The prognosis of lobar pneumonia in the Papua New Guinea Highlands

Lobar pneumonia, usually caused by pneumococci is the commonest cause for admission to hospitals in Papua New Guinea (PNG). The mortality rate is less than 3%. In a survey of 275 adults (mean age: 36 years) admitted to Goroka hospital in the Highlands of New Guinea with this diagnosis, adverse prognostic factors observed on admission were: age over 40 years, multilobar disease, anaemia (Hb less than 11g/d1) and history of illness commencing more than 7 days before presentation. Additional adverse factors demonstrated after admission included the presence of type 3 pneumococcus and bacteraemia. It is suggested that in the Highlands of PNG initial admission of ambulant patients with lobar pneumonia should be generally restricted to those with any of the first 4 factors.