Title |
Effectiveness of 13-pneumococcal conjugate vaccine (PCV13) against invasive pneumococcal disease in children in the Dominican Republic
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Published in |
BMC Infectious Diseases, April 2018
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DOI | 10.1186/s12879-018-3047-3 |
Pubmed ID | |
Authors |
Sara Tomczyk, Fernanda C. Lessa, Jacqueline Sánchez, Chabela Peña, Josefina Fernández, M. Gloria Carvalho, Fabiana Pimenta, Doraliza Cedano, Cynthia G. Whitney, Jennifer R. Verani, Hilma Coradin, Zacarías Garib, Lucia Helena De Oliveira, Jesús Feris-Iglesias |
Abstract |
Limited data are available on the effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) in resource-poor settings and PCV naïve populations. The Dominican Republic introduced PCV13 in September 2013 using a 2 + 1 schedule (2, 4, and 12 months) without a catch-up campaign. We evaluated PCV13 effectiveness against vaccine-type (VT) invasive pneumococcal disease (IPD) among children in the Dominican Republic. We conducted a matched case-control study. A case-patient was defined as VT-IPD identified by culture or polymerase chain reaction (PCR) from a normally sterile-site in a hospitalized child who was age-eligible to have received ≥1 PCV13 dose. Four age- and neighborhood-matched controls were enrolled for each case-patient. We collected demographic, vaccination history, and risk factor data. Conditional logistic regression was performed. Vaccine effectiveness was calculated as (1- adjusted matched odds ratio for vaccination) X 100%. We enrolled 39 case-patients and 149 matched-controls. Most case-patients had pneumonia with pleural effusion (64%), followed by meningitis (28%) and septicemia (13%). The most common pneumococcal serotypes identified included 14 (18%), 3 (13%), 19A (10%), and 1 (8%). Fewer case-patients had ≥1 PCV13 dose as compared to controls (61.5% vs. 80.0%; p = 0.006). Adjusting for malnutrition and socioeconomic status, VE of ≥1 PCV13 dose compared to no doses was 67.2% (95% CI: 2.3% to 90.0%). Only 44% of controls were up-to-date for PCV13, suggesting low vaccine coverage in the population. We found that PCV13 provided individual protection against VT-IPD in this resource-poor setting with a PCV-naïve population, despite low PCV13 coverage. Expanding vaccination coverage might increase PCV13 impact. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Venezuela, Bolivarian Republic of | 1 | 100% |
Demographic breakdown
Type | Count | As % |
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Scientists | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 54 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 9 | 17% |
Researcher | 8 | 15% |
Student > Master | 5 | 9% |
Student > Postgraduate | 4 | 7% |
Student > Ph. D. Student | 4 | 7% |
Other | 6 | 11% |
Unknown | 18 | 33% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 17 | 31% |
Nursing and Health Professions | 6 | 11% |
Biochemistry, Genetics and Molecular Biology | 2 | 4% |
Agricultural and Biological Sciences | 2 | 4% |
Psychology | 2 | 4% |
Other | 6 | 11% |
Unknown | 19 | 35% |