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Invasive pneumococcal disease burden and implications for vaccine policy in urban Bangladesh

W Abdullah Brooks1, Robert F Breiman, Doli Goswami

  • 1ICDDR,B, Mohakhali, Dhaka, Bangladesh. abrooks@icddrb.org

The American Journal of Tropical Medicine and Hygiene
|November 7, 2007
PubMed

Insights

Invasive pneumococcal disease (IPD) surveillance in Bangladesh revealed high incidence and significant antimicrobial resistance in children under five. Conjugate vaccines are expected to reduce IPD, pneumonia, and resistance.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Invasive pneumococcal disease (IPD) poses a significant threat to young children globally.
  • Population-based data on IPD incidence, serotype distribution, and antimicrobial resistance in Bangladesh were previously lacking.
  • Understanding these factors is crucial for public health interventions.

Purpose of the Study:

  • To determine the incidence and serotype distribution of IPD in children under five years old in urban Bangladesh.
  • To describe the clinical presentation and antimicrobial resistance patterns of IPD.
  • To evaluate the potential impact of conjugate vaccines on IPD and related outcomes.

Main Methods:

  • Active, population-based surveillance was conducted in 5,000 urban households.
  • Blood cultures were collected from eligible children aged <5 years between April 2004 and March 2006.
  • Isolation of Streptococcus pneumoniae and antimicrobial susceptibility testing were performed.

Main Results:

  • A total of 34 cases of IPD were identified among 6,167 eligible children.
  • Overall IPD incidence was 447 episodes/100,000 child-years, with 13-valent serotype-related IPD incidence at 276 episodes/100,000 child-years.
  • High rates of resistance were observed for cotrimoxazole (82.4%), ciprofloxacin (24.1%), and chloramphenicol (14.7%).

Conclusions:

  • IPD incidence, particularly related to vaccine serotypes, is substantial in young Bangladeshi children.
  • High antimicrobial resistance necessitates careful treatment strategies and highlights the importance of vaccination.
  • Current conjugate vaccines are anticipated to significantly decrease IPD, childhood pneumonia, and antimicrobial resistance in Bangladesh.

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