MacIntyre C R, McIntyre P B, Cagney M
National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
Epidemiol Infect. 2003 Dec;131(3):1091-6. doi: 10.1017/s0950268803001365.
The aim was to estimate the community incidence and risk factors for all-cause pneumonia in children in Western Sydney, Australia. A cross-sectional randomized computer-assisted telephone interview was conducted in July 2000, in Western Sydney. Parents of 2020 children aged between 5 and 14 years were interviewed about their child's respiratory health since birth. No verification of reported diagnosis was available. Logistic regression analysis was used to determine risk factors for pneumonia. A lifetime diagnosis of pneumonia was reported in 137/2020 (68%) children, giving an estimated incidence in the study sample of 7.6/1000 person-years. Radiological confirmation was reported in 85% (117/137). Hospitalization was reported in 41% (56/137) and antibiotic therapy in 93% (127/137) of cases. Using logistic regression modelling, statistically significant associations with pneumonia were a reported history of either asthma, bronchitis or other lung problems and health problems affecting other systems. In most cases, the diagnosis of asthma preceded the diagnosis of pneumonia. The community incidence of all causes of pneumonia is not well enumerated, either in adults or in children. This study provides community-based incidence data. The incidence of hospitalization for pneumonia in this study is comparable to estimates from studies in comparable populations, suggesting that retrospective parental report for memorable events is likely to be valid. We found a relationship between pneumonia and childhood respiratory diseases such as asthma, which has implications for targeted vaccination strategies.
目的是估算澳大利亚悉尼西部儿童全因性肺炎的社区发病率及风险因素。2000年7月在悉尼西部进行了一项横断面随机计算机辅助电话访谈。对2020名年龄在5至14岁儿童的家长就其孩子自出生以来的呼吸健康状况进行了访谈。无法对所报告的诊断进行核实。采用逻辑回归分析来确定肺炎的风险因素。在2020名儿童中有137名（6.8%）报告有一生患肺炎的诊断，据此估算研究样本中的发病率为每1000人年7.6例。85%（117/137）的病例有放射学确诊依据。41%（56/137）的病例报告有住院治疗，93%（127/137）的病例报告使用了抗生素治疗。采用逻辑回归模型分析，与肺炎有统计学显著关联的因素为报告有哮喘、支气管炎或其他肺部问题病史以及影响其他系统的健康问题。在大多数情况下，哮喘诊断先于肺炎诊断。无论是成人还是儿童，全因性肺炎的社区发病率都未得到充分统计。本研究提供了基于社区的发病率数据。本研究中肺炎的住院发病率与可比人群研究的估算结果相当，这表明家长对难忘事件的回顾性报告可能是有效的。我们发现肺炎与哮喘等儿童呼吸道疾病之间存在关联，这对针对性的疫苗接种策略具有启示意义。
