Population-based burden of pneumonia before school entry
in Schleswig-Holstein, Germany
Josef A. I. Weigl1, 2, 3 , Hans M. Bader4,
Achim Everding4 and Heinz J. Schmitt2
(1)
Paediatric Infectious Diseases,
Children's Hospital University Kiel, Kiel, Germany
(2)
Paediatric Infectious Diseases and
Centre for Preventive Medicine, University Mainz, Germany
(3)
Paediatric Infectious Diseases,
Department of General Paediatrics, Christian-Albrechts-University,
Schwanenweg 20, 24105 Kiel, Germany
(4)
Children and Adolescent Service within
the Public Health Service, 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 (28,00030,000) 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 82.086.1%.
The CAP-positive rate was 6.77.4%, 6.98.2% of whom had recurrent CAP.
The mean age at first CAP was 36.439.4 months (median 42 months). This
resulted in a population-based incidence for the age groups 01 year and
05 years (under 5) of 1,6641,932 and 1,3691,690 per 100,000,
respectively; 93.795.9% 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 3050% of that reported 20 to 40 years ago in the USA and Finland.
Keywords Cohort - Pneumonia - School
entry - Incidence - Public health service
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