Department of Social and Preventive Medicine, Laval University, Quebec City.
Can J Infect Dis Med Microbiol. 2007 Mar;18(2):121-7. doi: 10.1155/2007/713576.
In the United States, implementation of the seven-valent conjugate vaccine into childhood immunization schedules has had an effect on the burden of pneumococcal disease in all ages of the population. To evaluate the impact in Canada, it is essential to have an estimate of the burden of pneumococcal disease before routine use of the vaccine.
The incidence and costs of pneumococcal disease in the Canadian population in 2001 were estimated from various sources, including published studies, provincial databases and expert opinion.
In 2001, there were 565,000 cases of pneumococcal disease in the Canadian population, with invasive infections representing 0.7%, pneumonia 7.5% and acute otitis media 91.8% of cases. There were a total of 3000 deaths, mainly as a result of pneumonia and largely attributable to the population aged 65 years or older. There were 54,330 life-years lost due to pneumococcal disease, and 37,430 quality-adjusted life-years lost due to acute disease, long-term sequelae and deaths. Societal costs were estimated to be $193 million (range $155 to $295 million), with 82% borne by the health system and 18% borne by families. Invasive pneumococcal infections represented 17% of the costs and noninvasive infections represented 83%, with approximately one-half of this proportion attributable to acute otitis media and myringotomy.
The burden of pneumococcal disease before routine use of the pneumococcal conjugate vaccine was substantial in all age groups of the Canadian population. This estimate provides a baseline for further analysis of the direct and indirect impacts of the vaccine.
在美国，将 7 价结合疫苗纳入儿童免疫接种计划对各年龄段人群的肺炎球菌疾病负担产生了影响。要评估其在加拿大的影响，必须在常规使用疫苗之前对肺炎球菌疾病的负担进行估计。
从各种来源（包括已发表的研究、省级数据库和专家意见）估计了 2001 年加拿大人口中肺炎球菌疾病的发病率和费用。
2001 年，加拿大人口中有 56.5 万例肺炎球菌疾病，其中侵袭性感染占 0.7%，肺炎占 7.5%，急性中耳炎占 91.8%。共有 3000 人死亡，主要是肺炎所致，主要归因于 65 岁及以上人群。由于肺炎球菌疾病，有 54330 个生命年丧失，由于急性疾病、长期后遗症和死亡，有 37430 个质量调整生命年丧失。社会成本估计为 1.93 亿美元（范围为 1.55 亿至 2.95 亿美元），其中 82%由卫生系统承担，18%由家庭承担。侵袭性肺炎球菌感染占成本的 17%，非侵袭性感染占 83%，其中约一半归因于急性中耳炎和鼓膜切开术。
在常规使用肺炎球菌结合疫苗之前，加拿大所有年龄组人群的肺炎球菌疾病负担都相当大。这一估计为进一步分析疫苗的直接和间接影响提供了基线。
