Nation, ML;
Manna, S;
Tran, HP;
Nguyen, CD;
Vy, LTT;
Uyen, DY;
Phuong, TL;
Dai, VTT;
Ortika, BD;
Wee-Hee, AC;
et al.
Nation, ML; Manna, S; Tran, HP; Nguyen, CD; Vy, LTT; Uyen, DY; Phuong, TL; Dai, VTT; Ortika, BD; Wee-Hee, AC; Beissbarth, J; Hinds, J; Bright, K; Smith-Vaughan, H; Nguyen, TV; Mulholland, K; Temple, B; Satzke, C
(2023)
Impact of COVID-19 Nonpharmaceutical Interventions on Pneumococcal Carriage Prevalence and Density in Vietnam.
Microbiol Spectr, 11 (1).
e0361522.
ISSN 2165-0497
https://doi.org/10.1128/spectrum.03615-22
SGUL Authors: Hinds, Jason
Abstract
Nonpharmaceutical interventions (NPIs) implemented to contain SARS-CoV-2 have decreased invasive pneumococcal disease. Previous studies have proposed the decline is due to reduced pneumococcal transmission or suppression of respiratory viruses, but the mechanism remains unclear. We undertook a secondary analysis of data collected from a clinical trial to evaluate the impact of NPIs on pneumococcal carriage and density, drivers of transmission and disease, during the COVID-19 pandemic in Ho Chi Minh City, Vietnam. Nasopharyngeal samples from children aged 24 months were assessed in three periods - one pre-COVID-19 period (n = 1,537) and two periods where NPIs were implemented with increasing stringency (NPI period 1 [NPI-1, n = 307], and NPI period 2 [NPI-2, n = 262]). Pneumococci were quantified using lytA quantitative PCR and serotyped by DNA microarray. Overall, capsular, and nonencapsulated pneumococcal carriage and density were assessed in each NPI period compared with the pre-COVID-19 period using unadjusted log-binomial and linear regression. Pneumococcal carriage was generally stable after the implementation of NPIs. In contrast, overall pneumococcal carriage density decreased by 0.44 log10 genome equivalents/mL (95% confidence interval [CI]: 0.19 to 0.69) in NPI-1 and by 0.84 log10 genome equivalents/mL (95% CI: 0.55 to 1.13) in NPI-2 compared with the pre-COVID-19 period. Reductions in overall pneumococcal density were driven by reductions in capsular pneumococci, with no corresponding reduction in nonencapsulated density. As higher pneumococcal density is a risk factor for disease, the decline in density provides a plausible explanation for the reductions in invasive pneumococcal disease that have been observed in many countries in the absence of a substantive reduction in pneumococcal carriage. IMPORTANCE The pneumococcus is a major cause of mortality globally. Implementation of NPIs during the COVID-19 pandemic led to reductions in invasive pneumococcal disease in many countries. However, no studies have conducted a fully quantitative assessment on the impact of NPIs on pneumococcal carriage density, which could explain this reduction. We evaluated the impact of COVID-19 NPIs on pneumococcal carriage prevalence and density in 2,106 children aged 24 months in Vietnam and found pneumococcal carriage density decreased up to 91.5% after NPI introduction compared with the pre-COVID-19 period, which was mainly attributed to capsular pneumococci. Only a minor effect on carriage prevalence was observed. As respiratory viruses are known to increase pneumococcal carriage density, transmission, and disease, this work suggests that interventions targeting respiratory viruses may have the added benefit of reducing invasive pneumococcal disease and explain the reductions observed following NPI implementation.
Item Type: |
Article
|
Additional Information: |
© 2023 Nation et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (https://creativecommons.org/licenses/by/4.0/). |
Keywords: |
COVID-19, Streptococcus pneumoniae, Vietnam, carriage, density, nonpharmaceutical intervention, pneumococcal, Streptococcus pneumoniae, density, carriage, pneumococcal, Vietnam, COVID-19, nonpharmaceutical intervention |
SGUL Research Institute / Research Centre: |
Academic Structure > Infection and Immunity Research Institute (INII) |
Journal or Publication Title: |
Microbiol Spectr |
ISSN: |
2165-0497 |
Language: |
eng |
Dates: |
Date | Event |
---|
14 February 2023 | Published | 16 January 2023 | Published Online | 15 December 2022 | Accepted |
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Publisher License: |
Creative Commons: Attribution 4.0 |
Projects: |
|
PubMed ID: |
36645282 |
Web of Science ID: |
WOS:000914227400001 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/115167 |
Publisher's version: |
https://doi.org/10.1128/spectrum.03615-22 |
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