Epidemiology and etiology of childhood pneumonia
Open accessAbstract
Childhood pneumonia is the leading single cause of mortality in children aged less than 5 years. The incidence in this age group is estimated to be 0.29 episodes per child-year in developing and 0.05 episodes per child-year in developed countries. This translates into about 156 million new episodes each year worldwide, of which 151 million episodes are in the developing world. Most cases occur in India (43 million), China (21 million) and Pakistan (10 million), with additional high numbers in Bangladesh, Indonesia and Nigeria (6 million each). Of all community cases, 7-13% are severe enough to be life-threatening and require hospitalization. Substantial evidence revealed that the leading risk factors contributing to pneumonia incidence are lack of exclusive breastfeeding, undernutrition, indoor air pollution, low birth weight, crowding and lack of measles immunization. Pneumonia is responsible for about 19% of all deaths in children aged less than 5 years, of which more than 70% take place in sub-Saharan Africa and south-east Asia. Although based on limited available evidence, recent studies have identified Streptococcus pneumoniae, Haemophilus influenzae and respiratory syncytial virus as the main pathogens associated with childhood pneumonia.
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Mean incidences of pneumonia and diarrhoea in children younger than 5 years were substantially higher in emergency settings than in non-emergency settings in these countries.
“Mean incidences of pneumonia and diarrhoea in children younger than 5 years were substantially higher than those noted in these countries in non-emergency settings.83”
From Global burden of childhood pneumonia and diarrhoea (2013) · cites this paper as [83]
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Cites
Home visits: a strategy to improve newborn survival - Authors' reply
(2008) · Americanae (AECID Library) · doi:10.1016/s0140 · Cited by 22,524 · see citing works
Correspondence - Tranexamic acid for traumatic brain injury
(2005) · London School of Economics and Political Science Theses Online (London School of Economics and Political Science) · doi:10.1016/s0140-6736 · Cited by 11,894 · see citing works
WHO estimates of the causes of death in children
Bryce, J., Boschi-Pinto, C., Shibuya, K., & Black, R. E. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71877-8 · Cited by 2,108 · see citing works
Rothman, K. J., Greenland, S. 1., & Lash, T. L. (1998) · Cited by 2,106 · see citing works
Klugman, K. P., Madhi, S. A., Huebner, R. E., Kohberger, R. C., Mbelle, N. M., & Pierce, N. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa035060 · Cited by 1,013 · see citing works
Estimates of world-wide distribution of child deaths from acute respiratory infections
Williams, B. G., Gouws, E., Boschi-Pinto, C., Bryce, J., & Dye, C. (2002) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(01)00170-0 · Cited by 947 · see citing works
Cutts, F., Zaman, S., Enwere, G., Jaffar, S. S., Levine, O., Okoko, J. B., Oluwalana, C., Vaughan, A., Obaro, S., Leach, A. J., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71876-6 · Cited by 903 · see citing works
Bacteremia among Children Admitted to a Rural Hospital in Kenya
Berkley, J. A., Lowe, B. S., Mwangi, I., Williams, T., Bauni, E., Mwarumba, S., Ngetsa, C., Slack, M. P. E., Njenga, S., Hart, C. A., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa040275 · Cited by 851 · see citing works
Epidemiology of Acute Lower Respiratory Disease in Children
Glezen, W. P., & Denny, F. W. (1973) · New England Journal of Medicine · doi:10.1056/nejm197303082881005 · Cited by 617 · see citing works
Demographic and Health Survey, 2015
Care, C., & Zimstat (2015) · University of Zimbabwe Institutional Repository (University of Zimbabwe) · Cited by 606 · see citing works
Respiratory syncytial virus infection
Simões, E. A. F. (1999) · The Lancet · doi:10.1016/s0140-6736(99)80040-3 · Cited by 602 · see citing works
Estimating the causes of 4 million neonatal deaths in the year 2000
Lawn, J. E., Wilczynska-Ketende, K., & Cousens, S. N. (2006) · International Journal of Epidemiology · doi:10.1093/ije/dyl043 · Cited by 515 · see citing works
Global estimate of the incidence of clinical pneumonia among children under five years of age.
