Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Department of Pediatrics, Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
PLoS One. 2020 Feb 13;15(2):e0228799. doi: 10.1371/journal.pone.0228799. eCollection 2020.
Bangladesh introduced the 10-valent pneumococcal conjugate vaccine (PCV-10) in 2015. We measured population-based incidence of invasive pneumococcal disease (IPD) prior to introduction of PCV-10 to provide a benchmark against which the impact of PCV-10 can be assessed.
We conducted population, facility and laboratory-based surveillance in children 0-59 months of age in three rural sub-districts of Sylhet district of Bangladesh from January 2014 to June 2015. All children received two-monthly home visits with one week recall for morbidity and care seeking. Children attending the three Upazilla Health Complexes (UHC, sub-district hospitals) in the surveillance area were screened for suspected IPD. Blood samples were collected from suspected IPD cases for culture and additionally, cerebrospinal fluid (CSF) was collected from suspected meningitis cases for culture and molecular testing. Pneumococcal isolates were serotyped by Quellung. Serotyping of cases detected by molecular testing was done by sequential multiplex polymerase chain reaction.
Children under surveillance contributed to 126,657 child years of observations. Sixty-three thousand three hundred eighty-four illness episodes were assessed in the UHCs. Blood specimens were collected from 8,668 suspected IPD cases and CSF from 177 suspected meningitis cases. Streptococcus pneumoniae was isolated from 46 cases; 32 (70%) were vaccine serotype. The population-based incidence of IPD was 36.3/100,000 child years of observations. About 80% of the cases occurred in children below two years of age.
IPD was common in rural Bangladesh suggesting the potential benefit of an effective vaccine. Measurement of the burden of IPD requires multiple surveillance modalities.
孟加拉国于 2015 年引入了 10 价肺炎球菌结合疫苗（PCV-10）。我们在引入 PCV-10 之前测量了人群中侵袭性肺炎球菌病（IPD）的发病率，以便为评估 PCV-10 的影响提供基准。
我们在孟加拉国锡尔赫特区的三个农村分区中对 0-59 个月大的儿童进行了人群、设施和实验室监测。所有儿童每两个月接受一次家访，一周内对疾病和就医情况进行回顾。在监测地区的三个 Upazilla 健康中心（UHC，分区医院）对疑似 IPD 患儿进行筛查。从疑似 IPD 患儿中采集血液样本进行培养，此外，从疑似脑膜炎患儿中采集脑脊液（CSF）进行培养和分子检测。肺炎球菌分离株通过 Quellung 进行血清型分型。通过连续多重聚合酶链反应对通过分子检测检测到的病例进行血清型分型。
接受监测的儿童共提供了 126,657 个儿童年观察。在 UHC 中评估了 63384 个疾病发作。从 8668 例疑似 IPD 病例中采集了血液标本，从 177 例疑似脑膜炎病例中采集了 CSF 标本。从 46 例中分离出肺炎链球菌；32 例（70%）为疫苗血清型。人群中 IPD 的发病率为 36.3/100,000 儿童年观察。约 80%的病例发生在两岁以下的儿童中。
在孟加拉国农村地区，IPD 很常见，这表明有效疫苗具有潜在的益处。测量 IPD 的负担需要多种监测模式。
