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Childhood invasive pneumococcal disease in Tasmania, 1994-2000
D J F Christie1, D J Coleman, X Wan
1Department of Paediatrics, Royal Hobart Hospital, Public and Environmental Health Service, Department of Health and Human Services, Hobart, Tasmania.
Insights
Invasive pneumococcal disease affected Tasmanian children, with higher incidence in those under two years old. Most cases had predisposing conditions, highlighting the need for targeted immunization and better data collection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Invasive pneumococcal disease (IPD) poses a significant public health challenge globally.
- Understanding the epidemiology and antibiotic resistance patterns of IPD is crucial for effective disease control strategies.
Purpose of the Study:
- To determine the incidence and antibiotic resistance of invasive pneumococcal disease in children in Tasmania.
- To identify risk factors and predisposing conditions associated with IPD in the pediatric population.
Main Methods:
- A retrospective, population-based study analyzed laboratory records of Streptococcus pneumoniae isolates from sterile sites in Tasmanian children from 1994 to 2000.
- Medical records were reviewed to gather clinical information, disease course, and identify predisposing conditions.
Main Results:
- A total of 76 IPD cases were identified in children over the 7-year study period.
- The incidence of IPD was 28.5 per 100,000 children under 5 years and 54.3 per 100,000 children under 2 years.
- Penicillin resistance was low at 2.6%, with no high-level resistance detected. Predisposing conditions were present in 34% of cases.
Conclusions:
- The incidence of IPD in Tasmanian children was comparable to other Australian urban populations.
- A high prevalence of predisposing conditions underscores the importance of targeted immunization strategies for at-risk children.
- Improved data collection, particularly regarding Indigenous status and pneumococcal serotypes, is recommended for future surveillance and research.
Objective:
To describe the burden of invasive pneumococcal disease in Tasmanian children, including age-specific incidence and antibiotic-resistance pattern.
Methods:
A population-based retrospective study was carried out, examining cases of childhood disease associated with isolates of Streptococcus pneumoniae from normally sterile sites, identified via scrutiny of laboratory records at all major Tasmanian laboratories during a 7-year period between January 1994 and December 2000. Medical records were sub-sequently examined for information describing the clinical syndrome and course of disease.
Results:
Invasive pneumococcal disease was identified in 76 children during the 7-year period. The incidence per 100 000 children was 28.5 (95% CI 22.0-36.3) in children under 5 years and 54.3 (95% CI 40.2-71.8) in children under 2 years. The incidence of meningitis in children younger than 2 years was 12.2 (95% CI 6.1-21.8). Penicillin resistance was observed in 2.6% of cases, with no high level resistance. Predisposing conditions were identified in 34% of children with invasive disease.
Conclusions:
The incidence of invasive pneumococcal disease was comparable to many urban populations in Australia. The high rate of predisposing conditions supports the recommendations of the Australian Technical Advisory Group on Immunisation for targeted immunization in this group. The paucity of data describing Indigenous status is an argument for improved data collection in this area. The low level of penicillin resistance necessitates ongoing surveillance, and the lack of serotype information requires prospective data collection.