title: Epidemiological and economic burden of pneumococcal diseases in Canadian children.
abstract: BACKGROUND
  With the arrival of a new conjugate pneumococcal vaccine, it is important to estimate the burden of pneumococcal diseases in Canadian children. The epidemiological data and the economic cost of these diseases are crucial elements in evaluating the relevance of a vaccination program.
  
  
  METHODS
  Using provincial databases, ad hoc surveys and published data, age-specific incidence rates of pneumococcal infections were estimated in a cohort of 340,000 children between six months and nine years of age. The costs of these diseases to the health system and to families were also evaluated using data from Quebec and Manitoba.
  
  
  RESULTS
  Cumulative risks were one in 5000 for pneumococcal meningitis, one in 500 for bacteremia and one in 20 for pneumonia, leading to 16 deaths in the cohort. About 262,000 otitis media episodes and 32,000 cases of myringotomy with ventilation tube insertion were attributable to Streptococcus pneumoniae. Societal costs were estimated at $125 million, of which 32% was borne by the health system and 68% was borne by families. Invasive infections represented only 2% of total costs, while 84% were generated by otitis media.
  
  
  CONCLUSIONS
  Pneumococcal infections represent a significant burden for Canadian children and society that could be significantly reduced through immunization.
authors.affiliation: Department of Community Health Sciences, University of Sherbrooke, Sherbrooke, Quebec.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Petit
authors.forename: Philippe
authors.initials: P
authors.lastname: De Wals
authors.forename: Barbara
authors.initials: B
authors.lastname: Law
authors.forename: Theresa
authors.initials: T
authors.lastname: Tam
authors.forename: Lonny James
authors.initials: LJ
authors.lastname: Erickson
authors.forename: Maryse
authors.initials: M
authors.lastname: Guay
authors.forename: Alicia
authors.initials: A
authors.lastname: Framarin