EPIDEMIOLOGY AND DISEASE BURDEN OF PNEUMONIA IN KOREAN CHILDREN: IMPLICATIONS FOR IMPROVED TREATMENT AND PREVENTION

초록

Background: Globally, lower respiratory tract infections, including pneumonia, are common cause of childhood hospitalization and death but there are no large-scale studies that describe the epidemiology and disease burden of pneumonia hospitalizations among Asian children. Method: In Korea, 13 hospitals conducted a retrospective study of pediatric admission and discharge records as well as clinical laboratory specimen, bacterial isolate and chest radiography records from July 1, 2000 through June 30, 2003. Data were analyzed to describe patterns by age group, month, hospital and bacterial isolate. Hospital discharge records for children aged<5 years at each study hospital were identified using ICD-10 codes to estimate the disease burden of pneumonia. Result: Over the 3-year study period, 131,244 all-cause hospitalizations for children<5 years of age were identified and 14% of these were associated with pneumonia. Annual childhood pneumonia hospitalizations increased 44% from 4,725 in 2001-01 to 7,842 in 2002-3(mean annual rate: 144/1,000 all-cause hospitalizations). Invasive specimens(e.g. blood) tested by bacterial culture increased 48% from 31,456 to 60,271. For the 3-year period, S.pneumoniae accounted for 76%(n=928) of isolates representing major invasive bacterial pathogens. Chest radiograph utilization increased 43% and those interpreted by a radiologist increased 52%. One out of every 7 hospitalizations for children<5 years of age in Korea were associated with pneumonia. Conclusions: The substantial disease burden of pneumonia in Korean children underscores the urgent need for enhanced surveilance to guide development of improved treatment and control strategies.