Percorrer por autor "Froes, Filipe"
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- Evolução das hospitalizações por pneumonia pneumocócica na população portuguesa com 65 ou mais anos entre 1998 e 2015Publication . Kislaya, Irina; Rodrigues, Ana Paula; Uva, Mafalda; Froes, Filipe; Nunes, BaltazarAs pneumonias pneumocócicas apresentam um elevado peso na mortalidade e morbilidade na população idosa.
- Hospital admissions of adults with community-acquired pneumonia in Portugal between 2000 and 2009Publication . Froes, Filipe; Diniz, António; Mesquita, Margarida; Serrado, Margarida; Nunes, BaltazarRecent studies in the USA and northern Europe have shown an increase in community-acquired pneumonia (CAP). In southern Europe this increase has not yet been documented. We carried out a retrospective analysis from encoded information from the Portuguese database for hospital admissions which included all individuals aged 18 or above, with a primary diagnosis of pneumonia, who were discharged between 2000 and 2009. We excluded patients infected with Human Immunodeficiency Virus, immunocompromised individuals as a result of anti-cancer or immunosuppressive treatment and transplant recipients. Of the 294 027 admissions for CAP, 56% were male. The average age was 73.1 and the median age 77. Between 2000 and 2009 there was a 5% increase in the average age of patients admitted with CAP. Admissions for CAP represented 3.7% of total admissions of adult patients. The average annual rate of hospital admissions for adults with CAP was 3.61 per 1000 total population, rising to 13.4% for those>65. From 2000–2004 and 2005–2009 the average annual rate of hospital admission for CAP per 1000 population increased 28.2%. Hospital admissions for CAP in Portugal increased between 2000 and 2009. It has grown consistently over time varying according to age with males overrepresented.
- Impact of 13-valent pneumococcal conjugate vaccination introduction in children on pneumonia hospitalizations among adults aged 65 or more in PortugalPublication . Kislaya, Irina; Rodrigues, Ana Paula; Sousa-Uva, Mafalda; Gómez, Verónica; Froes, Filipe; Nunes, BaltazarThe incidence of pneumonia and pneumonia related hospitalizations still increasing in different European and American Countries. However, in western countries this increase is driven by secondary diagnoses, recurrent pneumonia episodes in elderly and among those with comorbidities. Given the high frequency of Streptococcus pneumoniae among all pneumonia, it is reasonable to expect that a wide use of pneumococcal vaccines would reduce the burden of pneumonia in the elderly due to a direct and indirect effect. In Portugal, pneumococcal vaccines are available since 1996: pneumococcal polysaccharide vaccine (PPSV23) in 1996; heptavalent conjugated pneumococcal vaccines (PCV7) in 2001; PCV10 in April 2009 and PCV13 in January 2010. PPSV23 and PCV13 are widely recommended for risk groups and elderly. PCV7 serotypes reduced from 31% in 1999–2003 to 11% in 2009–2011 in non-invasive pneumococcal pneumonia (PP), but no decreasing trend was observed for PCV13 and PPSV23 serotypes until 2011. Trends in pneumococcal pneumonia after PCV13 introduction are not known in Portugal. Thus, this study aims to assess population level impact of infant PCV13 introduction on burden of pneumonia among adults aged 65 or more in Portugal through comparison of trends in PP hospitalization rates before and after PCV13 introduction.
- Impact of infant pneumococcal vaccination on pneumococcal pneumonia hospitalizations in older adultsPublication . Kislaya, Irina; Rodrigues, Ana Paula; Sousa-Uva, Mafalda; Gómez, Verónica; Gonçalves, Paulo; Froes, Filipe; Nunes, BaltazarPneumonia is an important cause of morbidity, mortality and expenditure of health resources. Since the introduction of conjugated pneumococcal vaccines (PCV) in infant immunization programs in 2000s, there is consistent evidence of pneumonia reduction in vaccinated children1. Limited data are available on indirect effect of infant immunization on pneumonia burden in unvaccinated population subgroups. This study aims to assess the indirect effect of the introduction of infant 7-valent (PCV7) and 13-valent (PCV13) pneumococcal conjugated vaccines on the pneumonia burden among adults aged 65 or more years in Portugal, comparing trends in Pneumococcal Pneumonia (PP) hospitalization rates before and after the introduction of the PCV7/PCV13.
