The Burden of Invasive Bacterial Disease and the Impact of 10-Valent Pneumococcal Conjugate Vaccine in Children <5 years hospitalized for Meningitis in Lusaka, Zambia, 2010–2019. (1st September 2021)

• Record Type: Journal Article
• Authors: Yamba, Kaunda; Mpabalwani, Evans; Nakazwe, Ruth; Mulendele, Evans; Weldegebriel, Goitom; Mwenda, Jason M; Katsande, Reggis; de Gouveia, Linda; Chizema-Kawesha, Elizabeth; Chanda, Raphael; Matapo, Belem; Mwansa, James C L; Lukwesa-Musyani, Chileshe
• Is Part Of: Journal of infectious diseases. Volume 224:Supplement 3(2021)
• Page Start: S275
• Page End: S284
• Publication Date: 2021-09-01
• Subjects: Streptococcus pneumoniae -- Haemophilus influenzae -- Neisseria meningitidis -- Pneumococcal conjugate vaccine -- Zambia; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiab193
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Despite the availability of vaccines, invasive bacterial diseases remain a public health concern and cause childhood morbidity and mortality. We investigated the characteristics of etiological agents causing bacterial meningitis in children &lt;5 years in the years pre- (2010–2012) and post- (2014–2019) 10-valent pneumococcal conjugate vaccine (PCV10) introduction in Zambia. Methods: Streptococcus pneumoniae (Spn), Haemophilus influenzae (Hi), and Neisseria meningitidis (Nm) from cerebrospinal fluid (CSF) were identified by microbiological culture and/or real-time polymerase chain reaction. Results: During the surveillance period, a total of 3811 children were admitted with suspected meningitis, 16% (598 of 3811) of which were probable cases. Bacterial meningitis was confirmed in 37% (221 of 598) of the probable cases. Spn pneumoniae, Hi, and Nm accounted for 67% (148 of 221), 14% (31 of 221), and 19% (42 of 221) of confirmed cases, respectively. Thirty-six percent of pneumococcal meningitis was caused by 10-valent pneumococcal conjugate vaccine (PCV10) serotypes, 16% 13-valent pneumococcal conjugate vaccine and 39% by nonvaccine serotype (NVS). There was an association between the introduction of PCV10 vaccination and a decrease in both Spn meningitis and the proportion of PVC10 serotypes in the postvaccination period. Antimicrobial susceptibility of 47 Spn isolates revealed 34% (16 of 47) penicillin resistance. The 31 serotyped Hi accounted for 74% type b (Hib) and 10% type a (Hia). All 42 serogrouped Nm belonged to serogroup W. Conclusions: There was a decline in pneumococcal meningitis and proportion of PCV10 serotypes in the postvaccination period. However, the serotype replacement with non-PCV10 serotypes and penicillin resistance warrant continued surveillance to inform policy.