Risk Factors for Invasive Pneumococcal Disease Among Children Less Than 5 Years of Age in a High HIV Prevalence Setting, South Africa, 2010 to 2012

Details

• Alternative Title:
  Pediatr Infect Dis J
• Personal Author:
  von Mollendorf, Claire ; Cohen, Cheryl ; de Gouveia, Linda ; Naidoo, Nireshni ; Meiring, Susan ; Quan, Vanessa ; Lindani, Sonwabo ; Moore, David P. ; Reubenson, Gary ; Moshe, Mamokgethi ; Eley, Brian ; Hallbauer, Ute M. ; Finlayson, Heather ; Madhi, Shabir A. ; Conklin, Laura ; Zell, Elizabeth R. ; Klugman, Keith P. ; Whitney, Cynthia G. ; von Gottberg, Anne
• Corporate Authors:
  South African IPD Case–Control Study Group
• Description:
  Background:
  
  Invasive pneumococcal disease (IPD) causes significant disease burden, especially in developing countries, even in the era of pneumococcal conjugate vaccine and maternal-to-child HIV transmission prevention programs. We evaluated factors that might increase IPD risk in young children in a high HIV prevalence setting.
  
  Methods:
  
  We conducted a case–control study using IPD cases identified at 24 Group for Enteric, Respiratory and Meningeal disease Surveillance—South Africa program sites (2010–2012). At least 4 controls were matched by age, HIV status and hospital to each case. Potential risk factors were evaluated using multivariable conditional logistic regression.
  
  Results:
  
  In total, 486 age-eligible cases were enrolled. Factors associated with IPD in HIV-uninfected children (237 cases, 928 controls) included siblings <5 years [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI): 1.16–2.46], underlying medical conditions (aOR = 1.99, CI 1.22–3.22), preceding upper respiratory tract infection (aOR = 1.79, CI 1.19–2.69), day-care attendance (aOR = 1.58, CI 1.01–2.47), perinatal HIV exposure (aOR = 1.62, CI 1.10–2.37), household car ownership (aOR = 0.45, CI 0.25–0.83) and ≥2 7-valent pneumococcal conjugate vaccine doses (aOR = 0.67, CI 0.46–0.99). Among HIV-infected children (124 cases, 394 controls), IPD-associated factors included malnutrition (aOR = 2.68, CI 1.40–5.14), upper respiratory tract infection (aOR = 3.49, CI 1.73–7.03), tuberculosis in the last 3 months (aOR = 5.12, CI 1.69–15.50) and current antiretroviral treatment (aOR = 0.13, CI 0.05–0.38).
  
  Conclusion:
  
  Previously identified factors related to poverty, poor health and intense exposure continue to be risk factors for IPD in children. Ensuring delivery of pneumococcal conjugate vaccine and antiretroviral treatment are important for improving disease prevention.
  
  
• Subjects:
  Bacteremia Case-Control Studies Child, Preschool Female Health Status HIV Infections Humans Infant Infant, Newborn Male Meningitis, Bacterial Pneumococcal Infections Pneumococcal Vaccines Prevalence Risk Factors Socioeconomic Factors South Africa Vaccination

  More +
• Keywords:
  Children HIV HIV Exposure Pneumococcal Conjugate Vaccine Pneumococcus Risk Factors
• Source:
  Pediatr Infect Dis J. 34(1):27-34
• Pubmed ID:
  24992122
• Pubmed Central ID:
  PMC11632609
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  34
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:8e0c272b0f7dde69512a8bef98c8ecfcfa8c1122d3faef66276fb455f529cd2d366533295ed08ed88b9c8b26c8e0a5ff0a955fc03c5fd8e311d11a4f0179b071
• Download URL:
  https://stacks.cdc.gov/view/cdc/174797/cdc_174797_DS1.pdf
• File Type:
  [PDF - 399.08 KB ]