US children and adults with highrisk conditions

1
US children and adults with high-risk conditions

• Pen-Jung Lu PhD
• Surasak Youngpairoj, MD, MPH
• Carolyn Bridges, MD
• Guillermo Herrera, MD, MBA

2
US children and adults with high-risk conditions

• Estimate number of children and adults with
  high-risk conditions
• Contribute to informed decision process on
  antiviral and influenza vaccine
  allocation/priorities in the event of influenza
  pandemic

3
Data sources

• NHIS 2003
• High-risk conditions in adults
• Asthma, emphysema, bronchitis, coronary heart
  disease, angina, myocardial infarction, diabetes,
  and cancer.
• High-risk conditions in children
• Cystic fibrosis, sickle cell anemia, diabetes,
  congenital heart disease, other heart disease and
  conditions, asthma, cerebral palsy, muscular
  dystrophy, down syndrome, birth defects, other
  developmental disorders, mental retardation, and
  seizures.

4
Data sources

• NHIS 2002
• Other possible high-risk conditions in adults
• Stroke, birth defect, mental retardation,
  cerebral palsy, senility/dementia/Alzheimer,
  multiple sclerosis, Parkinsons disease, and
  seizures.
• Cancer in children
• National Cancer Institute, cancer statistics
  review 1975-2001.
• American Cancer Society, Cancer facts and figures
  2005.
• CDC/ NCCDPHP/Division of Cancer Prevention and
  Control, 2004 State Cancer Burden Data Fact
  Sheets.
• National Program of Cancer Registries, 2001
  incidence and mortality data.

5
Data sources

• Transplants and transplantation waiting list,
  children and adults
• UNOS (united network for organ sharing) 2005
• HIV/AIDS children and adults
• CDC/HIV/AIDS surveillance report 2003.
• UNAIDS 2004 report on the global AIDS epidemic.
• End stage renal disorder, dialysis patients,
  children and adults
• United States renal data system (USRDS) 2004
  annual data report.

6
High-risk conditions in children aged 0-17 NHIS
2003
7
High-risk conditions in children, number by age
group NHIS 2003
8
High-risk conditions in adults NHIS 2003
9
High-risk conditions in adults, number by age
group NHIS 2003
10
Other possible high-risk conditions in adults
NHIS 2002
11
Summary
12
Summary
13
Summary

• Children 6 months to 17 years
• High-risk condition 8,647,462
• HR and age recommendation (ACIP) 14,025,878
• Adults 18 years and over
• High-risk condition 44,526,841
• HR and age recommendation (ACIP) 65,225,952
• Total population
• High-risk condition 53,174,303
• HR age recommendation (ACIP) 79,393,147
• Person 50-64 without HR condition 45,540,121
• Total including 50-64 age recommendation
  125,033,268

14
Organ transplantation waiting list
UNOS/HHS/HRSA 2005
0-17 2,286 18 92,643
15
Organ transplantations UNOS/HHS/HRSA 2003-05
0-17 3.383 18 50,975
16
Cancer in children aged 0-19 ACS/CDC-NCHS 2001
rates/2003 population
17
Estimated Number of Persons Alive in the
U.S.Diagnosed With Cancer By Current
AgeInvasive/1st Primary Cases OnlyN9.8
Million Survivors)                             
                      
1Data Source November 2003 Submission
Populations from January 2001 were based on the
average of the July 2000 and July 2001 population
estimates from the US Bureau of Census. Complete
prevalence is estimated using the completeness
index method (Capocaccia et. al. 1997, Merrill
et. al. 2000). US Estimated Prevalence counts
were estimated by applying US populations to SEER
9 Limited Duration prevalence proportions.
18
HIV/AIDS confidential name-based infection
reporting US, 200333 areas
2003 correspond to app. 43 of the total US
cases. 40-45 thousand new cases 300,00 persons
living with HIV not diagnosed 50-100 thousand
HIV not reported UNAIDS estimate 950,000 person
living with HIV/AIDS in the US (2004)
Source CDCHIV/AIDS surveillance report, 2003
(Volume 15)
19
End stage renal disorder
20
The numbers expressed here are a count of events
and each one of these events is a silent tribute
to human life