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Impact of 13-Valent Pneumococcal Conjugate Vaccine on Colonization and Invasive Disease in Cambodian Children

Turner, P; Leab, P; Ly, S; Sao, S; Miliya, T; Heffelfinger, JD; Batmunkh, N; Lessa, FC; Walldorf, JA; Hyde, TB; et al. Turner, P; Leab, P; Ly, S; Sao, S; Miliya, T; Heffelfinger, JD; Batmunkh, N; Lessa, FC; Walldorf, JA; Hyde, TB; Ork, V; Hossain, MS; Gould, KA; Hinds, J; Cooper, BS; Ngoun, C; Turner, C; Day, NPJ (2020) Impact of 13-Valent Pneumococcal Conjugate Vaccine on Colonization and Invasive Disease in Cambodian Children. Clin Infect Dis, 70 (8). pp. 1580-1588. ISSN 1537-6591 https://doi.org/10.1093/cid/ciz481
SGUL Authors: Gould, Katherine Ann Hinds, Jason

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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 colonization and invasive disease in children aged <5 years. Methods There were 6 colonization surveys done between January 2014 and January 2018 in children attending the outpatient department of a nongovernmental pediatric hospital in Siem Reap. Nasopharyngeal swabs were analyzed 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 colonization data were modelled to estimate vaccine effectiveness (VE). Results Comparing 2014 with 2016–2018, and using adjusted prevalence ratios, VE estimates for colonization were 16.6% (95% confidence interval [CI] 10.6–21.8) for all pneumococci and 39.2% (95% CI 26.7–46.1) for vaccine serotype (VT) pneumococci. There was a 26.0% (95% CI 17.7–33.0) decrease in multidrug-resistant pneumococcal colonization. The IPD incidence was estimated to have declined by 26.4% (95% CI 14.4–35.8) by 2018, with a decrease of 36.3% (95% CI 23.8–46.9) for VT IPD and an increase of 101.4% (95% CI 62.0–145.4) for non-VT IPD. Conclusions Following PCV13 introduction into the Cambodian immunization schedule, there have been declines in VT pneumococcal colonization and disease in children aged <5 years. Modelling of dominant serotype colonization data produced plausible VE estimates.

Item Type: Article
Additional Information: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Streptococcus pneumoniae, Cambodia, children, colonization, vaccine, Streptococcus pneumoniae, Cambodia, children, colonisation, vaccine, 06 Biological Sciences, 11 Medical and Health Sciences, Microbiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Clin Infect Dis
ISSN: 1537-6591
Language: eng
Dates:
DateEvent
10 April 2020Published
7 June 2019Published Online
5 June 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
001World Health OrganizationUNSPECIFIED
MR/K006924/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
106698/Z/14/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
PubMed ID: 31175819
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110936
Publisher's version: https://doi.org/10.1093/cid/ciz481

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