The Impact of Pneumococcal Vaccination on Bacterial and Viral Pneumonia in Western Australian Children: Record Linkage Cohort Study of 469589 Births, 1996–2012

Fathima, Parveen; Blyth, Christopher C; Lehmann, Deborah; Lim, Faye Janice; Abdalla, Tasnim; Klerk, Nicholas de; Moore, Hannah C

doi:10.1093/cid/cix923

Cited by 50 publications

(37 citation statements)

References 28 publications

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“…Globally, bacteria, particularly Streptococcus pneumoniae and encapsulated and non-encapsulated strains of Haemophilus influenzae , are considered as the primary cause of pneumonia in young children 3. In recent years, there has been an increased focus on the role of respiratory viruses in childhood pneumonia, partly due to the reduction in bacterial disease associated with conjugate pneumococcal and Hib vaccine use6 7 and the increased capacity to detect virus through molecular diagnostic methods. These sensitive techniques have enabled detection of viruses in up to 92% of respiratory specimens of children with pneumonia 8–12.…”

Section: Introductionmentioning

confidence: 99%

The contribution of viruses and bacteria to community-acquired pneumonia in vaccinated children: a case–control study

Bhuiyan

Snelling

West

et al. 2018

Thorax

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IntroductionRespiratory pathogens associated with childhood pneumonia are often detected in the upper respiratory tract of healthy children, making their contribution to pneumonia difficult to determine. We aimed to determine the contribution of common pathogens to pneumonia adjusting for rates of asymptomatic detection to inform future diagnosis, treatment and preventive strategies.MethodsA case–control study was conducted among children <18 years in Perth, Western Australia. Cases were children hospitalised with radiologically confirmed pneumonia; controls were healthy children identified from outpatient and local immunisation clinics. Nasopharyngeal swabs were collected and tested for 14 respiratory viruses and 6 bacterial species by Polymerase chain reaction (PCR). For each pathogen, adjusted odds ratio (aOR; 95% CI) was calculated using multivariate logistic regression and population-attributable fraction (95% CI) for pneumonia was estimated.ResultsFrom May 2015 to October 2017, 230 cases and 230 controls were enrolled. At least one respiratory virus was identified in 57% of cases and 29% of controls (aOR: 4.7; 95% CI: 2.8 to 7.8). At least one bacterial species was detected in 72% of cases and 80% of controls (aOR: 0.7; 95% CI: 0.4 to 1.2). Respiratory syncytial virus (RSV) detection was most strongly associated with pneumonia (aOR: 58.4; 95% CI: 15.6 to 217.5). Mycoplasma pneumoniae was the only bacteria associated with pneumonia (aOR: 14.5; 95% CI: 2.2 to 94.8). We estimated that RSV, human metapneumovirus (HMPV), influenza, adenovirus and Mycoplasma pneumoniae were responsible for 20.2% (95% CI: 14.6 to 25.5), 9.8% (5.6% to 13.7%), 6.2% (2.5% to 9.7%), 4% (1.1% to 7.1%) and 7.2% (3.5% to 10.8%) of hospitalisations for childhood pneumonia, respectively.ConclusionsRespiratory viruses, particularly RSV and HMPV, are major contributors to pneumonia in Australian children.

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Section: Introductionmentioning

confidence: 99%

The contribution of viruses and bacteria to community-acquired pneumonia in vaccinated children: a case–control study

Bhuiyan

Snelling

West

et al. 2018

Thorax

Self Cite

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“…Evaluation of the in-house diagnostic rRT-PCR assay would be important to determine whether there are any missed variants/genotypes and whether this can be associated with the apparent gradual decline in HMPV prevalence observed in the current dataset. There is some evidence that reduction in bacterial pneumonia (eg S. pneumoniae), as has been seen in this coastal location over this study period (62), results in a reduction in viral pneumonia (63,64). Future investigations will be necessary to give more insight.…”

Section: Discussionmentioning

confidence: 73%

Human metapneumovirus prevalence and patterns of genotype persistence identified through surveillance of pediatric pneumonia hospital admissions in coastal Kenya, 2007-2016

