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Radiographically confirmed pneumonia in Malawian children and associated pneumococcal carriage after introduction of the 13-valent pneumococcal conjugate vaccine

Mzumara, Grace, Chirombo, James, Swarthout, Todd D., Bar-Zeev, Naor, Harawa, Philliness Prisca, Jalloh, Mohamed Sanusi, Kirolos, Amir, Mukhula, Victoria, Newberry, Laura, Ogunlade, Olawale, Wachepa, Richard, French, Neil, Heyderman, Robert S. and Iroh Tam, Pui-Ying ORCID: https://orcid.org/0000-0002-3682-8892 (2024) 'Radiographically confirmed pneumonia in Malawian children and associated pneumococcal carriage after introduction of the 13-valent pneumococcal conjugate vaccine'. Pneumonia, Vol 16, Issue 23.

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Abstract

Abstract
Background The 13-valent pneumococcal conjugate vaccine (PCV-13) was introduced in Malawi in 2011 with an expected impact of reducing pneumococcal pneumonia in children. We aimed to describe clinical characteristics and nasopharyngeal (NP) carriage of pneumococcus by serotype in children hospitalized with primary end-point pneumonia (PEP) between 2013 and 19 after the introduction of PCV-13.

Methods We conducted a secondary analysis of children aged under-5-years hospitalized with acute respiratory illness (ARI) in Malawi. Chest radiographs conducted at admission were read by two independent clinicians according to WHO criteria for PEP, and a third reviewer resolved discordant diagnoses. NP swab specimens were processed and Streptococcus pneumoniae growth was serotyped. Multivariable regression analysis was conducted to assess the association between clinical characteristics, NP serotypes, and PEP.

Results We had complete radiographic and NP serotype data for 500 children, of which 54 isolates were vaccine�type (VT) (10.8%), 165 were non-VT (NVT; 33.0%), and 281 had no pneumococcal growth (56.2%). Among these, 176 (35.2%) had PEP on chest x-ray. Among those with PEP, pneumococcal carriage was documented in 43.8% of cases,
and VT serotypes accounted for 10.8%. For children with PEP, we found no association between clinical characteristics and carrying either VT, NVT, or no pneumococcus.

Conclusion Carriage of S. pneumoniae remains high among children hospitalized with ARI in Malawi, but children with VT carriage were no more likely to have PEP than children carrying no pneumococcus or those with NVT carriage. There were no differences in clinical characteristics between those carrying VT, NVT, or no pneumococcus.

Item Type: Article
Subjects: QW Microbiology and Immunology > Immunotherapy and Hypersensitivity > QW 805 Vaccines. Antitoxins. Toxoids
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 202 Pneumonia (General or not elsewhere classified)
Faculty: Department: Education
Digital Object Identifer (DOI): https://doi.org/10.1186/s41479-024-00147-7
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 17 Oct 2024 14:27
Last Modified: 17 Oct 2024 14:33
URI: https://archive.lstmed.ac.uk/id/eprint/25438

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