engleski

Global burden of Streptococcus pneumoniae in children younger than 5 years in the pneumococcal conjugate vaccines (PCV) era: 2000-2015

Background and Aims: PCV is routinely used in more than 130 countries. To measure progress toward reducing the burden of pneumococcal disease and to inform prevention and treatment policies, we estimated country-specific morbidity and mortality of pneumococcal disease among children 1-59 months from 2000-2015. Method PCV clinical trial data were used to estimate the proportion of pneumonia cases and deaths attributable to pneumococcus. The proportion of meningitis deaths attributable to pneumococcus was derived from pathogen-specific meningitis case fatality and bacterial meningitis case etiology data from surveillance studies. We applied these proportions to WHO country- specific estimates of pneumonia deaths and cases and meningitis deaths from 2000-2015. The incidence and mortality of other invasive syndromes was estimated by the ratio of non- pneumonia, non-meningitis cases to meningitis cases. Disease burden estimates were adjusted for access to care and coverage of PCV and Hib vaccine. Estimates of vaccine effectiveness incorporated herd immunity and serotype replacement. Results We estimated 335, 000 pneumococcal deaths (uncertainty range: 240, 000-460, 000) in children 1-59 months in 2015, a decline from 670, 000 deaths (UR: 480, 000-920, 000) in 2000. Approximately 28, 000 pneumococcal deaths (UR: 20, 000-37, 000) in 2015 were in HIV-infected children. Ten countries in sub-Saharan Africa and Asia accounted for 65% of pneumococcal deaths in 2015. Conclusion Childhood pneumococcal deaths have declined by more than 50% from 2000 to 2015. They still cause 12% (UR: 9-16%) of all-cause deaths among children 1-59 months (excluding pneumococcal deaths in HIV-infected children) in 2015, warranting sustained and intensified efforts to reduce this burden further.

streptococcus pneumoniae children pneumococcal conjugate vaccines

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