Sanjeev M. Bijukchhe, Nepal

Patan Academy of Health Sciences Department of Paediatrics

Author Of 12 Presentations

 Conference Calendar

COMPARISON OF NASOPHARYNGEAL CARRIAGE OF PNEUMOCOCCUS AND ITS SEROTYPES AMONG NEPALI CHILDREN HOSPITALIZED WITH SEVERE AND NON-SEVERE PNEUMONIA (ID 764)

Session Name
Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults
Presenter
Authors

IMPACT OF THE INTRODUCTION OF THE PNEUMOCOCCAL CONJUGATE VACCINE ON PAEDIATRIC PNEUMONIA CASES IN NEPAL (ID 543)

Session Name
Vaccines - Impact of Vaccine programs and Serotype Replacement
Presenter
Authors

DETECTION OF NASOPHARYNGEAL VIRUSES IN PAEDIATRIC INPATIENT PNEUMONIA CASES BEFORE AND AFTER THE INTRODUCTION OF PCV10 VACCINE IN NEPAL (ID 329)

Session Name
Basic Sciences - Interaction with Microbiome, Viruses, other Bacteria
Presenter
Authors

ASSOCIATION BETWEEN C-REACTIVE PROTEIN LEVEL AND A RADIOLOGICAL END POINT CONSOLIDATION PNEUMONIA AMONG HOSPITALISED CHILDREN WITH SUSPECTED PNEUMONIA IN NEPAL (ID 618)

Session Name
Clinical Sciences - Diagnosis
Presenter
Authors

Abstract

Background

S. pneumoniae is one of the most common causes of paediatric bacterial pneumonia. In low-income countries such as Nepal, CRP level and blood culture can be useful in diagnosis assessment. We assessed the association between CRP/blood culture, and pneumonia with end-point consolidation.

Methods

We included children less than 5 years of age admitted with suspected pneumonia to Patan Hospital in 2018 and 2019, whose chest xray, CRP level and blood culture were done. CRP levels >40 mg/dl were considered elevated.

Results

There was a significant difference (p<0.001) in CRP levels between EPC-pneumonia and non-EPC pneumonia cases with a median (IQR) CRP of 46.2 (16, 215) in 141 EPC-pneumonia cases and a median (IQR) CRP of 13 (4, 35) in non-EPC pneumonia cases. The sensitivity and specificity of CRP >40mg/dl to detect EPC pneumonia were 50% and 84% respectively. The area under the ROC curve was 0.727 indicating good discrimination between EPC-pneumonia and non-EPC pneumonia. Among the EPC-pneumonia cases, 62% had elevated CRP and 3.5% had S. pneumoniae positive blood cultures.

Conclusions

There was a significant association between CRP and EPC pneumonia. Blood culture had low sensitivity to detect bacterial pneumonia, nevertheless, CRP may be a useful tool in diagnosis of bacterial pneumonia.

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IMPACT OF PCV10 IN NEPAL ON NASOPHARYNGEAL CARRIAGE OF PNEUMOCOCCUS IN YOUNG INFANTS PRIOR TO THEIR VACCINATION (ID 530)

Session Name
Vaccines - Impact of Vaccine programs and Serotype Replacement
Presenter
Authors

IS THERE A RELATIONSHIP BETWEEN PREVIOUS HISTORY OF PNEUMONIA, MENINGITIS OR SEPSIS AND NASOPHARYNGRAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE IN HEALTHY CHILDREN IN NEPAL (ID 752)

Session Name
Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults
Presenter
Authors

IMPACT OF NUMBER OF CHILDREN IN THE HOUSEHOLD ON NASOPHARYNGEAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE IN HEALTHY NEPALESE CHILDREN (ID 534)

Session Name
Population Sciences - Epidemiology, Economics, and Mathematical Modelling
Presenter
Authors

DOES VIRAL DETECTION IN THE NASOPHARYNX IMPACT THE DISTRIBUTION OF COLONISING PNEUMOCOCCAL SEROTYPES OBSERVED IN PNEUMONIA CASES AMONG NEPALESE CHILDREN? (ID 799)

Session Name
Basic Sciences - Interaction with Microbiome, Viruses, other Bacteria
Presenter
Authors

IMPACT OF 10-VALENT PNEUMOCOCCAL CONJUGATE VACCINE INTRODUCTION ON INVASIVE PNEUMOCOCCAL DISEASE (IPD) IN NEPALESE CHILDREN (ID 563)

Session Name
Vaccines - Impact of Vaccine programs and Serotype Replacement
Presenter
Authors

Abstract

Background

We assessed the distribution of pneumococcal serotypes in children with microbiologically-confirmed invasive pneumococcal disease (IPD) before (2014-2015) and after (2016-2019) PCV10 introduction in Nepal in 2015.

