Doctors probe puzzle of child pneumonia rates

By REBECCA WALSH

Auckland children are five times more likely to be admitted to hospital with pneumonia than children in other developed countries and researchers are trying to find out why.

Childhood pneumonia costs the country about $7 million a year in direct medical costs but much of it is thought to be preventable.

Dr Cameron Grant, associate professor of paediatrics in Auckland University's Faculty of Medical and Health Sciences, is the principal investigator of a study to look at the reasons for New Zealand's high hospitalisation rates.

"We want to know what the risk factors are so that we can find ways to reduce the number of children who get so sick they need hospital care," he said.

Pneumonia, an inflammation of the lungs caused by infection, could lead to chronic chest problems in later life.

It could also result in major disability and early death.

Dr Grant, a paediatrician at the Starship children's hospital, said that between 1993 and 1996, the admission rate for children aged 0-14 with pneumonia was 5 per 1000.

In the United States the figure was five to 10 times lower.

In New Zealand pneumonia, along with influenza, was the fourth most frequent cause of death in infants under 12 months old.

Dr Grant said Pacific children were particularly vulnerable to pneumonia, with one in 20 infants hospitalised in Auckland every year.

They also had more severe disease than children of other ethnicities.

About 900 preschool children would be recruited for the study - a third would be children hospitalised with pneumonia, another third would be children seen in the emergency department but not admitted to hospital and the rest would be children from the community who did not have pneumonia.

Researchers would investigate the children's nutrition, immunisation status, housing - for example if the house they lived in was damp or mouldy. They would also study the family's history of illness, primary care and socio-economic factors such as overcrowding.

The information would be collected from interviews with their parents, measuring the child's dietary intake and reviewing hospital and GP records.