title: [Community acquired pneumonia (CAP) in children younger than 5 years of age in southern Israel].
abstract: BACKGROUND
  Respiratory tract infections are a major cause of morbidity and mortality in children under the age of 5 years. The child population in southern Israel is divided into two main groups, Jewish and Bedouin, who differ in their socioeconomic status, with the Bedouin population living in lower socioeconomic conditions and overcrowding. Almost all children in southern Israel are treated at the Soroka University Medical Center.
  
  
  OBJECTIVE
  To compare the epidemiological and clinical data of Bedouin and Jewish children with community acquired pneumonia (CAP), who were treated at the Soroka University Medical Center.
  
  
  METHODS
  All chest X-rays of children under the age of 5 years, taken at the Pediatric Emergency room (PER) between the dates 4.11.2001 and 31.12.2007, were evaluated for pneumonia. Demographic and clinical data were collected to determine morbidity, hospitalization and mortality rates. Blood cultures and nasopharyngeal washes were taken to determine the pathogens of CAP.
  
  
  RESULTS
  A total of 38,045 chest radiographs were evaluated; CAP was diagnosed in 5,965 of them (15.6%). The risk of presenting to the PER with CAP in children under the age of 5 years was 8.3% in Bedouin children and 5.4% in Jewish children (p < 0.01). The cumulative risk for hospitalization due to CAP in children under the age of 5 years was 5.8% for the Bedouin children and 2.2% for the Jewish children (p < 0.01). The Bedouin children were younger than the Jewish children (43.5% under 1 year of age vs. 23.7% respectively, p < 0.01). Tachypnea, hypoxemia and mortality rates (71.9% vs. 61%, 31.7% vs. 18.6% and 3% vs. 0.3%, p < 0.01 respectively) were higher in Bedouin children than in Jewish children.
  
  
  CONCLUSIONS
  PER visits due to CAP are common, especially in Bedouin children. Bedouin patients were younger, with a more severe clinical course and with higher rates of morbidity, hospitalization and mortality than Jewish children. Improving living conditions, parental perception of disease severity and immunization programs (e.g. pneumococcal and influenza vaccine) could lead to a reduction in the gap between the two populations.
authors.affiliation: Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheba, Israel. Shalomb2@clalit.org.il
authors.forename: Shalom
authors.initials: S
authors.lastname: Ben-Shimol
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
authors.forename: Noga
authors.initials: N
authors.lastname: Givon-Lavi
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Bar-Ziv
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
mesh_terms: D018912:Arabs / Q000706:statistics & numerical data; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005843:Geography; D006785:Hospitals, University; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007585:Jews / Q000706:statistics & numerical data; D011014:Pneumonia / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013902:Radiography, Thoracic; D012959:Socioeconomic Factors