Rudan, I., Tomašković, L., Boschi-Pinto, C., & Campbell, H. J. (2004) · Europe PMC (PubMed Central) · Cited by 497 · see citing works
Self-citationMulholland, K., Hilton, S., Adegbola, R. A., Usen, S., Oparaugo, A., Omosigho, C., Weber, M., Palmer, A., Schneider, G., Jobe, K., et al. (1997) · The Lancet · doi:10.1016/s0140-6736(96)09267-7 · Cited by 407 · see citing works
Selwyn, B. J. (1990) · Clinical Infectious Diseases · doi:10.1093/clinids/12.supplement_s870 · Cited by 371 · see citing works
Respiratory syncytial virus infection in tropical and developing countries
Weber, M. W., Weber, M. W., Mulholland, E. K., et al. (1998) · Tropical Medicine & International Health · doi:10.1046/j.1365-3156.1998.00213.x · Cited by 370 · see citing works
Etiology of severe pneumonia in children in developing countries
Shann, F. A. (1986) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-198603000-00017 · Cited by 348 · see citing works
AETIOLOGY OF PNEUMONIA IN CHILDREN IN GOROKA HOSPITAL, PAPUA NEW GUINEA
Shann, F. A., Germer, S., Hazlett, D. T. G., et al. (1984) · The Lancet · doi:10.1016/s0140-6736(84)90764-5 · Cited by 290 · see citing works
Respiratory syncytial virus epidemics: the ups and downs of a seasonal virus
Stensballe, L. G., DEVASUNDARAM, J. K., & Simões, E. A. F. (2003) · The Pediatric Infectious Disease Journal · doi:10.1097/01.inf.0000053882.70365.c9 · Cited by 269 · see citing works
Mortality from acute respiratory infections in children under 5 years of age: global estimates.
Leowski, J. (1986) · PubMed · Cited by 207 · see citing works
Garenne, M., Ronsmans, C., & Campbell, H. J. (1992) · PubMed · Cited by 207 · see citing works
Madhi, S. A., Kuwanda, L., Cutland, C., & Klugman, K. P. (2005) · Clinical Infectious Diseases · doi:10.1086/429828 · Cited by 200 · see citing works
Gessner, B. D., Sutanto, A., Linehan, M., Djelantik, I. G. G., Fletcher, T., Gerudug, I. K., Ingerani, Mercer, D., Moniaga, V. A., Moulton, L. H., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(04)17664-2 · Cited by 199 · see citing works
&NA; (1999) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199910001-00004 · Cited by 181 · see citing works
The etiology of pneumonia in malnourished and well-nourished Gambian children
Adegbola, R. A., Falade, A. G., SAM, B. E., Aidoo, M., Baldeh, I., Hazlett, D. T. G., Whittle, H. C., GREENWOOD, B. M., & Mulholland, E. K. (1994) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199411000-00008 · Cited by 179 · see citing works
Clinical presentation of non-typhoidal Salmonella bacteraemia in Malawian children
Graham, S. M., Walsh, A. L., MOLYNEUX, E. M., Phiri, A. J., & Molyneux, M. E. (2000) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/s0035-9203(00)90337-7 · Cited by 179 · see citing works
Selected populations at increased risk from respiratory syncytial virus infection
Meissner, H. C. (2003) · The Pediatric Infectious Disease Journal · doi:10.1097/01.inf.0000053884.21238.13 · Cited by 172 · see citing works
Nontyphoidal Salmonella infections of children in tropical Africa
Graham, S. M., MOLYNEUX, E. M., WALSH, A. L., Cheesbrough, J., Molyneux, M. E., & Hart, C. A. (2000) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-200012000-00016 · Cited by 165 · see citing works
Morris, S. S., Black, R. E., & Tomašković, L. (2003) · International Journal of Epidemiology · doi:10.1093/ije/dyg241 · Cited by 161 · see citing works
Acute respiratory infections: a review.
