title: Epidemiology of invasive pneumococcal disease in Kumasi, Ghana.
abstract: There are few data on the epidemiology of invasive pneumococcal disease in Africa. We undertook a prospective study of these infections in Kumasi, Ghana, collecting clinical data on all patients with laboratory-confirmed pneumococcal meningitis, pneumonia or systemic sepsis associated with bacteraemia. A total of 140 cases were identified in the period from January 2002 to April 2005. The disease was most prevalent among patients <5 years of age and immediately following the peak of the harmattan wind. The majority of patients were treated with a combination of antibiotics, in part reflecting concerns regarding antibiotic resistance. Mortality was high (47%), with no evidence of an improved prognosis compared with earlier studies in the region. Although most isolates of pneumococci were resistant to tetracyclines and co-trimoxazole, there was no high-level resistance to penicillin and only 12% of isolates showed intermediate level resistance. Serotype 1 was the most common serotype (36%), whilst intermediate-level penicillin resistance was associated with serotype 14. Theoretical coverage by existing 7-, 9-, 11- and 23-valent vaccines was 26%, 63%, 64% and 76%, respectively. Vaccination may improve control of pneumococcal disease in Ghana, although modified vaccine formulations are required for local use.
authors.affiliation: Department of Medical Microbiology, St George's Hospital & Medical School, Blackshaw Road, London, UK.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Holliman
authors.forename: Helen
authors.initials: H
authors.lastname: Liddy
authors.forename: Julie D
authors.initials: JD
authors.lastname: Johnson
authors.forename: Ohene
authors.initials: O
authors.lastname: Adjei
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008586:Meningitis, Pneumococcal / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011446:Prospective Studies; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents