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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Centre for International Child Health, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Parkville, Victoria 3052, Australia.
H C
HC
Magree
F M
FM
Russell
R
R
Sa'aga
P
P
Greenwood
L
L
Tikoduadua
J
J
Pryor
L
L
Waqatakirewa
J R
JR
Carapetis
E K
EK
Mulholland
D019985:Benchmarking; D002675:Child, Preschool; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging* / Q000382:microbiology; D008297:Male; D011018:Pneumonia, Pneumococcal / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D011859:Radiography; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000472:pathogenicity