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Hospitalization Rate and Population-based Incidence of Hospitalization for Community-acquired Pneumonia Among Children in Suzhou, China

Shan, Wei, MPH*,†,‡; Shi, Ting, MD§; Zhang, Xiyan, MPH*,†,‡; Xue, Jian, MD§; Wang, Yin, MPH*,†,‡; Yu, Jia, MPH*,†,‡; Huang, Yukai, MPH*,†,‡; Lin, Sheng, MPH*,†,‡; Zhao, Genming, PhD*,†,‡; Tian, Jianmei, MD§; Zhang, Tao, PhD*,†,‡

The Pediatric Infectious Disease Journal: December 2018 - Volume 37 - Issue 12 - p 1242–1247
doi: 10.1097/INF.0000000000002016
Original Studies

Background: Data on hospitalization burden of community-acquired pneumonia (CAP) in children are very limited in China. This study aimed to estimate the hospitalization rate (HR) and population-based incidence of hospitalization of CAP for children <15 years of age in Suzhou, China.

Methods: This was a retrospective study of children hospitalized in Soochow University Affiliated Children’s Hospital from January 2010 to December 2014. Children who were residents of downtown Suzhou, 29 days to <15 years of age, with discharge diagnosis codes (International Classification of Diseases, 10th revision) including J09–J18 and J20–J22 were included. All-cause clinical community-acquired pneumonia (CCAP) and radiographically confirmed pneumonia (RCAP) were identified based on individual medical chart review. The HR and population-based cumulative incidence of hospitalization (HI) were calculated.

Results: Among 184,734 children <15 years of age admitted to Soochow University Affiliated Children’s Hospital during the study period, 31,302 children were identified as having CCAP and 24,218 (77.4%) children confirmed as having RCAP. CCAP hospitalization occurred year round and peaked during winter and early spring. The overall HRs for CCAP and RCAP were 189.0 [95% confidence interval (CI): 187.1–190.9] and 146.2 (95% CI: 144–148) per 1000 hospitalizations, respectively, and the HIs per 100,000 children annually were CCAP, 3235.8 (95% CI: 3207.3–3264.2) and RCAP, 2503.5 (95% CI: 2478.3–2528.6). For children <5 years of age, the HR for CCAP was 248.4 (95% CI: 245.9–250.9) and RCAP was 194.0 (95% CI: 191.4–196.3) per 1000 hospitalizations; the HI for CCAP was 6956.2 (95% CI: 6892.8–7019.6) and 5431.9 (95% CI: 5375.4–5488.4) per 100,000 children for RCAP. The highest HR and HI were observed in children 29 days to <6 months of age: HR for CCAP was 407.4 (95% CI: 400.9–413.9) per 1000 hospitalizations and HI for CCAP was 11,203.7 (95% CI: 11,026.8–11,380.6) per 100,000 children annually.

Conclusions: There is a considerable burden of CAP among children <15 years of age in Suzhou, particularly among children 29 days to <6 months of age and during winter and early spring. These data provide valuable information to monitor CAP trends over time in children of Suzhou, China.

From the *Department of Epidemiology, School of Public Health, Fudan University

Key Laboratory of Public Health Safety, Ministry of Education

Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China

§Soochow University Affiliated Children’s Hospital, Suzhou, China.

Accepted for publication February 1, 2018.

This study was sponsored by Fudan University. Funding was provided by Pfizer, Inc., Shanghai Municipal Commission of Health and Family Planning (GWTD2015S05 and 15GWZK0101), Suzhou Municipal Commission of Health and Family Planning (LCZX201508 and SZXK201508), the National Key Research and Development Program of China (2017YFC0211700) and SINO-US collaborative program on Emerging and Re-emerging Infectious Diseases (5U2GGH000018). The founders have no role in study design, data collection, data analysis and draft of manuscript.

The authors have no conflicts of interest to disclose.

Address for correspondence: Tao Zhang, PhD, Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China. E-mail: or Jianmei Tian, MD, Soochow University Affiliated Children’s Hospital, No. 92 Zhong Nan Street, Suzhou, China. E-mail:

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