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Τρίτη 11 Ιουνίου 2019

Impact of 13-Valent Pneumococcal Conjugate Vaccine on Colonisation and Invasive Disease in Cambodian Children
Paul Turner  Phana Leab  Sokeng Ly  Sena Sao  Thyl Miliya James D Heffelfinger  Nyambat Batmunkh  Fernanda C Lessa Jenny A Walldorf  Terri B Hyde  ... Show more
Clinical Infectious Diseases, ciz481, https://doi.org/10.1093/cid/ciz481
Published: 07 June 2019  Article history
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Abstract
Background
Cambodia introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in January 2015 using a 3+0 dosing schedule and no catch-up campaign. We investigated the effects of this introduction on pneumococcal colonisation and invasive disease in children aged <5 years.

Methods
Six colonisation surveys were done between January 2014 and January 2018 in children attending the outpatient department of a non-governmental paediatric hospital in Siem Reap. Nasopharyngeal swabs were analysed by phenotypic and genotypic methods to detect pneumococcal serotypes and antimicrobial resistance. Invasive pneumococcal disease (IPD) data for January 2012 – December 2018 were retrieved from hospital databases. Pre-PCV IPD data and pre-/post-PCV colonisation data were modelled to estimate vaccine effectiveness (VE).

Results
Comparing 2014 with 2016-2018, and using adjusted prevalence ratios, vaccine effectiveness (VE) estimates for colonisation were 16.6% (95% CI 10.6–21.8) for all pneumococci and 39.2% (26.7–46.1) for vaccine serotype (VT) pneumococci. There was a 26.0% (17.7–33.0) decrease in multi-drug resistant pneumococcal colonisation. IPD incidence was estimated to have declined by 26.4% (14.4–35.8) by 2018, with a decrease of 36.3% (23.8–46.9) for VT IPD and an increase of 101.4% (62.0–145.4) for non-vaccine serotype IPD.

Conclusions
Following PCV13 introduction into the Cambodian immunisation schedule there have been declines in VT pneumococcal colonisation and disease in children aged <5 years. Modelling of dominant serotype colonisation data produced plausible vaccine effectiveness estimates.

Streptococcus pneumoniae, colonisation, vaccine, children, Cambodia
Topic: cambodia child vaccines vaccines, conjugate microbial colonization serotype cambodian
Issue Section: Major Article

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