Epidemiology of Pneumococcal Carriage among HIV-Infected Individuals in the Conjugate Vaccine Era: A Study in Southern Ghana

by Dayie NT, Baffuor-Asare M, Labi AK, Obeng-Nkrumah N, Olayemi E, Lartey M, Slotved HC, Donkor ES

Published in BioMed Research International, 13 February 2019. 

 

 

Carriage of pneumococcus is considered as the precursor for development of pneumococcal disease. In sub-Saharan Africa, very little research has been done on the pneumococcus in relation to people with HIV infection in the era of pneumococcal conjugate vaccines. This study investigated pneumococcal carriage among HIV/AIDS patients in southern Ghana to determine the prevalence, risk factors, serotypes and antibiotic resistance of the organism.

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Long-term Association of 13-Valent Pneumococcal Conjugate Vaccine Implementation With Rates of Community-Acquired Pneumonia in Children

by Naïm Ouldali, MD; Corinne Levy, MD; Philippe Minodier, MD; Laurence Morin, MD; Sandra Biscardi, MD; Marie Aurel, MD; François Dubos, PhD; Marie Alliette Dommergues, PhD; Ellia Mezgueldi, MD; Karine Levieux, MD; Fouad Madhi, MD; Laure Hees, MD; Irina Craiu, MD; Chrystèle Gras Le Guen, PhD; Elise Launay, PhD; Ferielle Zenkhri, MD; Mathie Lorrot, PhD; Yves Gillet, PhD; Stéphane Béchet, MSc; Isabelle Hau, MD; Alain Martinot, MD; Emmanuelle Varon, MD; François Angoulvant, PhD; and Robert Cohen, MD

Published in JAMA Pediatrics 04 February 2019. doi:10.1001/jamapediatrics.2018.5273

 

 

In several countries, 5 years after 13-valent pneumococcal conjugate vaccine (PCV13) implementation, serotype replacement has been reported for invasive pneumococcal disease, which raises concerns about the long-term outcome of PCV13 implementation. The long-term effect of vaccination on community-acquired pneumonia (CAP) remains unknown. This study aimed to assess the long-term outcome of PCV13 implementation on CAP in children.

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Reductions in Community-Acquired Pneumonia Are Sustained After PCV13 Initiation

by John D. Cowden, MD, MPH reviewing Ouldali N et al.

Published in JAMA Pediatrics, 04 February 2019.

 

After widespread adoption of the 13-valent pneumococcal conjugate vaccine (PCV13), serotype replacement emerged in invasive pneumococcal disease. It is unclear whether a similar effect has occurred in community-acquired pneumonia (CAP). Researchers performed a prospective, interrupted time-series study of CAP rates in eight urban pediatric emergency departments in France during the 8 years following implementation of a national three-dose (at 2, 4, and 12 months of age) PCV13 vaccination campaign. Children 1 month to 15 years of age who had radiographically confirmed CAP were included in the study. Outcomes were rates of overall CAP, CAP with effusion, CAP with high inflammatory markers, CAP requiring hospitalization, and proven pneumococcal CAP.

 

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The role of pneumococcal conjugate vaccination in reducing pneumonia mortality

by Mark Jit and Stefan Flasche

Published in The Lancet Global Health, scheduled for release February 2019. DOI: https://doi.org/10.1016/S2214-109X(18)30540-0

 

 

"In The Lancet Global Health, Cynthia Schuck-Paim and colleagues examine pneumonia mortality in Brazilian children younger than 5 years from 1980 to 2014, to assess the effect of ten-valent pneumococcal conjugate vaccine (PCV10) that was introduced nationwide in 2010. These data are unique because there are few post-marketing PCV effectiveness studies with a mortality endpoint, and clinical trials generally do not have the power to detect significant mortality reductions. Furthermore, the 3 million infants born in Brazil every year grow up in a wide variety of socioeconomic circumstances. Therefore, the dataset has both the power to detect mortality endpoints and the diversity to draw parallels with many other global settings.

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Effect of pneumococcal conjugate vaccine introduction on childhood pneumonia mortality in Brazil: a retrospective observational study

by Cynthia Schuck-Paim, PhD; Robert J Taylor, PhD; Wladimir J Alonso, PhD; Daniel M Weinberger, PhD; Prof Lone Simonsen, PhD

Published in The Lancet Global Health, scheduled for release February 2019. DOI:https://doi.org/10.1016/S2214-109X(18)30455-8

 

 

Understanding the real-world effect of pneumococcal conjugate vaccines (PCVs) on pneumonia mortality is crucial because of the expectation that increased PCV use will substantially reduce the burden of pneumonia deaths in children younger than 5 years. However, few post-vaccine introduction studies have estimated the benefits of PCV use on childhood mortality and results have been inconsistent. Researchers set out to assess the effect of introduction of ten-valent pneumococcal conjugate vaccine (PCV10) on pneumonia mortality in children in Brazil. Between 1980 and 2010, a period during which Brazil's Human Development Index rose substantially, national pneumonia mortality in children younger than 5 years decreased from about 150 to 15 deaths per 100,000 children younger than 5 years. Despite rapid uptake of PCV10 after its introduction in 2010, researchers observed a further vaccine-associated decline of about 10% in national childhood pneumonia mortality with our primary analytical method, with a high degree of uncertainty in the estimates. Researchers also observed larger reductions in municipal childhood pneumonia mortality in all three age groups (3–11 months, 3–23 months, and 3–59 months) in municipalities with a high percentage of extreme childhood poverty and mothers with no primary education, with the largest decrease observed in children aged 3–23 months in municipalities with low maternal education (24%, 95% credible interval 7–35).  The large reduction observed from 1980 to 2010 in national pneumonia mortality in children younger than 5 years underscores that improvements in nutrition, hygiene, education, and health care have an important role in reducing pneumonia mortality. Although the PCV-associated reduction in childhood pneumonia mortality at the national level was modest, researchers found that PCV led to larger reductions in low-income municipalities. Similarly, large benefits might occur when PCVs are introduced in other low-income settings. This study was funded by the Bill & Melinda Gates Foundation and National Institute of Allergy and Infectious Diseases.   Access the full article here.   
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