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Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study

The prevalence of Streptococcus pneumoniae (pneumococcus) carriage is higher in adults who are infected with human immunodeficiency virus (HIV) than in adults who are not. We hypothesized that infants exposed to HIV become carriers of nasopharyngeal pneumococcus earlier and more frequently than infa...

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Autores principales: Heinsbroek, Ellen, Tafatatha, Terence, Chisambo, Christina, Phiri, Amos, Mwiba, Oddie, Ngwira, Bagrey, Crampin, Amelia C., Read, Jonathan M., French, Neil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4690474/
https://www.ncbi.nlm.nih.gov/pubmed/26628514
http://dx.doi.org/10.1093/aje/kwv134
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author Heinsbroek, Ellen
Tafatatha, Terence
Chisambo, Christina
Phiri, Amos
Mwiba, Oddie
Ngwira, Bagrey
Crampin, Amelia C.
Read, Jonathan M.
French, Neil
author_facet Heinsbroek, Ellen
Tafatatha, Terence
Chisambo, Christina
Phiri, Amos
Mwiba, Oddie
Ngwira, Bagrey
Crampin, Amelia C.
Read, Jonathan M.
French, Neil
author_sort Heinsbroek, Ellen
collection PubMed
description The prevalence of Streptococcus pneumoniae (pneumococcus) carriage is higher in adults who are infected with human immunodeficiency virus (HIV) than in adults who are not. We hypothesized that infants exposed to HIV become carriers of nasopharyngeal pneumococcus earlier and more frequently than infants who are not exposed to HIV. We compared infant pneumococcal acquisition by maternal HIV status and household exposure in Karonga District, Malawi, in 2009–2011, before the introduction of pneumococcal conjugate vaccine. Nasopharyngeal swabs were collected every 4–6 weeks in the first year of life from infants with known HIV-exposure status, their mothers, and other household members. We studied infant pneumococcal acquisition by maternal HIV status, serotype-specific household exposure, and other risk factors, including seasonality. We recruited 54 infants who were exposed to HIV and 131 infants who were not. There was no significant difference in pneumococcal acquisition by maternal HIV status (adjusted rate ratio (aRR) = 1.00, 95% confidence interval (CI): 0.87, 1.15). Carriage by the mother was associated with greater acquisition of the same serotype (aRR = 3.09, 95% CI: 1.47, 6.50), but the adjusted population attributable fraction was negligible (1.9%, 95% CI: 0.0, 4.3). Serotype-specific exposure to children under 5 years of age was associated with higher acquisition (aRR = 4.30, 95% CI: 2.80, 6.60; adjusted population attributable fraction = 8.8%, 95% CI: 4.0, 13.4). We found no evidence to suggest that maternal HIV infection would affect the impact of pneumococcal vaccination on colonization in this population.
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spelling pubmed-46904742015-12-30 Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study Heinsbroek, Ellen Tafatatha, Terence Chisambo, Christina Phiri, Amos Mwiba, Oddie Ngwira, Bagrey Crampin, Amelia C. Read, Jonathan M. French, Neil Am J Epidemiol Original Contributions The prevalence of Streptococcus pneumoniae (pneumococcus) carriage is higher in adults who are infected with human immunodeficiency virus (HIV) than in adults who are not. We hypothesized that infants exposed to HIV become carriers of nasopharyngeal pneumococcus earlier and more frequently than infants who are not exposed to HIV. We compared infant pneumococcal acquisition by maternal HIV status and household exposure in Karonga District, Malawi, in 2009–2011, before the introduction of pneumococcal conjugate vaccine. Nasopharyngeal swabs were collected every 4–6 weeks in the first year of life from infants with known HIV-exposure status, their mothers, and other household members. We studied infant pneumococcal acquisition by maternal HIV status, serotype-specific household exposure, and other risk factors, including seasonality. We recruited 54 infants who were exposed to HIV and 131 infants who were not. There was no significant difference in pneumococcal acquisition by maternal HIV status (adjusted rate ratio (aRR) = 1.00, 95% confidence interval (CI): 0.87, 1.15). Carriage by the mother was associated with greater acquisition of the same serotype (aRR = 3.09, 95% CI: 1.47, 6.50), but the adjusted population attributable fraction was negligible (1.9%, 95% CI: 0.0, 4.3). Serotype-specific exposure to children under 5 years of age was associated with higher acquisition (aRR = 4.30, 95% CI: 2.80, 6.60; adjusted population attributable fraction = 8.8%, 95% CI: 4.0, 13.4). We found no evidence to suggest that maternal HIV infection would affect the impact of pneumococcal vaccination on colonization in this population. Oxford University Press 2016-01-01 2015-12-01 /pmc/articles/PMC4690474/ /pubmed/26628514 http://dx.doi.org/10.1093/aje/kwv134 Text en © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Contributions
Heinsbroek, Ellen
Tafatatha, Terence
Chisambo, Christina
Phiri, Amos
Mwiba, Oddie
Ngwira, Bagrey
Crampin, Amelia C.
Read, Jonathan M.
French, Neil
Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study
title Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study
title_full Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study
title_fullStr Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study
title_full_unstemmed Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study
title_short Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study
title_sort pneumococcal acquisition among infants exposed to hiv in rural malawi: a longitudinal household study
topic Original Contributions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4690474/
https://www.ncbi.nlm.nih.gov/pubmed/26628514
http://dx.doi.org/10.1093/aje/kwv134
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