RESUMEN
Respiratory syncytial virus (RSV) is an important cause of severe respiratory disease in older adults. Understanding the disease burden is crucial for guiding vaccination policy and raising disease awareness. We estimated the burden of RSV hospitalizations and deaths in adults in five middle-income countries: Argentina, Brazil, Chile, Mexico, and Malaysia. Hospital discharge and death statistics due to any respiratory disease (ICD-10 codes: J00-99) from 2010 to 2022 were obtained. The RSV attributable burden on hospitalizations and deaths by age group was determined for 2019 using previously published estimates. Latin American countries showed distinct annual peaks in respiratory-related hospitalizations and deaths during winter months that were absent in Malaysia. Among ≥20-year-olds in 2019, there were 14,604 RSV-attributable hospitalizations nationally in Argentina, 44,323 in Brazil, 4529 in Chile, 7416 in Malaysia, and 8651 in Mexico, and 60-74% in ≥65-year-olds. There were also 3518 RSV-attributable deaths in Argentina, 9115 in Brazil, 801 in Chile, 704 in Malaysia, and 3806 in Mexico 79-88% in ≥65-year-olds. Incidences of RSV-attributable hospitalizations in ≥75-year-olds ranged between 256.3 and 294.3 per 100,000 population, and deaths between 33.6 and 112.9 per 100,000 population. RSV is associated with a substantial disease burden beyond pediatric age groups, and preventive vaccines could have a major impact on this burden, especially in older adults.
RESUMEN
Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with loss of lung function, poor quality of life, loss of exercise capacity, risk of serious cardiovascular events, hospitalization, and death. However, patients underreport exacerbations, and evidence suggests that unreported exacerbations have similar negative health implications for patients as those that are reported. Whilst there is guidance for physicians to identify patients who are at risk of exacerbations, they do not help patients recognise and report them. Newly developed tools, such as the COPD Exacerbation Recognition Tool (CERT) have been designed to achieve this objective. This review focuses on the underreporting of COPD exacerbations by patients, the factors associated with this, the consequences of underreporting, and potential solutions.
Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica , Humanos , Calidad de Vida , Progresión de la Enfermedad , HospitalizaciónRESUMEN
BACKGROUND: Treatment of osteoporosis with bisphosphonates can lead to important reductions in fracture rates. The effectiveness of bisphosphonates is however limited by inadequate treatment persistence. The introduction of weekly administered forms has been associated with improved treatment persistence. OBJECTIVES: This modelling study was designed to estimate the gain in persistence associated with a monthly treatment and the subsequent impact on fracture rates. METHODS: Osteoporosis treatment rates and persistence rates were obtained from a French general practice registry for weekly and daily bisphosphonates and from a US managed care database for monthly bisphosphonates. Survival analyses were used to assess persistence. Fracture, hospitalisation and fracture rates were attributed based on data from clinical trials with bisphosphonates and epidemiological data. RESULTS: Using a monthly treatment regimen, the reduction in the risk of vertebral and non-vertebral fractures with respect to untreated subjects was estimated to be 21.2% and 9.5% respectively. The reduction in risk of hospitalisation was estimated at 17.0% and the reduction of mortality at 18.1%. These reductions are around 60% higher as those estimated for daily bisphosphonate treatment and 25% higher than for weekly bisphosphonate treatment. CONCLUSION: This modelling approach supports the notion that increased treatment persistence associated with use of monthly bisphosphonate treatment regimens may result in a significant impact on osteoporotic fracture rates and consequent hospitalisation and mortality rates.