ObjectiveTo determine the incidence rate and mortality of community-acquired pneumonia (CAP) in adults in three cities in Latin America during a 3-year period.DesignProspective population-based surveillance study.SettingHealthcare facilities (outpatient centres and hospitals) in the cities of General Roca (Argentina), Rivera (Uruguay) and Concepción (Paraguay).Participants2302 adults aged 18 years and older with CAP were prospectively enrolled between January 2012 and March 2015.Main outcome measuresIncidence rates of CAP in adults, predisposing conditions for disease, mortality at 14 days and at 1 year were estimated. Incidence rate of CAP, within each age group, was calculated by dividing the number of cases by the person-years of disease-free exposure time based on the last census; incidence rates were expressed per 1000 person-years.ResultsMedian age of participants was 66 years, 46.44% were men, 68% were hospitalised. Annual incidence rate was 7.03 (95% CI 6.64 to 7.44) per 1000 person-years in General Roca, 6.33 (95% CI 5.92 to 6.78) per 1000 person-years in Rivera and 1.76 (95% CI 1.55 to 2.00) per 1000 person-years in Concepción. Incidence rates were highest in participants aged over 65 years. 82.4% had at least one predisposing condition and 48% had two or more (multimorbidity). Chronic heart disease (43.6%) and smoking (37.3%) were the most common risk factors. 14-day mortality rate was 12.1% and 1-year mortality was 24.9%. Multimorbidity was associated with an increased risk of death at 14 days (OR 2.91; 95% CI 2.23 to 3.80) and at 1 year (OR 3.00; 95% CI 2.44 to 3.70).ConclusionsWe found a high incidence rate of CAP in adults, ranging from 1.76 to 7.03 per 1000 person-years, in three cities in South America, disclosing the high burden of disease in the region. Efforts to improve prevention strategies are needed.

Background: Pneumococcal pneumonia is an important cause of morbi-mortality in argentinian adult population. In immunocompromised hosts and patients with known risk factors, the risk of infection by this pathogen is elevated. According to the Third National Enquiry of Risk Factors (Argentina 2013), the prevalence of application of pneumococcal vaccine is 16.2% (CI 95% 15.2-17.3), which demonstrates the limited adhesion to the practice guidelines by medical doctors. The immunization rate of private health care providers is unknown. The aim of the present study was to measure the pneumococcal immunization rate in defined risk populations in a private health center.Methods & Materials: We conducted an observational study in Austral University Hospital (Buenos Aires, Argentina) from June 2017 to October 2017 identifying patients treated in ambulatory care with four known risk factors: chronic cardiac disease (56 patients), chronic kidney disease (32 patients), chronic obstructive pulmonary disease (78 patients) and diabetes mellitus (52 patients).Results: Among the different risk factors, the pneumococcal immunization rate was: chronic cardiac disease 42.9% (24/56), chronic kidney disease 25% (8/32), chronic obstructive pulmonary disease 57.7% (45/78) and diabetes mellitus 11.5% (6/52). The overall rate of vaccination was 38.1% (83/218). Conclusion:Although the pneumococcal immunization rate of our private health center was significantly higher than the reported by the National Enquiry (38.1% vs. 16.2%), a lot of effort is still needed in order to promote this prevention strategy among risk populations.