Increase of chronic diseases in Singapore 1-3
25.4%
of the Singapore population suffers from at least one chronic condition. 1*
*Most prevalent chronic diseases include chronic kidney disease (31.9%), hypertension (18.5%), lipid disorders (18.3%), diabetes (8.7%), osteoarthritis (5.7%), asthma (5.1%), coronary heart disease (5.0%), renal disease (3.1%), cancer (without metastasis) (3.1%), and angina (1.9%).2†
Increasing prevalence of chronic diseases in Singapore.3‡
-Diabetes: increase from 8.8% in 2017 to 9.5% during the period 2019-2020
- Cardiovascular disease risk factors:
- Hypertension: significant increase from 2017 (24.2%) to 2019-2020 (35.5%).
- Hyperlipidaemia: blood cholesterol increased from 35.5% in 2017 to 39.1% in 2019-2020.
- Alcoholism: increase in regular drinking from 2% in 2017 to 2.2% in 2020
Prevalence of key chronic conditions in Singapore3
(2019-2020 versus 2017)
* Data extracted from the Singapore Mental Health Study (SMHS), a survey of Singapore residents aged 18 years and above conducted from December 2009 to December 2010.
† Cross-sectional study using de-identified, administrative data from the Ministry of Health in Singapore. The data include a total of 1 229 012 individuals residing in the Singapore Eastern Regional Health System region.
‡ National Population Health Survey; a cross-sectional population health survey conducted annually by the Ministry of Health and Health Promotion Board to track the health and risk factors, as well as lifestyle practices of Singapore residents.
AGE IS NOT THE ONLY RISK FACTOR: A wide range of conditions can make patients more vulnerable to pneumococcal pneumonia 4
Pneumococcal pneumonia risk rates vs healthy age-matched counterparts 4*
ACIP recommends Prevenar13 (PCV13) in series with PPSV23 for adults aged ≥19 years with an immunocompromising condition, CSF leak, or cochlear implant. 5
Shared clinical decision-making is recommended regarding administration of PCV13 to persons aged ≥65 years who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant and who have not previously received PCV13. If a decision to administer PCV13 is made, PCV13 should be administered first, followed by PPSV23 at least 1 year later. 5
ACIP=Advisory Committee on Immunization Practices; CDC=Centers for Disease Control and Prevention; CSF=cerebrospinal fluid; HIV=human immunodeficiency virus;
PCV13=13-valent pneumococcal conjugate vaccine; PPSV23=23-valent pneumococcal polysaccharide vaccine.
*Data from a retrospective cohort study from 3 large, longitudinal, US healthcare databases of medical and outpatient pharmacy claims from 2007-2010. 4
The presence of multiple chronic medical conditions can further increase the risk of pneumococcal pneumonia in adults 4
The rates for pneumococcal pneumonia increase with the number of at-risk conditions and this trend is consistent across age groups.
*Data from a retrospective cohort study from 3 large, longitudinal, US healthcare databases of medical and outpatient pharmacy claims from 2007-2010.4
IN ADULTS AGED 50-64: With each additional comorbid condition, the risk for pneumococcal pneumonia multiplies compared to healthy adults of the same age 4
IN ADULTS AGED 50-64 : Most adults under 65 at increased risk remain unvaccinated
According to the CDC from a National Health Interview Survey:
Only 25%
of adults aged 18-64 who are at increased risk for pneumococcal disease received a pneumococcal vaccine as of 2017, according to the CDC.6*
26.2% of the Singapore population has multimorbidity (same individual having concurrently 2 or more chronic conditions).
This proportion increases to >50% by the age of 60 years.2^
CDC=Centers for Disease Control and Prevention;
*Data from the 2017 National Health Interview Survey (NHIS) wherein respondents were asked if they had ever had a pneumonia shot. Adults were considered at high risk for pneumococcal disease if they had ever been told by a doctor or other health professional that they had diabetes, emphysema, chronic obstructive pulmonary disease, coronary heart disease, angina, heart attack, or other heart condition; had a diagnosis of cancer within the previous 12 months (excluding nonmelanoma skin cancer); had ever been told by a doctor or other health professional that they had lymphoma, leukaemia, or blood cancer; had been told by a doctor or other health professional that they had chronic bronchitis or weak or failing kidneys during the preceding 12 months; had an asthma episode or attack during the preceding 12 months, or were current smokers. 6

^Based on a population-based cross-sectional study used de-identified Singapore Eastern Regional Health System data collected between January 1, 2012, and December 31, 2016. Patients who were alive as of January 1, 2016, and residing in the Regional Health
System region in 2016 (N = 1181024).