| Autor: |
Naor Bar-Zeev, PhD, Todd D Swarthout, MSc, Dean B Everett, ProfPhD, Maaike Alaerts, PhD, Jacquline Msefula, BSc, Comfort Brown, Dipl, Sithembile Bilima, BSc, Jane Mallewa, MD, Carina King, PhD, Anne von Gottberg, ProfPhD, Jennifer R Verani, MD, Cynthia G Whitney, MD, Charles Mwansambo, FRCPCH, Stephen B Gordon, ProfPhD, Nigel A Cunliffe, ProfPhD, Neil French, ProfPhD, Robert S Heyderman, ProfPhD |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
The Lancet Global Health, Vol 9, Iss 7, Pp e989-e998 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
2214-109X |
| DOI: |
10.1016/S2214-109X(21)00165-0 |
| Popis: |
Summary: Background: The population impact of pneumococcal conjugate vaccines (PCVs) depends on direct and indirect protection. Following Malawi's introduction of the 13-valent PCV (PCV13) in 2011, we examined its impact on vaccine and non-vaccine serotype invasive pneumococcal disease among vaccine-eligible-age and vaccine-ineligible-age children and adults. Methods: We did a prospective observational time-series analysis and a case-control study. We used data from between Jan 1, 2006, and Dec 31, 2018, from laboratory-based surveillance at a government hospital in Malawi. This period included 6 years before and 7 years after introduction of PCV13. By use of negative-binomial regression, we evaluated secular trend-adjusted incidence rate ratio (IRR) in vaccine serotype and non-vaccine serotype invasive pneumococcal disease before and after introduction of PCV. We compared predicted counterfactual incidence in hypothetical absence of vaccine with empirically observed incidence following vaccine introduction. The case-control study assessed vaccine effectiveness, comparing PCV uptake among cases of vaccine-eligible-age invasive pneumococcal disease versus matched community controls. Findings: Surveillance covered 10 281 476 person-years of observation, with 140 498 blood and 63 291 cerebrospinal fluid cultures. A reduction in total (vaccine serotype plus non-vaccine serotype) invasive pneumococcal disease incidence preceded introduction of PCV: 19% (IRR 0·81, 95% CI 0·74 to 0·88, p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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