Surveillance for Invasive Pneumococcal Disease

Streptococcus pneumoniae bacteria (pneumococcus) is a major cause of disease and disability worldwide, and is vaccine-preventable. In 2015, the Ministry of Health of Nepal began providing a 10-valent pneumococcal conjugate vaccine to infants (PCV10) as the vaccine was introduced into its routine infant immunization schedule.

Monitoring hospitalized cases of disease over time

The long-term monitoring of disease, (disease surveillance), allows public health professionals to see trends over time. Surveillance of children admitted to Kathmandu’s Patan Hospital paediatric ward with presumed invasive bacterial disease or pneumonia has continued uninterrupted and with unchanged methods since 2005. These data are helping the Pneumo Nepal Project provide a holistic understanding of the burden and distribution of pneumococcal disease before and after vaccine introduction.

More than 90 distinct pneumococcal serotypes have been identified throughout the world, however only a small number of these serotypes cause the majority of disease in infants. The two pneumococcal conjugate vaccines (PCVs) available on the market protect against ten (PCV10) and thirteen (PCV13) of the most common serotypes, respectively. Decisions about which product to introduce in Nepal were informed by the available evidence from Patan Hospital's surveillance.

Based on specimens collected in the 10 years prior to vaccine introduction, the Pneumo Nepal study estimated that PCV10 would cover 75% of serotypes responsible for cases of invasive disease detected since 2005, and that the three additional serotypes included in the PCV13 product would only increase this coverage by 4%. The same data indicated that the majority of cases of invasive pneumococcal disease were caused by serotypes included in PCV10, suggesting that the vaccine could offer significant protection against pneumococcal disease in Nepal.

Fig. 1 Before Nepal’s introduction of PCV10 (2005-2015), most cases of invasive pneumococcal disease were caused by vaccine-preventable types

76% 4% 20% Cases of PCV10 type 76% Cases of PCV 13 type 4% Other cases 20%

Analysis of surveillance data as an indicator of vaccine impact is ongoing. For more information, contact our study coordinator.

Published Results

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Poster
Brian Wahl, Jyoti Kumari Yadhave, Rashmila Deshar, et al.
June 2016
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Poster
Shrijana Shrestha, Michael Carter, Meeru Gurung, et al.
June 2016
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Poster
Krishna G. Prajapati, Stephen Thorson, Meeru Gurung, et al.
April 2018
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Poster
Anju Maharjan, Stephen Thorson, Meeru Gurung, et al.
April 2018
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Poster
M. Chandra Gautam, Rama Kandasamy, Meeru Gurung, et al.
April 2018
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