Background

Human development index (HDI) is the most frequently indicator used of socioeconomic level in a nation. However, few studies have analyzed the role of HDI in the epidemiology of community-acquired pneumonia (CAP) in Costa Rica and worldwide.

Methods

A descriptive study analyzes the relationship between HDI and the incidence of CAP by county between the years 2005 to 2014 in Costa Rica.

Results

The incidence of CAP and HDI had an inversely proportional relationship. Over this period of time, HDI increased progressively (0.729 to 0.766); this was correlated with decrease of incidence in CAP (164.9 to 138.1 per 100.000 persons) (p = 0.005). When this index exceeded 0.75, the incidence showed significant decrease from 155.0 to 127.1 cases per 100,000 persons. Prior to this change, the average annual variation rate was -1.2% and turned to -2.9% after it. Counties with very high and / or high HDI had a significantly lower incidence of CAP compared to those with a medium HDI (OR = 0.62; CI95% 0.46 - 0.83 vs OR = 0.43; CI95% 0.30 - 0.61).

Conclusions

HDI is a good predictor of CAP incidence in Costa Rica; the higher the HDI the lower incidence of CAP.

Background

Pneumococcal disease (PD) case-fatality rate (CFR) in Costa Rica has being reported higher (8-30%) than in literature (3-22%).

Methods

Descriptive study of adult cases with culture-positive PD seeking care at two tertiary care hospitals in Costa Rica between 2014-2018. Information on demographics, clinical characteristics and outcomes was analyzed for each case.

Results

282 culture-positive PD cases were included. CFR is consistently higher in all risk groups among ≥ 60 y/o patients OR 2.31 [IC95 1.38-3.89].

Log-rank analysis showed an unequal 30-day mortality in adults ≥ 60 y/o (p=0.012) but no differences in risk related groups (p=0.91).

Conclusions

PD CFR vary between age and risk groups in Costa Rica. Across all risk groups, elder adults have the most risk of dying following PD. There is a similar mortality rate among all ages high-risk patients and at-risk patients. Prevention strategies to reduce the ongoing burden of mortality from PD are needed, especially for elderly patients.