Tendência da mortalidade por pneumonia em idosos no Brasil e o contexto da vacinação pneumocócica

• Autor(a) principal: Miranda, Denismar Borges de
• Data de Publicação: 2019
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/12272
• topic: Vacina pneumocócica 10-valente; Mortalidade; Pneumonia; Idosos; Análise de série temporal interrompida; Vacinação; Efeito de rebanho; 10-valent pneumococcal vaccine; Mortality; Pneumonia; Elderly; Interrupted time-series analysis; Vaccination; Herd effect; CIENCIAS DA SAUDE::SAUDE COLETIVA

Community-acquired pneumonia is one of the most common infectious diseases and is considered a major cause of morbidity and mortality in the elderly population worldwide. Studies show the direct and indirect impact of 10-valent pneumococcal vaccine on hospitalizations for pneumonia in several countries. There is scarce knowledge regarding this impact on mortality in the elderly in the world and, to date, no evidence in the Brazilian population. This study aimed to propose models for correcting mortality rates due to pneumonia in the elderly in Brazil and to evaluate the indirect impact of PCV-10, introduced in the childhood immunization schedule, at these rates. This is a time-series study of mortality rates from pneumonia in the elderly from 2005 to 2016. For the time-series analysis, the models for predicting pneumonia rates, if the vaccine had not been implemented, were Seasonal Autoregressive Integrated Moving Average (SARIMA) in the presence of seasonality, Auto Regressive Integrated Moving Averages (ARIMA) when there was only trend, and Autoregressive Moving Average (ARMA) in the absence of trend and seasonality. Percentage difference between observed and predicted rates were calculated, considering statistical significance of 5%. There was an increasing trend of mortality due to pneumonia in the elderly in Brazil. Interrupted time series analysis showed that the estimated pneumonia mortality rates from the study were significantly lower than those predicted by the analysis models. There was probably an indirect impact of PCV-10 on the elderly. In the Southeast region there was a statistically significant difference between the rates observed and the predicted in the three age groups of the elderly.