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

IF 8.5 Q1 RESPIRATORY SYSTEM
Grace Mzumara, James Chirombo, Todd D Swarthout, Naor Bar-Zeev, Philliness Prisca Harawa, Mohamed Sanusi Jalloh, Amir Kirolos, Victoria Mukhula, Laura Newberry, Olawale Ogunlade, Richard Wachepa, Neil French, Robert S Heyderman, Pui-Ying Iroh Tam
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引用次数: 0

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.

引入 13 价肺炎球菌结合疫苗后马拉维儿童经X光确诊的肺炎和相关的肺炎球菌携带。
背景:马拉维于 2011 年引入 13 价肺炎球菌结合疫苗 (PCV-13),预期可减少儿童肺炎球菌肺炎。我们的目的是在 PCV-13 引入后的 2013 年至 19 年间,按血清型描述因主要终点肺炎 (PEP) 而住院的儿童的临床特征和鼻咽 (NP) 肺炎球菌携带情况:我们对马拉维因急性呼吸道疾病(ARI)住院的 5 岁以下儿童进行了二次分析。入院时进行的胸部X光检查由两名独立的临床医生根据世界卫生组织的PEP标准进行判读,第三名判读者负责解决诊断不一致的问题。对NP拭子标本进行处理,并对生长的肺炎链球菌进行血清分型。我们进行了多变量回归分析,以评估临床特征、NP血清型和PEP之间的关联:我们获得了 500 名儿童的完整影像学和 NP 血清型数据,其中 54 个分离株是疫苗型(VT)(10.8%),165 个是非疫苗型(NVT;33.0%),281 个没有肺炎球菌生长(56.2%)。其中,176 人(35.2%)通过胸部 X 光检查获得了 PEP。在有 PEP 的病例中,43.8% 的病例有肺炎球菌携带记录,VT 血清型占 10.8%。我们发现,PEP 患儿的临床特征与携带 VT、NVT 或未携带肺炎球菌之间没有关联:结论:在马拉维因急性呼吸道感染住院的儿童中,肺炎球菌携带率仍然很高,但与不携带肺炎球菌或携带 NVT 的儿童相比,携带 VT 的儿童接受 PEP 的可能性并不大。携带 VT、NVT 或未携带肺炎球菌的儿童在临床特征方面没有差异。
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Pneumonia
Pneumonia RESPIRATORY SYSTEM-
自引率
1.50%
发文量
7
审稿时长
11 weeks
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