Angel Vila-Corcoles, Imma Hospital, Olga Ochoa-Gondar, Cinta de Diego, Eva Satue, Maria Aragon
Background: Published data on the frequency and distribution of high-risk factors for pneumococcal disease are limited. This study investigated the prevalence of high-risk underlying conditions for pneumococcal disease among people over 50 years in Catalonia, Spain. Methods: Cross-sectional population-based study including 2,033,465 individuals aged 50 years or older registered at 01/01/2015 in the Catalonian Health Institute. A previously validated institutional research clinical Database was used to identify high-risk conditions to suffer pneumococcal disease (functional or anatomic asplenia, cochlear implants, cerebrospinal fluid [CSF] leaks and/or immunocompromising conditions). Prevalence of risk conditions was compared according to gender and age strata. Results: Of the total 2,033,465 study population, an amount of 176,600 persons (8.7%) had any high-risk condition. Prevalence of high-risk subjects did not substantially differ by gender (9.2% in men vs. 8.2% in women; p<0.001), but considerably increased with increasing age (5.1% in 50-64 years vs. 10.6% in 65-79 years vs. 16.1% in people 80 years or older; p<0.001). Overall, 294 individuals (<0.1%) had anatomical or functional asplenia, 76 (<0.1%) cochlear implants, 41 (<0.1%) CSF leaks, 3,854 (0.2%) had immunodeficiency/AIDS, 16,815 (0.8%) had severe renal disease (nephrotic syndrome or renal failure), 5,034 (0.2%) had received bone marrow transplantation, 103,948 (5.1%) had recent cancer (diagnosed within 5 prior years) and 72,040 (3.5%) received immunosuppressive medication/radiotherapy. Conclusion: In our setting, almost ten percent of people over 50 years have any high-risk factor for pneumococcal vaccination, basically immunocompromising conditions.