Mukhchuluun Ulziibayar, Mongolia

National Center of Communicable Diseases Ministry of Health

Presenter of 1 Presentation

RISK FACTORS FOR SEVERE PNEUMONIA IN CHILDREN 2-59 MONTHS OF AGE IN THE PNEUMOCOCCAL CONJUGATE VACCINE ERA IN ULAANBAATAR, MONGOLIA, 2015-2019 (ID 1087)

Session Name
Vaccines - Impact of Vaccine programs and Serotype Replacement

Abstract

Background

Respiratory infection is the most common cause of childhood hospitalisation in Mongolia. Mongolia initiated a staged introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) into the routine immunisation programme in Ulaanbaatar from 2016. We aimed to describe the risk factors associated with severe pneumonia in children aged 2-59 months in the period surrounding PCV13 introduction.

Methods

Hospitalised children aged 2-59 months who met a predefined case definition for pneumonia were consented and enrolled at five hospitals between April 2015 and November 2019. Severe pneumonia was diagnosed in children with cough/difficulty breathing and tachypnoea plus lower chest indrawing or general danger signs or hypoxia (oxygen saturation < 90%).

Results

Over the analysis period total of 14,923 children were enrolled in the surveillance programme. Of these children 56% (8,283) had severe pneumonia and 70% (10,502) were <2 years of age. Factors associated with severe pneumonia included district of residence, child’s age (decreasing odds with increasing age), pre-existing asthma, use of household coal/wood, high C-reactive protein (>40) and winter season.

Conclusions

We identified a number of risk factors associated with severe pneumonia in the surveillance programme in Mongolia. It is important that high risk children are vaccinated and risk factors are monitored in the ongoing programme.

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Author Of 4 Presentations

MONITORING PCV13 IMPACT USING NASOPHARYNGEAL CARRIAGE SURVEILLANCE AMONG CHILDREN WITH PNEUMONIA IN MONGOLIA (ID 965)

Abstract

Background

In 2015, Mongolia was among the earliest countries in Asia to introduce PCV. To monitor the impact of PCV13 introduction, we commenced nasopharyngeal carriage surveillance among children with pneumonia 6 months prior to vaccine introduction.

Methods

We recruited children 2-59 months of age presenting with pneumonia to district hospitals and the national Maternal and Child Health hospital in two districts in Ulaanbaatar. Clinical and demographic data, vaccination status and nasopharyngeal swabs were collected. A random sample of swabs were selected for testing each month. Samples were examined by lytA qPCR, with positives serotyped by microarray.

Results

We recruited 4980 children and tested 983 children from November 2015 to April 2018. The median age was 1.27 and 25.81% of cases were vaccinated in the first and second year following PCV13 introduction, respectively. 474 and 48.22% had received antibiotics in the 48 hours before admission.

Conclusions

Following PCV13 introduction in Mongolia, the prevalence of pneumococcal carriage remained stable while the prevalence of PCV13-type carriage decreased among children with pneumonia. Reductions in PCV13 carriage likely correspond to reductions in disease due to PCV13 types, since carriage is a precursor for disease.

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RISK FACTORS FOR SEVERE PNEUMONIA IN CHILDREN 2-59 MONTHS OF AGE IN THE PNEUMOCOCCAL CONJUGATE VACCINE ERA IN ULAANBAATAR, MONGOLIA, 2015-2019 (ID 1087)

Session Name
Vaccines - Impact of Vaccine programs and Serotype Replacement

Abstract

Background

Respiratory infection is the most common cause of childhood hospitalisation in Mongolia. Mongolia initiated a staged introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) into the routine immunisation programme in Ulaanbaatar from 2016. We aimed to describe the risk factors associated with severe pneumonia in children aged 2-59 months in the period surrounding PCV13 introduction.

Methods

Hospitalised children aged 2-59 months who met a predefined case definition for pneumonia were consented and enrolled at five hospitals between April 2015 and November 2019. Severe pneumonia was diagnosed in children with cough/difficulty breathing and tachypnoea plus lower chest indrawing or general danger signs or hypoxia (oxygen saturation < 90%).

Results

Over the analysis period total of 14,923 children were enrolled in the surveillance programme. Of these children 56% (8,283) had severe pneumonia and 70% (10,502) were <2 years of age. Factors associated with severe pneumonia included district of residence, child’s age (decreasing odds with increasing age), pre-existing asthma, use of household coal/wood, high C-reactive protein (>40) and winter season.

Conclusions

We identified a number of risk factors associated with severe pneumonia in the surveillance programme in Mongolia. It is important that high risk children are vaccinated and risk factors are monitored in the ongoing programme.

Hide