Open Access

Risk factors and comorbidities for invasive pneumococcal disease in Western Australian Aboriginal and non-Aboriginal people

  • Faye J. Lima14,
  • Deborah Lehmann14,
  • Aoiffe McLoughlin14,
  • Catherine Harrison14,
  • Judith Willis14,
  • Carolien Giele24,
  • Anthony D. Keil34 and
  • Hannah C. Moore14Email author
Pneumonia20144:4010024

https://doi.org/10.15172/pneu.2014.4/463

Received: 2 April 2014

Accepted: 15 June 2014

Published: 11 September 2014

Abstract

Australian Aboriginal people have among the highest rates of invasive pneumococcal disease (IPD) worldwide. We investigated clinical diagnosis, risk factors, comorbidities and vaccine coverage in Aboriginal and non-Aboriginal IPD cases. Using enhanced surveillance, we identified IPD cases in Western Australia, Australia, between 1997 and 2007. We calculated the proportion with risk factors and comorbidities in children (<5 years) and adults (=15 years), as well as adults living in metropolitan and non-metropolitan regions. We then calculated the proportion of cases eligible for vaccination who were vaccinated before contracting IPD. Of the 1,792 IPD cases that were reported, 355 (20%) were Aboriginal and 1,155 (65%) were adults. Pneumonia was the most common diagnosis (61% of non-Aboriginal and 49% of Aboriginal adult IPD cases in 2001–2007). Congenital abnormality was the most frequent comorbidity in non-Aboriginal children (11%). In Aboriginal children, preterm delivery was most common (14%). Ninety-one percent of non-Aboriginal and 96% of Aboriginal adults had one or more risk factors or comorbidities. In non-Aboriginal adults, cardiovascular disease (34%) was the predominant comorbidity whilst excessive alcohol use (66%) was the most commonly reported risk factor in Aboriginal adults. In adults, comorbidities were more frequently reported among those in metropolitan regions than those in non-metropolitan regions. Vaccination status was unknown for 637 of 1,082 cases post-July 2001. Forty-one percent of non-Aboriginal and 60% of Aboriginal children were eligible for vaccination but were not vaccinated. Among adults with risk factors who were eligible for vaccination and with known vaccination status, 75% Aboriginal and 94% non-Aboriginal were not vaccinated. An all-of-life immunisation register is needed to evaluate vaccine coverage and effectiveness in preventing IPD in adults.

Keywords

Invasive pneumococcal disease risk factors comorbidities pneumonia immunization

Notes

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