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BMJ Open. 2018 Apr 10;8(4):e019439. doi: 10.1136/bmjopen-2017-019439.

Incidence rate of community-acquired pneumonia in adults: a population-based prospective active surveillance study in three cities in South America.

Author information

1
Fundación del Centro de Estudios Infectológicos, Buenos Aires, Argentina.
2
Department of Infectious Diseases, Hospital López Lima, General Roca, Argentina.
3
Department of Infectious Diseases, Universidad de la República, Hospital Maciel, Montevideo, Uruguay.
4
Hospital Maciel, Montevideo, Uruguay.
5
Sanatorio Casmer Femi, Rivera, Uruguay.
6
Department of Internal Medicine, Hospital Regional Concepción. Instituto de Previsión Social, Concepción, Paraguay.

Abstract

OBJECTIVE:

To determine the incidence rate and mortality of community-acquired pneumonia (CAP) in adults in three cities in Latin America during a 3-year period.

DESIGN:

Prospective population-based surveillance study.

SETTING:

Healthcare facilities (outpatient centres and hospitals) in the cities of General Roca (Argentina), Rivera (Uruguay) and Concepción (Paraguay).

PARTICIPANTS:

2302 adults aged 18 years and older with CAP were prospectively enrolled between January 2012 and March 2015.

MAIN OUTCOME MEASURES:

Incidence rates of CAP in adults, predisposing conditions for disease, mortality at 14 days and at 1 year were estimated. Incidence rate of CAP, within each age group, was calculated by dividing the number of cases by the person-years of disease-free exposure time based on the last census; incidence rates were expressed per 1000 person-years.

RESULTS:

Median age of participants was 66 years, 46.44% were men, 68% were hospitalised. Annual incidence rate was 7.03 (95% CI 6.64 to 7.44) per 1000 person-years in General Roca, 6.33 (95% CI 5.92 to 6.78) per 1000 person-years in Rivera and 1.76 (95% CI 1.55 to 2.00) per 1000 person-years in Concepción. Incidence rates were highest in participants aged over 65 years. 82.4% had at least one predisposing condition and 48% had two or more (multimorbidity). Chronic heart disease (43.6%) and smoking (37.3%) were the most common risk factors. 14-day mortality rate was 12.1% and 1-year mortality was 24.9%. Multimorbidity was associated with an increased risk of death at 14 days (OR 2.91; 95% CI 2.23 to 3.80) and at 1 year (OR 3.00; 95% CI 2.44 to 3.70).

CONCLUSIONS:

We found a high incidence rate of CAP in adults, ranging from 1.76 to 7.03 per 1000 person-years, in three cities in South America, disclosing the high burden of disease in the region. Efforts to improve prevention strategies are needed.

KEYWORDS:

community-acquiered pneumonia; incidence rate; mortality

PMID:
29643153
PMCID:
PMC5898349
DOI:
10.1136/bmjopen-2017-019439
[Indexed for MEDLINE]
Free PMC Article

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