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Socioeconomic risk factors for bacteraemic pneumococcal pneumonia in adults

  • J. H. FLORY (a1), M. JOFFE (a1), N. O. FISHMAN (a2), P. H. EDELSTEIN (a3) and J. P. METLAY (a1) (a2) (a4)...

Summary

Demographic and clinical risk factors are important in guiding vaccination policy for pneumococcal pneumonia. We present data on these variables from a population-based surveillance network covering adult bacteraemic pneumococcal pneumonia (BPP) in the Delaware Valley region from 2002 to 2004. Surveillance data were used with U.S. Census data and a community health survey to calculate stratified incidence rates. Missing data were handled using multiple imputation. Overall rates of adult BPP were 10·6 cases/100 000 person-years. Elevated rates were seen in the elderly (>65 years), Native Americans, African Americans, the less-educated (less than high-school education), the poor, smokers, and individuals with histories of asthma, cancer, or diabetes. Multivariable modelling suggested that income was more robustly associated with risk than African American race. Of methodological interest, this association was not apparent if census block-group median income was used as a proxy for self-reported income. Further research on socioeconomic risk factors for BPP is needed.

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Copyright

Corresponding author

*Author for correspondence: J. P. Metlay, M.D., Ph.D., Center for Clinical Epidemiology and Biostatistics, 712 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA. (Email: jmetlay@mail.med.upenn.edu)

References

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1. Kyaw, MH, et al. Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. New England Journal of Medicine 2006; 354: 14551463.
2. Freed, GL, Davis, MM, Clark, SJ. Variation in public and private supply of pneumococcal conjugate vaccine during a shortage. Journal of the American Medical Association 2003; 289: 575578.
3. Flannery, B, et al. Impact of childhood vaccination on racial disparities in invasive Streptococcus pneumoniae infections. Journal of the American Medical Association 2004; 291: 21972203.
4. Anon. Updated recommendations on the use of pneumococcal conjugate vaccine in a setting of vaccine shortage – Advisory Committee on Immunization Practices. Journal of the American Medical Association 2002; 287: 833834.
5. Butler, JC. Epidemiology of pneumococcal disease. In: Tuomanen, EIed. The Pneumococcus. Washington, DC: ASM Press, 2004, pp. 148168.
6. HEDIS 2006 Health plan employer data & information set. Vol. 3: Specifications for survey measures. Washington, DC: National Committee for Quality Assurance (NCQA); 2005, p. 248.
7. The Ambulatory Care Quality Alliance Recommended Starter Set. Clinical Performance Measures for Ambulatory Care. Agency for Healthcare Research and Quality. Rockville, MD (http://www.ahrq.gov/qual/aqastart.htm). Accessed 30 September 2008.
8. Ahmed, F, et al. Cost-benefit analysis of a new HEDIS performance measure for penumococcal vaccination. Medical Decision Making 2002; 22: S5866.
9. Robinson, KA, et al. Epidemiology of invasive Streptococcus pneumoniae infections in the United States, 1995–1998: opportunities for prevention in the conjugate vaccine era. Journal of the American Medical Association 2001; 285: 17291735.
10. Davis, MM. Race-based immunization recommendations and the potential to reduce health disparities. Journal of the American Medical Association 2004; 291: 22532255.
11. American Academy of Pediatrics, Committee on Infectious Diseases. Policy statement: recommendations for the prevention of pneumococcal infections, including the use of pneumococcal conjugate vaccine (Prevnar), pneumococcal polysaccharide vaccine, and antibiotic prophylaxis. Pediatrics 2000; 106: 362366.
12. Metlay, JP, et al. Impact of pediatric vaccination with pneumococcal conjugate vaccine on the risk of bacteremic pneumococcal pneumonia in adults. Vaccine 2006; 24: 468475.
13. Metlay, JP, et al. Macrolide resistance in adults with bacteremic pneumococcal pneumonia. Emerging Infectious Diseases 2006; 12: 12231230.
14. Czaja, C, Crossette, L, Metlay, JP. Accuracy of adult reported pneumococcal vaccination status of children. Annals of Epidemiology 2005; 15: 253256.
15. United States Census 2000. Washington, DC: US Census Bureau, 2005 (http://www.census.gov/main/www/cen2000.html). Accessed 1 December 2005.
16. Ruggles, S, et al. Integrated Public Use Microdata Series: Version 3.0 [Machine-readable database]. Minneapolis, MN: Minnesota Population Center; 2004 (http://www.ipums.org). Accessed 1 December 2005.
17. Southeastern Pennsylvania Household Health Survey. Philadelphia, PA: Philadelphia Health Management Corporation, 2004.
18. SAS Online Documentation (http://support.sas.com/documentation/onlinedoc/91pdf/sasdoc_913/whatsnew_10878.pdf). Accessed 5 September 2008.
19. Kenward, MG, Carpenter, J. Multiple imputation: current perspectives. Statistical Methods in Medical Research 2007; 16: 199218.
20. Allison, PD. Missing Data. Thousand Oaks, CA: Sage Publications, 2002.
21. Rothman, K. Modern Epidemiology, 2nd edn. Lippincott Williams & Wilkins, 1998.
22. Chen, FM, et al. Geocoding and linking data from population-based surveillance and the US Census to evaluate the impact of median household income on the epidemiology of invasive Streptococcus pneumoniae infections. American Journal of Epidemiology 1998; 148: 12121218.
23. Talbot, TR, et al. Asthma as a risk factor for invasive pneumococcal disease. New England Journal of Medicine 2005; 352: 20822090.
24. Thomsen, RW, et al. Risk of community-acquired pneumococcal bacteremia in patients with diabetes. Diabetes Care 2004; 27: 11431147.
25. Nuorti, JP, et al. Cigarette smoking and invasive pneumococcal disease. New England Journal of Medicine 2000; 342: 681689.
26. ACIP. Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recommended Reports 1997; 46(RR-8): 124.
27. Shariatzadeh, MR, et al. Bacteremic pneumococcal pneumonia: a prospective study in Edmonton and neighboring municipalities. Medicine (Baltimore) 2005; 84: 147161.

Keywords

Socioeconomic risk factors for bacteraemic pneumococcal pneumonia in adults

  • J. H. FLORY (a1), M. JOFFE (a1), N. O. FISHMAN (a2), P. H. EDELSTEIN (a3) and J. P. METLAY (a1) (a2) (a4)...

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