Epidemiology of invasive pneumococcal disease in the Arabian Peninsula and Egypt

Invasive pneumococcal disease (IPD) causes considerable morbidity and mortality among children worldwide. This review describes the burden of disease and pneumococcal serotypes/serogroups causing disease in children in the Arabian Peninsula and Egypt identified from a literature search from 1990 to 2007. The incidence of IPD in children aged ≤5 years ranged from 3.4 to 53.5 per 100 000. Bacteraemia cases were responsible for 61-100% (children <2 years) of total IPD. Pneumococcal meningitis cases ranged from 3% to 25% (<2 years) and from 7% to 30% (≤5 years). The most common IPD serotypes/serogroups were 14, 23F, 6B, 19F and 6A (≤5 years). Circulating serotypes/serogroups causing IPD potentially covered by the 7-valent pneumococcal conjugate vaccine (PCV-7) ranged from 49% to 83% (<2 years) and from 61% to 69% (≤5 years). Penicillin resistance among invasive isolates ranged from 0% to 78%. Case fatality and morbidity rates for pneumococcal meningitis were 0-22% and 10-62%, respectively. Incidence and morbidity data for meningitis and bacteraemia demonstrate a substantial vaccine-preventable burden of IPD in young children. Standardisation of definitions and development of improved regional surveillance/reporting would enable the region to measure better the impact of prevention strategies for IPD, such as infant-based immunisation programmes.