Population-based burden of pneumonia before school entry in Schleswig-Holstein, Germany

Abstract

Community-acquired pneumonia (CAP) is of predominant interest in analysing the burden of airway diseases. No population-based incidence data for children in Germany exist. In retrospective cohort studies from 1999 to 2001, parents of an entire age-class (28,000-30,000) of 5-to 7-year-old children at school entry medical examination (S1) in a complete federal state (Schleswig-Holstein, population 2.77 million) were interviewed by the Children and Adolescent Service of the Public Health Service. CAP was defined as pneumonia diagnosed by a physician at the time it occurred. The proportion of children investigated (participation rate) was 82.0-86.1%. The CAP-positive rate was 6.7-7.4%, 6.9-8.2% of whom had recurrent CAP. The mean age at first CAP was 36.4-39.4 months (median 42 months). This resulted in a population-based incidence for the age groups 0-1 year and 0-5 years (under 5) of 1,664-1,932 and 1,369-1,690 per 100,000, respectively; 93.7-95.9% received antibiotics. For each percent of CAP, 458 days (1999), 312 days (2000) and 319 days (2001) of at least one parent's work were lost, respectively. Conclusions: Despite a relatively weak case definition, the population-based incidence of CAP before school entry was the same as recently reported form California and about 30-50% of that reported 20 to 40 years ago in the USA and Finland.Keywords Cohort AE Pneumonia AE School entry AE Incidence AE Public health serviceAbbreviations ARI acute respiratory tract infection AE CAP community-acquired pneumonia AE CAS children and adolescent service AE LRI lower respiratory tract infections AE PHO public health office (Gesundheitsamt) Subjects and methodsIn three retrospective cohort studies from 1999 to 2001, parents of children aged 5-7 years were interviewed by the Children and Eur J Pediatr (2003) 162: 309-316

Recurrent Pneumonia in Children Admitted to Assiut University Children Hospital. Magnitude of the Problem and Possible Risk Factors

“…In pediatric patients, bronchiectasis causes an accelerated decline in lung function that leads to repeated hospital admissions due to acute infectious exacerbations, a poorer quality of life, and possible premature death in early adult life (34). Recurrent pneumonia was considered as a risk factor for development of bronchiectasis in 6.7%-8.5% of cases (1,10).…”

Recurrent Pneumonia in Children: A Reasoned Diagnostic Approach and a Single Centre Experience

“…Recurrent pneumonia (RP) is defined as at least two episodes of pneumonia in one year or three episodes ever, with intercritical radiographic clearing of densities [3]. Incidence data indicate that RP occurs in 7.7%–9% of all children with CAP [4,5,6,7,8,9]. As a result, RP represents a frequent presenting manifestation in the general pediatric practice and is a very common reason for referral to pediatric chest physicians [4].…”

“…Data on the underlying causes of RP in children come from retrospective case series [4,5,6,7,8,9,10], and prospective studies are lacking. The methodology for prospective studies of RP implies the recruitment of a large cohort of children, a thorough investigation of the cases, and the generation of predictive indices for confirming or excluding the diagnosis.…”

Clinical profile of recurrent community-acquired pneumonia in children

“…The Isle of Wight birth cohort study of 1,336 children followed up for 10 years found a 7.4% prevalence of ≥2 lower respiratory tract infections (LRTIs) including CAP [1]; a retrospective cohort study of German children aged 5–7 years found that 6.7-8.2% of the children had a positive history of CAP, 6.9-8.2% of whom had experienced rCAP [2]; and data from Toronto’s Hospital for Sick Children show that 238 of 2,900 children (8%) admitted because of CAP met the criteria for rCAP [3]. …”