Invasive pneumococcal disease in the Kimberley, 1995–2001
Invasive pneumococcal disease in the Kimberley, 1995–2001 Journal Article
Australian Journal of Rural Health
- Author(s): Mak, Donna B.
- Published: 2004
- Publisher: Blackwell Science Pty
- Volume: 12
- ISBN: 1440-1584
Abstract: Objective: To describe the epidemiology of invasive pneumococcal disease (IPD) in the Kimberley and examine whether cases could have been prevented by vaccination. Design: Prospective case series of IPD cases from 1 January 1995 to 31 December 2001. Setting: The Kimberley region of far north-western Australia. Subjects: Seventy IPD cases in 37 men and 33 women aged 5 months to 90 years. Aboriginal people comprised 90% (63/70) of cases. Main outcome measures: Demographic, clinical and microbiological characteristics of IPD cases. Proportion of cases caused by vaccine-preventable serotypes. IPD incidence in the Kimberley. Results: Pneumonia and bacteraemia were the commonest clinical presentations. Of IPD cases, 15% (children) and 67% (adults) had a risk factor for IPD. The case fatality rate was 13%. Of cases, 46% (95% confidence interval (CI) 35–58%) were caused by serotypes covered by an age-appropriate vaccine. Of the 26 cases eligible for pneumococcal vaccination, only 4 (16%) had been appropriately vaccinated. IPD incidence in Aboriginal people aged 15 years and over declined from 97.8/100 000 person years (95% CI 56.5–139.1) in 1997 to 38.1/100 000 person years (95% CI 22.5–53.9) in 2001. Conclusions: The significant proportion of cases caused by vaccine-preventable serotypes and that was, therefore, preventable underscores the importance of pneumococcal vaccination. What this paper adds: What is already known? IPD is a major cause of morbidity and mortality worldwide, and especially in Indigenous Australian populations; however, there is little published information about the epidemiology of this illness in the Kimberley region of Western Australia, which has a large Indigenous population. What does this study add? Many Kimberley IPD cases are caused by vaccine-preventable serotypes and are, therefore, potentially preventable. Following the introduction of an adult pnuemococcal vaccination program in 1996, IPD incidence in Kimberley Aboriginal adults fell significantly.
- Urls: http://dx.doi.org/10.1111/j.1440-1854.2004.00621.x
- Keywords: Aboriginal, epidemiology, evaluation, surveillance, vaccination