Work

Hospital based sentinel surveillance of bacterial meningitis in India

Year: 2016

Type: article

Abstract: Background: Pentavalent vaccine (a combination vaccine which protects against five killer diseases- diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type B) is being introduced in various states of India as a part of Universal Immunization Programme. In this context it is critical to establish sentinel sites across India for surveillance of H.influenzae type B meningitis and use this opportunity also for surveillance of pneumococcal and meningococcal meningitis. Keeping this in mind a hospital-based sentinel surveillance network was established at 11 places across the country and this study reports the results of first three years of this surveillance program Methods & Materials: This study was conducted in six states of India through 11 hospital based sentinel sites. Children aged one to 59 months who met with standard case definitions were included in the study and their sterile biological specimens were processed for laboratory identification of bacterial pathogens. Further characterizations of bacterial pathogens were in study reference laboratory. Reference laboratory reconfirmed bacterial identify and further characterized the isolates to identify serotypes and antimicrobial susceptibility profile. Results: A total of 10202 cases were suspected for bacterial meningitis in study population. Laboratory confirmed incidence rates for S. pneumonia, H. influenza and N. meningitidis in this study is found to be around 3.80%, 1.26% and 0.24% respectively. S. pneumoniae appears to be the predominant pathogen among laboratory identified bacterial pathogens with 71.7%, followed with H.influenzae (23.8%) and N.meningitidis (4.4%). For S.pneumoniae, 15% of positive cases had serotype data, showing serotypes 19F, 6B, 14, 6A and 14 were the predominant serotypes in India. Conclusion: Invasive bacterial disease appears to be a major problem in Indian children with S.pneumoniae dominating and H.influenzae decreasing in the pathogens list. If pneumococcal conjugate vaccine-13 incorporated into Universal Immunization Programme, it can provide protection against 79% of serotypes responsible for Invasive pneumococcal diseases in India. However continued surveillance representing all parts of the country is necessary to understand the complete picture of Invasive bacterial diseases in India

Source: International Journal of Infectious Diseases

DOI: 10.1016/j.ijid.2016.02.659

Authors: S. Mehendale, Y. Jayaraman, B. Veeraraghavan

Institutions: National Institute of Epidemiology, Christian Medical College, Vellore

Language: English

Topic: Bacterial Infections and Vaccines

Subfield: Microbiology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,900