Prospective Surveillance Study of Invasive Pneumococcal Disease Among Urban Children in the Philippines

Capeding, María Rosario; Bravo, Lulu; Santos, Jaime; Kilgore, Paul E.; Kim, Soon Ae; Balter, Ivana Haluskova; Hubler, Robin; Ye, Jian; Moscariello, Michele

doi:10.1097/inf.0b013e318298dfd5

Cited by 16 publications

(22 citation statements)

References 21 publications

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“…In our study, the average cost of a pneumonia admission was 253.1 USD, which is much higher than previous studies in Vietnam that ranged from 31 USD in 2006 to 158 USD in 2016 [12,17,38]. Caregivers in Vietnam frequently access antibiotics without formal medical assessment [40] and this is also common in other Asian countries; >40% of children admitted with acute respiratory tract infections in Mongolia [41] and >50% in The Philippines [42]. This is different from sub-Saharan Africa, where access to pre-admission antibiotics is more restricted [20].…”

Section: Discussionmentioning

confidence: 61%

Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

et al. 2019

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Pneumonia is the most common reason for paediatric hospital admission in Vietnam. The potential value of using the World Health Organization (WHO) case management approach in Vietnam has not been documented.We performed a prospective descriptive study of all children (2–59 months) admitted with “pneumonia” (as assessed by the admitting clinician) to the Da Nang Hospital for Women and Children to characterise their disease profiles and assess risk factors for an adverse outcome. The disease profile was classified using WHO pneumonia criteria, with tachypnoea or chest indrawing as defining clinical signs. Adverse outcome was defined as death, intensive care unit admission, tertiary care transfer or hospital stay >10 days.Of 4206 admissions, 1758 (41.8%) were classified as “no pneumonia” using WHO criteria and only 252 (6.0%) met revised criteria for “severe pneumonia”. The inpatient death rate was low (0.4% of admissions) with most deaths (11 out of 16; 68.8%) occurring in the “severe pneumonia” group. An adverse outcome was recorded in 18.7% of all admissions and 60.7% of the “severe pneumonia” group. Children were hospitalised for a median of 7 days at an average cost of 253 USD per admission. Risk factors for adverse outcome included WHO-classified “severe pneumonia”, age <1 year, low birth weight, previous recent admission with an acute respiratory infection and recent tuberculosis exposure. Breastfeeding, day-care attendance and pre-admission antibiotic use were associated with reduced risk.Few hospital admissions met WHO criteria for “severe pneumonia”, suggesting potential unnecessary hospitalisation and use of intravenous antibiotics. Better characterisation of the underlying diagnosis requires careful consideration.

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Section: Discussionmentioning

confidence: 61%

Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

et al. 2019

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“…A summary of the epidemiological parameters used in the analysis is provided in Table 1. Philippine-specific data on the incidence of pneumococcal meningitis, bacteremia and sepsis in children <5 years were taken from the PneumoNet study [16]. No published data were available on the IPD incidence among Filipinos older than 5 years of age.…”

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confidence: 99%

Do pneumococcal conjugate vaccines represent good value for money in a lower-middle income country? A cost-utility analysis in the philippines

et al. 2015

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ObjectivesThe objective of this study is to assess the value for money of introducing pneumococcal conjugate vaccines as part of the immunization program in a lower-middle income country, the Philippines, which is not eligible for GAVI support and lower vaccine prices. It also includes the newest clinical evidence evaluating the efficacy of PCV10, which is lacking in other previous studies. MethodsA cost-utility analysis was conducted. A Markov simulation model was constructed to examine the costs and consequences of PCV10 and PCV13 against the current scenario of no PCV vaccination for a lifetime horizon. A health system perspective was employed to explore different funding schemes, which include universal or partial vaccination coverage subsidized by the government. Results were presented as incremental cost-effectiveness ratios (ICERs) in Philippine peso (Php) per QALY gained (1 USD = 44.20 Php). Probabilistic sensitivity analysis was performed to determine the impact of parameter uncertainty. ResultsWith universal vaccination at a cost per dose of Php 624 for PCV10 and Php 700 for PCV13, both PCVs are cost-effective compared to no vaccination given the ceiling threshold of Php 120,000 per QALY gained, yielding ICERs of Php 68,182 and Php 54,510 for PCV10 and PCV13, respectively. Partial vaccination of 25% of the birth cohort resulted in significantly higher ICER values (Php 112,640 for PCV10 and Php 84,654 for PCV13) due to loss of herd protection. The budget impact analysis reveals that universal vaccination PLOS ONE |

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Section: Discussionmentioning

confidence: 52%

Characterisation of children hospitalised with pneumonia in central Vietnam: A prospective study

Kim

Tran

Fitzgerald

et al. 2019

Paediatric Respiratory Epidemiology

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Pneumonia is the most common reason for paediatric hospital admission in Vietnam. Revised World Health Organization (WHO) criteria recently adjusted the definition of "severe pneumonia" to reduce unnecessary hospitalization, but its impact on case management practices in Vietnam has not been documented. We performed a prospective descriptive study of all children (2-59 months) admitted with 'pneumonia' to the Da Nang Hospital for Women and Children in central Vietnam, to characterise their disease profile and assess risk factors for adverse outcome. We found that few hospital admissions met WHO criteria for 'severe pneumonia', suggesting unnecessary hospitalisation for intravenous antibiotics in a large number of children. Although adoption of the WHO case management will reduce unnecessary admissions, careful interpretation of signs and symptoms is required to ensure optimal management. We believe that this manuscript will be of interest to your international readership given that the findings reflect existing practice in large parts of Asia, which is different to reports from sub-Saharan Africa.

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Prospective Surveillance Study of Invasive Pneumococcal Disease Among Urban Children in the Philippines

Abstract: IPD is an important cause of morbidity and mortality among urban children in the Philippines. Our data support the expectation that widespread immunization would decrease IPD disease burden.

Cited by 16 publications

References 21 publications

Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

Do pneumococcal conjugate vaccines represent good value for money in a lower-middle income country? A cost-utility analysis in the philippines

Characterisation of children hospitalised with pneumonia in central Vietnam: A prospective study

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