Access

You are not currently logged in.

Access your personal account or get JSTOR access through your library or other institution:

login

Log in to your personal account or through your institution.

Surveillance of Pneumococcal Meningitis among Children in Sindh, Southern Pakistan

Anita K. M. Zaidi, Hassan Khan, Razzaq Lasi and Waheed Mahesar
Clinical Infectious Diseases
Vol. 48, Supplement 2. Coordinated Surveillance and Detection of Pneumococcal and Haemophilus influenzae Type B (Hib) Disease in Developing Countries (Mar. 1, 2009), pp. S129-S135
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/40308366
Page Count: 7
  • Download ($42.00)
  • Subscribe ($19.50)
  • Cite this Item
Surveillance of Pneumococcal Meningitis among Children in Sindh, Southern Pakistan
Preview not available

Abstract

Background. Information about the burden of invasive pneumococcal disease among children in Pakistan is limited. Methods. Surveillance of bacterial meningitis among children aged < 5 years was set up at 18 hospitals in southern Pakistan that fulfilled the following criteria: (1) > 30 pediatric admissions weekly, (2) skilled personnel to perform lumbar punctures, and (3) close proximity to an Aga Khan University Hospital laboratory collection point. Results. A total of 2690 children were admitted to the hospital with suspected acute bacterial meningitis, and 2646 (98%) underwent lumbar puncture. Of the 2646 cerebrospinal fluid specimens obtained, 412 (16%) were purulent, and pathogens were detected by culture or latex agglutination testing in 83 (20.1%) of the purulent specimens. Of the 83 isolates detected, 48 (57.8%) were Haemophilus influenzae typeb, 32 (38.5%) were Streptococcus pneumoniae, and 3 (3.6%) were Neisseria meningiditis. Overall, 81% of the pathogens detected were from children aged < 1 year. More than 50% of families reported definite prior antimicrobial use. The minimum detected incidence rates of purulent meningitis in Hyderabad were 112 cases per 100,000 children aged < 1 year and 45.3 cases per 100,000 children aged < 5 years. After adjustment for limitations in access to care and the low sensitivity of cerebrospinal fluid culture, the adjusted incidence rates of pneumococcal meningitis were 81 cases per 100,000 children aged < 1 year (95% confidence interval, 26.2-190.5 cases per 100,000) and 20 cases per 100,000 children aged < 5 years (95% confidence interval, 7.3-43.7 cases per 100,000). Of the 32 children with pneumococcal meningitis, 8 (25%) died during hospitalization. Conclusions. Our surveillance system detected a substantial burden of purulent meningitis among infants and children in southern Pakistan. H. influenzae type b and S. pneumoniae accounted for > 90% of detected pathogens. The use of vaccines against these 2 pathogens could prevent a substantial portion of disease and deaths in Pakistan.

Page Thumbnails

  • Thumbnail: Page 
S129
    S129
  • Thumbnail: Page 
S130
    S130
  • Thumbnail: Page 
S131
    S131
  • Thumbnail: Page 
S132
    S132
  • Thumbnail: Page 
S133
    S133
  • Thumbnail: Page 
S134
    S134
  • Thumbnail: Page 
S135
    S135