Invasive disease potential of Streptococcus pneumoniae serotypes before and after 10-valent pneumococcal conjugate vaccine introduction in a rural area, southern Mozambique
Por:
Massora S, Lessa FC, Moiane B, Pimenta FC, Mucavele H, Chaúque A, Cossa A, Verani JR, Tembe N, da Gloria Carvalho M, Munoz-Almagro C and Sigaúque B
Publicada:
3 dic 2019
Ahead of Print:
28 sep 2019
Resumen:
Background: Invasive pneumococcal disease (IPD) is a significant cause of morbidity and mortality among children worldwide. In April 2013, Mozambique introduced 10-valent PCV (PCV10) into the National Expanded Program on immunization using a three-dose schedule at 2, 3, and 4 months of age. We aimed to evaluate the invasive disease potential of pneumococcal serotypes among children in our region before and after PCV10 introduction.
Methods: We used data from ongoing population-based surveillance for IPD and cross-sectional pneumococcal carriage surveys among children aged <5 years in Manhica, Mozambique. To determine the invasive disease potential for each serotype pre- and post-PCV10 introduction, odds ratios (OR) and 95% confidence intervals (95% CI) were calculated comparing serotype-specific prevalence in IPD and in carriage. For each serotype, OR and 95% CI > 1 indicated high invasive disease potential and OR and 95% CI < 1 indicated low invasive disease potential.
Results: In the pre-PCV10 period, 524 pneumococcal isolates were obtained from 411 colonized children and IPD cases were detected in 40 children. In the post-PCV10 period, 540 pneumococcal isolates were obtained from 507 colonized children and IPD cases were detected in 30 children. The most prevalent serotypes causing IPD pre-PCV10 were 6A (17.5%), 6B (15.0%), 14 (12.5%), 23F (10.0%) and 19F (7.5%), and post-PCV10 were 6A (36.7%), 13 (10%), 1 (10.0%), 613 (6.7%) and 19A (6.7%). Serotypes associated with high invasive disease potential pre-PCV10 included 1 (OR:22.3 [95% CI 2.0; 251.2]), 6B (OR:3.1 [95% CI 1.2; 8.1]), 14 (OR: 3.4 [95% CI 1.2; 9.8]) and post-PCV10 included serotype 6A (OR:6.1[95% CI 2.7; 13.5]).
Conclusion: The number of serotypes with high invasive disease potential decreased after PCV10 introduction. Serotype 6A, which is not included in PCV10, was the most common cause of IPD throughout the study and showed a high invasive potential in the post-PCV10 period. (C) 2019 The Authors. Published by Elsevier Ltd.
Filiaciones:
Massora S:
Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
Lessa FC:
Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Moiane B:
Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
Pimenta FC:
Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Mucavele H:
Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
Chaúque A:
Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
Cossa A:
Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
Verani JR:
Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Tembe N:
Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
da Gloria Carvalho M:
Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Munoz-Almagro C:
Molecular Microbiology Department, Instituto de Recerca Pediatrica, University Hospital Sant Joan de Deu, Barcelona, Spain
Ciber of Epidemiology and Public Health, CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
Medicine Department, Universitat Internacional de Catalunya, Barcelona, Spain
Sigaúque B:
Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
Green Submitted, hybrid
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