Differences between Bedouin and Jewish population in clinical characteristics of patients admitted with community-acquired pneumonia

Abstract number: p1042

Novack  V., Avnon  L., Riesenberg  K., Schlaeffer  F.

Objectives: 

Ethnic groups have different inherent risk factors for contracting community-acquired pneumonia (CAP). In Southern Israel (population: 985,000) two ethnic groups live side by side: predominantly urban Jewish population and a population of Arab Bedouins (population: 144,000–14.3%) who are in social transition from being desert nomads to a settled lifestyle.

The objective of the study was to evaluate the differences in characteristics and outcome of CAP between these two populations for patients hospitalised during one winter season.

Methods: 

We conducted a hospital based prospective observational study. Soroka University Medical Centre is a 1200 bed tertiary care hospital, which serves as the only regional hospital for Southern Israel. During a 4-months period we assessed clinical as well as demographic characteristics of all patients hospitalised with CAP.

Results: 

262 patients were enrolled, of whom 58 (22.1%) were Bedouins. Bedouin patients were younger than the rest of the cohort (60.0 ± 20 vs. 66 ± 17 years, p = 0.05) and had lower rates of cardio-vascular diseases such as ischemic heart disease and cerebro-vascular disease (20.7% vs. 39.2%, p = 0.02). Bedouins had higher smoking rates (39.7% vs. 19.1%, p = 0.001), higher prevalence of COPD (31.0% vs. 9.3%, p = 0.001) and diabetes (41.4 vs. 25.0%, p = 0.01). There was no difference between pneumonia patients outcomes research team (PORT) scores of Bedouin and Jewish population at admission (median 83 points vs. 85 points, p = 0.61). Bedouin patients had lower rate of pre-hospitalisation antibiotics therapy compared to the rest (12.1% vs. 25.5%, p = 0.03). There were no differences in the length of hospitalisation (median 4 days, p = 0.8) or 30-day mortality rate between Bedouin and Jewish patients (3.4% vs. 8.8%, p = 0.26).

Conclusions: 

There were a number of differences in clinical characteristics between Bedouin and Jewish patients admitted to the hospital with CAP. Higher smoking and COPD rates in Bedouin patients may affect the microbiology of the CAP pathogens and this should be taken into consideration when therapeutic decisions are made. Despite socio-economic differences between the two ethnic groups, there was no difference in severity of CAP and clinical outcomes.