The burden of pneumococcal disease among adults in developed and developing countries: what is and is not known
The burden of pneumococcal disease among adults in developed and developing countries: what is and is not known
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DOI：
10.1016/s0264-410x(99)00122-x
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发表时间：
1999-07-30
期刊：
影响因子：
5.5
通讯作者：
Scott, G
中科院分区：
文献类型：
--
作者：
Fedson, DS;Anthony, J;Scott, G
发达国家成年人肺炎球菌疾病的负担既不广为人知，也没有得到重视。肺炎球菌性肺炎的发病率是不确定的，因为大多数患者无法得到准确的诊断。基于人群的侵袭性肺炎球菌疾病数据（例如，细菌血症和脑膜炎）表明，在所有发达国家，所有年龄段的人的年发病率大于或等于15-20例/100，000人，大于或等于50例/100，000老年人（大于或等于65岁）。在发展中国家，没有关于成人肺炎球菌疾病负担的基于人口的数据。对高危人群的研究、医院研究、疫苗效力试验、发达国家“本地人口”监测的推断以及发展中地区的人口研究都表明疾病负担很高。然而，这些估计数的广泛差异表明需要进行更好的研究。在所有国家增加成人中肺炎球菌疫苗的使用将取决于科学和公众对肺炎球菌疾病负担的更好理解。在发展中国家，对肺炎球菌疾病的影响进行深入的社区研究，或者采用“疫苗探测”方法，即对一个群体进行疫苗接种，并将肺炎的减少情况与对照群体进行比较，可以更准确地估计疾病负担和成年人接种肺炎球菌疫苗的潜在效果。(C)1999爱思唯尔科技有限公司。保留所有权利。
The burden of pneumococcal disease among adults in developed countries is neither widely known nor appreciated. The incidence of pneumococcal pneumonia is uncertain because a precise diagnosis cannot be obtained for most patients. Population-based data on invasive pneumococcal disease (e.g., bacteraemia and meningitis) suggest an annual incidence in all developed countries of greater than or equal to 15-20 cases per 100,000 persons of all ages and greater than or equal to 50 cases per 100,000 elderly adults (greater than or equal to 65 years). In developing countries there are no population-based data on the burden of pneumococcal disease among adults. Studies of high risk groups, hospital-based studies, vaccine efficacy trials, extrapolations from surveillance of "native populations" in developed countries, and demographic studies in developing regions all suggest a high burden of disease. The broad variation in these estimates, however, indicates that better studies are needed. Increased use of pneumococcal vaccines among adults in all countries will depend on better scientific and public understanding of the burden of pneumococcal disease. In developing countries, intensive community-based studies of the impact of pneumococcal disease, or, alternatively, a "vaccine probe" approach, in which a population is vaccinated and the reduction in pneumonia is compared with that in a control population, could give more accurate estimates of the burden of disease and of the potential effectiveness of pneumococcal vaccination among adults. (C) 1999 Elsevier Science Ltd. All rights reserved.