Community-Acquired Pneumonia in Latin America

Abstract

Community-acquired pneumonia (CAP) is associated with significant morbidity and mortality in Latin America and the Caribbean (LAC) region. Poverty, socioeconomic factors, and malnutrition influence the incidence and outcome of CAP in LAC. In LAC, is the most frequent microorganism responsible for CAP, (incidence: 24-78%); the incidence of atypical microorganisms is similar to other regions of the world. Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a growing problem in the LAC region, with the Caribbean being the second most affected area worldwide after Sub-Saharan Africa. Pneumococcal pneumonia remains the most common cause of CAP in HIV-infected patients, but and tuberculosis (TB) are also common in this population. The heterogeneity of the health care systems and social inequity between different countries in LAC, and even between different settings inside the same country, is a difficult issue. TB, including multidrug-resistant TB, is several times more common in South American and Central American countries compared with North America. Furthermore, hantaviruses circulating in the Americas (new world hantaviruses) generate a severe respiratory disease called hantavirus pulmonary syndrome, with an associated mortality as high as 50%. More than 30 hantaviruses have been reported in the Western Hemisphere, with more frequent cases registered in the southern cone (Argentina, Chile, Uruguay, Paraguay, Bolivia, and Brazil). Respiratory viruses (particularly influenza) remain an important cause of morbidity and mortality, particularly in the elderly. Low rates of vaccination (against influenza as well as pneumococcus) may heighten the risk of these infections in low- and middle-income countries.

Recent advances in the epidemiology and prevention of Streptococcus pneumoniae infections

“…Other studies and reviews published in the last four years from different parts of the world, including Australia 10,11 and the Asia Pacific region 12 , Canada 13,14 , Latin America [15][16][17] , and the Caribbean 17 , have documented similar findings. Namely, there is an ongoing high rate of pneumococcal pneumonia in all of these regions; in more recent years, this is often the case despite decreased rates associated with herd protection in adults from implementation of childhood PCV immunization as well as a residual burden of vaccine-serotype pneumonia and invasive pneumococcal disease (IPD), as described above.…”

Comprehensive risk assessment for hospital-acquired pneumonia: sociodemographic, clinical, and hospital environmental factors associated with the incidence of hospital-acquired pneumonia

“…Poverty and infectious diseases interact in complex ways [ 21 ], and poverty is a well-known risk factor for community-acquired pneumonia [ 12 , 13 ]. According to previous studies, poor individuals have a higher risk of community-acquired pneumonia as they are more likely to have uncontrolled chronic diseases and less likely to have sufficient medical resources and access to care, resulting in longer hospital stays and higher mortality [ 13 , 22 , 23 ]. In this study, patients in poverty had a slightly higher risk of HAP than those not in poverty.…”

“…However, studies on hospital environment-associated risk factors for HAP are limited. Furthermore, studies excluded poverty, which is a strong risk factor for other infectious diseases [ 12 , 13 ]. Thus, we conducted a comprehensive risk assessment, including sociodemographic, clinical, and hospital environmental factors associated with the incidence of HAP (Fig.…”

Gram-Positive Pneumonia: Possibilities Offered by Phage Therapy

“…However, the incidence and etiology of pneumonia are strongly correlated with its geographic distribution. Poverty, socioeconomic factors and malnutrition influence the incidence and outcome of CAP in some countries, such as Latin America and the Caribbean region, where S. pneumoniae has an incidence of 24–78% [ 10 ]. It must be noted that HAP, including VAP, represented almost 22% of all nosocomial infections from 2002 to 2003, which highlights the importance of pneumonia in the hospital environment.…”