THE TIME IS NOW: URGENT NEED TO TACKLE CHILDHOOD PNEUMONIA DEATHS IN NIGERIA (ID 248)
Abstract
Background
Pneumonia is the major cause of death among children under the age of 5 years, with pneumonia-associated deaths accounting for 15% of all deaths among under-five children globally. Sadly, Nigeria is the country with the highest cases of pneumonia-related deaths among children under five years globally, even when pneumonia is a preventable and treatable disease.
Methods
The Immunisation coverage of pneumonia preventable vaccines like Pneumococcal Conjugate vaccine (PCV) and Haemophilus influenzae type B vaccine (HIB) in Nigeria, were examined from 2015 to date, in comparison with other countries using the "2019 UNICEF Immunisation data: Immunisation coverage by antigen (country, regional and global trends)".
Results
Immunisation coverage (%) of PCV and HIB antigens has been all time low in Nigeria. In 2015, PCV3 vaccine coverage in Nigeria was 36%, while HIB vaccine was 42%. From 2016 to 2018, the coverage level (%) for PCV and HIB vaccines both stood at 57% each. When compared to countries like Zambia, Uganda, United Kingdom and others, Nigeria is lagging behing in optimal use of pneumonia preventable vaccines.
Conclusions
There is an urgent need to improve the uptake of pneumonia preventable vaccines by strengthening immunisation coverage in Nigeria, to arrest the ever rampaging pneumonia-associated deaths among under-five children.
PNEUMOCOCCAL COLONIZATION DENSITY PATTERNS OVER TIME IN YOUNG CHILDREN IN THE PERUVIAN ANDES (ID 246)
- Leigh Howard, United States of America
- Kathryn M. Edwards, United States of America
- Marie R. Griffin, United States of America
- Yuwei Zhu, United States of America
- Jorge E. Vidal, United States of America
- Keith P. Klugman, United States of America
- Ana I. Gil, Peru
- Nicole R. Soper, United States of America
- Isaac P. Thomsen, United States of America
- Claudio F. Lanata, Peru
- Carlos Grijalva, United States of America
Abstract
Background
Factors associated with nasopharyngeal pneumococcal colonization density have not been comprehensively characterized. Age, immunization status, geographical location, population density, season, and/or acute respiratory illness (ARI) may play a role. We assessed longitudinal colonization density patterns in young rural Peruvian children.
Methods
Nasopharyngeal samples were collected monthly from children aged <3 years followed prospectively each week for ARI from May 2009-September 2011. PCV7 was introduced in the region in 2009. Longitudinally-collected samples from a convenience sample of children with >=1 pneumococcus-positive sample underwent density assessment by lytA qPCR. Density values were log10-transformed to reduce skewness. Assessments were stratified by enrollment age.
Results
Pneumococcus was detected in 471/625 (75%) samples from 30 children; 20/30 (67%) were enrolled before age 1. Variability was observed in colonization densities by calendar quarter and enrollment age, with substantial overlap in density levels and trajectories over time among age groups (Figure). Median densities during ARI episodes (n=62) were 5.60 (IQR 4.36-6.24) compared to non-ARI periods (5.00 [3.98-5.93], n=409, p=0.023). 
Conclusions
Among these children, density varied by ARI status but did not clearly decrease with age. Future trajectory analyses will assess serotype-specific density colonization patterns and the association of serotype co-colonization, vaccination, and ARI status with pneumococcal density over time.
AWARENESS OF UKRAINIAN PRIMARY HEALTH CARE PROVIDERS ABOUT PNEUMOCOCCAL DISEASE PREVENTION (ID 382)
Abstract
Background
The rate of pneumococcal vaccination (PV) also is one of the lowest among Eastern Europe countries that imposes a high risk of pneumonia up to 400 cases per 100 thousand population and other related health issues. Although Primary Health Care providers (PHCPs) in Ukraine play an important role in administering vaccines to their patients the data about PHCP's awareness regarding pneumococcal immunization are lacking.
