1
|
Li Y, Liu C, Shi T, Sheng M, Chen Q, Zhu J, He N, Zhao G, Tian J, Zhang T. The Epidemiologic and Clinical Features of Radiographic-Confirmed Community-Acquired Pneumonia Among Chinese Children: A Retrospective Hospital-Based Study. Pediatr Infect Dis J 2024:00006454-990000000-00969. [PMID: 39105527 DOI: 10.1097/inf.0000000000004509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND To help understand the disease burden of vaccine-preventable bacterial disease, we delineated the epidemiologic and clinical characteristics of radiographic-confirmed community-acquired pneumonia (CXR-CAP) among Chinese children. METHODS We retrospectively screened the electronic database of the hospital information system to identify all pediatric CAP cases admitted to the Children's Hospital of Soochow University between 2010 and 2014. Radiographic findings and clinical data were extracted from the medical charts through individual chart reviews. CXR-CAP cases were defined as the presence of consolidation or pleural effusion noted on chest radiograph reports. We employed a multivariate logistic regression model to identify the potential risk factors associated with CXR-CAP. RESULTS Among the 27,485 hospitalized CAP cases with radiologic data, 6322 (23.00%) were identified as CXR-CAP cases, while 21,163 (77.00%) were categorized as non-CXR-CAP cases. Children with CXR-CAP were notably older than those without CXR-CAP (non-CXR-CAP; χ2 = 1313.22; P < 0.01). CXR-CAP cases exhibited a higher rate of intensive care unit admission (3.55% vs. 1.94%; P < 0.01), extended hospital stays (73.87% vs. 63.79%; P < 0.01) and increased mortality rates (0.19% vs. 0.04%; P < 0.01). The factors associated with CXR-CAP included age (>12 months), season (summer and autumn), fever, abnormal breath sounds, C-reactive protein (>8 mg/L) and alanine transaminase (>40 U/L). CONCLUSIONS CXR-CAP cases consisted of a substantial proportion of hospitalized patients with CAP and had more severe clinical manifestations than in-patients without CXR-CAP among Chinese children.
Collapse
Affiliation(s)
- Yudan Li
- From the Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Changpeng Liu
- From the Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Ting Shi
- Children's Hospital of Soochow University, Suzhou, China
| | - Mao Sheng
- Children's Hospital of Soochow University, Suzhou, China
| | - Qinghui Chen
- Children's Hospital of Soochow University, Suzhou, China
| | - Jun Zhu
- Children's Hospital of Soochow University, Suzhou, China
| | - Na He
- From the Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Genming Zhao
- From the Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jianmei Tian
- Children's Hospital of Soochow University, Suzhou, China
| | - Tao Zhang
- From the Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| |
Collapse
|
2
|
Lu Y, Chen Q, Ren S, Zhang Y, Yi L, Qian C, Shen J, Liu X, Jiang M, Wang B, Song J, Shao X, Zhang T, Tian J, Zhao G. Impact of COVID-19 Nonpharmaceutical Interventions on Respiratory Syncytial Virus Infections in Hospitalized Children. Influenza Other Respir Viruses 2024; 18:e13291. [PMID: 38653953 DOI: 10.1111/irv.13291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/14/2024] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Nonpharmaceutical interventions (NPIs) targeted at SARS-CoV-2 have remarkably affected the circulation of other respiratory pathogens, including respiratory syncytial virus (RSV). This study aimed to assess the changes in epidemiological and clinical characteristics of RSV infections in hospitalized children before and during the pandemic in Suzhou, China. METHODS We prospectively enrolled children aged < 18 years who were hospitalized in Soochow University Affiliated Children's Hospital with acute lower respiratory infection (ALRIs) from January 2018 to July 2022. Changes in epidemiological and clinical characteristics of RSV infections were analyzed. RESULTS Compared with the same period in 2018-2019, the difference in the overall positive rate of RSV was not statistically significant in 2020, while it increased significantly in 2021 (11.8% [662/5621] vs. 20.8% [356/1711], p < 0.001) and 2022 (9.0% [308/3406] vs. 18.9% [129/684], p < 0.001). Specifically, the positive rates declined considerably from October to December 2020 but sharply increased during the summer of 2021. Compared to prepandemic period, RSV infections were more frequently observed in older children during the pandemic. RSV-positive children exhibited milder clinical characteristics during the COVID-19 pandemic, including decreased proportion of patients with hospital stay ≥ 11 days (10.3% vs. 6.7%, p < 0.05), less requirement for oxygen therapy (13.7% vs. 6.9%, p < 0.001), and fewer cases of polypnea (12.2% vs. 9.7%, p < 0.05) and wheeze (50.1% vs. 42.9%, p < 0.001). CONCLUSIONS The implementation of multilayered NPIs targeted at COVID-19 has affected the activity of RSV. Ongoing monitoring of RSV is warranted as the changing RSV epidemiology can provide valuable insights for future healthcare system planning.
