Report on Invasive Disease and Meningitis due to Haemophilus influenzae and Streptococcus pneumonia from the Network for Surveillance of Pneumococcal Disease in the East African Region
Report on Invasive Disease and Meningitis due to Haemophilus influenzae and Streptococcus pneumonia from the Network for Surveillance of Pneumococcal Disease in the East African Region
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DOI：
10.1086/596494
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发表时间：
2009-03-01
影响因子：
11.8
通讯作者：
Wamae, Maranga
中科院分区：
文献类型：
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作者：
Mudhune, Sandra;Wamae, Maranga
在东非，幼儿肺炎球菌病的特征并不像在工业化国家那样清楚。虽然肺炎球菌可能导致大量死亡和发病，但普遍的诊断挑战加上公共卫生监测的初级性质使得仅用这些方法难以确定这些疾病的真正流行病学特征。然而，当地数据对于为疫苗部署辩论提供信息和评估疫苗影响至关重要。东非区域肺炎球菌疾病监测网络努力扩大世界卫生组织儿科细菌性脑膜炎监测网络发起的监测进程，以监测B型流感嗜血杆菌，从而监测肺炎球菌疾病。共119个H。已证实从2岁以上但5岁以下儿童中分离出流感病毒。其中B型83株（69.75%），其他抗原群19株，未定型17株。对于肺炎链球菌，共有442株分离株被证实为肺炎球菌; 302株分离株来自血培养，140株来自脑脊液培养。大多数分离株来自6-29个月年龄组的患者;在该年龄组中，七价疫苗的总体覆盖率为56%（由于血清型6A增加了交叉保护，增加到67%）。S.肺炎分离株对除甲氧苄啶-磺胺甲恶唑以外的大多数常用抗生素敏感，并且对青霉素没有表现出抗性。一个监测网络已经到位，以提供有关S的重要性的本地数据。肺炎是脑膜炎和菌血症的原因。目前可用的七价结合肺炎球菌疫苗中的血清型和相关血清型占6-29个月儿童侵袭性肺炎球菌疾病的三分之二。
Pneumococcal disease in young children has not been as well characterized in East Africa as it has been in industrialized countries. Although pneumococci are likely to cause substantial mortality and morbidity, universal diagnostic challenges plus the rudimentary nature of public health surveillance make the true epidemiological characteristics of these diseases difficult to ascertain with these methods alone. However, local data are critical to inform the debate on vaccine deployment and assess vaccine impact. The Network for Surveillance of Pneumococcal Disease in the East African Region has worked to expand the World Health Organization Paediatric Bacterial Meningitis Surveillance Network-initiated surveillance process aimed at Haemophilus influenza type b to perform surveillance on pneumococcal diseases. A total of 119 H. influenzae isolates from children aged > 2 years but < 5 years of age have been confirmed. Eighty-three isolates (69.75%) were serotype b, 19 belonged to other capsular antigen groups, and 17 were nontypable. For Streptococcus pneumoniae, a total of 442 isolates were confirmed to be pneumococci; 302 isolates were from blood cultures, and 140 were from cultures of cerebrospinal fluid. Most of the isolates were obtained from patients in the 6-29-month age group; in this age group, overall coverage by the heptavalent vaccine was 56% (increasing to 67% with the addition of cross-protection due to serotype 6A). S. pneumoniae isolates are susceptible to most commonly used antibiotics, with the exception of trimethoprim-sulfamethoxazole, and have exhibited no resistance to penicillin. A surveillance network is in place to provide local data on the importance of S. pneumoniae as a cause of both meningitis and bacteremia. Serotypes in the currently available heptavalent conjugate pneumococcal vaccine and related serotypes account for two-thirds of invasive pneumococcal disease among children aged 6-29 months.