The descriptive epidemiology of severe lower respiratory tract infections in children in Kiel, Germany

Klin Padiatr. 2005 Sep-Oct;217(5):259-67. doi: 10.1055/s-2004-820352.


Background: Lower respiratory tract infections (LRI) inflict a high burden of disease in children worldwide. Longitudinal, descriptive epidemiological data on different forms of LRI are urgently needed to differentiate this burden, compare population-based incidence rates between countries and to recognize trends.

Patients and methods: From July 1996 to June 2000, all children hospitalized with LRI, i. e. laryngo-tracheo-bronchitis (LTB), bronchitis, wheezing bronchitis-bronchiolitis (WBB), bronchopneumonia and pneumonia, in the municipal area of Kiel, Schleswig-Holstein, Germany, were analyzed by cross-sectional studies. Naso-pharyngeal aspirates (NPA) were analyzed by an in-house 9-valent multiplex-RT-PCR.

Results: In the 4-year observational period, 1 072 children aged 0 to 16 years (median 23 months) were hospitalized with LRI: 12 % (median 28 months) with LTB, 11 % (median 17 months) with bronchitis, 28 % (median 13 months) with WBB, 26 % (median 26 months) with bronchopneumonia and 22 % (median 47 months) with pneumonia. The prevalence of chronic underlying conditions (20 %) and low gestational age (13 %) varied in the different forms of LRI. The cumulative incidence rate of LRI rose steadily over the 4 years. The highest fraction was contributed by WBB, while pneumonia declined. The highest incidence rate ratio was attributable to respiratory syncytial virus (RSV, 0.46) and to children under 2 years of age.

Conclusions: LRI, especially obstructive forms of LRI, are increasing in Germany as described earlier for the USA, UK and Sweden. The major burden is carried by children under 2 years. RSV is the single pathogen with the highest impact.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Bronchiolitis / epidemiology
  • Bronchitis / epidemiology
  • Bronchopneumonia / epidemiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Germany / epidemiology
  • Gestational Age
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Laryngitis / epidemiology
  • Male
  • Measles Vaccine / administration & dosage
  • Pneumonia / epidemiology
  • Prevalence
  • Respiratory Syncytial Virus Infections / epidemiology
  • Respiratory Tract Infections / epidemiology*
  • Seasons
  • Sex Factors
  • Tracheitis / epidemiology


  • Measles Vaccine