Otitis Media Case Study

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Pneumococcal Conjugate Vaccine (Non-Typeable Haemophilus influenzae (NTHi) Protein D, Diphtheria or Tetanus Toxoid Conjugates) in Prevention of Acute Otitis Media in Children: A Cohort Study

Trixy G. Chu, M.D.
Department of Pediatrics
University of Santo Tomas Hospital

Daniel Rafael R. Cachola III, M.D
Department of Otorhinolaryngology-Head and Neck Surgery
University of Santo Tomas

Mary Agnes S. Regal, M.D., DPPS
Department of Pediatrics
University of Santo Tomas Hospital

Agnes Cecille G. Llamas, M.D., DPPS
Department of Pediatrics
University of Santo Tomas Hospital

Norberto V. Martinez, M.D., FPSOHNS
Department of Otorhinolaryngology-Head and Neck Surgery
University of Santo Tomas

Wilfredo R. Santos, M.D., DPPS
Department of Pediatrics …show more content…

In developing countries, the World Health Organization (WHO) attributes 51,000 deaths per year, in children under five years old, to otitis media. In Philippine General Hospital (PGH), acute otitis media constitutes 0.9% of ENT-OPD consults. (Magiba-Caro, et al., 2006). By three years of age, 75–80% of children will have had at least one episode, with the peak incidence occurring before the age of two years. (Grevers, 2010). Acute otitis media (AOM) is clinically defined as an inflammation of the middle ear with rapid onset of signs and symptoms of less than 3 weeks duration. (Magiba-Caro, et al., 2006) Most cases of AOM resolve spontaneously in less than 3 or 4 weeks, but a selected population will develop recurrent and severe disease. (Brouwer, et al., …show more content…

influenza NTHi became the most common pathogen for a period of time, but an increase in non-PCV-7 S. pneumonia was also noted. The distribution of pathogenic S. pneumoniae serotypes differs between countries and compared with the United States. PCV-7 offers reduced coverage in Europe, Africa, Latin America, and Asia, where nonvaccine pathogenic serotypes are more prevalent. In a study by Parra, et. al., among bacterial etiology for AOM, 64% of samples were culture positive for bacterial pathogens. H. influenzae and S. pneumoniae were the leading causes of bacterial AOM, detected in 34% and 29% of AOM episodes, respectively. The most commonly isolated S. pneumoniae serotypes were 19A, 19F and 23F. All H. influenzae isolates were identified as non-typeable. They found more H. influenzae than S. pneumoniae among otorrhea samples. They also documented more H. influenzae than S. pneumoniae in episodes among children less than 24 months of age. (Parraa, et al., 2011). Based on epidemiologic data from the Health Protection Agency (HPA), 35.9% of AOM cases were assumed to have been attributable to S. pneumoniae and 32.3% to NTHi. PHiD-CV is a 10-valent conjugate vaccine that includes an additional 3 serotypes (1, 5, and 7F) and uses a carrier protein derived from nontypable H influenzae (NTHi) for 8 of the 10 serotypes included. By virtue of using protein D from NTHi as a carrier protein, PHiD-CV may offer additional

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