Factors associated with pneumococcal carriage and density in children and adults in Fiji, using four cross-sectional surveys

Abstract

This study describes predictors of pneumococcal nasopharyngeal carriage and density in Fiji. We used data from four annual (2012-2015) cross-sectional surveys, pre-and postintroduction of ten-valent pneumococcal conjugate vaccine (PCV10) in October 2012. Infants (5-8 weeks), toddlers (12-23 months), children (2-6 years), and their caregivers participated. Pneumococci were detected and quantified using lytA qPCR, with molecular serotyping by microarray. Logistic and quantile regression were used to determine predictors of pneumococcal carriage and density, respectively. There were 8,109 participants. Pneumococcal carriage was negatively associated with years post-PCV10 introduction (global P<0.001), and positively associated with indigenous iTaukei ethnicity (aOR 2.74 [95% CI 2.17-3.45] P<0.001); young age (infant, toddler, and child compared with caregiver participant groups) (global P<0.001); urban residence (aOR 1.45 [95% CI 1.30-2.57] P<0.001); living with �2 children <5 years of age (aOR 1.42 [95% CI 1.27-1.59] P<0.001); low family income (aOR 1.44 [95% CI 1.28-1.62] P<0.001); and upper respiratory tract infection (URTI) symptoms (aOR 1.77 [95% CI 1.57-2.01] P<0.001). Predictors were similar for PCV10 and non-PCV10 carriage, except PCV10 carriage was negatively associated with PCV10 vaccination (0.58 [95% CI 0.41-0.82] P = 0.002) and positively associated with exposure to household cigarette smoke (aOR 1.21 [95% CI 1.02-1.43] P = 0.031), while there was no association between years post-PCV10 introduction and non-PCV10 carriage. Pneumococcal density was positively associated with URTI symptoms (adjusted median difference 0.28 [95% CI 0.16, 0.40] P<0.001) and toddler and child, compared with caregiver, participant groups (global P = 0.008). Predictors were similar for PCV10 and non-PCV10 density, except infant, toddler, and child participant groups were not associated with PCV10 density. PCV10 introduction was associated with reduced the odds of overall and PCV10 pneumococcal carriage in Fiji. However, after adjustment iTaukei ethnicity was positively

Direct and indirect effect of 10 valent pneumococcal vaccine on nasopharyngeal carriage in children under 2 years of age in Matiari, Pakistan

“…Pneumococcus became more easily detectable in the presence of rhinovirus infection [38] . In our study we found a negative association between ETS and VT carriage which is in contradiction with other reports [39] . Greenberg et al showed high rates of VT carriage in children exposed to tobacco smoke [40] .…”

Streptococcus pneumoniae Serotypes Carried by Young Children and Their Association With Acute Otitis Media During the Period 2016–2019

“…A possible explanation is that Sp transmission is high in Belgian DCCs, as high density of Sp in the nasopharynx is suggested to be a predictor of both transmission and disease probability ( 53 , 54 ). Dunne et al found that having upper respiratory tract infection symptoms was associated with an increased pneumococcal density ( 55 – 57 ). In the current study, 36.4% of children in DCCs presented common cold symptoms, which associates with the high pneumococcal density in DCC-children.…”

Streptococcus pneumoniaeserotypes carried by young children and their association with Acute Otitis Media during the period 2016 – 2019

“…high Sp density in the nasopharynx is suggested to be a predictor of transmission probability [50, 51] and of disease. Dunne et al found that having upper respiratory tract infection symptoms was associated with an increased pneumococcal density [52–54]. In Belgium, 36.4% of children in DCCs presented common cold symptoms, which associates with the high pneumococcal density in DCC-children.…”