Epidemiology

CAP is an important cause of morbidity and mortality among children worldwide. According to the World Health Organization, pneumonia accounts for 14% of all deaths globally of children <5 years old, and 22% of deaths among those aged 1-5 years.[6]​ Reported incidence in developed countries is around 30-40 cases per 1000 children <5 years old.[1]​ Incidence rates are higher in developing compared with developed countries and there is great variability in incidence data between similar countries, probably due to the use of differing diagnostic criteria and the under-representation of children >5 years old in the literature.[3]

In the US, CAP accounts for around 2 million outpatient visits per year, with the highest annual rates among children aged 1-5 years (32.3 to 49.6 per 1000 population).[4][5]​​​ Around 100,000 children are admitted to hospital annually in the US with CAP.[4] In European hospitals, around 14.4 per 10,000 children aged over 5 years and 33.8 per 10,000 children aged under 5 years are diagnosed with CAP annually.[3]

Incidence and mortality rates for CAP have fallen significantly in countries that have introduced routine immunisation against significant pathogenic causes, with a particularly important contribution from conjugate pneumococcal vaccination and Haemophilus influenzae b (Hib) vaccination.[7]

In otherwise healthy children, those <5 years old are at highest risk, and incidence is higher in boys than in girls across all age groups.[3]

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