Z","timestamp":1773045854355,"version":"3.50.1"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fonds de recherche Qu\u00e9bec \u2013 sant\u00e9"},{"DOI":"10.13039\/501100020867","name":"The Montreal Children\u2019s Hospital Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100020867","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The incidence of hospitalizations for acute respiratory infections (ARI) among young Indigenous children from Northern Canada is consistently high. ARIs requiring urgent air transfer can be life-threatening and costly. We aimed to describe their epidemiology, estimate age-specific incidences, and explore factors associated with level of care required.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We undertook a retrospective cohort study of children &lt;5 years old from Northern Canada transferred by urgent air transport for ARI from 2005 through 2014 to 5 pediatric tertiary care centers in Vancouver, Edmonton, Winnipeg, Ottawa and Montreal. Admissions were identified via ARI-related ICD-9\/10 coding and forward sortation area. Descriptive statistics and univariable analyses were performed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among 650 urgent air transfers, the majority were from Nunavut (n = 349, 53.7%) or Nunavik (n = 166, 25.5%), &lt;6 months old (n = 372, 57.2%), and without underlying comorbidity (n = 458; 70.5%). Estimated annual tertiary care ARI admission rates in infants &lt;1 year old from Nunavut (40.7\/1000) and Nunavik (44.5\/1000) were tenfold higher than in children aged 1 to 4 years. Bronchiolitis (n = 333, 51.2%) and pneumonia (n = 208, 32.0%) were the most common primary discharge diagnoses. Nearly half required critical care (n = 316, 48.6%); mechanical ventilation rates ranged from 7.2% to 55.9% across centres. The most common primary pathogen was respiratory syncytial virus (n = 196, 30.1%). Influenza A or B was identified in 35 cases (5.4%) and vaccine-preventable bacterial infections in 27 (4.1%) cases.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Interpretation<\/jats:title>\n<jats:p>Urgent air transfers for ARI from Northern Canada are associated with high acuity. Variations in levels of care were seen across referral centers, age groups and pathogens.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0272154","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T17:44:20Z","timestamp":1659030260000},"page":"e0272154","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Urgent air transfers for acute respiratory infections among children from Northern Canada, 2005\u20132014"],"prefix":"10.1371","volume":"17","author":[{"given":"Caitlin","family":"Prendergast","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9831-5681","authenticated-orcid":true,"given":"Joan","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea","family":"Caya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria E.","family":"Perez Trejo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iline","family":"Guan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"H\u00e9bert-Murakami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justina","family":"Marianayagam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zing-Wae","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celia","family":"Walker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Goldfarb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4704-9595","authenticated-orcid":true,"given":"Nick","family":"Barrowman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radha","family":"Jetty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Embree","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4232-871X","authenticated-orcid":true,"given":"Jesse","family":"Papenburg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"issue":"10053","key":"pone.0272154.ref001","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/S0140-6736(16)31012-1","article-title":"Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980\u20132015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"388","author":"H Wang","year":"2016","journal-title":"Lancet"},{"issue":"10200","key":"pone.0272154.ref002","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/S0140-6736(19)30721-4","article-title":"Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study","volume":"394","author":"KL O\u2019Brien","year":"2019","journal-title":"Lancet"},{"issue":"9","key":"pone.0272154.ref003","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1056\/NEJMoa1405870","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. children","volume":"372","author":"S Jain","year":"2015","journal-title":"N Engl J Med"},{"issue":"10098","key":"pone.0272154.ref004","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/S0140-6736(17)30938-8","article-title":"Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study","volume":"390","author":"T Shi","year":"2017","journal-title":"Lancet"},{"issue":"13","key":"pone.0272154.ref005","first-page":"1847","article-title":"Lower respiratory tract infections in Inuit infants on Baffin Island.","volume":"164","author":"A Banerji","year":"2001","journal-title":"CMAJ"},{"issue":"7","key":"pone.0272154.ref006","first-page":"376","article-title":"Respiratory disease in Canadian First Nations and Inuit children","volume":"17","author":"T. 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