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. 2019 Dec 3;37(51):7470-7477.
doi: 10.1016/j.vaccine.2019.09.079. Epub 2019 Sep 28.

Invasive disease potential of Streptococcus pneumoniae serotypes before and after 10-valent pneumococcal conjugate vaccine introduction in a rural area, southern Mozambique

Sérgio Massora  1 , Fernanda C Lessa  2 , Benild Moiane  3 , Fabiana C Pimenta  4 , Hélio Mucavele  5 , Alberto Chaúque  6 , Anélsio Cossa  7 , Jennifer R Verani  8 , Nelson Tembe  9 , Maria da Gloria Carvalho  10 , Carmen Muñoz-Almagro  11 , Betuel Sigaúque  12
Affiliations

Invasive disease potential of Streptococcus pneumoniae serotypes before and after 10-valent pneumococcal conjugate vaccine introduction in a rural area, southern Mozambique

Sérgio Massora et al. Vaccine. .

Abstract

Background: Invasive pneumococcal disease (IPD) is a significant cause of morbidity and mortality among children worldwide. In April 2013, Mozambique introduced 10-valent PCV (PCV10) into the National Expanded Program on immunization using a three-dose schedule at 2, 3, and 4 months of age. We aimed to evaluate the invasive disease potential of pneumococcal serotypes among children in our region before and after PCV10 introduction.

Methods: We used data from ongoing population-based surveillance for IPD and cross-sectional pneumococcal carriage surveys among children aged <5 years in Manhiҫa, Mozambique. To determine the invasive disease potential for each serotype pre- and post-PCV10 introduction, odds ratios (OR) and 95% confidence intervals (95% CI) were calculated comparing serotype-specific prevalence in IPD and in carriage. For each serotype, OR and 95% CI > 1 indicated high invasive disease potential and OR and 95% CI < 1 indicated low invasive disease potential.

Results: In the pre-PCV10 period, 524 pneumococcal isolates were obtained from 411 colonized children and IPD cases were detected in 40 children. In the post-PCV10 period, 540 pneumococcal isolates were obtained from 507 colonized children and IPD cases were detected in 30 children. The most prevalent serotypes causing IPD pre-PCV10 were 6A (17.5%), 6B (15.0%), 14 (12.5%), 23F (10.0%) and 19F (7.5%), and post-PCV10 were 6A (36.7%), 13 (10%), 1 (10.0%), 6B (6.7%) and 19A (6.7%). Serotypes associated with high invasive disease potential pre-PCV10 included 1 (OR:22.3 [95% CI 2.0; 251.2]), 6B (OR:3.1 [95% CI 1.2; 8.1]), 14 (OR: 3.4 [95% CI 1.2; 9.8]) and post-PCV10 included serotype 6A (OR:6.1[95% CI 2.7; 13.5]).

Conclusion: The number of serotypes with high invasive disease potential decreased after PCV10 introduction. Serotype 6A, which is not included in PCV10, was the most common cause of IPD throughout the study and showed a high invasive potential in the post-PCV10 period.

Keywords: Invasive disease potential; Invasive pneumococcal disease; Nasopharyngeal carriage; Pneumococcal conjugate vaccine.

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Conflict of interest statement

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1.
Fig. 1.
Incidence of invasive pneumococcal disease by serotype pre-PCV10 (2012–2013) and post-PCV10 (2014–2015) introduction in Mozambique.
Fig. 2.
Fig. 2.
Serotype distribution of nasopharyngeal pneumococcal colonization and invasive pneumococcal disease isolates pre-PCV10 (2012–2013 and post-PCV10 (2014–2015) introduction in Mozambique. (PCV10 serotypes: 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F and 23F/PCV13 serotypes: 3, 6A, 19A, and PCV10 serotypes).
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References

    1. O’Brien KL, Wolfson LJ, Watt JP, Henkle E, Deloria-Knoll M, McCall N, et al. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet 2009;374:893–902. 10.1016/50140-6736(09)61204-6. - DOI - PubMed
    1. Wahl B, O’Brien KL, Greenbaum A, Majumder A, Liu L, Chu Y, et al. Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000–15. Lancet Glob Heal 2018;6:e744–57. 10.1016/S2214-109X(18)30247-X. - DOI - PMC - PubMed
    1. Simell B, Auranen K, Käyhty H, Goldblatt D, Dagan R, O’Brien KL. The fundamental link between pneumococcal carriage and disease. Exp Rev Vacc 2012;11:841–55. 10.1586/erv.12.53. - DOI - PubMed
    1. Sigauque B, Verani J, Massora S, Vubil D, Acacio S, Nhampossa T, et al. Burden of invasive pneumococcal disease among children in rural Mozambique: 2001–2012. PLoS ONE 2018;13:1–13. - PMC - PubMed
    1. Bogaert D, De Groot R, Hermans PWM. Streptococcus pneumoniae colonisation: the key to pneumococcal disease. Lancet Infect Dis 2004;4:144–54. 10.1016/S1473-3099(04)00938-7. - DOI - PubMed

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