1. Incidence of Pneumococcal Pneumonia among Adults in Rural Thailand, 2006–2011: Implications for Pneumococcal Vaccine Considerations
- Author
-
Prabda Praphasiri, Pongpun Sawatwong, Charung Muangchana, Cameron Hurst, Sonja J. Olsen, Sara Tomczyk, Sathapana Naorat, Peera Areerat, Matthew R. Moore, Christopher J. Gregory, Henry C. Baggett, Somrak Chantra, Barameht Piralam, Somsak Thamthitiwat, and Julia Rhodes
- Subjects
Adult ,Male ,Rural Population ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Cost-Benefit Analysis ,Population ,medicine.disease_cause ,Pneumococcal conjugate vaccine ,Pneumococcal Vaccines ,Young Adult ,Virology ,Streptococcus pneumoniae ,medicine ,Humans ,Blood culture ,Intensive care medicine ,education ,Aged ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Incidence ,Age Factors ,Articles ,Middle Aged ,Pneumonia, Pneumococcal ,medicine.disease ,Thailand ,Hospitalization ,Pneumonia ,Infectious Diseases ,Pneumococcal vaccine ,Pneumococcal pneumonia ,Parasitology ,Female ,business ,medicine.drug - Abstract
The incidence of pneumococcal pneumonia among adults is a key driver for the cost-effectiveness of pneumococcal conjugate vaccine used among children. We sought to obtain more accurate incidence estimates among adults by including results of pneumococcal urine antigen testing (UAT) from population-based pneumonia surveillance in two Thai provinces. Active surveillance from 2006 to 2011 identified acute lower respiratory infection (ALRI)-related hospital admissions. Adult cases of pneumococcal pneumonia were defined as hospitalized ALRI patients aged ≥ 18 years with isolation of Streptococcus pneumoniae from blood or with positive UAT. Among 39,525 adult ALRI patients, we identified 481 pneumococcal pneumonia cases (105 by blood culture, 376 by UAT only). Estimated incidence of pneumococcal pneumonia hospitalizations was 30.5 cases per 100,000 persons per year (2.2 and 28.3 cases per 100,000 persons per year by blood culture and UAT, respectively). Incidence varied between 22.7 in 2007 and 43.5 in 2010, and increased with age to over 150 per 100,000 persons per year among persons aged ≥ 70 years. Viral coinfections including influenza A/B, respiratory syncytial virus (RSV), and adenovirus occurred in 11% (44/409) of pneumococcal pneumonia cases tested. Use of UAT to identify cases of pneumococcal pneumonia among adults in rural Thailand substantially increases estimates of pneumococcal pneumonia burden, thereby informing cost-effectiveness analyses and vaccine policy decisions.
- Published
- 2015