BACKGROUND: Streptococcus pneumoniae 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. The aims of this study were to determine the prevalence and serotype distribution of invasive 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 S. pneumoniae 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%). S. pneumoniae 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 <5 years who were admitted with fever and/or suspected 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 pneumococcal disease in young children in Kathmandu.
BACKGROUND:Streptococcus pneumoniae 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. The aims of this study were to determine the prevalence and serotype distribution of invasive 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 S. pneumoniae 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%). S. pneumoniae 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 <5 years who were admitted with fever and/or suspected 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 pneumococcal disease in young children in Kathmandu.
Authors: E J Williams; J Lewis; T John; J C Hoe; L Yu; S Dongol; D F Kelly; D T Griffiths; A Shah; B Limbu; R Pradhan; F Mawas; S Shrestha; S Thorson; A M Werno; D R Murdoch; N Adhikari; A J Pollard Journal: J Clin Microbiol Date: 2011-01-26 Impact factor: 5.948
Authors: Kathryn E Holt; Stephen Baker; Sabina Dongol; Buddha Basnyat; Neelam Adhikari; Stephen Thorson; Anoop S Pulickal; Yajun Song; Julian Parkhill; Jeremy J Farrar; David R Murdoch; Dominic F Kelly; Andrew J Pollard; Gordon Dougan Journal: BMC Infect Dis Date: 2010-05-31 Impact factor: 3.090
Authors: Zunera Gilani; Yuenting D Kwong; Orin S Levine; Maria Deloria-Knoll; J Anthony G Scott; Katherine L O'Brien; Daniel R Feikin Journal: Clin Infect Dis Date: 2012-04 Impact factor: 9.079
Authors: Sarah Hanieh; Mainga Hamaluba; Dominic F Kelly; Jane A Metz; Kelly L Wyres; Roberta Fisher; Rahul Pradhan; Disuja Shakya; Lochan Shrestha; Amrita Shrestha; Anip Joshi; Jocelyn Habens; Bishnu D Maharjan; Stephen Thorson; Erik Bohler; Ly-Mee Yu; Sarah Kelly; Emma Plested; Tessa John; Anja M Werno; Neelam Adhikari; David R Murdoch; Angela B Brueggemann; Andrew J Pollard Journal: PLoS One Date: 2014-06-06 Impact factor: 3.240
Authors: Rahul Pradhan; Umesh Shrestha; Samir C Gautam; Stephen Thorson; Kabindra Shrestha; Bharat K Yadav; Dominic F Kelly; Neelam Adhikari; Andrew J Pollard; David R Murdoch Journal: PLoS One Date: 2012-10-24 Impact factor: 3.240
Authors: Harish Nair; Eric Af Simões; Igor Rudan; Bradford D Gessner; Eduardo Azziz-Baumgartner; Jian Shayne F Zhang; Daniel R Feikin; Grant A Mackenzie; Jennifer C Moiïsi; Anna Roca; Henry C Baggett; Syed Ma Zaman; Rosalyn J Singleton; Marilla G Lucero; Aruna Chandran; Angela Gentile; Cheryl Cohen; Anand Krishnan; Zulfiqar A Bhutta; Adriano Arguedas; Alexey Wilfrido Clara; Ana Lucia Andrade; Maurice Ope; Raúl Oscar Ruvinsky; María Hortal; John P McCracken; Shabir A Madhi; Nigel Bruce; Shamim A Qazi; Saul S Morris; Shams El Arifeen; Martin W Weber; J Anthony G Scott; W Abdullah Brooks; Robert F Breiman; Harry Campbell Journal: Lancet Date: 2013-01-29 Impact factor: 79.321