RESEARCH

1. Opportunities for interventions to reduce childhood mortality from pneumonia in Bangladesh

In a recent edition of the Journal of Health, Population and Nutrition, Luby et al identify strategic directions for implementing interventions to further reduce premature death from infectious diseases in Bangladesh.  The authors note that, in contrast to marked improvements in mortality from diarrheal illnesses, the incidence of pneumonia-specific childhood mortality is largely unchanged in the past 25 years, and is now the number one infectious killer of children in Bangladesh.  To address childhood pneumonia, they call for the introduction of conjugate vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae, improvements in case management, including efforts to prevent delays in providing appropriate treatment, and wider use of zinc supplementation.  Luby et al stress the need for careful assessment of the impact of wide-scale use of the Hib and pneumococcal vaccines - both of which, with GAVI support, may be available for widespread use in Bangladesh in the near future.  The authors estimate that the implementation of these interventions would more than halve the incidence of pneumonia among Bangladeshi children.

2.  Improved oxygen systems found to reduce risk of death for children with pneumonia

Poor oxygen supplies in developing countries have worsened the ability of physicians to detect hypoxemia and manage childhood pneumonia. A recent multi-hospital effectiveness study published in the Lancet by Duke et al has assessed the effect of introducing an improved oxygen system on case-fatality rates of children with pneumonia in Papua New Guinea. The study included more than 11,000 children with pneumonia admitted to five hospitals in Papua, New Guinea, and compared case fatality rates in a pre-intervention group (admitted 2001-2004) to a post-intervention group (admitted 2005-2007).   The intervention consisted of the introduction of oxygen concentrators, pulse oximeters and a protocol for the detection of hypoxemia and the clinical use of oxygen in the five hospitals.  In the pre-intervention group, the case-fatality rate was 4.97%, compared to 3.22% in the post-intervention group, corresponding to a 35% reduction in the risk of death for a child with pneumonia.  The researchers also estimated the costs of implementing this system to be US$51 per patient treated and US$1673 per life saved, concluding that “With the recognition that a comprehensive and multifaceted approach is needed to reduce the worldwide burden of child mortality from pneumonia, we hope that more countries will consider developing similar programmes.”

3. Novel approaches to identify S. pneumoniae in community-acquired pneumonia

In the December 2008 issue of Clinical Infectious Diseases, Klugman et al review advances in the specific diagnosis of pneumococcal infections of community-acquired pneumonia.   For example, recent data from pneumococcal conjugate vaccine trials among children show that increased levels of the acute-phase reactants C-reactive protein (CRP) and procalcitonin may serve as useful adjuncts to chest radiographs in selecting patients with bacterial pneumonia for inclusion in clinical trials. After a thorough evaluation of the available methods, the authors conclude that the following tests for S. pneumoniae should be included in future clinical trials of both mild pneumonia in outpatients and severe pneumonia in hospitalized patients: culture of blood and of good-quality sputum, S. pneumoniae urinary antigen detection, quantitative assays of CRP and procalcitonin, and serological analysis of acute- and convalescent-phase serum samples (pending an FDA-licensed assay for PsaA).

MEDIA

4. Hong Kong announces inclusion of pneumococcal conjugate vaccine in its childhood immunization program

Hong Kong authorities recently announced plans to include the pneumococcal conjugate vaccine (PCV) in the childhood immunization program by September 2009.  Hong Kong is expected to be the first in Asia to assure access to PCV for all children under age two years. The program is estimated to benefit 70,000 infants annually.  At the inaugural meeting of the Hong Kong chapter of the Asian Strategic Alliance for Pneumococcal Disease (ASAP), ASAP Chairperson Dr. Lulu Bravo thanked Hong Kong for leading the way in addressing pneumococcal disease, noting that “Asia is lagging behind Latin America in the fight against [this] disease. All [of the Asian] governments should be concerned."

