Kempegowda Institute of Medical Sciences (KIMS), Bengaluru has established the country's largest Pneumococcal Disease Surveillance Programme. The nationwide programme aims to create a robust model for collating and centralizing national data on pneumococcal infections thereby enabling paediatricians to identify drug sensitivity and resistance patterns and also distribution of streptococcus pneumoniae.

A comprehensive data collection and management system programme will help to standardize treatment procedures, strengthen epidemiological surveillance, provide data on the disease burden and promote technical expertise in vaccination and prevention activities.

Pneumococcal Disease (PD) has been the leading cause of hospitalization and deaths among the elderly population above 50 years of age and children below five years of age in India. Around 140,000 Indian children succumb to Streptococcus pneumoniae annually. As a signatory to the WHO Millennium Development Goals (MDGs), India is committed to reduce the under five mortality to less than 41 per 1,000 live births by 2015 (MDG4).

However, with the current rate of reduction of under five mortality in India (69 in 2008 and 66 in 2009) India may encounter difficulties in achieving the MDG4 goals. To a large extent this is because of the country’s inability to reduce infant mortality due to pneumonia and diarrhoea, which are leading causes of child death in India. With a high fatality rate of 28 per cent due to PD among adults above 50 years of age, streptococcus pneumoniae has been identified as the most common pathogen accounting for 30-55 per cent of cases.

To combat PD, about 25-30 of India’s leading microbiologists, paediatricians and geriatricians have come together across the country to review the opportunities for driving the Pneumococcal Surveillance Programme. It is for the first time that such a robust mechanism is being adopted for the surveillance of an infectious disease in the country gathering data from 15 centres spread across the country including Ludhiana, Delhi, Jodhpur, Chennai, Vellore and Hyderabad. The programme will allow paediatricians to analyse disease patterns, document information and monitor disease management techniques.

“Data and isolates collected from 15 centres across India will be archived at KIMS Pneumococcal research laboratory. Surveillance for pneumococcal disease will be conducted using a variety of lab based methods and diagnostic tools,” said Dr K L Ravikumar, professor and head, Department of Microbiology, KIMS.

Epidemiological surveillance of bacterial pneumonia and meningitis across various age groups will be conducted as per the WHO surveillance guidelines. Organisms will be characterized, and archived for future access upto 30 years to contribute to the research activities including vaccine development, he added.

The surveillance model will help build awareness on the disease burden to evaluate health impacts and will help policy makers to plan appropriate interventions.

PD includes infections like pneumonia (lungs), meningitis (brain), bacteremia (blood) and otitis media (ear), especially fatal in young children and elderly. While pneumococcus can affect people of all age groups, infants and young children are at a heightened risk.

“The element of serotyping included in the PD Surveillance Programme is critical for diagnosis and treatment. There are 93 different serotypes (bacteria groups) of streptococcus pneumoniae, however not all serotypes cause the disease. This is why it is important to know the serotypes causing the disease in India which will help in developing proper preventive strategies including vaccination,” said Dr Nisarga, professor and HOD Department of Paediatrics, AIMS, Bellur.

According to Dr Premalatha, Professor, Department of Paediatrics, Vani Vilas Children’s Hospital, the hub-and-spoke model between KIMS and the 15 peripheral hospitals will help access data to enable accurate detection and treatment.