PNEUMOCOCCAL SEROTYPES ASSOCIATED WITH MORTALITY AMONG CHILDREN LESS THAN 5 YEARS IN SOUTH AFRICA IN THE POST-VACCINATION ERA (ID 163)

Session Name
Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults
Presenter
  • Annelies Müller, Switzerland
Authors
  • Annelies Müller, Switzerland
  • Jackie Kleynhans, South Africa
  • Linda De Gouveia, South Africa
  • Susan Meiring, South Africa
  • Vanessa Quan, South Africa
  • Cheryl Cohen, South Africa
  • Lucy J. Hathaway, Switzerland
  • Anne Von Gottberg, South Africa

Abstract

Background

Mortality due to S. pneumoniae is particularly high amongst children. We assessed the association of serotype with mortality in ages below 5 years in invasive pneumococcal disease (IPD) in the post-vaccine era in South Africa (SA).

Methods

We conducted surveillance for laboratory-confirmed IPD at 28 hospitals in SA during 2012-2018. We used multivariable logistic regression to compare the association of serotype with in-hospital outcome.

Results

Of 825 IPD cases with pneumococcal serotype, age and outcome data, 212(26%) died (31%(79/254) with meningitis, 21% (109/513) with bacteremia and 41%(24/58) from other invasive disease). Overall among IPD, compared to patients infected with serotype 8 (the most common serotype identified) and after adjusting for age, HIV status and specimen type, those with serotypes 15A (OR:5.0, 95%CI:2.0-12.1), 6A (OR:4.8, 95%CI:1.8-12.9), 19F (OR:3.3, 95%CI:1.3-8.6), 22F (OR:6.8, 95%CI:1.5-31.7), 17F (OR:3.8, 95%CI:1.2-12.2), 11A (OR:6.0, 95%CI:1.2-28.7), 13 (OR:4.1, 95%CI:1.2-14.7) and 35B (OR:2.6, 95%CI:1.1-6.2) were more likely to die. In meningitis cases, those with serotype 6A (OR:13.1, 95%CI:1.2-139.5) were more likely to die compared to serotype 8.

Conclusions

In the vaccine era in children aged <5 years, of the serotypes associated with increased mortality, the majority (15A, 22F, 17F, 11A, 13, 35B) are not included in the current conjugate vaccines.

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