Research: AVOIDABLE DEATHS

Invasive bacterial infections have been found to be the leading cause of death among children at a rural sub-Saharan district hospital. A new study, the largest of its type ever undertaken in Africa, highlights the need for prevention and for overcoming the political and financial barriers to widespread use of existing vaccines for bacterial diseases.

With little epidemiological data available on bacterial infections among children in sub-Saharan Africa, James Berkley, Anthony Scott and colleagues studied every acute paediatric admission to Kilifi District Hospital in Kenya. The team documented nearly 20 000 admissions, to assess the prevalence of bacterial infections and to identify the most common infectious organisms.

Of all childhood deaths, 22 per cent were associated with malaria, but 26 per cent were of children admitted with invasive bacterial infections. This suggests that bacterial disease may be causing more deaths in children than malaria, even in an area where malaria is endemic.

Extrapolation of these findings across sub-Saharan Africa would imply that disease due to just two bacterial species, Haemophilus influenzae and Streptococcus pneumoniae, would account for nearly half a million deaths in children under five every year. Most of these deaths could be prevented with the use of existing vaccines.

The study suggests that bacterial diseases are more important to public health than has been thought – a misperception that could explain the failure to prioritise the introduction of vaccines.

External links

• Berkley JA et al. Bacteremia among children admitted to a rural hospital in Kenya. N Engl J Med 2005;352(1):39–47.
• Kenya Medical Research Institute