- Indirect effect of 7-valent and 13-valent pneumococcal conjugated vaccines on pneumococcal pneumonia hospitalizations in elderlyPublication . Kislaya, Irina; Rodrigues, Ana Paula; Sousa-Uva, Mafalda; Gómez, Verónica; Gonçalves, Paulo; Froes, Filipe; Nunes, BaltazarBackground: Pneumonia is one of the leading causes of mortality and has a high burden in morbidity. In Portugal, 7-valent pneumococcal conjugated vaccine (PCV) was used since 2001 and PCV10/13 since 2009, being the last introduced into the National Immunization Program in 2015. Methods: We conducted an ecological study to evaluate the impact of PCV7 and PCV13 on pneumococcal pneumonia (PP) hospitalizations in adults aged 65 years or more in Portugal. National hospital discharge registry data from 1998/99 to 2015/16 were used, and PP hospitalization was defined as any hospitalization coded in primary diagnosis as 481 (ICD-9-CM) or J18 (ICD-10-CM). Poisson regression models adjusted for seasonality, influenza-like illness and allowing for overdispersion was used to estimate annual average change of PP hospitalization rate. To assess PP hospitalization trends before and after PCV7 and PCV13 introduction interrupted time series analysis was performed. Results: In 1998/99 PP hospitalization rate was 7.0 per 10,000 inhabitants, varying between 3.2 (females, 65-74 years) to 20.7 (males, +85 years), and annually increasing by 16% during the pre-PCV7 period. Statistically significant reduction of 14% per year in PP hospitalization rate was observed after PCV7 introduction. Between 2004/05 and 2009/10 PP hospitalization rate decreased annually by 4% and after PCV13 introduction by 11% per year. In 2015/16 we found an overall reduction of 2.9 (CI 95%: 2.7; 3.1) PP hospitalizations per 10,000 inhabitants (598 hospitalizations) attributable to PCV13, varying from 2.2 (CI 95%: 1.3; 3.1) (female, 65-74 years) to 5.6 (CI 95%: 3.8; 7.5) (female, +85 years). Conclusions: Our results suggest that introduction of both PCV7 and PCV13 vaccines resulted in the reduction of PP hospitalizations rates among older adults.
- Óbitos por gripe pandémica A (H1N1) 2009 em Portugal Período de Abril de 2009 a Março de 2010Publication . Froes, Filipe; Diniz, António; Falcão, Isabel; Nunes, Baltazar; Catarino, JuditeProcedeu-se à análise dos 124 óbitos notificados em Portugal por gripe pandémica A (H1N1) 2009 no período de Abril de 2009 a Março de 2010. A taxa de mortalidade estimada foi de 1,17/100.000 habitantes. Cerca de 60% dos falecidos eram do sexo masculino, a idade média foi de 47,6 anos e 66,7% apresentavam, pelo menos, um factor de risco para doença grave. As doenças pulmonar e cardíaca crónicas foram os factores de risco mais prevalentes, identificados em 24,7% e 20,7% dos casos, respectivamente. Mais de ¾ dos doentes foram internados em Unidades de Cuidados Intensivos (UCI). A pneumonia viral primária foi a principal causa de morte, diagnosticada em 79,7% dos doentes. Constatou-se haver diferença estatisticamente significativa em relação à distribuição da causa de morte nos grupos dos indivíduos com e sem factores de risco (p=0.048). Estimaram-se em 2 853 os anos potenciais de vida perdidos, o que equivale a 30,8 anos por 100.000 habitantes. Os valores encontrados são comparáveis, na generalidade, com os encontrados noutros países com o mesmo nível de desenvolvimento. Em futuras circunstâncias semelhantes deverá ser equacionada a notificação obrigatória dos casos de maior gravidade.