Pneumococcal Carriage and Serotype Distribution in Children With Otitis Media in Malaysia. (OM)
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ClinicalTrials.gov Identifier: NCT05429541 |
Recruitment Status :
Recruiting
First Posted : June 23, 2022
Last Update Posted : August 7, 2023
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Condition or disease |
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Streptococcus Pneumonia Otitis Media |
Otitis media (OM) is a condition defined as an inflammation of the middle ear and is one of the most commonly diagnosed infections in children, especially amongst those aged below 5 years (1). By 3 years of age, approximately 80% of children have experienced at least one episode of acute otitis media (AOM) in developed countries. More than 700 million AOM cases are reported annually worldwide at an incidence rate of 10.8%, with Southeast Asia reporting a yearly incidence of 8.2% and disease burden varying substantially by geographical location (2). In Malaysia, based on data published from a population based survey (n=7,041) conducted by the Ministry of Health in 2005 (3),OM with effusion (OME) prevalence was found to be 2.9% amongst individuals all ages, of which 46.5% suffered from hearing loss. Amongst children, OME prevalence was 3.8% in those aged ≤17 years, 1.4% in 13-17 year olds and 2.3% in children ≤12 years of age. The survey also found that prevalence was higher in rural settings (3.2%) compared to urban settings (2.7%). These findings were in contrast to an earlier cross-sectional study based on 5 to 6 years olds from kindergartens in 1993 (n=1,097), where prevalence was 17.9% in the urban district of Kuala Lumpur compared to 9.5% in rural Kuala Selangor (4). AOM was found in Malaysia to have a negative impact on both parental and child quality of life (QoL), with significant indirect healthcare costs and thus substantial economic burden in the population (5).
Studies on the epidemiology of AOM, especially those reliant upon clinical diagnosis and following the uptake of pneumococcal conjugate vaccination (PCV) are few and far between. In Malaysia the prevalence of OME, as described above, has been reported although limited to specific settings and locations, with even fewer assessments on AOM prevalence. Immunisation programmes against Spn have an impact on carriage, and consequently the causative pathogen and infecting strains of Spn in OM infections. There has been a consistent observed association between PCV introduction and a decline of AOM infections caused by Spn. As Malaysia is one of the more recent countries to start the PCV National Immunisation Programme (NIP), this presents an excellent opportunity to begin surveillance on pneumococcal carriage and serotype distribution allowing for a detailed assessment of the epidemiology of OM in the country.
Specific Objectives
- To determine the prevalence of Streptococcus pneumoniae (Spn) nasopharyngeal carriage among children 5 years of age and below with OM
- To determine Spn serotypes in children diagnosed with OM
Study Type : | Observational |
Estimated Enrollment : | 360 participants |
Observational Model: | Case-Only |
Time Perspective: | Prospective |
Official Title: | Pneumococcal Carriage and Serotype Distribution in Children With Otitis Media in Malaysia. |
Actual Study Start Date : | April 5, 2023 |
Estimated Primary Completion Date : | April 5, 2024 |
Estimated Study Completion Date : | September 30, 2025 |
Group/Cohort |
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Otitis Media (OM) Case Group
Case definition:
Otoscopic findings:
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- Prevalence of Streptococcus pneumoniae (Spn) nasopharyngeal (NP) carriage among young children with OM (AOM/OME/CSOM). [ Time Frame: 12 months ]The absence/presence of nasopharyngeal pneumococcal carriage will be tested using standard bacteriological methods and Streptococcus Pneumoniae (SPN) isolates will be inoculated for DNA extraction and tested by polymerase chain reaction (PCR) for pneumococcal carriage detection.
- Serotype distribution of Streptococcus pneumoniae (Spn) among young children with OM (AOM/OME/CSOM). [ Time Frame: 12 months ]Spn isolates will be sequenced using whole-genome sequencing (WGS) platform (Illumina, UK) to determine the infecting serotype(s) among children with OM. Serotype and sequence type will be derived from the genomic data using a pipeline to identify the serotype from Illumina WGS reads for given references and multilocus sequence type respectively.
Biospecimen Retention: Samples With DNA
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Ages Eligible for Study: | 3 Months to 5 Years (Child) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
Children aged ≥3 months and <5 years with clinically diagnosed AOM/CSOM whose parent/legal authorized representative (LAR) is willing to give consent on his/her behalf and attending general practitioner clinics, the ear, nose and throat (ENT) outpatient's department or admitted as a hospital inpatient at hospital sites.
Exclusion Criteria:
Any child aged ≥3 months and <5 years old
- who does not meet the case definition
- whose parent/guardian does not give consent on his/her behalf.
- who had nasal surgery,
- who has chronic respiratory diseases (including asthma) and cardiac condition
- with tympanostomy tubes
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05429541
Contact: Nur Alia Johari, PhD | +60 12 234 5651 | NurAliaJohari@imu.edu.my | |
Contact: Nurul Hanis Ramzi, PhD | +60 17 339 6532 | nurulhanis@imu.edu.my |
Malaysia | |
Sultan Ahmad Shah Medical Centre @International Islamic University Malaysia | Recruiting |
Kuantan, Pahang, Malaysia, 57000 | |
Contact: Zamzil Amin Ash'ari, MBBS zamzilamin@iium.edu.my | |
Contact: Norhidayah Kamarudin, MBBS norhidayahkamarudin@iium.edu.my; | |
Principal Investigator: Ailin Razali, MBBS | |
Sub-Investigator: Zamzil Amin Ash'ari, MBBS | |
Sub-Investigator: Norhidayah Kamarudin, MBBS | |
Universiti Putra Malaysia | Recruiting |
Serdang, Seri Kembangan, Malaysia, 43400 | |
Contact: Atiqah Farah Zakaria, MBBS atiqahfarah@gmail.com | |
Contact: Saraiza Abu Bakar, MBBS drsaraiza@yahoo.com | |
Principal Investigator: Atiqah Farah Zakaria, MBBS | |
Sub-Investigator: Saraiza Abu Bakar, MBBS |
Principal Investigator: | Lokman Hakim Sulaiman, PhD | International Medical University |
Responsible Party: | Lokman Hakim Sulaiman, MD, Deputy Vice Chancellor, Research, International Medical University |
ClinicalTrials.gov Identifier: | NCT05429541 |
Other Study ID Numbers: |
MISP #61353 |
First Posted: | June 23, 2022 Key Record Dates |
Last Update Posted: | August 7, 2023 |
Last Verified: | August 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Pneumonia, Pneumococcal Otitis Otitis Media Pneumonia Respiratory Tract Infections Infections Lung Diseases Respiratory Tract Diseases |
Ear Diseases Otorhinolaryngologic Diseases Pneumococcal Infections Streptococcal Infections Gram-Positive Bacterial Infections Bacterial Infections Bacterial Infections and Mycoses Pneumonia, Bacterial |