Ben-Shimol Shalom, Dagan Ron, Givon-Lavi Noga, Bar-Ziv Yaakov, Greenberg David
Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheba, Israel.
Harefuah. 2010 Mar;149(3):137-42, 196.
Respiratory tract infections are a major cause of morbidity and mortality in children under the age of 5 years. The child population in southern Israel is divided into two main groups, Jewish and Bedouin, who differ in their socioeconomic status, with the Bedouin population living in lower socioeconomic conditions and overcrowding. Almost all children in southern Israel are treated at the Soroka University Medical Center.
To compare the epidemiological and clinical data of Bedouin and Jewish children with community acquired pneumonia (CAP), who were treated at the Soroka University Medical Center.
All chest X-rays of children under the age of 5 years, taken at the Pediatric Emergency room (PER) between the dates 4.11.2001 and 31.12.2007, were evaluated for pneumonia. Demographic and clinical data were collected to determine morbidity, hospitalization and mortality rates. Blood cultures and nasopharyngeal washes were taken to determine the pathogens of CAP.
A total of 38,045 chest radiographs were evaluated; CAP was diagnosed in 5,965 of them (15.6%). The risk of presenting to the PER with CAP in children under the age of 5 years was 8.3% in Bedouin children and 5.4% in Jewish children (p < 0.01). The cumulative risk for hospitalization due to CAP in children under the age of 5 years was 5.8% for the Bedouin children and 2.2% for the Jewish children (p < 0.01). The Bedouin children were younger than the Jewish children (43.5% under 1 year of age vs. 23.7% respectively, p < 0.01). Tachypnea, hypoxemia and mortality rates (71.9% vs. 61%, 31.7% vs. 18.6% and 3% vs. 0.3%, p < 0.01 respectively) were higher in Bedouin children than in Jewish children.
PER visits due to CAP are common, especially in Bedouin children. Bedouin patients were younger, with a more severe clinical course and with higher rates of morbidity, hospitalization and mortality than Jewish children. Improving living conditions, parental perception of disease severity and immunization programs (e.g. pneumococcal and influenza vaccine) could lead to a reduction in the gap between the two populations.
呼吸道感染是5岁以下儿童发病和死亡的主要原因。以色列南部的儿童群体主要分为犹太人和贝都因人两组，他们的社会经济地位不同，贝都因人生活在社会经济条件较差且居住拥挤的环境中。以色列南部几乎所有儿童都在索罗卡大学医学中心接受治疗。
比较在索罗卡大学医学中心接受治疗的患社区获得性肺炎（CAP）的贝都因儿童和犹太儿童的流行病学及临床数据。
对2001年11月4日至2007年12月31日期间在儿科急诊室（PER）拍摄的所有5岁以下儿童的胸部X光片进行肺炎评估。收集人口统计学和临床数据以确定发病率、住院率和死亡率。采集血培养和鼻咽冲洗样本以确定CAP的病原体。
共评估了38045张胸部X光片；其中5965例（15.6%）被诊断为CAP。5岁以下儿童因CAP前往PER就诊的风险在贝都因儿童中为8.3%，在犹太儿童中为5.4%（p<0.01）。5岁以下儿童因CAP住院的累积风险在贝都因儿童中为5.8%，在犹太儿童中为2.2%（p<0.01）。贝都因儿童比犹太儿童年龄小（分别为43.5%小于1岁和23.7%，p<0.01）。贝都因儿童的呼吸急促、低氧血症和死亡率（分别为71.9%对61%、31.7%对18.6%和3%对0.3%，p均<0.01）高于犹太儿童。
因CAP前往PER就诊很常见，尤其是在贝都因儿童中。与犹太儿童相比，贝都因患者年龄更小，临床病程更严重，发病率、住院率和死亡率更高。改善生活条件、提高家长对疾病严重性的认识以及免疫计划（如肺炎球菌和流感疫苗）可能会缩小这两个人群之间的差距。
