In Tonga, pneumococcal conjugate vaccine is not a scheduled immunization. We identified all children in Tonga with invasive pneumococcal disease from 2010 to 2013. The average annual invasive pneumococcal disease incidence rate was 113/100,000 (<2 years), 50/100,000 (<5 years) and 25/100,000 (<15 years). The case fatality rate (<5 years) was 25%. The incidence rate and high case fatality rate indicate the need for pneumococcal conjugate vaccine.
Children and young people around the world face challenges to their health and wellbeing. In particular, in low‐ and middle‐income countries they experience a higher burden of disease, exacerbated by global inequity limiting access to quality health care. According to the inverse care law, the availability of quality health care varies inversely to the need of the population, and hardworking health‐care professionals in under‐resourced countries may face impediments to continued education or subspecialty training. In line with the Sustainable Development Goals, collaborations have been developed between high‐income and low‐ and‐middle‐income countries to address global disparities in health. These collaborations face challenges of high financial costs, difficulties creating long‐term sustainable change, and with the emergence of the COVID‐19 pandemic, border closures preventing fly‐in volunteers. In this paper, we describe the development of an innovative, paediatric‐specific model of care for training and support between high‐ and low‐income countries – Taking Paediatrics Abroad Ltd. Taking Paediatrics Abroad supports the development of mutually beneficial relationships between Australian paediatric health‐care professionals and paediatric health‐care professionals in developing countries and remote, underserved Australian Aboriginal communities. Since May 2020, there have been over 100 sessions covering a vast array of paediatric specialties. This article explores Taking Paediatrics Abroad's model of care, its implementation and challenges, and opportunities for the future.
Acute Rheumatic Fever (ARF) is an autoimmune condition caused by untreated Group A Streptococcal (GAS) infection of the upper respiratory tract (and possibly skin). Multiple or severe attacks of ARF can cause cardiac damage, known as Rheumatic Heart Disease (RHD) which remains a significant cause of morbidity and mortality globally and is rare in developed countries. In Australia, New Zealand (NZ) and the Pacific Region, the disease burden of ARF and RHD amongst Indigenous and Pacific communities is one of the highest in the world, usually affecting children and young adults. A GAS vaccine remains years from being available and until then, the most effective recommended preventative measure for ARF requires painful monthly intramuscular injections of Benzathine Penicillin G (BPG) for 10 years or more, known as secondary prophylaxis (SP). Adherence to SP remains a challenge in many settings and improved understanding of barriers and novel approaches to BPG delivery are urgently needed. To create a reformulation of BPG that encourages SP adherence, insight is needed into the reformulation preferences of those with ARF/RHD. This work seeks to explore the experiences and investigate children/teen on SP, family, and healthcare professional and practitioner preferences for potential BPG reformulation characteristics in Tonga. Three software applications will be adapted from pre-developed applications already piloted and pretested, and optimized for use to ensure age, cultural appropriateness and efficient data collection. This is the first time software applications have been successfully developed and utilized to collect qualitative and quantitative data on individual preferences for BPG formulations and dosing regimens in Tonga.
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