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Rates of radiologically confirmed pneumonia as defined by the World Health Organization in Northern Territory Indigenous children

Kerry-Ann F O’Grady, Debbie M Taylor-Thomson, Anne B Chang, Paul J Torzillo, Peter S Morris, Grant A Mackenzie, Gavin R Wheaton, Paul A Bauert, Margaret P De Campo, John F De Campo and Alan R Ruben
Med J Aust 2010; 192 (10): 592-595.

Summary

Objective: To determine the burden of hospitalised, radiologically confirmed pneumonia (World Health Organization protocol) in Northern Territory Indigenous children.

Design, setting and participants: Historical, observational study of all hospital admissions for any diagnosis of NT resident Indigenous children, aged between ≥ 29 days and < 5 years, 1 April 1997 to 31 March 2005.

Intervention: All chest radiographs taken during these admissions, regardless of diagnosis, were assessed for pneumonia in accordance with the WHO protocol.

Main outcome measure: The primary outcome was endpoint consolidation (dense fluffy consolidation [alveolar infiltrate] of a portion of a lobe or the entire lung) present on a chest radiograph within 3 days of hospitalisation.

Results: We analysed data on 24 115 hospitalised episodes of care for 9492 children and 13 683 chest radiographs. The average annual cumulative incidence of endpoint consolidation was 26.6 per 1000 population per year (95% CI, 25.3–27.9); 57.5 per 1000 per year in infants aged 1–11 months, 38.3 per 1000 per year in those aged 12–23 months, and 13.3 per 1000 per year in those aged 24–59 months. In all age groups, rates of endpoint consolidation in children in the arid southern region of NT were about twice that of children in the tropical northern region.

Conclusion: The rates of severe pneumonia in hospitalised NT Indigenous children are among the highest reported in the world. Reducing this unacceptable burden of disease should be a national health priority.

  • Kerry-Ann F O’Grady1,2
  • Debbie M Taylor-Thomson1
  • Anne B Chang1
  • Paul J Torzillo4,0
  • Peter S Morris1,5
  • Grant A Mackenzie6
  • Gavin R Wheaton7
  • Paul A Bauert8
  • Margaret P De Campo9
  • John F De Campo9
  • Alan R Ruben5

  • 1 Menzies School of Health Research, Charles Darwin University, Darwin, NT.
  • 2 School of Population Health and Department of Paediatrics, University of Melbourne, Melbourne, VIC.
  • 3 Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute, Melbourne, VIC.
  • 4 Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW.
  • 5 Northern Territory Clinical School, Flinders University, Darwin, NT.
  • 6 Bacterial Diseases Program, Medical Research Council (UK) Laboratories, Fajara, The Gambia.
  • 7 Department of Clinical Effectiveness, School of Medicine, Faculty of Health Sciences, Flinders University, Adelaide, SA.
  • 8 Royal Darwin Hospital, Darwin, NT.
  • 9 Bond University, Gold Coast, QLD.

Correspondence: k.ogrady@uq.edu.au

Acknowledgements: 

We thank Ross Andrews, Joan Cunningham (Menzies School of Health Research); Terry Nolan (University of Melbourne); John Carlin, Suzanna Vidmar (Murdoch Childrens Research Institute); Jane Benson (Johns Hopkins University Hospital); and Kim Mulholland, Tilman Ruff, and Thomas Cherian.

Competing interests:

Wyeth Vaccines provided funding for the study, but had no role in the design, data collection, analysis and interpretation, writing, or publication of the article. Kerry-Ann O’Grady has been a senior research officer on sponsored vaccine trials (GlaxoSmithKline, Wyeth, Merck Sharp & Dohme, MedImmune, and CSL) and a recipient of funds for epidemiological research (GlaxoSmithKline).

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