5. GAVI-supported vaccination programs have prevented 3.4 million deaths

The Global Alliance for Vaccines and Immunization (GAVI) announced that from 2000 to 2008, GAVI-funded immunization prevented an estimated 3.4 million deaths, according to World Health Organization data.  The latest Alliance progress report also projects that by the end of 2008, GAVI-supported vaccines will have reached a total of 213 million children in 76 developing countries around the world.  Other highlights of the reports include a projected rise between 2007 and 2008 in the number of children receiving the Hib vaccine (from 28.2 million to 41.7 million) and the hepatitis B vaccine (from 155.7 million to 192.2 million). GAVI Executive Secretary Julian Lob-Levyt said, "These numbers show the positive results of investment in human lives.  Only through long-term predictable funding can we guarantee that poor countries are able to improve their immunization programs in order to save lives.”

ANNOUNCEMENTS

Travel grants for the 12th Annual Conference on Vaccine Research available for developing country vaccine researchers

A travel grant program for airfare, registration, meal and hotel expenses is available for researchers from developing countries to attend the 12th Annual Conference on Vaccine Research in  Baltimore, MD, April 27-29, 2009.  The online application deadline is 7 December, 2008 for such scholarships and the related poster abstracts. For more information, please visit: http://www.nfid.org/conferences/vaccine09/

Latest PACE quarterly newsletter now available

For the latest quarterly newsletter of the Pneumococcal Awareness Council of Experts (PACE), please  click here.  This edition contains news about the launch of the Global Call to Action on Pneumococcal Disease Prevention, as well as Rwanda’s expected introduction of the pneumococcal vaccine into its national immunization program in January 2009.  It also profiles the International Pediatric Association, a PACE partner organization, and Professor Hans Rosling, a PACE member.

‘Survival: the struggle to breathe’ is a new documentary series on global health that is currently airing on BBC World News. 

The series highlights community-led interventions that can benefit millions of people if scaled-up, demonstrating what could be achieved with sustained political commitment. The episode focused on pneumonia follows Dr. Lulu Bravo – a member of the Pneumococcal Awareness Council of Experts (PACE) - through the slums of Manila, where poor air quality and poor social conditions exacerbate the problem of pneumonia. It provides a striking illustration of the role of air pollution as a risk factor for pneumonia and highlights interventions to reduce pneumonia including improved access to antibiotics and prevention by vaccination.

‘Survival: The Struggle to Breathe’ aired on BBC World News on 22nd November. Special podcasts from the episode and all eight full-length documentaries in the series can be found at: http://www.survival.tv/thebriefingroom. Local airing times can be found at: http://www.bbcworldnews.com/Pages/Schedules.aspx.

UPCOMING EVENTS

BIT will host their 1st annual World Vaccine Congress in Guangzhou, China from December 1-5, 2008. The theme will be "Building an Olympian Meeting Platform for Vaccine World” and the meeting is devoted exclusively to the research on vaccines and associated technologies for disease prevention and treatment. For more information, please visit: http://www.bitlifesciences.com/wcv2008/

The American Society of Tropical Medicine and Hygiene will hold their 57th Annual Meeting December 7-11, 2008 in New Orleans, Louisiana. Registration must be completed by Nov. 13th and more information can be obtained on the conference website: http://www.astmh.org/meetings/index.cfm

The Centers’ for Disease Control Annual Maternal and Child Health Epidemiology Conference will take place December 10-12, 2008 in Atlanta, GA. Health professionals working with maternal and child health data, programs, or policies, particularly at the national, state, tribal, and local levels are encouraged to attend. More information can be found by visiting: http://www.cdc.gov/reproductivehealth/MCHEpi/2008/AboutConference.htm

The 12th Annual World Congress on Public Health will be held in Istanbul, Turkey from April 27- May 1, 2009. Put on each year by the World Federation of Public Health Associations, the meeting will hold sessions on public health education, policy, civil society engagement, development, practice and research. Deadline for abstract submission has been extended to November 30th and more information can be found at: http://www.worldpublichealth2009.org/

ONLINE POLL

Results from Online PneumoADIP Poll

A PneumoADIP web-based poll surveyed our readers on what they believe to be the best intervention for reducing childhood pneumonia.  The leading answer was vaccines against Hib, pneumococcus, measles, and pertussis (85%), followed by improved nutrition (9%), improved case management/treatment (6%), and improved indoor air pollution (0%).  To view the results click here.