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Published on: February 15, 2013
Invasive pneumococcal disease in Jamaican children
D McGregor1, M Barton, S Thomas
1Bustamante Hospital for Children, Kingston, Jamaica.
Insights
Invasive pneumococcal disease significantly impacts young Jamaican children, causing severe illness and death, particularly in infants. Prevention strategies targeting HIV, malnutrition, and sickle cell disease are crucial.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Invasive pneumococcal disease (IPD) remains a significant global health concern, especially in developing nations.
- Jamaica faces challenges in managing IPD, necessitating local epidemiological data for effective intervention.
- Understanding risk factors and outcomes is vital for targeted public health strategies.
Purpose of the Study:
- To determine the incidence and characteristics of IPD in children under 10 years old in Kingston and St Andrew, Jamaica.
- To identify risk factors, outcomes, and antimicrobial resistance patterns associated with IPD.
- To inform preventative strategies for IPD in the Jamaican pediatric population.
Main Methods:
- A 5-year retrospective review of hospital admission data for IPD cases at Bustamante Hospital for Children.
- Data collection included patient demographics, clinical presentation, pre-existing conditions, treatment, and outcomes.
- Incidence rates were calculated for the Kingston and St Andrew region.
Main Results:
- A total of 111 IPD cases were identified, with an estimated incidence of 21/100,000 children under 10 years.
- The majority of cases (76%) occurred in children younger than 2 years, with all four deaths being infants.
- Key pre-existing conditions included sickle cell disease, HIV, and undernutrition. Penicillin resistance was 13.8%. Meningitis was a major cause of mortality and poor outcomes (28% of meningitis cases).
Conclusions:
- IPD poses a substantial burden of morbidity and mortality among young children in Jamaica.
- Targeted interventions focusing on HIV prevention, malnutrition, and improved care for children with sickle cell disease and HIV are essential.
- Reducing these underlying conditions can significantly decrease the incidence and impact of IPD.
Abstract:
A 5-year retrospective review of cases of invasive pneumococcal disease admitted to the Bustamante Hospital for Children, Jamaica was conducted. A total of 111 cases were identified. The estimated incidence of invasive pneumococcal disease in Kingston and St Andrew was 21/100,000 children under the age of 10 years. The majority of cases (76%) were in the under-2-years age group. All four deaths were of infants. Pre-existing medical conditions included sickle cell disease, HIV and undernutrition. The rate of resistance to penicillin was 13.8%. Meningitis accounted for three of the four deaths identified and poor outcome was identified in 28% of cases of meningitis. We conclude that invasive pneumococcal disease causes significant morbidity and mortality in young Jamaican children. Strategies directed at preventing HIV infection and malnutrition and improving the care of children with sickle cell disease and HIV infection would significantly reduce disease incidence.
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