Prevalence of pneumococcal nasopharyngeal colonization and serotypes circulating in Cameroonian children after the 13-valent pneumococcal conjugate vaccine introduction.


Journal

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 02 04 2020
revised: 14 06 2020
accepted: 15 06 2020
pubmed: 21 6 2020
medline: 27 10 2020
entrez: 21 6 2020
Statut: ppublish

Résumé

Streptococcus pneumoniae remains a major contributor to childhood infections and deaths globally. In Cameroon, the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in July 2011, using a 3-dose Expanded programme on immunization (EPI) schedule administered to infants at 6, 10 and 14 weeks of age. To evaluate PCV13 effects, we assessed pneumococcal nasopharyngeal colonization and serotype distribution among Cameroonian children after PCV13 introduction. Nasopharyngeal (NP) swabs were collected from eligible children aged 24-36 months in two cross-sectional surveys conducted from March to July: in 2013 (PCV13-unvaccinated), and in 2015 (PCV13-vaccinated). Using a systematic World Health Organization (WHO) cluster coverage sampling technique in 40 communities, NP swabs collected were processed following WHO recommendations. Standard bacterial culture techniques were used for the isolation of S. pneumoniae from gentamicin-blood agar plates and identification using optochin susceptibility testing. Serotyping was performed using sequential multiplex polymerase chain reaction, supplemented with Quellung test. Among the PCV13-vaccinated children, overall pneumococcal carriage prevalence was 61.8% (426/689) and PCV13 vaccine-type carriage prevalence was 18.0% (123/689). Eleven out of the 13 vaccine serotypes were detected in the vaccinated children. The most common serotypes were 19F (4.5%, 31/689) and 15B/C (7.3%, 50/689). In Cameroon, four years after infant vaccination nearly all of the PCV13-serotypes continued to circulate in the population. This suggests that the direct and indirect effects of the vaccination programme have not resulted in expected low levels of vaccine-type transmission. Continuous monitoring is needed to assess the long term effects of the PCV13 on nasopharyngeal carriage and disease.

Sections du résumé

BACKGROUND BACKGROUND
Streptococcus pneumoniae remains a major contributor to childhood infections and deaths globally. In Cameroon, the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in July 2011, using a 3-dose Expanded programme on immunization (EPI) schedule administered to infants at 6, 10 and 14 weeks of age. To evaluate PCV13 effects, we assessed pneumococcal nasopharyngeal colonization and serotype distribution among Cameroonian children after PCV13 introduction.
METHODS METHODS
Nasopharyngeal (NP) swabs were collected from eligible children aged 24-36 months in two cross-sectional surveys conducted from March to July: in 2013 (PCV13-unvaccinated), and in 2015 (PCV13-vaccinated). Using a systematic World Health Organization (WHO) cluster coverage sampling technique in 40 communities, NP swabs collected were processed following WHO recommendations. Standard bacterial culture techniques were used for the isolation of S. pneumoniae from gentamicin-blood agar plates and identification using optochin susceptibility testing. Serotyping was performed using sequential multiplex polymerase chain reaction, supplemented with Quellung test.
RESULTS RESULTS
Among the PCV13-vaccinated children, overall pneumococcal carriage prevalence was 61.8% (426/689) and PCV13 vaccine-type carriage prevalence was 18.0% (123/689). Eleven out of the 13 vaccine serotypes were detected in the vaccinated children. The most common serotypes were 19F (4.5%, 31/689) and 15B/C (7.3%, 50/689).
CONCLUSION CONCLUSIONS
In Cameroon, four years after infant vaccination nearly all of the PCV13-serotypes continued to circulate in the population. This suggests that the direct and indirect effects of the vaccination programme have not resulted in expected low levels of vaccine-type transmission. Continuous monitoring is needed to assess the long term effects of the PCV13 on nasopharyngeal carriage and disease.

Identifiants

pubmed: 32562849
pii: S1201-9712(20)30483-5
doi: 10.1016/j.ijid.2020.06.048
pii:
doi:

Substances chimiques

13-valent pneumococcal vaccine 0
Pneumococcal Vaccines 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

113-120

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

John Njuma Libwea (J)

Health Sciences Unit, Faculty of Social Sciences, Tampere University, Finland; Expanded Programme on Immunization, Cameroon; National Institute for Health and Welfare (THL), Finland. Electronic address: libwea_j@yahoo.com.

Kirsi Gröndahl-Yli-Hannuksela (K)

Institute of Biomedicine, Research Center for Cancer, Infections and Immunity, University of Turku, Finland.

Marie Kobela (M)

Expanded Programme on Immunization, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon.

Maija Toropainen (M)

National Institute for Health and Welfare (THL), Finland.

Outi Nyholm (O)

National Institute for Health and Welfare (THL), Finland.

Paul Koki Ndombo (PK)

Mother & Child Center (MCH), Chantal Biya Foundation, Yaoundé, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon.

Sinata Koulla-Shiro (S)

Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon; Ministry of Public Health, Yaoundé, Cameroon.

Hanna Nohynek (H)

Health Sciences Unit, Faculty of Social Sciences, Tampere University, Finland; National Institute for Health and Welfare (THL), Finland.

J Pekka Nuorti (JP)

Health Sciences Unit, Faculty of Social Sciences, Tampere University, Finland; National Institute for Health and Welfare (THL), Finland.

Jaana Vuopio (J)

Institute of Biomedicine, Research Center for Cancer, Infections and Immunity, University of Turku, Finland.

Arto A Palmu (AA)

Health Sciences Unit, Faculty of Social Sciences, Tampere University, Finland; National Institute for Health and Welfare (THL), Finland.

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