Bulla, A., & Hitze, K. L. (1978) · PubMed · Cited by 147 · see citing works
Straus, W. L., Qazi, S., Kundi, Z., et al. (1998) · The Lancet · doi:10.1016/s0140-6736(97)10294-x · Cited by 128 · see citing works
Etiology of acute lower respiratory tract infections in Gambian children
FORGIE, I. M., OʼNEILL, K. P., LLOYD-EVANS, N., et al. (1991) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199101000-00008 · Cited by 125 · see citing works
Lung Puncture in the Etiological Diagnosis of Pneumonia
Mimica, I. (1971) · American journal of diseases of children · doi:10.1001/archpedi.1971.02110040062002 · Cited by 124 · see citing works
Lagos, R., HORWITZ, I., TORO, J., Martin, O. S., Abrego, P. L., BUSTAMANTE, C., Wasserman, S. S., Levine, O. S., & Levine, M. M. (1996) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199603000-00008 · Cited by 123 · see citing works
Gaps in policy-relevant information on burden of disease in children: a systematic review
Rudan, I., Lawn, J. E., Cousens, S. N., Rowe, A. K., Boschi-Pinto, C., Tomašković, L., Mendoza, W., Lanata, C. F., Roca‐Feltrer, A., Carneiro, I. A., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)66697-4 · Cited by 123 · see citing works
Self-citationGhafoor, A., Nomani, N. K., Ishaq, Z., et al. (1990) · Clinical Infectious Diseases · doi:10.1093/clinids/12.supplement_8.s907 · Cited by 122 · see citing works
Etiology of acute lower respiratory tract infections in Gambian children
FORGIE, I. M., OʼNEILL, K. P., LLOYD-EVANS, N., et al. (1991) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199101000-00009 · Cited by 119 · see citing works
da Fonseca, W. L. M. S., Kirkwood, B. R., Victora, C. G., Fuchs, S., Flores, J. A. M., & Misago, C. (1996) · Europe PMC (PubMed Central) · Cited by 118 · see citing works
Lanata, C. F. (2004) · International Journal of Epidemiology · doi:10.1093/ije/dyh229 · Cited by 114 · see citing works
Weisman, L. E. (2003) · The Pediatric Infectious Disease Journal · doi:10.1097/01.inf.0000053883.08663.e5 · Cited by 110 · see citing works
Victora, C. G., Barros, F., Kirkwood, B. R., & Vaughan, J. (1990) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/52.2.391 · Cited by 100 · see citing works
Asghar, R. M., Banajeh, S. M., Egas, J., et al. (2008) · BMJ · doi:10.1136/bmj.39421.435949.be · Cited by 95 · see citing works
Klugman, K. P., Madhi, S. A., & Feldman, C. H. (2006) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0b013e328012c5f1 · Cited by 94 · see citing works
Baqui, A. H., Arifeen, S. E., Saha, S. K., Persson, L. Å., Zaman, K., Gessner, B. D., Moulton, L. H., Black, R. E., & Santosham, M. (2007) · The Pediatric Infectious Disease Journal · doi:10.1097/inf.0b013e31806166a0 · Cited by 92 · see citing works
O’Dempsey, T., MCARDLE, T. F., LLOYD-EVANS, N., Baldeh, I., Laurence, B. E., Secka, O., & Greenwood, B. M. (1994) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199402000-00009 · Cited by 86 · see citing works
Tupasi, T. E., de Leon, L. E., Lupisan, S., et al. (1990) · Clinical Infectious Diseases · doi:10.1093/clinids/12.supplement_8.s940 · Cited by 81 · see citing works
Bacterial isolates from blood and lung aspirate cultures in Gambian children with lobar pneumonia
Falade, A. G., Mulholland, E. K., Adegbola, R. A., et al. (1997) · Annals of Tropical Paediatrics · doi:10.1080/02724936.1997.11747904 · Cited by 74 · see citing works
A Community-Based Study of Acute Respiratory Tract Infections in Chlldren in Uruguay
Hortal, M., Benitez, A., Contera, M., et al. (1990) · Clinical Infectious Diseases · doi:10.1093/clinids/12.supplement_8.s966 · Cited by 50 · see citing works
Childhood pneumonia--progress and challenges.
Zar, H. J., & Madhi, S. A. (2006) · PubMed · doi:10.7196/samj.1269 · Cited by 45 · see citing works
Risk factors of acute lower respiratory tract infections in children under five years of age.
