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[Pneumonia as a cause of death in children (author's transl)]
Insights
Pneumonia deaths in children decreased significantly, but secondary pneumonia treatment remains challenging due to underlying conditions and opportunistic infections. Further research is needed for effective interventions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Pneumonia mortality rates in children aged one month to 15 years in Schleswig-Holstein saw a notable decline between 1954-1958 and 1969-1973.
- Overall child mortality also decreased in the same age group during this period.
Purpose of the Study:
- To analyze trends in pneumonia-related mortality and morbidity in children.
- To investigate the differing outcomes of primary versus secondary pneumonia.
- To identify factors contributing to the challenges in treating secondary pneumonia.
Main Methods:
- Retrospective analysis of death rates and treatment incidence for pneumonia in children aged one month to 15 years.
- Comparison of data from 1954-1958 and 1969-1973.
- Categorization of pneumonia cases into primary and secondary types.
Main Results:
- The yearly death rate from pneumonia in children (1 month-15 years) fell from 1.8 to 0.6 per ten thousand.
- The death rate for primary pneumonia decreased significantly, while secondary pneumonia mortality increased.
- The incidence of primary pneumonia cases fell by approximately 75%, and secondary pneumonia by 50%.
Conclusions:
- While overall pneumonia mortality has decreased, secondary pneumonia presents persistent treatment challenges, likely linked to underlying diseases or altered immune responses.
- The rise in secondary pneumonia mortality may be associated with unusual pathogens like Pneumocystis carinii.
- Further investigation into the management of secondary pneumonia and associated pathogens is warranted.
Abstract:
The yearly death-rate from pneumonia in children aged one month to 15 years has fallen in Schleswig-Holstein from 1.8 (1954-1958) to 0.6 per ten thousand (1969-1973). At the same time, total death-rate in the same age group has fallen from 14.5 to 9.3 per ten thousand children. The proportion of pneumonia in the total death-rate was 5.3% in 1971-1973, 1.6% in the first month of life and, after the sixteenth year, 2.3%. Pneumonia was in fourth place (after accident, malformation and neoplasm) as a cause of death in those more than one month old. The death-rate due to pneumonia had not fallen between 1954 and 1973, varying between 10% and 12%. While death-rate of "primary" pneumonia (without other underlying disease) had fallen from 5.7% (1954-1958) to 1.1% (1969-1973), the death-rate of "secondary" pneumonia rose from 16.8% to 21.4% during the same period. The total number of children aged between two months and 15 years treated for pneumonia fell by two thirds from 1954-1973 (1245 to 406). The incidence of "primary" pneumonia during the same period fell to about a quarter, that of "secondary" pneumonia to one half. The unsatisfactory result in the treatment of "secondary" pneumonia is probably due to the underlying primary disease or a weakening of defence mechanisms by treatment or the occurrence of unusual causative organisms (pneumocystis carinii, tubercle bacilli, Candida, Aspergillus), demonstrated only after death.