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Population-based burden of pneumonia before school entry in Schleswig-Holstein, Germany
Josef A I Weigl1, Hans M Bader, Achim Everding
1Paediatric Infectious Diseases, Children's Hospital University Kiel, Kiel, Germany. weigl@pediatrics.uni-kiel.de
Insights
This study analyzed community-acquired pneumonia (CAP) incidence in German children, finding rates similar to California but lower than historical US/Finnish data. CAP significantly impacted parental workdays.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Background:
- Community-acquired pneumonia (CAP) is a significant childhood respiratory illness.
- Population-based incidence data for CAP in German children were previously lacking.
- Understanding CAP burden is crucial for public health strategies.
Purpose of the Study:
- To determine the population-based incidence of CAP in children in Germany.
- To analyze the characteristics of CAP, including recurrent cases and age of first diagnosis.
- To assess the impact of CAP on parental work absence.
Main Methods:
- Retrospective cohort study involving interviews with parents of 5- to 7-year-old children during school entry medical examinations.
- Data collected from 1999 to 2001 in Schleswig-Holstein, Germany.
- CAP defined as physician-diagnosed pneumonia at the time of occurrence.
Main Results:
- The CAP incidence rate for children aged 0-1 year was 1,664-1,932 per 100,000, and for ages 0-5 years, it was 1,369-1,690 per 100,000.
- The CAP-positive rate ranged from 6.7-7.4%, with 6.9-8.2% experiencing recurrent CAP.
- Antibiotic treatment was administered in 93.7-95.9% of cases. Significant parental workdays were lost due to CAP.
Conclusions:
- The population-based incidence of CAP before school entry in Germany is comparable to recent California data.
- German CAP incidence is approximately 30-50% lower than reported in the USA and Finland decades ago.
- Despite a broad case definition, the study provides valuable epidemiological insights into childhood CAP.
Unlabelled:
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.