016 - IMPACT OF PNEUMOCOCCAL CONJUGATE VACCINE (PCV 10) ON BACTERIAL MENINGITIS IN NEPALESE CHILDREN (ID 492)

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Abstract

Background

Pneumococcus is one of the most common causes of invasive bacterial disease (IBD), including meningitis, in children. We assessed the impact of PCV10, introduced in Kathmandu in October, 2015, on bacterial meningitis in Nepalese children.

Methods

Children aged 30 days to 14 years admitted with suspected IBD at Patan Hospital were enrolled. CSF specimens were cultured; CSF samples containing >5 x109/L white cells were evaluated for presence of S.pneumoniae by antigen and PCR testing. Serotyping for pneumococcus was performed by the Quellung method. Bacterial meningitis was defined as diagnosis of meningitis at hospital discharge, or >100 x109/L CSFwhite cells or pathogen detected.

Results

CSF test results were available from 367 children pre-vaccine introduction (2014-2015) and 146 post-vaccine (2018) and out of them 86 (23.4%) and 27 (18.5%), respectively, had meningitis. Incidence of CSF white cells >100 x109/L declined from 25/367(6.8%) in the pre-vaccine to 5/146(3.6%) in the post-vaccine period. S.pneumoniae was detected in 6/86 (7.0%) meningitis cases pre-vaccine versus 0/27 meningitis cases post-vaccine.Over the 5 years of surveillance, 4 CSF samples were PCR positive for S.pneumoniae (serotypes 1, 14, 6B and 6A/B). The remaining 11 cases of pneumococcal meningitis were diagnosed by antigen testing.

Conclusions

Bacterial meningitis declined after PCV10 introduction in Nepal. Although proven pneumococcal meningitis cases were few, these also declined.

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015 - PNEUMOCOCCAL AND SEROTYPE CONTRIBUTION: POSSIBLE PREVENTION BY PCVS OF RECURRENT ACUTE OTITIS MEDIA (RAOM) IN CHILDREN (ID 106)

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