Invasive Pneumococcal Disease and Carriage among Children with Sickle Cell Disease in Ghana: A Post-vaccination Study

项目总结 肺炎球菌携带者是肺炎球菌疾病发展的先兆，也是 负责生物在人与人之间的传播。患有镰状细胞的儿童 疾病(SCD)特别容易感染侵袭性肺炎球菌病(IPD) 给免疫系统有缺陷的人L有效地处理包裹体 细菌。这导致了对SCD进行抗肺炎球菌预防的建议。 包括青霉素和23价多糖疫苗在内的儿童接种 (PPV23)过去。虽然这些预防措施降低了儿童中IPD的发病率 儿童SCD中，突破性疾病仍有发生，多见于3岁以下儿童。在最后一次 十年来，肺炎球菌结合疫苗(PCV)已在约80%的 撒哈拉以南非洲的国家。来自各种研究的流行病学证据表明 PCV可导致肺炎球菌血清型分布的转变，通常向非 疫苗类型包括携带疫苗和疾病疫苗。在撒哈拉以南的SCD高发区 在非洲，引入PCV后的肺炎链球菌监测数据仍然很少。目标是 这项拟议研究的目的是了解肺炎球菌携带者的流行病学和 加纳后结合疫苗时代SCD儿童中的侵袭性疾病。至 为了实现这一目标，我们将执行以下三个具体目标：(一)确定频率 卡介苗接种PCV13后SCD儿童肺炎球菌获得率的研究 携带的血清型及其持久性。(Ii)确定IPD的发病率和病因 儿童系统性红斑狼疮的血清型研究(Iii)评价分离的肺炎球菌的抗菌谱 并描述青霉素和/或多药耐药克隆。 这项研究的信息将对肺炎球菌的预防和管理有用。 加纳SCD儿童的感染情况。

PROJECT SUMMARY Pneumococcal carriage is the precursor for development of pneumococcal disease, and is also responsible for transmission of the organism from person-to-person. Children with Sickle Cell Disease (SCD) are particularly susceptible to invasive pneumococcal disease (IPD) due to the i n a b i l i t y of their defective immune system to effectively handle encapsulated bacteria. This has led to the recommendation of anti-pneumococcal prophylaxis for SCD children including the administration of penicillin and the 23-valent polysaccharide vaccine (PPV23) in the past. Though these prophylactic measures decreased the rate of IPD among SCD children, breakthrough disease still occurred, mostly in children aged <3 years. In the last decade, Pneumococcal Conjugate Vaccines (PCVs) have become available in about 80% of the countries in sub-Saharan Africa. Epidemiological evidence from various studies indicate that PCVs can cause a shift in the distribution of pneumococcal serotypes usually towards non- vaccines types in both carriage and disease. In areas of high SCD prevalence in sub-Saharan Africa, pneumococcal surveillance data following introduction of PCVs remain scarce. The goal of this proposed study is to understand the epidemiology of pneumococcal carriage and invasive disease among children with SCD in the post-conjugate vaccine era in Ghana. To address this goal, we will execute three specific aims as follows: (i) to determine the frequency of pneumococci acquisition in SCD children vaccinated with PCV13 and evaluate the common serotypes carried and their persistence. (ii) to determine the incidence of IPD and the causative serotypes among children with SCD. (iii) to evaluate the antibiogram of pneumococci isolated from children with SCD and describe the penicillin and / or multidrug resistant clones. Information from the study would be useful in the prevention and management of pneumococcal infections among children with SCD in Ghana.