Bacteremic Community-Acquired Pneumonia in Ethiopian Children: Etiology, Antibiotic Resistance, Risk Factors, and Clinical Outcome

By Abel Abera Negash, Daniel Asrat, Workeabeba Abebe, Tewodros Hailemariam Tsegaye Hailu, Abraham Aseffa, Mario Vaneechoutte

 

Open Forum Infectious Diseases, January 2019

 

Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality. We sought to determine the magnitude, etiology, and risk factors of CAP in children 5 years after introduction of pneumococcal conjugate vaccine (PCV) 10 in Ethiopia..

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Monitoring and the evaluation of impact as public health strategies: Contributions for the introduction of the new Cuban vaccine against Streptococcus pneumoniae

by N. Linares-Perez, M. E. Toledo-Romani, and Y. Valdes-Balbin

Published in Elsevier: Vacunas, published online 18 January 2019. DOI: https://doi.org/10.1016/j.vacune.2018.03.005

 

 

Vaccine evaluation studies, based on surveillance data, provide rigorous evidence on the population impact. Beyond the traditional clinical trials, these studies should be part of the evaluation strategy from its conception. Cuba has still not introduced a pneumococcal vaccination; thus a high priority has been given to the development and evaluation of a new heptavalent conjugate vaccine candidate (PCV7-T), which is currently in an advanced phase of clinical evaluation. This paper puts into perspective the value of surveillance and evaluation studies to quantify the effects and impact of the introduction and use of pneumococcal vaccination on invasive and non-invasive disease rates and nasopharyngeal colonisation (carrier status) in infants and pre-school children. The surveillance studies and the ongoing evaluation studies, as well as the main results of the former, are described. The methodological and operational challenges are also addressed. All these elements will contribute to the body of evidence that will support the decision-making on the introduction of the new Cuban vaccine in the National Vaccination Programme, and will form the basis for the evaluation of the health impact of the infant population after the introduction of the pneumococcal vaccine in Cuba.

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Regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in Germany

by Stephanie Perniciaro, Matthias Imöhl, Christina Fitzner, and Mark van der Linden

Published in PLOS One, 09 January 2019. https://doi.org/10.1371/journal.pone.0210278

 

 

Invasive pneumococcal disease (IPD) is responsible for nearly half a million deaths per year in children under five, and also represents 5% of all-cause child mortality. The German National Reference Center for Streptococci (GNRCS) has been collecting invasive pneumococcal isolates from children since 1997. Disease surveillance on pediatric IPD is ongoing throughout the world, with a notable uptick following the development of pneumococcal conjugate vaccines (PCVs), which are a common component of childhood immunization programs.

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Impact and cost effectiveness of pneumococcal conjugate vaccine in India

by Yuvaraj Krishnamoorthy, Salin K.Eliyas, Nayana P. Nair, Manikandanesan Sakthivel, Gokul Sarveswaran, and Palanivel Chinnakali

Published in Elsevier: Vaccine, 21 January 2019. https://doi.org/10.1016/j.vaccine.2018.12.004

 

 

World Health Organization has recommended the introduction of pneumococcal conjugate vaccine (PCV) in the childhood immunisation programme of all the countries in the world. In lieu of its introduction in India, there is a need to generate evidence on cost-effectiveness of this vaccine. The current study looks into the impact and cost-effectiveness of PCV vaccine in India.

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Comparison of two schedules of two-dose priming with the ten-valent pneumococcal conjugate vaccine in Nepalese children: an open-label, randomised non-inferiority controlled trial

by Rama Kandasamy, DPhil; Meeru Gurung, MD; Stephen Thorson, MD; Ly-Mee Yu, DPhil; Ushma Galal, MSc; Merryn Voysey, MBiostat; Sarah Kelly, MSc; Brian Wahl, PhD; Guy Berbers, PhD; Kier Finnegan, MSc; Imran Ansari, MD; Krishna Paudel, MD; Prof David R Murdoch, MD; Katherine L O'Brien, MD; Dominic F Kelly, PhD; Prof David Goldblatt, PhD; Prof Shrijana Shrestha, MD; and Prof Andrew J Pollard, FMedSci.

Published in The Lancet Infectious Diseases, 08 January 2019. DOI: https://doi.org/10.1016/S1473-3099(18)30568-1

 

 

Nepalese infants receive ten-valent pneumococcal conjugate vaccine (PCV10) with a 1 month interval between priming doses for programmatic reasons. Researchers aimed to investigate whether immune responses to PCV10 serotypes were non-inferior if the second priming dose of PCV10 was delivered at a 1 month interval as opposed to a 2 month interval. Researchers conducted an open-label, randomised, parallel group trial in healthy Nepalese infants aged 40–60 days at Patan Hospital, Kathmandu, Nepal. Children were eligible for inclusion if they were healthy, were born at more than or equal to 37 weeks' gestation, were residing in Kathmandu, and had not had any previous vaccinations other than BCG, and oral polio vaccine. Participants were randomly assigned (1:1) by means of a computer-generated list with randomly varying permuted block sizes accessed through a validated web-based interface, to receive PCV10 either at 6 weeks and 10 weeks of age (6 + 10 group) or at 6 weeks and 14 weeks of age (6 + 14 group), with both groups receiving a booster at 9 months of age. Laboratory staff, masked to study intervention, analysed serum samples for antibodies against PCV10 serotypes by ELISA. The primary outcome was to determine whether the 6 + 10 schedule was non-inferior to the 6 + 14 schedule at 9 months of age, on the basis of the proportion of infants with serotype-specific IgG greater than or equal to 0·35 μg/mL. Non-inferiority was established with a 10% margin, and the primary endpoint was measured in a modified intention-to-treat population, which included only participants who successfully had a blood sample collected. Researchers concluded that the 6 week, 14 week, and 9 month schedule should be implemented where possible. However, post-booster responses, which are thought to drive herd immunity, were similar in the two schedules. Therefore, the 6 week, 10 week, and 9 month schedule is an alternative that can be used when logistically necessary, and is expected to provide herd protection.  This trial is registered at ClinicalTrials.gov, number NCT02385513 and was funded by Gavi, the Vaccine Alliance.    Article access can be found here.  
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