Epidemiology of pneumonia in the pre-pneumococcal conjugate vaccine era in children 2-59 months of age, in Ulaanbaatar, Mongolia, 2015-2016


Autoři: Claire von Mollendorf aff001;  Sophie La Vincente aff001;  Mukhchuluun Ulziibayar aff003;  Bujinlkham Suuri aff003;  Dashtseren Luvsantseren aff003;  Dorj Narangerel aff004;  John de Campo aff001;  Margaret de Campo aff001;  Cattram Nguyen aff001;  Sodbayar Demberelsuren aff006;  Tuya Mungun aff003;  E. Kim Mulholland aff001
Působiště autorů: New Vaccines, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Vic., Australia aff001;  Department of Paediatrics, The University of Melbourne, Parkville, Australia aff002;  National Center of Communicable Diseases (NCCD), Ministry of Health, Ulaanbaatar, Mongolia aff003;  Ministry of Health, Ulaanbaatar, Mongolia aff004;  Department of Radiology, The University of Melbourne, Parkville, Australia aff005;  Expanded Programme on Immunization, World Health Organization, Ulaanbaatar, Mongolia aff006;  Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England, United Kingdom aff007
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0222423

Souhrn

Background

Respiratory diseases, including pneumonia, are the second largest cause of under-five mortality in Mongolia and the most common cause of childhood hospitalization. However information regarding the contribution of Streptococcus pneumoniae to pneumonia causation in Mongolia is limited. We aimed to describe the epidemiology of hospitalized children aged 2–59 months with pneumonia, enrolled into a surveillance program in the period prior to pneumococcal conjugate vaccine (PCV) introduction, in Mongolia.

Methods

An expanded pneumonia surveillance program enrolled children, who met the surveillance case definition, at participating hospitals, between April 2015 and May 2016. Cumulative incidence rates were calculated by district for all pneumonia endpoints using district specific denominators from the Mongolian Health Department census for 2016. Socio-economic and disease-associated factors were compared between districts using chi-squared tests.

Results

A total of 4318 eligible children with pneumonia were enrolled over the 14 month period. Overall the incidence for all-cause pneumonia in children aged 12–59 months was 31.8 per 1000 population; children aged 2–11 months had an almost four-fold higher incidence than children aged 12–59 months.

Differences were found between districts with regards to housing type, fuel used for cooking, hospital admission practices and the proportions of severe and primary endpoint pneumonia.

Discussion

This study shows a high burden of pneumonia in children aged 2–59 months in Mongolia prior to PCV introduction. Rates differed somewhat by district and age group and were influenced by a number of socio-economic factors. It will be important to consider these differences and risk factors when assessing the impact of PCV introduction.

Klíčová slova:

Medicine and health sciences – Pulmonology – Pneumonia – Epidemiology – Medical risk factors – Infectious diseases – Infectious disease control – Vaccines – Conjugate vaccines – Health care – Health care facilities – Hospitals – People and places – Geographical locations – Asia – Mongolia – Population groupings – Age groups – Physical sciences – Chemistry – Chemical elements – Oxygen – Earth sciences – Geography – Human geography – Housing – Social sciences


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PLOS One


2019 Číslo 9
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