title: Population-based burden of pneumonia before school entry in Schleswig-Holstein, Germany.
abstract: Community-acquired pneumonia (CAP) is of predominant interest in analysing the burden of airway diseases. No population-based incidence data for children in Germany exist. In retrospective cohort studies from 1999 to 2001, parents of an entire age-class (28,000-30,000) of 5- to 7-year-old children at school entry medical examination (S1) in a complete federal state (Schleswig-Holstein, population 2.77 million) were interviewed by the Children and Adolescent Service of the Public Health Service. CAP was defined as pneumonia diagnosed by a physician at the time it occurred. The proportion of children investigated (participation rate) was 82.0-86.1%. The CAP-positive rate was 6.7-7.4%, 6.9-8.2% of whom had recurrent CAP. The mean age at first CAP was 36.4-39.4 months (median 42 months). This resulted in a population-based incidence for the age groups 0-1 year and 0-5 years (under 5) of 1,664-1,932 and 1,369-1,690 per 100,000, respectively; 93.7-95.9% received antibiotics. For each percent of CAP, 458 days (1999), 312 days (2000) and 319 days (2001) of at least one parent's work were lost, respectively.
  
  
  CONCLUSIONS
  Despite a relatively weak case definition, the population-based incidence of CAP before school entry was the same as recently reported form California and about 30-50% of that reported 20 to 40 years ago in the USA and Finland.
authors.affiliation: Paediatric Infectious Diseases, Children's Hospital University Kiel, Kiel, Germany. weigl@pediatrics.uni-kiel.de
authors.forename: Josef A I
authors.initials: JA
authors.lastname: Weigl
authors.forename: Hans M
authors.initials: HM
authors.lastname: Bader
authors.forename: Achim
authors.initials: A
authors.lastname: Everding
authors.forename: Heinz J
authors.initials: HJ
authors.lastname: Schmitt
mesh_terms: D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D011014:Pneumonia / Q000453:epidemiology*; D012189:Retrospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data