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Impact of PCV7/PCV13 introduction on invasive pneumococcal disease (IPD) in young children: Comparison between meningitis and non-meningitis IPD |
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| Institution: | 1. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel;2. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;3. Pediatric Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem, Israel;4. Pediatric Infectious Diseases Service, Emek Medical Center, Afula, Israel;5. Department of Pediatrics, The Barzilai University Medical Center, Ashkelon, Israel;10. Centre National de Recherche et de Formation sur le Paludisme, Burkina Faso;11. Institute of Tropical Medicine, University of Tübingen, Germany;12. Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon;13. Makerere University College of Health Sciences, Uganda;14. Navrongo Health Research Centre, Ghana;15. Medical Research Council, Fajara, Gambia;p. Statens Serum Institut, Denmark;q. Harvard School of Public Health Research Collaboration, Boston, USA;1. Centre National de Recherche et de Formation sur le Paludisme, Burkina Faso;2. Institute of Tropical Medicine, University of Tübingen, Germany;3. London School of Hygiene & Tropical Medicine, UK;4. Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon;5. Makerere University College of Health Sciences, Uganda;6. Navrongo Health Research Centre, Ghana;7. Statens Serum Institut, Denmark;8. Centre for Infectious Disease Research in Zambia, Zambia;9. Centre for Medical Parasitology at Department of International Health, Immunology, and Microbiology, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark;1. Department of Pediatrics, Baylor College of Medicine and Section of Infectious Diseases, Texas Children''s Hospital, Houston, TX 77030, USA;1. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;2. Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA;3. Minnesota Department of Health, St Paul, MN, USA;4. Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA;5. Connecticut Department of Public Health, Hartford, CT, USA;6. New York State Department of Health, Albany, NY, USA;7. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;8. California Emerging Infections Program, Oakland, CA, USA;9. School of Public Health, Department of Epidemiology, University of California, Berkeley, CA, USA;10. Colorado Department of Public Health and Environment, Denver, CO, USA;11. Institute for Public Health, University of New Mexico, Emerging Infections Program, Albuquerque, NM, USA;12. Oregon Public Health Division and Oregon Emerging Infections Program, Portland, OR, USA;13. Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA;14. Infection Disease Section, Medical Specialty Care Service Line, Atlanta VA Medical Center, Atlanta, GA, USA;15. Stat-Epi Associates, Ponte Vedra Beach, FL, USA;p. Department of Pathology, University of Texas Health Science Center, San Antonio, TX, USA;1. Département des maladies infectieuses, Institut de Veille Sanitaire, Saint Maurice, France;2. Centre National de Référence des Pneumocoques, AP-HP, Hôpital Européen Georges Pompidou, Paris, France;3. Université Paris Sud, EA 4043 Châtenay-Malabry, France;1. Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel;2. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;1. Bill & Melinda Gates Foundation, 500 5th Avenue North, Seattle, WA 98102, USA |
| Abstract: | BackgroundThe worldwide introduction of pneumococcal conjugate vaccines (PCV) into National Immunization Programs resulted in rapid and substantial reduction of invasive pneumococcal disease (IPD) rates in children. However, the reduction of meningitis vs. non-meningitis IPD (nm-IPD) was not yet fully elucidated. We compared 7-valent and 13-valent PCV (PCV7 and PCV13) impact on pneumococcal-meningitis vs. nm-IPD in Israeli children <5 years.MethodsWe conducted an ongoing nationwide, prospective, population-based, active surveillance. PCV7 and PCV13 were implemented in Israel in July 2009 and November 2010, respectively. All pneumococcal isolates (blood and/or CSF) from IPD episodes in children <5 years from July 2000 through June 2015 were included. Extrapolation for missing serotypes (34.7% of all isolates) was conducted.Results4163 IPD cases were identified; 3739 nm-IPD (89.8%) and 424 meningitis (10.2%). During the pre-PCV period (2000–2008), children <12 months constituted 52.1% and 33.7% of meningitis and nm-IPD, respectively (p < 0.001). The respective proportions of non-PCV13 serotypes (non-VT) were 18.2% vs. 10.1%, (p < 0.001).Comparing the last study year (2014–2015) to the mean of pre-PCV period, meningitis incidence in children <5 years decreased non-significantly by 27%, while nm-IPD decreased significantly by 69%. Dynamic rates of meningitis and nm-IPD caused by PCV13 serotypes were similar, with 93% and 95% overall reductions, respectively. However, non-VT increased in meningitis relatively to nm-IPD, mainly in children <24 months. Serotype 12F rose sharply and significantly since 2009–2010 through 2014–2015 (28.6% of all non-VT meningitis in children <24 m).ConclusionsThe overall impact of PCV7/PCV13 in children <5 years in Israel was less prominent in meningitis than in nm-IPD. This could be attributed to the younger age of children with meningitis and differences in causative serotypes between the two groups, as the decline of the incidence of meningitis and nm-IPD caused by vaccine-serotypes is similar. Continuous monitoring of meningitis and nm-IPD is warranted. |
| Keywords: | PCV7 PCV13 IPD Children Meningitis Impact PCV7"} {"#name":"keyword" "$":{"id":"k0040"} "$$":[{"#name":"text" "_":"7-valent pneumococcal conjugate vaccine PCV13"} {"#name":"keyword" "$":{"id":"k0050"} "$$":[{"#name":"text" "_":"13-valent pneumococcal conjugate vaccine NIP"} {"#name":"keyword" "$":{"id":"k0060"} "$$":[{"#name":"text" "_":"National Immunization Program IPD"} {"#name":"keyword" "$":{"id":"k0070"} "$$":[{"#name":"text" "_":"invasive pneumococcal disease PCV10"} {"#name":"keyword" "$":{"id":"k0080"} "$$":[{"#name":"text" "_":"10-valent pneumococcal conjugate vaccine nm-IPD"} {"#name":"keyword" "$":{"id":"k0090"} "$$":[{"#name":"text" "_":"non-meningitis IPD CSF"} {"#name":"keyword" "$":{"id":"k0100"} "$$":[{"#name":"text" "_":"Cerebrospinal fluid PCR"} {"#name":"keyword" "$":{"id":"k0110"} "$$":[{"#name":"text" "_":"polymerase chain reaction IRR"} {"#name":"keyword" "$":{"id":"k0120"} "$$":[{"#name":"text" "_":"incidence rate ratio CI"} {"#name":"keyword" "$":{"id":"k0130"} "$$":[{"#name":"text" "_":"confidence interval 7VT+6A"} {"#name":"keyword" "$":{"id":"k0140"} "$$":[{"#name":"text" "$$":[{"#name":"__text__" "_":"PCV7 serotypes isolates"} {"#name":"hsp" "$":{"sp":"0 25"}} {"#name":"__text__" "_":"+"} {"#name":"hsp" "$":{"sp":"0 25"}} {"#name":"__text__" "_":"serotype 6A 5VT"} {"#name":"keyword" "$":{"id":"k0150"} "$$":[{"#name":"text" "_":"additional PCV13 serotypes non-13VT"} {"#name":"keyword" "$":{"id":"k0160"} "$$":[{"#name":"text" "_":"non-PCV13 serotypes SD"} {"#name":"keyword" "$":{"id":"k0170"} "$$":[{"#name":"text" "_":"standard deviation |
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