Long-term impact of 10-valent pneumococcal conjugate vaccine in Kenya: Nasopharyngeal carriage among children in a rural and an urban site six years after introduction.

Autor: Verani JR; Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Atlanta, GA 30333, United States; Division of Global Health Protection, Centers for Disease Control and Prevention, PO Box 606-00621, Village Market, Nairobi, Kenya. Electronic address: jverani@cdc.gov., Omondi D; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya., Odoyo A; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya., Odiembo H; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya., Ouma A; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya., Ngambi J; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya., Aol G; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya., Audi A; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya., Kiplangat S; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya., Agumba N; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya., Munywoki PK; Division of Global Health Protection, Centers for Disease Control and Prevention, PO Box 606-00621, Village Market, Nairobi, Kenya., Onyango C; Division of Global Health Protection, Centers for Disease Control and Prevention, PO Box 606-00621, Village Market, Nairobi, Kenya., Hunsperger E; Division of Global Health Protection, Centers for Disease Control and Prevention, PO Box 606-00621, Village Market, Nairobi, Kenya., Farrar JL; Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Atlanta, GA 30333, United States., Kim L; Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Atlanta, GA 30333, United States., Kobayashi M; Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Atlanta, GA 30333, United States., Breiman RF; Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, United States; Infectious Diseases and Oncology Research Institute, University of the Witwatersrand, 29 Princess of Wales Terrace, Johannesburg 2050, South Africa., Pimenta FC; Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Atlanta, GA 30333, United States., da Gloria Carvalho M; Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Atlanta, GA 30333, United States., Lessa FC; Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Atlanta, GA 30333, United States., Whitney CG; Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Atlanta, GA 30333, United States; Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, United States., Bigogo G; Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box: 1578 - 40100, Kisumu, Kenya.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2024 Nov 14; Vol. 42 (25), pp. 126120. Date of Electronic Publication: 2024 Aug 14.
DOI: 10.1016/j.vaccine.2024.07.021
Abstrakt: Background: Kenya introduced Synflorix™ (GlaxoSmithKline, PCV10-GSK), a 10-valent pneumococcal conjugate vaccine, in 2011, using three primary doses and, in select areas, catch-up campaigns. Surveys conducted 1-2 years post-introduction showed a stable prevalence of pneumococcal colonization, with declines in vaccine-type carriage. However, little is known about the long-term impact of PCV10-GSK in Kenya.
Methods: We conducted a cross-sectional survey of pneumococcal carriage among children aged <5 years in November-December 2017 in Kibera (Nairobi informal settlement, no catch-up) and Asembo (rural western Kenya, 2-dose catch-up for children 1-4 years), using the same methods and settings as prior annual surveys from 2009 to 2013. Participants were randomly selected from an ongoing population-based surveillance platform. Nasopharyngeal swabs were frozen in skim milk-tryptone-glucose-glycerin media within 4 h and underwent culture with broth enrichment for pneumococcus. Isolates were serotyped by polymerase chain reaction and Quellung.
Results: We enrolled 504 children, including 252 from each site; >90 % of participants had received 3 doses of PCV10-GSK. Pneumococcal colonization was detected in 210 (83.3 %) participants in Kibera and 149 (59.1 %) in Asembo, which was significantly lower than the prevalence observed in 2013 (92.9 % and 85.7 %, respectively). PCV10-GSK serotypes were detected in 35/252 (13.9 %) participants in Kibera and 23/252 (9.1 %) in Asembo, respectively; these prevalences were lower, but not statistically different, from vaccine-type carriage prevalences in 2013 (17.3 % and 13.3 %, respectively). In 2017 in both sites, serotypes 3, 6A, 19A, 19F, and 35B were among the most common serotypes.
Conclusion: Six years post-PCV10-GSK introduction, the prevalence of pneumococcal carriage among children has decreased, and the impact of PCV10-GSK on vaccine-type carriage has plateaued. Kenya recently changed from PCV10-GSK to Pneumosil™ (Serum Institute of India), a 10-valent PCV that includes serotypes 6A and 19A; these data provide historical context for interpreting changes in vaccine-type carriage following the PCV formulation switch.
Competing Interests: 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.
(Published by Elsevier Ltd.)
Databáze: MEDLINE
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