An estimated 12 million children under the age of five are hospitalized with severe acute lower respiratory infections (ALRI) each year, according to research in The Lancet.

Researchers performed a systematic review of studies published between Jan 1, 1990, and March 31, 2012, and from 28 unpublished population-based studies. Incidence estimates were applied to population estimates for 2010, to calculate the global and regional burden in children admitted with severe ALRI in that year.

The team discovered 11.9 million episodes of severe and 3.0 million episodes of very severe ALRI which resulted in hospital admissions in young children worldwide. Incidence was higher in boys, especially in South Asian studies.

Roughly 265,000 in-hospital deaths took place in young children, with 99% of these deaths in developing countries, according to author estimates. Therefore, the data suggest that although 62% of children with severe ALRI are treated in hospitals, 81% of deaths happen outside hospitals.

“Pneumonia has an enormous impact upon the lives of young children across the world,” said Harish Nair, PhD, University of Edinburgh Centre for Population Health Sciences. “This study shows that much more could be done to reduce infection and save lives, such as by improving access to hospitals in the developing world, or by ensuring that both boys and girls receive similar health care.”

Investigators believe “community-based management of severe disease could be an important complementary strategy to reduce pneumonia mortality and health inequities.”