HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Brooks, W. A. Articles by Luby, S. Search for Related Content PubMed PubMed Citation Articles by Brooks, W. A. Articles by Luby, S. Related Collections Bacterial Infection Drug-Resistance Epidemiology

Invasive Pneumococcal Disease Burden and Implications for Vaccine Policy in Urban Bangladesh

We undertook active population-based surveillance in 5,000 urban households among children < 5 years old to determine invasive pneumococcal disease (IPD) incidence, serotype distribution, clinical presentation, and antimicrobial resistance, which have not been previously described in population-based studies from the region. IPD was documented by blood culture isolation. From 01 April 2004 to 31 March 2006, 5,903 blood cultures were collected from 6,167 eligible children. Streptococcus pneumoniae was isolated from 34 pneumococcal patients; IPD was clinically associated with pneumonia (24%), upper respiratory infection (62%), and febrile syndromes (14%). Overall, IPD and 13-valent serotype–related IPD incidences were 447 and 276 episodes/100,000 child-years, respectively. Peak IPD incidence occurred during the cool dry seasons. Penicillin, cotrimoxazole, chloramphenicol, and ciprofloxacin resistances were 2.9%, 82.4%, 14.7%, and 24.1%, respectively. Current conjugate vaccines should substantially reduce IPD, childhood pneumonia, and antimicrobial resistance in Bangladesh.

Received January 21, 2007. Accepted for publication July 19, 2007.

Acknowledgments: The authors are grateful for the support of the PneumoADIP Project at the Bloomberg School of Public Health at Johns Hopkins University, and in particular, the advice and feedback from Maria Deloria Knoll, Farzana Muhib, and Jennifer Moisi from PneumoADIP on our surveillance and data collection methodology, Marie Diener-West in the Biostatistics Department of the Bloomberg School of Public Health, Johns Hopkins University, Amanatullah Khan and team for assistance with GIS mapping, and the assistance of Anjali Bilkis Ara and team for outstanding assistance with data management.

Disclaimer: This publication was supported by a subcontract from The Johns Hopkins University with funds provided by The Boards of the Global Alliance for Vaccines and Immunizations and the Vaccine Fund (GAVI) ("Agency"). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Agency. GAVI had no role in the data analysis, interpretation, or decision to publish.

^* Address correspondence to W. Abdullah Brooks, GPO Box 128 Mohakhali, Centre for Health & Pop Research, ICDDR, B, Mohakhali, Dhaka 1000. E-mail: abrooks{at}icddrb.org or abrooks{at}jhsph.edu

Authors’ addresses: W. Abdullah Brooks, Robert Breiman, Doli Goswami, Anowar Hossain, Khorshed Alam, Kamrun Nahar, Dilruba Nasrin, Noor Ahmed, Shams El Arifeen, Aliya Naheed, David Sack, and Stephen Luby, ICDDR,B, 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka 1212, Bangladesh. E-mails: abrooks{at}icddrb.org, abrooks{at}jhsph.edu. Samir K. Saha, Dhaka Shishu Hospital, Dhaka, Bangladesh.