Invasive pneumococcal disease burden and implications for vaccine policy in urban Bangladesh

W. Abdullah Brooks, Robert F. Breiman, Doli Goswami, Anowar Hossain, Khorshed Alam, Samir K. Saha, Kamrun Nahar, Dilruba Nasrin, Noor Ahmed, Shams El Arifeen, Aliya Naheed, David A. Sack, Stephen Luby

Research output: Contribution to journalArticlepeer-review

Abstract

We undertook active population-based surveillance in 5,000 urban households among children < 5 years old to determine invasive pneumococcal disease (IPD) incidence, serotype distribution, clinical presentation, and antimicrobial resistance, which have not been previously described in population-based studies from the region. IPD was documented by blood culture isolation. From 01 April 2004 to 31 March 2006, 5,903 blood cultures were collected from 6,167 eligible children. Streptococcus pneumoniae was isolated from 34 pneumococcal patients; IPD was clinically associated with pneumonia (24%), upper respiratory infection (62%), and febrile syndromes (14%). Overall, IPD and 13-valent serotype-related IPD incidences were 447 and 276 episodes/100,000 child-years, respectively. Peak IPD incidence occurred during the cool dry seasons. Penicillin, cotrimoxazole, chloramphenicol, and ciprofloxacin resistances were 2.9%, 82.4%, 14.7%, and 24.1%, respectively. Current conjugate vaccines should substantially reduce IPD, childhood pneumonia, and antimicrobial resistance in Bangladesh.

Original languageEnglish (US)
Pages (from-to)795-801
Number of pages7
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume77
Issue number5
DOIs
StatePublished - Nov 2007

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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