Background Childhood bacterial pneumonia and empyema rates have reportedly increased in recent years in Europe. In September 2006 the seven-valent pneumococcal conjugate vaccination (PCV7) was introduced to the childhood national immunisation programme in England following a successful PCV7 campaign in the USA. The aim of this study was to report national time trends in hospital admissions for childhood bacterial pneumonia and empyema in England before and after the introduction of PCV7.
Methods A population-based time-trend analysis of Hospital Episode Statistics data of children aged <15 years admitted to all NHS hospitals in England, with a primary diagnosis of bacterial pneumonia and empyema from 1997 to 2008 was performed. Annual crude and age-sex standardised hospital admission rates for bacterial pneumonia and empyema were calculated.
Results Admission rates for bacterial pneumonia and empyema increased from 1997 to 2006, then declined to 2008. Bacterial pneumonia rates decreased to 1079 (95% CI 1059 to 1099) per million children and empyema rates decreased to 14 (95% CI 11 to 16) per million children. The RR for bacterial pneumonia admissions was 1.19 (95% CI 1.16 to 1.22) in 2006 compared with 2004 and 0.81 (95% CI 0.79 to 0.83) in 2008 compared with 2006. For empyema, the corresponding RRs were 1.77 (95% CI 1.38 to 2.28) in 2006 compared with 2004 and 0.78 (95% CI 0.62 to 0.98) in 2008 compared with 2006.
Conclusion Childhood bacterial pneumonia and empyema admission rates were increasing prior to 2006 and decreased by 19% and 22% respectively between 2006 and 2008, following the introduction of the PCV7 pneumococcal conjugate vaccination to the national childhood immunisation programme.
- respiratory tract infection
- pneumococcal vaccines
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Funding This study represents independent research commissioned by the National Institute for Health Research Service Delivery and Organisation programme. The interpretation and conclusions contained in this study are those of the authors. EK is funded by a National Institute for Health Research doctoral fellowship. SS is funded by a National Institute for Health Research postdoctoral fellowship. AB and the Dr Foster Unit at Imperial are funded via a research grant from Dr Foster Intelligence, an independent healthcare information company. The Department of Primary Care and Public Health at Imperial College is grateful for support from the National Institute for Health Research Biomedical Research Centre scheme and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care scheme. Support was also received from the Medical Research Council and the Engineering and Physical Sciences Research Council.
Competing interests None.
Ethics approval Section 60 approval was obtained from the Patient Information Advisory Group (PIAG) to hold confidential data and analyse them for research purposes. Consent was given on behalf of patients since, for national data, individual consent is considered unfeasible. Ethics approval was also obtained from St Mary's local research ethics committee.
Provenance and peer review Not commissioned; externally peer reviewed.
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