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The Burden of Childhood Pneumonia in the Developed World: A Review of the Literature

Madhi, Shabir A. MD, PhD*†; Wals, Philippe De MD; Grijalva, Carlos G. MD, MPH§; Grimwood, Keith MD; Grossman, Ronald MD; Ishiwada, Naruhiko MD**; Lee, Ping-Ing MD††; Nascimento-Carvalho, Cristiana MD, PhD‡‡; Nohynek, Hanna MD, PhD§§; O’Brien, Katherine L. MD, MPH¶¶; Vergison, Anne MD, PhD‖‖; Wolter, Joanne MB BS, PhD***

Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e3182784b26
Review Articles
Abstract

Background: Estimates of the disease burden from childhood pneumonia are available for most developed countries, but they are based mainly on models. Measured country-specific pneumonia burden data are limited to a few nations and differ in case definitions and case ascertainment methods. This review describes pneumonia disease burden in developed countries.

Methods: We reviewed studies describing childhood pneumonia incidence in North America, Europe, Australia, New Zealand and Japan. Available estimates suggest that each year in developed countries there are up to 2.6 million cases of pneumonia, including 1.5 million hospitalized cases and around 3000 pneumonia deaths (compared with approximately 640 annual deaths from meningitis) in children <5 years of age.

Results: Data to inform policy decisions would be improved by information on burden and etiology of severe pneumonia, population-based incidence of ambulatory visits and hospitalizations and prevalence of complications and sequelae.

Author Information

From the *Medical Research Council: Respiratory and Meningeal Pathogens Research Unit; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, South Africa; Department of Social and Preventive Medicine, Laval University, Quebec city, Canada; §Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN; Queensland Children’s Medical Research Institute, Royal Children’s Hospital, The University of Queensland, Brisbane, Australia; University of Toronto and Credit Valley Hospital, Mississauga, Ontario, Canada; **Department of Pediatrics, Chiba University Graduate school of Medicine, Chiba, Japan; ††National Taiwan University Hospital, Taipei, Taiwan; ‡‡Department of Pediatrics, Federal University of Bahia School of Medicine, Salvador, Brazil; §§Department of Vaccines and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland; ¶¶Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; ‖‖Pediatric Infectious Diseases, Infection Control and Epidemiology Unit, Univ Libre de Bruxelles, Brussels, Belgium; and ***Outcontractor to GlaxoSmithKline Vaccines Belgium, Australia.

Accepted for publication October 09, 2012.

GlaxoSmithKline Vaccines funded all costs associated with the development and the publishing of the present article. S.A.M. received an honorarium and travel support from GlaxoSmithKline to attend the Pneumonia Advisory Board on the 13th and 14th October 2010 in Leuven, Belgium. He has received consultancy fees for participation in expert boards from Pfizer, GlaxoSmithKline, Merck Sharp and Dohme and Novartis, and payment for lectures from Pfizer and GlaxoSmithKline. P.D.W. received consulting fees and travel support from GlaxoSmithKline to attend the Pneumonia Advisory Board on the 13th and 14th October 2010 in Leuven, Belgium. P.D.W. has received consulting fees for board memberships and research grants from GlaxoSmithKline, Pfizer and Novartis. C.G.G. received an honorarium and travel support from GlaxoSmithKline to attend the Pneumonia Advisory Board on the 13th and 14th October 2010 in Leuven, Belgium. K.G. received consulting fees and travel support from GlaxoSmithKline to attend the Pneumonia Advisory Board on the 13th and 14th October 2010 in Leuven, Belgium. He has also received lectures fees from GlaxoSmithKline for presentations on pneumococcal conjugate vaccines. R.G. is a member of Advisory Boards for the following companies: Merck, GlaxoSmithKline, Bayer Pharma, Novartis, Nycomed and Abbott Laboratories. He has received research support from GlaxoSmithKline and Novartis, payment for lectures from GlaxoSmithKline, Bayer Pharma, Novartis, Nycomed and Abbott Laboratories, payment for development of educational presentations from Bayer Pharma and GlaxoSmithKline, and payment for travel expenses unrelated to the activities listed from Bayer, Novartis and GlaxoSmithKline. C.N.-C. received money for expert testimony from GlaxoSmithKline, specifically to present data on the burden of pneumonia in Brazil and neighboring countries during the Pneumonia Advisory Board on the 13th and 14th October 2010 in Leuven, Belgium. H.N. received consulting fees from GlaxoSmithKline to attend the Pneumonia Advisory Board on the 13th and 14th October 2010 in Leuven, Belgium. She has received money for board memberships and payment for lectures relating to pneumococcal vaccines from Pfizer, has served as technical advisor in pneumococcal conjugate vaccine development issues for GlaxoSmithKline and Pfizer and as a scientific consultant for Encorium. She was the coordinator of a phase III trial on 11-valent pneumococcal conjugate vaccine, which received funding support from Sanofi Pasteur. K.L.O.B. has current research grant support from GlaxoSmithKline and has participated in ad hoc external expert committees on pneumococcal vaccines for Merck, Sanofi Pasteur, GlaxoSmithKline and Pfizer. A.V. has received support from GlaxoSmithKline for travel to attend scientific meetings and has participated in advisory boards and given lectures on pneumococcal disease for Pfizer and GlaxoSmithKline. She has received institutional support and grants from Merck Sharp and Dohme for unrelated board memberships and research activities. J.W. is an independent consultant and medical writer who received funding from GlaxoSmithKline Vaccines to perform the literature review and write the first draft of this article. The authors have no other funding or conflicts of interest to disclose.

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Address for correspondence: Shabir A. Madhi, MD, PhD, National Institute for Communicable Diseases: a division of National Health Laboratory Service, 1 Modderfontein Road, Sandringham Gauteng, 131. South Africa. E-mail: shabirm@nicd.ac.za.

© 2013 Lippincott Williams & Wilkins, Inc.