Collapse
Affiliation(s)
- Yingfeng Lu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Qinghui Chen
- Department of Infectious Diseases, Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Shaolong Ren
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Youyi Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Liping Yi
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Chen Qian
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Jiaming Shen
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Xiaofei Liu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Miao Jiang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Biying Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Jian Song
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Xuejun Shao
- Clinical Laboratory, Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Tao Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Jianmei Tian
- Department of Infectious Diseases, Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| |
Collapse
|
3
|
Wetzke M, Schütz K, Kopp MV, Seidenberg J, Vogelberg C, Ankermann T, Happle C, Voigt G, Köster H, Illig T, Lex C, Schuster A, Maier R, Panning M, Barten G, Rohde G, Welte T, Hansen G. Pathogen spectra in hospitalised and nonhospitalised children with community-acquired pneumonia. ERJ Open Res 2023; 9:00286-2022. [PMID: 36923566 PMCID: PMC10009707 DOI: 10.1183/23120541.00286-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background Paediatric community-acquired pneumonia (CAP) is a leading cause of paediatric morbidity. However, particularly for outpatients with paediatric CAP, data on aetiology and management are scarce. Methods The prospective pedCAPNETZ study multicentrically enrols children and adolescents with outpatient-treated or hospitalised paediatric CAP in Germany. Blood and respiratory specimens were collected systematically, and comprehensive analyses of pathogen spectra were conducted. Follow-up evaluations were performed until day 90 after enrolment. Results Between December 2014 and August 2020, we enrolled 486 children with paediatric CAP at eight study sites, 437 (89.9%) of whom had radiographic evidence of paediatric CAP. Median (interquartile range) age was 4.5 (1.6-6.6) years, and 345 (78.9%) children were hospitalised. The most prevalent symptoms at enrolment were cough (91.8%), fever (89.2%) and tachypnoea (62.0%). Outpatients were significantly older, displayed significantly lower C-reactive protein levels and were significantly more likely to be symptom-free at follow-up days 14 and 90. Pathogens were detected in 90.3% of all patients (one or more viral pathogens in 68.1%; one or more bacterial strains in 18.7%; combined bacterial/viral pathogens in 4.1%). Parainfluenza virus and Mycoplasma pneumoniae were significantly more frequent in outpatients. The proportion of patients with antibiotic therapy was comparably high in both groups (92.4% of outpatients versus 86.2% of hospitalised patients). Conclusion We present first data on paediatric CAP with comprehensive analyses in outpatients and hospitalised cases and demonstrate high detection rates of viral pathogens in both groups. Particularly in young paediatric CAP patients with outpatient care, antibiotic therapy needs to be critically debated.
