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Published on: February 15, 2013
A Narrative Review of Pneumococcal Disease in Children in the Philippines
Amgad Gamil1, Miriam Y Lalas2, Maria Rosario Z Capeding3
1Emerging Markets Medical and Scientific Affairs, Vaccines Asia, Pfizer Inc, Pfizer Building, 5th floor, DMC, P.O. Box 502749, Dubai, UAE. Amgad.Gamil@pfizer.com.
Insights
Pneumococcal disease remains high in Philippine children despite vaccination. Enhanced surveillance is crucial for accurate data on disease incidence, serotypes, and antibiotic resistance to improve vaccination strategies and child protection.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Invasive pneumococcal disease (IPD) poses a significant public health challenge in the Philippines, particularly among young children.
- Despite the availability of the 13-valent pneumococcal conjugate vaccine (PCV13) through the National Immunization Program, high disease burden persists.
- Existing epidemiological data on IPD, nasopharyngeal carriage, and antimicrobial resistance are limited and show considerable variability.
Purpose of the Study:
- To review the current epidemiology of invasive pneumococcal diseases, nasopharyngeal carriage, and antibiotic resistance of Streptococcus pneumoniae serotypes.
- To assess vaccination coverage and identify gaps in protection against pneumococcal disease in children in the Philippines.
- To highlight the urgent need for comprehensive and contemporary disease surveillance to inform public health strategies.
Main Methods:
- Narrative review of existing epidemiological studies, surveillance data, and vaccination coverage reports related to Streptococcus pneumoniae in the Philippines.
- Analysis of data on disease incidence, serotype distribution, nasopharyngeal carriage rates, and antimicrobial resistance patterns.
- Evaluation of the impact of PCV13 introduction and current immunization program effectiveness.
Main Results:
- High burden of pneumococcal disease in young children persists despite PCV13 availability.
- Significant variability in reported data necessitates improved disease surveillance.
- While vaccine-type serotype diseases have declined, non-vaccine serotype diseases are an emerging concern; antimicrobial resistance data is limited but generally low in young children.
Conclusions:
- There is a critical need for active, comprehensive, and contemporary disease surveillance in the Philippines.
- Accurate data on IPD incidence, serotype distribution, and antibiotic resistance are essential for optimizing vaccination strategies.
- Enhanced surveillance will ensure better protection for Filipino children against pneumococcal disease.
Abstract:
This narrative review describes the epidemiology of invasive pneumococcal diseases, nasopharyngeal carriage, and antibiotic resistance of Streptococcus pneumoniae serotypes, and vaccination coverage in children in the Philippines. Epidemiological data show that, despite the availability of the free-of-cost 13-valent pneumococcal conjugate vaccine for infants as part of the National Immunization Program, the burden of pneumococcal disease in young children remains high in the Philippines. The significant variability in data reported between studies highlights an urgent need for active and comprehensive disease surveillance for more accurate estimates of pneumococcal disease in the country. Although data from 2001 to 2013 show high rates of pneumococcal carriage in children in the Philippines aged < 5 years, contemporary data are lacking, again emphasizing the need for active surveillance programs. The introduction of pneumococcal conjugate vaccines has resulted in substantial declines in disease caused by pneumococcal serotypes included in the vaccines, but the emergence of pneumococcal disease due to nonvaccine serotypes is an ongoing concern. Surveillance of actively circulating serotypes is critical to better understand vaccine coverage. Antimicrobial resistance of S. pneumoniae remains a significant threat to public health worldwide; data regarding antibiotic resistance in young children in the Philippines are limited, but reports generally show low rates of antibiotic resistance in this group. National immunization rates have increased in recent years, yet many individuals are still unprotected from pneumococcal disease. Overall, there is a critical need for contemporary and accurate disease surveillance in the Philippines. Such data would provide better estimates of pneumococcal disease incidence, serotype distribution, and antibiotic resistance to better inform vaccination strategies and to ensure that children in the Philippines are best protected against pneumococcal disease.
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