International Circumpolar Surveillance System for Invasive Pneumococcal Disease, 1999–2005
2008

Surveillance of Invasive Pneumococcal Disease in the Arctic (1999–2005)

Sample size: 11244 publication 10 minutes Evidence: high

Author Information

Author(s): Bruce Michael G., Deeks Shelley L., Zulz Tammy, Bruden Dana, Navarro Christine, Lovgren Marguerite, Jette Louise, Kristinsson Karl, Sigmundsdottir Gudrun, Jensen Knud Brinkløv, Lovoll Oistein, Nuorti J. Pekka, Herva Elja, Nystedt Anders, Sjostedt Anders, Koch Anders, Hennessy Thomas W., Parkinson Alan J.

Primary Institution: Centers for Disease Control and Prevention

Hypothesis

What are the rates and impacts of invasive pneumococcal disease (IPD) in Arctic regions following the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7)?

Conclusion

The introduction of PCV7 significantly decreased IPD rates among indigenous children in Alaska and northern Canada, but non-PCV7 serotype infections increased.

Supporting Evidence

  • IPD rates among indigenous children <2 years of age decreased by >80% after routine vaccination with PCV7.
  • Overall case-fatality rate for IPD was 10% across the study period.
  • Indigenous persons had higher rates of IPD compared to nonindigenous persons, with a relative risk of 4.4 in Alaska.

Takeaway

This study looked at how many people got sick from a type of bacteria in the Arctic and found that a new vaccine helped a lot, but some other types of the bacteria became more common.

Methodology

Data were collected from clinical laboratories and analyzed for IPD cases across multiple Arctic countries from 1999 to 2005.

Potential Biases

Potential detection bias due to varying diagnostic practices and reporting standards among participating countries.

Limitations

Data collection was inconsistent across regions, and not all countries participated in the same years, which may affect the completeness of the data.

Participant Demographics

The study included indigenous and nonindigenous populations from Alaska, northern Canada, Greenland, Iceland, Norway, and Sweden.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI 3.8–5.1

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3201/eid1401.071315

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