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Invasive pneumococcal disease in Oxford, 1985-2001: a retrospective case series
C C Grant1, A R Harnden, G Jewell
1Department of Paediatrics, University of Auckland, New Zealand. cc.grant@auckland.ac.nz
Insights
Children with invasive pneumococcal disease (IPD) face higher risks linked to social deprivation and specific congenital conditions. These include central nervous system malformations, heart defects, and chromosomal abnormalities, highlighting key risk factors.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Invasive pneumococcal disease (IPD) remains a significant pediatric health concern.
- Understanding risk factors is crucial for targeted prevention and management strategies.
Purpose of the Study:
- To characterize the clinical features and identify risk factors for invasive pneumococcal disease (IPD) in a pediatric population.
- To assess the association between social deprivation and congenital abnormalities with IPD risk.
Main Methods:
- Retrospective review of pediatric patient records (0-18 years) with IPD diagnosed between 1985 and 2001.
- Utilized the Jarman index to quantify social deprivation.
- Compared the prevalence of congenital abnormalities with national data.
Main Results:
- 136 children with IPD were analyzed; median age at diagnosis was 1.5 years.
- Children with IPD came from more socially deprived households (p < 0.001).
- Significant IPD risk increases were observed for central nervous system malformations (OR=99), congenital heart disease (OR=62), and chromosomal abnormalities (OR=32).
Conclusions:
- Increased social deprivation is associated with a higher risk of invasive pneumococcal disease (IPD) in children.
- Specific congenital conditions, including CNS malformations, congenital heart disease, and chromosomal abnormalities, significantly elevate IPD risk.
Aims:
To describe a series of children with invasive pneumococcal disease (IPD).
Methods:
A review of patient records for children aged 0-18 years admitted to the John Radcliffe Hospital with IPD from 1985 to 2001. Social deprivation was measured by the Jarman index. The proportion of children with congenital abnormalities was compared with national data.
Results:
We identified 140 children with IPD; complete data were available for 136 children. The median age at diagnosis was 1.5 years. The social deprivation score of households of children with IPD was higher than that of the average Oxfordshire household (-2.5 v -7.3, p < 0.001). Forty four per cent of cases had at least one preceding health problem. The children with preceding health problems were significantly older than those with no preceding problems (median age 2.67 years, interquartile range 1.21 to 6.20 versus 1.11 years, interquartile range 0.51 to 2.21; p < 0.001). There was an increased risk of IPD for children with central nervous system malformations (OR = 99, 95% CI 31 to 236), congenital heart disease (OR = 62, 95% CI 24 to 131), and chromosomal abnormalities (OR = 32, 95% CI 6.6 to 96).
Conclusions:
There is an increased risk of IPD associated with increased social deprivation; and also with central nervous system malformations, congenital heart disease, and chromosomal abnormalities.