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标题：Impact of the change in WHO’s severe pneumonia case definition on hospitalized pneumonia epidemiology: case studies from six countries
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作者：Fiona M Russell ; Rita Reyburn ; Jocelyn Chan 等
期刊名称：Bulletin of the World Health Organization
印刷版ISSN：0042-9686
出版年度：2019
卷号：97
期号：6
页码：386-393
DOI：10.2471/BLT.18.223271
出版社：World Health Organisation
摘要：Objective To quantify the impact of the change in definition of severe pneumonia on documented pneumonia burden. Methods We reviewed existing data acquired during observational hospitalized pneumonia studies, before the introduction of the pneumococcal conjugate vaccine, in infants aged 2–23 months from Fiji, Gambia, Lao People's Democratic Republic, Malawi, Mongolia and Viet Nam. We used clinical data to calculate the percentage of all-cause pneumonia hospitalizations with severe pneumonia, and with primary end-point consolidation, according to both the 2005 or 2013 World Health Organization (WHO) definitions. Where population data were available, we also calculated the incidence of severe pneumonia hospitalizations according to the different definitions. Findings At six of the seven sites, the percentages of all-cause pneumonia hospitalizations due to severe pneumonia were significantly less ( P < 0.001) according to the 2013 WHO definition compared with the 2005 definition. However, the percentage of severe pneumonia hospitalizations, according to the two definitions of severe pneumonia, with primary end-point consolidation varied little within each site. The annual incidences of severe pneumonia hospitalizations per 100 000 infants were significantly less (all P < 0.001) according to the 2013 definition compared with the 2005 definition, ranging from a difference of −301.0 (95% confidence interval, CI: −405.2 to −196.8) in Fiji to −3242.6 (95% CI: −3695.2 to −2789.9) in the Gambia. Conclusion The revision of WHO’s definition of severe pneumonia affects pneumonia epidemiology, and hence the interpretation of any pneumonia intervention impact evaluation.