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[A descriptive study of community-acquired pneumonia in childhood. A primary care perspective]
J C Buñuel Alvarez1, C Vila Pablos, E Tresserras González
1Area Básica de Salud Girona-4, Institut Català de la Salut. mrubiom@papps.org
Insights
Childhood pneumonia incidence in this district is 3.9%, with most cases resolving well in primary care (PC). Attending hospital casualty first, rather than PC, may increase admission rates, warranting further study.
Area of Science:
- Pediatric infectious diseases
- Epidemiology
- Primary care medicine
Context:
- Childhood pneumonia represents a significant global health burden.
- Understanding local incidence and characteristics is crucial for effective public health strategies.
- Primary care's role in managing pediatric pneumonia requires detailed evaluation.
Purpose:
- To determine the incidence and epidemiological characteristics of childhood pneumonia in a specific health district.
- To assess the resolution rate of pneumonia managed within primary care settings.
- To compare hospital admission rates based on the initial point of care (primary care vs. hospital casualty).
Summary:
- A retrospective study analyzed 63 episodes of pneumonia in 1604 children under 15.
- The incidence was 3.9%, with a female predominance and a peak in autumn-winter.
- Most cases (90.5%) resolved satisfactorily in primary care, while 9.5% required hospital admission.
Impact:
- Findings suggest that childhood pneumonia incidence in this region is relatively low compared to international data.
- The study highlights the effectiveness of primary care in managing the majority of pediatric pneumonia cases.
- Results indicate a potential increased risk of hospital admission when patients initially present to hospital casualty departments instead of primary care, suggesting a need for further analytical research.
Main Objective:
To determine the incidence of child pneumonia in our health district.
Secondary Objectives:
to establish its clinical and epidemiological characteristics, to establish the percentage resolution of the illness within primary care (PC), to describe the treatments given, and to compare admission rates according to whether the first consultation was in PC or hospital casualty.
Design:
A retrospective, longitudinal, descriptive study.
Setting:
Primary care.
Participants:
63 episodes diagnosed between 30-8-96 and 1-9-97 in 1604 children under 15.
Measurements:
Statistical measurements included: 95% confidence intervals, the ji squared test, Fisher's exact test.
Results:
Incidence was 3.9% (CI: 3-4.9%); female predominance, 53.3% (CI: 40.7-66%); seasonal predominance, autumn-winter 64.5% (CI: 52.6-76.4%). The most common signs were: high temperature, 93.3% (CI: 87-99.6%); cough, 66.1% (CI: 54-78.2%). 90.5% (CI: 83.2-97.7%) of pneumonia cases treated in PC evolved satisfactorily. 9.5% (CI: 2.3-16.8%) needed hospital admission. Patients who attended hospital on their own initiative went into hospital more often than those who attended the PC paediatrics clinic as their first option (p = 0.002).
Conclusions:
The incidence of pneumonia among children is lower than in other countries. The majority are treated and resolved properly in PC. Analytic studies are needed to determine whether first attending a hospital casualty department instead of a PC paediatric clinic involves a greater risk of hospital admission.