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High residual carriage of vaccine-serotype Streptococcus pneumoniae after introduction of pneumococcal conjugate vaccine in Malawi

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Swarthout, Todd, Fronterre, Claudio, Lourenço, José, Obolski, Uri, Gori, Andrea, Bar-Zeev, Naor, Everett, Dean, Kamng’ona, Arox W., Mwalukomo, Thandie S., Mataya, Andrew A., Mwansambo, Charles, Banda, Marjory, Gupta, Sunetra, Diggle, Peter, French, Neil and Heyderman, Robert S. (2020) 'High residual carriage of vaccine-serotype Streptococcus pneumoniae after introduction of pneumococcal conjugate vaccine in Malawi'. Nature Communications, Vol 11, Issue 1, e222.

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Abstract

There are concerns that pneumococcal conjugate vaccines (PCVs) in sub-Saharan Africa sub-optimally interrupt Streptococcus pneumoniae vaccine-serotype (VT) carriage and transmission. Here we assess PCV carriage using rolling, prospective nasopharyngeal carriage surveys between 2015 and 2018, 3.6–7.1 years after Malawi’s 2011 PCV13 introduction. Carriage decay rate is analysed using non-linear regression. Despite evidence of reduction in VT carriage over the study period, there is high persistent residual carriage. This includes among PCV-vaccinated children 3–5-year-old (16.1% relative reduction from 19.9% to 16.7%); PCV-unvaccinated children 6–8-year-old (40.5% reduction from 26.4% to 15.7%); HIV-infected adults 18-40-years-old on antiretroviral therapy (41.4% reduction from 15.2% to 8.9%). VT carriage prevalence half-life is similar among PCV-vaccinated and PCV-unvaccinated children (3.26 and 3.34 years, respectively). Compared with high-income settings, there is high residual VT carriage 3.6–7.1 years after PCV introduction. Rigorous evaluation of strategies to augment vaccine-induced control of carriage, including alternative schedules and catch-up campaigns, is required.

Item Type: Article
Subjects: QW Microbiology and Immunology > Bacteria > QW 142 Gram-positive bacteria (General)
QW Microbiology and Immunology > Immunotherapy and Hypersensitivity > QW 806 Vaccination
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 217 Pneumococcal infections
Faculty: Department: Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI): https://doi.org/10.1038/s41467-020-15786-9
Depositing User: Stacy Murtagh
Date Deposited: 11 May 2020 12:45
Last Modified: 14 May 2020 09:52
URI: https://archive.lstmed.ac.uk/id/eprint/14420

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