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Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study

BACKGROUND: Pneumonia is a leading cause of childhood mortality with Streptococcus pneumoniae a major contributor. Pneumococcal conjugate vaccines (PCVs) have been introduced into immunisation programs in many low- to middle-income countries (LMICs) yet there is a paucity of data evaluating the effe...

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Autores principales: Blyth, Christopher C, Britton, Kathryn J, Nguyen, Cattram D, Sapura, Joycelyn, Kave, John, Nivio, Birunu, Chan, Jocelyn, Satzke, Catherine, Ford, Rebecca, Kirarock, Wendy, Lehmann, Deborah, Pomat, William, Russell, Fiona M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8927990/
https://www.ncbi.nlm.nih.gov/pubmed/35308576
http://dx.doi.org/10.1016/j.lanwpc.2022.100432
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author Blyth, Christopher C
Britton, Kathryn J
Nguyen, Cattram D
Sapura, Joycelyn
Kave, John
Nivio, Birunu
Chan, Jocelyn
Satzke, Catherine
Ford, Rebecca
Kirarock, Wendy
Lehmann, Deborah
Pomat, William
Russell, Fiona M
author_facet Blyth, Christopher C
Britton, Kathryn J
Nguyen, Cattram D
Sapura, Joycelyn
Kave, John
Nivio, Birunu
Chan, Jocelyn
Satzke, Catherine
Ford, Rebecca
Kirarock, Wendy
Lehmann, Deborah
Pomat, William
Russell, Fiona M
author_sort Blyth, Christopher C
collection PubMed
description BACKGROUND: Pneumonia is a leading cause of childhood mortality with Streptococcus pneumoniae a major contributor. Pneumococcal conjugate vaccines (PCVs) have been introduced into immunisation programs in many low- to middle-income countries (LMICs) yet there is a paucity of data evaluating the effectiveness in these settings. We assess the effectiveness of 13-valent PCV (13vPCV) against hypoxic pneumonia, hospitalisation and other clinical endpoints in children <5 years living in Eastern Highlands Province, Papua New Guinea (PNG). METHODS: Data from two consecutive prospective observational studies (2013–2019) enrolling children <60 months presenting with pneumonia were included. Hypoxic pneumonia was defined as oxygen saturations <90%. Outcomes included hospitalisation, severe clinical pneumonia and death. 13vPCV status was determined using written records. Logistic regression models were used to estimate the odds ratios of key outcomes by 13vPCV vaccination status adjusted for confounders using inverse probability of treatment weighting. FINDINGS: Data from 2067 children (median age; 9 months [IQR: 5–11]) were included. 739 children (36.1%) were hypoxic and 623 (30.4%) hospitalised. Twelve children (0.6% of total cohort) died in hospital. 670 children (32.7%) were fully 13vPCV-vaccinated. 13vPCV vaccination was associated with a 28.7% reduction (95% confidence interval [CI]: 9.9; 43.6%) in hypoxic pneumonia and a 57.4% reduction (38.0; 70.7%) in pneumonia hospitalisation. INTERPRETATION: 13vPCV vaccination is effective against hypoxic pneumonia and pneumonia hospitalisation in PNG children. Strategies to improve access to and coverage of 13vPCV in PNG and other similar LMICs are urgently required. FUNDING: Funded by Pfizer Global and the Bill & Melinda Gates Foundation.
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spelling pubmed-89279902022-03-18 Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study Blyth, Christopher C Britton, Kathryn J Nguyen, Cattram D Sapura, Joycelyn Kave, John Nivio, Birunu Chan, Jocelyn Satzke, Catherine Ford, Rebecca Kirarock, Wendy Lehmann, Deborah Pomat, William Russell, Fiona M Lancet Reg Health West Pac Articles BACKGROUND: Pneumonia is a leading cause of childhood mortality with Streptococcus pneumoniae a major contributor. Pneumococcal conjugate vaccines (PCVs) have been introduced into immunisation programs in many low- to middle-income countries (LMICs) yet there is a paucity of data evaluating the effectiveness in these settings. We assess the effectiveness of 13-valent PCV (13vPCV) against hypoxic pneumonia, hospitalisation and other clinical endpoints in children <5 years living in Eastern Highlands Province, Papua New Guinea (PNG). METHODS: Data from two consecutive prospective observational studies (2013–2019) enrolling children <60 months presenting with pneumonia were included. Hypoxic pneumonia was defined as oxygen saturations <90%. Outcomes included hospitalisation, severe clinical pneumonia and death. 13vPCV status was determined using written records. Logistic regression models were used to estimate the odds ratios of key outcomes by 13vPCV vaccination status adjusted for confounders using inverse probability of treatment weighting. FINDINGS: Data from 2067 children (median age; 9 months [IQR: 5–11]) were included. 739 children (36.1%) were hypoxic and 623 (30.4%) hospitalised. Twelve children (0.6% of total cohort) died in hospital. 670 children (32.7%) were fully 13vPCV-vaccinated. 13vPCV vaccination was associated with a 28.7% reduction (95% confidence interval [CI]: 9.9; 43.6%) in hypoxic pneumonia and a 57.4% reduction (38.0; 70.7%) in pneumonia hospitalisation. INTERPRETATION: 13vPCV vaccination is effective against hypoxic pneumonia and pneumonia hospitalisation in PNG children. Strategies to improve access to and coverage of 13vPCV in PNG and other similar LMICs are urgently required. FUNDING: Funded by Pfizer Global and the Bill & Melinda Gates Foundation. Elsevier 2022-03-15 /pmc/articles/PMC8927990/ /pubmed/35308576 http://dx.doi.org/10.1016/j.lanwpc.2022.100432 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Articles
Blyth, Christopher C
Britton, Kathryn J
Nguyen, Cattram D
Sapura, Joycelyn
Kave, John
Nivio, Birunu
Chan, Jocelyn
Satzke, Catherine
Ford, Rebecca
Kirarock, Wendy
Lehmann, Deborah
Pomat, William
Russell, Fiona M
Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study
title Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study
title_full Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study
title_fullStr Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study
title_full_unstemmed Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study
title_short Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study
title_sort effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in eastern highlands province, papua new guinea: an observational cohort study
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8927990/
https://www.ncbi.nlm.nih.gov/pubmed/35308576
http://dx.doi.org/10.1016/j.lanwpc.2022.100432
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