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Epidemiology of invasive pneumococcal disease in Kumasi, Ghana

Richard E Holliman1, Helen Liddy, Julie D Johnson

  • 1Department of Medical Microbiology, St George's Hospital & Medical School, Blackshaw Road, London, UK.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|November 28, 2006
PubMed

Insights

Invasive pneumococcal disease is a significant threat in Ghana, particularly for young children. While penicillin resistance is low, current vaccines offer limited protection, necessitating tailored formulations for better control.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Microbiology

Background:

  • Limited epidemiological data exists for invasive pneumococcal disease (IPD) in Africa.
  • IPD poses a substantial public health challenge, especially in resource-limited settings.

Purpose of the Study:

  • To prospectively investigate the epidemiology of IPD in Kumasi, Ghana.
  • To characterize clinical features, antibiotic resistance patterns, and serotypes of pneumococcal infections.

Main Methods:

  • Prospective study of laboratory-confirmed IPD cases (meningitis, pneumonia, sepsis) from January 2002 to April 2005.
  • Data collection included clinical information, antimicrobial susceptibility testing, and serotyping of Streptococcus pneumoniae isolates.
  • Analysis of disease prevalence, risk factors, treatment, mortality, and vaccine serotype coverage.

Main Results:

  • 140 IPD cases were identified, predominantly in children under 5 years old and associated with the harmattan season.
  • High mortality rate of 47% was observed.
  • Most isolates were resistant to tetracyclines and co-trimoxazole, but high-level penicillin resistance was absent; 12% showed intermediate resistance.
  • Serotype 1 was most common (36%), linked to intermediate penicillin resistance with serotype 14.
  • Existing pneumococcal vaccines provided theoretical coverage ranging from 26% (7-valent) to 76% (23-valent).

Conclusions:

  • Invasive pneumococcal disease remains a critical issue in Ghana with high mortality.
  • While penicillin resistance is not high-level, antibiotic resistance is a concern.
  • Current pneumococcal vaccines have limited coverage, indicating a need for locally adapted vaccine formulations for effective disease control.

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