TY - JOUR
T1 - The impact of 10-valent Pneumococcal Conjugate Vaccine on the incidence of radiologically-confirmed pneumonia and clinically-defined pneumonia in Kenyan children
AU - Silaba, Micah
AU - Ooko, Michael
AU - Bottomley, Christian
AU - Sande, Joyce
AU - Benamore, Rachel
AU - Park, Kate
AU - Ignas, James
AU - Maitland, Kathryn
AU - Mturi, Neema
AU - Makumi, Anne
AU - Otiende, Mark
AU - Kagwanja, Stanley
AU - Safari, Sylvester
AU - Ochola, Victor
AU - Bwanaali, Tahreni
AU - Bauni, Evasius
AU - Gleeson, Fergus
AU - Knoll, Maria Deloria
AU - Adetifa, Ifedayo
AU - Marsh, Kevin
AU - Williams, Thomas N.
AU - Kamau, Tatu
AU - Sharif, Shahnaaz
AU - Levine, Orin S.
AU - Hammitt, Laura L.
AU - Scott, J. Anthony G.
N1 - Publisher Copyright:
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2018/7/18
Y1 - 2018/7/18
N2 - Background Pneumococcal conjugate vaccines (PCV) are highly protective against invasive pneumococcal disease caused by vaccine serotypes but the burden of pneumococcal disease in developing countries is dominated by pneumonia, most of which is non-bacteraemic. We examined the impact of PCV on pneumonia incidence. Methods We linked prospective hospital surveillance for clinically-defined WHO severe or very-severe pneumonia at Kilifi County Hospital from 2002-2015 to population surveillance at Kilifi Health and Demographic Surveillance System, comprising 45,000 children aged <5 years. Chest radiographs were read according to a WHO standard. A 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PCV10) was introduced in Kenya in January 2011. In Kilifi, there was a catch-up campaign for children aged <5 years. We estimated the impact of PCV10 on pneumonia incidence through interrupted time series analysis accounting for seasonal and temporal trends. Findings The incidence of admission with clinically-defined pneumonia in 2002/3 was 21·7/1000/year in children aged 2-59 months. This declined progressively over 13 years. By the end of March 2011, 61·1% of children aged 2-11 months received ≥2 doses and 62·3% of children aged 12-59 months received ≥1 dose of PCV10. Adjusted incidence rate ratios for admissions with radiologically-confirmed pneumonia, clinically-defined pneumonia, and diarrhoea (control condition), associated with PCV10 introduction, were 0·52 (95% CI 0·32-0·86), 0·73 (95% CI 0·54-0·97) and 0·63, (95% CI 0·31-1·26), respectively. The annual incidence of clinically-defined pneumonia in December 2010 was 12·2/1000; this was reduced by 3·3/1000 with PCV10 introduction. Interpretation Over 13 years, hospitalisations for clinically-defined pneumonia declined progressively at Kilifi County Hospital but fell abruptly by 27% in association with PCV10 introduction. The incidence of radiologically-confirmed pneumonia fell by 48%. The burden of childhood pneumonia in Kilifi, Kenya, has been reduced substantially by PCV10. Funding Gavi, Wellcome Trust
AB - Background Pneumococcal conjugate vaccines (PCV) are highly protective against invasive pneumococcal disease caused by vaccine serotypes but the burden of pneumococcal disease in developing countries is dominated by pneumonia, most of which is non-bacteraemic. We examined the impact of PCV on pneumonia incidence. Methods We linked prospective hospital surveillance for clinically-defined WHO severe or very-severe pneumonia at Kilifi County Hospital from 2002-2015 to population surveillance at Kilifi Health and Demographic Surveillance System, comprising 45,000 children aged <5 years. Chest radiographs were read according to a WHO standard. A 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PCV10) was introduced in Kenya in January 2011. In Kilifi, there was a catch-up campaign for children aged <5 years. We estimated the impact of PCV10 on pneumonia incidence through interrupted time series analysis accounting for seasonal and temporal trends. Findings The incidence of admission with clinically-defined pneumonia in 2002/3 was 21·7/1000/year in children aged 2-59 months. This declined progressively over 13 years. By the end of March 2011, 61·1% of children aged 2-11 months received ≥2 doses and 62·3% of children aged 12-59 months received ≥1 dose of PCV10. Adjusted incidence rate ratios for admissions with radiologically-confirmed pneumonia, clinically-defined pneumonia, and diarrhoea (control condition), associated with PCV10 introduction, were 0·52 (95% CI 0·32-0·86), 0·73 (95% CI 0·54-0·97) and 0·63, (95% CI 0·31-1·26), respectively. The annual incidence of clinically-defined pneumonia in December 2010 was 12·2/1000; this was reduced by 3·3/1000 with PCV10 introduction. Interpretation Over 13 years, hospitalisations for clinically-defined pneumonia declined progressively at Kilifi County Hospital but fell abruptly by 27% in association with PCV10 introduction. The incidence of radiologically-confirmed pneumonia fell by 48%. The burden of childhood pneumonia in Kilifi, Kenya, has been reduced substantially by PCV10. Funding Gavi, Wellcome Trust
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U2 - 10.1101/369686
DO - 10.1101/369686
M3 - Article
AN - SCOPUS:85095620649
JO - Advances in Water Resources
JF - Advances in Water Resources
SN - 0309-1708
ER -