Pneumonia as a cause of death in children (author's transl)

Abstract

The yearly death-rate from pneumonia in children aged one month to 15 years has fallen in Schleswig-Holstein from 1.8 (1954-1958) to 0.6 per ten thousand (1969-1973). At the same time, total death-rate in the same age group has fallen from 14.5 to 9.3 per ten thousand children. The proportion of pneumonia in the total death-rate was 5.3% in 1971-1973, 1.6% in the first month of life and, after the sixteenth year, 2.3%. Pneumonia was in fourth place (after accident, malformation and neoplasm) as a cause of death in those more than one month old. The death-rate due to pneumonia had not fallen between 1954 and 1973, varying between 10% and 12%. While death-rate of "primary" pneumonia (without other underlying disease) had fallen from 5.7% (1954-1958) to 1.1% (1969-1973), the death-rate of "secondary" pneumonia rose from 16.8% to 21.4% during the same period. The total number of children aged between two months and 15 years treated for pneumonia fell by two thirds from 1954-1973 (1245 to 406). The incidence of "primary" pneumonia during the same period fell to about a quarter, that of "secondary" pneumonia to one half. The unsatisfactory result in the treatment of "secondary" pneumonia is probably due to the underlying primary disease or a weakening of defence mechanisms by treatment or the occurrence of unusual causative organisms (pneumocystis carinii, tubercle bacilli, Candida, Aspergillus), demonstrated only after death.