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Invasive pneumococcal disease and long-term outcomes in children: A 20-year population cohort study

Kristen A Versluys1, Dean T Eurich1, Thomas J Marrie2

  • 1School of Public Health, University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9, Canada.

Lancet Regional Health. Americas
|February 13, 2023
PubMed

Insights

Invasive pneumococcal disease (IPD) significantly increases short-term mortality risk in children, even with vaccination. While long-term survival and hospitalization impacts are minimal, immediate IPD effects are substantial.

Area of Science:

  • Pediatric Infectious Diseases
  • Public Health
  • Epidemiology

Background:

  • Vaccines for Streptococcus pneumoniae exist but challenges in prevention persist.
  • Downstream health consequences in children following invasive pneumococcal disease (IPD) are not well understood.

Purpose of the Study:

  • To evaluate the short-term and long-term health outcomes in children diagnosed with invasive pneumococcal disease (IPD).

Main Methods:

  • Retrospective analysis of 888 Streptococcus pneumoniae isolates from sterile sites in children (0-17 years) in Alberta, Canada (1999-2019).
  • Age and sex-matched hospitalized population controls were used.
  • Linkage to administrative health datasets identified comorbidities and healthcare outcomes.
  • Cox proportional hazards models assessed time to mortality and hospitalization across short (<30 days), intermediate (30-90 days), and long-term (>90 days) follow-up periods.

Main Results:

  • A higher proportion of deaths occurred in IPD cases (4.8 deaths/1000 person-years) compared to controls (2.7 deaths/1000 person-years), with a significant adjusted hazard ratio (aHR) of 1.80.
  • The increased mortality risk was primarily driven by short-term mortality (aHR 8.78), with no significant differences observed in intermediate or long-term mortality rates between cases and controls.

Conclusions:

  • Invasive pneumococcal disease (IPD) continues to pose a significant threat to pediatric survival, despite the availability of vaccines.
  • While the long-term impact of IPD on mortality and hospitalizations may be limited, the immediate health consequences are substantial and require attention.
Abstract

Keywords:
ChildrenCohort studyEpidemiologyInvasive pneumococcal diseasePublic HealthStreptococcus pneumoniae

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