PDF(Pubmed)
Abstract：
BACKGROUND: Pneumococcal diseases (PDs) are among the leading causes of mortality and morbidity worldwide. However, the evidence on epidemiology, health economic, and patient-reported outcomes has not been systematically reviewed and published in Japan. This study aimed to assess the burden, treatment adherence and compliance, and serotype distribution associated with PDs in Japan.
METHODS: One hundred and eight studies were identified between January 2005 and June 2020. The identified studies were mostly regional and with a limited scale, clinical settings, and populations.
RESULTS: In 2013-2017, invasive PD incidence rates were 4.98-9.47/100,000 in <4-year-olds, 0.36/100,000 in 5-14-year-olds, 0.46/100,000 in 15-64-year-olds, and 1.50-5.38/100,000 in the elderly. The incidence of invasive PDs in children decreased from 24.6/100,000 in 2008 to 10.7/100,000 in 2013 after the introduction of PCV7 and further declined to 10.3/100,000 in 2014 after PCV13 was introduced. From 2014, the prevalence of PCV13 serotypes decreased across all age groups along with a decrease of PPV23 serotypes, but an increase of PPV23 serotypes not included in PCV13 among adults and the elderly. No study reported health-related quality-of-life data for PDs. In children, direct costs were 340,905-405,978 JPY (3,099-3,691 USD) per pneumococcal bacteraemia, 767,447-848,255 JPY (6,977-7,711 USD) per pneumococcal meningitis, and 79,000 JPY (718 USD) per pneumococcal acute otitis media episodes. In adults and the elderly, the direct cost of pneumococcal pneumonia was 348,280-389,630 JPY (3,166-3,542 USD). The average hospital stay length was 7.2-31.9 days in children, 9.0 days in adults and 9.0-28.7 days in adults and the elderly.
CONCLUSIONS: The epidemiological burden of PDs remains high in Japan, especially among children and the elderly with invasive PDs accounting for a very small proportion of all PDs. A significant impact of the PCV13 vaccine program was reported, while the PPV23\'s impact remains unclear. A substantial decrease in quality-adjusted life years in adults and the elderly and a high economic burden may exist.
METHODS: One hundred and eight studies were identified between January 2005 and June 2020. The identified studies were mostly regional and with a limited scale, clinical settings, and populations.
RESULTS: In 2013-2017, invasive PD incidence rates were 4.98-9.47/100,000 in <4-year-olds, 0.36/100,000 in 5-14-year-olds, 0.46/100,000 in 15-64-year-olds, and 1.50-5.38/100,000 in the elderly. The incidence of invasive PDs in children decreased from 24.6/100,000 in 2008 to 10.7/100,000 in 2013 after the introduction of PCV7 and further declined to 10.3/100,000 in 2014 after PCV13 was introduced. From 2014, the prevalence of PCV13 serotypes decreased across all age groups along with a decrease of PPV23 serotypes, but an increase of PPV23 serotypes not included in PCV13 among adults and the elderly. No study reported health-related quality-of-life data for PDs. In children, direct costs were 340,905-405,978 JPY (3,099-3,691 USD) per pneumococcal bacteraemia, 767,447-848,255 JPY (6,977-7,711 USD) per pneumococcal meningitis, and 79,000 JPY (718 USD) per pneumococcal acute otitis media episodes. In adults and the elderly, the direct cost of pneumococcal pneumonia was 348,280-389,630 JPY (3,166-3,542 USD). The average hospital stay length was 7.2-31.9 days in children, 9.0 days in adults and 9.0-28.7 days in adults and the elderly.
CONCLUSIONS: The epidemiological burden of PDs remains high in Japan, especially among children and the elderly with invasive PDs accounting for a very small proportion of all PDs. A significant impact of the PCV13 vaccine program was reported, while the PPV23\'s impact remains unclear. A substantial decrease in quality-adjusted life years in adults and the elderly and a high economic burden may exist.
摘要：
背景：肺炎球菌病（PD）是全球死亡率和发病率的主要原因之一。然而,流行病学的证据，卫生经济,患者报告的结局尚未在日本进行系统评价和发表.这项研究旨在评估负担，治疗依从性和依从性，以及与日本PD相关的血清型分布。
方法：在2005年1月至2020年6月之间确定了108项研究。确定的研究大多是区域性的，规模有限，临床设置，和人口。
结果：在2013-2017年，<4岁儿童的侵袭性PD发病率为4.98-9.47/100,000，5-14岁儿童0.36/100,000，15-64岁的0.46/100,000，和1.50-5.38/10万老年人。引入PCV7后，儿童侵入性PD的发生率从2008年的24.6/100,000下降到2013年的10.7/100,000，在引入PCV13后，2014年进一步下降到10.3/100,000。从2014年开始，PCV13血清型的患病率在所有年龄组都随着PPV23血清型的减少而下降。但成人和老年人中PCV13中未包括的PPV23血清型增加。没有研究报告与健康相关的生活质量数据。在儿童中，每次肺炎球菌菌血症的直接成本为340,905-405,978日元（3,099-3,691美元），每次肺炎球菌脑膜炎767,447-848,255日元（6,977-7,711美元），和每次肺炎球菌急性中耳炎发作79,000日元（718美元）。在成年人和老年人中，肺炎球菌肺炎的直接成本为348,280-389,630日元（3,166-3,542美元）。儿童的平均住院时间为7.2-31.9天，成年人9.0天，成年人和老年人9.0-28.7天。
结论：日本PD的流行病学负担仍然很高，特别是在儿童和老年人中，侵入性PD在所有PD中所占比例很小。据报道，PCV13疫苗计划产生了重大影响，而PPV23的影响尚不清楚。成年人和老年人的质量调整寿命年大幅下降，可能存在较高的经济负担。
方法：在2005年1月至2020年6月之间确定了108项研究。确定的研究大多是区域性的，规模有限，临床设置，和人口。
结果：在2013-2017年，<4岁儿童的侵袭性PD发病率为4.98-9.47/100,000，5-14岁儿童0.36/100,000，15-64岁的0.46/100,000，和1.50-5.38/10万老年人。引入PCV7后，儿童侵入性PD的发生率从2008年的24.6/100,000下降到2013年的10.7/100,000，在引入PCV13后，2014年进一步下降到10.3/100,000。从2014年开始，PCV13血清型的患病率在所有年龄组都随着PPV23血清型的减少而下降。但成人和老年人中PCV13中未包括的PPV23血清型增加。没有研究报告与健康相关的生活质量数据。在儿童中，每次肺炎球菌菌血症的直接成本为340,905-405,978日元（3,099-3,691美元），每次肺炎球菌脑膜炎767,447-848,255日元（6,977-7,711美元），和每次肺炎球菌急性中耳炎发作79,000日元（718美元）。在成年人和老年人中，肺炎球菌肺炎的直接成本为348,280-389,630日元（3,166-3,542美元）。儿童的平均住院时间为7.2-31.9天，成年人9.0天，成年人和老年人9.0-28.7天。
结论：日本PD的流行病学负担仍然很高，特别是在儿童和老年人中，侵入性PD在所有PD中所占比例很小。据报道，PCV13疫苗计划产生了重大影响，而PPV23的影响尚不清楚。成年人和老年人的质量调整寿命年大幅下降，可能存在较高的经济负担。
