Mortality and morbidity due to pneumonia and associated with diabetes by age group and locality in Bogotá, 1999-2007

Mortalidad y morbilidad por neumonía según grupos de edad, localidad y por causa asociada a diabetes en Bogotá 1999-2007

Introduction. Pneumonia is a public health concern due to its morbidity, mortality, and high economic and social cost. The elderly, together with the chronically ill, are the population most affected by complications due to this disease.

The aim of this paper is to determine the situation of mortality and morbidity due to pneumonia in Bogotá during the 1999-2007 period.

Methods. A review was carried out of the mortality database of the National Department of Statistics (DANE) for the 1999-2007 period, which is available at the city’s Health Department. The causes of mortality were selected in accordance with the International Classification of Diseases, taking into account: age group, locality of residence, pneumonia whose causes are associated with diabetes, and diabetes whose causes are associated with pneumonia. Information about morbidity, according to hospital discharge and age group, of 24 second- and third level healthcare institutions for the 2000-2006 period was also examined.

Results. The rate of hospital discharges due to pneumonia is highest among the group aged less than 5 years, with 57.1% (31.137), followed by the group aged 60 and older, with 19.5% (10.391).
The rate of mortality due to pneumonia for the group aged less than 5 years decreased dramatically, from 41.3 x100.000 inhabitants during 1999 to 11.9 x100.000 in 2007. The rate of mortality during the 8-year period assessed showed that the average mortality for the group aged 60 and older was 121 x100.000 inhabitants, which is 5 times higher than the mortality of the group aged less than 5 years.
With regard to mortality due to diabetes, 536 cases had pneumonia as an associated cause, with an average mortality rate of 1x100.000 inhabitants. The group most affected is that aged 60 and older, whose rate is 11.5 x 100.000 inhabitants and 447 cases.
The behavior of mortality by month is associated with periods of rain. It is highest during May and June both for children and adults. However, during the second semester of the year, it goes from September to November for children, whereas mortality among the elderly extends until December.

Discussion. Pneumonia is an important infectious cause of morbidity and mortality in Bogotá. There has been an obvious decrease in mortality due to pneumonia in children, possibly because of preventive strategies aimed at childhood. There is also evidence of remarkable and persistent mortality due to pneumonia among people aged 60 years and older, as well as among people with chronic diseases such as diabetes. Although we were not able to determine the etiologic agents associated with pneumonia, this paper gives us an idea of our epidemiological situation and is a useful tool in order to initiate preventive measures, such as vaccination.