Burden of clinical infections due to S. pneumoniae during Hajj: A systematic review

Amani S Alqahtani; Mohamed Tashani; Iman Ridda; Amgad Gamil; Robert Booy; Harunor Rashid

doi:10.1016/j.vaccine.2018.04.031

Burden of clinical infections due to S. pneumoniae during Hajj: A systematic review

Vaccine. 2018 Jul 16;36(30):4440-4446. doi: 10.1016/j.vaccine.2018.04.031. Epub 2018 Jun 20.

Authors

Amani S Alqahtani¹, Mohamed Tashani², Iman Ridda³, Amgad Gamil⁴, Robert Booy⁵, Harunor Rashid⁶

Affiliations

¹ National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Kids Research Institute at The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Saudi Food and Drug Authority, Riyadh, Saudi Arabia.
² National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Kids Research Institute at The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; The Discipline of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, The University of Sydney Medical School, Australia; Faculty of Medicine, University of Tripoli, Ain Zara, Tripoli, Libya.
³ California University of Science and Medicine, USA.
⁴ Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, Dubai, United Arab Emirates.
⁵ National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Kids Research Institute at The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; The Discipline of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, The University of Sydney Medical School, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, Australia; WHO Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University, Adelaide, Australia.
⁶ National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), Kids Research Institute at The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; The Discipline of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, The University of Sydney Medical School, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, Australia; WHO Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University, Adelaide, Australia. Electronic address: harunor.rashid@health.nsw.gov.au.

PMID: 29935859
DOI: 10.1016/j.vaccine.2018.04.031

Abstract

The burden of pneumococcal disease at Hajj has not been precisely evaluated through a systematic review. To this end we have conducted a systematic review on the burden of clinical infections due to Streptococcus pneumoniae among Hajj pilgrims. Major electronic databases including OVID Medline, Web of Science, OVID Embase, Social Sciences Citation Index, Google Scholar and relevant websites (e.g., online Saudi Epidemiology Bulletin) were searched by using MeSH terms and text words containing but not limited to 'Hajj', pneumonia and S. pneumoniae. This was buttressed by hand searching of reference lists of identified studies. Of 21 full text papers reviewed, nine articles were included in this review. Seven studies reported the burden of pneumococcal pneumonia and the other two reported the burden of invasive pneumococcal diseases including meningitis and sepsis. The proportion of pneumonia that was pneumococcal ranged from 1% to 54% of bacteriologically confirmed pneumonias. The pneumococcus accounted for 2/3rd of bacteriologically diagnosed meningitis cases, and 1/3rd of confirmed cases of sepsis. Case fatality rate of pneumococcal pneumonia was recorded in only two studies: 33.3% and 50%. Only one study provided data on antimicrobial susceptibility of S. pneumoniae isolates, reporting 33.3% to be penicillin resistant. None of the included studies provided data on serotype distribution of S. pneumoniae. This systematic review highlights the significance of pneumococcal disease during Hajj, and demonstrates paucity of data on its burden particularly on disease-causing serotype.

Keywords: Antimicrobial resistance; Hajj; Invasive pneumococcal disease (IPD); Pneumococcal vaccine; Pneumonia; S. pneumoniae.

Publication types

Review
Systematic Review

MeSH terms

Humans
Pneumococcal Infections / microbiology*
Pneumococcal Infections / prevention & control
Pneumococcal Vaccines / therapeutic use*
Pneumonia / immunology
Pneumonia / microbiology*
Streptococcus pneumoniae / immunology
Streptococcus pneumoniae / pathogenicity*

Substances

Pneumococcal Vaccines