Invasive pneumococcal disease in Jamaican children

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.