Dharmage, S. C., Rajapaksa, L. C., & Fernando, D. N. (1996) · PubMed · Cited by 43 · see citing works
Oyejide, C. O., & Osinusi, K. (1990) · Clinical Infectious Diseases · doi:10.1093/clinids/12.supplement_8.s1042 · Cited by 40 · see citing works
Ballard, T. J., & Neumann, C. G. (1995) · Journal of Tropical Pediatrics · doi:10.1093/tropej/41.1.8 · Cited by 37 · see citing works
Relationship between acute respiratory infection and malnutrition in children under 5 years of age
Cunha, A. (2000) · Acta Paediatrica · doi:10.1080/080352500750027943 · Cited by 35 · see citing works
Use of vaccine trials to estimate burden of disease.
Mulholland, K. (2004) · PubMed · Cited by 35 · see citing works
Immunological response to conjugate vaccines in infants: follow up study
Goldblatt, D., Miller, E. J., McCloskey, N., et al. (1998) · BMJ · doi:10.1136/bmj.316.7144.1569 · Cited by 34 · see citing works
Magnitude of acute respiratory infections in under five children.
Singh, M. P., & Nayar, S. (1996) · PubMed · Cited by 33 · see citing works
Bustamante-Calvillo, M. E., Velázquez, F. R., Cabrera-Muñóz, L., Torres, J. F., Gómez-Delgado, A., Enciso‐Moreno, J. A., & Muñoz‐Hernández, O. (2001) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-200105000-00005 · Cited by 31 · see citing works
Murtagh, P., Cerqueiro, M. C., Halac, A., Ávila, M. M., Salomón, H., & Weissenbacher, M. C. (1993) · Pediatric Pulmonology · doi:10.1002/ppul.1950160102 · Cited by 29 · see citing works
Zaman, K., Baqui, A. H., Yunus, M., et al. (1996) · PubMed · Cited by 28 · see citing works
Pneumocystis carinii pneumonia in Malawian children
Kamiya, Y., Mtitimila, E. I., Graham, S. M., Broadhead, R., Brabin, B. J., & Hart, C. A. (1997) · Annals of Tropical Paediatrics · doi:10.1080/02724936.1997.11747874 · Cited by 25 · see citing works
Some observations on the communicable diseases as public health problems.
Wc, C., & Assaad, F. A. (1973) · PubMed · Cited by 25 · see citing works
RESPIRATORY DISEASE IN CHILDHOOD
ANDERSON, H. R. (1986) · British Medical Bulletin · doi:10.1093/oxfordjournals.bmb.a072116 · Cited by 16 · see citing works
Junge, S., Nokes, D. J., Simões, E. A. F., et al. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-803678-5.00384-2 · Cited by 10 · see citing works
Pneumocystis carinii pneumonia in Malawian children
Kuruvilla, A., Bom, S., & Lightman, S. (2000) · Cited by 1 · see citing works
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Kermany, D. S., Goldbaum, M., Cai, W., Valentim, C. C. S., Liang, H., Baxter, S. L., McKeown, A., Yang, G., Wu, X., Yan, F., et al. (2018) · Cell · doi:10.1016/j.cell.2018.02.010 · Cited by 4,842 · see citing works
Nair, H., Nokes, D. J., Gessner, B. D., Dherani, M., Madhi, S. A., Singleton, R. J., O'Brien, K. L., Roca, A., Wright, P. F., Bruce, N., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60206-1 · Cited by 2,773 · see citing works
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Walker, C. L. F., Rudan, I., Liu, L., Nair, H., Theodoratou, E., Bhutta, Z. A., O'Brien, K. L., Campbell, H., & Black, R. E. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60222-6 · Cited by 2,356 · see citing works
Self-citationO'Brien, K. L., Wolfson, L. J., Watt, J. P., Henkle, E., Deloria-Knoll, M., McCall, N., Lee, E., Mulholland, K., Levine, O. S., & Cherian, T. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61204-6 · Cited by 2,398 · see citing works
Nair, H., Simões, E. A., Rudan, I., Gessner, B. D., Azziz-Baumgartner, E., Zhang, J. S. F., Feikin, D. R., Mackenzie, G. A., Moiïsi, J. C., Roca, A., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(12)61901-1 · Cited by 779 · see citing works
