Hospital-based surveillance of invasive pneumococcal disease among young children in urban Nepal

Background. <em>Streptococcus pneumoniae</em> is a leading cause of pneumonia and meningitis in young children. Before implementation of the pneumococcal conjugate vaccine in developing countries, there is an urgent need to provide regional epidemiological data on pneumococcal disease am...

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Glavni autori: Williams, E, Thorson, S, Maskey, M, Mahat, S, Hamaluba, M, Dongol, S, Werno, A, Yadav, B, Shah, A, Kelly, D, Adhikari, N, Pollard, A, Murdoch, D
Daljnji autori: Infectious Diseases Society of America
Format: Journal article
Jezik:English
Izdano: University of Chicago Press 2009
Teme:
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author Williams, E
Thorson, S
Maskey, M
Mahat, S
Hamaluba, M
Dongol, S
Werno, A
Yadav, B
Shah, A
Kelly, D
Adhikari, N
Pollard, A
Murdoch, D
author2 Infectious Diseases Society of America
author_facet Infectious Diseases Society of America
Williams, E
Thorson, S
Maskey, M
Mahat, S
Hamaluba, M
Dongol, S
Werno, A
Yadav, B
Shah, A
Kelly, D
Adhikari, N
Pollard, A
Murdoch, D
author_sort Williams, E
collection OXFORD
description Background. <em>Streptococcus pneumoniae</em> is a leading cause of pneumonia and meningitis in young children. Before implementation of the pneumococcal conjugate vaccine in developing countries, there is an urgent need to provide regional epidemiological data on pneumococcal disease among young children hospitalized in urban Nepal. Methods. Children aged 2 months to 5 years who were admitted to Patan Hospital, Kathmandu, with fever and/or suspected pneumonia, meningitis, or bacteremia were recruited. Blood culture specimens were collected from all participants. In cases of suspected meningitis, cerebrospinal fluid specimens were cultured and were tested for <em>S. pneumoniae</em> antigen. Results. A total of 885 children were recruited during the 21-month study period. Of these, 76 (9%) had meningitis and 498 (56%) had pneumonia, on the basis of clinical criteria. Radiographically confirmed pneumonia occurred in 354 (40%), and probable or definite meningitis occurred in 47 (5%). <em>S. pneumoniae</em> was isolated in specimens from 17 (2%) of the children. Serotypes 1 and 12A were isolated most frequently, and only 1 of 17 isolates had a serotype contained in the currently available 7-valent pneumococcal conjugate vaccine. Conclusions. More than 60% of children aged &lt;5 years who were admitted with fever and/or suspecte invasive bacterial disease in urban Nepal had the clinical syndromes of meningitis and/or pneumonia. A new generation of pneumococcal vaccines that prevent infection with a broader range of serotypes may be necessary to most effectively control pneuomococcal disease in young children in Kathmandu.
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spelling oxford-uuid:19fc34e9-f692-422c-8ac0-8c8f6e1143b22022-03-26T10:52:14ZHospital-based surveillance of invasive pneumococcal disease among young children in urban NepalJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:19fc34e9-f692-422c-8ac0-8c8f6e1143b2PaediatricsEnglishOxford University Research Archive - ValetUniversity of Chicago Press2009Williams, EThorson, SMaskey, MMahat, SHamaluba, MDongol, SWerno, AYadav, BShah, AKelly, DAdhikari, NPollard, AMurdoch, DInfectious Diseases Society of AmericaBackground. <em>Streptococcus pneumoniae</em> is a leading cause of pneumonia and meningitis in young children. Before implementation of the pneumococcal conjugate vaccine in developing countries, there is an urgent need to provide regional epidemiological data on pneumococcal disease among young children hospitalized in urban Nepal. Methods. Children aged 2 months to 5 years who were admitted to Patan Hospital, Kathmandu, with fever and/or suspected pneumonia, meningitis, or bacteremia were recruited. Blood culture specimens were collected from all participants. In cases of suspected meningitis, cerebrospinal fluid specimens were cultured and were tested for <em>S. pneumoniae</em> antigen. Results. A total of 885 children were recruited during the 21-month study period. Of these, 76 (9%) had meningitis and 498 (56%) had pneumonia, on the basis of clinical criteria. Radiographically confirmed pneumonia occurred in 354 (40%), and probable or definite meningitis occurred in 47 (5%). <em>S. pneumoniae</em> was isolated in specimens from 17 (2%) of the children. Serotypes 1 and 12A were isolated most frequently, and only 1 of 17 isolates had a serotype contained in the currently available 7-valent pneumococcal conjugate vaccine. Conclusions. More than 60% of children aged &lt;5 years who were admitted with fever and/or suspecte invasive bacterial disease in urban Nepal had the clinical syndromes of meningitis and/or pneumonia. A new generation of pneumococcal vaccines that prevent infection with a broader range of serotypes may be necessary to most effectively control pneuomococcal disease in young children in Kathmandu.
spellingShingle Paediatrics
Williams, E
Thorson, S
Maskey, M
Mahat, S
Hamaluba, M
Dongol, S
Werno, A
Yadav, B
Shah, A
Kelly, D
Adhikari, N
Pollard, A
Murdoch, D
Hospital-based surveillance of invasive pneumococcal disease among young children in urban Nepal
title Hospital-based surveillance of invasive pneumococcal disease among young children in urban Nepal
title_full Hospital-based surveillance of invasive pneumococcal disease among young children in urban Nepal
title_fullStr Hospital-based surveillance of invasive pneumococcal disease among young children in urban Nepal
title_full_unstemmed Hospital-based surveillance of invasive pneumococcal disease among young children in urban Nepal
title_short Hospital-based surveillance of invasive pneumococcal disease among young children in urban Nepal
title_sort hospital based surveillance of invasive pneumococcal disease among young children in urban nepal
topic Paediatrics
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