1.       Primary immune deficiency disorders

2.       Acquired immune suppression due to disease or treatment:

·         Haematological malignancies, including leukaemia and lymphoma

·         Any other malignancy on radiotherapy or chemotherapy

·         On biological therapy

·         On high or moderate doses of corticosteroids

·         On any other immune modulating or suppressant drug like methotrexate, azathioprine, MMF, tacrolimus, cyclophosphamide

·         Any transplant recipient

·         Any condition which requires a long-term immunosuppressive treatments

3.       Haematological conditions or other causes leading to asplenia or splenic dysfunction:

·         Thalassemia major and intermedius, 

·         Hereditary spherocytosis

·         Sickle cell disease

4.       Endocrine disorders:

·         Diabetes mellitus

·         Addison’s disease

·         Congenital Adrenal Hyperplasia                

·         Hypopituitary syndrome

·         Other significant hormonal dysfunction

5.        Chronic neuro-disability:

·         Cerebral palsy

·         Autism

·         Epilepsy,

·         Neuro-degenerative diseases

·         Neuro-muscular disorders

6.       Learning disabilities

·         Down syndrome

·         Severe or profound and multiple learning disabilities due to any aetiology

7.       Any other significant genetic and/or metabolic abnormalities that affect a number of systems

8.        Chronic heart disorders

·         Unrepaired congenital heart diseases

·         Repaired heart diseases with significant residual diseases or shunts

·         Haemodynamically significant acquired heart diseases

9.       Chronic respiratory disorders

·         Poorly controlled asthma which requires long term oral steroids or a history of severe asthma which required an ICU care 

·         Cystic fibrosis

·         Bronchopulmonary dysplasia

·         Interstitial lung diseases

·         Significant bronchiectasis due to any aetiology

·         Pulmonary hypertension

10.   Chronic kidney diseases and nephrotic syndrome on regular follow up

11.   Chronic liver diseases

12.   Chronic gastrointestinal disorders including inflammatory bowel disease