Table 8.
Studies describing global distribution of Pneumocystis jirovecii pneumonia.
| Author | Year | Study design | Study period | Country | Level of care | Population description | No. of patients | Prevalence |
|---|---|---|---|---|---|---|---|---|
| Anand et al. | 2011 | RCS SC | 2003–2009 | USA | Tertiary | Kidney or kidney-pancreas transplant recipients. | Total: 1352 | Laboratory confirmed PJP n = 4/1352 (0.3%) |
| Attia et al. | 2015 | RCS MC | 1996–2009 | USA | Tertiary | National registry of veterans with HIV-AIDS | Total: 41 993 | Incidence of PJP (2006–2009) 0.8% Raw data NS |
| Azoulay et al. | 2018 | PCSMC | January 2000–December2015 | France | Tertiary | ICU patients with haematological malignancies in acute respiratory failure | Total: 1338 | Confirmed PJP cases n = 134/1338 (10.0%) |
| Barreto et al. | 2016 | RCSSC | January 2006–04/2014 | USA | Tertiary | Patients aged ≥18 years with B-cell lymphoma receiving R-CHOP | 689 | PJP cases n = 10/689 (1.51%) 95% CI 0.57–2.43 |
| Basiaga et al. | 2018 | RCSMC | May 2000–June 2013 | USA | Multiple | Patients aged ≤18 years receiving ≥2 prescriptions of glucocorticoids in <60 days with or without TMP–SMX. | Total: 119 399 | PJP cases n = 6/119 399 (0.005%) |
| Choi et al. | 2018 | RCS SC | January 2013–December 2015 | South Korea | Tertiary | HIV-negative patients with PJP admitted to ICU for respiratory failure | 81 | n = 81 |
| Coelho et al. | 2014 | RCSSC | 1987–2012 | Brazil | Multiple | Patients with HIV/AIDS aged ≥18 years with opportunistic infections | 3378 | 22/7735 2009–2012; 140/18 137 total 1987–2012 |
| Coyle et al. | 2012 | RCS MC | July 2008–July 2011 | Northern Ireland | Multiple | Laboratory confirmed PJP | Total: 53 | Clinically significant PJP n = 51/53 (96.2%) |
| Evernden et al. | 2020 | RCSSC | January 2008–June 2017 | Canada | Tertiary | Adult allogenic HSCT recipients receiving anti-thymocyte globulin for GVHD prophylaxis | Total receiving PJP prophylaxis: 649 | Confirmed PJP patients n = 21/649 (32.4%) |
| Faini et al. | 2015 | NPSMC | 2012 | Tanzania | Tanzanian population | 43.6 million estimated Adults with HIV-AIDS 1500 000 |
Estimated incidence based on cases of HIV-AIDS n = 9600 ∼ 22/100 000 people |
|
| Figueiredo-Mello et al. | 2017 | PCSSC | September 2012–July 2014 | Brazil | Tertiary | HIV patients with CAP | 143 | Diagnosed PJP n = 52/143 (36%) |
| Kim et al. | 2016 | RCSMC | December 2006–July 2013 | South Korea | Multiple | Patients aged >18 years with HIV-AIDS | Total: 1086 | PJP cases n = 121/1086 (11.1%) |
| Kim et al. | 2019 | RCSSC | 2000–2017 | South Korea | Tertiary | Kidney transplant recipients aged ≥18 years | Total: 1502 | PJP cases n = 68/1502 (4.53%) |
| Lagrou et al. | 2015 | NPSMC | 2013 | Belgium | Multiple | Population of Belgium | 11 million estimated.People with HIV-AIDS∼20 000 | Estimated incidence n = 1201.1/100 000 people |
| Lee et al. | 2019 | RCS SC | February 2003–April 2017 | South Korea | Tertiary | Laboratory confirmed PJP with and without HIV-AIDS | Total: 424 | n = 424 |
| Lee et al. | 2020 | RCS SC | January 1997–March 2019 | South Korea | Tertiary | Kidney transplant recipients | Total: 1994 PJP only: 38PJP and CMV: 14 | n = 52/1994 (2.6%) |
| Li et al. | 2020 | RCS MC | January 2013–December 2019 | China | Tertiary | Patients aged ≥16 years with pneumonia treated with glucocorticoids | Total: 716 | Total confirmed PJP n = 134/716 (18.7%) CAP n = 128/635 (20.2%) HAP n = 21/81 (25.9%) |
| Liu et al. | 2020 | RCS SC | December 2013–December 2018 | China | Tertiary | Patients with nephrotic syndrome diagnosed with PJP | 57 | n = 57 |
| Lopez-Sanchez et al. | 2015 | RCS SC | January 2000–December 2013 | Spain | Tertiary | Adult patients with HIV-AIDS diagnosed with PJP | 136 |
n = 136 Incidence (2013) 3.3 cases/1000 patients-year |
| Lum et al. | 2020 | RCSMC | January 2015–December 2016 | USA | Tertiary | SOT recipients aged ≥18 years prescribed PJP prophylaxis | Total: 1173 | n = 2/1173 (0.2%) |
| Maartens et al. | 2018 | PCSMC | November 2011–October 2014 | South Africa | Patients aged ≥18 years with HIV-AIDS | 500 | n = 56/500 (11.2%) | |
