Incidence of pneumonia, bacteremia, and invasive pneumococcal disease in Pakistani children

Abstract

Summaryobjective To determine the incidence of pneumonia, bacteremia, and invasive pneumococcal disease (IPD) in Pakistani children <5 years old. results Overall, 5570 children contributed 3949 observation years. There were 1039 clinical cases of pneumonia, of which 54 were severe pneumonia and four cases of very severe disease according to WHO criteria. The overall pneumonia incidence was 0.26 (95% CI: 0.25-0.28) episodes per child-year. A pathogen was isolated from the blood of 29 (2.8%) pneumonia cases. Bacteremia incidence was 912 (95% CI: 648-1248) episodes per 100 000 child-years with a case fatality rate of 8%. The detected IPD incidence was 25 (95% CI: 1-125) episodes per 100 000 child-years. The under-five mortality rate was 55 per 1000 live births, with pneumonia causing 12 (22%) deaths among children <5 years old.

Nasopharyngeal carriage of Streptococcus pneumoniae in children under 5 years of age before introduction of pneumococcal vaccine (PCV10) in urban and rural districts in Pakistan

“…The prevalence of pneumococcal carriage can be used to estimate the potential for PCVs to reduce transmission of vaccine-type strains [13] and indirectly translates into impact on disease, as shown by previous carriage studies [11, 14, 15]. Such knowledge of baseline serotype prevalence among carriage strains in young children is important for countries like Pakistan, where the vaccine coverage is low and incidence of invasive pneumococcal disease (IPD) is quite high [16, 17]. There could be possible differences between carriage rates in the urban and rural populations due to difference in accessibility to care, socio-economic conditions and public health awareness.…”

Molecular Characterization of Pneumococcal Surface Protein A (PspA), Serotype Distribution and Antibiotic Susceptibility of Streptococcus pneumoniae Strains Isolated from Pakistan

“…Pakistan, a country located in South Asia, has the third most pneumococcal diseases in the world, especially ‘pneumococcal pneumonia,’ which makes it an ideal location to begin exploring pneumococcal serotypes and antibiotic susceptibility [ 16 ]. In this pilot study, we sought to characterize the prevalence of PspA from Pakistani pneumococcal isolates and identify the most prevalent family and clade.…”

Bloodstream Infection among Children Presenting to a General Hospital Outpatient Clinic in Urban Nepal

“…Every child enrolled had a blood culture performed irrespective of severity of disease. Studies conducted in South Asia that included children either concentrated on pneumonia or acute respiratory infections [15], [16], [17], included more severe patients [18], [19], collected data based on blood cultures received in the laboratory [20], [21], or focused on patients diagnosed with specific disease syndromes such as typhoid fever [22], [23]. Two studies [24], [25] which looked at typhoid and paratyphoid bacteremia are similar to our study; however, they were community-based studies and only the bacteremia rate from patients under five years from one of the two studies can be compared with our results (see below).…”