title: Invasive pneumococcal disease burden and implications for vaccine policy in urban Bangladesh.
abstract: 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.
authors.affiliation: ICDDR,B, Mohakhali, Dhaka, Bangladesh. abrooks@icddrb.org
authors.forename: W Abdullah
authors.initials: WA
authors.lastname: Brooks
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: Doli
authors.initials: D
authors.lastname: Goswami
authors.forename: Anowar
authors.initials: A
authors.lastname: Hossain
authors.forename: Khorshed
authors.initials: K
authors.lastname: Alam
authors.forename: Samir K
authors.initials: SK
authors.lastname: Saha
authors.forename: Kamrun
authors.initials: K
authors.lastname: Nahar
authors.forename: Dilruba
authors.initials: D
authors.lastname: Nasrin
authors.forename: Noor
authors.initials: N
authors.lastname: Ahmed
authors.forename: Shams
authors.initials: S
authors.lastname: El Arifeen
authors.forename: Aliya
authors.initials: A
authors.lastname: Naheed
authors.forename: David A
authors.initials: DA
authors.lastname: Sack
authors.forename: Stephen
authors.initials: S
authors.lastname: Luby
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001459:Bangladesh / Q000453:epidemiology; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D015994:Incidence; D007223:Infant; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011640:Public Policy; D013296:Streptococcus pneumoniae / Q000187:drug effects; D014505:Urban Population
chemical_list: D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines