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Rapid Decrease in Rates of Hospitalization Resulting From Invasive Pneumococcal Disease and Community-Acquired
Eduardo L López1, Eduardo Glatstein2, Gustavo C Ezcurra3
1Hospital de Niños "Ricardo Gutiérrez," Buenos Aires, Argentina.
Insights
Argentina
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health surveillance
Background:
- Argentina implemented universal pneumococcal vaccination in January 2012 using a 13-valent pneumococcal conjugate vaccine (PCV13).
- A 2+1 schedule and catch-up immunization were used for children under 2 years old.
- The study aimed to evaluate the impact of PCV13 on invasive pneumococcal disease (IPD) and community-acquired pneumonia (CAP) hospitalizations.
Purpose of the Study:
- To assess the burden of invasive pneumococcal disease (IPD) and community-acquired pneumonia (CAP) in hospitalized children under 5 years old.
- To compare disease burdens in the post-vaccination period (2012-2013) with the pre-vaccination period (2009-2011).
Main Methods:
- A multicenter, prospective, descriptive study was conducted across 5 pediatric reference centers in Argentina.
- Hospitalization rates per 10,000 admissions for IPD and/or CAP were analyzed.
- Clinical, epidemiological, and microbiological data were collected and statistically analyzed.
Main Results:
- Significant decreases in hospitalization rates for IPD and/or CAP were observed: 50% in 2012 (P = .003) and 51% in 2013 (P < .0001).
- Hospitalizations for empyema decreased by 39% (P = .03) and pneumococcal empyema by 67.8% (P = .007).
- Overall hospital stays for IPD and/or CAP reduced by 56%.
Conclusions:
- The introduction of PCV13 in Argentina led to rapid and significant reductions in IPD and CAP hospitalizations within the first two years.
- Further surveillance is needed to confirm these findings and the long-term effectiveness of the pneumococcal vaccination program.
Background:
In January 2012, Argentina included universal pneumococcal vaccination in the routine childhood vaccination program using a 13-valent pneumococcal conjugate vaccine (PCV13). A 2 + 1 schedule (2 doses in the first year of life and a booster dose at 12 months of age) in children aged <2 years and 2-dose catch-up immunization in children aged 13 to 24 months was administered during the first year of vaccine introduction. The purpose of this study was to assess the burdens of invasive pneumococcal disease (IPD) and/or community-acquired pneumonia (CAP) in hospitalized children younger than 5 years during the first 2 years of the program compared to those in the prevaccination period in our setting.
Methods:
This was a multicenter, prospective, and descriptive study. Rates of hospitalization resulting from IPD and/or CAP in 5 pediatric reference centers across the country were analyzed (every 10 000 admissions). Clinical, epidemiologic, and microbiological data were recorded. Statistical analysis using Stata 8.0 was performed.
Results:
A comparison of rates of hospitalization resulting from global IPD and/or CAP in the prevaccine (2009-2011) and postvaccine (2012-2013) periods revealed significant decreases of 50% (P = .003) and 51% (P < .0001), respectively. Significant decreases were also observed in number of hospitalizations resulting from empyema (39%; P = .03) and pneumococcal empyema (67.8%; P = .007); the reduction was not statistically significant for pneumococcal CAP (58%; P = .18). Hospital stays for IPD and/or CAP decreased by 56%.
Conclusion:
Rapid and significant decreases in the rates of hospitalization resulting from IPD and/or CAP during the first 2 years after PCV13 introduction were observed. A longer surveillance period is required to confirm these results and the effectiveness of the vaccination program.
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