OBJECTIVES: Pneumococcal disease (PD) is a leading cause of morbidity and mortality. This study aimed to estimate the burden of clinical syndromes associated with PD in Peru in 2019.

METHODS: A secondary analysis was conducted using data obtained from local databases from the Ministry of Health (~60% of population coverage). Clinical syndromes associated with PD (pneumonia, bacteremia, and otitis media) were identified using ICD-10 codes. The study population included all ages for pneumonia and bacteremia, and under 5 years (y) for otitis media. Incidence rates were expressed per 100,000 persons per year and stratified by age group.

RESULTS: In 2019, 48,860 pneumonia (19,230 inpatient and 29,630 outpatient) cases and 4,632 bacteremia cases were reported in all age groups. For otitis media, 176 hospitalizations and 21,872 outpatient visits occurred in children under 5y. The most affected age groups for pneumonia and bacteremia were <1y, 1-4y, ≥60y. For those aged ≥60y, 40.2% were inpatient pneumonia cases; the highest incidence rate was for outpatient pneumonia (290.8/100,000), followed by inpatient pneumonia (195.5/100,000) and bacteremia (70.4/100,000). The in-hospital case-fatality rate was high in ≥60y compared to the overall population for pneumonia (16.8% vs 7.6%) and bacteremia (60.4% vs 47.9%). In children <1y, outpatient pneumonia had the highest incidence rate (627.5/100,000), followed by inpatient pneumonia (664.5/100,000) and outpatient otitis media (611.7/100,000). In children 1-4y, outpatient otitis media had the highest rate (822/100,000), followed by outpatient pneumonia (285.2/100,000) and inpatient pneumonia (214.8/100,000). 78% of pneumonia and bacteremia hospitalizations occurred in children under 5y and 77% of the deaths in adults ≥60y.

CONCLUSIONS: The burden of clinical syndromes associated with PD was high in Peru, affecting mainly children under 5y and adults ≥60y. Strengthening immunization strategies by increasing vaccine uptake and serotype vaccine coverage may reduce the burden of pneumococcal disease in these populations.