High cost a big hurdle for pneumococcal disease

Bengaluru: Prevention of invasive infections among children in India below the age of five due to ‘Streptococcus pneumoniae’ has continued to be a challenge for the medical profession.

Sadly, unlike other countries, India has not yet included routine pneumococcal vaccination in the primary immunization program of infants and children. The reasons for this are the high cost of the vaccine and also the absence of an extensive pneumococcal surveillance study.

An exception is Dr K L Ravi Kumar, Professor Emeritus, Microbiology, Kempegowda Institute of Medical Sciences, the brain behind the Pan India distribution of Pneumococcal Serotypes Study (PIDOPS Study), India’s largest pediatric pneumococcal surveillance study, who shows the way forward in terms of vaccination and also enlightens pediatricians across the country through his extensive study. "Any death due to lack of vaccination is tragic. Which is why I thought that we should have an extensive surveillance study which would provide useful information on the incidence, clinical spectrum and serogroups of Invasive Pneumococcal Disease (IPD) in children,” says Dr Ravi.

He conducted the PIDOPS Study at seven institutional centers across India including Bengaluru, Chennai, Jodhpur, Ludhiana, Delhi, Kolkata and Kanpur for a duration of 2 years (July 2013-August 2015) and 51 sentinel centers, making it a total of 58 centers.

Speaking about earlier studies, the doctor says, “The past and existing pneumococcal surveillance studies are limited, of short duration and unevenly distributed. With India’s increasing population, diverse genetic pool and antibiotic overuse, pneumococci are also evolving and becoming antibiotic-resistant. It is important to find the pneumococcal serotypes responsible for pneumonia infections and understand their antibiotic resistance levels. We wanted to solve these concerns by initiating the PIDOPS Study.” In the PIDOPS study, 1504 samples were collected over 2 years from children with Invasive Pneumococcal disease. This pioneered the ‘PCRSeq Typing’ which is another milestone in molecular technology along with the traditional technique.

‘PCRSeqTyping’ helped identify pneumococcal infection in 30% of samples compared to 7% with the traditional method. This is a highly sensitive, robust, quick, economical and reliable technology for identifying and serotyping all 91 Serotypes,” concludes Dr Ravi.

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