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. 2022 Sep 10:30:100591.
doi: 10.1016/j.lanwpc.2022.100591. eCollection 2023 Jan.

Epidemiology of pneumonia in hospitalized adults ≥18 years old in four districts of Ulaanbaatar, Mongolia, 2015-2019

Kirsten Fagerli  1   2 , Mukhchuluun Ulziibayar  3 , Bujinlkham Suuri  3 , Dashtseren Luvsantseren  3 , Dorj Narangerel  4 , Purevsuren Batsaikhan  3 , Bilegtsaikhan Tsolmon  3 , Bradford D Gessner  5 , Eileen M Dunne  5 , Anneke C Grobler  1   2 , Cattram D Nguyen  1   2 , Tuya Mungun  3 , E Kim Mulholland  1   2   6 , Claire von Mollendorf  1   2
Affiliations

Epidemiology of pneumonia in hospitalized adults ≥18 years old in four districts of Ulaanbaatar, Mongolia, 2015-2019

Kirsten Fagerli et al. Lancet Reg Health West Pac. .

Abstract

Background: Community-acquired pneumonia is a leading cause of morbidity and mortality among children and adults worldwide. Adult pneumonia surveillance remains limited in many low- and middle-income settings, resulting in the disease burden being largely unknown.

Methods: A retrospective cohort study was conducted by reviewing medical charts for respiratory admissions at four district hospitals in Ulaanbaatar during January 2015-February 2019. Characteristics of community-acquired pneumonia cases were summarized by disease severity and age. To explore factors associated with severe pneumonia, we ran univariable and age-adjusted logistic regression models. Incidence rates were calculated using population denominators.

Results: In total, 4290 respiratory admissions met the case definition for clinical pneumonia, including 430 admissions of severe pneumonia. The highest proportion of severe pneumonia admissions occurred in adults >65 years (37.4%). After adjusting for age, there were increased odds of severe pneumonia in males (adjusted odds ratio [aOR]: 1.63; 95% confidence interval [CI]: 1.33-2.00) and those with ≥1 underlying medical condition (aOR: 1.46; 95% CI: 1.14-1.87). The incidence of hospitalized pneumonia in adults ≥18 years increased from 13.49 (95% CI: 12.58-14.44) in 2015 to 17.65 (95% CI: 16.63-18.71) in 2018 per 10,000 population. The incidence of severe pneumonia was highest in adults >65 years, ranging from 9.29 (95% CI: 6.17-13.43) in 2015 to 12.69 (95% CI: 9.22-17.04) in 2018 per 10,000 population.

Interpretations: Vaccination and other strategies to reduce the risk of pneumonia, particularly among older adults and those with underlying medical conditions, should be prioritized.

Funding: Pfizer clinical research collaboration agreement (contract number: WI236621).

Keywords: Adult pneumonia; Disease incidence; Hospitalization; Mongolia; Pneumonia.

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Conflict of interest statement

EKM and CVM are lead investigators of this study through Murdoch Childrens Research Institute, which was funded by Pfizer. MU, CDN, BS, DL, BP and TM are investigators on this collaborative research project funded by Pfizer. BDG and EMD are employees of Pfizer and own Pfizer stock or stock options. The other authors have no relevant conflicts of interest to declare. This study is a Murdoch Childrens Research Institute-sponsored study which is investigator-led, and funded under a collaborative agreement by Pfizer Inc.

Figures

Figure 1
Figure 1
Inclusion of study participants with respiratory-related admissions at four sentinel hospitals in Ulaanbaatar, Mongolia, January 2015– February 2019.
Figure 2
Figure 2
Total respiratory and clinical pneumonia hospital admissions in adults ≥18 years old, reported through retrospective chart review, Ulaanbaatar, Mongolia, January 2015–February 2019.
Figure 3
Figure 3
Monthly incidence rate of community-acquired pneumonia hospital admissions in adults ≥18 years old, by age group, reported through retrospective chart review, Ulaanbaatar, Mongolia, January 2015–December 2018.
See this image and copyright information in PMC

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