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Trends in Pneumococcal and Bacterial Meningitis in Brazil from 2007 to 2019

Cintia Irene Parellada1, Ariane de Jesus Lopes de Abreu2, Marina G Birck2

  • 1MSD Brazil, São Paulo 04583-110, Brazil.

Vaccines
|August 26, 2023
PubMed

Insights

Pneumococcal conjugate vaccination (PCV) reduced meningitis in Brazilian children but increased in adults. Expanding vaccination to older adults is recommended to reduce disease burden.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Pneumococcal conjugate vaccination (PCV) was implemented in Brazil's childhood program in 2010.
  • Universal pneumococcal vaccination for older adults remains unaddressed.
  • Streptococcus pneumoniae is a leading cause of bacterial meningitis, particularly in adults.

Purpose of the Study:

  • To analyze trends in pneumococcal meningitis incidence and case fatality rates (CFR) across all age groups in Brazil from 2007 to 2019.
  • To compare pre-PCV and post-PCV periods to assess the impact of vaccination.
  • To examine trends in overall bacterial meningitis to contextualize pneumococcal meningitis data.

Main Methods:

  • Utilized data from Brazil's National Surveillance System for bacterial and pneumococcal meningitis cases (2007-2019).
  • Employed joinpoint regression to analyze changes in incidence and CFR between pre-PCV (2007-2009) and post-PCV (2011-2019) periods.
  • Conducted comparative analyses of bacterial meningitis patterns and trends.

Main Results:

  • Over 13 years, 81,203 bacterial and 13,837 pneumococcal meningitis cases were recorded.
  • Post-PCV introduction, a 56.5% decrease in pediatric pneumococcal meningitis incidence was observed.
  • Adults showed an increasing trend in pneumococcal meningitis incidence, while CFR remained stable across most age groups.

Conclusions:

  • PCV significantly reduced pneumococcal meningitis in Brazilian children.
  • Increasing incidence in adults suggests a need for expanded vaccination strategies.
  • Recommendations include broadening PCV to older adults and utilizing vaccines with enhanced indirect protection.

Keywords:
Brazilepidemiologyinvasive pneumococcal diseasemeningitisvaccination

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