Methods
A self-administered online survey among 265 PHCPs (44 doctors, 221 nurses) was conducted in three Eastern Ukrainian regions. The level of basic knowledge and concerns regarding pneumococcal disease prevention and PV were evaluated.
Results
Overall 264 (99.6%) PHCPs highlighted the obvious need in strengthening evidence-based knowledge related to PV, immunization topics and communication skills. Right answers regarding administration and,safety of PV were obtained in 21% participants, 47% PHCPs had significant concerns. Only 8% of participants were convinced in aspects of effective communication. Physicians had higher knowledge regarding pneumococcal disease (32; 73%), compared to nurses (105; 47.5%), p=0.0016; but did not differ in aspects of PV efficacy and preventive potential.
Conclusions
The majority of Ukrainian PHCPs need to improve knowledge regarding pneumococcal disease prevention. Effective continuing evidence-based learning for providers may help address these concerns.
RISK OF INVASIVE STREPTOCOCCUS PNEUMONIAE INFECTION AMONG ADULTS EXPERIENCING HOMELESSNESS IN ANCHORAGE, ALASKA, 2005–2018 (ID 1078)
Abstract
Background
Invasive pneumococcal disease (IPD) among people experiencing homelessness (PEH) is not well understood.
Methods
We investigated age-adjusted IPD incidence and serotype distribution among adult PEH compared to the general adult population in Anchorage, Alaska from 2005-2018. We calculated IPD incidence per 100,000 person-years using statewide IPD surveillance of pneumococcal sterile site isolates, Census data, and the Anchorage Point in Time count of homeless persons. We examined incidence rate ratios and risk differences using Poisson exact, Chi square and Fisher’s exact tests.
Results
In 2012, PEH accounted for 0.4% of the adult population, but 14.4% of IPD. Compared to the adult population, PEH were 32.5 (95% CI 25.7-41.2) times as likely to have IPD and 34.2 (26.6-44.0) times as likely to have IPD with pneumonia. Compared to the general population with IPD, PEH with IPD were younger (mean age 48.6 vs. 56.7, P<.01), and more likely to abuse alcohol (82.4% vs. 25.1%, P<.01), but not different in the proportion with non-PCV13 serotypes (92.9% vs. 88.7%, P= 0.25). Non-PCV13 serotypes among PEH with IPD included serotype 20 (18.6%), 31 (14.0%), 12F (11%), 16F (9.3%) and 22F/6C/9N (7.0%).
Conclusions
Interventions are warranted for adult PEH who bear a disproportionate burden of IPD in Anchorage.
CORRELATION BETWEEN OCCUPANCY DENSITY AND CIGARETTE SMOKE EXPOSURE WITH COLONIZATION OF STREPTOCOCCUS PNEUMONIAE IN NASOPHARYNGEAL SWABS AMONG UNDER FIVE YEARS HEALTHY CHILDREN (ID 1167)
Abstract
Background
Colonization of Streptococcus pneumoniae in nasopharynx, especially among children under five years could be affected by risk factors of occupancy density and cigarette smoke exposure.
Methods
This study is a cross sectional design. We have been collected the nasopharyngeal (NP) swab among 56 healthy children under-five in three district with the high case of pneumonia in Padang city respectively. Demographic data and the risk factor of occupancy density and cigarette smoke exposure were recorded. Streptococcus pneumoniae detection was performed by culture on 8% sheep-blood agar plate followed by optochin susceptibility testing and bile solubility testing.
Results
Among 54 NP swabs of healthy children, we found the carriage prevalence of Streptococcus pneumoniae were 57,1% with the highest percentage of age group being two months to one year (66.7%). Statistical analysis showed that children with positive Streptococcus pneumoniae colonization with occupancy density was 17 children (53.1%) with p value = 0.668 and children with cigarette smoke exposure was 6 children (25%) with p value = 0.831.
Conclusions
There was no significant correlation between occupancy density and cigarette smoke exposure to Streptococcus pneumoniae colonization in nasopharyngeal swabs of children under five years.