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Volume 49, Number 2, April 2016

Population-based incidence of community-acquired pneumonia hospitalization in Hong Kong children younger than 5 years before universal conjugate pneumococcal immunization 


Susan S. Chiu, Pak-Leung Ho, Pek-Lan Khong, Clara Ooi, Lok Yee So, Wilfred H.S. Wong, Eunice L.Y. Chan


 

Corresponding author:

Susan S. Chiu, Corresponding author. Department of Pediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China. 



 

Background and purpose: 

We sought to document the incidence of pediatric hospitalization for bacterial pneumonia before universal childhood conjugate pneumococcal vaccination using two different methods of diagnosis.
 



 

Methods:

By following the World Health Organization (WHO) chest radiography (CXR) protocol, two radiologists independently read the CXRs of a cohort of systematically recruited children younger than 5 years. The children had acute respiratory infections and were admitted to one of two hospitals that care for 72.5% of all pediatric admissions on Hong Kong Island. Medical records were reviewed for clinical manifestation and to identify bacterial pneumonia diagnosed by pediatricians. 



 

Results:

In children younger than 5 years, the incidences of bacterial pneumonia, as diagnosed by pediatricians and by the WHO CXR standard, were 775.7 per 100,000 population [95% confidence interval (CI, 591.8–998.3)] and 439.5 per 100,000 population (95% CI, 304.6–614.5), respectively. The study period was from 2002 to 2004. 



 

Conclusion:

This study provided a reliable baseline estimate of the hospitalization burden of pneumococcal pneumonia in Hong Kong children before the advent of universal conjugate pneumococcal vaccination. 



 

Key words:

chest X-ray, children, community-acquired pneumonia, hospitalization