Surveillance for Streptococcus pneumoniae Meningitis in Children Aged !5 Years: Implications for Immunization in Uganda
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Date
2009
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical Infectious Diseases
Abstract
Affordable pneumococcal conjugate vaccines will soon become available to developing countries through the
Global Alliance for Vaccines and Immunization. Data on Streptococcus pneumoniae meningitis epidemiology
in Uganda will assist decision makers in determining the best national vaccine policy. We reviewed acute
bacterial meningitis surveillance data for children aged !5 years from 3 sentinel surveillance sites in 3 Ugandan
districts collected from 2001 through 2006. Serotype and antibiotic-resistance testing were performed on
pneumococcal isolates collected from 2005 through 2006 from the Kampala district in the tropical central
region of Uganda. Minimum pneumococcal meningitis incidence estimates were calculated for a portion of
the Kampala district and all of the Gulu district, where case ascertainment was more complete. At the 3 sites,
14,388 probable acute bacterial meningitis cases were observed. The most common cause identified was S.
pneumoniae ( ; np331 35% of all confirmed cases), which had an overall case fatality ratio of 19%. Yearly
pneumococcal meningitis incidence was 3–20 cases per 100,000 population in Kampala versus 28–42 cases per
100,000 population in Gulu. The most commonly identified serotypes were 6A/6B (40%); 43% of isolates were
serotypes that are in the available 7-valent pneumococcal conjugate vaccine and 70% are in the proposed 13-
valent pneumococcal vaccine. Twenty-five isolates (83%) had intermediate resistance to penicillin but none
were fully resistant. Pneumococcal meningitis is common and severe in Uganda, indicating a role for the
pneumococcal conjugate vaccine.
Description
Keywords
pneumoniae, Meningitis, Immunization
Citation
Kisakye, A., Makumbi, I., Nansera, D., Lewis, R., Braka, F., Wobudeya, E., ... & Gessner, B. D. (2009). Surveillance for Streptococcus pneumoniae meningitis in children aged< 5 years: implications for immunization in Uganda. Clinical Infectious Diseases, 48(Supplement_2), S153-S161.