Betuel Sigaúque1,2,3, Benild Moiane1, Sergio Massora1, Fabiana Pimenta4, Jennifer R Verani4, Helio Mucavele1, Alberto Chaúque1, Llorenç Quintó5, Rita T Dos Santos6, Maria da Gloria Carvalho4, Cynthia G Whitney4, Fernanda C Lessa4. 1. From the Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM). 2. Instituto Nacional de Saúde, Ministério de Saúde. 3. John Snow Inc. (JSI) on the Maternal and Child Survival Program - MCSP, Maputo, Mozambique. 4. Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Respiratory Diseases Branch, Atlanta, Georgia. 5. ISGlobal, Barcelona Center of International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain. 6. Hospital Central de Nampula, Ministério da Saúde, Moçambique.
Abstract
BACKGROUND: Pneumococcal carriage is a precursor of invasive pneumococcal disease. Mozambique introduced 10-valent pneumococcal conjugate vaccine (PCV10) in April 2013, using a 3-dose schedule without a booster. We evaluated PCV10 impact on pneumococcal carriage and colonization density by HIV status. METHODS: We conducted 2 cross-sectional surveys (pre and post PCV10 introduction) among children 6 weeks to 59 months old. Participants included HIV-infected children presenting for routine care at outpatient clinics and a random sample of HIV-uninfected children from the community. We collected demographic data, vaccination history and nasopharyngeal swabs. Swabs were cultured and isolates serotyped by Quellung. We selected serotypes 11A, 19A and 19F for bacterial density analyses. We compared vaccine-type (VT) carriage prevalence from the pre-PCV10 with the post-PCV10 period by HIV status. FINDINGS: Prevalence of VT carriage declined from 35.9% (110/306) pre already defined in the background. It should be pre-PCV (PCV) to 20.7% (36/174 fully vaccinated) post PCV (P < 0.001) in HIV-uninfected and from 34.8% (144/414) to 19.7% (27/137 fully vaccinated) (P = 0.002) in HIV-infected children. Colonization prevalence for the 3 serotypes (3, 6A, 19A) included in the 13-valent PCV but not in PCV10 increased from 12.4% (38/306) to 20.7% (36/174 fully vaccinated) (P = 0.009) among HIV- uninfected children, mainly driven by 19A; no significant increase was observed in HIV-infected children. VT carriage among unvaccinated children decreased by 30% (P = 0.005) in HIV-infected children, with no significant declines observed in HIV-uninfected children. CONCLUSION: Declines in VT carriage were observed in both HIV-uninfected and HIV-infected children after PCV10 introduction with an early signal of herd effect especially in HIV-infected children. Ongoing monitoring of increases in 19A carriage and disease is necessary.
BACKGROUND:Pneumococcal carriage is a precursor of invasive pneumococcal disease. Mozambique introduced 10-valent pneumococcal conjugate vaccine (PCV10) in April 2013, using a 3-dose schedule without a booster. We evaluated PCV10 impact on pneumococcal carriage and colonization density by HIV status. METHODS: We conducted 2 cross-sectional surveys (pre and post PCV10 introduction) among children 6 weeks to 59 months old. Participants included HIV-infectedchildren presenting for routine care at outpatient clinics and a random sample of HIV-uninfectedchildren from the community. We collected demographic data, vaccination history and nasopharyngeal swabs. Swabs were cultured and isolates serotyped by Quellung. We selected serotypes 11A, 19A and 19F for bacterial density analyses. We compared vaccine-type (VT) carriage prevalence from the pre-PCV10 with the post-PCV10 period by HIV status. FINDINGS: Prevalence of VT carriage declined from 35.9% (110/306) pre already defined in the background. It should be pre-PCV (PCV) to 20.7% (36/174 fully vaccinated) post PCV (P < 0.001) in HIV-uninfected and from 34.8% (144/414) to 19.7% (27/137 fully vaccinated) (P = 0.002) in HIV-infectedchildren. Colonization prevalence for the 3 serotypes (3, 6A, 19A) included in the 13-valent PCV but not in PCV10 increased from 12.4% (38/306) to 20.7% (36/174 fully vaccinated) (P = 0.009) among HIV- uninfected children, mainly driven by 19A; no significant increase was observed in HIV-infectedchildren. VT carriage among unvaccinated children decreased by 30% (P = 0.005) in HIV-infectedchildren, with no significant declines observed in HIV-uninfectedchildren. CONCLUSION: Declines in VT carriage were observed in both HIV-uninfected and HIV-infectedchildren after PCV10 introduction with an early signal of herd effect especially in HIV-infectedchildren. Ongoing monitoring of increases in 19A carriage and disease is necessary.
Authors: Fabiana C Pimenta; Benild Moiane; Fernanda C Lessa; Anne-Kathryn L Venero; Iaci Moura; Shanda Larson; Sergio Massora; Alberto Chaúque; Nelson Tembe; Helio Mucavele; Jennifer R Verani; Cynthia G Whitney; Betuel Sigaúque; Maria G S Carvalho Journal: BMC Pediatr Date: 2020-07-02 Impact factor: 2.125
Authors: Eleanor F G Neal; Stefan Flasche; Cattram D Nguyen; F Tupou Ratu; Eileen M Dunne; Lanieta Koyamaibole; Rita Reyburn; Eric Rafai; Mike Kama; Belinda D Ortika; Laura K Boelsen; Joseph Kado; Lisi Tikoduadua; Rachel Devi; Evelyn Tuivaga; Catherine Satzke; E Kim Mulholland; W John Edmunds; Fiona M Russell Journal: Vaccine Date: 2019-10-23 Impact factor: 3.641