Impact of pneumococcal conjugate vaccine on pneumonia hospitalization and mortality in children and elderly in Ecuador: Time series analyses |
| |
| Institution: | 1. Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador;2. Universidad Alcalá de Henares, Madrid, Spain;3. Department of Community Health, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil;4. Estrategia Nacional de Inmunizaciones, Ministerio de Salud Pública del Ecuador, Quito, Ecuador;5. Pan American Health Organization, PWR-Ecuador, Quito, Ecuador;6. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA;7. Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA;8. Comprehensive Family Immunization Project, Pan American Health Organization, Washington, DC, USA;1. Institute of Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany;2. Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria;3. Division of Pulmonology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, Germany;4. CAPNETZ STIFTUNG, Hannover, Germany;5. Research Group Clinical Epidemiology, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany;6. Thorax Center in the Ruhr Area, Department of Respiratory Medicine and Infectious Diseases, Evangelikal Protestant Hospital in Herne and Augusta Hospital in Bochum, Bochum, Germany;7. Medical Department I, Department of Respiratory Medicine, Goethe University Hospital, Frankfurt/Main, Germany;8. Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Germany;9. Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany;10. German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany;11. Department of Infectious Diseases and Pulmonary Medicine, and Division of Pulmonary Inflammation, Charité – Universitätsmedizin Berlin, Berlin, Germany;12. Department of Pneumology, Hannover Medical School, Hannover, Germany;1. Federal University of Minas Gerais, School of Medicine, Belo Horizonte, Brazil;2. Federal University of Bahia, School of Medicine, Salvador, Brazil;1. Sheba Med Ctr, Ramat-Gan, Israel;2. Tel-Aviv University, Tel-Aviv, Israel;3. Meir Med Ctr, Kfar Saba, Israel;4. Haddassah Med Ctr, Jerusalem, Israel;5. Tel-Aviv Med Ctr, Tel-Aviv, Israel;6. Rivka Ziv Med Ctr, Sefed, Israel;7. Wolfson Med Ctr, Holon, Israel;8. Emek Med Ctr, Afula, Israel;9. Maayanei Hayeshua Hosp, Bnei-Brak, Israel;10. Ben-Gurion University, Beer-Sheva, Israel;1. Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China;2. Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong;3. Laboratory of Data Discovery for Health (D²4H), Hong Kong, China;4. Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China;5. Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK;6. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China;7. School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China;8. Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China;9. Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China;10. Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China;11. Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China;12. Research Department of Policy and Practice, University College London School of Pharmacy, London, UK;13. Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK;1. Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia;2. Clinical and Population Perinatal Research, Kolling Institute, Northern Sydney Local health District, St Leonards, NSW, Australia;3. The University of Sydney Northern Clinical School, NSW, Australia;4. National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia;5. School of Public Health and Community Medicine, UNSW Medicine, The University of New South Wales, Sydney, NSW, Australia;6. Department of Infectious Diseases, Perth Children''s Hospital, Perth, WA, Australia;7. Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia;8. School of Public Health, Curtin University, Perth, WA, Australia;9. School of Medicine, University of Western Australia, Perth, WA, Australia;10. Department of Microbiology, PathWest Laboratory Medicine WA, Perth Children''s Hospital, Perth, WA, Australia;1. Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya;2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;3. Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK;4. Kenya Ministry of Health, Kilifi, Kenya;5. Kenya Ministry of Health, Nairobi, Kenya;6. London School of Hygiene & Tropical Medicine, London, UK |
| |
| Abstract: | BackgroundPneumococcal conjugate vaccines (PCV) reduce the burden of invasive pneumococcal disease and pneumonia hospitalizations. However, there is limited evidence of the effect of PCVs on pneumonia mortality in children. It is anticipated that indirect effects resulting from PCV use among children might further reduce the remaining burden of adult pneumococcal disease caused by pneumococcal serotypes contained in PCV. Whether this will result in reduced pneumonia mortality in children and adults is still not known.MethodsWe investigated the impact of PCV on pneumonia hospitalization and mortality in in Ecuador, where PCV was introduced in 2010, considering national data from secondary data sources from 2005 to 2015. Time series analysis using regression models were used to evaluate the decline in the number of all-cause pneumonia hospitalizations and deaths in the period post-PCV introduction. The target populations were children under 5 years and adults aged 50 years and over. Outcomes of interest were hospitalizations and mortality in which the main cause of hospital admission and death, respectively, were coded as ICD10 codes J12-18 (pneumonia). Three different models were fitted.ResultsWe demonstrate a sizeable impact of PCV in pneumonia hospitalization in children < 1 year (27% reduction, 95%CI 12–42%), and < 5 years of age (33% reduction, 95%CI 11–43%). The estimated impact of PCV in pneumonia mortality was a reduction of 14% in < 1 year (95%CI 0–33%), 10% in < 5 years (95%CI 0–25%), and 22% (95%CI 7–34%) in adults aged 50–64 years. Little evidence of a change was detected in elderly ≥ 65 years.ConclusionThis study is the first to report on the impact of PCV in pneumonia morbidity and mortality in children and older adults, being relevant to policy makers and global donors. Findings were consistent when using different models. Additional studies on the indirect effect of PCV in older adults are needed. |
| |
| Keywords: | Impact Pneumococcal diseases Immunization programs Pneumococcal conjugate vaccines Mortality Time series analyses |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
