Abstract
BackgroundPneumonia is the major cause of death in children globally, with more than 900,000 deaths annually in children under five years of age. Streptococcus pneumoniae causes most deaths, most often in the form of community acquired pneumonia. Pneumococcal conjugate vaccines (PCVs) are currently being implemented in many low-income countries. PCVs decrease vaccine-type pneumococcal carriage, a prerequisite for invasive pneumococcal disease, and thereby affects pneumococcal disease and transmission. In Uganda, PCV was launched in 2014, but baseline data is lacking for pneumococcal serotypes in carriage.ObjectivesTo study pneumococcal nasopharyngeal carriage and serotype distribution in children under 5 years of age prior to PCV introduction in UgandaMethodsThree cross-sectional pneumococcal carriage surveys were conducted in 2008, 2009 and 2011, comprising respectively 150, 587 and 1024 randomly selected children aged less than five years from the Iganga/Mayuge Health and Demographic Surveillance Site. The caretakers were interviewed about illness history of the child and 1723 nasopharyngeal specimens were collected. From these, 927 isolates of S. pneumoniae were serotyped.ResultsOverall, the carriage rate of S. pneumoniae was 56% (957/1723). Pneumococcal carriage was associated with illness on the day of the interview (OR = 1.50, p = 0.04). The most common pneumococcal serotypes were in descending order 19F (16%), 23F (9%), 6A (8%), 29 (7%) and 6B (7%). One percent of the strains were non-typeable. The potential serotype coverage rate for PCV10 was 42% and 54% for PCV13.ConclusionAbout half of circulating pneumococcal serotypes in carriage in the Ugandan under-five population studied was covered by available PCVs.
Highlights
Since 1990, the global under-five mortality rate decreased by 53%, from 91 to 43 per 1,000 live births [1]
About half of circulating pneumococcal serotypes in carriage in the Ugandan under-five population studied was covered by available Pneumococcal conjugate vaccines (PCVs)
Data on pneumococcal carriage was missing in 20 children in 2009 and in 18 children in 2011 due to refusal to sampling, failure to take a sample at the end of the interview or sample lost in the laboratory handling
Summary
Since 1990, the global under-five mortality rate decreased by 53%, from 91 to 43 per 1,000 live births [1]. Pneumococcal nasopharyngeal carriage is a prerequisite for invasive pneumococcal disease (IPD) [8] and the nasopharynx, of young children, is considered the reservoir and the main source of pneumococcal transmission. A range of 35–93% of healthy children aged under five years in low-income countries has been shown to be colonized with pneumococci in the nasopharynx [9,10]. Pneumococcal conjugate vaccine (PCV) reduces vaccine-type pneumococcal carriage and thereby the dynamics of serotype transmission and pneumococcal disease [11]. Pneumococcal conjugate vaccines (PCVs) are currently being implemented in many low-income countries. PCVs decrease vaccine-type pneumococcal carriage, a prerequisite for invasive pneumococcal disease, and thereby affects pneumococcal disease and transmission. In Uganda, PCV was launched in 2014, but baseline data is lacking for pneumococcal serotypes in carriage
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