Collapse
Affiliation(s)
- Martin Wetzke
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in End stage and Obstructive Lung Disease (BREATH) Hannover and Airway Research Center North (ARCN) Lübeck, Member of the German Center for Lung Research (DZL), Lübeck, Germany.,These authors contributed equally
| | - Katharina Schütz
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Excellence Cluster RESIST (EXC 2155), Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) Hannover, Hannover, Germany.,These authors contributed equally
| | - Matthias Volkmar Kopp
- Biomedical Research in End stage and Obstructive Lung Disease (BREATH) Hannover and Airway Research Center North (ARCN) Lübeck, Member of the German Center for Lung Research (DZL), Lübeck, Germany.,Department of Paediatric Allergy and Pulmonology, Clinic of Pediatrics UKSH, University of Luebeck, Lübeck, Germany.,Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland
| | - Jürgen Seidenberg
- Department of Paediatric Pneumology and Allergology, Universitätsklinik für Kinder- und Jugendmedizin Oldenburg, Oldenburg, Germany
| | - Christian Vogelberg
- University Children's Hospital, Technical University Dresden, Dresden, Germany
| | - Tobias Ankermann
- Department of Paediatric Pulmonology, Clinic of Pediatrics UKSH, University of Kiel, Kiel, Germany
| | - Christine Happle
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in End stage and Obstructive Lung Disease (BREATH) Hannover and Airway Research Center North (ARCN) Lübeck, Member of the German Center for Lung Research (DZL), Lübeck, Germany.,Excellence Cluster RESIST (EXC 2155), Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) Hannover, Hannover, Germany
| | - Gesche Voigt
- Department of Paediatric Allergy and Pulmonology, Clinic of Pediatrics UKSH, University of Luebeck, Lübeck, Germany
| | - Holger Köster
- Department of Paediatric Pneumology and Allergology, Universitätsklinik für Kinder- und Jugendmedizin Oldenburg, Oldenburg, Germany
| | - Thomas Illig
- Biomedical Research in End stage and Obstructive Lung Disease (BREATH) Hannover and Airway Research Center North (ARCN) Lübeck, Member of the German Center for Lung Research (DZL), Lübeck, Germany.,Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Christiane Lex
- Department of Paediatric Pulmonology, University of Göttingen, Göttingen, Germany
| | - Antje Schuster
- Department of Paediatrics, University of Düsseldorf, Düsseldorf, Germany
| | - Ralph Maier
- Private Practice for Children, Tuttlingen, Germany
| | - Marcus Panning
- Institute of Virology, University of Freiburg, Freiburg, Germany
| | - Grit Barten
- Biomedical Research in End stage and Obstructive Lung Disease (BREATH) Hannover and Airway Research Center North (ARCN) Lübeck, Member of the German Center for Lung Research (DZL), Lübeck, Germany.,CAPNETZ STIFTUNG, Hannover, Germany
| | - Gernot Rohde
- CAPNETZ STIFTUNG, Hannover, Germany.,Department of Respiratory Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Tobias Welte
- Biomedical Research in End stage and Obstructive Lung Disease (BREATH) Hannover and Airway Research Center North (ARCN) Lübeck, Member of the German Center for Lung Research (DZL), Lübeck, Germany.,Department of Pulmonary Medicine, German Centre for Lung Research, Hannover Medical School, Hannover, Germany
| | - Gesine Hansen
- Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in End stage and Obstructive Lung Disease (BREATH) Hannover and Airway Research Center North (ARCN) Lübeck, Member of the German Center for Lung Research (DZL), Lübeck, Germany.,Excellence Cluster RESIST (EXC 2155), Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) Hannover, Hannover, Germany
| |
Collapse
|
4
|
Feng J, Zhang C, Chen H, Chen Z, Chen Y, He D, Pan Q, Zhou Y, Chen Z, Zhuang X. Shen-Ling-Bai-Zhu-San Enhances the Antipneumonia Effect of Cefixime in Children by Ameliorating Gut Microflora, Inflammation, and Immune Response. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:7752426. [PMID: 36118084 PMCID: PMC9473888 DOI: 10.1155/2022/7752426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/09/2022] [Accepted: 08/20/2022] [Indexed: 11/24/2022]
Abstract
