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Streptococcus pneumoniae Carriage Prevalence in Nepal: Evaluation of a Method for Delayed Transport of Samples from Remote Regions and Implications for Vaccine Implementation
- Source :
- BASE-Bielefeld Academic Search Engine, PLoS ONE, PLoS ONE, Vol 9, Iss 6, p e98739 (2014)
-
Abstract
- Background: Pneumococcal disease is a significant cause of morbidity and mortality in young children in Nepal, and currently available pneumococcal conjugate vaccines offer moderate coverage of invasive disease isolates. Methods: A prevalence study of children aged 1.5 to 24 months in urban and rural Nepal was conducted. In the urban group, nasopharyngeal swabs (NPS) were transported using silica desiccant packages (SDP) with delayed processing (2 weeks), or skim-milk-tryptone-glucose-glycerin (STGG) with immediate processing (within 8 hours). Pneumococcal nasopharyngeal carriage prevalence, serogroup/type distribution and isolate genotypes (as defined by multilocus sequence typing) were determined. Results: 1101 children were enrolled into the study: 574 in the urban group and 527 in the rural group. Overall carriage prevalence based on culture from specimens transported and stored in STGG was 58.7% (337/574), compared to 40.9% (235/574) in SDP. There was concordance of detection of pneumococcus in 67% of samples. Using the SDP method, pneumococcal carriage prevalence was higher in the rural population (69.2%; 364/526) compared to the urban population (40.9%; 235/574). Serogroup/type distribution varied with geographical location. Over half of the genotypes identified in both the urban and rural pneumococcal populations were novel. Conclusion: The combination of delayed culture and transport using SDP underestimates the prevalence of pneumococcal carriage; however, in remote areas, this method could still provide a useful estimate of carriage prevalence and serogroup/type distribution. Vaccine impact is unpredictable in a setting with novel genotypes and limited serotype coverage as described here. Consequently, continued surveillance of pneumococcal isolates from carriage and disease in Nepali children following the planned introduction of pneumococcal conjugate vaccines introduction will be essential. © 2014 Hanieh et al.
- Subjects :
- Bacterial Diseases
Male
Rural Population
Serotype
Health Screening
Pediatrics
Spatial Epidemiology
Time Factors
Genotyping Techniques
Urban Population
lcsh:Medicine
INFANTS
Global Health
medicine.disease_cause
Pneumococcal Vaccines
INFECTION
Epidemiology
Medicine and Health Sciences
Prevalence
EPIDEMIOLOGY
Clinical Epidemiology
Public and Occupational Health
lcsh:Science
Pediatric Epidemiology
Health Systems Strengthening
Molecular Epidemiology
education.field_of_study
Multidisciplinary
Child and Adolescent Health Policy
Child Health
Pneumococcus
Bacterial Pathogens
3. Good health
Multidisciplinary Sciences
Infectious Diseases
Streptococcus pneumoniae
Medical Microbiology
Genetic Epidemiology
Child, Preschool
Carrier State
Epidemiological Methods and Statistics
Science & Technology - Other Topics
Female
Research Article
YOUNG-CHILDREN
medicine.medical_specialty
General Science & Technology
Concordance
Population
DETERMINING CAPSULAR SEROTYPES
Microbiology
Infectious Disease Epidemiology
Specimen Handling
Nepal
Diagnostic Medicine
Internal medicine
SURVEILLANCE
MD Multidisciplinary
medicine
Humans
Serotyping
education
Microbial Pathogens
Genotyping
INVASIVE PNEUMOCOCCAL DISEASE
Health Care Policy
Science & Technology
NASOPHARYNGEAL CARRIAGE
Population Biology
IDENTIFICATION
business.industry
lcsh:R
Biology and Life Sciences
Streptococcus
Infant
Health Care
SEQUENTIAL MULTIPLEX PCR
Carriage
Multilocus sequence typing
lcsh:Q
Health Statistics
business
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- BASE-Bielefeld Academic Search Engine, PLoS ONE, PLoS ONE, Vol 9, Iss 6, p e98739 (2014)
- Accession number :
- edsair.doi.dedup.....a789f32c880d13e861950e6f930c7cdb
- Full Text :
- https://doi.org/10.1371/journal.pone.0098739