Pneumococcal Meningitis in Infants and Toddlers: Epidemiology and Potential Impact of a Cuban Conjugate Vaccine - Abstract
Objective: To describe pneumococcal meningitis main epidemiological features in young children, and discuss potential effect of Cuban Pneumococcal Conjugate Vaccine.
Methods: Nationwide retrospective observational study (1998-2016), in children <2 years old based on surveillance. It were estimated incidence,
mortality and case-fatality rate and pneumococcal meningitis cases comprised in community acquired bacterial meningitis of unknown bacteriological etiology. Prediction of cases (2017-2020) was by time series modelling using generalized linear model methodology.
Results: 385 cases in children <2 years old, with incidence 7.8/105 population; in infants 9.7/105 population and toddlers 5.9/105 population. Highest overall incidence arose in 2000 (15.1/105 population), decreasing toward 2016. Surveillance reported 106 overall fatalities, causing mortality of 2.1/105population and 27.5 % case-fatality rate, with similar figures by age groups. Biggest proportion of disease occurred at fourth (13.0 %), second (10.4 %), and sixth (10.0 %), months of birth, with topmost case-fatality rate at ninth (55.5 %), fifth (31.6 %), and tenth (30.0 %), months of birth. Adjusted sum of pneumococcal meningitis cases reached 633, with incidence of 12.8/100 000 population and descending trend.Pneumococcal meningitis prediction in children <2 years old was two cases monthly and annually around 22.
Conclusions: Pneumococcal meningitis still is the major and most lethal cause of community acquired bacterial meningitis in Cuban children. Introduction of Cuban new heptavalent PCV (serotypes 1, 5, 6B, 14, 18C, 19F, 23F) might decrease considerably Pnm and other clinical features in a near future. Surveillance must follow closely subsequent changes in epidemiological behavior