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Published on: February 23, 2014
Pneumococcal infection among hospitalized Egyptian children
Iman H Draz1, Eman F Halawa, Ghada Wahby
1Departments of aPediatric bPublic Health cClinical and Chemical Pathology, Cairo University, Cairo, Egypt.
Insights
Pneumococcal disease is increasing in Egyptian children under 5, with higher risks for infants. This highlights the need for national surveillance and vaccination strategies to combat rising infections and drug resistance.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Epidemiology
Background:
- Pneumococcal disease remains a significant global health concern, particularly in young children.
- Limited data exists on the epidemiology and clinical outcomes of pneumococcal infections in Egypt.
Purpose of the Study:
- To describe the detection rates, clinical manifestations, and outcomes of pneumococcal disease in children under 5 years old in Egypt.
- To assess the incidence of invasive pneumococcal disease (IPD) versus non-IPD.
Main Methods:
- A hospital-based study conducted from 2008 to 2011 at Cairo University Pediatric Hospital.
- Laboratory-confirmed Streptococcus pneumoniae cases were analyzed for demographic data, clinical features, comorbidities, diagnostic tests, antibiotic resistance, and outcomes.
Main Results:
- An increasing trend in pneumococcal detection rates was observed over the 4-year study period.
- Infants under 1 year had a significantly higher vulnerability to infection (110.5/100,000) compared to older children (21.6/100,000).
- The overall case fatality rate was 33.3%, with IPD having a much higher fatality rate (75%) than non-IPD (12.5%).
Conclusions:
- Pneumococcal infections are substantial and increasing in young Egyptian children, with a notable rise in multidrug-resistant strains.
- Younger children and high-risk populations are particularly vulnerable, underscoring the need for enhanced surveillance.
- The findings support the urgent need for national surveillance to guide policy and decision-making prior to widespread vaccine introduction.
Aim:
We aimed to describe the detection rate spectrum of clinical manifestations, and outcome of pneumococcal disease in children younger than 5 years admitted to the largest referral pediatric hospital in Egypt.
Materials And Methods:
This was a hospital-based study to detect laboratory-confirmed Streptococcus pneumoniae cases among children younger than 5 years. Data on demographic characteristics, clinical diagnosis, comorbidities, diagnostic tests, antibiotic resistance, and clinical outcome were collected during the study years from 2008 to 2011.
Results:
During the 4-year study period, 22 018 cases younger than 5 years had cultures performed at Cairo University Pediatric Hospital microbiology laboratory. We estimated the annual detection rate of total Streptococcus pneumonia infection to be 54.5/100 000. The incidence of invasive pneumococcal disease (IPD) was half the incidence of non-IPD (18.2 and 36.4/100 000, respectively). Infants of 1 year or younger were statistically more vulnerable to Streptococcus pneumonia infection compared with children between 1 and 5 years of age (annual rate: 110.5/100 000 and 21.6/100 000, respectively). The overall pneumococcal annual case fatality was 33.3% and was higher in IPD (75%) than in non-IPD (12.5%) cases. There was an obviously increasing trend of the pneumococcal detection rate throughout the 4 years of the study (P<0.0001).
Conclusion And Recommendations:
Our results confirm the substantial and increasing pneumococcal infection, the emerging of multidrug resistant isolates, and the vulnerability of the younger age group and high-risk population, which calls for a national surveillance to inform policy and decision-making before national wide vaccine introduction.
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