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Pneumococcal prophylaxis for children with sickle cell disease in Africa
  1. M de Montalembert1,2,
  2. V Brousse1,2,
  3. J-R Zahar3
  1. 1
    Service de Pédiatrie Générale, Hôpital Necker, Paris, France
  2. 2
    Centre de Référence pour la prise en charge de la drépanocytose en Ile de France, France
  3. 3
    Service de Bactériologie, Hôpital Necker, Paris, France
  1. M de Montalembert, Service de Pédiatrie Générale, Hôpital Necker, 149 rue de Sèvres, 75015 Paris, France; Mariane.demontal{at}nck.aphp.fr

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Penicillin prophylaxis and pneumococcal vaccination are routinely used in the United States and in Europe to prevent invasive pneumococcal diseases (IPD) in children with sickle cell disease (SCD). Their usefulness in African children with SCD has been recently challenged.1 Indeed, a study of blood cultures in 155 SCD children with temperatures >38°C cared for in one medical centre in Uganda identified Streptococcus pneumoniae in only 6% of episodes. We agree with the authors that large, well-constructed studies assessing the risk of IPD in Africa are in order. However, we would like to suggest that their relatively small and monocentric …

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