Epidemiology of pneumococcal meningitis in sentinel hospital surveillance of Viet Nam, 2015-2018.


Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
18 Oct 2024
Historique:
received: 23 04 2024
accepted: 07 10 2024
medline: 19 10 2024
pubmed: 19 10 2024
entrez: 18 10 2024
Statut: epublish

Résumé

Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae), and Neisseria meningitidis (N. meningitidis) are leading causes of childhood bacterial meningitis and preventable by vaccines. The aim of this hospital-based sentinel surveillance is to describe the epidemiological characteristics of pneumococcal meningitis, including disease burden, and to provide baseline data on pneumococcal serotype distribution to support decision making for pneumococcal conjugate vaccine (PCV) introduction in Vietnam. Surveillance for probable bacterial meningitis in children 1-59 months of age is conducted in three tertiary level pediatric hospitals: one in Hanoi and two in Ho Chi Minh City. Cerebrospinal fluid (CSF) specimens were collected via lumbar puncture from children with suspected meningitis. Specimens were transferred immediately to the laboratory department of the respective hospital for cytology, biochemistry, and microbiology testing, including culture. PCR testing was conducted on CSF specimens for bacterial detection (S. pneumoniae, H. influenzae, and N. meningitidis) and pneumococcal serotyping. During 2015-2018, a total of 1,803 children with probable bacterial meningitis were detected; 1,780 had CSF specimens available for testing. Of 245 laboratory-confirmed positive cases, the majority were caused by S. pneumoniae (229,93.5%). Of those with S. pneumoniae detected, over 70% were caused by serotypes included in currently available PCV products; serotypes 6 A/6B (27.1%), 14 (19.7%), and 23 F (16.2%) were the most common serotypes. Children with laboratory-confirmed pneumococcal meningitis were more likely to live in Hanoi (p < 0.0001) and children 12-23 months of age were at greater odds (OR = 1.65, 95% CI: 1.11, 2.43; p = 0.006) of having confirmed pneumococcal meningitis compared to children < 12 months of age when compared to those without laboratory-confirmed bacterial meningitis. Additionally, children with confirmed pneumococcal meningitis were more likely to exhibit signs and symptoms consistent with clinical meningitis compared to negative laboratory-confirmed meningitis cases (p < 0.0001) and had a greater odds of death (OR = 6.18, 95% CI: 2.98, 12.86; p < 0.0001). Pneumococcal meningitis contributes to a large burden of bacterial meningitis in Vietnamese children. A large proportion are caused by serotypes covered by PCVs currently available. Introduction of PCV into the routine immunization program could reduce the burden of pneumococcal meningitis in Viet Nam.

Sections du résumé

BACKGROUND BACKGROUND
Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae), and Neisseria meningitidis (N. meningitidis) are leading causes of childhood bacterial meningitis and preventable by vaccines. The aim of this hospital-based sentinel surveillance is to describe the epidemiological characteristics of pneumococcal meningitis, including disease burden, and to provide baseline data on pneumococcal serotype distribution to support decision making for pneumococcal conjugate vaccine (PCV) introduction in Vietnam.
METHODS METHODS
Surveillance for probable bacterial meningitis in children 1-59 months of age is conducted in three tertiary level pediatric hospitals: one in Hanoi and two in Ho Chi Minh City. Cerebrospinal fluid (CSF) specimens were collected via lumbar puncture from children with suspected meningitis. Specimens were transferred immediately to the laboratory department of the respective hospital for cytology, biochemistry, and microbiology testing, including culture. PCR testing was conducted on CSF specimens for bacterial detection (S. pneumoniae, H. influenzae, and N. meningitidis) and pneumococcal serotyping.
RESULTS RESULTS
During 2015-2018, a total of 1,803 children with probable bacterial meningitis were detected; 1,780 had CSF specimens available for testing. Of 245 laboratory-confirmed positive cases, the majority were caused by S. pneumoniae (229,93.5%). Of those with S. pneumoniae detected, over 70% were caused by serotypes included in currently available PCV products; serotypes 6 A/6B (27.1%), 14 (19.7%), and 23 F (16.2%) were the most common serotypes. Children with laboratory-confirmed pneumococcal meningitis were more likely to live in Hanoi (p < 0.0001) and children 12-23 months of age were at greater odds (OR = 1.65, 95% CI: 1.11, 2.43; p = 0.006) of having confirmed pneumococcal meningitis compared to children < 12 months of age when compared to those without laboratory-confirmed bacterial meningitis. Additionally, children with confirmed pneumococcal meningitis were more likely to exhibit signs and symptoms consistent with clinical meningitis compared to negative laboratory-confirmed meningitis cases (p < 0.0001) and had a greater odds of death (OR = 6.18, 95% CI: 2.98, 12.86; p < 0.0001).
CONCLUSIONS CONCLUSIONS
Pneumococcal meningitis contributes to a large burden of bacterial meningitis in Vietnamese children. A large proportion are caused by serotypes covered by PCVs currently available. Introduction of PCV into the routine immunization program could reduce the burden of pneumococcal meningitis in Viet Nam.

Identifiants

pubmed: 39425015
doi: 10.1186/s12879-024-10065-0
pii: 10.1186/s12879-024-10065-0
doi:

Substances chimiques

Pneumococcal Vaccines 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1179

Informations de copyright

© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

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Auteurs

Dac Trung Nguyen (DT)

National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.

Thi Loan Nguyen (TL)

National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.

Allison Olmsted (A)

Centers for Disease Control and Prevention, Atlanta, GA, USA.

Thi Hong Duong (TH)

National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.

Hong Mai Hoang (HM)

National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.

Lien Huong Nguyen (LH)

National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.

Mahamoudou Ouattara (M)

Centers for Disease Control and Prevention, Atlanta, GA, USA.

Jennifer Milucky (J)

Centers for Disease Control and Prevention, Atlanta, GA, USA.

Fernanda C Lessa (FC)

Centers for Disease Control and Prevention, Atlanta, GA, USA.

Thi Trang Dai Vo (TTD)

Pasteur Institute in Ho Chi Minh City, Ho Chi Minh, Viet Nam.

Van Thanh Phan (VT)

Pasteur Institute in Ho Chi Minh City, Ho Chi Minh, Viet Nam.

Thi Hien Anh Nguyen (THA)

National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.

Nguyen My Nguyet Pham (NMN)

Ho Chi Minh City Children Hospital No.2, Ho Chi Minh City, Viet Nam.

Huu Khanh Truong (HK)

Ho Chi Minh City Children Hospital No.1, Ho Chi Minh City, Viet Nam.

Thi Quynh Tram Phan (TQT)

Pasteur Institute in Ho Chi Minh City, Ho Chi Minh, Viet Nam.

Thi Hong Hoa Bui (THH)

National Paediatric Hospital, Hanoi, Vietnam.

Van Khang Pham (VK)

National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.

Makiko Iijima (M)

World Health Organization, Hanoi, Viet Nam.

Binh Le (B)

Centers for Disease Control and Prevention, Hanoi, Viet Nam.

Lindsay Kim (L)

Centers for Disease Control and Prevention, Hanoi, Viet Nam.
US Public Health Service, Rockville, MD, USA.

Jennifer Loo Farrar (JL)

Centers for Disease Control and Prevention, Atlanta, GA, USA. ihi4@cdc.gov.
, 1600 Clifton Road NE, Atlanta, GA, 30329, USA. ihi4@cdc.gov.

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