Análise da morbidade por pneumonia em crianças menores de cinco anos de idade na Mesorregião Norte Mato-Grossense

Abstract

Introduction: Pneumococcal pneumonia is an infection caused by Streptococcus pneumoniae; i t is the most common serious form of pneumococcal disease in children in Brazil and in the worldwide. Globally, the introduction of the pneumococcal vaccine has been contributed to the reduction of pneumonia rates. In Brazil, in 2010, 10-valent pneumococcal conjugate vaccine (PCV10) was introduced in the National Immunization Program (PNI) for children <2 years of age. There are evidences from post-vaccination studies showed the impact of PCV10 in children for pneumococcal diseases in Brazil. However, evidence of the impact of PCV10 in the northern region of Mato Grosso is not yet known, then we assessed the hospitalization of pneumonia in children <5 years of age, living in the northern region of Mato Grosso from 2008 to 2016. METHODS: A retrospective, before-after study was conducted with hospitalization data of children <5 years of age from 2008 to 2016. The data were available at the Hospital Information System (SIH-SUS). The monthly and annual rates of hospitalization for pneumonia and all nonrespiratory diseases (comparison group) were calculated using the number of hospitalizations divided by the estimated number of population at risk (x 10,000). The rates were analyzed fo r the pre- (Jan/2008-Jun/2010) and post-vaccination periods (Jul/2011-Dec/2016). The Student's t-test was applied to assess the mean of the rates per period. P values <0.05 were considered statistically significant. The difference in the mean of the rates per period was obtained by [(mean of pre-vaccination rate – mean of post-vaccination rate/mean of pre-rate)*100]. Results: Annual rates of pneumonia hospitalization decreased in the study period, while rates for the comparison group remained stable. The mean of monthly hospitalization rates in the post-vaccination period for pneumonia in children <5 years of age decreased 18.7% (p = 0.0188). For all non-respiratory diseases, the mean of hospitalization rates increased 3.8% (p = 0.3514). Statistically significant reduction was observed in children aged 1 to 4 years (19.0%, p = 0.0164), but not for the group <1 years of age (18.2%, p = 0.0610). Conclusion: Annual hospitalization rates for pneumonia decreased in children <5 years of age living in the northern region of Mato Grosso during the study period. We identify an impact of vaccination with PCV10 in hospitalized cases of pneumonia in children <5 years of age, especially in the 1-4 years age group. Further investigation is needed to ascertain the effect of the PCV10 in children <1 years of age.