Wednesday, June 11, 2008

Health/Medical: Burden of pneumococcal disease high among Indonesian children

Jakarta - /Medianet International-AsiaNet/ - Vaccine Intervention Saves Lives -- New studies, presented this week at the 6th International Symposium on Pneumococci & Pneumococcal Diseases (ISPPD) investigates the burden of pneumococcal disease (PD) among Indonesian children.

According to the World Health Organization (WHO), PD is the leading cause of vaccinepreventable death in children younger than five years of age worldwide, however, specific data on the incidence of PD in Indonesia has previously not been available.

Two studies, conducted by the International Vaccine Institute, assessed clinical cases of PD including meningitis, sepsis and pneumonia in Surabaya and Denpasar. Data from the Sanglah Hospital in Denpasar and Soetomo Hospital in Surabaya were retrospectively collected for the period of January to December 2006.[1],[2] In Denpasar, researchers evaluated the 448 hospitalisations due to invasive pneumococcal disease (IPD) in children less than five years. The highest incidence of disease was found in Denpasar city, Bagung and Gianyar districts.

Pneumonia was the most common clinical presentation of PD, accounting for 82% of patients.

The second study, based out of Surabaya, evaluated the 680 hospitalisations due to IPD reported in children younger than five years. Pneumonia again was the most common presentation of pneumococcal disease during the study period, accounting for 77% of patients. Among the 680 hospitalisations, 118 children died.

The studies confirm infants in Indonesia are at significant risk of severe infection and even death due to PD. As the main clinical presentation of PD is pneumonia, the studies indicate the need for prevention strategies for respiratory disease.

Following recommendation from the Strategic Advisory Group of Experts (SAGE) on immunization, the World Health Organization considers that the pneumococcal conjugate vaccine should be a priority for inclusion in national childhood immunisation programs.[3] Not only do immunizations provide protection to children and infants, it also can protect adults as well. Known as "herd protection"; it is an important indirect benefit extended to adults following the routine vaccination of children, and is an important consideration in economic evaluations.

Further population-based data on pneumococcal disease incidence will be critical to inform vaccine policy in Indonesia.

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[1] Nyambat B, Dijanto I, Kilgore P, et al. The Epidemiology of Invasive Pneumococcal Disease-Associated Syndromes Among Children in Surabaya, Indonesia. Abstract presented at the 6th International Symposium on Pneumococci & Pneumococcal Diseases (ISPPD).

[2] Nyambat B, Purinit PS, Kim SW, et al. Invasive Pneumococcal Disease-Associated Syndromes in Denpasar, Indonesia, 2006. Abstract presented at the 6th International Symposium on Pneumococci & Pneumococcal Diseases (ISPPD).

[3] World Health Organization. Pneumococcal conjugate vaccine for childhood immunization, March 2007-WHO position paper. Wkly Epidemiol Record 2007;12:93-104.

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