Self-citationWatt, J. P., Wolfson, L. J., O'Brien, K. L., Henkle, E., Deloria-Knoll, M., McCall, N., Lee, E., Levine, O. S., Hajjeh, R., Mulholland, K., et al. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61203-4 · Cited by 501 · see citing works
Long term sequelae from childhood pneumonia; systematic review and meta-analysis
Edmond, K., Scott, S., Korczak, V., Ward, C., Sanderson, C., Theodoratou, E., Clark, A., Griffiths, U., Rudan, I., & Campbell, H. (2012) · PLoS ONE · doi:10.1371/journal.pone.0031239 · Cited by 175 · see citing works
Self-citationHousehold characteristics associated with handwashing with soap in rural Bangladesh
Luby, S. P., Halder, A. K., Tronchet, C., Akhter, S., Bhuiya, A., & Johnston, R. B. (2009) · The American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2009.09-0031 · Cited by 135 · see citing works
Man, W. H., Clerc, M., de Steenhuijsen Piters, W. A. A., van Houten, M. A., Chu, M. L. J. N., Kool, J., Keijser, B. J. F., Sanders, E. A. M., & Bogaert, D. (2019) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201810-1993oc · Cited by 89 · see citing works
Comparative impact assessment of child pneumonia interventions
Niessen, L. (2009) · Bulletin of the World Health Organization · doi:10.2471/blt.08.050872 · Cited by 81 · see citing works
Zinc supplementation for the prevention of pneumonia in children aged 2 months to 59 months
Lassi, Z. S., Haider, B. A., & Bhutta, Z. A. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005978.pub2 · Cited by 71 · see citing works
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Amrulloh, Y., Abeyratne, U., Swarnkar, V., & Triasih, R. (2015) · 2015 6th International Conference on Intelligent Systems, Modelling and Simulation · doi:10.1109/isms.2015.41 · Cited by 69 · see citing works
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Zeng, J., Lu, C., & Deng, Q. (2017) · Journal of Thermal Biology · doi:10.1016/j.jtherbio.2017.02.012 · Cited by 26 · see citing works
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Paul, B., Saha, I., Mukherjee, A., Biswas, R., Roy, S., & Chaudhuri, R. N. (2011) · Journal of the Egyptian Public Health Association · doi:10.1097/01.epx.0000399137.11413.e0 · Cited by 13 · see citing works
- Authors
- Rudan, I.
- Affiliations
- University of Split (HR)
- Corresponding author
- Rudan, Igor
- ORCID
- Rudan, Igor
- Venue
- Bulletin of the World Health Organization
- Publisher
- WHO Press
- Published
- 2008-05-01
- Volume
- 86
- Issue
- 5
- Pages
- 408-416
- ISSN
- 0042-9686 (ISSN-L)
- PMC
- PMC2647437
- OpenAlex
- W2098196189
- Cited by
- 1,422
- References
- 64
- Citations by year
- 2026: 32 · 2025: 56 · 2024: 52 · 2023: 54 · 2022: 83 · 2021: 96 · 2020: 102 · 2019: 87 · 2018: 106 · 2017: 77 · 2016: 82 · 2015: 124 · 2014: 89 · 2013: 108 · 2012: 79
- FWCI
- 47.76
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Bulletin of the World Health Organization (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Funders
- National Science Foundation
- Bill and Melinda Gates Foundation
- World Health Organization
- Topics
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Keywords
- pediatric pneumonia, incidence, mortality, risk factors, exclusive breastfeeding, malnutrition, indoor air pollution, low birth weight, measles vaccination, Streptococcus pneumoniae, Haemophilus influenzae, respiratory syncytial virus, hospitalization, sub-Saharan Africa, Southeast Asia
- MeSH terms
- Child, Preschool, Humans, Infant, Infant, Newborn, Pneumonia, Risk Factors, Socioeconomic Factors, Global Health, Incidence, Prevalence, AIDS-Related Opportunistic Infections, Haemophilus Vaccines, Respiratory Syncytial Virus Infections, Pneumococcal Vaccines, Health Status Disparities, Healthcare Disparities
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