Hospital‐Based Surveillance of Invasive Pneumococcal Disease among Young Children in Urban Nepal

Williams, Eleri; Thorson, Stephen; Maskey, Mitu; Mahat, Sandeep; Hamaluba, Mainga; Dongol, Sabina; Werno, Anja M.; Bk, Yadav; Shah, Aparna Singh; Kelly, Dominic F.; Adhikari, Neelam; Pollard, Andrew J.; Murdoch, David R.

doi:10.1086/596488

Cited by 37 publications

(39 citation statements)

References 13 publications

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“…Since April 2005, as part of a microbiological surveillance study, all children admitted to the children's ward of Patan Hospital with suspected invasive bacterial disease or pneumonia have routinely had blood samples and, where appropriate, cerebrospinal fluid (CSF) samples cultured. All pathogens isolated from blood and/or CSF samples were stored at Ϫ70°C (12,38). Hib disease-causing isolates were obtained from this collection for comparison with isolates from children carrying Hib.…”

Section: Methodsmentioning

confidence: 99%

“…However, the absolute number of cases in the study was small, and there is still uncertainty about the relative importance of Hib in Asia. In urban Nepal, we have previously identified a significant burden of pneumonia in children less than 5 years old admitted to a hospital (12,38). While Hib is likely to be the cause of many of these cases of pneumonia, most children with Hib pneumonia have negative blood cultures, and confirmation is therefore not possible (6).…”

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confidence: 99%

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Haemophilus influenzae Type b Carriage and Novel Bacterial Population Structure among Children in Urban Kathmandu, Nepal

Williams¹,

Lewis²,

John³

et al. 2011

J Clin Microbiol

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Haemophilus influenzae type b (Hib) is a major cause of invasive bacterial infection in children that can be prevented by a vaccine, but there is still uncertainty about its relative importance in Asia. This study investigated the age-specific prevalence of Hib carriage and its molecular epidemiology in carriage and disease in Nepal. Oropharyngeal swabs were collected from children in Kathmandu, Nepal, from 3 different settings: a hospital outpatient department (OPD), schools, and children's homes. Hib was isolated using Hib antiserum agar plates, and serotyping was performed with latex agglutination. Hib isolates from children with invasive disease were obtained during active microbiological surveillance at Patan Hospital, Kathmandu, Nepal. Genotyping of disease and carriage isolates was undertaken using multilocus sequence typing (MLST). Swabs were taken from 2,195 children, including 1,311 children at an OPD, 647 children attending schools, and 237 children in homes. Overall, Hib was identified in 5.0% (110/2,195; 95% confidence interval [95% CI], 3.9% to 6.4%). MLST was performed on 108 Hib isolates from children carrying Hib isolates and 15 isolates from children with invasive disease. Thirty-one sequence types (STs) were identified, and 20 of these were novel STs. The most common ST isolates were sequence type 6 (ST6) and the novel ST722. There was marked heterogeneity among the STs from children with disease and children carrying Hib. STs identified from invasive infections were those commonly identified in carriage. This study provides evidence of Hib carriage among children in urban Nepal with genetically diverse strains prior to introduction of universal vaccination. The Hib carriage rate in Nepal was similar to the rates observed in other populations with documented high disease rates prior to vaccination, supporting implementation of Hib vaccine in Nepal in 2009.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Haemophilus influenzae Type b Carriage and Novel Bacterial Population Structure among Children in Urban Kathmandu, Nepal

Williams¹,

Lewis²,

John³

et al. 2011

J Clin Microbiol

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“…Elerie J. Williams et al also could recover only 9 bacteria from culture of 199 CSF sample. (9) The positivity of CSF cultures in TBM has been reported to vary from 8% to 58% by several workers in India. (10) Our patients showed significant CSF leucocytosis with neutrophilic predominance (90%) and high CSF protein (>50 mg/dl) (72.7%) in bacterial meningitis compared to the nonbacterial meningitis group.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Clinical Profile and Laboratory Parameters in Patients With Suspected Meningitis and Their Outcome at a Tertiary Centre , Bareilly U . P .

Pandey¹,

Pratap²

2015

jemds

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A prospective study was carried out in department of Pediatrics between January 2013-June 2014. All patients admitted as suspected meningitis meeting our inclusion criteria were followed till discharge. Clinical profile, laboratory parameters and outcome at discharge were assessed. Total 95 patients were enrolled in the study. Out of which 73 patients were followed up till discharge meeting our inclusion criteria. Forty seven (64.38%) were diagnosed as Tubercular meningitis, 22(30.13%) as pyogenic meningitis and 4(5.47%) as aseptic meningitis. CSF ADA, CSF glucose and CSF WBC count were significant in diagnosis of meningitis. Early detection and prompt therapy are most important factors in prognosis of meningitis.

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“…For example, in its efforts to measure the burden of IPD around the world, the PneumoADIP programme 14 found that, while many sentinel systems with large populations in their catchment areas identified more than 30 hospitalized, laboratory-confirmed cases a year in children aged under 5 years, 7,15,16 others identified substantially fewer. 7,[17][18][19][20] However, the alternative approach of establishing sentinel surveillance at hospitals that treat a large proportion of their areas' IPD cases has the disadvantage that, without a population-based surveillance system, it is difficult to estimate the percentage of cases in the population seen at an individual hospital. Pooling several individual hospitals to create a sentinel system with a large enough total number of baseline cases may be more practical.…”

Section: Researchmentioning

confidence: 99%

Sentinel versus population-based surveillance of pneumococcal conjugate vaccine effectiveness

Hampton¹,

Zell²,

Schrag³

et al. 2012

Bull World Health Org

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Hospital‐Based Surveillance of Invasive Pneumococcal Disease among Young Children in Urban Nepal

Cited by 37 publications

References 13 publications

Haemophilus influenzae Type b Carriage and Novel Bacterial Population Structure among Children in Urban Kathmandu, Nepal

Haemophilus influenzae Type b Carriage and Novel Bacterial Population Structure among Children in Urban Kathmandu, Nepal

Assessment of Clinical Profile and Laboratory Parameters in Patients With Suspected Meningitis and Their Outcome at a Tertiary Centre , Bareilly U . P .

Sentinel versus population-based surveillance of pneumococcal conjugate vaccine effectiveness

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