Community acquired pneumonia incidence among children less than 5 years of age in Concordia, Argentina: vaccination impact

Abstract

Objective To measure the effectiveness of pneumococcal conjugated vaccine (PCV13) against Community Acquired Pneumonia (CAP) and invasive pneumococcal disease, 2 years after the vaccine (2+1) was included into the National Immunization Program of Argentina, and to describe variables associated with bacterial pneumonia and hospitalization. Methods This was a prospective, population-based surveillance study of CAP incidence (ambulatory and hospitalized) among children less than 5 years of age in the Department of Concordia (Entre Rios, Argentina) from April 2014 – March 2016. The diagnosis of probable bacterial pneumonia (PBP) was determined following the standardized WHO protocol. Incidence during the post-vaccine introduction period was compared with the results from a previous study that used similar methodology for the pre-PCV13 introduction period from 2002 – 2005. Results During the study period, 330 patients had a clinical diagnosis of CAP, of which 92 were PBP (6 with pleural effusion). S. pneumoniae was not isolated from any sample. No factors associated with PBP were found in multivariable analysis. The decrease in PBP and pleural effusion was significant in relation to the previous study: 63% (P < 0.0001) and 80.9% (P < 0.003), respectively. PCV13 uptake was 97.3% for the 1st dose and 84.8% for the booster dose. Conclusions PCV13 was effective to reduce incidence of consolidated pneumonia and pleural effusion, among children less than 5 years of age in Concordia, Argentina. Vaccination is a very effective public health strategy for reducing vaccine preventable diseases, with impact on burden of disease and hospitalization.

Systematic review on the impact of the pneumococcal conjugate vaccine ten valent (PCV10) or thirteen valent (PCV13) on all-cause, radiologically confirmed and severe pneumonia hospitalisation rates and pneumonia mortality in children 0-9 years old

“…When we considered these eight studies, which included age groups below 10 years of age, the median decline in radiologically confirmed pneumonia hospitalisation was 38% (range = 12% [ 33 ] to 79% [ 51 ]). Study results by age group were: for age group <12 months, median = 50% (range = 23% [ 40 ] to 53% [ 49 ]); for age group 12-23 months, median = 29% (range = 25% [ 33 ] to 70% [ 49 ]); for age group 24-59 months, median = 60% (range = 12% [ 33 ] to 79% [ 51 ]); for age group <5 years, median = 48% (range = 22% [ 40 ] to 70% [ 51 ]); and there were no vaccine impact studies for the 5-9 years age group. Four studies among age groups <12 months, 12-23 months, 24-59 months, 5-10 years, and 5-14 years showed no change.…”

“…Eight included studies evaluated the PCV10 or PCV13 on radiologically confirmed pneumonia hospitalisations [16,33,40,41,[48][49][50][51] (Table S6 in the Online Supplementary Document). All but two [48,50] specified that they used the WHO-defined radiologically confirmed pneumonia definition [52].…”

Doenças infecciosas: inovações e aprendizados para área médica

“…2, p. 583, 2016). Na América Latina e Caribe, estimou-se alta mortalidade por PAC em crianças, com Streptococcus pneumoniae representando a grande maioria da etiologia bacteriana desses casos (RUVINSKY et al, 2018).…”

“…A vacinação é uma estratégia de saúde pública muito efetiva para reduzir doenças que podem ser evitadas com vacina, com impacto na morbidade e nas internações hospitalares (RUVINSKY et al, 2018). Intervenções, incluindo medidas preventivas, como as vacinas conjugadas contra Haemophilus influenzae tipo b e pneumococo (23-valente não conjugada), e estratégias de condução terapêutica, como as diretrizes da Organização Mundial da Saúde (OMS) para o Manejo Integrado de Doenças Prevalentes na Infância (AI-DPI), causaram declínio constante na incidência e mortalidade por pneumonia (Sociedade Brasileira de Pediatria, 2021).…”