Oketch¹,

Kamau²,

Otieno³

et al. 2019

Preprint

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Background Human metapneumovirus (HMPV) is an important respiratory pathogen that causes seasonal epidemics of acute respiratory illness and contributes significantly to childhood pneumonia. Current knowledge and understanding on its patterns of spread, prevalence and persistence in communities is limited. Methods We present findings of a molecular-epidemiological analysis of nasal samples from children < 5 years of age admitted with syndromic pneumonia between 2007 and 2016 to Kilifi County Hospital, coastal Kenya. HMPV infection was detected using real-time RT-PCR and positives sequenced in the fusion (F) and attachment (G) genes followed by phylogenetic analysis. The association between disease severity and HMPV genotype was assessed using Chi-square test for independence. Results Over 10 years, 274/6756 (4.10%) samples screened were HMPV positive. Annual prevalence fluctuated between years ranging 1.2% to 8.7% and lowest in the recent years (2014-2016). HMPV detections were most frequent between October of one year to April of the following year. Genotyping was successful for 205/274 (74.8%) positives revealing A2b (41.0%), A2c (10.7%), B1 (23.4%) and B2 (24.9%). The dominance patterns were: genotype A2b between 2007-11, B1 between 2012-14, and A2c in more recent epidemics. Genotype B2 viruses were present in all the years. These patterns mirrored the global picture. Temporal phylogenetic clustering within the genotypes for both local and global sequence data was seen. Genotypes occurring in each epidemic season were comprised of multiple variants. Pneumonia severity did not vary by genotype (p=0.264). In both the F and G gene, the sequenced regions were found to be predominantly under purifying selection. Conclusion Genotype and strain patterns from this rural African setting temporally map with global strain distribution, suggesting a well-mixed global virus transmission pool of HMPV. Persistence in the local community is characterized by repeated introductions of HMPV variants from the global pool. The factors underlying the declining prevalence of HMPV in this population should be investigated.

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“…14 In Australia, data linkage methodologies have been used to quantify case ascertainment in communicable disease registers; 15 to improve estimates of selected communicable diseases; [16][17][18][19] to better describe the burden of selected communicable diseases among Aboriginal and Torres Strait Islander people; [3][4][5]20 to improve communicable disease morbidity and mortality estimates; [21][22][23] and to evaluate immunisation programs. [24][25][26][27] These are all important examples of how data linkage can be applied to support communicable disease research in Australia, and results from these studies are often used to inform policy making and program improvement. 14 However, there is comparatively little use of data linkage by jurisdictional health departments to support communicable disease surveillance and control activities in an ongoing manner or to systematically address underlying gaps in communicable disease data collections.…”

Section: Use Of Data Linkage To Improve Communicable Disease Surveillmentioning

confidence: 99%

“…In the communicable diseases setting, data linkage can be used to evaluate public health interventions and guide policy development 14 . In Australia, data linkage methodologies have been used to quantify case ascertainment in communicable disease registers; 15 to improve estimates of selected communicable diseases; 16–19 to better describe the burden of selected communicable diseases among Aboriginal and Torres Strait Islander people; 3–5,20 to improve communicable disease morbidity and mortality estimates; 21–23 and to evaluate immunisation programs 24–27 . These are all important examples of how data linkage can be applied to support communicable disease research in Australia, and results from these studies are often used to inform policy making and program improvement 14 .…”

mentioning

confidence: 99%

Use of data linkage to improve communicable disease surveillance and control in Australia: existing practices, barriers and enablers

Rowe

Stephens²,

Cowie³

et al. 2019

Australian and New Zealand Journal of Public Health

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Objectives: To review the use of data linkage by Australian state and territory communicable disease control units, and to identify barriers to and enablers of data linkage to inform communicable disease surveillance and control activities. Methods: Semi‐structured telephone interviews were carried out with one key informant from communicable disease control units in all eight Australian states and territories between October 2017 and January 2018. Results: Key informants from all Australian states and territories participated in the interview. A variety of existing practices were identified, with few jurisdictions making systematic use of available data linkage infrastructure. Key barriers identified from the review included: a lack of perceived need; system factors; and resources. Existing regulatory tools enable data linkage to enhance communicable disease surveillance and control. Conclusions: We identified considerable variation in the use of data linkage to inform communicable disease surveillance and control activities between jurisdictions. We suggest that routinely collected, disparate data are systematically integrated into existing surveillance and response policy cycle to improve communicable disease prevention and control efforts. Implications for public health: Existing gaps in communicable disease surveillance data may affect prevention and control efforts. Data linkage is recognised as a valuable method to close surveillance gaps and should be used to enhance the value of publicly held health data.

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The Impact of Pneumococcal Vaccination on Bacterial and Viral Pneumonia in Western Australian Children: Record Linkage Cohort Study of 469589 Births, 1996–2012

Cited by 50 publications

References 28 publications

The contribution of viruses and bacteria to community-acquired pneumonia in vaccinated children: a case–control study

The contribution of viruses and bacteria to community-acquired pneumonia in vaccinated children: a case–control study

Human metapneumovirus prevalence and patterns of genotype persistence identified through surveillance of pediatric pneumonia hospital admissions in coastal Kenya, 2007-2016

Use of data linkage to improve communicable disease surveillance and control in Australia: existing practices, barriers and enablers

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