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Title: Epidemiology of radiographically-confirmed and bacteremic pneumonia in rural Thailand
Authors: Prabda Prapasiri
Sutthi Jareinpituk
Anek Keawpan
Teerasak Chuxnum
Henry C. Baggett
Somsak Thamathitiwat
Sonja J. Olsen
Mahidol University
Thailand Ministry of Public Health
Centers for Disease Control and Prevention
Nakhon Phanom Provincial Health Office
Keywords: Medicine
Issue Date: 1-Jul-2008
Citation: Southeast Asian Journal of Tropical Medicine and Public Health. Vol.39, No.4 (2008), 706-718
Abstract: Pneumonia remains a leading public health concern in Thailand. Using population-based surveillance during January 2004-December 2006, we describe incidence, mortality, and bacterial etiologies of chest radiograph-confirmed pneumonia requiring hospitalization in one rural Thai province. Of 19,316 patients who met the case definition for clinical pneumonia, 9,596 (50%) had a chest radiograph, and 4,993 (52%) of those had radiographically-confirmed pneumonia. The incidence of radiographically-confirmed pneumonia ranged from 199 to 256 per 100,000 persons per year; 151 (3.0%) patients died. The annual average pneumonia mortality rate was 6.9 per 100,000 persons (range 6.2 to 7.8 per 100,000) and was highest in persons aged <1 year (64/100,000) and ≥65 years (44/100,000). Of 4,993 patients with radiographically-confirmed pneumonia, 1,916 (38%) had blood cultures, and 187 (10%) of those had pathogens isolated. Pathogens causing bacteremic pneumonia included B. pseudomallei (15% to 24% of bacterial pathogens), E. coli (9.2% to 25%), S. pneumoniae (7.9% to 17%), K. pneumoniae (2.2% to 6.4%), and S. aureus (4.3 to 5.3%). Bacteremia was significantly associated with pneumonia mortality after controlling for age, sex, HIV status and measures of disease severity in a logistic regression model (OR=5.2; 95% confidence interval= 2.2 - 12). Pneumonia remains an important cause of morbidity and mortality in Thailand, as in other countries in Southeast Asia. These findings can inform pneumonia clinical management and treatment decisions and guide public health programming, including the development of effective prevention strategies.
ISSN: 01251562
Appears in Collections:Scopus 2006-2010

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