Methods

Children (aged 2 months to <14 years) admitted to Patan Hospital, Nepal with pneumococcus detected in blood, CSF or pleural fluid were included. Serotyping was by Quellung method.

Results

Pre-vaccine, 6/22 (27.3%) IPD cases were age <2 years; post-vaccine, 5/36 (13.9%) were <2 years. Ratio of vaccine-type to non-vaccine-type IPD among <2y olds was 5:1 pre-vaccine and 2:3 post-vaccine; among >=2y olds, the ratio was 13:1 pre-vaccine and 7:1 post-vaccine. Most (32/41, 78%) vaccine-type IPD was serotype 1: 3/7 among <2 year olds (n=1 post-vaccine); 29/34 among >=2 year olds (n=17/19 post-vaccine were >4 years old). Among 44 IPD cases detected from blood, 36 (82%) were vaccine-type (n=29 were ST1), and 7 were non-vaccine-type (6C, 10A (n=2), 19A, 24F, 38, 41). Of 13 detected from CSF (1 culture, 3 PCR and 9 Binax-only), 5 were serotyped (1, 14, 6B, 6A/B, 7F) .The 3 pleural fluid cases were serotypes 1 (n=2) and 19A.

Conclusions

Post-PCV10 introduction, IPD among <2 year olds fell; although a high proportion of ST1 IPD remains, most were >4 years old.

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NASOPHARYNGEAL CARRIAGE PREVALENCE OF SEROTYPES 3, 6A, 19A AND 6C IN NEPALESE CHILDREN: IS IT TIME TO SWITCH FROM PCV10 TO A DIFFERENT PCV? (ID 528)

Session Name
Vaccines - Impact of Vaccine programs and Serotype Replacement
Presenter
Authors

ANTIMICROBIAL SUSCEPTIBILITY PROFILE AND SEROTYPE DISTRIBUTION OF PNEUMOCOCCAL BLOOD CULTURE ISOLATES FROM NEPALESE CHILDREN (ID 672)

Session Name
Basic Sciences - Conventional and Molecular Microbiology
Presenter
Authors

IMPACT OF PCV10 INTRODUCTION ON NASOPHARYNGEAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE IN HEALTHY CHILDREN IN RURAL AND URBAN NEPAL (ID 531)

Session Name
Vaccines - Impact of Vaccine programs and Serotype Replacement
Presenter
Authors

Abstract

Background

The ten-valent pneumococcal conjugate vaccine (PCV10) was introduced in Nepal in 2015. We compared the nasopharyngeal carriage of PCV10 and non-PCV10 serotypes of pneumococcus between pre-vaccine (2015) and post-vaccine (2017-2018) years in two different regions of Nepal.

Methods

Nasopharyngeal samples obtained in healthy Nepalese children aged 6-59 months in urban (Patan, Kathmandu) and 6-23 months in rural (Okhaldhunga) settings were transported in STGG (Skim Milk-Tryptone-Glucose-Glycerol) media, cultured for pneumococcus and serotyped by the Quellung method.

Results

The carriage prevalence decreased for all PCV10-type serotypes except 7F in both the settings. PCV10-type prevalence decreased from 29.7% in rural and 17.2% in urban children pre-vaccine to 9.0% and 8.6% post-vaccine, respectively. Pre-vaccine, the most frequently found serotypes in both settings were 19F, 6B, 14. Post-vaccine, the non-PCV10 serotypes were more common; serotypes 34, 6C, 19A and 15B were most common in rural and 6A, 34, 11A, 6C and 15B in urban settings.

Conclusions

Since the introduction of PCV10, carriage prevalence of PCV10 serotypes have reduced and non-PCV10 serotypes have increased in both settings raising the possibility of replacement disease. Continued monitoring of changes in PCV10-serotypes and non-PCV10 serotypes, especially those covered by PCV13, is important to assess vaccine impact.

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