Abstract
Pneumococcal meningitis still remains a serious global threat for children and adolescents. The aim of this study was to assess main epidemiological features of Pneumococcal meningitis, some risks for fatality and major pneumococcal serogroup/serotypes and their potential coverage by the available pneumococcal conjugate vaccines. An observational study of 569 confirmed cases (1998-2012) was completed based on surveillance system. Incidence, case-fatality rate and seasonality were estimated. Association of different variables related with dead was assessed by using Relative Risk and its 95% confidence interval with p＜0.05 considered as significant. A common protocol was used for the isolation and identification of Streptococcus pneumoniae. Overall incidence reached 1.3 per 10^5 population, with annual variations. Infants showed the highest incidence (10.7 per/10^5 population) especially at 4^(th), 2^(nd) and 6^(th) month of age. Seasonality was confirmed in January-March. Overall case-fatality rate reached 23.2% with highest figures in infants. Delayed hospitalization (≥24 hours) showed association (p＞0.05) in 6-11, 12-14 and 15-19 years old (Relative Risk=3.61, 3.00 and 3.16 respectively). Proportion of S. pneumoniae isolates covered by commercial pneumococcal conjugate vaccines ranked 53.0-71.4%. Pneumococcal meningitis affects predominantly infants and is particularly lethal in Cuba. Seasonal increase occurs in winter. Hospitalization ≥24 hours may contribute to increase fatality. Main S. pneumoniae serogroups/serotypes circulating among Cuban children and adolescents are included in commercial pneumococcal conjugated vaccines. We emphasize the importance of continuous nationwide surveillance to achieve more comprehensive insights into pneumococcal epidemiology as well as their contribution to the assessment of future immunization strategies.
Highlights
Pneumococcal infections remain a major cause of severe disease in childhood worldwide
Main S. pneumoniae serogroups/serotypes circulating among Cuban children and adolescents are included in commercial pneumococcal conjugated vaccines
We emphasize the importance of continuous nationwide surveillance to achieve more comprehensive insights into pneumococcal epidemiology as well as their contribution to the assessment of future immunization strategies
Summary
Pneumococcal infections remain a major cause of severe disease in childhood worldwide. Pérez et al, (2010) reported an improved surveillance system: the CABM Surveillance which was implemented in 1998 as a part of the National Program for Control and Prevention of the Neurological Infectious Syndrome (NPCPNIS) It allowed identifying Streptococcus pneumoniae as the main causative microorganism of CABM and the most lethal, after a significant decrease of meningitis attributable to Neisseria meningitidis serogroups A, B and C and Haemophilus influenzae type b following massive and continuous vaccination through National Immunization Program as reported by Dickinson et al, (2001) and Pérez et al, (2010). The purpose of this paper was to describe the main epidemiological features of Pnm in children and adolescents, to assess the association of timely hospitalization with mortality, as well as to determine major serogroups and serotypes of S. pneumoniae responsible for community-acquired meningitis and their potential coverage by the available pneumococcal conjugate vaccines
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