Effect of early measles vaccine on pneumococcal colonization: A randomized trial from Guinea-Bissau

Autor: Peter Aaby, Cesario Martins, Jørgen Skov Jensen, Stine Byberg, Christine Stabell Benn, Aksel Karl Georg Jensen, Lars Hervig Jacobsen, Nadja Skadkær Hansen, Hilton Whittle, Morten Bjerregaard-Andersen
Jazyk: angličtina
Rok vydání: 2017
Předmět:
0301 basic medicine
Male
RNA viruses
Pediatrics
Viral Diseases
Antibiotics
lcsh:Medicine
medicine.disease_cause
Pathology and Laboratory Medicine
Families
0302 clinical medicine
Prevalence
Medicine and Health Sciences
Colonization
Guinea-Bissau
Public and Occupational Health
030212 general & internal medicine
Poisson Distribution
lcsh:Science
Children
Vaccines
Multidisciplinary
Antimicrobials
Child Health
Drugs
Vaccination and Immunization
3. Good health
Anti-Bacterial Agents
Vaccination
Streptococcus pneumoniae
Infectious Diseases
Medical Microbiology
Viral Pathogens
Viruses
symbols
Female
Pathogens
Research Article
DNA
Bacterial
medicine.medical_specialty
Infectious Disease Control
medicine.drug_class
030106 microbiology
Measles Vaccine
Immunology
Parenting Behavior
Measles Virus
Real-Time Polymerase Chain Reaction
Microbiology
Pneumococcal Infections
03 medical and health sciences
symbols.namesake
Microbial Control
medicine
Journal Article
Humans
Poisson regression
Microbial Pathogens
Pharmacology
Behavior
Biology and life sciences
business.industry
lcsh:R
Bacterial pneumonia
Organisms
Infant
Correction
medicine.disease
Pneumococcal vaccine
Age Groups
Paramyxoviruses
People and Places
lcsh:Q
Population Groupings
Measles vaccine
Preventive Medicine
business
Measles
Zdroj: PLoS ONE
Hansen, N S, Byberg, S, Hervig Jacobsen, L, Andersen, M B, Jensen, A K G, Martins, C, Aaby, P, Skov Jensen, J, Stabell Benn, C & Whittle, H 2017, ' Effect of early measles vaccine on pneumococcal colonization : A randomized trial from Guinea-Bissau ', PLOS ONE, vol. 12, no. 5, e0177547 . https://doi.org/10.1371/journal.pone.0177547
PLoS ONE, Vol 12, Iss 5, p e0177547 (2017)
Skadkær Hansen, N, Byberg, S, Hervig Jacobsen, L, Bjerregaard-Andersen, M, Jensen, A K G, Martins, C, Aaby, P, Skov Jensen, J, Benn, C S & Whittle, H 2017, ' Effect of early measles vaccine on pneumococcal colonization : A randomized trial from Guinea-Bissau ', PLOS ONE, vol. 12, no. 5, e0177547, pp. 1-15 . https://doi.org/10.1371/journal.pone.0177547
ISSN: 1932-6203
Popis: BACKGROUND: Measles vaccine (MV) may have non-specific beneficial effects for child health and particularly seems to prevent respiratory infections. Streptococcus pneumoniae is the leading cause of bacterial pneumonia among children worldwide, and nasopharyngeal colonization precedes infection.OBJECTIVE: We investigated whether providing early MV at 18 weeks of age reduced pneumococcal colonization and/or density up to 9 months of age.METHOD: The study was conducted in 2013-2014 in Guinea-Bissau. Pneumococcal vaccine was not part of the vaccination program. Infants aged 18 weeks were block-randomized 2:1 to early or no early MV; at age 9 months, all children were offered MV as per current policy. Nasopharyngeal swabs were taken at baseline, age 6.5 months, and age 9 months. Pneumococcal density was determined by q-PCR. Prevalence ratios of pneumococcal colonization and recent antibiotic treatment (yes/no) by age 6.5 months (PR6.5) and age 9 months (PR9) were estimated using Poisson regression with robust variance estimates while the pneumococcal geometric mean ratio (GMR6.5 and GMR9) was obtained using OLS regression.RESULTS: Analyses included 512 children; 346 early MV-children and 166 controls. At enrolment, the pneumococcal colonization prevalence was 80% (411/512). Comparing early MV-children with controls, the PR6.5 was 1.02 (95%CI = 0.94-1.10), and the PR9 was 1.04 (0.96-1.12). The GMR6.5 was 1.02 (0.55-1.89), and the GMR9 was 0.69 (0.39-1.21). Early MV-children tended to be less frequently treated with antibiotics prior to follow up (PR6.5 0.60 (0.34-1.05) and PR9 0.87 (0.50-1.53)). Antibiotic treatment was associated with considerably lower colonization rates, PR6.5 0.85 (0.71-1.01) and PR9 0.66 (0.52-0.84), as well as lower pneumococcal density, GMR6.5 0.32 (0.12-0.86) and GMR9 0.52 (0.18-1.52).CONCLUSION: Early MV at age 18 weeks had no measurable effect on pneumococcal colonization prevalence or density. Higher consumption of antibiotics among controls may have blurred an effect of early MV.TRIAL REGISTRATION: clinicaltrials.gov NCT01486355.
Databáze: OpenAIRE
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