Declines in Pneumonia and Meningitis Hospitalizations in Children Under 5 Years of Age After Introduction of 10-Valent Pneumococcal Conjugate Vaccine in Zambia, 2010–2016

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Mpabalwani, Evans M ; Lukwesa-Musyani, Chileshe ; Imamba, Akakambama ; Nakazwe, Ruth ; Matapo, Belem ; Muzongwe, Chilweza M ; Mufune, Trust ; Soda, Elizabeth ; Mwenda, Jason M ; Lutz, Chelsea S ; Pondo, Tracy ; Lessa, Fernanda C
• Description:
  Background
  
  Pneumococcus is a leading cause of pneumonia and meningitis. Zambia introduced a 10-valent pneumococcal conjugate vaccine (PCV10) in July 2013 using a 3-dose primary series at ages 6, 10, and 14 weeks with no booster. We evaluated the impact of PCV10 on meningitis and pneumonia hospitalizations.
  
  Methods
  
  Using hospitalization data from first-level care hospitals, available at the Ministry of Health, and from the largest pediatric referral hospital in Lusaka, we identified children aged <5 years who were hospitalized with pneumonia or meningitis from January 2010–December 2016. We used time-series analyses to measure the effect of PCV10 on monthly case counts by outcome and age group (<1 year, 1–4 years), accounting for seasonality. We defined the pre- and post-PCV10 periods as January 2010–June 2013 and July 2014–December 2016, respectively.
  
  Results
  
  At first-level care hospitals, pneumonia and meningitis hospitalizations among children aged <5 years accounted for 108 884 and 1742 admissions in the 42 months pre-PCV10, respectively, and 44 715 and 646 admissions in the 30 months post-PCV10, respectively. Pneumonia hospitalizations declined by 37.8% (95% confidence interval [CI] 21.4–50.3%) and 28.8% (95% CI 17.7–38.7%) among children aged <1 year and 1–4 years, respectively, while meningitis hospitalizations declined by 72.1% (95% CI 63.2–79.0%) and 61.6% (95% CI 50.4–70.8%), respectively, in these age groups. In contrast, at the referral hospital, pneumonia hospitalizations remained stable and a smaller but significant decline in meningitis was observed among children aged 1–4 years (39.3%, 95% CI 16.2–57.5%).
  
  Conclusions
  
  PCV10 introduction was associated with declines in meningitis and pneumonia hospitalizations in Zambia, especially in first-level care hospitals.
  
  
• Subjects:
  Child, Preschool Hospitalization Hospitals, Pediatric Humans Immunization Programs Infant Medical Records Meningitis, Bacterial Pneumococcal Vaccines Pneumonia, Pneumococcal
• Source:
  Clin Infect Dis. 2019; 69(Suppl 2):S58-S65
• Pubmed ID:
  31505628
• Pubmed Central ID:
  PMC6761309
• Document Type:
  Journal Article
• Funding:
  001/World Health Organization/International
• Place as Subject:
  Zambia
• Volume:
  69
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:b63c58759e5e0d3a0c6df2f95b4b0dff16942324034095f8c9a4b2c141f97dfd
• Download URL:
  https://stacks.cdc.gov/view/cdc/90848/cdc_90848_DS1.pdf
• File Type:
  [PDF - 1.52 MB ]