Objective Shen-Ling-Bai-Zhu-San (SLBZS) is used for treating gastrointestinal disorders. However, the role of SLBZS in treating pneumonia in children is still unclear. Methods In this study, children (≥2 and <9 years) with pneumonia were treated with 0.1 g cefixime (cefixime group) or 0.1 g cefixime + 9 g SLBZS (SLBZS + cefixime). The drugs were administered twice daily for 10 days. The therapeutic effects of the two groups were compared. The white blood cell (WBC), neutrophil, and lymphocyte counts; neutrophil-lymphocyte ratio (NLR); serum inflammatory factor levels; and gut microflora were assessed. Results The clinical efficacy of SLBZS + cefixime treatment of pneumonia in children was higher than that of cefixime alone (93.3% vs. 86.7%). Both cefixime and SLBZS + cefixime treatments decreased the area of pulmonary inflammatory lesions, reduced white blood cell and neutrophil counts, neutrophil-lymphocyte ratio, inflammation, and increased lymphocyte count in children with pneumonia compared with those before treatment. Moreover, SLBZS enhanced the anti-inflammation and immunity-enhancing effects of cefixime in children with pneumonia. SLBZS + cefixime treatment decreased Enterobacter, Enterococcus, Bacteroides, and Fusobacterium counts and increased Bifidobacterium and Lactobacillus counts. Compared with the cefixime treatment group, the count of the six bacterial strains in the SLBZS + cefixime treatment group was closer to the normal level. Conclusion SLBZS enhanced the antipneumonia effect of cefixime in children with pneumonia by ameliorating gut microflora, inflammation, and immune response.
Collapse
Affiliation(s)
- Jinli Feng
- Emergency Department, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| | - Cheng Zhang
- Clinical Laboratory, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| | - Houjun Chen
- Emergency Department, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| | - Ziliang Chen
- Emergency Department, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| | - Yongfeng Chen
- Emergency Department, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| | - Degen He
- Pediatrics, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| | - Qianyi Pan
- Prevention and Health Section, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| | - Yongmao Zhou
- Pediatrics, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| | - Zhaoyang Chen
- Pediatrics, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| | - Xiaozheng Zhuang
- Pediatrics, Zhongshan Hospital, Guangzhou University of Chinese Medicine, Zhongshan, Guangdong 528401, China
| |
Collapse
|
5
|
Ren S, Shi T, Shan W, Shen S, Chen Q, Zhang W, Dai Z, Xue J, Zhang T, Tian J, Zhao G. Hospitalization rate of respiratory syncytial virus-associated acute lower respiratory infection among young children in Suzhou, China, 2010-2014. Influenza Other Respir Viruses 2022; 16:789-799. [PMID: 34989118 PMCID: PMC9178065 DOI: 10.1111/irv.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background There is a limited amount of data in China on the disease burden of respiratory syncytial virus‐ (RSV) associated acute lower respiratory infection (ALRI) among young children. This study aimed to estimate the hospitalization rate of RSV‐associated ALRI (RSV‐ALRI) among children aged 0–59 months in Suzhou, China. Methods All cases from children hospitalized with ALRI who were aged 0–59 months in Suzhou University Affiliated Children's Hospital during January 2010 to December 2014 were retrospectively identified. Detailed diagnosis and treatment data were collected by reviewing each individual's medical chart. In accordance with the World Health Organization (WHO) influenza disease burden estimation, the hospitalization rate of RSV‐ALRI among children aged 0–59 months in Suzhou, China, was then estimated. Results Out of the 28,209 ALRI cases, 19,317 (68.5%) were tested for RSV, of which the RSV positive proportion was 21.3% (4107/19,317). The average hospitalization rate of RSV‐ALRI for children aged 0–59 months was 14 (95% confidence interval [CI]:14–14)/1000 children years, and that for children aged 0–5, 6–11, 12–23, and 24–59 months were 70 (95% CI: 67–73), 31 (95% CI: 29–33), 11 (95% CI: 10–12), and 3 (95% CI: 3–3)/1000 children years, respectively. Conclusion A considerable degree of RSV‐ALRI hospitalization exists among children aged 0–59 months, particularly in those under 1 year of age. Therefore, an effective monoclonal antibody or vaccine is urgently needed to address the substantial hospitalization burden of RSV infection.
