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.
Magree
H C
HC
Centre for International Child Health, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Parkville, Victoria 3052, Australia.
Russell
F M
FM
Sa'aga
R
R
Greenwood
P
P
Tikoduadua
L
L
Pryor
J
J
Waqatakirewa
L
L
Carapetis
J R
JR
Mulholland
E K
EK
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