Pre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.

<h4>Background</h4>Introduction of pneumococcal vaccines in Nigeria is a priority as part of the Accelerated Vaccine Introduction Initiative (AVI) of the Global Alliance for Vaccines and Immunisation (GAVI). However, country data on the burden of pneumococcal disease (IPD) is limited and...

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Autores principales:	Ifedayo M O Adetifa, Martin Antonio, Christy A N Okoromah, Chinelo Ebruke, Victor Inem, David Nsekpong, Abdoulie Bojang, Richard A Adegbola
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/42775354ec414975add48c018e217fcd
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spelling	oai:doaj.org-article:42775354ec414975add48c018e217fcd2021-11-18T07:29:28ZPre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.1932-620310.1371/journal.pone.0030548https://doaj.org/article/42775354ec414975add48c018e217fcd2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22291984/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Introduction of pneumococcal vaccines in Nigeria is a priority as part of the Accelerated Vaccine Introduction Initiative (AVI) of the Global Alliance for Vaccines and Immunisation (GAVI). However, country data on the burden of pneumococcal disease (IPD) is limited and coverage by available conjugate vaccines is unknown. This study was carried out to describe the pre vaccination epidemiology and population biology of pneumococcal carriage in Nigeria.<h4>Methods</h4>This was a cross sectional survey. Nasopharyngeal swabs (NPS) were obtained from a population sample in 14 contiguous peri-urban Nigerian communities. Data on demographic characteristics and risk factor for carriage were obtained from all study participants. Pneumococci isolated from NPS were characterised by serotyping, antimicrobial susceptibility and Multi Locus Sequencing Typing (MLST).<h4>Results</h4>The prevalence of pneumococcal carriage was 52.5%. Carriage was higher in children compared to adults (67.4% vs. 26%), highest (≈90%) in infants aged <9 months and reduced significantly with increasing age (P<0.001). Serotypes 19F (18.6%) and 6A (14.4%) were most predominant. Potential vaccine coverage was 43.8%, 45.0% and 62% for PCV-7, PCV-10 and PCV-13 respectively. There were 16 novel alleles, 72 different sequence types (STs) from the isolates and 3 Sequence Types (280, 310 and 5543) were associated with isolates of more than one serotype indicative of serotype switching. Antimicrobial resistance was high for cotrimoxazole (93%) and tetracycline (84%), a third of isolates had intermediate resistance to penicillin. Young age was the only risk factor significantly associated with carriage.<h4>Conclusions</h4>Pneumococcal carriage and serotype diversity is highly prevalent in Nigeria especially in infants. Based on the coverage of serotypes in this study, PCV-13 is the obvious choice to reduce disease burden and prevalence of drug resistant pneumococci. However, its use will require careful monitoring. Our findings provide sound baseline data for impact assessment following vaccine introduction in Nigeria.Ifedayo M O AdetifaMartin AntonioChristy A N OkoromahChinelo EbrukeVictor InemDavid NsekpongAbdoulie BojangRichard A AdegbolaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 1, p e30548 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ifedayo M O Adetifa Martin Antonio Christy A N Okoromah Chinelo Ebruke Victor Inem David Nsekpong Abdoulie Bojang Richard A Adegbola Pre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.
description	<h4>Background</h4>Introduction of pneumococcal vaccines in Nigeria is a priority as part of the Accelerated Vaccine Introduction Initiative (AVI) of the Global Alliance for Vaccines and Immunisation (GAVI). However, country data on the burden of pneumococcal disease (IPD) is limited and coverage by available conjugate vaccines is unknown. This study was carried out to describe the pre vaccination epidemiology and population biology of pneumococcal carriage in Nigeria.<h4>Methods</h4>This was a cross sectional survey. Nasopharyngeal swabs (NPS) were obtained from a population sample in 14 contiguous peri-urban Nigerian communities. Data on demographic characteristics and risk factor for carriage were obtained from all study participants. Pneumococci isolated from NPS were characterised by serotyping, antimicrobial susceptibility and Multi Locus Sequencing Typing (MLST).<h4>Results</h4>The prevalence of pneumococcal carriage was 52.5%. Carriage was higher in children compared to adults (67.4% vs. 26%), highest (≈90%) in infants aged <9 months and reduced significantly with increasing age (P<0.001). Serotypes 19F (18.6%) and 6A (14.4%) were most predominant. Potential vaccine coverage was 43.8%, 45.0% and 62% for PCV-7, PCV-10 and PCV-13 respectively. There were 16 novel alleles, 72 different sequence types (STs) from the isolates and 3 Sequence Types (280, 310 and 5543) were associated with isolates of more than one serotype indicative of serotype switching. Antimicrobial resistance was high for cotrimoxazole (93%) and tetracycline (84%), a third of isolates had intermediate resistance to penicillin. Young age was the only risk factor significantly associated with carriage.<h4>Conclusions</h4>Pneumococcal carriage and serotype diversity is highly prevalent in Nigeria especially in infants. Based on the coverage of serotypes in this study, PCV-13 is the obvious choice to reduce disease burden and prevalence of drug resistant pneumococci. However, its use will require careful monitoring. Our findings provide sound baseline data for impact assessment following vaccine introduction in Nigeria.
format	article
author	Ifedayo M O Adetifa Martin Antonio Christy A N Okoromah Chinelo Ebruke Victor Inem David Nsekpong Abdoulie Bojang Richard A Adegbola
author_facet	Ifedayo M O Adetifa Martin Antonio Christy A N Okoromah Chinelo Ebruke Victor Inem David Nsekpong Abdoulie Bojang Richard A Adegbola
author_sort	Ifedayo M O Adetifa
title	Pre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.
title_short	Pre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.
title_full	Pre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.
title_fullStr	Pre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.
title_full_unstemmed	Pre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.
title_sort	pre-vaccination nasopharyngeal pneumococcal carriage in a nigerian population: epidemiology and population biology.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/42775354ec414975add48c018e217fcd
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Pre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.

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