High pneumonia lifetime-ever incidence in Beijing children compared with locations in other countries, and implications for national PCV and Hib vaccination.
OBJECTIVE
To compare the proportion of Beijing children who have ever had pneumonia (%Pneumonia) to those in other locations, and to estimate by how much national vaccine coverage with Pneumococcal Conjugate Vaccine (PCV) and Haemophilus Influenzae Type b (Hib) could reduce Beijing %Pneumonia.


METHODS
%Pneumonia was obtained for each age group from 1 to 8 years inclusive from 5,876 responses to a cross-sectional questionnaire. Literature searches were conducted for world-wide reports of %Pneumonia. Previous vaccine trials conducted worldwide were used to estimate the pneumococcal (S. pneumoniae) and Hib (H. influenzae) burdens and %Pneumonia as well as the potential for PCV and Hib vaccines to reduce Beijing children's %Pneumonia.


RESULTS
The majority of pneumonia cases occurred by the age of three. The cumulative %Pneumonia for 3-8 year-old Beijing children, 26.9%, was only slightly higher than the 25.4% for the discrete 3 year-old age group, similar to trends for Tianjin (China) and Texas (USA). Beijing's %Pneumonia is disproportionally high relative to its Gross National Income (GNI) per capita, and markedly higher than %Pneumonia in the US and other high GNI per capita countries. Chinese diagnostic guidelines recommend chest X-ray confirmation while most other countries discourage it in favor of clinical diagnosis. Literature review shows that chest X-ray confirmation returns far fewer pneumonia diagnoses than clinical diagnosis. Accordingly, Beijing's %Pneumonia is likely higher than indicated by raw numbers. Vaccine trials suggest that national PCV and Hib vaccination could reduce Beijing's %Pneumonia from 26.9% to 19.7% and 24.9% respectively.


CONCLUSIONS
National PCV and Hib vaccination programs would substantially reduce Beijing children's pneumonia incidence.
China Meteorological Administration Training Centre, China Meteorological Administration, Beijing, China.|Department of Building Science, Tsinghua University, Beijing, China.
Fang
F
Qu
Independent Researcher, Colts Neck, New Jersey, United States of America.
Louise B
http://orcid.org/0000-0002-5778-6134
LB
Weschler
School of Environmental Science and Engineering, Tianjin University, Tianjin, China.
Yuexia
Y
Sun
Department of Building Science, Tsinghua University, Beijing, China.
Jan
J
Sundell
D000367:Age Factors; D000068476:Beijing / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D019741:Haemophilus influenzae type b / Q000276:immunology; D006801:Humans; D015994:Incidence; D007223:Infant; D007252:Influenza Vaccines / Q000276:immunology*; D008297:Male; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D011159:Population Surveillance; D013296:Streptococcus pneumoniae / Q000276:immunology; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000276:immunology*
D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate