Abstract
Background: This study aimed to summarise the evidence on the impact of routine administration of 10-valent and 13-valent pneumococcal conjugate vaccines on pneumonia in children under five years of age in sub-Saharan Africa. Methods: A systematic search of the literature was conducted including primary research reporting on the impact of 10- or 13-valent pneumococcal vaccines on childhood pneumonia in a sub-Saharan African country. Case-control, cohort, pre-post and time-series study designs were eligible for inclusion. Thematic narrative synthesis was carried out to summarise the findings. Results: Eight records were included in the final analysis, 6 records were pre-post or time-series studies, 1 was a case-control study and 1 report combined pre-post and case-control studies. Vaccine impact on clinical pneumonia measured as percentage reduction in risk (%RR) was mostly non-significant. The reduction in risk was more consistent in radiological and pneumococcal pneumonia. Conclusions: Evidence of the positive impact of routine infant pneumococcal vaccination on clinical pneumonia incidence in sub-Saharan Africa is inconclusive. Ongoing surveillance and further research is required to establish the long term trend in pneumonia epidemiology and aetiology after PCV introduction. PROSPERO registration: CRD42019142369 30/09/19.
Highlights
Pneumonia is one of the leading causes of childhood deaths globally, in sub-Saharan Africa[1]
This review aims to summarise the existing evidence on the impact of routine administration of pneumococcal conjugate vaccines on clinical pneumonia, radiological pneumonia and pneumococcal pneumonia in children under five years of age in sub-Saharan Africa
Eligibility criteria We included primary, individual and population-based studies conducted in sub-Saharan Africa evaluating 10-valent or 13-valent Pneumococcal conjugate vaccines (PCV) impact in children published in English since 1 January 2010
Summary
Pneumonia is one of the leading causes of childhood deaths globally, in sub-Saharan Africa[1]. Over a 100 million cases of pneumonia are reported in children less than five years of age, mostly in poor countries in Africa and Asia[2,3,4]. This study aimed to summarise the evidence on the impact of routine administration of 10-valent and 13-valent pneumococcal conjugate vaccines on pneumonia in children under five years of age in sub-Saharan Africa. Methods: A systematic search of the literature was conducted including primary research reporting on the impact of 10- or 13-valent pneumococcal vaccines on childhood pneumonia in a sub-Saharan African country. Conclusions: Evidence of the positive impact of routine infant pneumococcal vaccination on clinical pneumonia incidence in subSaharan Africa is inconclusive.
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