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Pneumococcal Carriage in Sub-Saharan Africa—A Systematic Review

BACKGROUND: Pneumococcal epidemiology varies geographically and few data are available from the African continent. We assess pneumococcal carriage from studies conducted in sub-Saharan Africa (sSA) before and after the pneumococcal conjugate vaccine (PCV) era. METHODS: A search for pneumococcal carr...

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Autores principales: Usuf, Effua, Bottomley, Christian, Adegbola, Richard A., Hall, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3896352/
https://www.ncbi.nlm.nih.gov/pubmed/24465464
http://dx.doi.org/10.1371/journal.pone.0085001
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author Usuf, Effua
Bottomley, Christian
Adegbola, Richard A.
Hall, Andrew
author_facet Usuf, Effua
Bottomley, Christian
Adegbola, Richard A.
Hall, Andrew
author_sort Usuf, Effua
collection PubMed
description BACKGROUND: Pneumococcal epidemiology varies geographically and few data are available from the African continent. We assess pneumococcal carriage from studies conducted in sub-Saharan Africa (sSA) before and after the pneumococcal conjugate vaccine (PCV) era. METHODS: A search for pneumococcal carriage studies published before 2012 was conducted to describe carriage in sSA. The review also describes pneumococcal serotypes and assesses the impact of vaccination on carriage in this region. RESULTS: Fifty-seven studies were included in this review with the majority (40.3%) from South Africa. There was considerable variability in the prevalence of carriage between studies (I-squared statistic = 99%). Carriage was higher in children and decreased with increasing age, 63.2% (95% CI: 55.6–70.8) in children less than 5 years, 42.6% (95% CI: 29.9–55.4) in children 5–15 years and 28.0% (95% CI: 19.0–37.0) in adults older than 15 years. There was no difference in the prevalence of carriage between males and females in 9/11 studies. Serotypes 19F, 6B, 6A, 14 and 23F were the five most common isolates. A meta-analysis of four randomized trials of PCV vaccination in children aged 9–24 months showed that carriage of vaccine type (VT) serotypes decreased with PCV vaccination; however, overall carriage remained the same because of a concomitant increase in non-vaccine type (NVT) serotypes. CONCLUSION: Pneumococcal carriage is generally high in the African continent, particularly in young children. The five most common serotypes in sSA are among the top seven serotypes that cause invasive pneumococcal disease in children globally. These serotypes are covered by the two PCVs recommended for routine childhood immunization by the WHO. The distribution of serotypes found in the nasopharynx is altered by PCV vaccination.
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spelling pubmed-38963522014-01-24 Pneumococcal Carriage in Sub-Saharan Africa—A Systematic Review Usuf, Effua Bottomley, Christian Adegbola, Richard A. Hall, Andrew PLoS One Research Article BACKGROUND: Pneumococcal epidemiology varies geographically and few data are available from the African continent. We assess pneumococcal carriage from studies conducted in sub-Saharan Africa (sSA) before and after the pneumococcal conjugate vaccine (PCV) era. METHODS: A search for pneumococcal carriage studies published before 2012 was conducted to describe carriage in sSA. The review also describes pneumococcal serotypes and assesses the impact of vaccination on carriage in this region. RESULTS: Fifty-seven studies were included in this review with the majority (40.3%) from South Africa. There was considerable variability in the prevalence of carriage between studies (I-squared statistic = 99%). Carriage was higher in children and decreased with increasing age, 63.2% (95% CI: 55.6–70.8) in children less than 5 years, 42.6% (95% CI: 29.9–55.4) in children 5–15 years and 28.0% (95% CI: 19.0–37.0) in adults older than 15 years. There was no difference in the prevalence of carriage between males and females in 9/11 studies. Serotypes 19F, 6B, 6A, 14 and 23F were the five most common isolates. A meta-analysis of four randomized trials of PCV vaccination in children aged 9–24 months showed that carriage of vaccine type (VT) serotypes decreased with PCV vaccination; however, overall carriage remained the same because of a concomitant increase in non-vaccine type (NVT) serotypes. CONCLUSION: Pneumococcal carriage is generally high in the African continent, particularly in young children. The five most common serotypes in sSA are among the top seven serotypes that cause invasive pneumococcal disease in children globally. These serotypes are covered by the two PCVs recommended for routine childhood immunization by the WHO. The distribution of serotypes found in the nasopharynx is altered by PCV vaccination. Public Library of Science 2014-01-20 /pmc/articles/PMC3896352/ /pubmed/24465464 http://dx.doi.org/10.1371/journal.pone.0085001 Text en © 2014 Usuf et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Usuf, Effua
Bottomley, Christian
Adegbola, Richard A.
Hall, Andrew
Pneumococcal Carriage in Sub-Saharan Africa—A Systematic Review
title Pneumococcal Carriage in Sub-Saharan Africa—A Systematic Review
title_full Pneumococcal Carriage in Sub-Saharan Africa—A Systematic Review
title_fullStr Pneumococcal Carriage in Sub-Saharan Africa—A Systematic Review
title_full_unstemmed Pneumococcal Carriage in Sub-Saharan Africa—A Systematic Review
title_short Pneumococcal Carriage in Sub-Saharan Africa—A Systematic Review
title_sort pneumococcal carriage in sub-saharan africa—a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3896352/
https://www.ncbi.nlm.nih.gov/pubmed/24465464
http://dx.doi.org/10.1371/journal.pone.0085001
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