Collapse
Affiliation(s)
- Shaolong Ren
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Ting Shi
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Wei Shan
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Si Shen
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Qinghui Chen
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Wanqing Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Zirui Dai
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jian Xue
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Tao Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jianmei Tian
- Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| |
Collapse
|
6
|
Chen K, Zhang X, Tao Y, Wang Y, Xue J, Liu C, Feng S, Yan Y, Chen Q, Tian J, Zhao G, Shao X, Zhang T. Hospitalization for Invasive Pneumococcal Diseases in Young Children before Use of 13-Valent Pneumococcal Conjugate Vaccine, Suzhou, China. Emerg Infect Dis 2021; 27:69-75. [PMID: 33350921 PMCID: PMC7774583 DOI: 10.3201/eid2701.181415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease (IPD) was introduced in China in April 2017. We describe 105 children <5 years of age who were hospitalized for IPD at Soochow University Affiliated Children’s Hospital in Suzhou, China, during January 2010–December 2017. We calculated the incidence of hospitalization for IPD as 14.55/100,000 children in Suzhou. We identified 8 different capsular serotypes: 6B (28.4% of cases), 14 (18.9% of cases), 19A (18.9% of cases), 19F (12.2% of cases), 23F (10.8% of cases), 20 (4.1% of cases), 9V (4.1% of cases), and 15B/C (2.7% of cases). These results provide baseline data of IPD before the introduction of this vaccine in China, enabling researchers to better understand its effects on IPD incidence.
Collapse
|
7
|
Sun Y, Li H, Pei Z, Wang S, Feng J, Xu L, Gao P, Cao B, Zhan S. Incidence of community-acquired pneumonia in urban China: A national population-based study. Vaccine 2020; 38:8362-8370. [PMID: 33199077 DOI: 10.1016/j.vaccine.2020.11.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Community-acquired pneumonia (CAP) is one of the major global health problems worldwide. However, the epidemiological information of CAP is limited in China. This study aimed to estimate the incidence rate of CAP and describe the epidemiologic characteristics among the Chinese population. METHODS We conducted a retrospective analysis of CAP incidence using the Chinese Urban Basic Medical Insurance database of 23 provinces in 2016, which covered 427.52 million urban beneficiaries of all age groups in Mainland China. CAP episodes were identified using a diagnosis-term-derived algorithm, and multiple CAP records of one single person within 90 continuous days were considered as one single episode. The incidence rates were calculated and described by sex, age, region, and season. RESULTS A total of 1.42 million patients were identified as having one or more CAP episodes, and finally a sum of 1.48 million CAP episodes were counted. The overall incidence of CAP was 7.13 (95% CI: 6.11-8.15) per 1000 person-years, in males 7.32 (95% CI: 6.28-8.35) and females 6.93 (95% CI: 5.92-7.94) per 1000 person-years, respectively. The incidence varied by age with a U-shaped curve peaking in children aged < 5 years old [65.80 (95% CI: 62.52-69.08)] and elderly population aged ≥ 80 years old [14.98 (95% CI: 13.63-16.34)]. The incidence varied markedly by regions. Furthermore, the rate showed a clear seasonal trend, which peaked in spring, decreased in summer and autumn, and re-ascended in winter. CONCLUSION This study reveals a relatively high level of CAP incidence in China. These findings provide baseline data for establishing effective prevention strategies, targeted at susceptible populations, regions, and seasons in China.
Collapse
Affiliation(s)
- Yixin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Hui Li
- Department of Pulmonary and Critical Care Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China; Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China
| | - Zhengcun Pei
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jingnan Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China; Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
| |
Collapse
|