Chest X-ray-confirmed pneumonia in children in Fiji.

To calculate the incidence and document the clinical features of chest X-ray- (CXR-) confirmed pneumonia in children aged between 1 month and 5 years living in Greater Suva, Fiji.

A retrospective review was undertaken of children aged between 1 month and 5 years with a discharge diagnosis suggesting a lower respiratory tract infection (LRTI) admitted to the Colonial War Memorial Hospital in Suva, Fiji, in the first 10 days of each month from 1 January 2001 to 31 December 2002. Clinical data were collected and CXRs were reread and classified according to WHO standardized criteria for CXR-confirmed pneumonia.

Two hundred and forty-eight children with LRTI met the inclusion criteria. CXRs were obtained for 174 (70%) of these cases, of which 59 (34%) had CXR-confirmed pneumonia. The annual incidence of CXR-confirmed pneumonia was 428 cases per 100,000 children aged between 1 month and 5 years living in Greater Suva. If a similar proportion of the children for whom CXRs were unavailable were assumed to have CXR-confirmed pneumonia, the incidence was 607 per 100,000. The incidence appeared to be higher in Melanesian Fijian than Indo-Fijian children. The case-fatality rate was 2.8% in all children with LRTI, and 6.8% in those with CXR-confirmed pneumonia.

This is the first study to document the incidence of CXR-confirmed pneumonia in a Pacific Island country, and demonstrates a high incidence. A significant proportion of hospital admissions of children with LRTI are likely to be preventable by the introduction of pneumococcal conjugate vaccine.

Keywords Pneumonia, Pneumococcal/diagnosis/epidemiology; Lung/radiography; Respiratory tract infections/classification/ epidemiology; Child; Retrospective studies; Fiji (source: MeSH, NLM).

Mots clés Pneumopathie à pneumocoque/diagnostic/épidémiologie; Poumon/radiographie; Voies aériennes supérieures, Infection/ classification/épidémiologie; Enfant; Etude rétrospective; Fidji (source: MeSH, INSERM).

Palabras clave Neumonía neumocócica/diagnóstico/epidemiología; Pulmón/radiografia; lnfecciones del tracto respiratorio/ dasificación/epidemiología; Estudios retrospectivos; Niño; Fiji (fuente: DeCS, BIREME).