Pneumococcal carriage in sub-Saharan Africa--a systematic review.

<h4>Background</h4>Pneumococcal epidemiology varies geographically and few data are available from the African continent. We assess pneumococcal carriage from studies conducted in sub-Saharan Africa (sSA) before and after the pneumococcal conjugate vaccine (PCV) era.<h4>Methods<...

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Autores principales:	Effua Usuf, Christian Bottomley, Richard A Adegbola, Andrew Hall
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bf9c04cbfc014f8cb3ca8c0a81eda276
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spelling	oai:doaj.org-article:bf9c04cbfc014f8cb3ca8c0a81eda2762021-11-18T08:37:19ZPneumococcal carriage in sub-Saharan Africa--a systematic review.1932-620310.1371/journal.pone.0085001https://doaj.org/article/bf9c04cbfc014f8cb3ca8c0a81eda2762014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24465464/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Pneumococcal epidemiology varies geographically and few data are available from the African continent. We assess pneumococcal carriage from studies conducted in sub-Saharan Africa (sSA) before and after the pneumococcal conjugate vaccine (PCV) era.<h4>Methods</h4>A search for pneumococcal carriage studies published before 2012 was conducted to describe carriage in sSA. The review also describes pneumococcal serotypes and assesses the impact of vaccination on carriage in this region.<h4>Results</h4>Fifty-seven studies were included in this review with the majority (40.3%) from South Africa. There was considerable variability in the prevalence of carriage between studies (I-squared statistic = 99%). Carriage was higher in children and decreased with increasing age, 63.2% (95% CI: 55.6-70.8) in children less than 5 years, 42.6% (95% CI: 29.9-55.4) in children 5-15 years and 28.0% (95% CI: 19.0-37.0) in adults older than 15 years. There was no difference in the prevalence of carriage between males and females in 9/11 studies. Serotypes 19F, 6B, 6A, 14 and 23F were the five most common isolates. A meta-analysis of four randomized trials of PCV vaccination in children aged 9-24 months showed that carriage of vaccine type (VT) serotypes decreased with PCV vaccination; however, overall carriage remained the same because of a concomitant increase in non-vaccine type (NVT) serotypes.<h4>Conclusion</h4>Pneumococcal carriage is generally high in the African continent, particularly in young children. The five most common serotypes in sSA are among the top seven serotypes that cause invasive pneumococcal disease in children globally. These serotypes are covered by the two PCVs recommended for routine childhood immunization by the WHO. The distribution of serotypes found in the nasopharynx is altered by PCV vaccination.Effua UsufChristian BottomleyRichard A AdegbolaAndrew HallPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e85001 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Effua Usuf Christian Bottomley Richard A Adegbola Andrew Hall Pneumococcal carriage in sub-Saharan Africa--a systematic review.
description	<h4>Background</h4>Pneumococcal epidemiology varies geographically and few data are available from the African continent. We assess pneumococcal carriage from studies conducted in sub-Saharan Africa (sSA) before and after the pneumococcal conjugate vaccine (PCV) era.<h4>Methods</h4>A search for pneumococcal carriage studies published before 2012 was conducted to describe carriage in sSA. The review also describes pneumococcal serotypes and assesses the impact of vaccination on carriage in this region.<h4>Results</h4>Fifty-seven studies were included in this review with the majority (40.3%) from South Africa. There was considerable variability in the prevalence of carriage between studies (I-squared statistic = 99%). Carriage was higher in children and decreased with increasing age, 63.2% (95% CI: 55.6-70.8) in children less than 5 years, 42.6% (95% CI: 29.9-55.4) in children 5-15 years and 28.0% (95% CI: 19.0-37.0) in adults older than 15 years. There was no difference in the prevalence of carriage between males and females in 9/11 studies. Serotypes 19F, 6B, 6A, 14 and 23F were the five most common isolates. A meta-analysis of four randomized trials of PCV vaccination in children aged 9-24 months showed that carriage of vaccine type (VT) serotypes decreased with PCV vaccination; however, overall carriage remained the same because of a concomitant increase in non-vaccine type (NVT) serotypes.<h4>Conclusion</h4>Pneumococcal carriage is generally high in the African continent, particularly in young children. The five most common serotypes in sSA are among the top seven serotypes that cause invasive pneumococcal disease in children globally. These serotypes are covered by the two PCVs recommended for routine childhood immunization by the WHO. The distribution of serotypes found in the nasopharynx is altered by PCV vaccination.
format	article
author	Effua Usuf Christian Bottomley Richard A Adegbola Andrew Hall
author_facet	Effua Usuf Christian Bottomley Richard A Adegbola Andrew Hall
author_sort	Effua Usuf
title	Pneumococcal carriage in sub-Saharan Africa--a systematic review.
title_short	Pneumococcal carriage in sub-Saharan Africa--a systematic review.
title_full	Pneumococcal carriage in sub-Saharan Africa--a systematic review.
title_fullStr	Pneumococcal carriage in sub-Saharan Africa--a systematic review.
title_full_unstemmed	Pneumococcal carriage in sub-Saharan Africa--a systematic review.
title_sort	pneumococcal carriage in sub-saharan africa--a systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/bf9c04cbfc014f8cb3ca8c0a81eda276
work_keys_str_mv	AT effuausuf pneumococcalcarriageinsubsaharanafricaasystematicreview AT christianbottomley pneumococcalcarriageinsubsaharanafricaasystematicreview AT richardaadegbola pneumococcalcarriageinsubsaharanafricaasystematicreview AT andrewhall pneumococcalcarriageinsubsaharanafricaasystematicreview
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Pneumococcal carriage in sub-Saharan Africa--a systematic review.

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