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Continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in Ghana five years after introduction of 13-valent pneumococcal conjugate vaccine
BACKGROUND: Increases in pneumococcal meningitis were reported from Ghanaian regions that lie in the meningitis belt in 2016–2017, despite introduction of 13-valent pneumococcal conjugate vaccine (PCV13) in 2012 using a 3-dose schedule (6, 10, and 14 weeks). We describe pneumococcal meningitis epide...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128537/ https://www.ncbi.nlm.nih.gov/pubmed/30192772 http://dx.doi.org/10.1371/journal.pone.0203205 |
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author | Bozio, Catherine H. Abdul-Karim, Abass Abenyeri, John Abubakari, Braimah Ofosu, Winfred Zoya, Justina Ouattara, Mahamoudou Srinivasan, Velusamy Vuong, Jeni T. Opare, David Asiedu-Bekoe, Franklin Lessa, Fernanda C. |
author_facet | Bozio, Catherine H. Abdul-Karim, Abass Abenyeri, John Abubakari, Braimah Ofosu, Winfred Zoya, Justina Ouattara, Mahamoudou Srinivasan, Velusamy Vuong, Jeni T. Opare, David Asiedu-Bekoe, Franklin Lessa, Fernanda C. |
author_sort | Bozio, Catherine H. |
collection | PubMed |
description | BACKGROUND: Increases in pneumococcal meningitis were reported from Ghanaian regions that lie in the meningitis belt in 2016–2017, despite introduction of 13-valent pneumococcal conjugate vaccine (PCV13) in 2012 using a 3-dose schedule (6, 10, and 14 weeks). We describe pneumococcal meningitis epidemiology in the Ghanaian Northern and Upper West regions across two meningitis seasons. METHODS: Suspected meningitis cases were identified using World Health Organization standard definitions. Pneumococcal meningitis was confirmed if pneumococcus was the sole pathogen detected by polymerase chain reaction, culture, or latex agglutination in cerebrospinal fluid collected from a person with suspected meningitis during December 2015-March 2017. Pneumococcal serotyping was done using PCR. Annual age-specific pneumococcal meningitis incidence (cases per 100,000 population) was calculated, adjusting for suspected meningitis cases lacking confirmatory testing. FINDINGS: Among 153 pneumococcal meningitis cases, 137 (89.5%) were serotyped; 100 (73.0%) were PCV13-type, including 85 (62.0%) that were serotype 1, a PCV13-targeted serotype. Persons aged ≥5 years accounted for 96.7% (148/153) of cases. Comparing 2015–2016 and 2016–2017 seasons, the proportion of non-serotype 1 PCV13-type cases decreased from 20.0% (9/45) to 4.1% (3/74) (p = 0.008), whereas the proportion that was serotype 1 was stable (71.1% (32/45) vs. 58.1% (43/74); p = 0.16). Estimated adjusted pneumococcal meningitis incidence was 1.8 in children aged <5 years and ranged from 6.8–10.5 in older children and adults. CONCLUSIONS: High pneumococcal meningitis incidence with a large proportion of serotype 1 disease in older children and adults suggests infant PCV13 vaccination has not induced herd protection with this schedule in this high-transmission setting. |
format | Online Article Text |
id | pubmed-6128537 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-61285372018-09-15 Continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in Ghana five years after introduction of 13-valent pneumococcal conjugate vaccine Bozio, Catherine H. Abdul-Karim, Abass Abenyeri, John Abubakari, Braimah Ofosu, Winfred Zoya, Justina Ouattara, Mahamoudou Srinivasan, Velusamy Vuong, Jeni T. Opare, David Asiedu-Bekoe, Franklin Lessa, Fernanda C. PLoS One Research Article BACKGROUND: Increases in pneumococcal meningitis were reported from Ghanaian regions that lie in the meningitis belt in 2016–2017, despite introduction of 13-valent pneumococcal conjugate vaccine (PCV13) in 2012 using a 3-dose schedule (6, 10, and 14 weeks). We describe pneumococcal meningitis epidemiology in the Ghanaian Northern and Upper West regions across two meningitis seasons. METHODS: Suspected meningitis cases were identified using World Health Organization standard definitions. Pneumococcal meningitis was confirmed if pneumococcus was the sole pathogen detected by polymerase chain reaction, culture, or latex agglutination in cerebrospinal fluid collected from a person with suspected meningitis during December 2015-March 2017. Pneumococcal serotyping was done using PCR. Annual age-specific pneumococcal meningitis incidence (cases per 100,000 population) was calculated, adjusting for suspected meningitis cases lacking confirmatory testing. FINDINGS: Among 153 pneumococcal meningitis cases, 137 (89.5%) were serotyped; 100 (73.0%) were PCV13-type, including 85 (62.0%) that were serotype 1, a PCV13-targeted serotype. Persons aged ≥5 years accounted for 96.7% (148/153) of cases. Comparing 2015–2016 and 2016–2017 seasons, the proportion of non-serotype 1 PCV13-type cases decreased from 20.0% (9/45) to 4.1% (3/74) (p = 0.008), whereas the proportion that was serotype 1 was stable (71.1% (32/45) vs. 58.1% (43/74); p = 0.16). Estimated adjusted pneumococcal meningitis incidence was 1.8 in children aged <5 years and ranged from 6.8–10.5 in older children and adults. CONCLUSIONS: High pneumococcal meningitis incidence with a large proportion of serotype 1 disease in older children and adults suggests infant PCV13 vaccination has not induced herd protection with this schedule in this high-transmission setting. Public Library of Science 2018-09-07 /pmc/articles/PMC6128537/ /pubmed/30192772 http://dx.doi.org/10.1371/journal.pone.0203205 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication. |
spellingShingle | Research Article Bozio, Catherine H. Abdul-Karim, Abass Abenyeri, John Abubakari, Braimah Ofosu, Winfred Zoya, Justina Ouattara, Mahamoudou Srinivasan, Velusamy Vuong, Jeni T. Opare, David Asiedu-Bekoe, Franklin Lessa, Fernanda C. Continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in Ghana five years after introduction of 13-valent pneumococcal conjugate vaccine |
title | Continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in Ghana five years after introduction of 13-valent pneumococcal conjugate vaccine |
title_full | Continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in Ghana five years after introduction of 13-valent pneumococcal conjugate vaccine |
title_fullStr | Continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in Ghana five years after introduction of 13-valent pneumococcal conjugate vaccine |
title_full_unstemmed | Continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in Ghana five years after introduction of 13-valent pneumococcal conjugate vaccine |
title_short | Continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in Ghana five years after introduction of 13-valent pneumococcal conjugate vaccine |
title_sort | continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in ghana five years after introduction of 13-valent pneumococcal conjugate vaccine |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128537/ https://www.ncbi.nlm.nih.gov/pubmed/30192772 http://dx.doi.org/10.1371/journal.pone.0203205 |
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