Abstract
BackgroundUpdated population-based data on the frequency and distribution of risk factors for pneumococcal disease is scarce. This study investigated the prevalence of distinct comorbidities and underlying risk conditions related to an increasing risk of pneumococcal disease among Catalonian middle-aged and older adults.MethodsCross-sectional population-based study including 2,033,465 individuals aged 50 years or older registered at 01/01/2015 in the Catalonian Health Institute (Catalonia, Spain). The clinical research database of the Information System for the Development of Research in Primary Care (SIDIAP database) was used to identify high-risk (asplenia and/or immunocompromising conditions) and other increased-risk conditions (chronic pulmonary, cardiac or liver disease, diabetes mellitus, alcoholism and/or smoking) among study subjects.ResultsGlobally, 980,310 (48.2%) of the 2,033,465 study population had at least one risk condition of suffering pneumococcal disease (55.4% in men vs 42.0% in women, p < 0.001; 41.7% in people 50–64 years vs 54.7% in persons 65 years or older, p < 0.001). An amount of 176,600 individuals (8.7%) had high-risk conditions (basically immunocompromising conditions). On the other hand, 803,710 persons (39.5%) had one or more other risk conditions. In fact, 212,255 (10.4%) had chronic pulmonary diseases, 248,377 (12.2%) cardiac disease, 41,734 (2.1%) liver disease, 341,535 (16.8%) diabetes mellitus, 58,781 (2.9%) alcoholism and 317,558 (15.6%) were smokers.ConclusionIn our setting, approximately 50 % of overall persons 50 years or older may be considered at-risk population for pneumococcal disease (almost 10 % have high-risk conditions and 40 % have other risk conditions).
Highlights
Updated population-based data on the frequency and distribution of risk factors for pneumococcal disease is scarce
[4] persons with functional or anatomic asplenia are at the highest risk for pneumococcal infection, because this condition leads to reduced clearance of encapsulated bacteria from the bloodstream. [1, 2, 4] Other adults at increased risk for developing pneumococcal infection or experiencing severe disease and complications include immunocompetent persons with chronic heart diseases, chronic pulmonary diseases, chronic liver diseases, diabetes mellitus, alcoholism and smoking. [5,6,7,8] Elderly persons (i.e, 65 years or older) are a major high-risk group for pneumococcal infections considering that certain degree of immunosenescence occurs in the elderly and, the prevalence of chronic illnesses increases with age
The present study investigated the prevalence of distinct comorbidities and underlying conditions related to increasing risk for pneumococcal infections among Catalonian middle-aged and older adults
Summary
Updated population-based data on the frequency and distribution of risk factors for pneumococcal disease is scarce. [8,9,10,11] Usually, the published data was calculated for distinct children age subgroups, adults 18–64 years and elderly persons, but generally there are no specific data disaggregated for distinct adult age subgroups (i.e, younger or middle-aged adults) despite the fact they may have distinct risks for pneumococcal disease. According to these studies, incidence of IPD is around 10 cases per 100,000 population-year among healthy adults over 18 years, with rates up to 50-times higher in some immunocompromised individuals (e.g, haematological cancer and/or HIV infection). The PPV23 was marketed in 1983 [4] whereas the PCV13 has only been available for use in adults since 2012. [12] From a public health point of view, the availability of two different vaccines for adults and the possibility of sequential vaccination with both vaccines is a key point to establish different vaccination strategies
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