Claire von Mollendorf1, Cheryl Cohen, Linda de Gouveia, Nireshni Naidoo, Susan Meiring, Vanessa Quan, Sonwabo Lindani, David P Moore, Gary Reubenson, Mamokgethi Moshe, Brian Eley, Ute M Hallbauer, Heather Finlayson, Shabir A Madhi, Laura Conklin, Elizabeth R Zell, Keith P Klugman, Cynthia G Whitney, Anne von Gottberg. 1. From the *Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service; †School of Public Health, Faculty of Health Sciences, University of the Witwatersrand; ‡Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; §Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Gauteng, South Africa; ¶Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand; ‖Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; **Dr George Mukhari Hospital, Paediatrics Department, Medunsa University, Gauteng, South Africa; ††Red Cross War Memorial Children's Hospital, and the Department of Paediatrics and Child Health, University of Cape Town, Cape Town, Western Cape; ‡‡Universitas and Pelonomi Hospitals, Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, Free State, South Africa; §§Tygerberg Hospital and Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, Western Cape, South Africa; ¶¶ National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention; and ‖‖Hubert Department of Global Health, Emory University, Atlanta, GA.
Abstract
BACKGROUND: Invasive pneumococcal disease (IPD) causes significant disease burden, especially in developing countries, even in the era of pneumococcal conjugate vaccine and maternal-to-child HIV transmission prevention programs. We evaluated factors that might increase IPD risk in young children in a high HIV prevalence setting. METHODS: We conducted a case-control study using IPD cases identified at 24 Group for Enteric, Respiratory and Meningeal disease Surveillance-South Africa program sites (2010-2012). At least 4 controls were matched by age, HIV status and hospital to each case. Potential risk factors were evaluated using multivariable conditional logistic regression. RESULTS: In total, 486 age-eligible cases were enrolled. Factors associated with IPD in HIV-uninfected children (237 cases, 928 controls) included siblings <5 years [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI): 1.16-2.46], underlying medical conditions (aOR = 1.99, CI 1.22-3.22), preceding upper respiratory tract infection (aOR = 1.79, CI 1.19-2.69), day-care attendance (aOR = 1.58, CI 1.01-2.47), perinatal HIV exposure (aOR = 1.62, CI 1.10-2.37), household car ownership (aOR = 0.45, CI 0.25-0.83) and ≥2 7-valent pneumococcal conjugate vaccine doses (aOR = 0.67, CI 0.46-0.99). Among HIV-infected children (124 cases, 394 controls), IPD-associated factors included malnutrition (aOR = 2.68, CI 1.40-5.14), upper respiratory tract infection (aOR = 3.49, CI 1.73-7.03), tuberculosis in the last 3 months (aOR = 5.12, CI 1.69-15.50) and current antiretroviral treatment (aOR = 0.13, CI 0.05-0.38). CONCLUSION: Previously identified factors related to poverty, poor health and intense exposure continue to be risk factors for IPD in children. Ensuring delivery of pneumococcal conjugate vaccine and antiretroviral treatment are important for improving disease prevention.
BACKGROUND:Invasive pneumococcal disease (IPD) causes significant disease burden, especially in developing countries, even in the era of pneumococcal conjugate vaccine and maternal-to-child HIV transmission prevention programs. We evaluated factors that might increase IPD risk in young children in a high HIV prevalence setting. METHODS: We conducted a case-control study using IPD cases identified at 24 Group for Enteric, Respiratory and Meningeal disease Surveillance-South Africa program sites (2010-2012). At least 4 controls were matched by age, HIV status and hospital to each case. Potential risk factors were evaluated using multivariable conditional logistic regression. RESULTS: In total, 486 age-eligible cases were enrolled. Factors associated with IPD in HIV-uninfectedchildren (237 cases, 928 controls) included siblings <5 years [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI): 1.16-2.46], underlying medical conditions (aOR = 1.99, CI 1.22-3.22), preceding upper respiratory tract infection (aOR = 1.79, CI 1.19-2.69), day-care attendance (aOR = 1.58, CI 1.01-2.47), perinatal HIV exposure (aOR = 1.62, CI 1.10-2.37), household car ownership (aOR = 0.45, CI 0.25-0.83) and ≥2 7-valent pneumococcal conjugate vaccine doses (aOR = 0.67, CI 0.46-0.99). Among HIV-infectedchildren (124 cases, 394 controls), IPD-associated factors included malnutrition (aOR = 2.68, CI 1.40-5.14), upper respiratory tract infection (aOR = 3.49, CI 1.73-7.03), tuberculosis in the last 3 months (aOR = 5.12, CI 1.69-15.50) and current antiretroviral treatment (aOR = 0.13, CI 0.05-0.38). CONCLUSION: Previously identified factors related to poverty, poor health and intense exposure continue to be risk factors for IPD in children. Ensuring delivery of pneumococcal conjugate vaccine and antiretroviral treatment are important for improving disease prevention.
Authors: Kristina E Rudd; Niranjan Kissoon; Direk Limmathurotsakul; Sotharith Bory; Birungi Mutahunga; Christopher W Seymour; Derek C Angus; T Eoin West Journal: Crit Care Date: 2018-09-23 Impact factor: 9.097
Authors: Jocelyn Chan; Tuya Mungun; Purevsuren Batsaixan; Mukhchuluun Ulziibayar; Bujinlkham Suuri; Dashpagam Otgonbayar; Dashtseren Luvsantseren; Cattram D Nguyen; Dorj Narangarel; Eileen M Dunne; Kimberley Fox; Jason Hinds; Monica L Nation; Casey L Pell; E Kim Mulholland; Catherine Satzke; Claire von Mollendorf; Fiona M Russell Journal: Lancet Reg Health West Pac Date: 2021-07-30