Community-based estimates of incidence and risk factors for childhood pneumonia in Western Sydney

Abstract

The aim was to estimate the community incidence and risk factors for all-cause pneumonia in children in Western Sydney, Australia. A cross-sectional randomized computer-assisted telephone interview was conducted in July 2000, in Western Sydney. Parents of 2020 children aged between 5 and 14 years were interviewed about their child's respiratory health since birth. No verification of reported diagnosis was available. Logistic regression analysis was used to determine risk factors for pneumonia. A lifetime diagnosis of pneumonia was reported in 137/2020 (68%) children, giving an estimated incidence in the study sample of 7.6/1000 person-years. Radiological confirmation was reported in 85% (117/137). Hospitalization was reported in 41% (56/137) and antibiotic therapy in 93% (127/137) of cases. Using logistic regression modelling, statistically significant associations with pneumonia were a reported history of either asthma, bronchitis or other lung problems and health problems affecting other systems. In most cases, the diagnosis of asthma preceded the diagnosis of pneumonia. The community incidence of all causes of pneumonia is not well enumerated, either in adults or in children. This study provides community-based incidence data. The incidence of hospitalization for pneumonia in this study is comparable to estimates from studies in comparable populations, suggesting that retrospective parental report for memorable events is likely to be valid. We found a relationship between pneumonia and childhood respiratory diseases such as asthma, which has implications for targeted vaccination strategies.

Complicated pneumonia in children

“…Two prospective population-based studies estimate that incidence of CAP is 32.8-33.8 cases per 10 000 children under the age of 5 years or 14.4-14.7 cases per 10 000 children under the age of 16 years in northern Europe [2,3]; the majority of these patients will be managed effectively by primary care, though the threshold for referral and admission to hospital in those less than 6 months of age should be lower [4]. Hospitalisation rates for CAP in children range from 9.5% to 42% [5][6][7] and the median time to resolution of symptoms in children with oxygen saturations of .85% at the time of admission is 9 days, regardless of whether treatment is with oral amoxicillin or intravenous benzylpenicillin [8].…”

Inter-observer agreement in interpreting chest X-rays on children with acute lower respiratory tract infections and concurrent wheezing

“…28,29 Thus, the complexity of a clinical presentation that may include pneumonia and bronchial obstruction implies not only an underlying clinical challenge, but also interdependence between the two conditions.…”

Comparison of oral amoxicillin and intravenous benzyl penicillin for community acquired pneumonia in children (PIVOT trial): a multicentre pragmatic randomised controlled equivalence trial

“…Pneumonia is a common paediatric illness with 2.5 million cases annually in Europe,1 most commonly in children aged <5 years (incidence 21–36/1000 in the developed world) 2 3. Around 40% of cases require hospitalisation 2 3.…”