| Macedo-Viñas and Denning | 2018 | CCSMC | 2016 | Uruguay | Multiple | Population of Uruguay | Population of Uruguay: 3444 006 estimated People with HIV-AIDS ∼12 000 |
Estimated incidence based on cases of HIV-AIDS n = 481.4/100 000 people |
| Nam et al. | 2020 | CCSSC | June 1989–December 2016 | South Korea | Tertiary | Cases: immunosuppressed patients with IBD and PJP. Controls: immunosuppressed patients with IBD without PJP. |
6803 |
n = 6/6803 (0.09%) 10.4/100 000 person-years |
| Neofytos et al. | 2018 | RCS MC | 2008–2016 | Switzerland | Multiple | All patients within the national SOT registry of Switzerland | Total: 2842 | n = 41/2842 (1.4%) |
| Özenci et al. | 2019 | CSSMC | 2016 | Sweden | Multiple | Population of Sweden | 9995 153 estimated | n = 297/9995 153 (0.003%) |
| Park et al. | 2020 | CSSSC | 1999–2015 | South Korea | Tertiary | Cases: Patients with kidney or kidney-pancreas transplant and PJP Controls: Patients with kidney or kidney-pancreas transplants |
Total: 161 Cases: 67/161 (41.6%) Controls: 94/161 (58.4%) |
n = 67/161 (41.6%) |
| PERCH Study Group | 2019 | CCS MC | August 2011–January 2014 | Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, Zambia |
Multiple | Cases: children aged 1–59 months admitted to hospital with severe pneumonia. Controls: age-group-matched children randomly selected from communities surrounding study sites. |
Total: 9351 Cases: 4232 Controls: 5119 |
PJP in NP/OP specimens n = 692/8894 (7.8%) |
| Quinn et al. | 2018 | RCSSC | January 2007–August 2014 | USA | Tertiary | Paediatric oncology patients who received ≥1 dose of pentamidine for PJP prophylaxis | 754 | n = 4/754 (0.5%) |
| Rekhtman et al. | 2019 | RCSMC | December 2012–December 2017 | USA | Multiple | Patients aged ≥18 years treated with immunosuppressive drugs or corticosteroids who had neither HIV-AIDS or cancer | 3366 086 | n = 406/3366 086 (0.012%) |
| Saeed et al. | 2015 | RCSSC | January 2009–May 2013 | Bahrain | Tertiary | HIV-AIDS patients with or without opportunistic infections | 194 | Total n = 10/194 (5.1%) HIV-AIDS with opportunistic infection n = 10/66 (15.1%) |
| Schmidt et al. | 2018 | RCS SC | January 2000–June 2017 | Germany | Tertiary | Patients with microbiological confirmation of PJP | 240 | n = 240 |
| Schoffelen et al. | 2013 | RCS MC | June 1996–January 2011 | The Netherlands | Multiple | Patients in a national HIV-AIDS registry who developed PJP | Patients in registry n = 13 844 |
PJP n = 1055/13 844 (7.6%) |
| Shi et al. | 2020 | RCS SC | January 2014–December 2018 | China | Tertiary | Adults with SRD admitted to the ICU due to acute respiratory failure | 259 | n = 103/259 (39.8%) |
| Singh et al. | 2015 | RCSSC | NS | India | Tertiary | Patients with clinical suspicion of PJP | Total n = 180 Adults n = 150 (83.3%) Children n = 30 (16.7%) |
PJP confirmed by PCR n = 18/180 (10.0%) |
| Singh et al. | 2019 | RCS SC | March 2014–March 2017 | India | Tertiary | Patients with HIV-AIDS and PJP | Clinically suspected PJP n = 76 |
PJP confirmed by both microscopy and PCR n = 17/76 (22.4%) |
| Wei et al. | 2018 | RCSMC | January 2006–December 2013 | Taiwan | Multiple | HIV-negative patients with NHL who did or did not receive rituximab | Total n = 12 158 Rituximab treated n = 7554 (62.1%) No rituximab n = 4604 (37.9%) |
PJP in rituximab treated n = 223/7554 (2.95%) PJP in no rituximab n = 61/4604 (1.33%) |
| Yukawa et al. | 2018 | CCSSC | January 2010–December 2014 | Japan | Tertiary | Patients with RA who did not receive TMP–SMX | n = 2640 | n = 19/2640 (0.7%) |
CAP, community acquired pneumonia; CCS, case control study; CI, confidence interval; GVHD, graft versus host disease; HAART, highly active antiretroviral therapy; HAP, hospital acquired pneumonia; HIV, human immunodeficiency virus; HSCT, haematopoietic stem cell transplant; IV, intravenous; MC, multicentre; NPS, national prevalence study; NS, not stated (by authors); PCS, prospective cohort study; PJP, Pneumocystis jirovecii pneumonia; RA, rheumatoid arthritis; RCS, retrospective cohort study; SRD, systemic rheumatic diseases; SC, single centre; SOT, solid organ transplant; TMP–SMX, trimethoprim–sulfamethoxazole.