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Incidence of clinically significant bacteraemia in children who present to hospital in Kenya: community-based

A J Brent1, I Ahmed, M Ndiritu

  • 1Wellcome Trust/KEMRI Centre for Geographic Medicine Research, Coast, PO Box 230, Kilifi, Kenya. andrew_brent@doctors.org.uk

Lancet (London, England)
|February 14, 2006
PubMed

Insights

Invasive bacterial disease, including pneumococcal bacteraemia, is twice as common in Kenyan children as previously thought. These findings support the urgent need for pneumococcal vaccine implementation in sub-Saharan Africa.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Invasive bacterial disease (IBD) burden estimates in sub-Saharan Africa often underestimate the true incidence by focusing only on hospitalized patients.
  • Underestimation of IBD incidence hampers effective vaccine implementation strategies in the region.
  • This study aimed to determine the incidence of bacteraemia in all children presenting to a Kenyan hospital, regardless of their clinical condition or admission status.

Purpose of the Study:

  • To accurately assess the incidence of bacteraemia in children presenting to a hospital in Kenya.
  • To evaluate the clinical significance of bacteraemia and the effectiveness of clinical signs in its diagnosis.
  • To provide data supporting public health interventions, such as vaccine introduction.

Main Methods:

  • A community-based observational study involving blood cultures from 1093 children attending a Kenyan hospital's outpatient department.
  • Utilized a Demographic Surveillance System to estimate bacteraemia incidence.
  • Investigated the clinical presentation, outcomes, and diagnostic utility of clinical signs for bacteraemia.

Main Results:

  • The overall yearly incidence of bacteraemia was 2440 per 100,000 children under 2 years and 1192 per 100,000 children under 5 years.
  • Pneumococcal bacteraemia incidence was 597 per 100,000 children under 5 years.
  • Clinically significant bacteraemia was twice as common, and pneumococcal bacteraemia four times as common, as previously estimated, with clinical signs proving poor indicators.

Conclusions:

  • Clinically significant bacteraemia is more prevalent in Kenyan children than previously reported.
  • The high incidence of pneumococcal bacteraemia strongly supports the introduction and widespread use of the pneumococcal vaccine in sub-Saharan Africa.
  • Accurate incidence data are crucial for effective disease control and prevention programs.
Abstract

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